Guest viewing is limited

TKR Thank Goodness I Only have Two Knees!

selketine

senior
Joined
Jun 13, 2015
Messages
371
Age
61
Location
Maryland
Gender
Female
Country
United States United States
I just had my right knee replaced yesterday (1/9/23) and hope to get the other knee done by this summer. So far so good I think. I can't quite get my leg straight and still tough to bend but that's expected. PT came to the house today and the exercises seemed gentle enough and she didn't force my leg anywhere. Even taking the pain med, the knee is not making me happy. I know I have staples and he used a tourniquet but I haven't seen my leg at all yet as he wants the wrap to stay on until Friday. I had trouble sleeping and had to get up and take more pain meds and decided to camp out in the recliner where I got a few more hours of sleep.

I like to get up and walk a bit every hour or so because it seems to feel good. I can't tell for sure if the nerve block has worn off but it's definitely hurting more than right after surgery. My strong med is prescribed every 6 hours but I feel like I might need it every 5.

It also hurts it more to have it elevated about my heart - like my toes go sleep and the knee aches more. I have to alternate doing that. I have the ice machine going as well when I'm seated/lying down. They staff didn't seem all that into the ice machines - no idea why.
 
Welcome to the Healing Side, @selketine! Thanks for starting a recovery thread.

Please don't worry about your ROM right now. You will be very swollen from the surgical trauma for weeks and your knee can't bend and extend fully while it is swollen. Keep icing and elevating.

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 we are all 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 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.

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.

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
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

Please keep in mind that 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.
 
My strong med is prescribed every 6 hours but I feel like I might need it every 5.
You can add Tylenol in between your pain meds as long as you don't go over 4,000 mg a day. You have to count everything that has acetaminophen in it to be sure to not go over the 4000 mg a day.

For the first 6 weeks or so, I slept in the recliner for a few hours, then the bed for a few hours. Bad sleep is unfortunately, completely normal. Be sure to take lots of naps. You need your sleep and it doesn't matter when or where you sleep as long as you sleep! When you are sleeping your body can concentrate more on healing itself.
 
It also hurts it more to have it elevated about my heart - like my toes go sleep and the knee aches more. I have to alternate doing that.
Alternating is a good idea when your leg is so upset, fresh out of surgery. Elevating will get better with time, as will everything else. :console2:
 
My strong med is prescribed every 6 hours but I feel like I might need it every 5.
You can add Tylenol in between your pain meds as long as you don't go over 4,000 mg a day. You have to count everything that has acetaminophen in it to be sure to not go over the 4000 mg a day.
Oh yes I’ve been taking Tylenol along with the stronger stuff (which doesn’t have any Tylenol or ibuprofen, etc mixed in). It’s always seem like Tylenol does nothing for me no matter what I took it for! I think it might enhance the productiveness of the stronger med if I took them together. They also mentioned that to me yesterday after surgery that I could take a couple of Tylenol when I took the pain medicine so I’ve been doing that.
 
Are you icing enough? Ice is a great pain reducer along with lowering inflammation. Getting inflammation down will help to lower the swelling, which is also painful.
 
Don't be afraid to call your surgical team to ask if you can take more pain meds. The next day or so after my last TKR, I had a big increase in pain and what they had prescribed wasn't cutting it. I was even running a low fever; it was my body's reaction to the increased pain. I was able to take 2 pills every 4-6 hrs and that really helped me. Everyone is different and has his/her own reaction to pain and meds. If you don't feel it is covering your pain enough, please call your doctor and ask for help.
 
Agree 100% with @Susie-Q. My pain was out of control the first weekend on my first knee. I didn’t get an increase then but I mentioned it to him before my second surgery and he had no problem with starting me at a higher strength. Then after the first 2 weeks I went back down to the lower strength.

On the elevating, don’t feel obligated to put your knee in an uncomfortable position, keep it where it’s most comfortable for you and you can always try again a day or two down the road. I never quite got my heels above my heart because it sort of hurt but I sat in an easy chair with my feet and calves on a pillow. Also, if you are only supporting your heels that’s one of the exercises to increase extension and they only wanted me to do that for 5 minutes. (There’s probably a better way to explain what I’m saying here so jump in anyone…..)
 
Are you icing enough? Ice is a great pain reducer along with lowering inflammation. Getting inflammation down will help to lower the swelling, which is also painful.
Yes I think so. I have an ice machine as my brain won’t let me remember the name of it. I wear it when I sit down or at night when I’m in bed. It is 10 mins on and 10 off most of the day.
 
Don't be afraid to call your surgical team to ask if you can take more pain meds. The next day or so after my last TKR, I had a big increase in pain and what they had prescribed wasn't cutting it. I was even running a low fever; it was my body's reaction to the increased pain. I was able to take 2 pills every 4-6 hrs and that really helped me. Everyone is different and has his/her own reaction to pain and meds. If you don't feel it is covering your pain enough, please call your doctor and ask for help.
I woke up feeling meh and I think I have a low grade fever. We have a new thermometer and I don’t trust it. My husband feels fine and he also got 101 on it so I think something is wrong with it! I did call the surgeons office and they said over 101 to go to urgent care. That’s a walk in clinic with my HMO and you wait hours to be seen. I’d have to be half dead to consider trying that.

Sometimes I do need 2 pills or taking them less than 6 hours apart. My stomach is not feeling the greatest today either. I don’t have any cold or virus symptoms.
 
