The TKR Experience (or...Wish I Had Another Kidney Stone)
Posted , 86 users are following.
Most Important... Everyone heals at their own pace. Don't judge yourself by anyone else's progress. This is between you, your PT and your doc.
That being said...here are some "ballpark" estimates...
1. Medication... Take your pain meds. This is not a test of endurance. Need 'em? Take 'em. Ballpark... Most people are off the the opioids in 4-6 weeks; some need them longer. 800mg Ibuprophin or Tramadol (both RX) after that if you need it. The opioids will make you constipated and possibly dependent. Nobody wants something highly addictive in their medicine cabinet; toss them as soon as you can.
2. Pain... A TKR is really, really, really, really painful...no getting around it...especially the first month. Don't measure your pain levels daily...monthly is better as you'll see dramatic changes from the longer time span. Ballpark... The worst of the pain will probably be gone within 90 days...but again, everyone's different.
3. Assistance... Crutches, walker, cane...whatever you need for as long as you need it. Ballpark... Most people are off of all those items within 90 days but the sooner the better. Gotta start to learn how to walk on your own again...sometimes, you have to push it. (NOTE: This may not apply to people with previous hip/knee/leg problems or to the elderly.)
4. Pysical Therapy... Gotta do it. Your therapist will work with you to both straighten and bend your knee. Full range of motion is zero degrees straight and greater than 120 degrees bent ( 0 / +120 ). I started at -14 / +84 and finished 9 weeks of PT at -1 / +128. Ballpark... Depending on age, previous conditions, individual circumstances, you should shoot for the full range of motion goal. If you can't get there at PT (I was still one degree from straight), finish the work in the gym or therapy pool. The closer you get the better...but again, everyone's different. You should consult with your doc and PT. Who wants to walk with a limp or a cane the rest of their life???
5. Exercise... After PT, ya gotta rebuild the muscles in your leg, especially the quad. Walking, swimming, stairs, whatever. You have to rebuild your strength to support the knee. Ballpark... Since it's during and after PT, this work usually falls within the 3 to 6-month range for most people. My daughter has been an ACSM- and ACE-certified personal trainer and graduate nutritionist for the past 16 years. Her recommendation: Build endurance before strength. Warm up on a bike for 30-45 minutes (set the seat high enough for full leg extension)...then do your stretches. For your exercises, start with NO weight but perform 3-4 sets of 12-15 reps each until you are at ease with every exercise and are not tired out by them. Use your good leg to stabilize yourself during the the exercise...don't use the good one to fake the reps. The idea is to get the bad leg as strong as the good one before you fully exercise them together again or even isolate the bad leg for exercise. Once you can't tell one leg from the other (feeling balanced and not relying on the good one), start adding weight...slowly....like 5 pounds at a time, again using the good leg to stabilize yourself. Any pain, strain or swelling means you did too much too fast. Back off...you'll eventually have equal strength in both legs. PS: I guess people with BTKRs can do both legs together...I'd have to ask her.
6. Swelling... This is the knee's way of telling you that you overdid it. Back off, ice, elevation, rest. Ballpark... Everyone does this at one point or another. Listen to and learn from your body. Avoid pushing it too far. There's a fine line between progressing and heading off the cliff. Everyone has to find that sweet spot for themselves.
7. Sensations... There will be numbness at the incision site. Nerves have been cut. Ballpark... Crapshoot; normal feeling may come back or it may not. Some people have an uncomfortable sensation of the knee rubbing against clothing or sheets. Hint: Wrap the knee loosely with an Ace Bandage or buy a "knee sleeve" and slide it on over the knee. Easy Fix.
8. Sciatica... If you've never experienced this intense pain from your back, through your hip and then running down your leg, be thankful...be very, very thankful. On occasion, the sacroiliac (SI) joint on one or both sides of your hip will lock up and pinch/inflame the sciatic nerve. This happens because we change our gait to compensate for the knee pain. In layman's terms, "you threw your back out." Ballpark... Some people get it, some don't...another crapshoot. Possible solutions: steroid injections, Celebrex, Lyrica, 800mg Ibuprophin, chiropractic, therapy pool, accupuncture. Whatever works; talk to your doc. It's temporary but painful; cross your fingers and toes that you don't experience it.
