TKR Update

[Layla]

Best Wishes for surgery tomorrow! Let us know how you're doing when you're feeling up to it.
We'll be here for support if you need it.
@DOCCUKE

 

[DOCCUKE]

Thanks. I will be staying over tomorrow night & if all goes well home the next day.
I will update the site after I get home. Not gonna lie a bit anxious. This knee is definitely done. Been collapsing allot half a step from a wheelchair. Not sure if it is worse or better that I know how much pain is coming. But I am all in now!!
Thanks DOC

 

[Jockette]

Not sure if it is worse or better that I know how much pain is coming. But I am all in now!!

Hopefully this time things will go much better! Best Wishes!

 

[Layla]

You're welcome!
We certainly understand feeling anxious. Think of the improved mobility you'll have with two new knees. Gone will be the chronic pain, fear of your leg collapsing or needing to use a wheelchair. It's a new opportunity for an improved quality of life. Considering everything you learned from your first TKR, once you're back healing in the comfort of your home I'm betting you'll do very well. Cheers!
@DOCCUKE

 

[DOCCUKE]

Thanks. I will be staying over tomorrow night & if all goes well home the next day.
I will update the site after I get home. Not gonna lie a bit anxious. This knee is definitely done. Been collapsing allot half a step from a wheelchair. Not sure if it is worse or better that I know how much pain is coming. But I am all in now!!
Thanks DOC

I am in pre-op now going in shortly

 

[benne68]

See you on the healing side!

 

[DOCCUKE]

Ok dummy question how long should use the ice cuff? On for an hour. Then off?I screwed up fell asleep and while sleeping pulled the power out. Mommy knee is warm hope I did not damage anything back on with the ice cuffnow

 

[DOCCUKE]

Also my upper thigh area is really sore dontvremember if that is normal hurts to just touch it.

 

[Jockette]

Many members ice as long as they want to, as long as there is a cloth between your skin and the cold source.

Your surgeon probably used a tourniquet on your thigh, thus the pain.

 

[Layla]

Welcome to recovery, DOCCUKE! Good to hear from you.

how long should use the ice cuff

Icing for up to twenty minutes only is what most of us have heard or been advised to do following an injury. Following joint replacement, ice is a critical part of pain management and should be used not only on the joint, but any surrounding areas of discomfort for as often and as long as you're comfortable doing so, always placing fabric between your skin and the ice source. Icing helps bring relief from the soft tissue trauma and internal swelling. Icing is a great natural pain reliever and best of all, it's free. While some care providers do put a maximum time on icing, others suggest you ice as often as you see fit.

Also my upper thigh area is really sore

Hmm, I wonder why? in addition to a tourniquet, it's connected to the recently traumatized knee.

Remember the song we sang as kids -
Ankle bone connected to the leg bone
Leg bone connected to the knee bone
Knee bone connected to the thigh bone

You know drill, meds on schedule, ice and elevation to help with inflammation, rest and gentle movement as strained muscles and irritated nerves begin to heal and adjust to the prosthetic and post op activity.
You're on your way! I hope you sleep well tonight.

 

[Jockette]

And here’s a refresher course for you:

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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

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

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[ouchie!]

Hope all went well. Interesting about the BMI thingy as I’m in the UK and my local health trust wouldn’t do my surgery as my BMI was 40 and it would have been free. However after many years of pain I decided to raise the money to go private and I just managed to pass their 40 BMI limit, but after the stress of the surgery and sorting my husband out who has dementia, I lost a stone in weight! Now my BMI is 38. Every cloud has a silver lining………take care.

