TKR When oh when oh when

Jammy

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Will I feel better? I am 68 yrs old, and 10 weeks post-TKR (also known as the Dragon). My ROM has always been pretty good and is now 122. A week after surgery it was 115 so I guess that's some improvement. But I STILL have some pain and am taking tramadol or Advil. The tramadol helps the "hot spots" on the outside of the knee, but causes constipation more than Advil. With Advil I have to take it with a couple of crackers and it doesn't do as much and I still often get a stomach ache. Ugh.

Not only is this surgery a pain in the knee, it is a pain in the butt and the constant struggle can get very depressing. That is why I joined this forum. My experience so far is there are good days (rare) and then the Dragon shows up and says, NO WAY, and you have several bad days, and the Dragon says GOOD! I normally feel crappy and I am/was a healthy thin non-crappy feeling person before this surgery. I had bone and bone caused by arthritis and thought I should have this surgery before things got too bad.

My highly rated doctor told me there'd be two weeks where it's quite rough and then you slowly begin to get better. NOT. My knee feels like there's a tennis ball in there wanting to come out and play. I complained again about pain to my doctor in January and she prescribed a 6-day steroid pack methylprednisolone for the swelling. It did seem to help with the swelling but not for long; the Dragon wouldn't have me smiling.

I have noticed that I hurt more during and after physical therapy and am tempted to stop that, even though it's supposed to be so helpful. I don't know about you but I hate having my painful knee pushed down really hard until I almost cry. I stick with it because I don't want to fail in my recovery and this is what my doctor wants me to do.

I haven't even gotten to the interrupted sleep and awful fatigue. I am worried I will feel like this for another six months. I am close to looking into getting a therapist, the mental kind. If only I had the money for one, but hey, Medicare doesn't cover this like they cover a TKR.
Sorry so long, but Leonard Cohen didn't write "Hallelujah" in a day.
 
Hello and welcome to BoneSmart and recovery. I am sorry to read of your struggles and pain.
I have noticed that I hurt more during and after physical therapy and am tempted to stop that, even though it's supposed to be so helpful. I don't know about you but I hate having my painful knee pushed down really hard until I almost cry. I stick with it because I don't want to fail in my recovery and this is what my doctor wants me to do.
Please refrain from engaging in movement that causes discomfort or pain. Do not allow anyone to forcefully manipulate your leg. While your range of motion is currently limited, it will naturally increase as the swelling subsides and the pain eases. Give it time. At ten weeks post op you're still early into a recovery that can last a full year for most and even longer for some.

Below you'll find the Recovery Guidelines. Please read the articles on ICE and ELEVATE and if you're not doing both, I'd advise you begin. It will help with swelling and the pain. I wish you comfort and hope you begin feeling better soon. We're here for support if you need us.


KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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

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 a 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 history before providing advice.
 
Please leave the date of your surgery below and which knee was replaced so we're able to create a signature for you.

Two other articles that may be of interest - the article on Energy Drain and also the one on Post Op Blues. Check those out even if you don't make it through all of the Guidelines.
 
But I STILL have some pain and am taking tramadol or Advil. The tramadol helps the "hot spots" on the outside of the knee, but causes constipation more than Advil. With Advil I have to take it with a couple of crackers and it doesn't do as much and I still often get a stomach ache. Ugh.
Sorry that you are still in pain.
It can be a very slow journey and it is easy to get dispirited.
I too didn't find ibuprofen ( Advil) much use. I found naproxen ( GP prescription) much better although you need to take a stomach protector with it. I still take it currently, although my knee is a lot better - but I use it for my bad back. I take the stomach pill ( omeprazole) as soon as I wake and then the naproxen with breakfast an hour later, and any later doses with meals. With any non- steroidal it is the anti inflammatory action that helps- so it takes a few days of regular medication to kick in.
The other thing that really helped me was getting my GP to prescribe some sleeping medication. I got zopiclone but others here (@beachy) talk highly of trazadone. Either way getting a half decent night's sleep really helps healing and mood.
 
Red flag!!

If you hurt after PT, they’re pushing too hard this early in your recovery. You have achieved good ROM thus far and it will continue to improv. Never let anyone force your knee into any position!

You might consider ending your formal PT sessions and doing the exercises on your own. I only had formal PT for five weeks then continued the exercises and increased my walking little by little as well as my daily activities. You might be surprised how much household chores can help just by adding some extra motions. For example, when I do dishes, I do some gentle bends or standing on one foot to improve balance.
 
How to train your dragon.
Welcome to Bonesmart, Jammy!

Your recovery sounds typical. It's scary when you try to do everything your doc recommends then you still feel.... crappy. Or crappier.
For starters, take some time and study everything Layla sent you.
Then take a break from PT. You need to rest your baby knee. Ice, elevate, rest. You can do GENTLE exercises on your own. And just taking short walks, ADLs will eventually help to train your dragon.
I know this goes against everything your highly rated doc told you, but he/she never had a knee replacement.
Just try to rest from PT, but keep moving a bit and you should see results.
 
To @EalingGran - I don't know how to reply to your post, but, thank you for your email. Isn't naproxen the same as Aleve? I haven't taken that yet. Just Advil. I could ask my nurse for that -- I have a bad back, also, ever since this surgery it seems. Can you please let me know what you take for a "stomach protector"? I am getting sick of saltines.

To @FourCats and @beachy - I am taking five days off from PT but feel I need to continue it as PT is at the same location and I think my dr really wants me to keep at it. I am going to talk to the PT again about her pressing down on the knee. Unlike others here, I am more likely to do more exercises at the facility than at home. Most things I do don't hurt me except the pressing of the knee and stretching the back of the leg/knee. Ow. At home I am able to walk in our pool (I live in Florida) which helps also.

