TKR Two years out from October 2023 TKR

[Dmcfad2]

PT went well this morning. I really like my therapist. She believes less is more. She gave me a nice leg massage, moving from the ankle up to the knee. It felt so good. She told me not to do anything that hurts. She did give me some exercises for me to try if I feel like it. My bend is pretty much non-existent at this time, but she said not to be concerned. She had me just sit on her table and dangle my legs for a second. She believes you shouldn’t do anything that hurts. Just like Bonesmart preaches. I will be working with her here at my home for at least 4 weeks, maybe more.
Last night I got very stiff and swollen. Quite painful. I’m better today.
At this time, I cannot lift my leg by myself. I need my husband or a leg lifter to help me. I’m looking forward to when I can do it by myself.

 

[Layla]

Wonderful news! Seems like you hit the jackpot with the therapist. How great to have someone that isn't pressuring you with unrealistic ROM timelines, painfully manipulating your leg, telling you no pain, no gain etc.
You have her for four weeks and she gives massages too. Lucky you…She's a keeper!
Glad you're feeling better today after a painful evening yesterday.
@Dmcfad2

 

[Dmcfad2]

Day 5 post op. Had a good nights sleep. I haven’t had any trouble sleeping. I am on the couch and sleep propped up on my back with my calf on a pillow for elevation and the Polar Ice Machine set for 20 minutes on, 20 minutes off all night. My husband changes out the frozen ice bottles about 3 am and it feels so good. I have been so lucky in the sleep area!
My knee is always stiff and swollen when I wake up. I do foot pumps to help loosen it up. I can tell that things are improving today. I have less pain and more movement. i have been taking oxy 10 mg every 4 hours. My surgeon gave me a refill yesterday and said he hopes I will be able to start tapering off the dose within this next week. For my 4 am med last night, I went down to one 5 mg oxy and one tylenol 500mg and that seemed to work just fine, although I can tell I’m due for another dose at 8:00 am. Starting to feel a little achy and sore.
So far this recovery has been about what I expected. Pain is worse at night, but I anticipate it getting better every day now. I am looking forward to getting more movement as time goes on. I have a long way to go, but I feel very positive!

 

[sistersinhim]

You are so blessed with your ability to sleep well in your early recovery. How unusual this is!

 

[Dmcfad2]

So, this morning after getting dressed, I lay in bed and did some gentle stretching exercises that my PT told me I could do when I felt ready. I did 3 quad sets, 3 calf stretches, 3 hamstring stretches, 10 glute squeezes and 5 heel slides. Pretty gentle stuff and pretty easy except for the heel slides. Doing the slides, i went to the point of discomfort, held for 5 seconds and then released. I did that 5 times. None of the exercises felt painful. That was about two hours ago and I am having some very achy feelings in my knee now. I am assuming it is because of the exercises. Do you think I should do them if it causes aching afterwards? I want to improve, but don’t want to overdo it, either. I’m just sitting here icing and elevating, waiting until I can take my pain meds again! 20 more minutes. LOL I will say that it isn’t unbearable pain, just achiness.

 

[benne68]

None of the exercises felt painful. That was about two hours ago and I am having some very achy feelings in my knee now. I am assuming it is because of the exercises. Do you think I should do them if it causes aching afterwards? I want to improve, but don’t want to overdo it, either.

I think your knee is telling you that you did too much and that it is not ready for all that exercise so soon post-op.

Just an FYI: my surgeon told me NOT to exercise for the first two weeks post-op, other than to get up and walk a bit every couple of hours for circulation. He said that it was more important to get the inflammation down and that there would be plenty of time for exercise later.

You are only a few days into recovery. Give it time.

 

[Jockette]

That was about two hours ago and I am having some very achy feelings in my knee now. I am assuming it is because of the exercises. Do you think I should do them if it causes aching afterwards? I want to improve, but don’t want to overdo it, either.

Just an FYI: my surgeon told me NOT to exercise for the first two weeks post-op, other than to get up and walk a bit every couple of hours for circulation. He said that it was more important to get the inflammation down and that there would be plenty of time for exercise later.

You are only a few days into recovery. Give it time.

I agree with benne68. Just moving about the house doing necessary daily activities will give your new knee all the healing mobility it needs.

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.

 

[Dmcfad2]

Thank you!
@benne68 @Jockette

 

[mendogal]

I agree that doing all of that on any day is way too much!!!!! (Heck, its too much at 8 weeks out)
I agree with the philosophy here that walking plus slowly adding daily activities of life is the most prudent, knee friendly way to rehab.
If you do choose to do one exercise, my suggestion is quad sets because they start to activate the quads, which helps with walking and ADLs.
However three sets is way too much. We aren't athletes in training! As my surgeon said, in the early days, "less is better!"
When you're relaxing in the recliner or on the sofa, do a half dozen. A couple of hours later, if things haven't flared up, do another half dozen... etc. They shouldn't hurt nor add to your swelling; if they do, back off.

 

[Dmcfad2]

Post op day 6.

Last night was pretty bad. Two days ago, I asked for a refill on my pain meds. I am taking 10 mg Oxy every 4 hours. I got a reply from my surgeons PA saying she had sent in a refill but that she would like me to think about tapering off the narcotics over the next week. The refill was for
( 42 ) 5 mg pills. When I take 2 every 4 hours, they last me 3.5 days. That isn’t very long. So, I decided to go to 1 pill at night while I am sleeping and supplement each pill with a Tylenol 500 mg to make them last longer. Oh, my! I was in so much pain during the night and this morning. It brought me to tears. I am so concerned about tapering off this soon, but she has made me feel like some kind of drug seeker! Why would she tell me that when I am still fresh from surgery? My husband is upset because this is causing me undo stress. I just want to worry about getting better and now I’m stressing about pain medication. Plus, I started PT which only ramps up the pain. I guess I am just venting here. I plan on going back to 2 pills before my PT this morning, and I am in so much pain right now that I can’t wait to take them at 8 am! I know we aren’t supposed to chase the pain. Should I call the office and ask her to call me so I can tell her my concerns? Any advice?

