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Questions after recent TKR

Posted , 13 users are following.

peter73207
peter73207

Hello everyone,

I had a TKR 11 days ago and this is much harder than expected. Have been pretty much in a constant 5-7 pain level the entire time. I was originally released on hydromorphone, which worked great in the hospital, but didn't help very much after being released.

Have since switched to Percecet, which helps, but still near impossible to get

comfortable for any length of time. Is this normal?

I have only been to 1 physio appt so far since leaving hospital but my ROM is not so great. Before the op, I couldn't straighten my leg better than maybe 18 degrees. I'm under 15 now but expected it to be much better. Is it reasonable to expect to get it to at least 4 or 5 in time? The bend is only at just under 90 so I know there's lots of work ahead of me there as well.

Another thing I have noticed in the past two days, is every once in a while it feels like

someone takes a red hot razor and slices an arc at the side of my leg just below the

knee, or that a very fine cut has just been torn open. It's very hard to describe but man is it brutal. Only lasts a few seconds but stops you dead cold. Has anyone else experienced this?

Than you for any response. It's encouraging beyond words to be able to share experiences with others. Hope I can be of help to others here as well.

 

2 likes, 49 replies

49 Replies

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  • Butthillrob
    Butthillrob peter73207

    Posted

    Hi Peter. Take heart from this forum.  It's really helped me to share with others and to know that we are all in the same boat. I am just 7 days post op. There is no exact science or perfect answer to our recovery. Nobody can prepare us.  Not even the medics This is my second knee, and oh boy it's so different to the first. I too struggled to get a 90 bend. I had massive swelling on the knee and severe bruising toe to thigh. The surgeons really hammer us on the table and as mentioned all the soft tissue bits take the brunt. This in turn means we get it also  Keep to regular icing, elevation and meds.  Exercise is awful but try your best  It gets easier ad swelling reduces. Yes you will have assorted pains.  One tries to reason why. It's the bodies response to what we have been through  It will get better. Gabapentin or lyrical can help with nerve pain. Discuss with your doctor  I can't raise my leg independently. But advice from forum family had taught me how to do it and I'm grateful for help . Hang on in. We are all here to help and share.

    Robert

    • peter73207
      peter73207 Butthillrob

      Posted

      Thank you also Butthillrob for the encouragement and positive outlook.

      My bruising was also pretty severe. From thigh to ankle but it has much

      improved. Knee is still badly swollen but like others are saying here, that might take some time to improve. My staples come out Monday and I'm hoping that will make a diff.

      Will let everyone know how it goes. In the mean time, I'm hangin in my friend. You also do the same. It will continually get better. Maybe slow but sure.

      Peter 

  • susan20089
    susan20089 peter73207

    Posted

    Hi peter all I can say is that I reiterate everything else that has been said. This is a very cruel ooeration and it takes no prisoners. The sharp pains you describe are a matter of course. I am four weeks post op and sometimes don't know what to do with myself when the pains are bad.  People who haven't had this op cannot comprehend how painful it is. Just take rest and lots of it, fluids and pain relief, this will get you through it. Good luck xx
    • peter73207
      peter73207 susan20089

      Posted

      Thank you so much Susan and boy your right on when you say "sometimes dont know what to do when the pain gets so bad". You toss and turn, dont know whether to cry or throw stuff around the room.

      I have an Ipad and have been keeping a spreadsheet on how my days are progressing.

      Sounds funny and maybe even senseless,  but I have entered and re-entered the same thing many times over using diff words but it has kept my mind side tracked from the pain.

      This forum has also been a very positive motivator for me.

      In Psalm 37:5 it says:

      Commit thy way unto the LORD; trust also in him; and he shall bring it to pass. 

      I will pray for a speedy and full functional recovery for each of you.

      Thanks again

      Peter 

  • glenda29798
    glenda29798 peter73207

    Posted

    Hi Peter! I thought it would be all a bit of a "breeze" as I was fairly young at 57 with no other health problems but what a shock I had! I'm now at 9 weeks 2days and still wake up at night in pain if I forget my meds, but at first I woke up every hour at night, had very little energy in the day and had moments of real depression. My bend was only about 75' for the first three weeks and so yours is very good at 90' so don't worry! I only reached 100' last week and can now turn the pedals on a static bike but as I write this, my leg is elevated and I've got my ice pack velcroed onto my poor, swollen knee! No one explains what this very major operation actually involves before you have it done and as far as I can make out very few patients seem to recover in a short time and have no pain, or depression etc etc.

