Total knee replacement

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Hi got the dreaded news Friday not looking forward to post op pain and discomfort would love to hear how you got through the first 3 weeks and when you could walk without aids. I have been through hip replacement but told knee replacement are worse for pain and recovery any experiences are welcome .

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  • Posted

    If you are a shy person like me that people don't listen to this is the time to verbally tell your nurses and doctors any ongoing problems you are having.   It took 17 days for someone to take me seriously when I tried to tell them my pain meds were not strong enough.  We worry about becoming a drug addict but someone who takes their pain meds on a schedule so they can do physio and get some rest are being reasonable.  My pain meds were only lasting 16 out of 24 hours.  If you're in pain then those who love you will also be in pain.  You need lots of rest, ice, and pain control, ice so you can do your exercises so you can get your life back.  Don't expect anyone else to know what you need.  Speak up.  I will be three weeks post op tomorrow.  Have three weeks before I graduate to a cane or walk solo.  Better than that will be sleeping on my side again.  I wish you well.  

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    • Posted

      Thank you lywn good to hear from you, how are you coping psychologically with pain and recovery.  Fortunately having had a hip replacement I now know the shock of the swelling and first 3 days being the worst I had experienced in my life I never thought I would have to enter that place again, I just want to build the courage and strength to deal with post surgery pain and recovery.
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    • Posted

      In the past I'd had a surgery where the anaesthesiologist was not doing his job and let me wake up partially while having surgery.  I thought with this surgery I would be all the way under but didn't know until the last minute that I wouldn't be all the way under.  I'm still having panic attacks because of it and pain meds have within them the possibility of giving you weird thoughts and panic attacks. I think what is helping me the most is thinking about going on walks this spring and taking nature pictures and going fishing in a near by loch. I wasn't able to do that last spring.  Even though I am 65 I look forward to getting back to work too.  I'm blessed to have a good husband who is helping me with the ice packs and exercises.  Do you have anyone who can help you and keep you motivated?    

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  • Posted

    Hi Hew, first 2/3 weeks were hell for me, mainly at night as was having shooting pains down my leg.  Luckily had a good GP who listened and gave me some morphine, although I don’t think this worked entirely!  Now at 6 weeks and on very low pain meds now.  Only problem for me is the bend that I’m really struggling with. Keep thinking positively, we’ll all get there, just a different journey for all. Keep talking to us on here, I’ve found everyone very helpful and supportive. Best Wishes.
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    • Posted

      Thank you Sharon looks like this group will be what's gets us all through it will help me plan worse case scenario. Glad to hear you got over the 3 week hump which I found the worse post hip replacement. 

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  • Posted

    Ice, ice and more ice along with pain medication and tylenol. I did pre -op exercises faithfully and am in physical therapy. Surgery was only 6 weeks ago.

    I have had numerous orthopedic surgeries - lumbar, neck etc. and nothing compares to this. Sorry. I got to go without any walking aids at 3 weeks in my home only and everywhere at 4.5. However, if I am tired or going for a longer walk, I take my cane. I listen to my body and therapist.

    Good luck!

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  • Posted

    Hip and knee are totally different...knee is waaaaaaaaay worse.

    Had my hip done in 2009.  After the hospital and rehab joint (10 days total), I started PT, gym and therapy pool five hours a day, six days a week.  Fully rehabbed in a total of six weeks.  Done.  Very little pain...kicked its butt.

    TKR in March of 2016.  First 30-60 days are the worst...gets better after that.  It takes a year to fully recover...period...because, unlike a hip, you CANNOT push a knee...ever.  You spend your first month just drooling on your pajamas.  Not kidding.  This is not easy.  Here's some light reading...

    https://patient.info/forums/discuss/the-tkr-experience-or-wish-i-had-another-kidney-stone--524499

    https://patient.info/forums/discuss/the-tkr-recovery-bell-curve--563756

    Lots more out there.  Click on my name or picture and then "See All Discussions".  Enjoy.

