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TKR The long and winding road - round 2

TimeBuster

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@Rather I can't help it but every time I read the title of your thread (the long and winding road) I think of the Beatles LOL

I feel your pain, my first six weeks sleep was elusive to me too. I had a terrible bout of restless leg syndrome for the first six weeks. I slept in the recliner no matter how hard I tried to get comfortable in every few minutes I had to get up and stretch my legs. If I got two hours of sleep per night that was a lot.

Hang in there eventually it gets better.
 
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Rather

Rather

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Coming back from radio silence and I’m 8 weeks out from surgery. As in Celle’s wonderful scribble progress chart, my recovery has been moving in many unpredictable directions.

The setbacks:
1. I was unable to sleep more than 4-5 hours at night in 1-1.5 hour segments until this past weekend when I finally managed 7 hours with only 3 major wakeups -yea!!! As everyone knows, lack of sleep makes you grumpy, dopey and sleepy - and I have been all 3 all of the time.

2. Went back to work pt after 5 weeks and ft at 6 weeks. I work at a college, so while I could schedule some meetings in my office, I also had to hike across campus at least once each day and climb many stairs. Not fun.

3. Had excruciating pain in IT band, hamstrings and in tendon behind the knee. PT was no help whatsoever. Suffered for a couple of weeks before I found a solution - see progress #3 below.

The progress:
1. Stamina seems to have returned. I walked over a mile Saturday morning buying produce and goodies at the farmer’s market. I iced for an hour and then took my 2 greyhounds out for a long walk in the afternoon. And I was not exhausted.

2. Being back at work has stopped the boredom in its tracks. Being surrounded by people and projects has lifted my spirits and made me feel useful again.

3. I directed the PT to follow Bone Smart guidelines, but I didn’t find her helpful. Found an OT recommended by colleagues and she is WONDERFUL. She diagnosed my muscle problems as emerging from a bad walking gait I had developed - I was using a cane occasionally, hiking my hip and walking straight-legged. She taped me up and ordered me back to the walker to change my walking gait. She even made me practice walking with the walker while she watched. Yesterday I graduated back to with and without the cane and am walking correctly - she has the before and after videos to prove it. My IT band has calmed down as have my hamstrings - yea!!! They were also a major sleep disturbance. She took a holistic approach to my recovery rather than simply focusing on ROM and it was exactly what I needed.

4. I started driving again at 5 weeks and regained some independence. I won’t claim to have been graceful entering and exiting the car, but I made it.

5. Saw my OS at 7.5 weeks and he was delighted. The extension is 0 and ROM was 105. He said that ROM would come over time - thought he must be reading BoneSmarty, but he hadn’t heard of it. I gave him the URL.

The bottom line:
I still have a ways to go - many more weeks. The knee is stiff in the morning and after I’ve been sitting too long. I left hydrocodone weeks ago, but I still need Tylenol 2-3 times in 24 hours. I’ll continue with OT for a while because she is helping me heal. But based on everything - and some days/nights have been really bad - I am willing to do the other knee later this year. I didn’t expect to feel that way at this point or perhaps ever.

I have read Bone Smart posts without posting myself and the wisdom, experiences, questions, answers, and support have been so very helpful. Thanks to all who are much more frequent and eloquent writers than I am.
 

Denny39

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Rather said:
Accepting the unpredictability of this recovery and my inability to exert any control over my knee is much harder than it sounds when you read the wisdom from posters on these pages about the knee being in charge. And I am guessing that I will have to revisit that mantra on a regular basis like some sick version of Groundhog Day. But the experiences of the past couple of days led me to my knee’s name. Meet Journey who is deciding what my path and experience will be like and who has no customer service focus at all. No, Journey is running this show and I’ll do my best to survive it to the end.
@Rather I just read your post for the first time this morning. You have a great approach to this wonderfully and miserably chaotic and unpredictable experience. It seems you have an advantage over most of us who, like me, went into this with no idea whatsoever what it was really like. The most serious surgery I had previously experienced was arthroscopic Miniscus repair, and that was gone and forgotten well within a week. So, knowing this would undoubtedly be “considerably” worse, I generously budgeted 5 - 6 weeks for recovery from this. You hit the nail on the head when you said that accepting the unpredictability of the process, and the inability to be in control is difficult. It is very difficult indeed, but accepting it, and settling into the groove with that mindset is therapeutic in itself. Imagine my shock when I read that “short term” recovery is considered 8 - 12 weeks. I characterized those first 8 weeks as 2 REALLY, REALLY rotten weeks, followed by 2 REALLY rotten weeks, followed by 2 rotten weeks, followed by 2 miserable weeks. Someone immediately responded “Yup, I just made it to REALLY rotten, I can’t wait to be miserable”.