    I found this forum when I was awake at night and it has definitely kept me going through this saga, so keep in touch and the people here who have got the TKR tee shirt will get you through it!

     

    • peter73207
      peter73207 glenda29798

      Posted

      Hi Glenda,

      just finished my 2nd set of exercises for the day and I could chew through a steel bar right about now. Aaaaah! These exercises are tough! I too am only 60 with no previous health problems. Was very active kayaking/canoeing, biking etc and figured this wouldn't be that bad but man was I wrong. Your comment about the TKR Tee shirt brought a real smile to my face. Thank you so much.

      I agree, no one can really prepare you for this. Others told me it would be painful but you can't understand the reality until you go through it.

      Thank you for you encouragement and will definitely keep in touch. Please do the same.

      I wish you a speedy and full recovery.

      Peter 

  • fran54306
    fran54306 peter73207

    Posted

    oh Peter, they say its the most painful op ever ,and they dont lie. I know others will sympathise because weve all been ther. It truly does get easier,all you need right now is to conquer the pain thats the most important thing. Its like evryone tells you,its a huge thing youve undergone,your a brave lad! Deal with the pain first thats the key and then the exercises and the lovely icepacks,and for goodness sake be kind to yourself your a bloody hero! Its an up and down road ahead but it does get better every week and soon you will be amazed at how much you can do and how far youve come,so chin up,and good luck. This is the place for all the support and most of the answers too.

     

  • britta217
    britta217 peter73207

    Posted

    hi peter ... very early days for you.  so the good news is that each day is one day closer to it getting better.  the bad news is that it will be a battle every day.  telling you anything else would be lying.  but you know what you are working towards, full mobility of your leg without pain.

    in answer to your question is that getting the stretch in just 4-5 physio sessions is possible but rather unlikely which is why exercising is very, very important.  my stretch was always good, my bend was bad despite everything.  you just have to keep at it and do you best and definitely not get too focused on that in the first weeks.  healing is important.

    i am one of us on here who is taking lyrica.  in general i would definitely confirm that getting your cocktail of meds right is your top priority.  it will help you keep mobile, do your exercises and even sleep.  if you feel yours is not right, then make sure you get what you need from your doc.  the rest will follow with time.  how much time is totally individual.

    britta - somewhere around 16 weeks - in switzerland

  • Timo007
    Timo007 peter73207

    Posted

    Hi Peter

    I guess we all have different pain threshholds and also maybe sustain different amounts of nerve and soft tissue damage. At only 11 days out it's still is pretty early days yet. I am about 3 weeks out and each day is getting a bit easier and bettter for me. I too get the odd sharp pains to the side and the back of the knee, and usually ice pack it up on the sofa for around half an hour which seems to help. I would not be too concerned yet, but if things dont slowly improve in a couple of weeks (or get worse) then I would certainly seek more medical advise. Its a slow steady journey with highs and lows, so trying to maintain a good mental approach is important and often under rated by the medico's. Just Try and stay foccused and positive. Cheers, Paul 

  • Butthillrob
    Butthillrob peter73207

    Posted

    Hi Peter, as a separate issue. I really am struggling to sleep, cant get a position for the knee or me to sleep. Would welcome any suggestions as I am shattered with 2"hours a night sleep.
    • susan20089
      susan20089 Butthillrob

      Posted

      Hi there I have been having the same problems with sleep but bought some Nytol (UK) and I find I am sleeping for about five hours now instead of two or three, but still on my back and can only sleep on my couch not in bed. 
    • Butthillrob
      Butthillrob susan20089

      Posted

      Hi Susan and thanks for suggestion. Will give it a try. Its early days for me. 7day post op. It's a double whammie coping with knee and lack of sleep. Here's hoping for a better night.

      robert

    • Timo007
      Timo007 Butthillrob

      Posted

      Hi

      This is actually a really common issue judging from the Googling I have done. I actually barely slept for the first week at home and felt like a Zombie! My wife kept nagging me not to sleep during the day, but even this did not help at night. Best advice is to sleep whenever you can, whether thats 15 minutes after getting out of bed, midday, or the afternoon. Sleep is sleep and it all helps. I had my first real good night only two nights ago. Last night I went to bed at 11pm and slept through until 4 am. I went into the spare room so as not to disturb the wife and watched an episode of 'midsomer murders' on the iPad (Lol) and then listened to some favourite music on my iPod until around 5:30am before dozing off again and waking at 8:30am.

