PKR what is normal?

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dogwalker

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Hi, I'm new to the forum. Early 60s, I had a left knee Oxford Partial in November 2012 and the right knee partial 3 months ago in late March. Brilliant and caring surgeon and all was well until I got home. I was under pressure to start back working, from home, 2 weeks after op at my computer and had to get back to doing most of the cooking, housework etc (as my other half is Ill with an undiagnosed neurological problem) so I've not been doing physio as much as I should. I went back to computing, travelling by tube into London after 4 weeks and walking the dog for about an hour or so every day.

But I am getting very frustrated at only being able to go up and down stairs crab fashion, being unable to squat, bend or walk on uneven ground and still need a stick in Town as I'm afraid of losing my balance. I'd love to get back to gardening but had to give up in frustration today! Is this normal? I've also just lost my job, partly due to some mistakes I made when I first started working again, while fuzzy-headed on Tramadol! Any advice, feedback would be very welcome. Thanks.
 
@dogwalker , Welcome to BoneSmart! Sounds like a good case of not allowing yourself to heal. Back to work (even if it's home based) in 2 weeks and then full time at 4! You don't need any physio - you need rest! Are you icing and elevating your knee? I know you are under pressure to work both home and away - but unless you allow that knee to heal you are never going to get the mobility you need.

I'll give you some reading to do. It looks like a lot, but the articles are short and should give you some insight as to what to expect during recovery:
First are the mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
And then the articles in order of importance .
Group A
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice

Group C
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"

Group D
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
Sleep deprivation is pretty much inevitable - but what causes it?
 
Welcome to Bonesmart Dogwalker,
I agree with Jaycey, you are doing way too much, she has given you good advice.
Sounds like you belong to the OverDidIt Club #ODIC, you have a lot of company here, we all seem to have to learn the hard way that the knee is in charge.
Sorry to hear you lost your job because of early mistakes.
Let us know how you are doing,
 
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Hi Jaycey & Pumpkin, and thanks so much for the advice and even more for the support. People at work and even friends had seemed to think I should be fully recovered by now so it's good to hear from others who acbtually understand that it's not like a bout of flu! I was feeling guilty about not doing much cleaning and spending a lot of time lying down when I'm not working but I won't anymore. I'm going to start putting my recovery first for a change and start icing and elevating more. We only get one PT session here post-op normally so it's too easy to miss it altogether. I'll read the articles tonight too. Thanks again!
 
I also agree with Jaycey---you are doing too much, too soon. I returned to the classroom at eight weeks post BTKR, and, looking back, that was much too early and slowed down my recovery.

At this stage of the game, the more you do, the more your knee will fight back and stiffen up, swell, and be painful.

While what you are doing seems, at this time, to be innocuous, it all adds up to too much. Cut back on the activities---walking the dog, etc., and take more time to ice, elevate, and rest, so you can keep that surgical knee happy.

I'm going to start putting my recovery first for a change and start icing and elevating more.
That is a great attitude! Ice, elevation, and rest will help you immensely.
 
I am sorry to hear about the challenges from your job I hope you can take some time to recover and find a great opportunity in the future I had my surgery June 11 and I hope to continue to progress as well as I have been but look for a three-month recovery try to take time for yourself look forward to hearing more


Sent from my iPhone using BoneSmart Forum
 
Oh yes, take the time to ice and elevate as much as possible!! Perhaps even at work? You will feel so much better for it!

And if you can, possibly, get a bit of household help? Local church group? Any friends of neighbors who may be able to shop for you or ? Any small thing to help would make a world of difference. I couldn't do this on my own.




Ollie. LTKR June 10, 2014
 
dogwalker, would you give me the actual date of your recent surgery please? 'Late' March is a bit vague!
I was under pressure to start back working, from home, 2 weeks after op at my computer and had to get back to doing most of the cooking, housework etc so I've not been doing physio as much as I should.
My thoughts here are that physio is very over-rated even for knee replacements. It's been my unhappy observations that people generally tend to do far too much and end up doing themselves more harm than good.
I am getting very frustrated at only being able to go up and down stairs crab fashion, being unable to squat, bend or walk on uneven ground and still need a stick in Town as I'm afraid of losing my balance. I'd love to get back to gardening but had to give up in frustration today! Is this normal?
Do I take it by this that your were required to get back to 'normal duties' at 4 weeks again? I'm betting the answer is yes! Fact is, you are still only 12 weeks out and so it's not at all unexpected you are unable to do those things. FWIW It took me 4 months to start going upstairs normally and another 6 weeks after that before I could do it downstairs, so for that, as far as I am concerned you are right on track! UNLESS you have been unable to do these things since your first PKR, you never said about that.

So I suggest you read the recovery articles very carefully and take it all on board. Miss nothing out.


I'm also going to ask you some questions and it would be very helpful if you would answer each one individually in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!
aflagsforworship.co.uk_jo_pic_images_nonofisss.gif
)


2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.
 
Overwhelmed by the support and advice given. Thank you so much! It really makes a huge difference. I'll reply properly later when I'm not working - but yes! I can see I am doing far too much.
 
Definately doing too much. Have you been able to slow down at all? How's the pain and function?
 
Oh yes, take the time to ice and elevate as much as possible!! Perhaps even at work? You will feel so much better for it!
This would help out---I was able to do it when I returned to the classroom---I would ice and elevate during my panning and lunch periods.

eople at work and even friends had seemed to think I should be fully recovered by now
Those folks do not have a clue as to what you and your body have been through---physically, emotionally, and psychologically. Recovery from a TKR or a BTKR is something very few people can comprehend.
 
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