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TKR TKR Right Recovery and losing my right mind

Neveragain2021

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Omgoodness…thank you for being here for me at this time.

I’m 62 and have suffered with osteo and rheumatoid arthritis since I was in my 30’s. When I found that the steroid shot was only giving me effective relief for 4 weeks, I knew it was time to listen to the doctor and schedule the surgery. And yes, I had gone to a level where tkr was my only option.
After having my surgery rescheduled 3x, and dealing with the anxiety and depression associated with it, we got the go ahead.

But now, I can’t sleep, can’t eat, afraid to drink too much because of the struggle to the bathroom at night. I’m hoping y’all have some tips that are tried and true. Also, came home with major bed sores so you know I’m just loving the back sleeping.

Listen, any tip, any tip, if it worked for you I’ll try it. It’s been almost a month postop (21st). I feel like I’m losing my mind.
 
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Neveragain2021

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After reviewing some postings, I figured you guys might need some more info.
I’m on Percocet 5-325 every 6 as needed and Tylenol in between. I am currently in a pre-diabetic status A1c from 10.4 to 6.1, I have a cpap. I take metformin and gabapentin for diabetes and neuropathy. The pt comes 3x a week and the nurse on Tuesday, thank you Lord for insurance!

I’m walking several times a day, exercise 3x a day with a walker and a support to help bend the knee. I’m at 0 and have reached 90 degrees but, I’m totally stiff in the morning.

Hope this helps. I’m looking forward to those tips!
 

Sisterpat

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:welome: Never again! So sorry you are struggling!
Here are our guidelines and some good suggestions.

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 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.
 

Jockette

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Welcome to Bonesmart, you’ve come to the best place for support!

I’m walking several times a day, exercise 3x a day with a walker and a support to help bend the knee. I’m at 0 and have reached 90 degrees but, I’m totally stiff in the morning.
One way to keep your pain level down is to go easy on the exercises. Once a day is plenty, and don’t do them all at once, space them out through the day. Too many exercises before your knee is ready for them can increase your pain and swelling and keep your knee inflamed. Gentle is the way to go, your knee has been through a surgery that causes a lot of trauma and you are healing, not training.

What do you mean by a support to help bend the knee?

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

I found that elevating my leg at night helped me sleep, and being on my back was more comfortable with my legs elevated. I didn’t have bed sores, though, I’m very sorry you do.
 

GZGirl22

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I find the mornings are when my knee is stiff as well. Ease into your mornings with elevation and ice before putting the knee to a lot of work. I find a gentle entry into activity helps. Hoping you are soon past the early tough stages and feeling better
 

Abbylayla

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@Neveragain2021 stiffness is totally normal. Jeez, I'm a year out and I still feel stiffness but boy that knee is strong!
Ice & elevation as you've already heard really goes a long way. Don't overdue the exercise. That always results in a depressing setback. I'm one of those rare ones who did not do PT because my hips are very bad and greatly reduces my range of motion. But I did my easy exercises like heel slides etc and I'm just as good as those who went for months. So soon after your surgery a 0 & 90 are great numbers! Your getting there!
What is your fear of walking at night? Are you afraid of falling? Do you have a walker or something else to steady you? Not drinking enough runs a risk for dehydration which will just cause additional problems for you not the least of which will make healing slower and make you weaker.
The early days can be a challenge for sure. Stay on your med schedule. Eat healthy. Do your exercise. Elevate & ice ice ice. Also keep up your progress reports on BoneSmart. There's lots of support & knowledge here to help you through.
You may not see it now but there will come a time when you think of this ordeal & say "No big deal"!
 

_Annie_

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I am here to tell you that life does get better! I’m a year out from my 2nd knee replacement & life is very good. I do remember that the first months after my TKR’s were spent elevating & icing with the ice machine day and night. Seriously- day and night! The only time I wasn’t elevating and icing was when I was using the bathroom, PT, getting something to eat, or some light house keeping chores. When I was getting ready to leave the hospital after the first TKR, the nurse on duty told me to keep that ice machine on day & night. She said forget about the 20 minutes on - 20 minutes off rule, which was what the papers I got from the hospital said. She said that icing is the key in controlling the pain. I did what she said and my pain was very manageable. Not that I didn’t have issues during recovery, I had constipation, a stitch infection, PT that was too strenuous, etc., but never pain that I couldn’t live with. After the bone on bone pain I had prior to surgery, the pain I had after surgery didn’t compare. Thanks to Bonesmart, I knew to stay no to PT that hurt or caused pain the day after. Back to the ice machine - we froze water in bottles that we recycled in & out of the freezer as needed. We had 3 sets of bottles/day in use. We also worked in crushed ice around the bottles as much as we could. I put a pillow case between my knee and the circulating water pads. I wish everyone that has a lot of pain after TKR would at least try the elevating and icing day and night and see if that would help.
 
