TKR Take Two

I’m so sorry about your sister and what your whole family went through, and continue to do so. :console2:

What an awesome daughter you have. I have daughters like that, too.

You sound like you’re doing well in your recovery. I couldn’t lift my leg myself for a couple of weeks, so don’t worry. I don’t know if I’d do the windshield motion, and to be honest, I’m not sure I could have, 5 days out. Don’t continue if it causes additional discomfort.

Remember, regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 
At 5 days, I couldn’t yet lift my leg much less perform straight leg raises! Don’t push this early in the game. Actually, don’t push at ANY stage of the game :loll:. Your new knee will heal just fine on it’s own schedule. You have good family support and good BoneSmart support, so you are not alone. We are here 24/7 for you.
 
I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
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.​


4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
Today has been a difficult one pain wise. I'm staying on top of pain med dosage/times, plus icing constantly. I need to get elevation smoothed out. I haven't been using the lounge doctor pillow and just propping the heel of my foot on a pillow. Home PT tomorrow morning.
 
Can anyone offer an. opinion on the use of knee immobilizers? My OS has me in one at bedtime. What I'm discovering is my knee is pretty much frozen in an extended state when I get up during the night and when I get up to start my day. It seems counterintuitive to use this device unless there is an issue with extension. I'm beginning to think the recent pain I've been experiencing could be the result of the knee immobilizer which is standard post-op protocol for this Dr.
 
It is unusual to use an immobilizer brace as standard after knee replacement surgery. I have to agree with you that trying to use it at night would be the worst! New knees can stiffen up during the night even without a brace to hold your leg in an extended position.

Assuming you aren't having any problems with your knee that require the use of the brace, I would say you have two options: (1) try a few nights without it, ice your knee during the night and see how it feels or (2) contact your surgeon's office and ask why the need for the brace and what they expect it to accomplish. If the answer is that it's to promote extension, there are many other ways to do that with stretching exercises and even just walking.
 
Hi Jamie! Thanks for your response. No issues with the new knee. Extension is great, flexion is painful (go figure). I was going to try a few nights without the immobilizer and see how that goes.
 
Sounds like a plan.
 
First night without the immobilizer and I notice that my leg doesn't feel frozen in a full blown extension. Also the pain has decreased and is much more manageable. I usually wake up 2-3 times during the night and did slip into it for about 2 hours. My two week post op is next Tuesday, 6/22. Gathering questions to ask at that visit.
 
If you are doing well without the immobilizer, stand your ground with the OS and explain the situation to him. Be confident. It’s your knee and you are in charge.
 
If you are doing well without the immobilizer, stand your ground with the OS and explain the situation to him. Be confident. It’s your knee and you are in charge.
Thank you Sisterpat for your words of encouragement and support.
 
Have been feeling good these past few days. Decided to skip a dose of Percocet. Not a good idea. It works great for pain relief, but it makes me nose run and have sore areas inside my nostrils. Need to find an alternative. And the sleep monsters have arrived stealing from me the joy of good, solid rest! Argh!
 
Jewlz, as I just posted on another thread, you may well be doing too much during the day, but nighttime has its own challenges regardless.
Your body’s circadian clock helps manage your immune system, Michael Smolensky, a biological rhythm researcher and adjunct professor of biomedical engineering at the University of Texas, says
“When the immune system is activated” — like when you’re sick with the common cold — “its infection-fighting cells release a variety of chemicals, some of which induce inflammation in the infected tissues,” he explains.
According to Smolensky, the inflammation resulting from an immune system is not constant, but tied primarily to one's circadian rhythm. Thus, symptoms probably worsen during sleep hours, when our immune systems shift into overdrive.
The worsening of symptoms at night are made noticeable by the fact that during the day, your immune system tends to mellow out. It’s not unusual to feel a bit better around those times, but then see symptoms come back with a vengeance later at night.

So, this is yet another reason nighttime is such a challenge, even if you have behaved yourself during the day. When the inflammation tones down in that knee with time, decent sleep will return. Hang in there.
 
Ohhhhh! I love science so this information on circadian rhythm and the immune system shifting in to overdrive makes sense! Understanding the why goes a long way for me. Thanks for sharing that insight with me, Sr. Pat.

Any thoughts or experience with Percocet? It does a great job for pain, but as I mentioned, it makes my nose run and I've even developed sore areas in my nostrils. Today I feel so out of it I don't even wanna take it anymore. I'm overdue for a dose, and am considering taking two 500mg Tylenol in its place.
 
I wasn’t prescribed Percocet, but Norco. Try the Tylenol. Can you take Motrin? Many of our members have had success alternating Tylenol and Motrin.
 
Can't take Motrin on orders from my GI. I'm going to give the Tylenol a go. Thank you!
 
I take Norco and it has Tylenol in it so be careful adding Tylenol.
 
If you add Tylenol, you need to keep track of any other medication you take that also has Tylenol in it. You can take a total of 4,000 mg of Tylenol in a 24 hour period, so adjust the extra dose of Tylenol if it’s in any of your other medications. The bottle most likely says 3,000 in 24 hours, but that’s in case people don’t know to check their other medications.

Tylenol works best if you keep a steady amount in your system. Taking it occasionally doesn’t work as well.
 
If you add Tylenol, you need to keep track of any other medication you take that also has Tylenol in it. You can take a total of 4,000 mg of Tylenol in a 24 hour period, so adjust the extra dose of Tylenol if it’s in any of your other medications. The bottle most likely says 3,000 in 24 hours, but that’s in case people don’t know to check their other medications.

Tylenol works best if you keep a steady amount in your system. Taking it occasionally doesn’t work as well.
Thanks Jockette.

The Percocet is the only other drug I'm taking that has acetaminophen and I'm stopping that drug completely. I can't tolerate the side effects. So, today, 6/20 I took as ordered two 5-325 Percocet. at 5:20am, two 500mg Tylenol at 2:20pm and two 500mg Tylenol at 9:30pm. If I'm doing my math right, I've had 2650mg of Tylenol today. I'm taking the Tylenol every 6 hours per label instructions. I can also bump up to 650mg every 8 hours if necessary. And I've found that Tylenol works best when taken on a routine basis.
 
When I went off my prescription pain medication I took 2 extra strength Tylenol, which equaled 1,000 mg, every 6 hours, including a dose during the night, which totaled 4,000 for the 24 hour period. I wasn’t pain free, but it was manageable and I didn’t have the side effects of the prescriptions.
 

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011

Members online

Forum statistics

Threads
65,167
Messages
1,596,864
BoneSmarties
39,356
Latest member
JanieMarie
Recent bookmarks
0
Back
Top Bottom