TKR Swollen 9 months post op<

[sistersinhim]

@cannygirl, I understand! I had my tkr in June. During the summer it was in the 90s and I had to go outside to warm up. Inside I was wrapped in a blanket all the time! KarriB used an electric throw during her icing. When I have my left one done, I will order an electric throw, too!

 

[cannygirl]

Happy New Year from Scotland

 

[cannygirl]

Day 22.
So far I am managing on Slow release OxyContin with no top-up - just using ice/cold packs to control pain after exercise. Yesterday I managed a 10 minute walk up the road and it was so good too be out in the fresh air. I think I may be beginning to see ‘daylight’ at the end of the tunnel.

 

[Arttie]

That is about the time frame where the days seemed brighter for me.

 

[SusieShoes]

Though I hesitate to tell people this early on (not like it's a promise or anything!), three weeks is kind of where lots of people start to see that daylight! I know I did. I ditched my walker at that point and started using a cane, cut way back on the pain meds, and also took longer walks than before. It's so wonderful when things start looking up!

 

[kneeper]

Yesterday I managed a 10 minute walk up the road and it was so good too be out in the fresh air.

That is so good for your mood, isn't it? I had my tkrs in the summer and just walking and/or sitting outside for a short time helped me feel a little less "trapped" in the house. I'm a pretty natural slug but even I got a little stir crazy.

 

[cannygirl]

I did mine every 3 hours as instructed by my Doctor - I just didn't go over the max 24 hour allowance. I know - from what I've been told - that pain causes stress and does not allow good healing to take place. So if your prescription allows it, I would think it would help you immensely. But I'm sure others will have more solid medical advice.

Here I am at day 25 and feeling a bit glum. I have been gradually reducing my meds carefully but with no guidelines. I thought I was doing well but today after a careful work-out on a stationary bike at the gym, I have been really sore since and no amount of ice elevation etc is relieving it. I feel as if I have taken a step backward. I really don’t want to up the meds as I don’t have much left and my doctor is not likely to back me. I feel caught by the need to keep moving and the safety of pain control if I don’t move much. Surely I should be further on than this by now.


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[Celle]

It's not even a month yet since you had this major surgery. It really is a bit soon to be reducing your pain medications. The time to do that is when you find you are forgetting a dose and not feeling increased pain.
Josephine suggested this way to handle coming off the pain medications:

"Here is a suggested schedule for cutting back on prescription pain medications. Stay at each level for 3-4 days or even longer if you notice the pain symptoms increasing. This schedule assumes you are starting with one pill every 4 hours before beginning the reduction process.

1 pill every 6 hours and 2 at bedtime
1 pill every 6 hours and 1½ at bedtime
½ pill every 4 hours and 1½ at bedtime
½ pill every 6 hours and 1½ at bedtime
½ pill every 8 hours and 1½ at bedtime
½ pill every 8 hours and 1 at bedtime
1 pill if you are really doing something active during the day and 1 at bedtime

It is usually better to wean off these meds over several weeks, not several days. But.....if you are still having pain, then your body is healing and you still need pain relief. And in this case, I would discuss your pain management with your GP instead of your surgeon."
​

It sounds as if you allowed yourself to be led into doing too much at PT last time. Remember this:

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
​

Take a pain pill - you need it.
It may be that your own doctor (or your surgeon) will be willing to prescribe some Tramadol for you when the current pills run out - it's a useful "step-down drug that works well in combination with Tylenol.

I feel caught by the need to keep moving and the safety of pain control if I don’t move much. Surely I should be further on than this by now.

No, you shouldn't be further along by now. recovery from a knee replacement takes a long time - as long as a full year for complete recovery of all your tissues. You've had major surgery that caused a lot of trauma and it takes time to heal. Recovery is more like a marathon than a sprint.
It's easy to expect too much, too soon, but do try to allow your knee the time it needs to heal.

You only need to keep moving gently. Your knee doesn't need a lot of exercise.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

And don't start worrying about getting addicted to the drugs. It's unlikely to happen:
Myth busting: on getting addicted to pain meds

 

[Jockette]

At any and every point in our recovery we all thought “by this point surely we should be further along”.

The truth is, at any point, we are right where we should be. It’s a very long recovery. No one tells us that before surgery, so we worry and/or get frustrated.

Our knee will recover at its own pace, not ours, our PT’s, or even our surgeon’s pace. The sooner we accept that, the more relaxed we will be.

The knee is in charge.

 

[Bikesouth]

Ups & downs of TKA recovery is all your experiencing. If you discuss your pain levels with your ortho explaining the PT routine you should be able to transition down to less strength on a narcotic.

 

[Arttie]

I think that the theme song from "Those Magnificent Men in their Flying Machines" could well be our recovery song. We go uppity up up and sometimes down diddy down. Nevertheless it does get better.

 

[MSgirl]

I think you are doing great! Although drs. tell us 10-12 months to recover, somehow we don't think it means us. You are doing so much better than many, many folks. I was one of those who did PT but found out early on that starting too soon caused me huge problems and increased the need for pain meds. I stopped for awhile and it was so much more effective later on. Listen to the people on this forum. Wait to do PT and let your knee have its time.

