TKR Terraplane's post op fun

[Terraplane]

My surgery 9/8/20 went off with no real problems. Was out of recovery about 10 am and OS Dr Pappademos was pleased with the result according to my wife. Let the adventure begin! Next morning OS came by early and once I realized who he was we had a brief talk. He wanted me to go on home that day (9/9) which seemed ok by me. The night before a handheld scanner by my bed malfunctioned at 4am and an alarm sounded every 5-10 minutes for the rest of the night. Was fixed before I left in mid pm. Who needs sleep?

Got home about 3pm and on the bed soon after. Was feeling pretty good and after all the recommendations to keep up on meds I let some oxy slide a few hours and by yesterday (9/10) I was hurting. It took until into last night to catch up on painkillers and I got a good nights sleep and feel much better today. That 3rd day hurting idea is no myth.

Now it is day 4 and I go to initial PT later this morning. I decided not to ice this morning to keep knee from stiffening up. Funny thing about icing......Day 2 a cafeteria employee brought my breakfast and moved my ice machine back and forth with her foot, getting it out of her way. I didn't notice until after noon that it was unplugged and so mostly no ice from early am until I got home at 3pm. I'm not sure if swelling is up or down since the knee is so big.

Hope this makes sense, I'm pretty sleepy with Tramadol and Oxy. I want to thank everyone here for making this such a great resource and place for encouragement.

Terraplane

 

[Starsfan22]

Take meds, sleep. Ice, elevate. That's your job, you only responsibility for the next few weeks. Make sure to set guidelines with your PT

 

[Roy Gardiner]

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​

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.

 

[Jockette]

Best wishes! Take it easy and rest a lot. And 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.

 

[Terraplane]

9/15 went to OS's office and nurse pulled waterproof bandage, gauze off and cleaned the incision. Looked good. Stitches will be absorbed and Steri strips were put back on. She seemed happy with everything and that is all I get from everyone.

Had my 3rd outpatient PT today. Have asked them to back off slightly doing leg straightening. Was sore after the 2nd PT with too firm pushing down by PT. They listen but today's said I need to get to 0 degree in 5-6 weeks as that is the window or would probably never get it. I got on a recumbent bike and pedaled back and forth and today got all the way around backwards. After a few reps it got fairly smooth. I asked about switching to a cane and she tried me out on it and ok'd me to use one. Also ok'd me to go down to basement to pedal a recumbent stationary bike. Wasn't expecting that! I have had these results (that I remember) Sept 11th 68/14, Sept 14th 95/5 and today 9/16 was 8/109. I didn't do much straightening yesterday because I was sore from earlier PT and decided to rest it mostly. I do exercises 2-3 times a day if no PT and maybe 1 or 0 if PT day. Tomorrow I start walking on an underwater treadmill with a waterproof bandage temporarily put on.

Again, thanks to everyone for this great site, I read a lot before the surgery and feel comfortable with what I'm told by medical staff and challenge what I'm not sure about. Just got back from a short walk outside to "enjoy" the smoke from the West and a beautiful, non-windy Kansas evening.

 

[Jockette]

They listen but today's said I need to get to 0 degree in 5-6 weeks as that is the window or would probably never get it.

This is not true, it took longer than that for mine to get straight. There is no window of opportunity. My ROM continued to increase after my first year, and after my second year.

 

[Jockette]

Myth busting: "window of opportunity" in TKR

This "six week window of opportunity" surgeons often speak about is little more than a myth. It presupposes that all patients have the ability to create adhesions which is far from the truth. It also ignores the simple fact that in the first 3-4 weeks after surgery, swelling reactive to the...

bonesmart.org

 

[Bob1653]

@Terraplane I to had my TKR on Sep 8. I feel that I am more sore the past 2 days than I was all last week. I had my 3rd PT session today and my ROM is less now than last Friday. Today I made it to 90 and +1. I keep trying to push past discomfort but I stop when I reach the pain level. I keep reading that the first two weeks are the worse.
I hope you continue to have a great recovery.

 

[Starsfan22]

My OS told me I only had 6 wks to get numbers on my new tkr. I went home and took a nap. With my first I got more ROM and flexion by just doing everyday activities and walking. Lengthing stride really made a difference for me and it happened after 8 mo.

 

[Peaches0000]

Makes you wonder where they get these “have to be at O “ in 6 weeks number?
My Extension at 12 weeks was a 9, I accidentally did 20 squats to the floor at PT with wall bungee cords at 10 weeks= yowza- thought that was the right way- can’t blame my therapist, he was working with someone else at the time. 2 weeks later at my 12 week surgeons appt., I was -2 ; so it can happen at anytime, try not to worry, your doing great!

