6 weeks post op

Swelling seems to be based on how extensive the surgery was. My wife had to have the knee opened and worked on 4 times (PKR) so she has had lots of swelling for months and months.

I've been reading up on the swelling and it's called a seroma. It seems to happen when the  the lymph/blood vessels have been damaged (unavoidably, during surgery) and skin comes loose from the facia below it. It's usually made up of serous fluid (pale yellow) and is slowly reabsorbed back into the body. 

If it lingers for long, the doctor can suck it out with a syringe but there are two schools of thought on this: 1. Introducing a syringe (even under sterile conditions) can cause an infection in the knee and 2. Not draining it can lead to an infection of the knee also. Kind of a Catch-22.

If the body doesn't reabsorb the fluid, a wall can develop encircling the fluid and isolating it.

One treatment for fluid not getting reabsorbed is using a sclerosing material such as talc or erythromycin or about 4 or 5 other compounds. This seems to work pretty well with few side effects but not enough studies have been done to recommend completely. 

So, just ignore all the above and I'm sure you will be fine soon.  If not, come back to this thread and you can review it at that time and ask a doctor about all this.

"Hey dad", I asked to the umteenth time from the rear seat of the '49 Chevy..."How long till we get there?"  My father stoically replied: "We'll get there when we're there."

A TKR is the most Zen of all surgeries.  When will it be better?..."When it's better."  We are the ultimate "McDonald's" society.  We put in our order and we want the food NOW!!!  We ask for something and EXPECT it to be delivered overnight, two-day priority, etc.  It doesn't work that way with a knee.  There are no timetables, there are no date expectations, there is no "I should feel better by now."  There just isn't any of that.

Your answers: The swelling will be gone when the swelling is gone.  Done.  If you push the knee in any way, it swells.  Stop pushing the knee.  Even so, you will notice that the TKR side still looks a bit larger than your original knee even a year later.  Things like swelling, stiffness, clicking sounds usually resolve by the 18 month mark.  Some sooner, some longer.  There are no timetables, there are no guarantees.

If this sounds harsh...it is because it's the stark reality of a TKR recovery.  Very, very few people skate through this and recover very quickly.  I've read over 4,000 posts in two years...it is a really rare occurrence. On the other side, it's also really rare for people to be in significant pain with loss of mobility after 12-18 months.  Virtually all of us have moved on with our lives by then thankful for the surgical miracle and happy not to be in a wheelchair for the rest of our lives.

Energy?  My doc said: "All the healing energy of your body is being directed at your knee."  Period.  Eat healthy, hydrate, exercise.  Start to rebuild your dead quads, core and glutes after you finish the ROM work.  Most people report "feeling more like their old selves" at around nine months.  Some quicker, some later.  Same with sleep.  As the worst of the pain subsides, sleep gets better.  But there are things you can do to help...

https://patient.info/forums/discuss/trouble-sleeping-post-tkr--539591

This is an annoying but temporary problem.  For a full recovery, get all expectations and time-related questions out of your head...only screws up your brain.  There are only three things of import...three things you have to hold in your heart, mind and soul: time, work and patience.  That's it...that's the key.  The knee needs time to heal, you have to do the ROM and muscle rebuild work and, finally, you have to have the patience to let it all happen when it's meant to happen.  I know...we all should have taken "the blue pill" when Morpheus offered it to us in the first place...

I've heard all kinds of recovery timelines on this and other forums (forii?).  It seems really individual.  Maybe there's a medical web site out there that has a typical timeline, etc.  I've read posts that describe swelling and pain 2 years out. I've also noticed this energy drop, especially at mid afternoon, when I just need to lay down (and I always hated napping).  I'm at 4 weeks out.

 I like waiting to hear what Chico has to say before I respond to these queries now. He has lots of good advise and knowledge to give and for us to learn from about our venture and it’s consequences. I am recovering fast, according to the averages. My ROM is where it should be for a comfortable life. As for your question about the pain,  my wife reminds me that I quit yelling in the middle of the night from the pain around 6 to 8 weeks. Now at 11 1/2 weeks the pain from surgery it’s gone. More importantly, the pain from arthritis is gone!  Swelling gone. Meds are 1 ibuprofen 2xs a day (more out of a 10 year habit) then need for pain relief.  My doctors talked me into bilateral TKR because I was a good candidate. In shape, active lifestyle, time to heal as I recently retired, low BMI and most of all “lucky DNA.” If you (as an exception to the rule) feel you fit about where I am, TKR heals fast...but knock on wood for Chico’s sake because he’s right about our Fed-Ex mentality. We Want It Now!   If you have access to a recumbent bike and C2 rowing machine, I found a good workout on both helped me a great deal. I keep my aerobic up, ROM and flexibility up help pass the time in a more productIvey conducive filler to my new healing lifestyle. Thanks to the advise I get here, I will be patient and not throw these blessings out the window for impulsiveness. 

Good luck, nice to hear I’m not alone as an outlier.