I am on day 17 of my 2nd TKR, trying desperately to apply what I learned on the first. But it is a well established discipline not to try not compare any two knees, even your own. Confirmed! One thing does remain constant however, and that is my general characterization of the first 8 weeks. You are 5 weeks ahead of me on this one.

I had the first one done December 10, 2018. It was about the middle of the 4th month when I began to realize more noticeable improvements from week to week. Into the 5th month, I could sometimes see significant improvements from day to day. At 6 months, I was walking a lot of the time as it nothing had ever happened. Then, at 6 months, 1 week, and 4 hours, I again walked into the hospital, signed on the dotted line, and laid down on the table, in spite of the fact that I said at about 8 weeks, “I don’t care how bad the other one is, I ain’t doin’ this again”. You did mention something about a lack of control didn’t you. Oh well, they say history often repeats itself.

Hope your recovery continues on a steady course to a strong full recovery.
 

Denny39

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Actually, I never thought of naming my knee. If I did, I would probably be “Chaos”. I used to have a dog I named that, for a comparably good reason.
 
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@Denny39 Thanks for sharing your expectations and realities. I long for months to go quickly, much like those rapidly flying away calendar pages you see in old movies. And on the other hand, I can't quite believe that I am closing in on 9 weeks since my surgery.

Yesterday, however, I joined the ODIC - big time. I decided that since it was Independence Day, I would show some love to that idea - being independent. I woke up early and made breakfast for hubby and son - the first time in many, many weeks. Then I walked the dogs farther than I had done since long before surgery. Then it was time to bake and frost a cake in honor of the holiday, clean the kitchen, and make homemade coleslaw and pulled pork sandwiches for dinner. About 1/3 of the way into that last set of activities, I realized that perhaps I had overshot the goal a bit. Last night I paid the price, trying to sleep while keeping my leg elevated and with the ice machine strapped to my knee. Not much rest was had and today my knee is stiff and fed up. :bignono: Lesson learned.
 

Denny39

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@Rather, Seems you did get a bit carried away there. Knees remain choosy what they will allow for the first few weeks, and they can become quite vindictive when you (even if inadvertently) cross the line. You are however, now getting close to that 4 1/4 month marker where I first began to realize significant improvement from week to week. At 5 1/2 months, it was sometimes day to day. Hopefully it will be the same for you. From what you’re saying, I think it probably will.

Your comment on time was familiar as well. Someone once told me that how long a minute is depends on which side of the bathroom door you are on. TKR has that same effect on a week. How long it is depends on which side of the surgery you are on. The week leading up to it went quite rapidly. The week(s) leading away from it, not so rapidly, especially the first one. But then on the other hand, I can hardly believe that I am 3 weeks out tomorrow. So, on my schedule, I am currently half-way through the REALLY rotten stage, and half-way to miserable. Time marches on.

Hope your knee forgives you soon.
 
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kreismama

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@Rather
I had my left TKR on Feb 26, and my sister was a god send preparing me for post op home care. She’s had several neck and back surgeries so she knew exactly what I would need once home from the hospital. Good thing because I didn’t think of any of these things. She got me a toilet riser, shower seat and tub/shower handle to help me get out of the shower without falling. My shower is a tub type not a stall shower so it was a bit hard to get in and out, but I found it easier to put the shower seat in the very back of the tub then back in sitting first then lifting my legs in the tub using my elastic strap I brought home from the hospital to lift my knee. With the shower seat placed all the way back in the tub I had the most room to lift my legs in without having to over bend my knee. The rail handle was placed in the middle of my tub side to help me lean and pull myself up and out. The seat was key. It was wide and sturdy so it never moved when I was getting in and out. I also had my Mom close by or helping me the first few times showering so I didn’t fall getting in and out.

