TKR The Knee Team journey begins!

[leejaa]

For me, basically either in bed or in recliner on back with leg elevated and iced. I could not transition to side at that time - took quite a few weeks for me. Walked when I had to go to the bathroom or when I was at home again to go to kitchen to get something to drink or heat up lunch. My husband was at work from 6a-6p so I heated up something for lunch by myself, otherwise he would make me breakfast and dinner. Exercises were only ankle pumps, leg lifts and heel slides . No CPM - my OS does not use it. I think the first week PT came to the house 2x/wk and again only did some leg lifts and heel slides in bed and sitting. My whole plan was to follow the mantra and get the swelling down as keep it down. Worked for me.

 

[leejaa]

Also, forgot - took my pain meds by the clock and stool softeners the same way as well as eating grapes- fresh and frozen and oranges and apples quite a bit to keep my bowels somewhat active.

 

[referee54]

What was your typical first week post-op schedule like? Lying down on back, elevated legs, transition to side(?), walking frequently, exercising, CPM, etc?

My first week---actually my first weeks were spent in a recliner flat on my back. My knees were elevated and I iced as much as I could. It took me quite some timne to sleep on my sides---and in the first days, I was quite uncomfortable. I was not in any pain, but I just did not feel right.

Waling frequently? Nope, I did walk around the house, but not frequently---and each week I would walk a tiny bit more. Remember, yo are just one week removed from very traumatic knee surgery.

Exercises---when I was a week out, I was very gentle and id stretching, ankle pumps, and heel slides. That is all you need to be doing, too.

As for the CPM, I did not use one---my OS did not believe in them.

 

[SmartChoice]

Wow, this is awesome feedback! I feel I have been really overworking it being afraid for it to become stiff, and instead I have beat it up, poor thing!!! First thing in a.m., I walk to bathroom, and begin walking the hallway, into LR, and kitchen. Sit up during the day, getting leg bent to 85. Lie down, ice, not always elevating,they did not do that in hospital (?). Icing most of day, exercise twice a day and try to use CPM twice a day, no wonder I'm hurting!!!!

 

[referee54]

Wow, this is awesome feedback! I feel I have been really overworking it being afraid for it to become stiff, and instead I have beat it up, poor thing!!!

Patience, Grasshopper, Patience!!
You have been out of surgery one week. Your knee is very, very early in the recovery stage. There is no hurrying this---be genlte, be patient, and do not try to rush things. Your knee---and yourself---will be much happier.

Lie down, ice, not always elevating,they did not do that in hospital (?).

Always ice and elevate. It will help reduce your swelling. Make it a habit.

exercise twice a day

What kind? I would take it very, very easy---nothing to harsh---gentle exercises such as ankle pumps, heel slides, and gentle stretching. Anything else right now is most counter-productive.

 

[SmartChoice]

NO wonder I'm miserable......I do the following exercises with PT, long arc quads, terminal knee extension, plus the usual ones you mentioned. The heel slides, they tried pushing me all the way back and I said NO! See, I'm just doing as instructed by Homehealth PT, doing as instructed, being a newbie at this.

 

[SmartChoice]

I'm shaking my head, the hospital had me walking the hallways from therapy to group therapy the 2nd day post-op. The PT mentioned I was doing so well, I was ready for a cane. I shook my head in disbelief! Prior to TKR, I did exercise & prepare my legs for postop exercise, but just because I did, does not mean my body is ready for more assault!

 

[kar1963]

One week out i was having at home pt and using a walker. My pt was heel slides with a grocery bag on my foot so the slide was smooth, then streches and bends of the knee by the therapist. I would get up evry hour and a half and walk a little . I was not told to ice or elevate in the hospital but thank gawd for bs i knew to do it, iwas not on a cpm machine nor had compression stockings. As far as sleeping in bed i was about two months post op before i could manage it, i still have some nights where my recliner feels better than my bed. Take your time and really listen to your knee.. rushing or pushing yourself will set you back .. i was lucky that i did not have bowel issues but i did ewt alot of jello and apple sauce to keep things moving.

Your healing journey has just begun ,relaxe and be kind to yourself

 

[referee54]

Canes, crutches, walkers---remember, we all heal at different rates and in different manners and times. I came home with a walker, moved to two crutches (then used them as canes, and finally to a cane for a very brief period of time. Try not to worry what your walking aid is---they all fit your own individual needs.

I'm shaking my head, the hospital had me walking the hallways from therapy to group therapy the 2nd day post-op.

They wheeled me to and from OT and PT in a wheelchair. I was very grateful for this.

NO wonder I'm miserable......I do the following exercises with PT, long arc quads, terminal knee extension, plus the usual ones you mentioned. The heel slides, they tried pushing me all the way back and I said NO! See, I'm just doing as instructed by Homehealth PT, doing as instructed, being a newbie at this.

Please be gentle---your patience will be rewarded; right now, though, just do the gentle exercises and let your knee recover from the war that was waged inside of it.

