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Miserable from TKR: What can I do to get better?

Posted by tracy70 @tracy70, Sep 29, 2021

I had a right TKR 2 weeks ago. I have been miserable. I was in severe pain for 1 1/2 weeks. I am still in pain. I have a lot of stiffness. I have burning in my knee. I am depressed. I can’t sleep. I have taken more medicine in the past 2 weeks then I have in my entire life. I have been having pt at home. I start outpatient pt next week. My lower leg/knee hurts so bad when sitting. I cannot straighten my leg all the way out. When laying down, there is a gap between the bed and the back of my knee. I try to do the exercises that pt told me to do. But it hurts so bad. I wish I would have not had this surgery done!

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joanwine | @joanwine | Oct 1, 2021

Don’t despair. This is a very painful procedure. I hated the first couple of weeks, everything hurt including my head and back. It felt never-ending. I am eight weeks post OP TKR Right side and just starting to feel like myself. The pain is less, the stiffness remains but that’s normal, PT is painful, but ice and take an OTC before and after and it will be manageable. I know it seems hard to believe but It does get better.

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1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | Oct 1, 2021
In reply to @libertyusa "Oh, for goodness sake. Am I niaeve? I expected TKR to go well and with PT..." + (show)
@libertyusa

Oh, for goodness sake. Am I niaeve? I expected TKR to go well and with PT be almost as good as new. Well....guess not. First TKR was perfect; not much discomfort, walking almost right away. 3 yrs. later, TKR by a different surgeon. This TKR was sort of OK, but not as perfect. AND I AM REALLY TIRED OF THIS FEELING OF IMBALANCE WHEN I WALK. I NEVER EVER HAD THIS PROBLEM IN MY LIFE. Something, I think, is wrong with the alignment. I work hard at PT to build core and leg muscles to help support my back (another issue). I can play sports (golf and picklball) - but limited to length of time. My problem is balance!! I do not walk smoothly. Is it too much to expect these surgeries to work perfectly?? (Do I expect too much.). But I want to go to a specialist (not my surgeon) to determine what can be done about walking with a smooth gait and not "pitched" forward. I still have numbness after 2 years, but much improved. People think surgeon clipped a nerve. Well, by gosh, what am I supposed to do about that?
Can someone tell me what type of specialist I should go to to become more balanced. My surgeon suggested using a "Dr. Scholl's" type of foot pad. C'mon. How about something more sophisticated? OK, sorry, enough tears and self pity. Can someone suggest what type of specialist can correct my walking gait? Shall I go to the same hospital, but ask for a different Dr. What type of Dr.? Or am I supposed to just be happy with this second-rate surgery from one of the best hospitals in the NY area? Surgeon has a great manner, but I want results. Sorry for sharing my frustration and lack of direction..............

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Wow, how frustrated you must feel.
I had a very difficult recovery from my 4th hip replacement surgery, and my surgeon referred me to an awesome Physical Therapy Rehab clinic (not just a typical "cookie cutter" here's what we do after this surgery place). They are an adjunct of a large rehab center that treats people after traumatic injuries, limb loss, stroke, etc.
I got an evaluation, then gait training (I had limped for years) which helped my back too, balance training (to get rid of fear of falling) and strength and endurance work. Some was in a pool, the rest on land, with twice a day work to do at home. It took 2 months of hard work, and continued daily exercises for 6 months, but I got my life back. Perhaps such a program will work for you. I found mine through the Physician's Assistant who worked with my surgeon when regular PT wasn't enough.
Sue

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norakathryn | @norakathryn | Oct 2, 2021

