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TKR TKR with Fibro and Raynauds and RA, anyone else?

beralc

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Thought I’d start my recovery journey now as my surgery is tomorrow. I’ll be at the hospital for 8am UK time. I look forward to picking your brains and also hope to offer suggestions from my own experiences, that will hopefully help others coming after me.

So happy this forum exists. See you on the other side.
 
Best Wishes!

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
ice
take your pain meds by prescription schedule (not when pain starts!)​
If you want to use something to help heal the incision,
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.​

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. At week 4 and after you should follow this

6. Access to these pages on the website

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.
 
Best Wishes tomorrow, beralc!
Will be watching for your first post and look forward to supporting you on the journey!
@beralc
 
Well everything went well. Spinal was bliss. What with my other conditions it was the first time in about 27 yrs I’ve had absolutely no pain in my lower body. Had my op RTKR about 2:00 pm yesterday UK and at almost
9:20 pm pain started to kick in particularly after my first post op wee, so a bit of moving about. Unfortunately I discovered very quickly the message given strongly on here about taking medication regularly. I asked for analgesia when I used the bedpan, but by the time staff managed to give me any it was nearly an hour later and I’ve been playing catch up ever since. Unfortunately that has meant despite codeine and paracetamol and morphine tabs, I had no sleep and never went into reasonably good analgesic effects, hovering instead on the edge of only just bearable.

06.40 am now and I’m glad to see the day at last. Praying I get home today. With regards to my other conditions, when I’m at home I often take medication slightly in advance of pain as I know when I’ll suffer before it happens very often. Being in hospital means you’re relying on staff to be available, so if I get home I can start my own regimen and have help from family. So far just as painful as described.

I’m starting a journal now in case I have the left knee done, so I can remember things.
 
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@beralc hope you get home today, agree you will be in charge of your med times. I am 4 weeks RTKR in UK, West Sussex. I am a slow healer it seems and having to cope with swelling is a little hard but take each day. With the wonderful support on here you will never be alone. Wish you well x
 
So sorry you're playing catch-up with the pain, that you're hovering in the barely bearable zone and losing sleep.
Hopefully they discharge you for home today where you'll feel more in control resting in comfortable familiar surroundings. Safe travels home! Wishing you lots of comfort, beralc! :console2:
@beralc
 
Unfortunately the day basically got worse after getting us up for a wash etc. semi weight bearing from the get go, which certainly surprised me for some reason I thought you started off non weight bearing. Didn’t go well, blood pressure plummetted and my whole body suffered centralised Sensitization from the Fibromyalgia. I honestly couldn’t decide what was worse my body pain or knee pain. I was in a sorry state and the staff thought there was no way I’d be getting home today. Lots of tears and feeling desperate. But once my BP sorted itself out I got up again and that was slightly easier and each time I moved my other pains started to settle. Didn’t really find any of the analgesia really had a good effect and getting up did help once the nausea settled .


I guess it’s only day one and there’s a long road to recovery,but couldn’t have had a much worse start. Great news is I made it home to my husband’s care and I’m hoping my recovery starts now. Thanks for your comments, I think I’m going to need a lot of hand holding.
 
I don’t usually have blood pressure issues, but mine went low right after surgery too, and other members have said the same, so I think it’s not uncommon.

Glad you’re back home, there’s no place like home! :flwrysmile:
 
Hi @beralc
Welcome home!

The most common protocol after a knee replacement seems to be "weight bearing as tolerated." The rational is that the implant "settles" into place best while under load.

For most of us of course this is initially quite minimal/partial, relying on a walker or crutches (walker is very much my personal preference but it seems as if in the UK crutches are more in use).

I'm glad your fibro may be already adjusting to the pain and inflammation of your knee. Do try to take pain meds on a schedule for a couple of weeks (it's helpful to keep notes on this).

Until your tummy settles, don't force heavy foods for a while. Warm liquids (broths, tea, etc) and just a little light food.

Once there's no nausea, you still might favor lighter fare for a week or two. Pretein is so important for healing so I'll ask @Layla to post her list of high protein snacks for you.
 
@Jockette Yes I believe it’s even more common after spinal anaesthesia too. I think I just reached the “what have I done” moment very quickly, but I’m hoping it was a series of things that all collided and were totally out of my control. Thank you.
 
Hi @beralc
Welcome home!

The most common protocol after a knee replacement seems to be "weight bearing as tolerated." The rational is that the implant "settles" into place best while under load.

For most of us of course this is initially quite minimal/partial, relying on a walker or crutches (walker is very much my personal preference but it seems as if in the UK crutches are more in use).

I'm glad your fibro may be already adjusting to the pain and inflammation of your knee. Do try to take pain meds on a schedule for a couple of weeks (it's helpful to keep notes on this).

Until your tummy settles, don't force heavy foods for a while. Warm liquids (broths, tea, etc) and just a little light food.

Once there's no nausea, you still might favor lighter fare for a week or two. Pretein is so important for healing so I'll ask @Layla to post her list of high protein snacks for you.
Excellent post and great info thanks. Yes I prefer the more stable base of the Walker especially when you’re taking strong medications and low on sleep. Fortunately I have been given a Walker and crutches to move on to when I feel able so that’s good,a raised toilet seat and bath board to sit on too so did very well.