      I am a side sleeper, and have found that a 'thin' pillow between the legs helps (NOTE: As your physio has probably told you DO NOT sleep on your back with apillow UNDER your operated knee. To make matter a bit worse, I ended up with two bad bedsores on each buttock (from a couple of nights of having to sleepo my back in the hospital bed) that have thankfully healed up now. They were red raw and the bone was bruised underneath. I was actually more worried about getting a secondary infection from these than the knee wound!

      I have had bad reactions from sleeping pills in the past, but was getting close to considering some 'Natural' one, but hopefully I won't need these now. I am sure you too will come good in a little while.

      Cheers, Paul (Timo)

    • Butthillrob
      Butthillrob Timo007

      Posted

      Hi Paul, it's frustrating. As you said little and often helps. The problem is you get conditioned and habits form which don't help. I too sleep on side but the cushion doesn't help me. It did in hospital, but I think that was more down to meds. Will persevere.

      Robert

    • peter73207
      peter73207 Butthillrob

      Posted

      Hi Glenda,

      just finished my 2nd set of exercises for the day and I could chew through a steel bar right about now. Aaaaah! These exercises are tough! I too am only 60 with no previous health problems. Was very active kayaking/canoeing, biking etc and figured this wouldn't be that bad but man was I wrong. Your comment about the TKR Tee shirt brought a real smile to my face. Thank you so much.

      I agree, no one can really prepare you for this. Others told me it would be painful but you can't understand the reality until you go through it.

      Thank you for you encouragement and will definitely keep in touch. Please do the same.

      I wish you a speedy and full recovery.

      Peter

      Hi Suzy, until your post I had no idea what manipulation even was. Have been trying to read up on it on the net and it sounds as though ROM increases significantly and they yield a fairly high success rate. Keep a positive mental attitude! 

      Hi Butthillrob,

      yes, as others have said, that appears to be one of the curses associated with this op. 

      My pattern has typically been to be up every hr to hr and half because of either pain, time to take meds or use the bathroom. In getting back to sleep it's always a struggle to find a position that is most comfortable and tolerable. Sometimes that is minutes sometimes hrs. As Timo has said, sleep is sleep. I grab whatever amount of time I can regardless of the time of day.

      On the good side, I am now noticing longer bouts of being comfortable and am seeing definite improvement in functionality. Progress is very slow but progress none the less.

      I had 1 night so far where I slept 3 hrs at a time. Woke only to take meds again and fell right back asleep. So don't get discouraged, things do get BETTER

      Susans suggestion of nytol sounds like a good one to me. Wonder how it might effect others meds. Think I might check this as well.

      Here's looking to some Happy zzzzzzz's my friend. 

    • Oldfatguy1
      Oldfatguy1 Butthillrob

      Posted

      Others have mentioned the nytol but it has active meds for other needs such as congestion, coughing etc. All of these additives can cause people with hypertension problems. If you have high blood pressure by chance, I would suggest caution using it as a sleep aid. You don't want to trade lack of sleep for a stroke.
    • susan20089
      susan20089 Oldfatguy1

      Posted

      With respect, I have re-read the leaflet for Nytol and there is no mention of using caution if you suffer from high blood pressure, which I in fact suffer from - it contains antihistamine which in itself aids sleep.  I work for a doctor myself who, if she needs sleep, swears by taking piriton as a aid to sleeping. I cannot therefore see that using Nytol as a short term "fix" to aid sleep as posing a significant problem.  Only my opinion of course....
    • Oldfatguy1
      Oldfatguy1 susan20089

      Posted

      That's really strange Susan as in the states it's part of the disclaimer or at least it was. I haven't used it for years as my doc made it a no no. It's the strong alcohol level plus a couple of the ingredients. It is really difficult to judge meds as each country has its own set of statndards. Someone mentioned a cortison cream or creams for pain that aren't sold OTC in the UK but are stacked high and advertised widely. I'll check furthur when I go to the pharmacy next time. Don't want to  unintentionally mislead anyone
    • susan20089
      susan20089 Oldfatguy1

      Posted

      Yes I agree it's very strange how things differ between countries. It is always best to err on the side of caution though. It did concern me a bit when I read your post about the hypertension.   Can't see anything regarding this. Shame I am not at work to check it out.   It is an otc med so I would have thought it would be ok. I will see if I can find out more too.  Thanks xx
    • Oldfatguy1
      Oldfatguy1 susan20089

      Posted

      The other thing, I guess there is a pill form I wasn't aware of. The liquid form is 33% alcohol and that was the docs concern when taking BP meds which I have been on for 20 years. I googled the product and there is a long list of side effects and conditions. One of much concern to people in pain, the edginess and nerviousness to some wouldn't be good. I would suggest anyone desiring to use it, google and see if you are subject to any of the conditions. 
    • michelle343434
      michelle343434 peter73207

