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[REVISION TKR] Tabbykit's recovery from TKR revision

lovetocookandsew

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I understand how it can be discouraging when you compare yourself to others. My advice to you is not to compare your knee and recovery to anyone else's knee. I know you want a quick recovery so you can get back to your life, but at 16 days out you're just barely getting started and still have a long road ahead. It will be filled with good days and not-so-good days. But somewhere around three months you will feel significantly better; not 100% recovered by any means, but much better.

I know it's almost a cliche, but everyone's knees and bodies recover differently. There are similarities, but no knee will recover exactly the same as another knee; even two knees on one body will recover differently. Heck, I've had a TKR and a revision on the same knee and those recoveries were like night and day! One recovery was miserable, slow and painful, the other was almost without pain, pretty easy and totally boring. Same body, same knee and two totally different recoveries.

As for the difference in your ROM, hospital measured ROM is basically useless as in most cases the swelling hasn't set in yet so almost everyone's ROM will decrease after a few days or so. Plus, one day you'll have decent ROM, the next day it will have decreased again. This has to do with the amount of swelling present on any given day, external swelling you can see and internal swelling you cannot see. On day 17 after my revision I had almost no visible swelling, yet could not bend my knee far; that was because I had plenty of internal swelling that wasn't visible and it was keeping me from bending. Later on down the road my knee was again visibly swollen, so you never know where you'll be at any point and just need to allow your knee to recover at it's own pace.

Don't stress over ROM; it will come with time. That's why I've not allowed anyone to measure my ROM this last time; I knew it would be different every time someone measured it so numbers were meaningless to me. What I measured was my ability to do things on a daily basis. I could see small progress in my ability to walk and move around, lift my leg on my own, bend a little more over time, and so on. Where you are today, very early in your average year-long recovery, is not where you'll be next week, next month, two months from now and so on. It takes a lot of patience to travel this path; I encourage you to dig deep and find that well so you can draw from it daily.
 

Jockette

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I read seem to show that so many have a better ROM even at this stage.
You’ve only read a small sampling of threads. I’ve been here for over 2 years and very few members have “good” ROM, whatever that is, at 16 days.

Please don’t worry about your ROM. It will return. Between my PTs and my surgeon, they had me soooo stressed out about my ROM. Mine took a while but it’s fine now, and looking back, there was no need for me to be so stressed about it, and no need for them to cause me such stress.
 

sistersinhim

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Is it normal for ROM to decrease so much?
Oh yes, it is expected. While you are in the hospital you are a whole lot less active. Once coming home your activity picks up. Then your swelling increases. This makes your ROM worse. You can not bend a water hose full of water with the nozzle shut off. It the same thing with your knee. Get that water out and your ROM improves. You do that by little activity, just ADL, ice, elevation and resting.
 
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tabbykit

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Day 21 postop. Still not sleeping that well, but able to lie on my side for a while helps me get an hour or two at a time. Have to sit on the edge of the bed or stand and stretch several times between snatches of sleep. Trying to nap in the daytime too. My husband went back to work last Thursday so I'm home alone during the day. He gets the bathroom ready for me to shower, then waits till I am downstairs. He has the Cryocuff and tea waiting for me. I spend the day icing and elevating for about 1-1.5 hours at a time, then up to exercise and walk round the house. I walked out in the garden at weekend. I can spend a little time at my desk morning and afternoon, and do a few easy chores such as sort laundry, put a simple dinner in the crockpot. My bend is still not great, maybe 50, although the swelling does seem to be going down. I know I have to be patient! Hope everyone else is doing well.
 
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tabbykit

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Day 23 - not feeling great. A change in pain over the kneecap, painful to lift leg up now. Continuing to ice elevate etc, but feels like I'm going backwards not forwards. Bend still poor at I estimate 45 degrees. Anyone had similar?
 

lovetocookandsew

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This recovery is a roller coaster, and you'll have days when you're feeling pretty good, and days when you're not feeling that great. It doesn't mean you're going backwards; it's all part of the overall forward progression of recovery. Hang in there, over time you will notice improvement when looking back.
 

winemama

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@tabbykit you have to stop being so hard on yourself, I know it is hard getting in the mind set that this is a 52+ recovery, God knows it was for me. Please don’t compare yourself to others. I love reading everyone’s blog. Take it day by day
 

kneeper

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You say you are exercising. What are you doing. Other than some gentle bending you don't need to do much. It sounds like you're doing things like cooking? I found even a little time on my feet the first weeks increased the swelling/stiffness.
 
