TKR Taking it Day by Day

[LadyDeb04]

Hello everyone. I just wanted to keep you all posted about my surgery and recovery. I had TKR of my left knee on May 11. Everything went very well. The worst thing that happened is that I broke out in a very bad rash around the surgical area of my knee. The doctor thinks that it was probably caused by something they used during surgery but they don't know exactly what caused my skin to break out in such a terrible way. It could have been any number of things they just don't know. My leg was itching so bad, and it had big reds spots all around the surgical area. They told me to take Benadryl to help with the itching. I decided to buy a special soap for Eczema even though I don't have Eczema and I also bought a lotion for Eczema as well. I am treating it like Eczema because I feel that the soap and the lotion will help to heal the rash and stop the itching.

The other thing that is going on is that I have absolutely no appetite and I feel very weak, so I have been drinking Ensure to get the nutrition that I need. By the time this is over I will have loss a significant amount of weight which is a good thing.

The pain has not been unbearable, and I only take the pain meds when absolutely necessary. I started PT 4 days after surgery. They come out to my home. I can walk around my home without a walker or a cane. I take a cane with me if I am going to go out which I have not been doing except for a post op appointment.

To sum it all up, I guess I can say that so far, the surgery has been a success and I am happy that it's over. It will take a lot of work to get where I need to be but I did not have this surgery to fail so I will do my best to be successful.

 

[sistersinhim]

he worst thing that happened is that I broke out in a very bad rash around the surgical area of my knee.

Many people are allergic to the tape that is used on the dressing. I know this is miserable

. I decided to buy a special soap for Eczema even though I don't have Eczema and I also bought a lotion for Eczema as well. I am treating it like Eczema because I feel that the soap and the lotion will help to heal the rash and stop the itching.

Be very careful to not get anything close to the incision. You don't want to allow any bacteria to invade it.

The other thing that is going on is that I have absolutely no appetite and I feel very weak, so I have been drinking Ensure to get the nutrition that I need.

This is normal. I drank protein drinks for about a month before I could stomach real food.

It will take a lot of work to get where I need to be

Actually, working hard will give you bad results for most. When you work hard, you keep the knee inflamed, increasing the swelling and worsening the ROM. It's best to have just gentle movements for at least a few months. Over exercising causes setbacks. Gentle movements allow the knee to heal.

 

[sistersinhim]

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

KNEE RECOVERY 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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.

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
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy

5. At week 4 and after you should follow this
Activity progression for TKRs

6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital

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 a 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 history before providing advice.

Try out our great new opportunity to improve your gait. It's OneStep. It's free and you will find it to be a huge help to you. Click here: OneStep

 

[benne68]

Welcome to the healing side, @LadyDeb04!

Sounds like you are off to a good start, but please take a slowly! As SIH said, pushing yourself -- or letting your PT push you -- in these early weeks is counterproductive and will only delay your recover. This is "race" won by the tortoises -- slow and steady.
Keep us posted on your progress.

 

[LadyDeb04]

Thank You. I will definitely take your advice

 

[Layla]

The other thing that is going on is that I have absolutely no appetite and I feel very weak, so I have been drinking Ensure to get the nutrition that I need.

I am sorry you're feeling this way. Feeling weak is awful. I hope your appetite returns soon.

Following surgery your body needs a high amount of protein and iron. The amino acids in the protein help repair muscle damage by regenerating tissue and speeding up wound healing. I wonder if snacks sound more appealing than the thought of a meal? Here are some protein ideas -
Nuts,Trail Mix
Turkey roll ups (cheese or veggies rolled inside the turkey) Canned Salmon on Crackers, Chicken Salad
Greek Yogurt, Cottage Cheese, Hard Boiled Eggs
Tuna, Veggies & Hummus, Edamame
Peanut Butter and Apple or Peanut Butter on Celery
Cheese Slices, Beef Sticks
Protein Bars, Protein Shakes
No Bake Energy Bites (many online recipes)

Very best wishes to you!

 

[benne68]

Happy one month an-knee-versary, @LadyDeb04!

How are you feeling? Give us an update when you have a chance!

 

[Layla]

Stopping by to wish you a Happy One Month Anniversary!
I hope all is well and you're enjoying steady progress. We'd love to hear from you as time allows.
A great week to you!
@LadyDeb04

 

[LadyDeb04]

I want to thank everyone for their encouragement. I really appreciate it. I am doing very well except for the fact that I feel totally drained of energy. I associate this lack of energy with blood loss as well as my body trying to repair itself. Total knee replacement surgery is a major surgery, so I guess it is not uncommon for people to feel a loss of energy after having surgery. The bad rash that I had right after surgery is gone so I am really happy about that because I was constantly itching, and I could not scratch because that would have made matters worse so I am happy not to have to deal with that problem any longer. I was put on blood thinners for a month so today was my last day having to take those. So all and all I can say that the surgery went well. I am still working with the Physical therapist on bending. I can straighten my leg out but I am having more difficulty with bending it. I get frustrated with that problem, but I am working on it and hopefully I will be able to achieve this goal of being able to bend my leg in the near future.

 

[sistersinhim]

Your traumatized and swollen soft tissues inhibit bending. This is normal and your bend will improve as time goes on. Exercising won't make it heal any faster than it's going to, but it can slow it down. Doing too much too soon causes inflammation which causes swelling which restricts your bend. All you need to do are your very gentle, non-forced movements. Never go into pain, just a little discomfort. Pain tells you that your knee isn't healed enough to do that and will react with more swelling and less bend.

It's a time and patience thing!

 

[Jockette]

I can straighten my leg out but I am having more difficulty with bending it. I get frustrated with that problem, but I am working on it and hopefully I will be able to achieve this goal of being able to bend my leg in the near future.

Regaining our ROM does not require forceful bending or painful exercises. That is counterproductive.

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.

 

[Layla]

Hi Deb,

I am doing very well except for the fact that I feel totally drained of energy. I associate this lack of energy with blood loss as well as my body trying to repair itself. Total knee replacement surgery is a major surgery, so I guess it is not uncommon for people to feel a loss of energy after having surgery.

Good old energy drain....you're certainly not alone in experiencing that.
Our body's energy supply isn't limitless. So when we're in healing mode after major surgery
our energy will be used for healing first, not leaving a great reserve for all the other activity of daily life. It is completely normal to feel tired for quite some time. How long....most likely relates to your body's rate of healing. Making our best effort to get adequate sleep and rest is beneficial. Our body does it's best healing while we're sleeping. So snooze whenever you're able.

 

[Layla]

Happy Two Month Anniversary!
How are you doing? We'd love to hear from you if you have time to share your progress.
I hope you're doing well and enjoying the Summer.
@LadyDeb04