Oh! I’m so very sorry. Pain for that long and sleeplessness will make you feel like you’re going crazy. The most important part right now is 1- that the surgeon believes the surgery was successful. If there’s nothing wrong physically that you need to address besides all the inputs of rehab then that’s good. Number 2-you need to get some sleep. Please talk to your doctor about how you can do that. Either a sleeping medication or tea or meditation or some thing but I know that if you cannot sleep you cannot heal. sleep is critical to the recovery process. Number 3- I’ve had many hip surgeries 30+, some foot surgeries hand surgeries and I will tell you that my two knee replacements as of six years ago were the most painful. I couldn’t believe it because it’s such a common surgery. And I felt like my knees were on fire for two weeks. Ice was critical. Ice on your knees as often as possible. But I will tell you that six months after that surgery I refer to my knees as the best joints that I have. They don’t impact anything I do. They are pure joy, pure painless joy it is 100% worth getting your knees replaced. You will get there it’s gonna take a little bit more time, take it in order. Make sure the knees are structurally correct make sure you find out how you can sleep ask your doctor about that, and then understand that in a few months you’re gonna look at your knees and you’re gonna want to kiss them because they will change your life in a positive way. But you’ve got a put in a lot of hard work and it will hurt sometimes. So mitigate everything else around you and focus on your knees healing

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2 replies
ginzy53 | @ginzy53 | Oct 3, 2021
In reply to @norakathryn "Oh! I’m so very sorry. Pain for that long and sleeplessness will make you feel like..." + (show)
@norakathryn

Oh! I’m so very sorry. Pain for that long and sleeplessness will make you feel like you’re going crazy. The most important part right now is 1- that the surgeon believes the surgery was successful. If there’s nothing wrong physically that you need to address besides all the inputs of rehab then that’s good. Number 2-you need to get some sleep. Please talk to your doctor about how you can do that. Either a sleeping medication or tea or meditation or some thing but I know that if you cannot sleep you cannot heal. sleep is critical to the recovery process. Number 3- I’ve had many hip surgeries 30+, some foot surgeries hand surgeries and I will tell you that my two knee replacements as of six years ago were the most painful. I couldn’t believe it because it’s such a common surgery. And I felt like my knees were on fire for two weeks. Ice was critical. Ice on your knees as often as possible. But I will tell you that six months after that surgery I refer to my knees as the best joints that I have. They don’t impact anything I do. They are pure joy, pure painless joy it is 100% worth getting your knees replaced. You will get there it’s gonna take a little bit more time, take it in order. Make sure the knees are structurally correct make sure you find out how you can sleep ask your doctor about that, and then understand that in a few months you’re gonna look at your knees and you’re gonna want to kiss them because they will change your life in a positive way. But you’ve got a put in a lot of hard work and it will hurt sometimes. So mitigate everything else around you and focus on your knees healing

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I too can sympathize with your story. It is exactly the same as my own. I am now nearly 4 weeks post surgery. I have been off the opioids for a week and a half but still have issues with swelling pain and sleeping though all are significantly less than they were during the first few weeks. Getting sleep has been a challenge but I am finally able to sleep on my side as well as on my back. I’m getting more and better sleep each week.

As I’m sure you have heard or read the physical therapy is by far the most important part of your recovery. Do what they say during your sessions and more importantly every day at home. I have learned there is a very fine line at therapy. Do not push yourself to the point that it is painful but do push yourself to where it is uncomfortable. A good therapist should not push you into pain and if that is the case I would recommend switching and finding someone else.

Although my range of motion is not that great yet it has been proved consistently and I have graduated from a walker to a cane and have started driving again. Just these small freedoms bring light at the end of the tunnel. Like you, I also began to wonder why I got the surgery. However I am starting to believe that this will work out well for me in the end.

If you are able I recommend getting out of the house and being with friends or having them over to your house. I feel getting out of the house even just for a car ride and conversation improved my mood immensely. And being able to drive and be slightly independent was a major boost to morale.

This has turned out to be a long journey so far and I am resigned to the fact that it still has a ways to go. Hang in there!! You are literally on the edge of turning the first of many corners on your way to full recovery. Be well.

