TKR The Recovery Journey Begins: Second TKR

[Iloved3]

Saw my doctor and got my staples out. What a sense of relief!

My pain has diminished and the constant icing and elevation has brought the swelling way down!

I am gently doing quad sets and heel slides and I am seeing some improvement!

My husband had his knee x-rayed and he has arthritis, lots of inflammation and what looks like meniscus tear. They are getting him set up for an MRI next week.

A friend got us to our appointments and my daughter is bringing us ice and other needs.

I started feeling a lot better just in time to help him. Now we will see if he has to have surgery!

 

[Iloved3]

@Celle @SusieShoes and anyone with ideas. I am seeing good improvement in my RTKR done Sept 27. Pain is much better. I am using only Tylenol except for adding one Tramadol at night. My gently forced bend was 90 degrees a week ago. I can now sit comfortably bent at 90 degrees and can gently force further bend now, so I know I am progressing. Will see PT on Monday and get a measurement. I can walk well and stand for longer periods.

My question is about my LTKR done June 14. I have 130/0 and walk very well. Since my RTKR, my left knee is sore from being my primary weight bearer. It just does not seem strong enough to lift my obese body easily from a sitting position. I use my arms and accomplish it, but my left knee is quite sore.

I am icing my right knee almost constantly and occasionally icing my left knee, but it is sore. I want to make sure my LTKR is still healing well. Any suggestions?

 

[Celle]

Well, your left knee is still only a toddler and it is doing double duty. That's bound to have some effect on it, so allow it to grumble. It's only 4 months into a year-long recovery, so ice it whenever you're icing your right knee, if you can. It will be OK, but it's probably more painful than it would be if you hadn't had the right knee done as well.

As for getting up from a chair, I'm glad you're using your arms, but do use your right knee a bit as well. After all, if you'd had both knees done on the same day, your newest knee would be having to work as well.

Please stop forcing the bend on your right knee. I know you say you're doing it gently, but it's not good and not necessary. The only ROM that counts is the one you get when bending your knee using your unassisted leg muscles.

 

[Iloved3]

@Celle Thanks for the advice. I have been reluctant to put much weight on my right knee yet while riding, but I will pay more attention it.

I will ice more often on the left knee. My extra ice packs have been busy since my husband hurt his knee, but he has stopped icing now.

I understand your advice on doing exercises, but what I am doing is not causing pain or swelling. I am doing 5 quad sets, some calf stretches that do not hurt and 10 heel slides. And I walk around the house. Mostly I sit in my Zero gravity chair with my legs elevated and my GameReady icing my leg. My pain has reduced a lot!

 

[rubyyarn]

My knees are acting much the same way. My surgeries happened about the same time as yours, except I got my right knee done first. I don't think anything is wrong with the implants...it is a year-long recovery, so of course the first knee will have complaints. Maybe slap an ice bag on whoever is hurting and go with the flow.

By all means use your hands and whatever else is necessary to stand up. A cane or a walker might help in that area even if you don't use it otherwise. As you get stronger, you will need them less and less.

There always seems to be something with this recovery, yes?

 

[Iloved3]

@rubyyarn

Boy isn't that the truth. Each day brings a new pain or strain or tightness in a new place! It is quite an adventure!


We are on exactly the same schedule, aren't we? My first one seemed so much easier than this one, maybe because I have two new knees this time. I am using my ice machine on the newest one and an ice pack on the other.


Are you hitting the totally bored, cabin fever stage? PT is an exciting outing at this point! I know it will get better, but I am just so impatient.

Good to talk to someone at my stage of recovery!!!

 

[rubyyarn]

Cabin fever? Tell me about it! I seem to have the feeling "OK, I've got the other one done, can I be well now?"

I think the first knee was better only in memory. Reviewing my thread, this knee seems about the same as the other or even a bit better. It's just we don't have as much stored energy for dealing with the second knee.

That's funny about looking forward to PT as a chance to get out...that is just how I feel about it

 

[SusieShoes]

My advice would be: if your knee is sore, ice it. Doesn’t matter which knee. If your knee is sore, it’s telling you it would like a little ice and elevation. It’s also telling you it’s not completely happy with the work it’s being asked to do. Some of that is perfectly normal, of course. It’s very new to its position and workload. Remember back to after surgery and how very sore (and unhappy) it was. At this point, you need to figure out if it is simply new-knee unhappy or unhappy with something you’re doing.

