TKR Tourniquet pain

Week 2

Finding I can easily walk for ten minutes. I use the cane but am not really placing weight on the cane. I do not want a limp, so the cane is there for stability and in case I step wrong, but the weight is being carried on the leg for the most part. I am making a conscious effort to walk heel to toe. The walking around often lessens the knee pain I get from being stationary too long. I am learning that if I wake up in pain, my first move is to get up and make a bathroom run whether I need it or not because the movement makes an immediate difference in my pain level. I am guessing it may mean less stiffness in the AM as well.

I am continuing to cut back on the Oxy during the day but have had a couple nights where I still need 5mg to get to sleep. I am not toughing it out---when I need them, I still take them. It is worth the good night’s sleep, even if it is only 4 hours.

Odd things I am noticing…

Having pains in new places, like every day and sometimes even every hour. Not necessarily excruciating pains, just pings and throbs coming out of nowhere. This seems to be ebbing as the week goes on. Fingers crossed that trend continues. As the week passed a lot of these pains have lessened. I find putting BOTH legs up also helps reduce the hip strain I have been feling. Towards the end of the week the pain was better, but I am noticing more swelling. I have been on my feet more and thinking maybe I need to ease off a bit.

Sometimes after I do my PT exercises, I get a series of electrical jolts on my skin surface around the knee joint. It’s likely the nerve tissue trying to come back. Feels like being zapped with one of those mosquito zapper badminton racquets that were popular a few years back. It makes you jump and is unpleasant. Usually goes away within a few minutes and tapping the spot or applying pressure helps it to cease, but a very odd sensation. This also seems to be lessening, though I still get a few zaps here and there.

Appetite still down – not complaining. I have lost 4 pounds since the surgery. It’s not that I am not eating, I am consuming the same calories I was gaining with prior to surgery but I read somewhere your metabolism boosts temporarily after surgery so you burn more calories.

At PT this week, I still have full extension and flexion is up to 108 in spite of the feeling of being stiffer and a bit more sore on the day it was measured. Pain has diminished during the day. Today I took 2.5 mg Oxycodone at 6:30 this morning and did not need any all day. I did take half a tablet before bedtime as that seems to be my worst time of day. Still, happy to be weaning off so quickly and easily. Tomorrow marks 2 weeks out!
 
Week 3

Noticing a substantial drop in the pain this week. Going all day with no Oxy (except for ½ a tablet on PT days) and have reduced the Oxy at night by a lot. Swelling is still there but the pain is far less. Knee gets warm but not hot. Slowly getting more comfortable to sleep though still cannot side sleep just yet.

Making small but steady gains in flexion. Got on the bike for oscillations the first time this week. I had two days in a row of PT due to a family emergency that left me without a ride on my usual day. Sore after the double days of PT, so I rested. Elevated. Iced. Next day swelling down and no pain. Actually feeling pretty good the past two days, even during and after the home PT exercises.

Fewer nerve zaps this week. The numbness seems to be lessening slightly.

Walking indoors without the cane. Still have it outdoors for stability on uneven surfaces. Bending definitely easier this week. Trying to consciously walk heel-to-toe.

Was able to prepare my own breakfasts and lunches this week and even made dinner one night. I do get tired somewhat quickly though. I also have some muscle fatigue in new places since I have not been doing much the past three weeks.
 
This sounds like a great report. You will become fatigued more easily, but that will correct itself as your recover. Be careful when your out, I find people don't rush around you as badly when you have a cane. Pre TKR I used to think badly about people with canes, now post multiple TKR I look at them as an odd badge of honor! Funny how one's perspective changes.

Be careful not to overdo.
 
@GZGirl22 it sounds like you are coming along very well!

At nearly 8 weeks I still struggle with reduced stamina. I just try to do a little more week by week. And I still use my cane or walking poles outdoors, for safety and to signal to people to steer clear of me.

Today will be my first postop trip to costco, and I will sit down and wait for my husband to come through the checkout lines if I get tired.
 
This sounds like a great report. You will become fatigued more easily, but that will correct itself as your recover. Be careful when your out, I find people don't rush around you as badly when you have a cane. Pre TKR I used to think badly about people with canes, now post multiple TKR I look at them as an odd badge of honor! Funny how one's perspective changes.

Be careful not to overdo.
Thanks for the cane tip. I don't mind having it with me and if it is a visible reminder to give me some space, I am all for it. :)
 
@GZGirl22 it sounds like you are coming along very well!

At nearly 8 weeks I still struggle with reduced stamina. I just try to do a little more week by week. And I still use my cane or walking poles outdoors, for safety and to signal to people to steer clear of me.

Today will be my first postop trip to costco, and I will sit down and wait for my husband to come through the checkout lines if I get tired.
Thanks Jo. I was lucky that I had a cortizone shot that was still working in the months leading up to the op and I used that time to get the legs in the best possible shape for the surgery. Lots of stretching and LOTS of weighted leg lifts. I credit that to my great recovery, though I know that is not possible for everyone. In PT I have met a number of folks who wished they had done more Prehab work. And I expect I will be continuing the leg work for many long years. :) My whole body feels better because of it.
 
though I know that is not possible for everyone
Yes, unfortunately you are the exception @GZGirl22 . Many of our members have mobility issues due to pre-op pain and various degrees of damage to joints.
 