 

[Terraplane]

@Bob1653 & @Starsfan22 I agree with you. Probably won’t challenge PT’s unless they make an issue of it. Bob1653 did you get behind on meds? I did last week & won’t again! I am the king of taking naps. Always have liked them but now have no guilt.

 

[Bob1653]

@Terraplane I got behind on the day I left the hospital. We live 1.5 hours from the hospital and by the time we got home and my wife got my prescriptions filled I was several hours behind and boy did I know it. I have been doing fine with Tylenol during the day and one dose of the oxycodone when I went to bed. That has been working fine until last night. I couldn't get comfortable for anything. I was awake most of the night and have taken the oxycodone 3 times through out the night. I am hoping this increase of being uncomfortable is a sign of healing going on internally.

 

[sistersinhim]

I am hoping this increase of being uncomfortable is a sign of healing going on internally.

Nighttime pain is usually an indication that you did too much during the day and it shows up at night while trying to relax and go to sleep. Look back and see what you did that was different on the day before and that will probably explain why your night was a painful one.

 

[leejaa]

I found that I did not do well without medications on a regular schedule, even at night so I would set my alarm and take pain meds. I kept something to drink by my recliner or bed depending where I was sleeping and some crackers so I would not take on an empty stomach and take my pain medication.

I also iced non stop unless walking which meant having ice on at night and changing it when it was no longer cold. Whenever I got up to use the bathroom I would get fresh ice packs and when sleeping upstairs I took a small cooler with extra ice packs with me so I had it handy. I had issues sleeping so I was awake quite often.

 

[Terraplane]

I'm still taking oxy on a schedule but am trying to add an hour to doses every 2 days or so. I use the tramadol in between those doses to smooth it out. Probably being too careful but I remember that day and a half of pain! Bowel issues are my only real problem now. That will go away with oxy and tramadol.......

 

[leejaa]

I stayed on pain meds for quite a while. I took Dilaudid for about 4 wks and then Vicodin for another 4 weeks. Having major pain is not helpful to healing.

Stay very well hydrated, take stool softener and eat some prunes as a regular thing and then when difficulties arise you might need something stronger. Luckily for me I like prunes and prune juice but did have to take miralax a couple of times also. I also ate lots of frozen grapes for snacks as an addition of fiber and fruit.

 

[Terraplane]

Wow! Can't believe how I let this page slip for a month.......Am released from PT today 6 weeks post op. Walking 25+ minutes/day or riding my bike about the same amount. Met with OS Pappademos last week and all is good. I am not taking any meds for a week or so out of caution but my only daily hurdle is sleeping all night. Since it is almost Halloween I tell people I "haunt" the house every night about 2-3am for a lap around to loosen up the knee and mostly go back to sleep. OS says that will be the last thing to be well.

One problem I had was with constipation and tried the usual high fiber things but OS's nurse gave me the best advice of Magnesium pills. They were taken 2 in the morning and 2 at night and had good effect a few days later.

I've said it before but this board is the best for preparing me for the surgery and PT, etc. I have stood my ground when PT hurt and they know to stop. Today I am 0 degrees on straightening and 123 degrees bending. Reading all the endless pages here on many subjects and individual's experiences gave me such a leg up when experiencing PT or random pains. Thanks to all for contributing. I don't have much new to add. My best advice it to get in as good of shape as you can prior to the surgery.

One last item.....I have lost 20 lbs since the surgery. I found myself not hungry in the days following surgery and dropped 5 lbs the first week. I could stand to drop at least 30 lbs and decided to eat healthy but very small meals and cut out most sweets and soda. I now rarely eat second helpings, only a bite of chocolate after lunch and dinner and have lost 20 lbs in 6 weeks. Am now losing at a rate of 2 lbs/week now which is healthier than 5 per week. I think I will keep it up till I am down to 170lbs (was 210). Don't know where this willpower came from!

Thanks to all
Terraplane

 

[Terraplane]

Looks like I'm just writing this for me but have continued with home PT 3-4 times a week and riding bike. Yesterday rode 50 minutes with some hills and OK. Today will be good weather so will go again, hopefully 60+ minutes. Weight 189 so losing it slowly. Thankful recovery going well so far. 7 1/2 weeks since TKR.

 

[Jockette]

You are doing really well to be riding on your bike so long, this early in recovery, there’s no way I could have done that at your stage! Just be sure to listen to your knee, if there’s any extra pain and swelling, cut back a little bit.

 

[Terraplane]

Thanks, I take it pretty easy but am wanting to increase to maybe 2 hr rides on the bike paths here in Wichita. I rode a little over 1 hr today and knee is warm but not swollen. Is always warm. I don't stand up when climbing and spin easy. I read others experiences' and am fortunate. We usually go with friends to Colorado to cross country ski in late January but if I go maybe just a little snowshoeing. Or not with Covid.