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  • Posted

    Hi hew,

    Are you in UK or somewhere else?

    Experiences are hugely different for different knees, people, and also different PT protocols.

    But reading around here can at least mean you get some examples of experiences. Your own may be easier than you expect... just saying... but it is good to be aware of some common challenges!

    First two weeks biggest challenge for me.....

    Got steadily better...quite enjoyed some aspects of it!

    Now seven months post op...wow, fantastic, so worth the effort!

    Regarding walking unaided, this was my experience...

    I started walking unaided for very short distances, (and only sometimes) around house only, at around 5 weeks post op.

    Even at 8 weeks I was only walking around house without support, but if experiencing any pain, I used a stick in house also. I used support (two crutches or a crutch and a stick) for walks of around ten minutes outside. I was working on increasing strength through exercises but wanted to keep pain and swelling reduced as much as possible. I could move quite fast on crutches!

    My physio was encouraging me to keep all the support I needed for as long as I needed it, which I agreed with. Quads were very weak and I was having issues with the operated leg tending to give way. I feel that this approach was helpful to me in that it helped my gait to keep using two supports...I dispensed with one crutch often times, and used one crutch and one walking pole together as it was easier to use on public transport. Much easier to hold just one crutch and a thinner walking pole!

    Learning to walk without support was rather an odd experience, but walking in swimming pool helped a lot, and once I started working on walking unaided it only took about three weeks to really take off, though at the time I was not sure I would be able to walk normally again! It felt like being a toddler and learning to walk for the first time!

    This was my experience, many people seem to walk unaided sooner.

    All the best to you!

    Adopt positive mindset, it will help immensely!

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  • Posted

    Read the other replies and just want to say that pain management is crucial. If possible, stay away from Norco (hydrocodone) . Extremely constipating. I was switched to oxycodone and felt much better. Stay ahead of the pain.  As painful as it is, you must do the home exercises. I used vitamin E cream on my scar to help to soften the area.  I had right knee, so could not drive for about 9 weeks.   Get a raised toilet seat.  

    Good luck to you and stay in touch. This forum got me through some of my darkest days. Read the links from Chico Marx.

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    • Posted

      Hi 

      Thank you all for your comments I can see that this forum will help me prepare for what is to come. I had oxycotin and it made me feel so peculiar so I will want to avoid. My concern is that is the pain management as its key to recovery. Post my hip op many times I lost the drive to do my Physio because I felt overwhelmed by everything. I want to use all the knowledge and experience of yourselves to plan ahead. I thought after my hip replacement I was surgery free little did I know a year to the day it would all begin against . I have chosen the same surgeon for continuity of care. Fingers crossed for me. Thank you all peeps you are heroes and don't know it to overcome all you have.

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    • Posted

      Oxycontin is the brand name for plain, generic OXYcodone.  When combined with acetaminophen (generic Tylenol), it goes by the brand name Percocet.  Another similarly effective opioid is generic HYDROcodone.  When combined with acetaminophen, it goes by the brand names Vicodin and Norco...among others. If you can't tolerate oxycodone, have your doc put you on the hydrocodone.  They are equally effective but based on different molecules. The biggest difference is that hydrocodone is more likely to make you constipated (US National Institutes of Health)...take a stool softener.

      In the UK, there seems to be some usage of Co-codamol (a combination of acetaminophen and codeine) or just generic codeine...so that's another option.

      Yes, pain management is very important. Do not hesitate to tell your doc what is working and what is not.  Medication choice and dosage can be varied.  If you are tolerating a particular drug well but not getting adequate relief, the doc can up the dosage or direct you to take it more often (ex: every 4 hours instead of 6).  Gotta work with your doc to get it right as quickly as possible.  

      Do NOT worry about addiction to these painkillers. You will be on them for a month...maybe two but at a lower dosage (titrating down).  You will most likely absolutely need an opioid painkiller...not many people can handle the first month without them.  This is a VERY tough surgery...be prepared.