 

[Layla]

I'm so sorry. It is sad how quickly they try to wean people off medications they'll never abuse, but only need temporarily to get beyond the normal healing pain of a major surgery. It can't hurt to call your OS's office and be honest with them about your level of pain and concern about how quickly you may use up your prescription.
If you don't get any satisfaction out of that communication, maybe a call to your PCP?
@Dmcfad2

 

[Layla]

Probably a dumb question, but are you icing as much as you're able to tolerate? I did it almost constantly for the first several weeks and found it helped immensely.

 

[Mutti3]

You are 6 days post op, your OS should’t even be thinking of you tapering off Oxy. I started tapering at week 3 because the pain was decreasing. Call your OS office. It is cruel to deny legitimate pain management. Hopefully your OS will listen.

 

[Jockette]

Plus, I started PT which only ramps up the pain.

Stop doing the PT. You can start back up with it after your pain settles down. PT that makes you feel this bad is not helping you heal.

I plan on going back to 2 pills before my PT this morning,

It is not a good idea to take pain medication before PT, so you can do the PT, because it will mask pain that will tell you that you’ve done more PT than you knee is ready for. Then, when the medicine wears off, you are in much worse pain.

 

[sistersinhim]

I started PT which only ramps up the pain.

PT should not increase your pain. If it does, then it's the wrong PT. It won't hurt you to stop it for at least a month. Walking around your house is all the PT you need. This is natural PT that will rehab your knee just fine.

I plan on going back to 2 pills before my PT this morning

Never take pain pills before PT. That just masks your pain allowing you to do much more than your knee is ready for you to do. Your pain at night is telling you this. Nighttime pain is an indication that you are doing too much during the day. Cut way back until your pain gets under control.

Should I call the office and ask her to call me so I can tell her my concerns? Any advice?

Many times a primary care doctor will prescribe pain meds when the OS won't. One of the best pain relievers is plain ole ice. You should be applying ice packs the whole time you are sitting or lying down. I had two ice machines, one for my den and one for the bedroom. Since I was back and forth from my recliner to my bed for the first month or so, I had ice ready for me wherever I had to sleep. I kept it on all night and all day. As long as you have a cloth between your knee and the ice source, you can ice continuously.

 

[mendogal]

100% agree with @Jockette .... put off PT, do your short walks and in between ice and elevate!

 

[Dmcfad2]

I ice and elevate constantly. I have an ice machine that cycles every 20 minutes on and off round the clock. I elevate as much as I can. Sometimes it hurts to elevate and makes my knee ache. But, I try to do it every hour for 20 minutes.
I know some here have recommended no PT right now, and I appreciate the advice, but my therapist is very gentle. I had a good PT session today. My therapist is the best. She listens and doesn’t hurt me. Plus, she gives me the best knee massages. I got to 60° flexion today and 0° extension. I know not to focus on that, but it still made me happy.
I am laying here icing and elevating right now. I’m feeling a bit better and plan on not doing much else today. I will be talking to my surgeons office about staying on my medication for another week to 10 days and then weaning off. My therapist said that two weeks of narcotic pain medication is quite common and recommended I talk to my surgeon directly if they won’t refill next time. Otherwise, I may contact my PCP. Thanks for all the support!

 

[Layla]

It is good to read you're icing and I trust you know whether your therapist is an asset to your recovery since this isn't your first rodeo. At only six days post op, there's going to be pain to varying degrees and it seems you're doing all you can to remain comfortably mobile. A peaceful evening to you!
@Dmcfad2

 

[Dmcfad2]

Post op Day 7
I had another of what are coming to be known as my “middle of the night” breakdowns. I do so well all day, but as soon as my lights go out around 11pm, something happens. I take my before bed meds (I went back to the Oxy10 mg, thinking it would be better), drift off to sleep only to awaken about 2 am needing to use the bathroom, stiff, sore and in pain. My husband helps me get up, but by the time I shuffle in to the bathroom with my walker, I am in tears. Then, once I make it back to the couch, I have a mini breakdown that lasts about 10 minutes before it subsides and I get the ice machine wrapped around my knee, settle back, say a prayer and finally sleep again. Boy, what a roller coaster. So much more difficult than both my hips. I know it will get better, but I just don‘t see the light at the end of the tunnel quite yet. My poor husband. He has been a saint through all of this. I know he feels helpless when I’m crying. He just pats me on the back and tells me it will get better. He is my rock. We have been married for 51 years. In fact, my surgery was on our 51st anniversary!
So, it’s a beautiful morning here in Oceanside. I’m having coffee and feeling human again. I’ve put on my “positive thinking” hat and I’m ready for a new day.

 

[Layla]

Aww, I'm so sorry. Thankfully you seem to have a loving caregiver in your husband. Fifty One years of marriage...you're blessed!

We do often read that TKR's can be a more difficult recovery than THR's. While that's very cold comfort, know that the struggle is real / normal, but temporary as it will get better given more time. At only one week post op, you're in those very early days of the healing process. Thankfully with a few tears, lots of ice and some prayer, you're able to drift off again.

Enjoy the beautiful morning in your neck of the woods! It is gray, soggy, rainy here so I'm a smidge envious of your lovely morning with coffee, but just as the sun will shine here again, mobility without pain will soon be restored for you.
Chin up, brighter days are on the way!
@Dmcfad2