Start using both legs along with your arms to help lift you from sitting. It’s tempting to put more of the load onto the “good” knee, but that’s not necessary after a few weeks. You will find it easier to use both knees in tandem, though it might hurt a little more at first. Getting up from sitting, like walking up and down stairs, is an excellent exercise in itself that helps strengthen your quads and other muscles. Your legs might get a little sorer doing this at first, but that’s what icing and elevation are for, to give them a little TLC until they get used to their job.

I’m with Celle on not forcing a bend. No need to do that. Your bend is fine for your point in recovery and will get even better as your knee continues to recover. Forcing it, even gently, accomplishes nothing and might actually set it back a bit. PT loves to force a bend to get a “better” number, but the number is completely artificial unless you can achieve it on your own.
I’m so happy to hear you and your twin Rubyyarn are doing so well!

 

[Iloved3]

Thanks @SusieShoes for the advise. I am now using both legs for sit to stand! It hurts but it makes sense to do that now. I am icing both of them and that is helping. I am not doing any more stretches until I go to PT tomorrow, but lots of ice and elevation! I have to stop fighting Mother Nature!

@rubyyarn Glad to hear I am not the only one with cabin fever at this point. I know there is a long haul ahead, but I am so ready to be done. I always thought I was a pretty patient person until now!!!!!!

 

[Iloved3]

@SusieShoes @Celle @Josephine and anyone else with professional knowledge or personal experience with blood sugar issues:

Everyday seems to bring on a new problem. Here is the latest.

I am diabetic. I take Metformin ER 1500 mg per day. My last A1c, before my surgery, was 6.0. Since the surgery my BS has been all over the place. I have to admit I ate terribly the first couple of weeks. BS has been running higher than ever before. It was 205 Thursday. I cut out all the junk and have eaten extremely well for two days. Yesterday it ran between 117 and 136 all day.

At midnight my BS was 117. I had a bad night with insomnia. I am not having much pain, just can't fall asleep. Finally fell asleep around 4:30 am and slept until 10:30. When I got up my bs was 190 again!

I have an appt with my nurse practitioner next Thursday to discuss the problem. She is out of town until then. The doctor I talked to felt it could wait until then.

So my questions are:
1) Is this common? Does all the stress from surgery cause bs fluctuations like this in lots of people?
2) Does lack of sleep and weird sleep patterns make this happen? My surgeon said insomnia is the number one complaint from his TKR patients!
3) Any suggestions for stabilizing my bs?


I know this is not a crisis but I am concerned about the effect of high BS on my healing!

I would appreciate input from anyone out there!

 

[Celle]

Yes, the surgery can play havoc with your blood sugars and your dose of Metformin may have to be adjusted for a while.
SusueShoes has practical experience of that and I'm sure she'll be along to tell you about it.

Lack of sleep is indeed very common and there is an article about it in the recovery reading we left you -
Sleep deprivation is pretty much inevitable - but what causes it?
The best way to handle it is to take daytime naps. Sleep where you can, when you can, and how you can.
Your sleep pattern should eventually return to normal, but it can take about 3 months.

PS: Please try not to start a post with a series of tags - it makes it difficult for people reading on mobile devices because all they can see at first on their small screens is that list of tags.

 

[SusieShoes]

Deep breaths. Stress causes elevated blood sugars (easily handled by non-diabetics but not by us), so relaxation and calm is what you need. You talked with a doctor and the doctor says you can wait until Thursday, so that sounds like a plan.

1) Is this common? YES. Surgery and stress... can you think of a stronger connection? Pain and stress... ditto. So you had a major surgery, twice, and you’ve been dealing with pain. Your body has responded by elevated blood sugars. Mine was higher after my surgery. It’s back to pre-surgical levels, but barely. Still, it didn’t happen overnight.

2) Sleep disruption and insomnia. Also stressful, no? If bad sleep happens, try not to fret about it. Bad sleep is definitely the number one complaint around here! It’s distressing and annoying and... might not go away entirely for a few months. If you can make peace with missing a little sleep here and there (advice galore on the forum on ways to cope with it), you will help your blood sugars as well as your sanity.