      Stepping up from oxy and hydro are morphine and then Dilaudid (hydromorphone) and finally fentanyl.  You don't want to go there.  Stepping down from oxy and hydro are Tramadol and then generic ibuprofen.  That's usually the path to titrate down from the heavy-duty painkillers. 

      It's all really trial and error.  When you can't tolerate one med, switch to another.  No one can tell you what will work or how bad the pain will be.  Just know that there are options here so work with your doc.

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  • Posted

    Hi Hew!

    The best advice I have for you is to keep as positive as you can. Endorphins help with pain, and looking at the whole experience as a means for repairing your knee really does help.

    I had such horrendous pain prior to surgery! I honestly could not wait to be done with my pain. I had a nerve block and additional medication for the first 24 hours in the hospital. I was up and walking the next day. I was VERY surprised that my surgical pain was FAR LESS than what I had been experiencing for at least four years.

    I had pain where the TOURNIQUET was placed on my thigh, a feeling of extreme heaviness of the leg, and swelling. My second knee replacement done three and a half months after the first knee was much easier than my first. Have no idea why!

    Be patient with yourself. I found keeping a journal allowed me to to be able to reflect on my progress. Little bits of success help you feel like everything is worth the trouble of going through the operation.

    I had six months of physical therapy between my two knee replacements. Lots of stretching, strength training and balance work helped me to get back my life again.

    I'm two years out from my surgeries and am able to walk as much as I want, climb hills and steps, shop and garden and live life again. I looked at surgery as "temporary inconvenience/ permanent improvement.

    Here's wishing you strength, calm, and a positive attitude going forward!??

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  • Posted

    G'day Hew,

    ?Well I've just speed read through the other posts and to one degree or another I agree with everyone. on 6 Nov I'll be 2 years out from surgery, life is perfect. I was 71 at the time of my surgery (which was for a partial knee replacement) but I had the additional challenge in that I have a heart arrhythmia and am on Warfarin for life. so stroke awareness was an issue for all of us.

    Nevertheless I'm reasonably fit and I survived. I am in Cornwall, UK and I was operated in a private hospital by a private surgeon as an NHS patient.

    ?I had only one PT session, all my PT was given as 'homework' for me to do on my own at home in my own time according to an NHS booklet. I also used short videos that can be found on YouTube.

    ?I was around 5 to 6 weeks when I was walking with one crutch and 8 weeks at which time I could walk normally without crutches and drive my car again, and back to work as a bus driver at 11 weeks. I took it a day at a time, no hurry, made every day a winning post. Hey though, the pain was unbelievable for the first few weeks and because of the Warfarin I can take very few pain killers. But it was a no brainer - take the pain or have a stroke.... I'll take the pain anytime. I was tried on some sort of liquid morphine, didn't work, nor did Tramadol. Ended up with my usual, Co-Codomol 30/500 (prescription grade only). This whole process is butchery ....... sheer, unadulterated butchery, and the best thing I ever did was go to my sports injury massage therapist who spent weeks on toning my lower and upper leg muscles so that the surgeon had the best possible leg to go and butcher. 3 weeks post op I had the dressing removed and given the all clear from infection and so went back to my therapist and she spent a few weeks massaging the incision line and all around it .... the objective being to prevent scar tissue forming inside the knee. In my view the two big dangers with this surgery are infection and scar tissue. They will impede any PT you are given to do.

    ?By the way, I had self dissolving staple stitches along my incision line, so I never had to go and have my 'stitches out'.

    Anyway Hew, good luck.

    ?John

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  • Posted

    Hew, I forgot to say ......... that I learned to walk again too. You might find this on YouTube too. basically,  (an exaggeration of course) you learn to walk ... heel, ball, and toe.

    ?So, in slow motion -  its heel down first, then move to the ball of the foot, then to the toes. Heel, ball and toe. It forces the leg to work. How do you know you've got there.... assuming your non operated leg is in good condition, then you've got there when your operated knee and leg can match the non operated one.

    John

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