TKR Unexpected Aftermath

Nrecovery

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On May 10 after a lengthy time of denial and avoidance I finally submitted to total knee replacement of my right knee. Although I had been briefed beforehand as to pain and difficulty in post Op I was unprepared for to get reality that has unfolded.
Although I am told by Rehab therapists that I am progressing well ( successfully drove after 2 weeks) I live alone and find the hours of solitude combined with pain to be contributing to a depressed and negative outlook.
I sometimes feel as though normality ( walking) will never return and that quality of life will be substantially affected.
At this point I am a concerned as to the mental effects as I am to the physical ones. I know my time frames is skewed and that overall ( comparatively speaking) I am ahead of the game but depression is making it's presence very known.
 

Jockette

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Hi and Welcome!

Depression is very common in this recovery, we even have an article about it in our Library:

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!)​

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.
 

ski_bum

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On May 10 after a lengthy time of denial and avoidance I finally submitted to total knee replacement of my right knee. Although I had been briefed beforehand as to pain and difficulty in post Op I was unprepared for to get reality that has unfolded.
Although I am told by Rehab therapists that I am progressing well ( successfully drove after 2 weeks) I live alone and find the hours of solitude combined with pain to be contributing to a depressed and negative outlook.
I sometimes feel as though normality ( walking) will never return and that quality of life will be substantially affected.
At this point I am a concerned as to the mental effects as I am to the physical ones. I know my time frames is skewed and that overall ( comparatively speaking) I am ahead of the game but depression is making it's presence very known.
Unlike most you were informed about Post Op. I understand, but I have a caring helping wife. Good luck with your recovery.
 

Roy Gardiner

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I sometimes feel as though normality ( walking) will never return and that quality of life will be substantially affected.
Yes it will. And yes your life will be substantially affected - for the better. Time will tell, try just to relax and let healing happen. Watch telly etc.
 
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Nrecovery

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Although this is my first day and experience with this post, I have realized a very important fact. Those who live alone are faced with a unique set of challenges.
The main one is that of isolated time to think. That can be both a blessing and a curse.
Reading here has opened my eyes that this is not just an 'isolated' experience but a communal one. It has helped to realign my 'time perception' in that at 1 month post op I am able navigate my home, cook, drive attend rehab on my own. However my nights and mornings are dominated by pain and I am still several weeks away from returning to work. Perhaps I need to reframe my experience in the glass "half full" interpretation.
 

Layla

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Welcome to recovery and congrats on your new knee. I’m sorry you’re struggling with depression. Please understand that it will pass and you’re certainly not alone. Following is a link to a thread that may bring you comfort, some ideas or simply a feeling of camaraderie with others that have felt the same. Chin up….Brighter days are on the way! :SUNsmile:
https://bonesmart.org/forum/threads/depression-post-op-blues-open-for-all.34457/
@Nrecovery
 

Jockette

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at 1 month post op I am able navigate my home, cook, drive attend rehab on my own. However my nights and mornings are dominated by pain and I am still several weeks away from returning to work.
You are doing very well for only one month post op. However, the extra pain at night might be due to being too active. Since you live alone, the daily activities are important, so maybe cut back on any exercises you are doing. (By the way, what are those exercises?)

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.
 
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Nrecovery

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Thanks to all for the encouraging words and thoughts. Another reason ( I surmise)for the night/morning pain is that I am weaning myself from the arsenal of medications I took for the first month post surgery. I have drastically reduced the more powerful ones.
I am mindful to not ( overdo) exercise which is my bent but apply necessary movement procedures to facilitate maximum healing.
I was blessed to have found a superb Surgical team followed by a dedicated and skillful Rehab Therapy staff.
I get very positive feedback as to my progress.
One thing I have gleaned from a month of being homebound is that although having access to countless TV sources that about 97% on television is pure garbage ( in my opinion) Music/ reading are a far better source of escape and improvement.
 
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Nrecovery

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To answer the "What are those exercises? question.They are all prescribed by my Therapists at Physical Therapy Rehab. I regulate them between challenge and pushing beyond.
 

Jockette

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One thing I have gleaned from a month of being homebound is that although having access to countless TV sources that about 97% on television is pure garbage ( in my opinion) Music/ reading are a far better source of escape and improvement.
I agree!

Another reason ( I surmise)for the night/morning pain is that I am weaning myself from the arsenal of medications I took for the first month post surgery. I have drastically reduced the more powerful ones.
If you can take Tylenol, you might consider that.

The most effective way to take Tylenol is 2 x 500 mg tablets every 6 hours, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular Tylenol doses, so you stay within that safe 24 hour limit of 4,000 mg.

I’m glad you have faith in your PTs, but just be aware that they are not all created equal, and some give us more to do than our healing knee is ready for, which can increase our pain.
 

benne68

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Perhaps I need to reframe my experience in the glass "half full" interpretation.
Yes! One thing that helped me a great deal was documenting my "achievements." One a week, I would make a list of all the things (even the little ones) that I was able to do, along with a list of the things I was looking forward to being able to do. As items moved from one list to the other, I saw real progress and it helped me keep that glass-half-full perspective!
 
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Nrecovery

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Your input is greatly appreciated. I am on the beginning laps of the Rehab process and am quite 'green' in experiential knowledge. I am.influenced ( from the past) to the "no pain,no gain" philosophy.
Reading comments on this post suggest a closer look to post op activity.
Although my regiments are strenuous and challenging, I am in fact gaining increased motion and strength. Based on posts of yours and others I will take a much closer look at my reaction and progress.
Thank you.
 

Jockette

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kneeper

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My PT told me if after exercises the pain stayed elevated for an hour or more, that I had done too much and do a bit less next time.
Are you taking some time to rest during the day? I found I was at my most frustrated about mid-afternoon and my mindset improved after a lie down.

Also, perhaps you have friends or family who could give you a brief call periodically. I had some who would call just to check in for a short chat and I found that really helped when recovering alone.
 

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I listened to music too. TV was lame- the only show I could tolerate in the background was “building off the grid” not sure why by the the far off locations seemed appealing. Sitting outside for a few minutes everyday really helped me as well. Getting some sunshine on your face always help boost endorphins.
 

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Music/ reading are a far better source of escape and improvement.
You are one of the lucky ones who can concentrate on reading in these early days. Many of us had plans and a reading list but we could not focus on reading. I agree, it's a much better route than rubbish telly!
 

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I kept reading the same paragraph over and over the first few weeks. I just gave up and vegged in front of the TV, but have no idea what I was watching!
 

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I understand the feeling of isolation, my girlfriend broke up with me (5 year relationship) shortly before my surgery, so I'm alone in a big house. Hang in there, it's sometimes tough, a lot of people here are pulling for you, and have great advice.
 

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