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[TKR] When will the swelling end?

Discussion in 'Knee Replacement Recovery Area' started by smcsmc727, Feb 12, 2017.

  1. smcsmc727

    smcsmc727
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    I had a total replacement of my right knee on February 8th 2017 and was released to go home on February 11, 2017.

    Surgery took place at 7:30 AM and in the late afternoon they had me doing exercises in bed, but I was too weak and dizzy to do anything else but stand myself up near the bed.

    Between the compression bandages, visits from techs taking vital readings, and nurses administrating meds and shots I slept less than an hour the first night.

    I had some chicken soup and that went well so I was taken off a restricted diet. My next meal was a turkey dinner.

    The evening nurse asked me "Are you hot?" I said, "Some women find me attractive."

    Body functions were all messed up. At the 13 hour mark I had a catheter inserted. I told the nurse,"Usually I take a woman out for dinner before we get to this point." That got a laugh.

    The nurses liked coming into my room because I'm always warm. I kept asking them to turn down the heat and most of their other patients in their upper 60's or older are cold and want their rooms as warm as possible. Not me.

    I have a buddy who lives in another part of the country who just had his knee done. He is two weeks ahead of me. When I did my 2nd P.T. session at the hospital I tried to match my friend's score of 90 degrees on the leg bend. I thought he told me he did that on the 2nd day. I was able to match his score, but when I told him that he said, "what?! It took me two weeks to get to that point." I was mistaken as to when he achieved the 90.

    I understand now though how I did it. I was still full of operating blocks and had just had a morphine shot. Now that I'm home and trying to wean myself off the narcotics it's much tougher.

    The trade off is this: A little more pain, but less disruption to my digestive system.

    From what I read here, you're better off if you aren't so gung ho (I'm an alpha type, over-achiever), so maybe a little more pain will force me to ease up and give my body a chance to heal.

    My last dosage of Hydrocodone was this morning at 3:45 AM. I've been taking Tylenol instead and yes, I am hurting more. It's about a 5 or 6 with stiffness, but not intolerable.

    I had two doses of Milk of Magnesia since coming home and mid-morning I had a canon-velocity bowel movement. First one in 3 days. I've actually had 3 and hope now it's safe to pass gas again.

    Tomorrow is my first out-call physical therapy. We'll see how it goes. Off of the hydrocodone I don't expect to perform at the level I did in the hospital, at least not for a while.

    A cousin of mine had both knees replaced and he lent me his water cooler circulator and that helps.

    Pain Report:
    1) IV needle - took the nurse 4 jabs to get in and was fairly painful
    2) Catheter - major pain going in, not so bad coming out
    3) Morphine shot in thigh - short intense sting
    4) laxative shot in stomach - scarier sounding than it was. Needle was tiny.
    5) Removal of drain from knee - just a second or two sting
    6) Current residual pain to knee - 4-6 on a 1 to 10 scale and very stiff. Takes walking around a while to loosen up.

    I have staples.
    I am able to make all transfers from the bed to the walker, from the walker to various chairs in the house, from the walker to the toilet (I installed a 5 inch seat with hand rails), and after a minor accident in bed last night I decided to just get up and use the bathroom in my bedroom.

    That's where I'm at right now.
     
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  2. skigirl

    skigirl Moderator

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    As you said, achieving goals is going to be your undoing!! Right now your body needs rest, elevation and lots of ice. Many people do manage without opiods, you might ask your doctor about tramadol. It is a mild, synthetic narcotic that does not have such severe side effects.

    It is had to move too much when you are in pain, but really, right now, you don't need to be moving that much. I stayed in bed for most of the first two weeks, icing and elevating. I got up for bathroom, ice and food! Otherwise I was down for the count. By week three most of the swelling was gone and i was ready to move a little more.

    Most of all, do not allow the PT to push or pull your leg right now---that will CAUSE more swelling and injury to your knee. Your knee is not out of shape, it is injured and needs to recovery before you can address the muscle issues.
    Ice to control pain and swelling
    Elevation is the key to controlling pain and swelling

    I am also going to give you the articles from our library that we recommend to those who are in early recovery. The articles are all short and easy to read---and they are excellant to entertain you while you are lying there with your leg elevated!!!

    Here are the BoneSmart 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!
    - be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

    Next is a FAQ (Frequently Asked Questions) thread.

    And here are some very crucial articles
    BoneSmart philosophy for sensible post op therapy

    The importance of managing pain after a TKR and the pain chart
    Swollen and stiff knee: what causes it?
    Energy drain for TKRs

    Myth busting: no pain, no gain
    Activity progression for TKRs
    Heel slides and how to do them

    Extension: how to estimate it and ways to improve it

    Elevation is the key
    Ice to control pain and swelling

    Healing: how long does it take?
    Chart representation of TKR recovery
    Myth busting: the "window of opportunity" in TKR

    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?

    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.
     
  3. Pumpkln

    Pumpkln Forum Advisor

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    I agree with Skigirl, it is important to let you knee heal and obtain adequate pain relief. Lack of good pain control can lead to increased swelling, inflammation, and pain.
    Don't compare yourself to anyone else, as you found, you can be mistaken about their recovery.
     