 

[DOCCUKE]

Thanks. I will be staying over tomorrow night & if all goes well home the next day.
I will update the site after I get home. Not gonna lie a bit anxious. This knee is definitely done. Been collapsing allot half a step from a wheelchair. Not sure if it is worse or better that I know how much pain eis coming. But I am all in now!!
Thanks DOC

Well so far it is getting more painful everyday. I feel like I am going to lose my dang mind. Pt lady wanted me to do leg lifts that was about 2000 on a scale of 1 to 10 at the moment pretty discouraged and taking a month off no pay if I need more time then the as t it will send me into a financial spiral. Not so cheery todayhopecyou sare all well peace
DOC

 

[Jockette]

Pt lady wanted me to do leg lifts that was about 2000 on a scale of 1 to 10 at the moment pretty discouraged

Cancel the formal PT for a few weeks. This PT has you in training mode, and that is not appropriate for 2 days out of surgery. This will do much more harm than good. Right now you are in the very beginning stages of healing. PT can be helpful, but it has to be the correct PT, and this one isn’t it.

As @mendogal has said, her medial team was unanimous in beleiving less is more in the early weeks. There will be plenty of time to do more rehab later, after you have some time to heal.

Right now all you need are very gentle bends and short walks, like to and from the bathroom.

Seriously, you don’t need any exercises right now, just gentle movements to give the new knee some mobility. I don’t understand why some PTs don’t understand this.

 

[benne68]

Pt lady wanted me to do leg lifts

What? You are three days post-op!

My surgeon is another one who said that the first two weeks are for rest and recovery. He told me nothing but walking and some gentle bends until I was two weeks out. I have had two successful recoveries following those instructions.

Please don't let her push you into doing anything painful. Your poor leg needs time to heal.

 

[Layla]

Oh no, the pain you described sounds awful! This is the time you may want to consider listening to your body over a PT that cannot feel your pain. I'll join the chorus of "gentle bends" only for now. Your poor leg has just been through trauma. Give yourself the TLC you deserve and you'll have a positive result. Lots of time for exercises...later.
Take care and have a great rest of the day!
@DOCCUKE

 

[DOCCUKE]

Pt lady wanted me to do leg lifts that was about 2000 on a scale of 1 to 10 at the moment pretty discouraged

Cancel the formal PT for a few weeks. This PT has you in training mode, and that is not appropriate for 2 days out of surgery. This will do much more harm than good. Right now you are in the very beginning stages of healing. PT can be helpful, but it has to be the correct PT, and this one isn’t it.

As @mendogal has said, her medial team was unanimous in beleiving less is more in the early weeks. There will be plenty of time to do more rehab later, after you have some time to heal.

Right now all you need are very gentle bends and short walks, like to and from the bathroom.

Seriously, you don’t need any exercises right now, just gentle movements to give the new knee some mobility. I don’t understand why some PTs don’t understand this.

It is aggravating when they push it. They are supposed to be the experts. I thn some of them are just sadistic

 

[Jockette]

It is aggravating when they push it. They are supposed to be the experts.

Yes, we think they are the experts. However, they are all trained differently, and have their opinions on this rehab.

I have been trained by Bonesmart, and I don’t believe in the no pain, no gain method. I believe we should let our body heal before stressing it with exercises that cause pain and create more inflammation and swelling. Those things do not enhance healing.

So, you are entitled to your opinion about your recovery. Your opinion is the most important of all.

Remember what the Recovery Guidelines say:

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.

Your choice.

 

[mendogal]

@DOCCUKE
Are they literally pushing your knee or leg? That's a firm NO.
Members have had muscle and tendon damage from that kind of "therapy."

My entire ortho team's mantra was that in the early weeks Less Is Better.
Hourly walk while awake. Ankle movements and quad sets were my therapy (while icing and elevating anytime I wasn't on my hourly walk or up attending to hygiene or something). Once I tolerated sitting up five minutes I added slow gentle heel slides. That probably wasn't for a couple of weeks.

I like quad sets because they help the quads wake up, stimulate coordination between nerve and muscle, promote gentle extension, and support circulation.

 

[Layla]

It is aggravating when they push it. They are supposed to be the experts. I think some of them are just sadistic.

Please tell them you're feeling uncomfortable, or you're in pain and feel it's too much for you at this stage and that you don't think you're ready for that level of PT yet. You can ask them to make adjustments so you're engaging in something more manageable, of less intensity. After all, YOU are the one experiencing the discomfort and often pain afterward, not them.

Hopefully you slept well overnight. Happy Friday, DOCCUKE!