10 days post tkr and hurting more

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I am 68 yr. old and had my left knee tkr 10 days ago. I was already a candidate for tkr but had hoped to do hip first when an unexpected fall in April 2016 changed all of that. I had meniscus tears and a lot of trauma to my kneecap. I had already been doing steroid injections for years so decided it was time. I had no idea how much pain I would be in and how hard it would be to try to do most things on my own. I woke in the hospital feeling no pain for 2 days because I had a nerve block during the surgery. I saw the PT ladies once in the hospital when they had me get up and use a walker. They would not let me walk very far and I was released the next day. I was not given any exercises or directions except that walking was good for me. I see the surgeon this Wednesday to have staples removed and I assume maybe have some PT set up? I read through this forum and see how important the exercises are but cannot really find a time line for them. Am I okay not starting them right away? I still have a lot of pain and ice and raise my leg frequently. I have finally been able to shower and wash my hair etc. Standing while doing all of that makes me really tired and hurting but I manage. Mostly I would rather just stay in bed or sleep, but am trying to get up daily. I am keeping pain Meds at a minimum because when I first got home I had a horrible bout of constipation. Then I used Miralax and had a horrible diarrhea episode (I have IBS-D).  I cannot seem to figure out the right balance and get pain relief. I cannot take any NSAIDS because of low kidney function so am prescribed Percocet. It does help, doesn't eliminate the pain but definitely helps, still afraid to take it more than once a day.

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  • Posted

    I am taking hydrocodin with Tylenol every 4 hours, this seems to be the only way I can do the PT exercises they want me to do, I was given very limited post surgery information too, but it seems stretching and bending are really important to curtail scar tissue from forming and having better future movement
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  • Posted

    No one who has not gone through tkr understands the pain involved. It is a long and painful process. Not weeks but months. I am 4 months in and still in pain plus swelling. They say it gets better. When? I am also going through frozen shoulder pain.I don't know which one is worse. I hope there's a light at the end of this tunnel.
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  • Posted

    Peggy....I'm three weeks out and I can't stress or tell you how important PT has been for my recovery. PT was and is essential in getting the knee to bend to 120 degrees and straight to 0 or 180 degrees. I totally understand about laying in bed and sleeping but it's so important to get up and move and stretch that leg. I too struggle with the balance of pain meds and PT. I can say this every week I complete of PT I'm that much better and see significant improvement over the past week. Sorry to hear about constipation problems I take one Docusate Sodium 8.6 tablet twice a day for constipation and it helps me immensely. As I stated in a previous discussion I take 6 5MG. of Oxycodone a day and that helps a lot. I'm trying to cut that down but the pain is still too great. I wish the best for you and again can't stress how important PT has been for me. Take care and stay on the forum it's been very very helpful for me.

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  • Posted

    Hi Peggy

    I think you're a perfect example of how we're all different.....and are given different information too, apparently a bit randomly! I'd risk the wrath of a physio and say you're probably okay just generally getting more mobile, as you are....but by the end of two weeks you definitely need a proper physio regime.

    I really hope you get referred for physio (PT) when you see your doc, but if you're not, insist that you need it! The exercises are quite gentle to begin with ( heel slides, quad tightening, hamstring curls, that kind of thing) but they are absolutely essential for your future recovery.

    So don't worry, you're okay up to now, but you must get exercises or physio soon. That's as I understand it smile

    Also I hope someone is helping you with meals etc. Keep drinking lots of water, ice and elevate as you are, and keep positive.

    All the best to you x

     

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    • Posted

      Thank you for your kind reply. I did get a lot of replies but no real time line, so you gave me more of an idea there. I see my doctor in 2 days so will ask about PT then. My situation changed after my surgery. My husband was going to help me and has some but he developed a kidney stone as soon as I was released and has been in severe pain himself. I know when I am in horrible pain someone else is not my priority. I am disappointed but he did not plan it. We are like two basket cases trying to manage right now. He has not been able to helpe me with exercising or routine things. It has meant I have done laundry and a few necessary chores. I think the pain would not be so bad if I could take my Meds as needed without worrying about constipation or diarrhea, they make it hard. I've only taken about 3 pain pills in the 11 days I have been home. I'm not "being brave" or thinking I am better and don't need them, I do. I just am afraid of constipation or diarrhea. I have both magnesium and stool softener but when I used them I had a horrible IBS-D episode.