9. For simple discomfort that doesn't need RX painkillers... Aside from the standard OTC pain meds, here's a suggestion: Voltaren Gel (diclofenac) is a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing substances in the body that cause pain and inflammation. Voltaren is used to treat mild to moderate pain, or signs and symptoms of osteoarthritis or rheumatoid arthritis. I use this almost every night; just rub it in. Works in 10-15 minutes. RX only. Get your MD to write a script for lots of tubes (I got five right out of the box.). Checked with a few pharmacists about an OTC pain relieving cream...they all told me to get my doc to write a script for Voltaren. Don't think about it; just do it.
10. Post-Op Depression... No one..NO ONE...talks about this, not even the docs. Found out the hard way when I had my hip replaced in 2009. Hospital, rehab facility then home. Started crying and couldn't stop for three days. Called my MD cousin. Told me that it was Post Operative Depression. This is a KNOWN condition that occurs frequently in people who have had an operation that removed an original part of their body. Not so bad for appendix, gallbladder, etc. Moderate to severe for hips, knees, shoulders, etc. Really bad for heart transplants, traumatic brain injury, etc. For us, it's a definite possibility so be prepared. Blown away for three days with the hip until I knew what it was. Gone in 24 hours because I was now aware of it. For the knee, I was totally prepared. Kicked its butt. Remember...this is a definite possibility so be prepared. If you start feeling really sad and you're crying all the time post-op...now you know. Get out of the house into some sunshine. Take extra Vitamin D. Eat healthy; hydrate. Do not let this get to you and do not start anti-depressants. This is a temporary condition. Concentrate on pain management and rehab...PT and gym...endorphins do wonders in combatting depression. Get on top of it, wrestle it to the ground and beat the everlovin' crap out of it.
11. Long Recovery... That "swollen look", popping and clicking sounds, stiffness...all normal. Ballpark... All of this should resolve in 12-18 months...or maybe it won't. Who the hell knows...I'm just thankful that I'm walking again and not in a wheelchair for the rest of my life. Goal...get back on my skates again. After 44 years playing hockey, it's been too long. I'll never play the sport again but just skating would be soooooo great. Just have to see what happens.
12. Goals... This is easy. SHORT TERM (3-4 months): Get off the opioid pain meds; switch to non-addictive pain killers if you need them. Use the Voltaren Gel. Go to PT and get your full range of motion back (0 / +120). Toss your walking aids. MID-TERM (4-12 months): Rebuild your leg and core strength. Complete any range of motion therapy/exercises so you are walking normally, especially up and down stairs. Start adding close-to-normal activities, like walking a mile every day if that was your "thing". Begin with a lesser distance and increase without any knee swelling. LONG TERM (12-18 months and beyond): Set realistic goals for leading a fully normal life again...as if the TKR had never happened. However, there may be activities that you once did and must now avoid. For me, I can skate but not play competitive hockey ever again. For others, running may be bad because of impact issues while speed walking might be a good substitute. There are plenty of on-line resources that list OK, possible and "never again" activities for people with knee and hip replacements. Your doc will probably have his/her own ideas but this is from The Mayo Clinic: "After you've recovered, you can enjoy a variety of low-impact activities, such as walking, swimming, golfing or biking. But you should avoid higher impact activities — such as jogging, skiing, tennis and sports that involve contact or jumping. Talk to your doctor about your limitations." I saw one site that listed singles tennis as a no-no but doubles was OK becuse there was less movement and impact. It's all very individual but the ultimate goal is to lead a healthy, active, productive life again...a far cry from lying in bed in utter pain one week post-op.
Did I miss anything?