@GZGirl22 it sounds like you are coming along very well!

At nearly 8 weeks I still struggle with reduced stamina. I just try to do a little more week by week. And I still use my cane or walking poles outdoors, for safety and to signal to people to steer clear of me.

Today will be my first postop trip to costco, and I will sit down and wait for my husband to come through the checkout lines if I get tired.
Good to hear you ae coming around. My first time shopping with my wife, I took the shopping cart and found it was so easy to walk comfortably heel to toe. It was almost fun for the freedom,lol.
 
Week 4 - Feeling very fortunate

In PT they are adding new “activities”. Seeing some quad soreness as a result, but not really a lot of knee pain. I do get a bit stiff and sore the day after, but I am not really in a lot of pain while doing the exercises. Usually rest, elevation, and ice and I am fine in a day for the most part. I can do a 8 inch step walkover exercise now without doing “good up, bad down”. Not ready to do a flight of stairs yet. I will do 3 or 4 at a time if I can use both rails for support. On the bike and going all the way around for 10 minutes with some resistance and no problem.

Walking without a cane (unless going shopping or any distance outdoors). Am doing more of the cooking, cleaning, making beds, laundry, etc. in small doses. Gradually becoming less fatigued and having the leg down more and elevating less. Still icing several times a day. By the end of 4 weeks, I hope to be putting in 5000 steps daily. I plan to add 500 more each week until I am back to 10K daily.

On day one of this week, I went over 24 hours with no Oxy. This weekend, I went 72 hours without Oxy and it has not been a problem. Hoping to really limit it until I finish the Eliquis and can switch to an NSAID. Will try PT tomorrow with just Tylenol. First time with that.
 
Week 5

Sleeping is definitely improving. I can almost side sleep now, too. Stamina is improving slowly and I am doing about 5500 steps per day. It is odd, but the knee feels stiff even though my ROM is improving. I am doing more so maybe it is “stiff” for the activities I am doing, but still an improvement over before. Using only Tylenol for pain and not taking it on a schedule, mainly for PT sessions and TYL or TYL PM to get to sleep (if needed).

I am able to do many of my previous activities (still not vacuuming but I can touch up with the light stick vac). I have a one-month evaluation with OS this week. Incision looking good, very minimal bruising. Zingers are back this week. Not as bad as before.

PTs had been pushing strengthening and just put on too much weight. I told them that’s not how I want to do this (I was really sore and couldn’t do my at home exercises the day after PT) so they listened and cut the weights in half. Since then, I did the exercises at PT and am not seeing the soreness in the joint, swelling, and stiffness of earlier in the week. I know my body better than they do. I lift weights. I know a good strain of a heavier weight vs. that bad strain of overextending yourself and not being able to control it properly. Gotta look out for yourself. It is still work, but feels right.

Had my one-month evaluation this week. Still full extension and hit 126 degrees flexion today! Walking 5500 steps a day. As the weather cools I am hoping to take it outdoors more.
 
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.
 
Thanks Jockette!

My one month post op appt with OS was today. They are very happy with the progress. Got my car keys back and an OK to ease into my weightlifting, pilates, and other activities but to go with caution. Also were fine with bike, walking, and elliptical. My stamina is improving and I am not even using Tylenol at this point, so it's all good! :)
 
GZ, wonderful progress! You go, girl! Be aware there might be some days when you feel you are backsliding, but know that it is only temporary and you will take 3 steps forward for every step back!
 
Well I am about 7 weeks out now. I am going up stairs conventionally with no problem, coming down still "catches" but it is getting better. I am walking about 7000 steps a day. Am starting to feel like life is becoming normal. I can sleep on my side for an hour or so before it gets uncomfortable. Flexion is now over 125. I am continually grateful for the fact that my recovery has been uneventful and thankful to this forum for all the information and encouragement.
 
What a great post! You will be an encouragement to those coming up behind you.
 
The first thing i said after waking up from surgery was “Why the hell does my thigh hurt so bad?” The joint specialist at the hospital told me from the tourniquet. I was shocked.
after i was gone a day or two i called my surgeons office and told them my thigh pain was so much worse than the knee pain. I was told it would eventually go away and it has gotten about 85% better but it still aches to lean on my thigh with my arm if I’m sitting down. It’s been 5 weeks. My thigh muscle is just now starting to wake up as they say now to rebuild the muscle after 30+ years of no cartilage in my left knee and horrible arthritis. Bone on bone for that long takes a toll on you. I’m only 57 and had been suffering all that time. Ugh.
I am hoping i will be knee pain free eventually soon.
 
@GZGirl22
Reminder to keep you recovery posts in your recovery thread, allowing you a diary of your recovery.
Thank you,
Chris
 
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@jincoug08 I fully understand about bruise on Quad etc..
For a couple days it hurt to touch my Quad.
Work the Muscles before they fade away.
 

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