Bilateral TKR The other side<

sooz

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So good to gave the surgery over. Total on left knee (Stryker Triathlon) and partial on right (Makopkasty) surgery went well. First day I was very nauseous, even after spinal and sedation.

Feel pretty good now, pain controlled, using ice machine heaps and using walker. Have done part of the hospital corridor and back. Day three now and physio wants me up for meals and a little more walking.

I must say, even though I have stiffness it is so far better that I expected. Doc says off to rehab Monday which will be day six. All good
 
Welcome to recovery, @sooz .
I'm glad things are going well. Do make sure the PTs don't overwork those new knees!

Here is your post-op reading:
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
5. Here is a week-by-week guide for 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

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.
 
Welcome to the wonderful world of recovery, @sooz. :yay:

Surprising, isn’t it, that the stiffness isn’t as bad as feared? I thought so, too. Maybe it’s because our knees hurt soooo much ahead of surgery that post-surgical pain slinks off in shame. Of course, it’s more likely that you are having excellent pain control. Sounds like you’re doing great so far!
 
Welcome to the best place for information about knee replacements. Be sure to read the articles and follow the guidelines. If your do, you'll have a much quicker and less painful recovery.
 
Welcome, happy to hear you are doing so well. I am just behind you as my surgeries are scheduled for the week after next. Baby your baby knees.
 
Day nine. Physiotherapy is progressing nicely..they are very kind and don't force anything. They take me from my room to their gym for an hour each day. My right knee (partial) has 115 degrees flexion and zero extension. The left (total) has 100 degrees flexion and 10 extension. Still happy to take painkillers as the left gets a bit achey and loving the icing. The journey has been much better than I expected and at this stage will be discharged next Wednesday which will be 2 weeks and a day after surgery. So nice to see the progress.
 
have been home nearly a week. was able to quit the oxycodone 2 days ago and only take panadol when needed. it is more discomfort than pain. saw doctor yesterday...everything is good. scheduled for x-rays in three months followed by consult. I feel the worst is behind me. I can walk unaided and sleep on my side/tummy with a pillow between my legs. still some stiffness but that is slowly getting better. Very pleased with the outcome.
 
So happy to hear you’re doing so well! Better yet, you’re happy with your new knees. :yay:
 
Nearly six weeks post op. My physio massages my knee (he calls it release) and that helps. I massage the scar and that also helps.

The frustrating part is having one good day and then a painful one. Night time is still not great. I wake after midnight with stiffness (have a walk around) but can be painful going back to bed. So looking forward to a good long nights sleep.

I can ride the recumbent bike and walk well but it does not take much to cause swelling and soreness. This surely is a pig of an operation but I am still glad I did it and look forward to each week passing so it gets easier. My greatest comfort is the ice pack.
 
Ice is the best! :ice: I iced faithfully for four months, gradually decreasing to once a day after my morning walks. Now I ice only occasionally, because I kinda like it. It feels so good! Great pain killer, too, during those middle recovery months when you still get soreness after physical activity. Ice and Tylenol were my best friends.

Nighttime and sleep can be tricky for a while yet. How do you sleep? I found my knees did NOT like to sleep in any normal sleeping position, at least not on a bed. In bed my knees only liked if I was on my back, with legs elevated on my foam wedge. They were happy with that, and would greet the morning pain-free. If I tried to sleep without the wedge, or on my side, my knees (especially my cranky left knee) would wake me up with pain during the night, and be unhappy come morning, with swelling and soreness. So if you aren’t elevating, you could try that and see if it works for you.

Everyone, though, seems to have trouble with sleep. I think it’s easy, through normal movement during sleep, to put our legs/knees into prolonged positions they don’t like. They tell us so when they ache and wake us up.

You’ll soon find (I hope) that your knees will start swelling less after exercise, as long as the exercise is not too much for them. It was at around two months that I was able to take longer walks (around the block), as opposed to smaller walks a few times a day. I noticed around that time that my knees weren’t as painful. Be careful when that happens, though. It’s tempting to think “I so got this! I can resume all the things!” It’s too soon for all the things. But you can start adding a little here (a short trip to the mall), a little there (running a few small errands), and see how those work out. And as things work well (no swelling after, knees stay happy), you keep going!
 
ask away Josephine
 
Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?
ai63.tinypic.com_eta39s.jpg


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
1.pain level......during the day only if i lie down, then it burns at base of knee where the scar ends 2-3. Night time is ok till around midnight then stiff and a 5

2. off all pain meds except 2 665mg panadol osteo at bedtime.

