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TKR UPDATE: Still trying to recover! 10 weeks post op...

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Wow Theresa so sorry to hear you are suffering so. I hope they can come up with some type of pain treatment for you. NO ONE should ever have to suffer like that. I too am stunned that a doctor says you have the worst knee ever, then doesn't properly control your pain. Hummmpphhh mad for you!!! I am wondering if its becuz you took opiod pain meds prior to your TKR? I have been advised that I will have a tougher time with pain after my TKR becuz I already take percoset for chronic pain now. Keeping you in my prayers! Hugs!
 
Have you tried a heating pad for the muscles? No heat on the knee but it's ok away from the knee.
 
Nanners I was not really on much of an opiod prior to the surgery other than Lortab that had been given to me recently and I was taking very rarely like as in a couple times a week. I have a high tolerance for pain but this is bone pain. I cannot take NSAIDS which would be most helpful for this due to Gastric bypass. I have had 3 nerve blocks in the past 2 months (2 of them for my back and the 3rd post op for the knee) and none of them have been effective. I am not sure what i going on with that. However, today is a better day. Hubby and I have come up with a management of the pain that includes the percocet every 4 hours, ice, CPM and ankle pumps. This is helping! PLUS at 9 days out it should be getting better.

Kneeper I have done heat for the muscle spasms and it helps a bit. Thanks!
 
Theresa,
Given your experience with your medical team so far, they may not be willing to do this. But our Joint Center allows Valium for the spasms. On my last night in hospital, I was having spasms and pain and unable to sleep. The nurse brought Valium and said I was the last person in her group who had not had it yet. It helps you rest too. I left with a script for occasional use only and a warning from the doc that if I were too sedated, I could not exercise properly. I have used it once only at night when the spasms were again causing too much pain to sleep.

I've also wondered if a massage therapist could help alleviate pain in the hip and calves, away from the new joint of course. Best wishes. I pray that you will suffer less very soon.
Cheryl
 
I am VERY depressed and frustrated at this point. Everyone talks about how well their replacement went and mine is a horror story for me!

First of all my surgery which was projected for about 1 hour lasted 2 hours! Why? When my surgeon opened up my knee he got a BIG surprise! He said that he had no idea how I walked! My knee had totally collapsed.

Afterwards I received the nerve block which DID NOT WORK! My first memory was raw PAIN! Severe, excruciating to the point that I was hysterical! The only thing that I really remember about the hospital stay is PAIN! PAIN has been a huge issue for me for 5 LONG weeks! Cramping has also been present but since I started the outpatient PT it has increased. Literally to the point that it has drawn my foot down and my toes even further. I am on my 4th muscle relaxant since surgery. I rocked the home PT but the outpatient PT is a different story.

I have been riding my stationary bike up to 3 miles a day. I called the case manager at rehab yesterday and she told me to skip PT that day and to do moist heat followed with ice and rest and to stay off of my bike. This is so discouraging. I am SICK of pain meds and muscle relaxants. PT said that I could do some gentle stretching of the leg but nothing strenuous. She said that I have been to rough with myself as far as PT and that I need to be nicer to me. LOL. Yeah, I admit that I PUSH with anything that I do. But I have always rocked any surgery that I have ever had!

However, this has sidelined me and I am frustrated, discouraged and at my wit's end. They told me on my 2 week follow up visit that my other knee was a grade 4 and ready for surgery as well but that it was up to me. I can say that I am no where near appreciating this surgery and can promise any one who asks that the other knee will be there a while with NO surgery! This has been the worst experience of my life. It's not like I wanted to wait 20 years after I was told that I needed knee replacement! No one wanted to do it! All the other doctors said that I was too young!

Yes.....I am very discouraged and just want this all to end! Anyone have any encouragement or words of advice? I am open to all!
 