      Posted

      Hi peter..I've read your story...I had my surgery Oct 1..then I had fall and they had to go back and fit muscle that had torn away from the tendent...then I had another fall last week which I end of breaking 2 toes on my right foot...Ive had knee surgery 4 times on my left knee..it been up hill battle for me...my doc gave me some muscle relaxer..to help after taking my first pill that night I was able to sleep all night long...trust me it's very hard and it take time 
    • Butthillrob
      Butthillrob michelle343434

      Posted

      Hi Michelle. I think I started the sleep debate. I'm 7 day post op. Sleep is poor 2 hrs if lucky. I value the forums suggestions. But will take gp advice to ensure no drug interactions etc.

      Robert

    • michelle343434
      michelle343434 Butthillrob

      Posted

      Hi Butthillrob...I agree with u...before I'm given anything my doc always check to make sure u won't have any problems...sleep is one of the biggest thing I was having....the more surgeries u have on the same knee the more pain u will go thur...the bring etc.u may feel as I was told is sometimes left blood..that will make it hurt lot more I've had my knee drain..just last week and my doc pull 2 tube of blood out of my knee...and that made it some what feel better..I'm in the USA...so every doc is different on how they do things..I wish u the best and hope..u can get some sleep soon. Take care Michelle 
    • susan20089
      susan20089 michelle343434

      Posted

      Hi I wonder can I ask about this this knee drain, do you come out of hospital with this still in your knee? In UK we only have knee drain in for max 2 days. Mine was out the day after op. The blood was transfused back into me. 
    • Butthillrob
      Butthillrob susan20089

      Posted

      My knee drain was on for 2 days.  What's amazing me is that bruising is still coming out. The surgeons must really hammer at us. I'm now 8 days post op. As mentioned desperate for sleep. Working on exercises. Not easy with the bend. Still swollen ice pack on now. Slight lower back pain but I put that down to odd and strange sleeping positions, all to no avail.
    • susan20089
      susan20089 Butthillrob

      Posted

      Yes I know the bruising comes out for weeks. I have a lot of burning in the knee now. Seems every day it's something new, pain wise,  I didn't exercise loads in first few weeks as I thought it more important to rest after the trauma.  
    • Butthillrob
      Butthillrob susan20089

      Posted

      No rules for us,  anything goes. Not needed to up meds. Ok for now with codeine and paracetamol. It's early days as I'm constantly reminded  Hang on in, it will be worth it

      Robert

    • peter73207
      peter73207 michelle343434

      Posted

      Hi Michelle,

      Thank you so much for the encouragement.

      You have certainly had your fare share of pain. This is a tough enough battle after 1 surgery. I can't possibly imagine 4. The folks on this forum I think have helped me as much as anything. You realize your not alone and your in others thoughts an prayers.

      Never underestimate the healing power in prayer.

      God bless

      Peter 

    • peter73207
      peter73207 Butthillrob

      Posted

      I also think thats most wise.

      I finally fell sound asleep. Must have been out cold for a good 2 hrs and then....ring...ring.ring...wrong number! Aaaaah!

      oh well, you have admit there is some twisted humor in this somewhere. Haha

    • peter73207
      peter73207 susan20089

      Posted

      Yes I too continue to keep experiencing new sorts of pain. After 12 days now I can see definite improvement but then someting else pops up. Like 1 step forward and 2 back. Guess the body is slowly waking up as well. Perhaps from it's own internal anesthesia. Believe ith's all a sign of progress and recovery!
    • Butthillrob
      Butthillrob peter73207

      Posted

      It's a rocky road. My previous TKR was a breeze 6 years ago  obviously no two alike  What did help.once mobile was to go walking in swimming pool. Just up and down. The massage and resistance lifting and bending whilst walking was a huge help
    • anne02414
      anne02414 peter73207

      Posted

      The surgeon who performed the 4th on the 13th did a fantastic job but all three prior were performed within 10months by another surgeon. After reviewing the surgery notes after getting my records from his office I discovered to my horror that after opening the flaps at the onset of the first TKR he saw a large cystic lesion full thickness; ie:osteomyelitis of of the femur! Instead of treating the infection he slapped on the implant which of course led to failure 3 months later. I gave all this info to this home health PT with also the diagnosis of severe osteoporosis that I'm treating with Boniva. I'm seeing my Pain Mgmt MD on the 26th, thank God.

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