Yes, the first three weeks can be pretty awful but the pain won't suddenly disappear after that time. It just gets better. Try to be gentle with yourself and your new knee.

 

[kneeper]

With tkr recovery nothing is quick--except maybe the consequences of overdoing. When you overdo, often it will be a day or two ( with some tlc for the knee) to get back to the pain status you were at before.

If you have combined reducing pain meds and overdoing I'm not surprised your knee feels lousy right now.
We've all overdone at one time or another--unfortunately it's a bit of trial and error to learn what overdoing is at each point in recovery.

 

[Ella61]

Thank you thank you - you’ll set me off in tears again [emoji847]


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You will def improve. I've had both done. My last one was done 6 months ago and no pain. Hang in there. Do the exercises they give u. Elevate and ice. Do the heel slides to make sure u don't build up scar tissue and keep increasing range of motion. The rest nature will take care of.

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[Celle]

Do the heel slides to make sure u don't build up scar tissue and keep increasing range of motion.

@Ella61 - I want to correct this misunderstanding you seem to have been told.

1. Scar tissue (more correctly termed adhesions) is not just sitting there, waiting to grow if you don't exercise enough. In spite of all the fuss about them, they are actually quite rare.
2. Doing too much exercise is more likely to cause adhesions than to prevent them.
3. Adhesions don't develop in the early weeks of recovery anyway.
4. Your knee does not need a lot of exercise in the early weeks. Just walking around the house is sufficient.
5. It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

 

[Ella61]

@Ella61 - I want to correct this misunderstanding you seem to have been told.

1. Scar tissue (more correctly termed adhesions) is not just sitting there, waiting to grow if you don't exercise enough. In spite of all the fuss about them, they are actually quite rare.
2. Doing too much exercise is more likely to cause adhesions than to prevent them.
3. Adhesions don't develop in the early weeks of recovery anyway.
4. Your knee does not need a lot of exercise in the early weeks. Just walking around the house is sufficient.
5. It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

Thanks for correction

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[cannygirl]

Thank you to all you wonderful people. I have only just discovered your responses and been feeling so low today. I guess my problem is that my GP said she was being “generous” with the medication she prescribed before the festive holidays, and that I shouldn’t need it all. It is difficult to get an appointment and so I am stuck with OxyContin that I am cutting in half to reduce the meds. This is just holding me as long as I don’t try to do too much. I use lots of ice and elevation. I feel that I can do 1 activity a day (in addition to a few domestic chores). and otherwise I am a ‘waste of space’, half dozing and not doing much else. But I want to drive, do my own shopping, get moving, see my clients... while I am on the strong stuff this is not going to happen!

 

[Ella61]

Thank you to all you wonderful people. I have only just discovered your responses and been feeling so low today. I guess my problem is that my GP said she was being “generous” with the medication she prescribed before the festive holidays, and that I shouldn’t need it all. It is difficult to get an appointment and so I am stuck with OxyContin that I am cutting in half to reduce the meds. This is just holding me as long as I don’t try to do too much. I use lots of ice and elevation. I feel that I can do 1 activity a day (in addition to a few domestic chores). and otherwise I am a ‘waste of space’, half dozing and not doing much else. But I want to drive, do my own shopping, get moving, see my clients... while I am on the strong stuff this is not going to happen!

I know exactly how u feel. U should know that it will get better. You will be independent again. U just have to give it some time. Everybody heals at a different rate and everyone's pain tolerance is different. Ice and elevate. Rest and it does get better. It's very hard. U did a very brave thing.

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[sistersinhim]

You shouldn't be doing too much now, anyway, so ice and elevate as much as possible. Your knee isn't even a month old, and should be treated like the infant it is! Your knee has to be the boss for another month or two.

 

[Celle]

I feel that I can do 1 activity a day (in addition to a few domestic chores). and otherwise I am a ‘waste of space’, half dozing and not doing much else. But I want to drive, do my own shopping, get moving, see my clients... while I am on the strong stuff this is not going to happen!

You are still in the very early days of a year-long recovery - not yet even 4 seeks since major surgery that cause a lot of trauma. Both your knee and your body need time and rest, so you can heal.

"Half dozing and not doing much else" is exactly what you should be doing right now. Check your activities again with this article, to see what you should be doing:
Activity progression for TKRs

Try not to think of resting as "lying around, doing nothing." Instead, think of it as working hard, to give your knee the best possible chance of healing well.
In other words, when you are icing and elevating and watching TV, you are not 'lazing around' - you are "engaging in a carefully considered, proactively designed, heuristically programmed, dynamically structured recovery programme".

Give yourself and your knee the time you both need, to recovery. Stop expecting to do too much, too soon.
The Energy drain for TKRs is there for a purpose - to heal your knee. Try to co-operate with it.

Driving, shopping, seeing clients - these will all come, with time.
There is nothing you can do to speed up the recovery process. Relax and let it happen.

This article may help you:
Nurturing mother: how to let go and accept help