3. knee swelling moderate except after exercise when it is a little more

4. ROM when sitting is 115 and 5 left knee total, right knee partial 120 and 0

5. ice only once a day, occasionally twice for 40 minutes

6. elevate around 2 hours a day

7. light housework and cooking and a little gardening sitting on a stool. i can walk around the supermarket for 30 - 40 minutes easily

exercise at home
heel slides a day x10 per day
knee clenches held for 2 seconds 10 reps x twice a day
leg lifts with quad clenched x10
recumbent bike 5 minutes (can do full rotation easily)
some stretching

I go to physio twice a week for 30 minutes and I am happy for him to deeply massage my knee front and side) and quads.
 
1. pain level during the day only if I lie down, then it burns at base of knee where the scar ends 2-3. Night time is ok till around midnight then stiff and a 5
You said "pain level during the day" but gave no number - so what is the pain level during the day?
Midnight you get pain at 5 with stiffness - this is connected with your pain meds - or lack of them!
You get a burning pain in the scar 2-3 - I think you should discuss this with your GP as it sounds like neuropathy for which you need something like gabapentin
2. off all pain meds except 2 665mg panadol osteo at bedtime.
Why are you off all pain meds when you are only 6 weeks out? Six weeks is the time when you need them most of all! And Panadol-osteo is only paracetamol which is not effective enough for you right now. I suggest you also discuss with your GP, having some Tramadol for a few weeks. It will make all the difference.
3. knee swelling moderate except after exercise when it is a little more
I see - and you included this swelling in your pain score did you?
4. ROM when sitting is 115 and 5 left knee total, right knee partial 120 and 0
That's actually very good for only 6 weeks out. Very good!
5. ice only once a day, occasionally twice for 40 minutes
Given the amount of swelling you have you should ice for at least 40-60mins and more than 4 times a day.
6. elevate around 2 hours a day
And elevate when you ice.
7. light housework and cooking and a little gardening sitting on a stool. I can walk around the supermarket for 30 - 40 minutes easily
Did you read the recovery articles Celle left you in post #2? Amongst them was this one Activity progression for TKRs in which it clearly states

Weeks 6 and onward
Start taking car trips to the shops but keep them short and sweet at the start, no longer than 15-20 minutes
Take at least one 5 minute rest while you are out.

Activity: a very little ironing, washing, meal prep but get someone else to clear up after. Wash up but someone else clears the table, brings you the dirty dishes, dries and puts them away after, NOT you!!

I suggest you go back and read all the articles.


exercise at home - do these only once a day and none at all at the weekends
heel slides a day x10 per day - this is a very bad way to do heel slides. Read this Heel slides and how to do them properly.
knee clenches held for 2 seconds 10 reps - never heard of these but you don't need them anyway!
leg lifts with quad clenched x10 - here again, once you can do leg lifts you don't need to do them any more!

some stretching - what stretches?
recumbent bike 5 minutes (can do full rotation easily) - that's good!

I go to physio twice a week for 30 minutes and I am happy for him to deeply massage my knee front and side) and quads - is that all you do? If not, what else do you do?

In summary, I'd say that
a) you need better pain meds
b) you need to get some gabapentin
c) you should stop all exercises principally because you don't need to do them any more - your ROM is already excellent
d) if you continue to do the exercises, you will risk increasing pain and swelling and a regressing ROM
 
thank you so much for your advice Josephine. I have taken this onboard and I am sure it will help. The thing I am most looking forward to is the passage of time when the pain/stiffness will lessen and I can get a normal (for me) nights sleep. Heres hoping. Also thanks for the time you give to this group which is appreciated by many I am sure
:)
 
horray at last. just gone 8 weeks.............I am very excited as the last few nights I have
managed to sleep right through except for one wake and turn over !!! by taking 2 panadol at bedtime I can now enjoy sleeping without the throbbing pain. Also over the same time frame the numb areas have reduced by half and the little electric shocks in my knees have lessened. I believe for me I have turned the corner finally but will certainly follow advice and not think I can do whatever I want just yet. For the first time since my operationI am feeling glad to have done it. Hoping everyone else is feeling better and wishing you all a merry Christmas. Next year is going to be amazing :)
 
Fantastic! And you will continue to get better as time goes on! Enjoy your Christmas and New Years with your new knees!
 
Yay to a good night's sleep!:sleep:
 
Just passed the three month mark. I notice improvement by the week...not by the day. I am almost pain free but still get told by my knees if I overdo it.

I have 135 flexion on one knee and 125 on the other. One of the best things for me has been the physio massaging my muscles that support the knee.

I have a very small area in each knee that is mildly numb but for the most part I have good feeling.

Tried kneeling the other day and it was possible..only for 10 seconds but I am sure this will improve with time.

Am sleeping well (on my stomach or side) and only take 2 panadol at night. still using a pillow between the knees.

I believe I am 90% there which I believe is pretty good for 3 months.

Finally glad I had the operation and so pleased to get them both out of the way at the same time....it was certainly worth it. The advice given here has been invaluable both for recovery and psychologically. My thanks to you all. :loll:
 

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