To Layla - Is there a way to reply to each of these posts individually?
 
Last edited by a moderator:
Hi Jammy,
When you want to reply to someone you can tag them by putting this symbol -> @ directly in front of their name which will alert them to your message the next time they're on the forum. Notice I did it above for you.
Tagging other members and answering tags

I hope yo have a good week, Jammy!
@Jammy
 
Can you please let me know what you take for a "stomach protector"? I am getting sick of saltines.
It is a drug like omeprazole that cuts the acid secretion in your stomach and protects it from the effects of the non- steroidal anti- inflammatory drugs. It is usually presented together with naproxen.
 
. I don't know about you but I hate having my painful knee pushed down really hard until I almost cry. I stick with it because I don't want to fail in my recovery
Agree with everyone above that you must not let this happen. It is really not good for your knee.
For extension my pilates teacher puts a soft squishy pilates ball under my knee with my foot propped up a little. I then push down into the ball using my muscles ( especially trying to engage the medial quads). No forcing using pushing by me or her.
 
I am taking five days off from PT but feel I need to continue it as PT is at the same location and I think my dr really wants me to keep at it
Please ask your doctor if he thinks that pain is good in PT, and if so, why?

Pain is your body telling you damage is being caused. It's why athletic training hurts - and the benefit is that the body rebuilds damaged muscle stronger. But this is not training, it's healing. Stretching exercises to regain ROM need not and indeed should not hurt.

Stretching

The Bible is Bob Anderson, Stretching, ISBN 0-7207-1351-X

Right at the beginning he states that stretches should be held for 10-30sec only. As long as you don’t break this rule and never go to the point of pain, you can stretch as often as you like.
 
Don't let any physio make your pain worse. I would stop going as they can actually make recovery much more difficult. I had a physio with my last surgery who actually harmed me by giving me the wrong exercises far too early in recovery.
 
Will I feel better? I am 68 yrs old, and 10 weeks post-TKR (also known as the Dragon). My ROM has always been pretty good and is now 122. A week after surgery it was 115 so I guess that's some improvement. But I STILL have some pain and am taking tramadol or Advil. The tramadol helps the "hot spots" on the outside of the knee, but causes constipation more than Advil. With Advil I have to take it with a couple of crackers and it doesn't do as much and I still often get a stomach ache. Ugh.

Not only is this surgery a pain in the knee, it is a pain in the butt and the constant struggle can get very depressing. That is why I joined this forum. My experience so far is there are good days (rare) and then the Dragon shows up and says, NO WAY, and you have several bad days, and the Dragon says GOOD! I normally feel crappy and I am/was a healthy thin non-crappy feeling person before this surgery. I had bone and bone caused by arthritis and thought I should have this surgery before things got too bad.

My highly rated doctor told me there'd be two weeks where it's quite rough and then you slowly begin to get better. NOT. My knee feels like there's a tennis ball in there wanting to come out and play. I complained again about pain to my doctor in January and she prescribed a 6-day steroid pack methylprednisolone for the swelling. It did seem to help with the swelling but not for long; the Dragon wouldn't have me smiling.

I have noticed that I hurt more during and after physical therapy and am tempted to stop that, even though it's supposed to be so helpful. I don't know about you but I hate having my painful knee pushed down really hard until I almost cry. I stick with it because I don't want to fail in my recovery and this is what my doctor wants me to do.

I haven't even gotten to the interrupted sleep and awful fatigue. I am worried I will feel like this for another six months. I am close to looking into getting a therapist, the mental kind. If only I had the money for one, but hey, Medicare doesn't cover this like they cover a TKR.
Sorry so long, but Leonard Cohen didn't write "Hallelujah" in a day.
Jammy, I can understand your desire to get a therapist!! I do think a couple of sessions would be of great benefit for everyone going through this very difficult experience! Writing and reaching out on here is therapeutic. I think major surgery is such a difficult thing to have done to your body and heal from and no-one or nothing prepares you for the mental anguish that can arise when you find yourself disabled all of a sudden.

My nurse at the hospital said that whilst intellectually you have agreed to the treatment it's the equivalent for the body to being run over by a bus!!

Sometimes I have felt quite claustrophobic, panicky, trapped, frightened all at once.... and that is way beyond my normal day to day, for sure. I even went as far as thinking how I would cope if people broke into the house and being absolutely powerless. I think these are very natural responses to the difficult situation.

It is actually a trauma that the body has gone through and is now adjusting to. I find it very reassuring here on this site to hear that others have hit such low points and they have passed and they are now doing really well.

The facts remain that my body is actually doing well and I need to be very gentle with myself, have low expectations and just do the best I can every day and not let the frightening thoughts take hold.

Putting one foot in front of the other (literally) is much more helpful that looking at the mountain peak and thinking how on earth am I going to get up there!!
:hugzz:
Sending you a big hug.
 
Isn't naproxen the same as Aleve? I haven't taken that yet. Just Advil. I could ask my nurse for that
Naproxen, Aleve and Advil are all NSAIDS and you need to protect your stomach from them. We suggest something with protein before taking any NSAID since protein takes longer to digest and can protect your tummy from them.
 
@Roy Gardiner - My surgeon is a woman. I am just trying to get better. I know my body, which is why I canceled my PT for Friday and now have 5 days off. I really don't want to stop PT altogether though.

@Layla - Like this? And a reply to each person in this one area?​

@PhilippaC - Thank you for your kind thoughts! I think it could be worse though, to actually be run over by a bus!

@beachy - Thank you for your input!

@EalingGran - I appreciate all your suggestions and taking the time to read my lengthy post!
 
Yes, @Jammy ... you did it perfectly!
 

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