It all sounds pretty normal at that stage. At 5 weeks or so I was convinced the surgeon had made a mistake and something was very wrong.
Is your pain controlled now? You need to get that sorted out. Be kind to yourself, ice, elevate and stretch. I too thought I could skoosh through the exercises and make a miraculous recovery but I soon learned differently! It takes a lot of patience, a lot of resting with a little exercise. It will get better in its own time and you just have to hang in here. This recovery can take up to a year, it's a long road and you are just setting out. You WILL get there but you need to sort out pain issues.
 
Theresa, I had a flashback when reading your post to my own posts with my first tkr. I am an athlete--have always healed fast and powered through everything. I tried to do that with my tkr--like you are now and it was a disaster.

First things first---I also pushed and pushed my knee. I just had surgery to remove scar tissue that developed on that knee at least partially because I pushed my inflamed knee so hard. I am being tough on you, but really, you are not doing yourself any favors here. If you knee is swollen , it is inflamed. Over exercsing an inflamed knee can cause adhesions to form. so-----it is your choice right here and now.

Because of my frustration, I lashed out at everyone---I put plenty of self pitying posts on this board. Woe is me, I hurt and I hate my knee, yada, yada, yada. It did not help.

Here is what helped!!! I decided for the first time to take good care of myself. After all, one of the reasons I had knee surgery was my constant pushing of myself to be first, the best, the fastest. I changed. I decided to respect my knee and to give it the time to heal. I decided that I could put the time to good use too. I watched the complete works of Jane Austen on DVD. I discovered Masterpiece Theater and Downton Abbey. I read a ton of books and I took some knitting classes and met lots of new women friends. Life is to be lived---so find a way to live life with a knee that needs some rest and ice and elevation. Take care of your knee now so that you don't have to do it later--like me.

Really too----at three months---12 weeks, you are half way there, it was a miracle and my leg felt so much better, I could do what I wanted to do. At five weeks----30 minutes is too long on that bike. Ride for 15 mine, take a break, ice your knee and then go on a gentle walk for the other 15 min. take the time to look at flowers and birds in your neighborhood.

I ate a lot of lunches with friends--and then I would go home and rest. At 5 weeks with my second knee (I had it done a year later) I was lying down probably 40% of the time. resting, icing, knitting, watching dvds. Guess what--that knee does not bother me at all!!!

This is a long recovery---even if you were an olympian. You cannot rush this and you will need to find some kind of acceptance so that you can enjoy life again instead of being unhappy. I feel for you--I have been there and I know that you are just as smart as I am and will figure it out too.


I have some reading for you!
The first set is essential reading, the second is useful and the third just good information but you will need it all
The importance of managing pain after a TKR and the pain chart
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
 
Theresa, please forgive me if this seems critical, but I really am trying to help.

You need to liaise with the medical people to get the correct pain medication. At five weeks you've only just started and without the correct, appropriate medication you will be in pain.

Riding your bike three miles? No, please please stop. I am a very keen cyclist, yet barely touched my bike for two months, and even then was sitting on it for a few moments, just to rotate the pedals and get the knee stretch. You should not be doing exercise at the moment, your knee is damaged needing recovery, it is not unfit needing training.

Here is the mantra:

- If it hurts, don't do it.
- If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it.
- If you won't die if it's not done, don't do it.
- Don't stand if you can sit; don't sit if you can lie down

You said it yourself:
PT said that I could do some gentle stretching of the leg but nothing strenuous. She said that I have been to rough with myself as far as PT and that I need to be nicer to me. LOL. Yeah, I admit that I PUSH with anything that I do
Click to expand...
Please, don't push any more. In this case the PT is correct. By pushing a damaged knee you compound the damage and put yourself back.

Now. Have some choccy. Watch the telly. Have some more choccy. Don't get up. See? Easy innit.

Don't forget that ice and elevation as well, it works to reduce swelling and therefore pain.