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Neveragain2021

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Even when after I moved to the cane during the day, for a while I used the walker overnight and first thing in the morning.
thank you for that @kneeper. They moved me to a cane this week, but the mornings I feel most comfortable with the Walker. I’m trying to trust the system.
 

maryo52

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  1. Get a potty chair to be next to you.
  2. If you don't already have it, insist on home health to help you heal from bedsores. (The facility that sent you home with bedsores failed you. They should be reported.)
  3. Can't eat - why? Are you constipated? If you're taking narcotics, you'll need to take some pre-emptive Metamucil or something to keep things regular, and maybe a dose or two of Milk of Magnesia to unclog.
  4. Get a big body pillow so you can side sleep.
  5. Make a list of needs which you can post on the fridge so when someone says "let me know what I can do," let them choose from the list. Some of us (me) don't like asking directly.
  6. When you get out of bed or the chair, tighten your quad a few times to be sure it's ready to do its job. With all the problems you describe, I can well imagine your quad does not fire well.
I hope some of these help.
 
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Neveragain2021

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When I was getting ready to leave the hospital after the first TKR, the nurse on duty told me to keep that ice machine on day & night. She said forget about the 20 minutes on - 20 minutes off rule, which was what the papers I got from the hospital said. She said that icing is the key in controlling the pain. I did what she said and my pain was very manageable.

Back to the ice machine - we froze water in bottles that we recycled in & out of the freezer as needed. We had 3 sets of bottles/day in use.

I wish everyone that has a lot of pain after TKR would at least try the elevating and icing day and night and see if that would help.
Thank you. I was so cold after surgery and the first week after surgery, I ran from the ice machine. But, I do see the benefits now, and thanks to you, will try to increase my usage.
 
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Neveragain2021

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  1. Get a potty chair to be next to you.
  2. If you don't already have it, insist on home health to help you heal from bedsores. (The facility that sent you home with bedsores failed you. They should be reported.)
  3. Can't eat - why? Are you constipated? If you're taking narcotics, you'll need to take some pre-emptive Metamucil or something to keep things regular, and maybe a dose or two of Milk of Magnesia to unclog.
  4. Get a big body pillow so you can side sleep.
  5. Make a list of needs which you can post on the fridge so when someone says "let me know what I can do," let them choose from the list. Some of us (me) don't like asking directly.
  6. When you get out of bed or the chair, tighten your quad a few times to be sure it's ready to do its job. With all the problems you describe, I can well imagine your quad does not fire well.
I hope some of these help.
3. I seemed to have lost my total appetite, I was consumed with prayer for deliverance and crying. My evacuation is good and my appetite is coming back but the surgeon is monitoring my weight loss, it was a condition of my surgery. So I’m stressing.
4. Will do
5. Yes…sounds good
6. Thank you, great idea, doing it now
 

babcha

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Really sorry to hear you are struggling.
I had desperate probs with needing the bathroom at night that I had nothing to drink after 4pm. Then I found a charity here in England that sold a female portable urinal.
Basically a hand held light weight jug with attached lid and a female shaped top.
Pop it beween your legs and teplace the lid until morning.
It literally saved my sanity and possible a nasty fall.
Hang in there, I am at 3 months, with a little improvement every week.
Sending you good wishes from the U.K.
xxx
 
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Neveragain2021

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OMGoodness… BoneSmart
I think you just saved me some tears! I’m not properly elevating my knee! I’m having a rough day, with measuring 92 yesterday, and pain and swelling today. I contacted pt and laid it at their door, too much, I’m not yet 4wks postop.
Thanks to @_Annie_ , my ice machine is working overtime today!

This community has been a Godsend! I can’t tell you how low I was those first few days, but I’m sure some do know.

You’re all in my daily prayers.
 
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Jockette

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When you have a chance, read through the Recovery Guidelines, they really do have a lot of good information.


When it comes to PT, remember, 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.
 

babcha

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Hello again!
The picture is of a male jug, you will need a ladies!
I had awful experience with PT.
Each time it knocked me back for a few days with swelling and pain.
Then I saw the Specialist!
He said to take it easy, no aggressive exercises etc. I have only just started walking for any lenght of time and I feel that I am better, slow and steady than rushing.
Really hope you sleep better tonight now that you needn't worry so much.
It's a long, slow but steady way to recover.
I am the proof!!
God bless.
 
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Neveragain2021

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Doing better. Lots of pillows in my house now.
Sleeping is getting a little better. I’m still fighting the stiffness. Yesterday, I went to bed early because my leg was one unit and very uncomfortable. I’m icing between 3 to 4 times a day, and getting around sometimes with no cane.

I made the mistake of mentioning my support system (you guys) to my pt and she got a little miffed when I spoke about the resulting swelling and pain after we pushed to 92. Thanks to you guys, I’m advocating for myself.

Thanks for being here.
 

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