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2 replies
Mentor
Sue, Volunteer Mentor | @sueinmn | Oct 3, 2021
In reply to @ginzy53 "I too can sympathize with your story. It is exactly the same as my own. I..." + (show)
@ginzy53

I too can sympathize with your story. It is exactly the same as my own. I am now nearly 4 weeks post surgery. I have been off the opioids for a week and a half but still have issues with swelling pain and sleeping though all are significantly less than they were during the first few weeks. Getting sleep has been a challenge but I am finally able to sleep on my side as well as on my back. I’m getting more and better sleep each week.

As I’m sure you have heard or read the physical therapy is by far the most important part of your recovery. Do what they say during your sessions and more importantly every day at home. I have learned there is a very fine line at therapy. Do not push yourself to the point that it is painful but do push yourself to where it is uncomfortable. A good therapist should not push you into pain and if that is the case I would recommend switching and finding someone else.

Although my range of motion is not that great yet it has been proved consistently and I have graduated from a walker to a cane and have started driving again. Just these small freedoms bring light at the end of the tunnel. Like you, I also began to wonder why I got the surgery. However I am starting to believe that this will work out well for me in the end.

If you are able I recommend getting out of the house and being with friends or having them over to your house. I feel getting out of the house even just for a car ride and conversation improved my mood immensely. And being able to drive and be slightly independent was a major boost to morale.

This has turned out to be a long journey so far and I am resigned to the fact that it still has a ways to go. Hang in there!! You are literally on the edge of turning the first of many corners on your way to full recovery. Be well.

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Thank you for the encouraging report. Life after surgery is not fun, and to let people know there can be hope is wonderful. Your tip about getting out to lift your mood is terrific!
Sue

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ellerbracke | @ellerbracke | Oct 4, 2021

@tracy70: I know how you feel - the first 2-3 weeks after the surgery are rough. As others have said, keep icing the knee, and do the PT. Pain is different for each person, as is their tolerance. My pain was pretty intense, but after 3 previous (different) orthopedic surgeries requiring months of rehab I’ve learned to tolerate it better.
Don’t worry about being able to get your leg straightened out. Some people can do it within days, it took me almost 5 months to get the last, final, degree. I found that the bend/flex is more important for everyday purposes.

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1 reply
tracy70 | @tracy70 | Oct 4, 2021
In reply to @artscaping "Good evening @tracy70. Oh my, oh my. I am trying to put my head around your..." + (show)
@artscaping

Good evening @tracy70. Oh my, oh my. I am trying to put my head around your situation. You must be shocked at the pain and discomfort you are having. May I welcome you to Connect? i just had my second TKR 7 weeks ago. I remember having some very tough times and feeling frightened. Did you have a nerve block? They are supposed to keep you quite comfortable and free of pain for a couple of post-surgery days. Another question...... did you have robotic surgery? That surgery is minimally invasive and also assures the patient and the surgeon that the surgery was done to plan without incident.

Two weeks is not a lot of time in what can be a full year of recuperation and when you are in pain it seems like forever. I don't think you are expected to have an adequate range of motion (ROM) at this point. Neither should you be so worried about the gap between your bed and the back of my knee. That measurement called an extension requires several weeks of stretching your leg.

What are you using for pain control right now? How are you sleeping? Have you ever heard of MFR....myofascial release therapy?
That sure might help. And most important.....are you icing your knee several times a day. Do you have a wedge to put your knee on so that it is elevated above your heart?

I am here for you and want to help you.
Chris

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Yes, I did have a nerve block. It got me thru that day. I’m not sure what you mean by robotic surgery. My Dr performed the surgery. I was on Oxycodone and Tylenol. Once I finished the Oxycodone, they prescribed me Hydrocodone. That is what I am still taking along with the Tylenol. Sleep is a nightmare. Not sure I even know what the word sleep is anymore. I cannot find a comfortable position, no matter what I have tried. A couple few hours at a time is all I get. I have not heard of MFR. What is that? I am icing it. I did get a wedge to put my leg on. I couldn’t use the wedge for the first week, week and a half because the pain was excruciating when I put my leg up on it. I also couldn’t ice as much as I should have during that first week because that too hurt so bad and caused a burning feeling. And that was with a towel wrapped around my knee. Thank you for your response.

