TKR TKR January 19

IndigoKnee

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Hello,
So pleased to have found this site. I had my TKR 13 days ago and went for my first physio check up yesterday - I'm in the UK and we don’t get offered the amount of PT that seems to happen in the US. I was told I should be walking further and needed to make my knee do straight lifts, with a towel rolled under the knee, even though that makes me cry with pain. I came home feeling very discouraged and unhappy but after reading the info on this site I understand that actually I am doing ok and must be patient. I feel much brighter today and have found such good info on here including the correct way to elevate.
 
And, as I,mmsure you've been learning here - there's nothing good to come of 'crying with pain.' ESPECIALLY barely 2 weeks post-op. Being kind to yourself doesn't mean being lazy or sloughing off. Baby steps, dear!
 
Agree- just look after yourself and don't be discouraged. It is definitely a marathon not a sprint. Most important is to keep your spirits up and just keep going doing a little bit more as you feel able.
 
Thank you. We often feel that the experts know best but in other areas of my life I have always listened to my body and my own instincts and shall do that with this, especially now I have found such good info on here.
 
@IndigoKnee, welcome to bonesmart! :flwrysmile: Please tell us the exact date of your surgery, whether it was a total or partial, and which knee it was. We will add that information to your signature for you. Being able to see this helps us all to know how far along you are in your recovery.

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

KNEE RECOVERY 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 these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital

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.

Try out our great new opportunity to improve your gait. It's OneStep. It's free and you will find it to be a huge help to you. Click here: OneStep
 
Those straight leg lifts were very painful to me when I started PT. My therapist didn't encourage me to do anything excruciatingly painful, but did say to just give it a little try once a day, which I did. I'll say it was uncomfortable, not painful. It tooks couple weeks before my leg would even move an inch, but then one day out of no where, my leg lifted several inches. Now at 8 weeks out, I can raise and lower my straight leg any amount I want without any pain. It will come for you too. I had no idea how patient I would need to learn to be before my TKR.
 
Sistersinhim - surgery was January 19 2023 TKR left leg.

Thanks for all the replies, good to hear from people who have been through this.
 
Now day 14 after the op. When I saw the physio on Monday she said I should go back onto the codeine as I need to get the pain under control. However, that is making me feel faint - I have a tendency to low blood pressure anyway and codeine lowers it further. Obviously the thought of fainting with my post op knee is very scary! Anyone else had this problem?
 
Not that issue but I found it hard to tolerate codeine due to constipation. I am generally a bit intolerant of medication and find I need lower doses due to ? slow metabolising. I have a pill cutter and try a lower dose if I am having problems. Maybe a lower dose a bit more frequently would work for pain but not affect the blood pressure?
 
The biggest thing I had with codeine was constipation. It was really bad so be warned if you go back on it take plenty laxatives. Take care Jcx.
 
Did you explain to your health care provider that the codeine causes issues? They can usually prescribe a substitute for the codeine.
 
Haven’t taken any codeine today as felt so ghastly. I had constipation as well which is something I have never experienced before. I have sent an email to my GP (I'm in uk - primary health care provide) but haven’t heard back. I’ll try to get hold of them tomorrow but since Covid it’s really difficult to be able to speak to them - there is a window of opportunity to book a phone consultation by phoning between 8 & 8.15 and after that it’s impossible, and at the moment at 8.00 am I'm groggy. If I have too much pain to sleep I’ll try a small dose.
 
Sorry you are struggling with this, @IndigoKnee. I hope you will get a reply soon.

In the meantime, are you taking anything else for pain relief? I also have a bad reaction to codeine and had to rely on acetaminophen (paracetamol) and ibuprofen, taken at regular intervals around the clock. It's important to be consistent in order to stay ahead of the pain. Icing and elevating also helped.

Let us know how you make out.
 
I managed to speak to a nurse at my medical centre and she was horrified by how much codeine I was taking, especially as I have a tendency towards low blood pressure. She has prescribed Co-codamol which although that has codeine in it is only 8mg per tablet. Felt pretty ghastly yesterday- still faint and nauseous so mainly rested, just some heel slides, a few tightening the quads with a straight leg, and walking round indoors as felt too faint to risk leaving the house. The District Nurse came in mid afternoon to check the wound and change the dressing. She said it’s healing well and can have the dressing off completely on Tuesday. I took paracetamol and ibuprofen during the day & last might I took one co-codamol (500 paracetamol/8 codeine) before bed and another in the night plus Diazepam to help relieve the muscle spasms and slept reasonably well. I find daytime the pain is simply in the joint but at night it is the whole leg with 'pins and needles' as well. Feel so much better today and tried the exercise where a rolled towel goes under the knee and you lift the foot. This had been impossible before and was the one that made me cry but today actually lifted the foot a couple of inches. It just shows that what Bonesmart says is true that these movements will come, don’t need to push it. I have a lot of back pain at the moment, which I am prone too - arthritis plus riding fall many years ago - so that’s annoying as makes it hard to rest. Long update but really good to know there is a community out there who truly understand. The information on here has been so useful as most other sites still give the 'no pain no gain' guidance.
 
I hope your new meds help with pain and you don't have the side effects.
The first 2-3 weeks are really tough. Its not magically easier past that, but gradually gets better. I can't stress how much ice and elevation have helped me. Not 20 min here and there. I will do it for most of the day when the swelling is bad.
Hang in there, better days are coming.
 
I can't stress how much ice and elevation have helped me. Not 20 min here and there. I will do it for most of the day when the swelling is bad.
Totally agree with @beachy I found lots of icing made all the difference and cut my need for stronger painkillers.
Do you have an ice machine?
 
I don’t have an ice machine, been using home made cold bags. I did ask at the hospital before the op about renting one I had seen advertised but it was £190 a week and they said not to bother.

I will try and ice more
 
I had my first TKR 19 Jan 2019 here in the UK, I was given ice packs and a wrap to hold them in. Even a pack of peas in a tea towel will help you, I could only tolerate Paracetemol but made sure I took then regularly throughout the day to keep on top of the pain. To help with the straight leg lift I used a Theraband to lift my leg loosening it slightly to lower the leg until I was able to lift and lower without it. You could use a belt if you don’t have a Theraband.

As others have said it’s early days so be kind to yourself. I found walking outside helped with the pain. I started just walking a couple of lamposts and back increasing slowly day by day. Good luck with the rest of your recovery.
 

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