TKR thneed's Right TKR

[thneed]

TKR right 6/8/2022

Hi everyone! I made this account a few months ago and poked around a bit, but to be completely honest I didn't really want to know too much about the surgery or recovery because I was worried it would scare me off and I would never get it. I know that's terrible, like an ostrich with his head in the sand, but I am a baby when it comes to medical procedures or pain. But I'm here now 7 days past my first TKR (the other one needs to be done as well).

During the surgery I got the spinal though I was also asleep. I went home the same day. I started official PT on the 3rd day (though I'd been doing exercises at home before). I am supposed to take off my bandage tomorrow though I'm a bit scared to do that, I'm just afraid the wound won't be protected. I do have my husband and teen kids at home to help so that's wonderful.

I feel okay I guess. My leg feels so tight all the time, and now that I'm looking around here and elsewhere, I don't think I've been elevating my knee properly. I just ordered one of those wedges recommended here, and in the meantime have a contraption made of pillows to tide me over. I am hoping the proper elevating will relieve the tightness (which I assume is swelling). I have been icing quite frequently since the beginning. A question, though: When you elevate, can you ice at the same time or should those be done separately?

I think for now the worst is the lack of decent sleep. I sleep at most 2 hours at a time, and I can only sleep on my back because it's too painful to sleep on my side yet. And although I do dream, so I'm getting into that good REM sleep, I'm still exhausted all the time. Also, whenever I wake up I have to go to the bathroom, so I actually get out of bed every 2 hours. It sucks so bad.

And the compression socks! While I totally understand the reasons for them, they feel so constricting especially at night. I can't stand to have my feet covered when I sleep (in fact, before surgery I usually hang at least one foot off the side of the bed), so it's quite an adjustment.

I would say, after that first day when the pain blocker wore off, it's going okay. I wasn't prepared for the mental/emotional impact, though, so it's nice to be here looking at others' stories so I don't feel so alone.

And I am scared I won't want to get the second one done. So far, if you asked me now, I would do it. But there's a long way to go. I was really hoping to get it done in 3 months but I guess we'll see.

 

[Jockette]

Hi and Welcome!

I am supposed to take off my bandage tomorrow though I'm a bit scared to do that, I'm just afraid the wound won't be protected.

It will be fine, it does need air to heal well.

My leg feels so tight all the time,

Yes, swelling causes tightness, but so does this surgery. Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.

And the compression socks! While I totally understand the reasons for them, they feel so constricting especially at night.

They might be the wrong size, check with your surgeon about a different size. Snug is appropriate, too tight and causing constriction is counterproductive.

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 all people are 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: 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

​

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​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[InkedMarie]

Hi there & welcome! Yes, ice & elevate at the same time. The Lounge Doctor you ordered is great. For the first few weeks, ice most any time you’re sitting or lying. Always have a cloth or towel between you and the ice. I iced overnight for the first couple weeks, keeping it off after the middle of the night potty break.

Marie

 

[ski_bum]

And I am scared I won't want to get the second one done. So far, if you asked me now, I would do it. But there's a long way to go. I was really hoping to get it done in 3 months but I guess we'll see.

You should watch the next surgery. I watched both my surgeries.
I personally think doing the second one in 3 months would be good. Get it over with.
I was 9 months apart because I downhill skied after 6 months for 96 half days. Didn't want to miss a season.
Now I am 2 1/2 months post op second knee and it seems like I have been in recovery for ever.
Good luck with recovery wishing you all the best.

 

[Roy Gardiner]

I was really hoping to get it done in 3 months but I guess we'll see

I had mine done at the same time; one surgery, one recovery. Tough for a couple of weeks but shortest total recovery time. My take would be to get the 2nd done ASAP; only then does full recovery start.

 

[thneed]

@Jockette Thank you for your kind words, and the suggestion about the socks. Today is the day I remove them and the bandage, and if I have a hard time I will let the surgeon know and see if I can get a different size.

@InkedMarie I will ice while elevating then, when I can. In fact I'm doing it right now as we speak.

@ski_bum Watching the surgery, as in being awake? Nothing would terrify me more.

@Roy Gardiner My surgeon won't do two at a time, and I wouldn't have wanted to anyway. But I'm glad you were able to and it worked out for you. And you're right, I'm already in recovery so why not add the second knee while I'm here and get it all over with.

Sorry folks, I don't know how to do the quote thing. I tried but got frustrated. I'm very sleep-deprived right now. But thank you all for your kind words.

Speaking of sleep, last night was the worst yet. I slept in 45-90 minute increments, and lay there forever in between trying to fall back asleep. And when I did sleep I had the most horrible nightmares. I have got to figure this sleep thing out or I will go crazy.

 

[Roy Gardiner]

I don't know how to do the quote thing

See here for help

why not add the second knee while I'm here and get it all over with

Exactly, if it were me I'd go back to the surgeon with a 'how soon?' question.