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  4. highlander

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    Welcome to the other side! Nice to have another guy on the forum. Make sure you control your pain levels, you can get a lot more done - whether thats rest, sleep or PT. Im a pretty tough dude, and I realized early on not to worry too much about whether its a narcotic or not. The trick is to keep on top of the pain, instead of it keeping on top of you. The next few days there will be pain- so use all the tools in your bag. Im 3.5 weeks into this- it gets much better after week two- then you can experiment with weaning and different med combos.
     
  5. Celle

    Celle Forum Advisor

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    There are several of you men on here. Keep reading the threads and you'll find each other.
     
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  6. L.I.T

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    Ha! Enjoyed reading your first post!

    Welcome, and glad you came out of the gates running. Nothing new to add to what others said - but I'll echo everyone who said don't worry about taking the pain pills as you need them. I, too, have a relatively high pain threshold and was on hydrocodone, 1 pill every 6 hrs at first. After trying to wean off early, I realized I was not doing myself any favors by trying to 'handle' the pain. Besides.... The pain will be with you for a while. Better to minimize the pain so you can do your exercises and have less stress!

    Glad to have you here, and keep coming back!
     
    Last edited by a moderator: Apr 15, 2017
  7. Red's Mom

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    Welcome and good luck with your recovery! Don't let the pain get too bad, control it so you can rest, elevate and ice. Your knee, your journey but I believe 100% in the mantras!
     
  8. Roy Gardiner

    Roy Gardiner Forum Advisor

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    Best to keep taking the meds by prescription; why suffer? There's little or no danger of addiction if you're taking the stuff for pain not for fun.
     
  9. Cratchit

    Cratchit

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    Nothing to add except to say :wave:. Love your introduction - too funny! Hope your first out-call PT goes well.
     
  10. Roy Gardiner

    Roy Gardiner Forum Advisor

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    Please don't regard it as a competition, your knee will be in charge. Rather like animals in captivity that under carefully controlled conditions of living space, temperature, air quality and diet have been observed to conduct themselves exactly as they damn please.
     
  11. Giantstu

    Giantstu

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    @smcsmc727 brilliant welcome wouldn't have minded you next to me in hospital to cheer me up.
     
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  12. smcsmc727

    smcsmc727
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    Thank you all for your great responses to my introductory post. I've been home 4 days now and our entire household has been affected by my surgery. Using my grabbing tool as a pointer I gave my wife a tour of the kitchen. "This is where the food gets prepared, and that's a frying pan. That little rectangular box on the counter is called a Microwave. We call that white and black appliance under the cabinets, a Stove." That's good for the first day. Tomorrow we'll cover "The wonders of the refrigerator, and what's all that stuff in the pantry?"

    18 years ago I proposed to my wife. I asked her, "Do you cook?" She gave me an honest reply.

    "I'm a programmer analyst. I don't cook, but I make enough to take us out to eat."

    Two things followed that statement. First, I did all of the cooking for our family, and 2nd, in 2009 we both lost our jobs and there was a dramatic cut back in meals outside of the house.

    Knowing it would be a while before I felt like cooking again I did a little cooking before my surgery. I made a huge pot of spaghetti, and I bought some prepared meals that my wife could bake or microwave. Our next door neighbor Daisy, who had knee surgery last year, brought over a large container of home made potato salad.

    So far we've had spaghetti and potato salad 3 nights in a row. I'm not complaining - no animals or children were hurt in the preparation of those meals.

    "Say Hello To My Leetle Friend - PAIN."

    Initially, I went back and forth about whether to make full use of my pain meds or try to reach some middle ground between taking them on a regular schedule or trying to get by with a combination of Hydrocodone and Tylenol.

    There were two issues for me. First, I've lived a life with very little vice (I'm sure we can overlook the large bowl of Jello, the monkey, and the toilet plunger on our honeymoon weekend). I've never smoked, I rarely drink, and I have always viewed my body as a temple. (or was it a playground? I always get those two things confused).

    So just the idea of taking a controlled substance for whatever reason presents me with a moral dilemma. Okay, I actually got over that part of the problem in about 3 seconds.

    The other issue for me was Hydrocodone's affect on my digestive system. After taking 10 mg's of H every 3 hours at the hospital I had gone 3 days without a real bowel movement (the kind a mother could be proud of).

    While I was in the hospital they gave me some pills and a shot and there was a little activity the day I went home. In the morning I began firing blanks. I was pleased. At least SOMETHING was going on. I was so bloated.
    Nope, my first evening nothing but air biscuits.

    At bedtime I took a healthy swig of "doctor recommended" Phillips Milk of Magnesia. I could already hear my stomach, "Let's Get Ready To Rumble!"

    In the wee hours of the morning a primal urge beckoned me. Mounting my faithful steed (I named my walker Walker), I ambled into the bathroom.