Are you icing enough? Ice is a great pain reducer along with lowering inflammation. Getting inflammation down will help to lower the swelling, which is also painful.
Yes I think so. I have an ice machine as my brain won’t let me remember the name of it. I wear it when I sit down or at night when I’m in bed. It is 10 mins on and 10 off most of the day.
For effective icing to reduce pain we recommend at least 45 minutes on, making sure the skin is protected by a layer of cloth.
Shorter periods might result in rebound swelling.

If the thermometer is an old fashioned manual one, it needs to be shaken down to under normal between uses.
 
(There’s probably a better way to explain what I’m saying here so jump in anyone…..)
Yes, you will want your whole leg supported, not just your heels. The Lounge Doctor is a great idea but also if you have a recliner or reclining couch and some pillows, make sure to lay them along the length of your leg (underneath, of course).

My stomach is not feeling the greatest today either
Are you eating something when taking your meds? This is important as most pain meds can be hard on your stomach.
 
It is 10 mins on and 10 off most of the day.
Oh, this isn't near long enough. I had my going the whole time I was sitting or lying down, hours at a time. I had a dish towel between the ice water source and my leg to protect myself from freezer burn, so no harm came to me. Ice is a fantastic pain reducer and in my opinion, you can't over do it as long as protected from freezer burn.
 
Hello selketine,
Below you’ll find some info compiled after a little research on the topics of icing and fever post op -

Following surgery ice is frequently used as a means to minimize pain and swelling resulting from the surgical trauma. Following injury, patients are commonly advised to ice no longer than 20-25 minutes several times a day. But with a surgical incision, it is perfectly fine to ice your wound as often as is comfortable for you, providing you place fabric between your bare skin and the ice source. A small towel is ideal for added protection. This is why the ice machines have pads that don't get quite as cold as an actual ice pack. Icing is an excellent means to control pain following surgery and each individual needs to find out what schedule works best for them.


A low grade fever (less than 101.5 F) during the first week after surgery is a normal response by the body to the stress of surgery. It is most often caused by inflammatory response to the tissue injury sustained during surgery. After the first week if you have a fever that lingers for more than a few days, or if a fever over 101.5 F begins several days after surgery, it's recommended that you contact your physician to rule out the possibility of anything serious.

I hope you have a peaceful and relaxing evening and weekend.
@selketine
 
For effective icing to reduce pain we recommend at least 45 minutes on, making sure the skin is protected by a layer of cloth.
Shorter periods might result in rebound swelling.

If the thermometer is an old fashioned manual one, it needs to be shaken down to under normal between uses.
It's an ear thermometer and we recently bought it cause our old one stopped working. I think it is giving us bad readings. I really think my nausea may be caused by taking the meds without eating something.
It is 10 mins on and 10 off most of the day.
Oh, this isn't near long enough. I had my going the whole time I was sitting or lying down, hours at a time. I had a dish towel between the ice water source and my leg to protect myself from freezer burn, so no harm came to me. Ice is a fantastic pain reducer and in my opinion, you can't over do it as long as protected from freezer burn.
I've adjusted my machine so it is 40 on and 10 off. My leg is still wrapped with a bandage and I have thick pajama pants on - and I added a dish towel - too much? Since my leg is wrapped and the wrap is not supposed to come off until tomorrow, I can't really check to see how cold my skin is under that. Thanks for the tip!
 
(There’s probably a better way to explain what I’m saying here so jump in anyone…..)
Yes, you will want your whole leg supported, not just your heels. The Lounge Doctor is a great idea but also if you have a recliner or reclining couch and some pillows, make sure to lay them along the length of your leg (underneath, of course).

My stomach is not feeling the greatest today either
Are you eating something when taking your meds? This is important as most pain meds can be hard on your stomach.
I think not eating and taking meds could be the culprit. I'm going to make sure to eat before I take anything.

My HMO is sending a PT to the house - 3x this week and 3x next week. So I had PT yesterday and today and will again tomorrow. It's been fairly low key I think. She isn't manipulating my leg. She's like "well you just had surgery so these things you can try as you feel like it.

I do like standing up and walking and try to get up every hour or so just to go to the bathroom. It actually feels kind of good to straighten my leg - bending it is harder as I think there's just too much swelling to get much on that. It does feel fairly strong which surprises me! The surgeon said he had to do extra "something" cause I was so knock-knee'd so there's more in there to heal. Probably tomorrow I'll be back here saying the opposite and that it is killing me. The PT will help me take off the big wrap bandage tomorrow which I'm looking forward to getting rid of. The large bandaid type stays on until I get the staples out on the 24th I think. Overall maybe my pain level was better today? Seems to be worse at night so I may eat my words!
 
She isn't manipulating my leg. She's like "well you just had surgery so these things you can try as you feel like it.
I like this PT!

It does feel fairly strong which surprises me!
In my pre op class they told me not to be afraid the first time I stood up after surgery, they assure me the leg would be strong, so I always had confidence in the replaced knee.
 
My leg is still wrapped with a bandage and I have thick pajama pants on - and I added a dish towel - too much?
Yes, this is too much. You can put the ice pack right on your bandage. With all these other things, none of the cool is getting to your knee.
 
The surgeon said he had to do extra "something" cause I was so knock-knee'd so there's more in there to heal.
I had the opposite- my leg had bowed out. I was told that the tendons and muscles gradually adjust when your leg is off kilter, but when they are suddenly straightened they don’t have time so it can cause problems. So don’t be surprised if you get pains in odd places. The first two weeks after surgery my foot hurt worse than my knee, and it was probably more swollen too. No one really knew why but they attributed it to the leg straightening.
 
Probably tomorrow I'll be back here saying the opposite and that it is killing me.
This little scribble mimics your words. :wink:

[Bonesmart.org] Thank Goodness I Only have Two Knees!
 

Staff online

Back
Top Bottom