      I have gotten myself beverages and light food to eat, but have not cooked meals. I shower and wash hair every morning and do a load of laundry every other day. I have tried bending my knee making my leg go under as much as I can before horrible pain. I have lifted my leg up off the bed and held it a few seconds. With no formal list of PT I have not tried other exercises. I do not have a high stool to use. If hubby were well I could easily send him to buy one but he is in pain. He's had these episodes of kidney stones in the past, they just have to pass and it takes time. Our daughter had a pre-arranged trip to London arranged with our grandson for school, so she is not available now either. It sort of just all happened inconveniently. My one other question is that I always have had insomnia and had a hard time sleeping. Since this surgery, I am super tired all the time. I easily fall asleep at night, wake up twice during night for bathroom breaks, go right back to sleep after about 10 minutes of pain before knee area settles down and then sleep until about 11 AM! I get up shower, wash my hair, brush my teeth, dress etc. then go sit on couch and am exhausted again. I should mention, my doctor told me I could shower 5 days after surgery, but could not sit or soak in water. I have stitches and staples. The staples come out Wednesday, the incision site looks good, has no real bruising (and I bruise very easily), it is not red and the swelling has decreased. At first my leg was swelled from knee thru my foot, now it is only in knee area and truthfully no worse than before my surgery since the knee was injured then, It only gets warm after a lot of activity but the stitches feel super tight most of the time. Hubby keeps telling me to not bend it, afraid my stitches will burst open. He tries to get me to not do much, he got angry when I did laundry. I wish the doctor had talked to him more about what I needed to do. Thankfully my house is one story but large so even though I have cursed that fact during this, it does mean I have to walk further to get to the bathroom etc. so I do get some exercise. I often am grimacing in pain and often get aching in the knee area. I'm glad I found this forum as my information is very apparently lacking. I will try to get much more info during my doctor visit. I only hope hubby has passed that stone by the time of my doctor appointment and can take me. I want him to have the info too, to properly help me and not discourage me from doing things for myself. I honestly tried to be prepared for this ahead of time but apparently did not have enough info and did not foresee hubby being in pain at the same time. I am the usual caregiver, not him, although with kidney stones there is not much I can ever do for him anyway. I wrote down the exercises and although I do not have a stool, hopefully I can try the others and get the stool soon. I have a very bad left hip, same side as my replaced knee, so have to be very careful with anything that harms hip or I won't be able to complete any PT. such as squats.  I had planned to have hip replacement first until I had this terrible fall on the left knee and it had to come first. I need to do all PT I can protecting my hip in the meantime. My sister-in-law who lives in another state told me that Aqua therapy was the best way if you have other bad joints as it is easier on them. However I know I will not be able to soak in water for awhile yet. I do have a pool when I am able, but again do not know what exercises to try once doctor says I can use the pool. I will try to post more Thursday after my doctor appointment, hopefully I will have more direction then. In the meantime I will be trying some of the simpler PT exercises to get started.

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    • Posted

      Oh you poor thing, you are going through so much.

      It will pass, you will feel stronger, and your husband will pass the stones.

      It's all just a matter of time. But, and it's a big but, you are more important than the laundry. Don't do anything at the moment that you don't need to.

      And you do need to do excesices or you will be back in hospital for a manipulation.

      Just try to do what you can, but it is so important that you do them every day to stop your knee stiffening up.

      If you don't get a good bend at the beginning, you may never get it, and it's such a big surgery to go through to have it fail.

      I have other disabilities so I really do understand how hard it is to cope with the pain and everything else, you have to be strong and think about your future.

      When you can go in the pool, one of the best excesices you could do, is just to walk in the water, the resistance makes your leg muscles stronger.

      I may make your hips ache more at first, but try to keep it up.

      Above all, just remember that everyone on here has gone through the pain,and come out the other side.