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tabbykit

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@kneeper thanks for your response. No, I'm not cooking or doing any chores. I get breakfast and a sandwich for lunch, get drinks etc but my husband does everything else when he comes home. I am resting, icing, elevating, then up about every 1 to 1.5 hours to walk round the house. Exercise 3 times a day, heel slides etc as per BS, just added using exercise bike but can't pedal, just going gently back and forth for a few minutes for bend. Also sitting at my desk once a day, 30 mins max then back to ice and elevate. Wondering about a Tens unit to help with pain as I can only take paracetamol - but have seen conflicting info on this. Would love to hear if anyone has found a Tens unit helpful for home use!
 

kneeper

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Ah, it sounds like about the right amount of activity. I was still taking pain meds (every 5-6 hours during the day) at your point in recovery. :console2:
 
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tabbykit

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Anyone had success using a TENS machine to aid with pain reduction? Pain level ok mostly when at rest but severe when walking (and of course when exercising). Is this usual at this stage? now in week 4 of recovery. I read a lot of threads here but not seeing specific mention of pain on walking. Still using crutches or walker.
 

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I used a tens machine weeks 5&6 and it helped especially in the evenings. Dont use it much now and reducing pain meds (Paracetamol) to 3x1000mg a day instead of 4 (have gone down to morning and night a couple of times when I forgot mid afternoon dose).
 

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@tabbykit take a deep breath, then another, no one is going to lie to you, but TKR’s are a horror show, just when you start feeling good, you start feeling sad. 4 weeks is rough. And again, deep breath. Take this recovery hour by hour, look for little victories, they are there. One more time breathe
 
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tabbykit

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Thanks all. I am trying to stay positive and take things slowly, was able to walk around the garden (with my walker for security) most days this week, which seemed like quite an achievement! I may try a TENS machine, especially as I don't feel paracetamol is helping, and I can't take anything else. Re paracetamol I have forgotten to take it at times and felt no difference at all.I guess I should keep taking it though? At least it's one med my body seems to tolerate. I have PT tomorrow and see the surgeon next week so will update then.
 

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Tough when you can't tolerate pain meds. Glad you're able to get out and into the garden, definitely a mood improver. :SUNsmile:
 

Celle

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Wondering about a Tens unit to help with pain as I can only take paracetamol - but have seen conflicting info on this
I may try a TENS machine, especially as I don't feel paracetamol is helping, and I can't take anything else. Re paracetamol I have forgotten to take it at times and felt no difference at all.I guess I should keep taking it though?
I think a TENS unit would be helpful. Here's an article about them:
TENS machines for pain management

Paracetamol (Acetaminophen/Tylenol) does need to be taken on a regular basis for post-op pain relief. The safe therapeutic dose is 1,000 mg (2 x 500 mg tablets) 4-6 hourly, to a daily total of 4,000 mg (4 doses).
Check any other medications you're taking, to make sure there is no Paracetamol in them. If there is, reduce one or two of you other doses, so you stay within that safe daily limit of 4,000 mg.

If you take more than 1,000 mg of Paracetamol in one dose, or if you exceed 4,000 mg in 24 hours, there is some danger of liver damage, but if you stay within those limits the danger is minimal.
 
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tabbykit

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Saw PT this morning. She checked my gait, had me stand in front of a mirror and said it was good if I could do this at home to check I am standing and walking in a balanced way. She did some massage, and measured my bend at 55, so 5 degrees better than than last time. She said she is sure there is some improvement to be made, so feeling a little more positive.
 
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tabbykit

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Start of week 6 now, progress report. Saw OS last week (at 4.5 weeks) and he was satisfied everything was going well. He looked at my bend but no numbers were mentioned. He said something about it being more difficult for me as I have had a poor 4 years since the original TKR, so muscles, walking patterns are now having to adapt. Will see him in 8 weeks. Physio yesterday - am seeing her about every 10 days - her suggestion, she did some massage behind the knee and calf, checked my gait, measured at 60, so up from 55 last time, 50 first visit. So that's good for me, as long as it continues to increase then it doesn't matter if it's slower than others. Still icing, elevating, with breaks to sit at my desk or do small tasks. Walk around the house often, switching between crutches and sticks, as stick can hurt my hands. Last year I bought Smart Crutches, which have been great, as they give support but take the pressure off the hands. Going on a trip next week, 3 hours drive (husband driving!) to stay with friends in The Lake District. Taking ice machine, wedge pillow, gel packs etc!
 

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