TKR Ups and downs (11 weeks post op)

[Rayna]

Tomorrow makes 5 weeks since my surgery. This post will just be a "point in time" record so I can keep track of how I'm progressing.

After getting back on an around-the-clock schedule of taking Tylenol last week, my pain is under control again. In fact, I hardly have any. Swelling and tightness after walking, after sitting, and after standing is the main issue. I elevate and rest after each activity. ( It usually leads to a nap.) My surgeon says no icing until six weeks, so this is my only remedy until next week.

I had an at-home PT for the first 4 weeks, and she was great. She scrupulously followed my surgeon's hands-off, no intense exercise protocol. She just helped me figure things out (like how to manage our low toilets), answered questions, and helped me with my gait when I went from a walker to a cane. She said I had gained enough flexion to be able to walk without a limp, but I needed to pay attention to not limping. I use the cane very little now, only when I first get out of bed in the morning mostly. And if I can ever leave the house, I'll take it with me then.

Generally, I am patient with the recovery process, except when I'm not. I had the blues a bit yesterday and a bad case of the if-onlys: if only there wasn't so much snow and ice, I could walk outside; if only I could drive, I could run errands and get a haircut; if only I could do all the things I want to do. I'm at that stage I always come to after being incapacitated by illness or coming through a crisis. I have just enough energy and focus to start taking care of things that dropped to floor while I was out of commission, but not enough to get very far, and so I feel overwhelmed and unhappy with my self.

My husband has not had an easy time lately, and it pushes me to the limits of my resources to know how to help him at a time when I need help too. The other day he had an episode where he was face-down on the floor, soaked with sweat, and unable to get up. I got the walker I'm no longer using and held it steady while he gradually got his hands on it and pulled himself up. Then I helped him into dry clothes and made sure he ate something. He's diabetic and I think his blood sugar had gotten too low. I'm glad I was able to help him, but I did get on the pity pot for a while -- why is everything so hard? Why can't I just focus on myself and be taken care of? The only cure for that is gratitude, so then I work on that.

Sleep is a problem for me as it is for so many here. It helps to know that it's a common problem in recovery from a TKR. I take Ambien whenever I can, on nights when I don't need to be up and dressed early in the morning. If I don't take Ambien, I'm up all night, and that's when I read the recovery threads here. There are enough people who've had problems develop with their knees after an easy start that I don't take for granted my own trouble-free recovery so far. I realize I have a long way to go and anything can happen, but I'm hopeful that my recovery will continue as it started.

 

[kneeper]

Sounds like you're doing really well. Sorry to hear about the scary episode with your husband. I hope his doctor is watching his blood sugar, etc.

 

[Rayna]

Just had a lesson in energy drain. Slept last night without Ambien. After a little bout of wakefulness around 3 a.m., fell back asleep till 8:30. A miracle!

I felt the best yet on waking -- refreshed, clear headed, and my knee just a little stiff. So, I might expect my energy supply to last a little longer today, right? Nope. I decided to do one little extra thing after breakfast. I washed up the dishes left from last night. It took maybe 25 minutes. By the last few minutes, I was completely drained, and now I'm resting on the couch scraping together some energy for a shower.

 

[sistersinhim]

It does take a while before the energy is back like normal. Your knee is still so young, most of your body's energy is going into healing it. So, when you get pooped, just remember that your body is concentrating on healing your knee! That's a good thing!

 

[kneeper]

Yeah 25 minutes on your feet is too much this early. But we often have to learn these things for ourselves. But congrats on the good sleeping!

 

[Rayna]

I'm a little concerned. I've been elevating, resting/sleeping the last 5 hours, and I am as exhausted as ever, not at all recovered. Is this still normal?

 

[SusieShoes]

Yep, still normal. At around one month after TKR, it’s not unusual for a person to get totally wiped out by simple household chores, going to an appointment, or engaging in a small amount of any activity. Standing in the shower wiped me out once at around four weeks. It was surprising —seriously? A shower?— but there it was. A trip to see the doctor, with my husband driving the car and dropping me off at the door, not even walking across the parking lot, put me napping in the recliner for the rest of the day. It was an 8 am appointment.

Early recovery is full of ups and downs. You’ll experience a minor triumph one day and the next something will put you off your game: exhaustion, swelling, pain, yet another night of disrupted sleep (right when you thought you’d overcome it). Recovery is as much a mental trial as a physical one. If you can find a way to “go with the flow,” meaning just follow your knee each day and not try to anticipate the next move, recovery will happen with less stress. Because your knee is healing full-speed ahead, and you really are rather a passenger at this stage.

 

[Suzette]

Hi Rayna
I am a little behind you having had my TKR on the 12 Dec, so just over 4 weeks.

I had a great start, was as high as a kite and overjoyed with progress, my extension great and bend was good, then the pain started about 2.5 weeks after the op.

I don't use a stick in the house and I do try and behave myself with pottering about. But the knee throb is horrendous, deep inside my knee at the back and seems to travel up my thigh.