 

[Jockette]

Speaking of sleep, last night was the worst yet. I slept in 45-90 minute increments, and lay there forever in between trying to fall back asleep. And when I did sleep I had the most horrible nightmares. I have got to figure this sleep thing out or I will go crazy.

Your medication could be causing those dreams.

Try to relax about not being able to sleep, it’s par for the course early in this recovery:

Sleep deprivation is pretty much inevitable - but what causes it?

Time and again members complain about not being able to sleep and after a while, that it gets to making them feel frustrated, despairing, depressed and even ill. I thought perhaps a short treatise on the reasons for disturbance of sleep patterns was long overdue. It won't help you to sleep but...

bonesmart.org

 

[lovetocookandsew]

Sleep deprivation is actually pretty normal after this surgery. After some surgeries, I've been able to sleep, but not after every surgery, so what I did when I couldn't sleep was I watched TV. I binge watched old TV shows, so my mind would basically blank out, and I didn't lie there getting frustrated trying to sleep. Often, the TV bored me enough that I fell asleep. I also watched it to while away the hours and hours I was lying around icing and elevating, and very often fell asleep even in the daytime. That's the key right now; sleep whenever, and wherever, you can.

Are you using ice packs or an ice machine to ice? I had an ice machine which, for me, was much better than the ice packs I used after my original TKR. I found it was much more efficient and lasted a lot longer than the packs. I could ice non-stop all night, and only had to change the frozen bottles around every 6 hours or so, as opposed to every thirty minutes for the ice packs. Plus, it was icy cold from start to finish, whereas the packs were only that cold for a short time before starting to warm up.

 

[sistersinhim]

I have got to figure this sleep thing out or I will go crazy.

Sleep whenever and wherever you can. I slept in the recliner for a while then on the bed for a while. This went on around the clock for the first month or so. I am a side sleeper, too, and being unable to do so left me with little sleep. I found sleeping in the recliner was actually better than the bed at first. Once I was able to sleep on my sides some the bed was an improvement over the recliner.

 

[Odieodell]

Sleep is definitely evasive early on. I’m a side sleeper, so not much sleep was had while laying on my back. So I slept on my side as much as I could while using a pillow to prop top leg on while laying with legs in a scissor position (top ahead of bottom leg). I actually found laying on my side with my surgical leg on the bottom was the most comfortable as opposed to having it on the top. However, I still woke up every few hours and would need to switch sides. It was much better than laying on my back.

 

[Jockette]

It is not necessary to quote in order to reply. Just type your reply in the box.

 

[thneed]

@Roy Gardiner thanks, I tried the quote thing based on the link you gave but it said I don't have enough posts yet to use links, so I'll try it again later. And yeah, I have my first doctor appointment on Monday, and you bet i'm asking him about surgery #2.

@Odieodell I sleep that way too! The scissors thing. And I'll have you know, I tried it again last night and got to about a minute before I had to stop, which is longer than I've been able to do before. But ah, that one blissful minute of sleeping on my side!

And guess what everyone, I slept pretty decently last night! I think part of it was thanks to you all chiming in and telling me it was normal, sometimes just commiserating with others who have been through the same thing really helps.

I slept differently this time. I elevated my leg and fell asleep that way. I don't have my Lounge Doctor yet but I used the 3 pillow stack method I saw here in one of the threads about elevating. It was comfortable and it really seemed to help! As the night wore on I did wake up a lot, but when I did I slowly removed a pillow until I was flat again by like 4am. But I was able to fall right back asleep each time, and one time I slept a full 2-1/2 hours! It was blissful and I feel better this morning.

I just want to make sure, is it okay to sleep with your leg elevated, as long as you do it properly? I know it's probably a dumb question, but I don't want to assume anything.

Also, big news yesterday I took off my bandage! And changed my compression socks (that was an ordeal). I took it off last night before bed, and then my knee really seemed to hurt when I got up to walk around. I can't imagine why, if maybe the bandage was holding the skin in a certain position and now gravity was taking over? or was it in my head? Either way, I felt a lot more pain than I had been, especially at the knee cap, so I took 2 of my pain medication instead of 1 (the label says you can do that and I've done it a couple times). Maybe that also helped me sleep.

Anyway, I consider this to be progress! Here's to a great knee day for all of us today.

 

[Jockette]

I’m glad you’re feeling better this morning and had better sleep. Yes, it’s fine to sleep with your legs elevated, I actually still sleep this way, 5 years after my surgery!

It really is nice to be here, among others going through the same thing. Even though we all know others who have been through this, too often they forget the tough details of recovery, and make it seem like they had an easy recveory and why aren’t we doing better than we are.

 

[Odieodell]

Either way, I felt a lot more pain than I had been, especially at the knee cap, so I took 2 of my pain medication instead of 1 (the label says you can do that and I've done it a couple times). Maybe that also helped me sleep.

I definitely learned to take my pain medication before bed and to keep medication at my bedside with water should I be due and need it.