3) The more you can zen, the better your blood sugars will respond. Calm and tranquility help your healing in part because it also helps your blood sugars. Pain control helps a lot for the same reasons. Less stress = better blood sugars (research about the role of cortisol if you want to know more about why). Of course be good about your diet, too. I also ate rather horribly the first couple of weeks home —in rehab they had me on a diabetic diet— but I went back to my low-carb, more protein diet early on and have stayed on it.

Your blood sugars might remain elevated for a bit. When I talked to my doctor about mine (they were 120ish and before surgery I was 100ish), she told me that was just fine. Once I was able to take up regular exercise by walking longer distances every day, my blood sugars got lower.

Yours being above 200... I cannot give you medical advice on that. Try to get them down using calm and diet, of course. If they stay high, call your doctor again. Just to be on the safe side. But if your doctor has told you this number is not a problem that needs immediate attention, opt for calm and have that discussion on Thursday. Your medication might need to be adjusted.

 

[Iloved3]

I am sorry. I thought I was doing it the right way. I thought if I wanted responses from certain people I was supposed to tag them. I will stop.

 

[Iloved3]

I do think that not getting as much activity and exercise has an effect too. I am getting up and walking more as I can.

Thank you for your very supportive response, @SusieShoes . I hope it is ok to tag you as I was advised to not use tags. I find that confusing.

My stress level has been much higher with this TKR as my pain has been greater and my husband hurt his knee so I have been doing a lot more of my own care earlier.

I figured out a way to transport my own ice and frozen bottles for my ice machine and am making my own breakfast and snacks before I felt I was quite ready for that. He has an MRI this week so I am worried about him.

I will try to relax more. I am sleeping during the day as the urge strikes me. I think I am getting enough sleep, but the odd hours interfere with regular eating and blood sugar control. I will try to eat more small snacks when I am awake and be more zen!!!

Thanks again!

 

[Celle]

I am sorry. I thought I was doing it the right way. I thought if I wanted responses from certain people I was supposed to tag them. I will stop.

I hope it is ok to tag you as I was advised to not use tags. I find that confusing.

I'm sorry I confused you - I didn't mean to do that - but I didn't say don't use tags. I just asked you not to start a post with a list of them, and I gave you a reason why. It's quite OK to start a post by tagging one person.
It's just that tagging several people at once at the start of a post can present a few difficulties.
This article explains:
How to tag another member; how to answer when someone tags you

 

[rubyyarn]

The tags aren't the problem, just don't start a post with a string of them. Write a few words first. Maybe a line of tags is OK at the end?

 

[Celle]

Maybe a line of tags is OK at the end?

There isn't very often a need to tag multiple people. Iloved3 tagged three of us because she wanted some advice, but you don't need to routinely tag the people following your thread. They're going to read it anyway. Just tag someone if you have something in particular to address to her/him.

If you read the article about tagging, you'll see it gives a good example of how to tag more than one person in the same post.

 

[Iloved3]

Thanks, I will be more careful.

 

[Celle]

We all make mistakes when we're new here. I've made some doozies in my time and I still make a few.

 

[Iloved3]

Well, today has been a really great day!!!


First, I slept, in my bed last night rather than the recliner, for nine hours with two bathroom breaks. It was fabulous!


Today, my best friend came up to visit and give me a ride to PT. First, it was lovely to get out in the beautiful fall weather. Second it was great to spend time with a friend; staying home has been mighty lonely. We talked and talked and talked!


I showed a good gain in PT today. I measured 90 degrees last week and 102 degrees today. All my icing and elevating has paid off!


Today my knee is much less swollen, my incision looks great and my pain is way down. I am using only Tylenol except at night and for PT still adding one Tramadol.


After PT we went to Walmart to get my prescription. It was not ready so we shopped and I walked all over Walmart with little pain!! Had fun buying some things for my 2 year old grandson. Standing still results in aching, but walking felt pretty good!!!


At dinner tonight, I was able to sit with my leg down without all the aching I have been experiencing. It made dinner much more enjoyable!


I thought I would be hurting after PT and more walking and exertion today, but it has been 5 hours and I still feel pretty good! Of course I am elevating and icing tonight!


I think I have really turned the corner on my recovery! I know there is a long way to go, but I am feeling pretty upbeat!