Even weeks post op as I was feeling stronger and could stand to shower, I would sit halfway through my shower to rest before getting out. I would also let the hot water hit my knee as I sat and would bend my knee for a bit to stretch it.

Good luck with your recovery.
 

knee#2

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Those shower bath benches are great invention! I also practice bending and then straightening while water fills, I like to have several inches of very warm water in bottom of tub, incision still bit crusty so no pool yet. I had my TKR May 8. I also discovered that my old goose down comforter is perfect to tuck between knees / back and truly comforts!
 
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Rather

Rather

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Five months of recovery from my first TKR and now I’m starting all over again. Just got home from yesterday’s surgery. Same OS and hospital. But much more pain this time. My thigh is screaming from the tourniquet. And I have sharp pain where my knee meets my quad when I try to lift it with the leg lifter. Strangely, the pain is worse when I am elevating and icing than when I am sitting with my leg extended.

I reread my thread earlier and it seems those first two weeks were the hell I didn’t remember. Maybe my pain isn’t worse this time - I had just forgotten what it was really like.
 
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Rather

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Could someone add the words “- round 2” to the title of this thread? Thanks so much!
 

Jockette

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Welcome to Recovery again!
Could someone add the words “- round 2” to the title of this thread? Thanks so much!
I passed that request on to a moderator for you.
 
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Rather

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Thanks, @Jockette Last night was a hydrocodone-induced sleep in the reclining chair with my watch alarm going off on regular intervals for meds. I’m icing and elevating, hoping that the 3-week mark comes quickly. That was the point for me with the last knee that I could accept that I was getting better.

For the first knee, everyday was an adventure and each scintilla of pain relief was a treasured surprise. This time I know the pain will get better, but that seems to make me more impatient than I was before. Clueless might be a real blessing and I am not that anymore.
 
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Rather

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How is it that no matter how many times we read something, we don’t actually believe it until we experience it ourselves? This knee hurts. The pain in multiple places and my ability to move it very much at all without pain far exceeds my first knee. (And there comes the truism - every knee is different.)

Now I’m finding it difficult to believe that I’ll feel better with time...once burned twice shy. I know that I’m only at the beginning of those first 2 really, very, totally, beyond awful weeks, but right now it is difficult to believe that this pain will ease.
 

Jockette

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Keep telling yourself it will be fine, you got this! You’re a pro at this now! :console2:

Here a refresher 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.

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.
 

luvcats

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Isn't it funny how the same surgery on the same body with the same surgeon can be so completely different?
I did my knees serially too. It is a rough road, although you gave yourself a longer gap, so hopefully your cabin fever won't be quite so bad in a few weeks.

My first knee hurt a lot more. I had a lot more cramping in the muscles, it was generally just really awful. My second knee wasn't fun, but it was significantly less awful. I'm sorry your 'less awful' let was the first one.
 
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Rather

Rather

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I kept moving my gap between surgeries. When I scheduled my first, I also scheduled the 2nd for 2 months later. After my first follow-up visit, I moved the 2nd surgery to 6.5 months out on Thanksgiving week, planning to be away from work in December, a slow time for the campus. Fast forward to Sept 30 when a key manager in my group told me she was retiring on Dec 6. Yikes!

I called my OS to see if they could move me up and they said that they just had a cancellation for the following Monday - was I interested? I gulped and said yes. And that's how I got this gap of 5 months. If I hadn't already done one, I don't think I could have jumped so fast. With this schedule, I should be able to get back to work before my colleague leaves - IF my 2nd knee decides to behave a bit better.
 

Benay

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So interested to follow your second knee recovery. Wishing you all the best .
 

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