I was required to have my ankle to knee wrapped with an ace bandage for 3 weeks when I slept, so at 4 weeks my sensitive incision was exposed to sheets and blankets. It drove me crazy! I learned from someone here, after the fact, that a cling wrap like Saran Wrap put around the knee loosely will help desensitize it from materials rubbing against it, so you may want to try that if you have that problem as well. I wouldn’t recommend doing this if your incision still seems open. Otherwise, just make sure the incision has been cleaned before doing it.

 

[Axx72]

@thneed Welcome to the club!!! This is an amazing group of people to learn from!

I found my TKR to be counterintuitive in that they need movement or they get achy and sore, unlike the many sports injuries I’ve had to recover from. TKRs don’t like to be in one position while u sleep. My sleep is still no more than 4-5 hours at a time, up from 1 to 2, so it does improve!
I began moving/walking/stretching as soon as I could after surgery because it was a pain reliever.

Listen to your body and push your limits as much as ur TKR will let u. U r ur own pacesetter.

 

[MarkTKR]

Hi thneed,

Sleep gets better, trust me.

I had TKR on Dec 23rd, then on Jan 13th after pretty much full recovery I ruptured my Patella Tendon in the same TKR knee! on Jan 20th another knee surgery followed by 8 weeks in a full straight leg cast, 2 more weeks after that in a straight leg brace before could could try to bend.

Sleeping post TKR was difficult. I napped when I could. But it was getting better quickly. By Jan 13th I was sleeping pretty well in bed. Then the tendon rupture happened.

We rented an adjustable hospital bed and it was a life saver. I could only sleep on my back, never been a back sleeper either. But the cast weighed almost 40 pounds it seemed so there was no choice.

Like you I slept little bits at a time. I admittedly spent a lot of time late at time watching stupid youtube vids just to pass the time until I would get sleepy again. Sometimes I watched a full movie. Most of the time I would get tired enough to fall asleep about 2:30am and get 2-3 hours in.

When the cast came off I had the brace to deal with. I tried several times to sleep on my preferred right side but it just didn't work.

I remember the day, some 12 weeks after the tendon surgery when the doc said I could ditch the brace. That night I slept so well it was amazing. I still tossed and turned but I could sleep on my side for once.

But the uphill range of motion battle began. When the brace came off I could bend my left leg maybe 20 degrees. I went to PT 3x a week and did bike stretching at home and slowly over a period of almost 6 weeks increased ROM to about 90 degrees. I still could not do a full circle on the bike either forward or backward.

I remember reaching 105 degrees and still being prevented from the full circle then one night I managed a full backward circle! It was tight and it really pushed, but I was so elated. From that point forward I could stretch forward and backward and after a minute or two get to full circles.

Now almost 6 weeks from that date I can easily do full circles. My ROM is up to about 130 degrees and I can sleep pretty much the night through. I still wake up at times with my left leg feeling like a band of small aliens have moved in and made it their home as they experiment on my bones and tissues. But a few flexes and repositionings and I can generally get back to sleep.

So for me, it's been 6 months and things are getting closer to normal. My knee still has quite a few of its "alien" periods and it still doesn't feel "normal" but I can walk, move, and do most of what a want. So the light is there but the tunnel is still long.

Keep you chin up. Do what you feel like doing, rest when you can. It will improve!

 

[thneed]

@Jockette Thanks! And I agree about sharing our journeys and helping others. I have been reading so many of the threads here and while sometimes it makes me paranoid about doing things wrong, in most cases it sets my mind at ease. I like how the threads are arranged, each thread is a person's journey. I expected a more traditional forum layout, like by topic, but this really makes more sense and then becomes a diary of sorts we can look back on and see our progress, especially if we are facing future surgeries.

Do you know if there is a thread somewhere that explains the acronyms people are using? I have looked around and I'll keep looking but if you know where to point me I would appreciate it. I only know a few, like TKR and MUA, and that's about it.

 

[Jockette]

Don’t worry too much about doing things wrong in this recovery, not every suggestion works for every person. You will also find many different opinions between surgeons and PTs about what to do in this recovery, which means that’s all they are, opinions and guidelines.

People 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.

We do have this thread:

abbreviations and acronyms

A AAOS American Academy of Orthopedic Surgeons ABD abduction: moving towards the center line of the body ACI Autologous chondrocyte implantation ACL Anterior cruciate ligament (knee) ACT Acceptance and commitment Therapy ADD adduction: moving away from the center line of the body APAP...

bonesmart.org

Here’s a link to the whole list of articles in the Bonesmart Library. Lots of topics there!
https://bonesmart.org/forum/threads/library-index.14830/

 

[Odieodell]

I only know a few, like TKR and MUA, and that's about it.

TKR = Total Knee Replacement
MUA = Manipulation Under Anesthesia (sometimes done by surgeon if they believe you have developed adhesions which are preventing flexion or ROM = Range Of Motion.