 

[SmartChoice]

I'm thinking about canceling my PT visit for tomorrow & just chill.

 

[referee54]

I'm thinking about canceling my PT visit for tomorrow & just chill.

We all like the idea of working hard---we have this work ethic instilled in us that, if we work hard, good things will come.

We have to, in the early days of recovery, fight that urge, as working hard only causes additional swelling, stiffness, and soreness.

Sometimes doing less is more---and remember,sometimes you need a psychological break from this, too.

Recovery tcan take much longer than we would like it to, and there is no way for us to shorten it. If you work hard, your knee will rebel and "go on strike." Taking it easy will allow the knee to settle down.

 

[SmartChoice]

One week postop TKR, of course my knee is swollen, but I have an area on the exterior side of knee, just above the compression hose line. It is between the incision area & flesh that goes to back of knee. What causes this to swell & become extremely hard?

 

[Hwa1538]

Smart choice: just be patience. Eat a lot of fruits, vegetables and nuts. Do small knee movements more frequently, like every hour. It will get better and better. Do not cut med too soon. I am 5 weeks now and I just reduced my med from 6 times a day to four times bit I also add Advil. Everyone recovers different, just listen to your own knee. You will see the progress.

 

[NetballKnees]

Hi SmartChoice ... Although a "newbie" in the TKR department (6 weeks out), I too have that really hard area. I also had it on the inside of my knee, but that has loosened up nicely now. To my mind I think it is due to the swelling. The knee is not a very big area (well, most aren't - mine is a different story entirely ) and I think that the angry tissues swelling under the skin would stretch the skin to its capacity. I do not think it would be anything too serious, but always willing to be told differently by the many and much more experienced people on here. I will tag a couple of them and hopefully they will come on and provide you with a bit of learned advice. Josephine Jamie bottomshollow

I hope your recovery goes well, with no hiccups and that your pain is well controlled. One thing I have learnt on here is please rest, ice and elevate - toes above nose.

Visit here regularly any time you are concerned, scared, feeling down and/or teary and someone will always give you reassurance.

Take Care ...
Ellen

 

[Jamie]

SmartChoice, the problem is swelling. You just had major surgery and your tissues are very angry right now. Icing will help with pain, swelling and with that "hard" area. I suggest you ice your knee as much as possible (even while you sleep). Just be sure you put a kitchen towel or other cloth between the ice source and your skin for protection.

Here are some basic recovery articles for you:

First are the mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

And then the articles in order of importance .
Group A
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice

Group C
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

Group D
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

 

[NetballKnees]

Hi SmartChoice ... I don't know how good it is for you (well, I do really - it's not), but I found that when I had a McDonalds coffee frappe - my constipation problem was solved.

You are still very new from your surgery. I am at 6 weeks tomorrow and still swollen, with very little bend. I have also joined the ODIC a couple of times, but always have to pay the price afterwards. I am still learning to be a patient patient. I want to have recovered yesterday, or preferably the day after surgery. You seem to be learning the lesson quicker than I did.

At the moment I only take Panadol Osteo or Panadol soluble for any discomfort or pain. As I have said in my thread though, the pain in my non-surgical knee is worse as I sustained a medial collateral ligament strain in the first week after the op. But being so new from surgery, you definitely should listen to the wise and experienced advice of the others on this site.

I hope your recovery goes smoothly from hereon in and life treats you well. Ellen

 

[maggie may]

Be gentle with yourself
Be compassionate with yourself
You will recover and do great!!!
Best thoughts!
Ice elevate rest

 

[maryo52]

There are dozens of different aches, pains, complaints, experiences, and whatnot during recovery that trouble or concern us that are of no significance and which time takes care of. In one sense your knee got "fixed," and in another it has just been through a train wreck! As a result, as most of us observe, orthos practically turn a deaf ear to us in the first few months.

There are issues that really do need attention, though. It doesn't sound like this is one of them. But let me include a knee drawing here so you can describe the areas you're talking about, just to be sure:

 

[Cryotech]

I'm just putting in my helpful advice. I was in an automobile accident several years ago and I used a CryoTech 100 by IsoComforter. This little ice chest that circulated water kept me off the meds while instantly relieving pain for me. I didn't have to play the "balance the ice" routine. I just put the pad on, filled the cooler with ice and water according to the instructions, turned it on, and off I was to the road to recovery. I still use it to this day if I feel any discomfort. Something for all patients in these forums could benefit from. Just ask the doctor whats best.

 

[GimpyGal]

I had several red, hard, hot and swollen spots about the size of a silver dollar, around my incision, as well as about 2" from the incision. It was worrisome enough that I had the home health care nurse pop in, as I was afraid it was the beginning of an infection.

Curiously, both the nurse and the doctor determined it was hives. They suspect I might be allergic to the Triple Antibiotic Ointment applied there. 4 weeks post-op and the hives are still present after I stir them up during massage.