The Fibro will take a while to settle but that is at least a condition I’m used to. Yes not wanting anything too much food wise. I’m actually very up on Protein and where to find it so all good there thanks. My husband and I both use an App and have high protein intake levels to reach,daily. I started this App before my left knee arthroscopy last September, so my body will have been benefiting from that for about 6 months now. Many thanks ☺️
 
Isn’t it amazing the difference 24hrs makes, as well as getting sleep and managing your own pain relief. I managed 9hrs sleep overnight!!! I was still wearing my glasses, lamp on and still holding my kindle when I woke this morning:heehee:
I’ve got my pills all set up with alarms to remind me when to take them. Mentally feel a lot more positive. Best of all my pain is about a 3 whereas it hadn’t gone below a 7-9 yesterday. So I feel I’ll really be able to start my journey of gentle exercise.

It’s great being able to share the highs and lows on here. ❤️
 
I was still wearing my glasses, lamp on and still holding my kindle when I woke this morning:heehee:
You must have slept like a rock :heehee: That is amazing, you were out cold. :zzz:
Restorative rest like that though, is the best. Wishing you many more nights of sound sleep.
 
You are so right regarding how much 24hrs can make. I had my surgery 0n 12/12/24 and have been journaling everyday since. I have been amazed how much the body changes so quickly. Good days and bad days but I think more good to come. I still have difficulty at night sleeping. I only an able to get 3 hours here and there. I am glad you were finally able to sleep.
 
Thanks both. Overall a more positive than negative day. Stairs are my biggest challenge (also because my left knee, post Arthroscopy last Sept. isn’t that strong) and simply getting on and off the sofa.
One thing I’m mindful of is the correction to the alignment of my knee, l had valgus presentation prior to surgery and the outer aspect of my foot rolled over to the right. Did anyone have this? Did you find you had to consciously place your foot squarely on the floor when walking? My foot seems to want to stay in the rolled out position, will my brain/body eventually retain itself to walk normally or should I do exercises to correct it?
I’d be interested to read anyone’s thoughts on that.
 
Hi @beralc. Glad to read that you are seeing improvement! Getting up from the sofa (especially if it is low) and climbing stairs are challenging for everyone at this early stage of recovery. You are only a couple of days out!

Regarding your foot, I had a similar issue. My right foot splayed out to the side because of my varus knee. I had walked with it that way for years as my knee deteriorated. It worried me at the beginning, but it did resolve with time as all the soft tissues in my leg adapted to the new and improved body alignment.

My PT said there were no specific exercises for it; just to give it time and to focus on proper gait -- heel-to-toe walking -- once I was stable.
 
Hi @beralc. Glad to read that you are seeing improvement! Getting up from the sofa (especially if it is low) and climbing stairs are challenging for everyone at this early stage of recovery. You are only a couple of days out!

Regarding your foot, I had a similar issue. My right foot splayed out to the side because of my varus knee. I had walked with it that way for years as my knee deteriorated. It worried me at the beginning, but it did resolve with time as all the soft tissues in my leg adapted to the new and improved body alignment.

My PT said there were no specific exercises for it; just to give it time and to focus on proper gait -- heel-to-toe walking -- once I was stable.
Thank you. I think I’m coming to the realisation that if your brain/body can accommodate an altered gait and balanced things out, when the knee was diseased, it stands to reason that it can do it again, when things are put right. So as you say I’m just concentrating on making sure my foot is flat on the floor and mindful of my gait, once I’ve taken a step.

I feel you learn quite quickly, generally, what works and what doesn’t post surgery, so it’s about giving yourself time care and patience isn’t it.

I think I’m getting the pain pretty well managed,but could probably do with elevating and icing more routinely rather than ad hoc icing. I’m still feeling positive and definitely much less overwhelmed, than in the first day or so. I’m also very fortunate that I seem to sleep well, that could be because of some sleep training I adopted for myself a couple of years ago because of extremely poor sleep, so I think it’s paying off and that I’m just simply exhausted.


I have to say hats off to anyone who has both knees done at the same time and/or are recovering on their own. I have total respect for you as I don’t know what I’d do without my husband being here to help.

Thanks again.
 
I had something different called external rotation which my surgeon stated would be resolved with surgery and while it eventually corrected, it wasn't immediately post op, which I misunderstood thinking it would be. Naturally I questioned it at my first post op appointment and was reminded that it can take time, especially if it was longstanding pre op. Our soft tissues need to heal and our muscles strengthen, all needs to adjust to the prosthetic. In an effort to retrain my gait, I was advised to pay attention to how I placed my foot on the ground, without straining, forcing, or over correcting. It is a gradual process.
I think I’m coming to the realisation that if your brain/body can accommodate an altered gait and balanced things out, when the knee was diseased, it stands to reason that it can do it again, when things are put right
Makes sense and I agree!
Have a great rest of the day!
 
I’m just concentrating on making sure my foot is flat on the floor and mindful of my gait
That's wise. Remember that it takes at least 30 days to change a habit! You will get there with time.
:yes:
 
Thank you both for your insights. Haven’t had the best day today, didn’t sleep so well last night and wasn’t able to manage my pain quite so well during the day, don’t really know why, but it’s no more than I was expecting so I’m keeping to my routine. I’m learning something everyday and it’s very early days so I’m giving myself time. I’m known for my patience where others are concerned, not so much with myself, so I think I’m doing very well not rushing anything
 
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