PKR Zab’s recovery thread.

zab

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Jan 4, 2018
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Hi folks thought I would create a recovery thread to help others in their research, and for me to read back over in the future.

Well it’s 5PM here is Perth so I’m about 5hrs post Makoplasty left knee medial PKR feeling absolutely fine (I know calm before the storm!)

Had a spinal anaesthetic, for those worried don’t on a pain scale the injection was a 2 however the actual administration of the drug was just the weirdest feeling not at all painful just damn weird. So glad I went with the spinal absolutely zero after effects feel completely normal.

Woke up in recovery then transferred to my room, they took bp fairly low, had some sandwiches, orange juice and a cup of tea as I was so hungry. BP every 15ish minutes until it was normal (about 3hrs) now every hour.

The knee has no pain yet just a very slight ache, right leg feels normal however left is still fairly numb, especially the foot not sure the circulation 100% yet.

Physio has been , nice and easy a few straight legs lifts, thigh squeezes with her hand under the back of the knee to check pressure, knee extensions with a rolled up towel under the knee,knee bends and standing up and putting even pressure on both knees with the help of a frame. Felt a bit light headed when I stood up.

Oh and I’ve been given one slow release pain killer, she did say what it was but I’ve forgot already.
 
Just had bp done and perfect, given two panadol.
 
@zab Glad your doing good so far. I'm having he spinal also in 9 days so glad to.read your post on it.
Good luck with recovery hope it goes well for you
 
Physio has been , nice and easy a few straight legs lifts, thigh squeezes with her hand under the back of the knee to check pressure, knee extensions with a rolled up towel under the knee,knee bends and standing up and putting even pressure on both knees with the help of a frame. Felt a bit light headed when I stood up.
Not at all sure about those, if they're putting force through your new knee it's not necessarily a good thing. Of course there's no pain because of the drugs! If they want to do these again after the painkillers have worn off, then if they hurt, don't do them!

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. Here is a week-by-week guide for Activity progression for TKRs
6. Access these pages on the website


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
Dinner, antibiotics by IV and an anti inflammatory tablet.

Right leg feels totally normal, left (operated leg) still really numb from the knee down been assured circulation in fine.
 
After surgery they kept asking how my pain was. I had no spinal or femoral block. They said Dr. put in lots of local. I was maybe a 2/10. I kept waiting for the tidal wave of pain to hit (as it did in 2010 with my original TKR). I was on an anti-inflammatory and acetaminophen. Hopefully you'll just ease into good pain management.
 
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After surgery they kept asking how my pain was. I had no spinal or femoral block. They said Dr. put in lots of local. I was maybe a 2/10. I kept waiting for the tidal wave of pain to hit (as it did in 2010 with my original TKR). I was on an anti-inflammatory and acetaminophen. Hopefully you'll just ease into good pain management.

Thanks for the reply I am only 1 maybe 2 for pain, hope it goes as you say and just eases into good pain management they have me on one slow release pain killer can’t remember the name along with panadol and an anti-inflammatory for now, tramadol has been mentioned for when I go home should I need it.
 
Day 1 - nurse that took my bp at 1am was concerned about numbness in my left knee an foot so called duty anaesthetiest, so after the op before I came around I was given slow acting local anaesthetic which works for 12 - 24 hrs and it’s finally wearing off was getting concerned I wouldn’t get discharged this morning but lookin good now :egypdance:
 
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Yay! Let us know when you get home and settled.
 
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Been visited by everyone that needs to see, sat in the discharge lounge with a pile of scripts too collect on the way home.
 
Home at last over did it big time walking around chemist and an hour sat in the passenger seat home, knee like a football but not a huge amount of pain, cyrocuff on elevated and Netflix.
 
Glad to hear you're home. Netflix, ice and elevation sound just the ticket.
 
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@zab, the cryocuff is a lifesaver. Over here in my hospital they swear by the cryocuff system but only send you home with the cuff but not the ice bucket(health and safety, the cuff cant be used on anyone else but the bucket can). I went ahead and ordered the cryocuff bucket from Amazon, best £40 I’ll ever spend. Means you can ice continually, especially during the night. Wishing you well with your recovery:)
 
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Thanks @Lilli215 they are a great bit of kit aren’t they? picked mine off gumtree cuff and ice bucket for $50 (about 25 quid) right bargain.

No huge pain about a 2-3 severe swelling though but expected as it’s the first time I’ve spent any real up and about, is only day 1 I suppose.
 
@zab that certainly was a bargain. I’m just back from first physio appointment since I came home from hosp and was dreading it as I’ve quite a lot of swelling on thigh and was struggling with heel slides but everything wentfine and I measured at 105, last measurement in hosp was 85 so it might not feel like it but it’s improving. Now celebrating with a coffee:egypdance:
 
Day 2

Had a decent nights sleep went to bed about 10pm think I woke about twice but went straight back off which is a pretty normal sleep pattern for me woke at just gone 5am.

Fell asleep with cryrocuff on and swelling has gone down a bit over night, as I live alone I've been up doing normal things this morning so expect a bit of a battle with the swelling for a while.

One area Bonesmart doesn't delve into deeply is post operative nutrition and nutrition in general is something that has always interested me so I have been a bit obsessive in my research on post op feeding to ensure I'm eating the right food and getting the right nutrients to aid recovery.

I'm using an app called myfitnesspal to make sure I'm getting all my macros correct and for me I'm looking to get 50% from Carbs (212g), 30% from protein (127g) and 20% (37g) from (good) fats. It's really important for about 3 months post OP to up your protein intake to aid the repair to all that soft tissue and muscle that has been damaged. So my pantry, fridge and freezer are full of things like sweet potatoes, brow rice, tons of veggies of all sort, fresh fruit, frozen berries and fruit for smoothies, chicken and salmon for protein and I've also bought some supplements in the form of whey protein, powdered BCAA (branch chain amino acids) and L Glutamine. I won't bore you with what I'm eating daily though.

Right had a morning smoothie time to ice and elevate for an hour.
 
@zab, during my early weeks of recovery, I couldn’t believe what I was able to eat without putting on any weight despite the fact that I was just laying around. Then I realized that a lot of healing was occurring which takes energy, protein, etc. As long as one continues to eat healthy, you shouldn’t have to worry about gaining weight during the early weeks as most of those calories are used to repair damaged tissues.
 
@NavyGunns I know during my research into nutrition it was suggested you need to increase your diet by 300-400 calories a day to aid muscle and soft tissue repair, which was really surprising. Despite my knee I was very active in the gym and on the bike prior to my op so aim to maintain a similar intake in the hope the reduction in energy used for exercise is used for the repair process.

Despite a good nights sleep I can't believe how many naps I keep taking, seem to be getting in a cheeky 20-30 minutes in every couple of hours. Feeling fine no real pain but the swelling is huge.
 
Sounds about right for what you should expect in terms of nights. When the sleepless nights syndrome hits, those naps will be precious. At first I tried hard to avoid them thinking it would help me sleep at night, but I was fooling myself. Don’t fall into the same trap. If you feel like you need a nap, grab it.
 

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