7. Recovery at Home

Practical Wisdom for Recovery

Do not expect smooth, continuous progress during rehab. That was the most important lesson I learned from my first TKR. There will be good days and bad days. My body was still adapting to my new knee and I was still recovering from a highly invasive surgery. But how do you continue to manage pain, when you repeatedly wake up from a bad night’s sleep depressed? How do you continue to do your exercises when you don’t see much improvement? Over the course of my rehabs, I generated a set of GAWPPs for myself. GAWPP stands for “Generally Applied Wisdom for Practical Purposes”. These are simple ways to make your life better.

GAWPP #1: Take your medication as prescribed and keep good records. 
Adopt the Sign and Swallow principle – take your pills out of the bottles, sign for them and then swallow. In my addled state, there was no way I could just remember what I had taken when. I could barely remember my own name. Phone apps can be very useful in implementing the sign and swallow principal, reminding you when to take your medications and keeping track of your usage and supply.

Keep a careful record of all medication taken. Adopt the “Sign and Swallow” principle.

An important corollary to this is: Don’t get behind on your pain pills because it will be very difficult to catch up. As we discussed in the prehab section above, pain increases stress and slows healing. It also just isn’t nice to experience. I fully understand the reluctance to take pain medication and I truly resented the fact that pain made me dependent upon medication. But I also realized how important those pills were to my recovery. If you have any reluctance about taking pills, speak to your doctor and develop a plan for reducing medication going forward.

Feeling buried in meds

The beginning of a beautiful friendship

GAWPP #2: Learn to think of ice as your friend.
Now is the time to embrace that friendship. Wise use of the ice wraps (3 to 4 times a day for 15–20 minutes at a time – protect your skin by putting the ice inside a dish towel) or ice therapy machines (up to two hours at a time) will help limit your need for opioids. Ice speeds healing by reducing swelling and inflammation. While you ice, keep your leg elevated and your knee as straight as possible. Continue icing throughout your recovery or whenever your knee feels excessively hot or tight. I found it especially useful to ice my knees before getting on the exercise bike – even months after the surgery.

GAWPP #3: Keeping your legs above your head is the best way to manage swelling. You can also learn to massage your leg to move the fluid. With one hand on each side of the knee, massage the leg towards the body to move fluid by pressing it upwards (i.e.towards you head). If you stroke downwards towards the ankle, do so gently.

Next: Practical Wisdom for Recovery, Continued