43 likes, 339 replies
marilyn22260 CHICO_MARX
Posted
Hi Chico,
I don't think you missed a thing. In fact, every time I think I turned the corner, something else comes up (ie: suture area on top of thigh red and swollen, stitch looking like it wants to come out). And that's when I read your detailed post. I'm the lady who has the problem sleeping, and has the feeling of a rock and a huge band around my knee and ankle.
Well, 9 weeks post op and the pt measured my bend yesterday and it was 115. I started to cry for joy. Of course he bent it until I almost fainted, but I am thankful.
I did notice that many of us, and I don't know if they are male or female have extreme fatigue which is what I have. I started a lot of supplements and yesterday my naturopath gave me Cucucumin, which is turmeric root and liquid tumuric for pain and inflammation. I'll try anything at this point. I'm getting ready to take a 5 hour flight to LA in 3 weeks so it's a good goal. Goals, as you mention are very important.
So again, I want to extend my thanks to you and all of you who have taken the time to write such good thoughts and advice.
Have a good weekend everyone.
Mkhp marilyn22260
Posted
Hi marilyn... Your doing great girl. I'm 16 weeks po at 107/3. That measure was done without doing any stretches before hand. I'm at the point where pt is working on strengthening my leg. Next week I'll be discharged n she'll do one last measure at end of week. Last week for the first time I went to visit friends for a week, so only did exercises once a day instead of two times a day. So oops I had a little fun/normality!?! Anyway back to work. I'm a slow healer, but at least I'm healing, and staying positive to reach my goals of at least 120+ bend and 0 stretch..... I'll get there. So have no fear, it's tough work, if you put in the effort everyday you'll get there. Healing blessings blowing your way, ?????? ?????? ?????? ??
susie07313 CHICO_MARX
Posted
Hi guys, looking for some more wisdom, please. Was doing ok after 5 weeks, of course struggling with pain, good and bad days, bit weepy, religious about exercises, trying to be realistic. However, have caught a fluey chest infection, and am totally flattened - can't seem to keep vertical, legs collapsing, no appetite (problem as diabetic and have to eat strict diet and times). Still exercising in bed on the bend and flatten but can barely function. is this normal? Is it so much worse due to the existing shock to the body?
Any advice appreciated... feeling pressurised by family to get better
x
CHICO_MARX susie07313
Posted
1. Read everything in the original post.
2. Take care of the chest infection FIRST!!! You don't want to end up with pneumonia!!!
3. Screw the family. Really. This is your body...period. Have heard this from others and everyone's response is the exact same thing. Swing a crutch...whack them with a cane...roll them over with a walker. Don't take crap from anyone...ANYONE!!!
tijim susie07313
Posted
Hi Susie .. great advice from Chico and if your family doesn't know it can take anywhere from 12-18mths for recovery depending on your knee. I hope you're on antibiotics for you infection .. the moment I'm not well was told by surgeon to get to drs and on antibiotics asap so an infection doesn't get into the blood stream. Cos if it does it can stop and your knee and then your new knee will become infected needing a replacement. Please take care and make family research your op .. it's a big deal .. one of my sons said oh it's only a knee and can't get over how long it's taking to heal. I'm 10mths post op but have had issues along the way .. waiting for them to clear up so I can have my other knee done.
Always remember look after you NUMBER 1 you are what's important until you have recovered and it's a long slow hurdle for some of use. Take care x
susie07313 CHICO_MARX
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susie07313 tijim
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Thank you so much for understanding. I resorted to showing my mother in law a photo of an open knee with the replacement just inserted.... perhaps that will do the trick.I am also sick of other people telling me "oh, so and so had a hip replacement and they were back dancing/ski-ing/hang gliding after 4 weeks.....
Hope you are well, and thank you again x
sue37592 susie07313
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We will all soon be dancing soon....might jus take a while xx
CHICO_MARX susie07313
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But rehabbing a hip is VERY different from recovering from a TKR. I've had both and was warned before the TKR that the knee takes way longer to recover from than the hip. Finished the hip off in six weeks (five hours a day, six days a week, gym and therapy pool). I'm now 5-months post TKR and doing very well...but it takes time and work. People who try to return to work in six weeks are fooling themselves. So many report swelling and pain every day. Duh... Too soon, although some lucky souls have pulled it off.