Good luck and all the best
 
We've followed Ski Girl through all she has described, and she's certainly the one to understand where you are at. Listen to her. You have to change your approach. I'm 12 weeks and only do 10 minutes on that bike, mostly at a level 1. It's not about heroics at this point. I'm so sorry you are in such pain. There may be reasons for it that are beyond your control, but you need to retreat and give it over to the knee and time. I had a hand injury that took six months to be able to make a fist. It took 1 1/2 years to get completely past arthroscopic knee surgery. You can't speed it up, but you can slow it down. Give it a try. Stop everything, make yourself comfy someplace, and elevate and ice for a few days! See what happens!
 
Welcome to Bonesmart, great advice in the earlier posts. Just wanted to add my femoral block did not work either. O BOY, was that painful when I woke up screaming:gaah: . The very surprised nurse got something going asap, WHEW! You have my sympathy that you had to go through that. The positive part was I had a quad that worked that same day.:tada:
Be sure you have better pain control, if your OS won't give you what you need, call or see you GP for pain medications.
Rest, Ice, Elevation, and Medication are your knees best friends right now. Give yourself time to heal, then you can start active rehabilitation.
Take good care, and read all the posts that Skigirl gave you,
 
I add an "amen" to what's already been said. I was in horrible pain, too, and felt like it never was really controlled. That was my own fault for not speaking up. When my OS started giving me grief about the pain med, I called on my GP who took care of it for me.

In your case, your overworking of your knee sounds like you're pushing yourself to prove something maybe? In my case I had brutal PT, but it was b/c of my OS and the therapists. They kept pushing and trying to bend my poor, swollen, and traumatized knee. I believe they set back my recovery for quite a while.

Then I found bonesmart....tada!! It all clicked for me, and it sure made more sense than what the doctor was saying to me. So I've embraced their philosophy and started seeing improvements very quickly. I've still got a ways to go, but I've come a long way since the days of screaming and crying (literally) at PT.

I hope you'll read the great articles and really take to heart what everyone's saying here, b/c IT WORKS!!!

Best of luck to you!
 
Hi Theresa,

I am so sorry to hear about your experience with TKR. It sounds like a nightmare, from the very beginning. I can only imagine how frustrated you are at this point. It's like you kicked a bees nest!

So, what next? I think you need to focus on the things that need immediate attention. Pain management, either through your OS or regular physician, but you need to get things under control. I hear you loud and clear about wanting to be off meds, but until your system gets working better, you won't get well, and it just drags out.

You need to reset your expectations. This surgery is like no other, and you cannot and should not compare this to anything else you have experienced. I know you are young, so am I, and in fact, I think that actually works against us. Our minds tell us we should be able to bounce back quickly due to our age; it's just not so. I believe we have a harder time dealing with pain control. We have a harder time being patient. We need to get back to work sooner.the world thinks the same way we do, that our recovery should be quick. It won't be, that is reality.

Forget about your other knee. It will be waiting for its turn, whenever that may be. Table that subject indefinitely.

Then slow down. Deep breathe, dig in. This is a process, to heal from a very major surgery. My surgery took much longer than anticipated as well, OS said my knee was a wreck, said he didn't know how I was getting around on it. You cannot rock this, you have to work through it. Less is more with rehab. Slow, gentle stretching. Control the swelling with ice, which will take weeks and weeks. keep a journal and write down each day how you feel, what happened, what changed. Slowly you will see progress, but day to day it's impossible to see any real change.

You can't and don't control this. It's physiology and it is unique. Some people have great results and get back in the swing of things very quick. For some of us, it is a glacial pace.

If you read my thread, you'll see that I had LTKR a year ago. Had an MUA at 3 months post op, and still could not get extension, at 15-20 degrees from straight, with pain and quad issues. I recently had a revision, which involved opening the original TKR scar, taking out the spacer, remove all the scar tissue and doing a posterior capsular release, put in a new spacer and sew me back up. The surgery was supposed to be 2 hours. It was 2 1/2, and the OS said the scar tissue had actually calcified. Pretty much my worst case scenario. The surgery was 2 weeks ago. The first 3 days were awful, lots of pain, so much bruising all around the knee. And after that, things got better. I finally had solved the problem that was specific to me. It took me a year. And it's not over, I still have lots of work to do to keep the extension that came from this surgery.