      Best of luck with everything, and let us know how things go when you see the doctor.

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  • Posted

     You should excersice from day one or your knee will not bend or straighten and you may need MUA

    This is really important for a good range of movement.

    You can't just stay in bed, or your surgery will not be successful.

    Slowly and gently, you will get there.

    You need wrap round ice packs, for after excersice, put on your knee for 20 mins, then back in freezer.

    Sit on a high stool, legs off the ground, and slowly swing your leg back and forth, build up the time as days go by.

    Stand in front of your work top in the kitchen, hold on with both hands, slowly do a mini squat, only part way down, and slowly back up.

    raise up on your toes and hold, slowly go back down.

    Raise your bad knee behind you, slowly, it doesn't matter if it's just a few inches at first, and hold, then slowly back down.

    Turn side on to the worktop, one leg in front of the other, and slowly bend the front one while keeping the back leg straight, lean forwards, and slowly back. Change legs and repeat.

    Do all these excersices in repetitions of 10, three times daily.

    When you are able to do this easily increase the number.

    You HAVE to stick to this and do every day.

    These are PT excersices, and will unstiffen your knee, but you have to be committed and do them every day.

    Use ice and take painkillers, you can make yourself better, believe me I've been there and done it with both knees.

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  • Posted

    I'm 68 and 13-weeks post-LTKR.  Pain...check.  Percocet...check.  PT...absolutely.

    Look at Laura3333's reply and my thread titled "Zero Degrees!!!"  This will be neither fast nor easy but the pain will end and you will get back full range of motion if you do the PT and home exercises.  Get off the painkillers as soon as you can (Percocet and other opioids are very constipating), get a good therapist to work your knee and hit the gym.  After 9 weeks of PT, I'm -1 / +128...takes a lot of work so be prepared.

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  • Posted

    Use colase before starting mirilax. One is a stool softener and the other a laxative. Try colase 2 times a day. Dont let pain keep you from excercising as it will set you back rehab wise.

    I hope you have a waterproof seal on those staples. If not......DONT BATHE....that's a straight line to an infection. I won't bore you and everyonevelase but I've bee through 11 leg surgeries and 5 rehabs. Be kind to yourself and don't overdo it. Work slowly and steadily. Straighten your leg.....tighten your quads ....do leg lifts gently. Ice and elevate. Be sure and hydrate. Dehydration is an enemy of healing and also contributes to constipation. Others on here will offer great suggestion as you are in a revival tent full of believers......believers that knee problems are roadways filled with hazards and pitfalls.

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  • Posted

    By the way......I'm 79 and have been battling knee problems for 13 years, all caused by as rare tumor
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  • Posted

    As everyone else has said. PT is very important. And the right pt person. I stayed with someone for 6 weeks and wasn't getting anywhere. At 7 weeks I had manipulation done. Trust me you don't want that done. You can avoid it by moving and bending your knee. You need to not let scar tissue form. Exercising when you're in pain is not easy but we have all done it. I always took my pain meds 1 hr before pt in earlier days. It helped me to get through it....good luck to you..
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  • Posted

    Hi again Peggy smile

    You certainly do have a lot to cope with! Re physio, you have been sufficiently active and kept moving so far, but you really do need a proper physio plan to start this week. I agree with others that this is essential. The exercises need only take half an hour a day to start with (building up to more) and I would say that if you have to choose, leave the laundry and do the exercises. It's important too to take pain meds if at all possible, as this will help your mobility. Can your doctor suggest how to balance this with the IBS? 

    I too have other health conditions so I know what it's like to try to deal with several at a time - not easy. However, you must put yourself first for a while, not least because your recovery from this op will help your hubby, daughter and grandchildren in future, when you will be more mobile.

    Youre in a difficult situation but it will get better. Sending you every good wish x

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  • Posted

    Take the Percocet as ordered which I'm sure is more than once a day....as I have said before, there is no award for going without pain meds. Prune juice was my best friend; 6 oz every morning.

    Good luck, this surgery is a hard road. Get your expectations down to realistic ones and TAKE YOU MEDS so you can PT back to normal.

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