I take oromorph (morphine) when it is severe. I take cocodamol and gabapentin also. The strange thing is, the pain I get is worse when I take my weight off my knee and during the late afternoon and most of the night. Sleeping is not good.

My father in law passed away the weekend and I have read that stress can make pain worse.

I too had a drain wipe out today and went to my room where I elevated and slept and cried.

I am with you on your recovery and it does seem that there are very good days and bad... I read your post with interest as I felt I wasn't progressing as I should , but it looks like we are both doing well really and it's normal that we keep having these days of despair.

I hope your husband is ok and we keep progressing.

X

 

[Rayna]

@Suzette, Thanks for stopping by. It's interesting that our recoveries are so similar. You're right that stress makes things worse. Grief is exhausting too. I learned that when my daughter died 4 1/2 years ago. Very much like now, anything I did drained me, especially anything that required focus or social interaction. I think that is when I learned to be patient and gentle with myself, which is serving me now in recovery. You have my deepest sympathy on the loss of your father-in-law.

On a lighter note, I keep seeing the Brits referring to using sticks, but never canes or walkers. Are sticks crutches? I would love to have that cleared up.

By the way, you look a lot like my sister!

 

[Arttie]

At your stage I resolved to only accomplish 1 activity per day. Now at 9 weeks things are becoming "more normal"

Your recovery title reminded me of this:

Auntie Mame visiting Upson Downs.

 

[Suzette]

Hi Rayna

Thanks for your reply. I too am so sorry for your loss, it is exhausting. Xx

To answer your question on the stick. It's a walking stick AKA a cane

Today I am not going to do anything. I am going to have a total rest day and give my knee some healing time . I do think i over did it yesterday.

My photo is from when I had my hips replaced in 2015. It's funny as someone on the hip side of bonesmart, also said I looked like their sister!

I do hope you have a good day today
X

 

[Celle]

On a lighter note, I keep seeing the Brits referring to using sticks, but never canes or walkers. Are sticks crutches? I would love to have that cleared up.

A stick is a walking stick.

I keep a folding one in my car.

I grew up in the UK and to me a cane is something the teacher used, to discipline naughty pupils.


Crutches are of two kinds - under-arm or forearm:

And these are walkers, walking frames, or Zimmer frames:

And then there are hiking poles - I once saw a Japanese man using these very effectively instead of crutches:

 

[Rayna]

Interesting. My husband and I were trying to figure out why sticks instead of canes, which seems more formal. We finally decided it was in the cause of being precise and unambiguous, reserving cane for the disciplinary item, etc.

 

[Suzette]

It is exactly what I think the cane is. The mention of 'The Cane' when at school in the 70's put fear into everyone.

Although some of the lads thought of it as a status symbol if they were ever 'caned' !

 

[Celle]

I also think of a cane as being the white stick that blind people use - it's not used for support, but to make people aware and to feel for hazards:

 

[Jockette]

I have the folding one, mine has a second, lower handle to help you get up from sitting. It’s not really very stable for helping me get up but hopefully better than nothing. I haven’t had to use it yet for that , but when I tried it out it wasn’t very stable for that purpose.

I keep it folded up in my bowling bag since the bowling alley ‘s restrooms have the lower toilets, including their “handicap” one. I haven’t used it there yet, though. I try to wait until I get home!

It does work great for regular walking or to help me go up stairs.

It sure unfolds quickly, though, at an alarming rate! Someone could get hurt if they didn’t know that!

 

[Rayna]

Today makes 6 weeks post op, and I've hit a "down". Something changed in the past several days. I've been waking with pain despite taking Tylenol around the clock and right before bedtime. It's more than just the usual morning stiffness that improves after a while. Today the pain stayed with me all day, and I'd have to put it at a 4. It consists of a sharp ache and increased stiffness, though there is no apparent swelling. Resting and elevating all day, hoping to get on top of this.

 

[Suzette]

Hi Rayna

I think I know that ache. Mine feels like it's in the knee cap area at the moment. Like a constant deep sharp ache/throb. No position I put my leg in helps. Sometimes I seem to get a cramp like feeling in my knee too. I have no swelling on the outside but am assuming we have swelling on the inside somewhere.

Last week this same ache was on the sides of my knee. So it seems to move.

I have no idea what triggered it or why it moves position. I did get a little excited yesterday, as I was actually nearly pain free for 5 hours, so I thought the worse was over. Then it came back again.

It would be interesting to know if others have had this sudden increase in pain, for no specific reason, well other than a TKR !

It does certainly make the emotions go down again. Especially when everything seemed to be improving and the pain manageable.

I am with you x

 

[Rayna]

Thank you, Suzette. You described the pain exactly. Maybe the knee is telling me I overdid something, but I don't know what that would be. I wish my knee wouldn't be so mysterious about it and just come right out and tell me plainly.

 

[Suzette]

It is a complete guessing game isn't it?

May be we do keep over doing it. But sometimes I feel that I haven't done anything different to the days before, then the pain/throb starts.

I am also beginning to wonder if the constant moving about in the night trying to get comfortable, is somehow irritating the knee or even twisting it?

I think I am going to have to have a complete rest day again.