Just ignore the idiots who think you should just bounce back immediately from this. There's a reason for the title of this post... It is literally the most painful experience of my life...and I played hockey for 44 years and have had four kidney stones. I have a Ph.D. in pain. Wait until one of your critics has a TKR and then look them in the eye... Payback. Don't you love it when poeople make judgments about someone else's pain without ever having gone through it themselves?
I'm a Sicilian from Brooklyn. If you ever need Carmine and Paulie to pay someone a visit, just let me know.
shan99257 susie07313
Posted
Oh don't you HATE it when people do that Susie?? I get that all the time from people! They have got NO IDEA unless they have been through it! That's why this site is such a Godsend for all of us! Keep up the good healing!
Mkhp tijim
Posted
Kindly ask your family member(s). To put themselves in your shoes for just a couple hours for one day. Ask them to tye up one leg so it can't touch floor. Ask them to do their normal activities and figure out how to get around, maybe then they may get a clue. Too bad you can't stick a couple needles/pins into the top of knee cap (just to add some pain). Ha ha, hang in there, fast healing prayers blowing your way.... ?????? ?????? ?????? ... Best, kathy p
CHICO_MARX Mkhp
Posted
Hmmmmm...needles and pins...
Doll. Face of person on doll. Insert needles and pins. I'm sure you can find some voodoo chant on the Internet.
That's the ticket!!!
susie07313 shan99257
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Susie
susie07313 Mkhp
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susan22517 CHICO_MARX
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I'm a week out on a TKR and first 2 days thought, "I wouldn't wish this on my worst enemy." But, am now starting a mental list of people I DO wish this on. I know, I know....petty. But fun. Glad I found this forum.
CHICO_MARX susan22517
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We should compare lists but I'm afraid it would get very political, very quickly!!! This forum isn't the place for that...lol...
Dcweather CHICO_MARX
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Agreed! Yove trumped me there
CHICO_MARX Dcweather
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ROTFLMAO!!!!! Hey...I just got to "Guru" status!!! Damn...wish it paid more...
NZJENNI CHICO_MARX
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fostersmith61 susan22517
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Hey Susan
I'm post op TKR almost 9 weeks. I wish you well. I found the first 5-6 weeks hell. Monotonous, painful, and discouraging. Sleeping at night without Oxycodone, "feghettabout it!"Advice and promising news from this 55 yr old fit male.
-PT no pain no gain (I hate that saying but here it is very true)
-Best thing I found to make a PROFOUND difference in decreasing pain and increasing ability was the bike. Painful to try those first few revolutions but a must!
- walk, walk, walk! You will find in 5-6 weeks your success will become self fulfilling. That is to say, the more you do, the more you can do! I'm pretty much doing everything I was doing pre-op. Some tightness and occasional use of ice machine but things WILL get better. I felt EXACTLY as you do now....(wtf did i just do to myself???)
Peace!
NZJENNI Dcweather
Posted
It's good isn't it !
Dcweather fostersmith61
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NZJENNI fostersmith61
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Great to hear
I was so excited last night when my knee allowed me to complete a revolution on my stationary bike - PT had me doing it back and forward as far as I could and whoops I went right around. It was quite frightening in its own wee way but I did it again and then again several times...I feel very clever now and my PT will be thrilled when I see her today.
I am starting my fourth week post TKR. Ice is my best friend as is binge watching TV shows on Netflix - something I am only learning to do to beat the constant sedentary state and the boredom that comes with it
NZJENNI Dcweather
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Dcweather CHICO_MARX
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I once heard a great definition of a minor operation - "It's one that someone else is having". It is so true, easy to be glib about someone else's problems but when the boot's on the other foot ............
Dave
fostersmith61 Dcweather
Posted
Right DC!