    I dropped "trou" and got into a comfortable position on the 5 inch toilet seat I had installed over my toilet. Suddenly I thought of boy scout camp; those wooden outhouses where you sat on a bench like structure with a large hole cut out, and you hoped nothing could reach you from the muck 5 feet below your vulnerable thingy.

    Suddenly, the train was about to leave the station.

    Elon Musk has designed a Tesla that can go from 0 to 60 miles in 3.2 seconds when placed in "Insane" mode.
    Apparently, my butt has an "Insane" mode. While I didn't clock it with a stop watch, I'm fairly certain that what emerged from my body did so with greater velocity than a Tesla off the starting line. It's a wonder I didn't fly off the toilet and out the window and on to my neighbor's roof.

    That madness continued and I finally rid myself of post-surgical bloat. There were "post-disaster" clean-up issues to be dealt with. A FEMA team in white level A vapor proof suits entered my bathroom as Red Cross personnel stood by to offer additional assistance.

    My two dogs cowered across the bedroom with their paws over their noses and tears running down their furry little jowls.

    I survived. That's what we humans do. We endure and we survive.

    Last night was rough. I went to bed at 9:00 PM and fell asleep watching TV, dozing on and off until 12 Midnight. I dropped some H, visited the scene of the crime (bathroom), and returned to bed. I dozed again off and on for maybe 2 hours, and woke up dreaming a team of tiny soldiers were in my mouth stabbing my tongue with their bayonets. I was parched. H does that to my mouth. I got a drink and only dozed again off and on until 5:00 AM when I got up and was going to try to feed the dogs and let them out.

    My wife, who sleeps in another bedroom down the hall due to loud snoring (her) was up and took care of the dogs.

    This morning I went to Physical Therapy in a more or less wasted condition.

    My physical therapist is a pretty young lady named Jessie. She greeted me with a smile and said, "Good morning Stu. May I call you Stu?" I responded with, "Either that or Big Boy." (I'm 5'4") She laughed - my morning was made.

    She asked me how I was doing? I told her, "Pain has me under her control!"

    I was swollen, achy, exhausted before we did anything, and in general feeling pretty bad. Fortunately, Jessie does not believe in forcing anything and lets me set limits in terms of pain thresholds, and even trying new exercises.

    She frequently asks me if I need to rest before moving on to the next exercise? If by REST you mean a nice two hour nap with my dogs on each side of me, why yes, I'd enjoy a little rest right now. However, if you mean that silly little two minute pause between reps, we can forego it.

    I told her, "I'm an adrenaline junkie - let's just go for it" as I pulled on the band around my ankle.

    I made it through another day and lived to tell about it. WE ARE SPARTA!
     
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    Last edited by a moderator: Apr 15, 2017
  13. Aquafool

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    Love your writing style! Keep it coming, Stu!


    Sent from my iPhone using BoneSmart Forum
     
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  14. Cratchit

    Cratchit

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    Laughed out loud at that! :rotfl:
     
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  15. Kathi 777

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    @smcsmc727 just keep the positive attitude and you will own this experience and be in great shape for summer. 1/10/17 i had bilateral tkr and i have been following the less is more and giving my knees some time to heal. I am an over achiever by nature and have things to do... well... this has slowed me down a bit but i still get out almost every day and the dogs keep me busy.


    Sent from my iPad using BoneSmart Forum
     
  16. GingerP

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    @smcsmc727. You are a whoot! Your description of life items brings a smIle to those of us who have also experienced some challenges. My trip to the 5 inch seat was much later and came in small unsatisfying results until I too took a swig of some good stuff. Oh how those things we take for granted in life "do" make a difference to our day.
    Wishing you a good day and evening. Continued healing to you. :)
     
  17. Arttie

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    "...those wooden outhouses where you sat on a bench like structure with a large hole cut out, and you hoped nothing could reach you from the muck 5 feet below your vulnerable thingy."

    I know what you mean. Those plastic porta potties seem to always leave me with a blue tush.:tantrum:
     
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  18. KarriB

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    Well, it's been great getting to know you! I also had never taken anything stronger than a Tylenol in my life, so 10mg of oxycodone seemed a bit much to me. My best friend who had a TKR a few years befor told me not to worry about dependence or addiction. So I loaded up on Miralax and once I came off the iron pills things moved pretty good. I began to forget a dose of pain meds around week 3-4, so I began cutting them in half.

    Try not to worry about the meds, they're just for a short while and your body will be cleaned out in a month or so. Also, they may help you sleep a little better. I highly recommend Miralax, it has no taste and mixes with water.
     
  19. Debdoub

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    Thanks for being so entertaining! I cannot take any codeine/codone as I get violently ill - 24 of 32 hours spent in the hospital were with a yellow pan below my chin. Once I got them to agree that it wasn't working, I moved to Tramadol only. I've never taken the max I could but at ten weeks post surgery, I still take at least one a day.

    I found that two weeks made a difference and six weeks even more. I tweaked my knee at eight weeks and so have covered some of the same ground but it is improving every day.

    Good luck!
     
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  20. Giantstu

    Giantstu

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