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2 replies
tracy70 | @tracy70 | Oct 4, 2021
In reply to @sprinrosa64 "SO SORRY, 2WKS is not much time yet, you just went thru a very tough surgery,..." + (show)
@sprinrosa64

SO SORRY, 2WKS is not much time yet, you just went thru a very tough surgery, far tougher than doctors tell you. Keep pushing with the PT , take the meds, they help BUT YOU MUST BE YOUR OWN VOICE IF YOU DON'T SEE IMPROVEMENTS GET ON YOUR DOCTOR. Please keep trying with the PT if in 2 more wks you don't see things getting better I will tell you my story. BUT RIGHT NOW KEEP THE FAITH AND CLEAR YOUR MIND , TAKE THE MEDS AND WORK PT

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Thank you! This has been such a hard surgery on me, mentally and physically. Yes, it is far tougher and worse then what I was expecting. I am trying so hard to keep my faith. I am just so depressed since this surgery.

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tracy70 | @tracy70 | Oct 4, 2021
In reply to @chickenhaslips "Be careful with the narcotics.They can be very addictive as we know. I only took them..." + (show)
@chickenhaslips

Be careful with the narcotics.They can be very addictive as we know. I only took them at night.During the day I took Tylenol and Motrin.You can use them together as directed .Use a lot of ice and elevation.It’s still early.Follow the PT instructions.And yes this surgeons don’t ever describe how tough it is .Hang in there .It will get better.

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Thank you! I have started weaning off the narcotic pain medicine. They have me on a blood thinner for a month, so I can’t take Motrin. I wish I could. Motrin has always worked better for me then Tylenol. I am icing and elevating. Yes, this surgery is absolutely tough!

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tracy70 | @tracy70 | Oct 4, 2021
In reply to @labbadia1 "Your pain with flexion and in general (2) weeks after a total knee replacement is to..." + (show)
@labbadia1

Your pain with flexion and in general (2) weeks after a total knee replacement is to be expected. I have had (2) total knee replacements (first RT knee 7/9/2020 & second LT knee 9/19/2020). I'm 75 years old. The physical therapy for the first (6-8) weeks after the surgery is really really very painful, but you have to just push through it, otherwise you'll end up with a stiff knee that requires the surgeon to manipulate it for you under general anesthesia. If your knee isn't so stiff that the physician wants to manipulate it himself, your knee will NOT become more flexible on it's own without physical therapy. And you don't want your PT to end before you can sufficiently flex your knee to the extent required. Without sufficient flexion in your knee, your gait will be affected and you won't be able to walk normally as you should, which will eventually become a big problem and cause new problems & new pain in the long run. The really bad pain, in my case, lasted until the end of the physical therapy (after the 12 weeks of therapy). I found that BEFORE the physical therapist worked on my knee, I had to take a pain medication dose. When the physical therapist first started working on bending & straightening my knee joint, I screamed in pain often, but she knew enough to not stop and kept working on my knee. At the end of the PT, your bending knee flexion should be 120 degrees or better and your straight leg flexion should be close to zero. As far as pain medications, get ahead of the pain. In other words, don't wait until the pain is so bad that you then HAVE to take a dose. Stay on schedule taking the pain medications, since it's better to not have the pain set in than it is to tamp it down after it becomes unbearable. I can now bend both knees 127 degrees and straighten both knees down to zero. Good luck.

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OMGosh, I don’t even know how you could do TKR on both knees a few months apart. After this, I don’t think I will ever get my other one done. I have been doing in home PT for two weeks. This week I will be doing outpatient PT. You can believe, I will be doing PT until my knee is right. I am trying to push myself at home with the exercises, but it is hard. Hopefully going to therapy will make a huge difference then doing it at home. I hope my TKR is a success like yours. They say it gets better, I just hope I can get to that point. Thank you for reaching out to me.

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