So, start thinking marathon. Think long term. Start thinking process. And don't compare your progress to anyone else. It will drive you crazy. You are unique. You will get well over time. But it does take time.

Please listen to what the others have said. Ski girl has a story similar to yours, she is wise. Come here and let your frustrations loose. We all know what it's like. We will support you.

Take care and I will look forward to your updates.

Be well,

Dawn
 
Gee, guess what? I have nothing to add to these excellent posts! You wanted advice and encouragement - you got it here in spades! Heed and apply and you will find everything calms down.

btw, my surgeon promised me faithfully that I would totally HATE him by week 2 and probably until week 6 - he wasn't far wrong! He also promised that I would be totally convinced this had been the WRONG decision and whatever had I done to myself. He was right on that too. That's why he doesn't see his patients until at least 10 weeks out! Sensible chap!
 
WOW!!! You all are so supportive! SkiGirl your information is right on! I have to keep reminding myself that it takes time and let nature take it's course. I hope that I have not caused damage with the pushing my exercise routine. I have practically lived with it elevated and with ice on it all day. This just is not the course that I had planned but it is the one that was dealt to me. Thanks so much for everyone's support and personal stories. It helps to k now that I am not the only ones with these struggles. Pain management has been tough for me due to allergies. I don't want to feel like a 'seeker' calling the doctor so much for refills on the medications. They only dispense a 10 day supply at thee time so it seems that I am endlessly calling for refills. This healing process is very very tiring. Again thank you to everyone!
 
It's just a regulation, that's all and has nothing to do with you seeking. It's not your fault if the authorities are stupid enough to require things to be this way. Don't let that protocol guilt you into thinking like that.
 
Also, some drugs like Tramadol, I simply called my GP and she dispensed 100 tablets to me. Some docs are hard and some are easy. My own doc told me at three weeks, that my pain was gone. I laughed and asked him if that worked with his patients? I got him to give me a script for 50 instead of 25 because I was paying my co pay for each of those little drips and dregs!! K
 
The biggest problem with the 10 day scripts is that I live 3 hours away. Therefore they must mail my prescriptions to me which takes 3 days to get here. Totally aggravating. I have a pain management doctor and I called his office. They said that the pain that I am suffering is from the surgery and that the surgeon must be the one to treat it! IT gets more frustrating. My GP is 8 1/2 months pregnant. She has a scheduled C section in 10 days! I will be relying on the person who is covering for her in which I have NO rapport with! I think that I will give her office a call tomorrow and see if she can do anything to help me. I cannot take NSAIDS due to gastric bypass. I am on Percocet, skelaxin and that's it. I am reading and have done more elevation and getting the foot up! HEY THAT WORKS.....pain is much less. Thanks SkiGirl!
 
By all means find another primary care physician as you know your doctor will be wrapped up with (a) childbirth and (b) a baby. Doctors here cannot give refills on narcotics. So they need to have a rapport with you as well and work with you in order for them to feel OK writing new Rx for pain meds. Many of us on this forum ended up having doing pain management via our PCP.

And, I second everything everyone else said even without reading them because we are all bonded around the concept of gentle PT, and for a reason: we all learned the hard way the pushy stuff doesn't work with injured muscles (injured from surgery). PT is meant to build fitness. The PT has to start slow and build only as the tissues heal which really is in the 8-12 week area.

I bet once you get started going easy on your knee, you won't need muscle relaxants, and you'll need less pain med. So going easy will solve several problems at once.
 
Sorry it's been such a rough time. We all empathize and wish the best for you to have a smoother recovery. :console2:
 
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