I drove myself to to the gym (even post 5 mg oxy 😳
at 17 days post op. I was tired of being house bound and needed to push myself. I was shocked at the benefit and it only served to incentivize me.
fostersmith61 NZJENNI
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NZJENNI fostersmith61
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Thanks for the encouragement - I want to be back on my boogie board this summer
fostersmith61 NZJENNI
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That's awesome! Boogie Jenni! I'm so glad to be boating, going to the gym, and being narcotic free. Soon my friend, soon!
susan22517 fostersmith61
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Thanks for the encouragement! I had zero comprehension of this pain even though I've had c-sections and bilateral foot surgery. I kept hearing from all these 80 yr. old people, saying TKR was the best thing they ever did. Warrior generation!
I'm 54 but caught a glimpse of myself in the mirror this morning, hunched over my walker, with a pinched, mean look on my face--and I looked exactly like my hateful 1st grade teacher. At least it made me laugh.
NZJENNI susan22517
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OH GOD I sooo get that !! We need before and after pics. I looked at myself with all my mobility aids and elevated toilet seat and saw my Mother in law - not an encouraging picture but one to give me motivation to get my old self back
fostersmith61 susan22517
Posted
Well great to hear someone my age underwent this surgery. You should do great due to youth and more muscle mass. I COMPLETELY GET looking in the mirror as NZJENNI points out. Between the walker, cane, and raised toilet device I thought NO WAY! it does get better, slowly..... I'm told women tolerate the PT pain better than men, but there is pain. I joked with the PT lady and told her "I'm not responsible if these staples pop off and fly at you like bullets". BTW you gain 5 degrees and significant pain reduction when staples/sutures come out. They act as a restrictive device to your ROM.
susan22517 fostersmith61
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He did internal sutures, so no staples. Wanted me to have a pretty scar. This makes me illogically angry.
LOL at NZJENNI...I was thinking of my beloved Mother-in-law this morning. I really encouraged her to do a TKR at 80 and would go over and force her to do her PT. She died 2 months ago---I wish I could call her and apologize! She did have 9 good years with her knee though and didn't once slap me for being so cheerful during her PT sessions.
CHICO_MARX susan22517
Posted
There was a study done a long time ago of women who gave birth and had kidney stones. Given the choice, the vast majority would opt for another child rather than enduring another stone.
I've had FOUR kidney stones and now a TKR. Give me another TEN stones!!! Please!!! Not another TKR...
Mkhp CHICO_MARX
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Mkhp fostersmith61
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MeggsMum susie07313
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Hi Susie. My response to people who say "you don't look sick" (I aso have fibro), is " and you don't look stupid, but looks can be deceiving".
CHICO_MARX MeggsMum
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I'm from Brooklyn...we get more physical. Beat them repeatedly with your cane or run them over with your walker. See if they like the pain...
debi51 CHICO_MARX
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Chico, you are a silver tongued devil. You make me laugh and forget I hurt. I did want to tell you (I may have mentioned I use essential oils) that I have found an oil after much trials that is relieving some of the discomfort. I am diluting oregano oil, it's a hot oil and needs to be diluted, and it's working. Voltaren is not possible for me because I'm highly allergic to nsaids. Thank you for your positive encouragement and outlook on all of this. I have also been approved by the ins company for 8 more visits to my pt for strengthening. I am anxious to see if the therapist can explain the immense bruising I get anymore - I barely had any after surgery
😊😊😊
CHICO_MARX debi51
Posted
Voltaren is only the second best topical anti-inflammatory out there. The very, very, very best is available through certain dispensaries in certain states (like Colorado) if you have a certain "medical card". Call it "Green Slime", Green Goo" or, as the natives there say, just plain "Lotion". Works in less than 5 minutes. All natural...no chemicals...plant based. Find a friend who has the magic "card" and get some.
Oregano oil...I'll get a big bottle and use some on my pasta! I'll check my local Sprouts store...they have all the oils. Thanks.
debi51 CHICO_MARX
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