Bilateral TKR 1 year check-in

[rosietosie]

I'm in complete agreement with Jeano on the constipation. As long as you are on the pain meds, you should be taking stool softeners even after you finally get things moving. The stool softners will not cause diarrhea. I take 4 tablets twice a day of the generic brand from Costco. Then make sure you have a high fiber diet - lots of fruits and veggies plus high fiber grains. Use the Metamucil if needed to boost your fiber intake. I only had to use it once and it is not bad. Lastly if things still are not moving, use a laxative such as milk of magnesia. After three doses, i was cleaned out enough i could have gone in for a colonoscopy!!!! My husband had a particularly rough time with constipation after his surgery and he was vigilant about making sure i didn't have the same problem. He also had Fleet suppositories and enemas handy just in case I needed them. Thankfully did not go that far. I think the idea of using them scared it right out of me!! Also note that if your digestive system is normally sluggish, it will be so afterwards so the laxatives and stool softeners may not necessarily speed up your system.

For your pain meds, you may want to keep some crackers handy so you can have some food in your stomach. This helped with my nausea. As many have said, stay ahead of the pain especially in the first weeks where you are having surgical pain. Take them by the clock. I use the app Dosecast to keep track of my meds. I like this ooe because you put in the intervals for your doses (e.g. 3 hours) and it automatically calculates when your next dose is due. This is a helpful feature when you want to try to stretch out the time between doses. Then you can change the interval to your new schedule.

Hope you are having better days now.

 

[Shmi47]

So it is my 8th night. I am in a lot of pain right now. I have knees elevated they are achey and just uncomfortable. I am taking opana er 20 mg every 12 and 10 mg every 4 hours. I always need before it's due. I icing and I freeze inside. I can't get warm. I just feel like I can't keep up with the pain. I can't sleep. I am just always uncomfortable. Is this normal at this stage? I am in rehab and the thought of going home is dreadful. Because no one to get me ice etc. I be already hit the blues. Is there something I am doing wrong? I just need help.


42 and Btkr 9/5/14

 

[jeano]

You are probably undermedicated, can you negotiate for some Tylenol?? . I hated the extended relief morphine (similar to the opana, I think) and had much better relief from Dilaudid alone for the most recent knee. I also did fine on lortab, in general I think my body does better on the hydrocodones than on the morphine.

My first knee was in cool weather and I wouldn't have made it without warm clothing, a Sherpa fleece Costco throw, and a cat. They probably won't let you have a heating pad in rehab but they might be able to warm a blanket.

Ice when you are home may well be an issue, though I think maintaining a supply will be more of an issue than just getting it in your machine or whatever you are using. Will you be having home health/friends/relatives/neighbors available to do some things for you until you can drive?

 

[happymum]

Hi, sounds like they need to get you on better pain meds. The ladies have given you some good hints on constipation remedies. What do the rehab staff have to help you? If your feeling down tell a nurse and also if you don't want to go home yet negotiate longer in rehab.
I was in rehab for 2 weeks and I had only one knee done, you are doing fine but while your in rehab ask for help with the pain and constipation.
Take it easy and remember everyday things start to get easier, it's still in the early early days for you.
Love Deb

 

[kneeper]

I like the warm blanket idea. I was freezing too, early in my recovery and had a fleece throw on a lot of the time. And that was with the AC up to 78 degrees.

 

[katiejarr]

Prunes!!! Eat 3-4 every day, they work, I promise! I have always had issues with this and prunes are my friend!!! Hang in there!!!! And drink a lot of water and eat prunes, they really work, I promise!!!

 

[Shmi47]

Hi all, I am just checking in tonight. Well, i have finally turned a corner. I feel in less pain, but still alot of swelling. I feel like after one week, I am in a good place, but I have been in constant pain since i arrived. Today, i was crying at PT again because I felt so shaky and swollen again. I am still in rehab as well bc, I don't know how on earth I could have made it home. My Dr. wants my ROM at 130 by October 8th. Today my right was at 86 and left was at 90. I have a way to go.
One bothersome thing that I am wondering if anyone has are these body jerks. It happens constantly throughtout the night that my legs or body just jumps while I am asleep. Its starting to make me crazy. I also wake up very stiff. I don't have much motivation based on pain. I have just accepted that my body may not be able to handle pain very well. Anyway, its nice to see all the other people having a good experience. Take care to all.

 

[Big Tuna]

I had the same body jerks but only at night as I was trying to fall asleep. I think it was the Hydrocodone I was taking because the body jerking went away after I got off the meds.

 

[rosietosie]

Glad to know that you are having better days. Keep icing and elevating for the swelling.

I have the body jerks. I'm still on oxycodone. Mostly whsn I'm getting ready to fall asleep.

 

[jeano]

130 by Oct 8!???? Methinks the bar is set way too high for barely a month after surgery.

Whatever you do, DO NOT feel like you have failed if you don't make this goal! And DO NOT 'work harder' if the PT or anyone else starts giving you pressure or threatening MUA.

I of the infamous textbook perfect recoveries, She Who Confounds Expectations and Walks Out Of The Hospital the Very Day Of Surgery---I didn't have any thing CLOSE to 130 when PT kicked me out after the first knee! That was a bit more than 5weeks. I was somewhere around 121. I could mount and ride a horse, which was my primary goal, and basically I got graduated because I was just taking up space and showing off. I am now ten months out from that knee, and NOW my flexion IS around 130.

If your knees are swollen and painful you need more ice and elevation and less activity. @Jamie please weigh in.

 

[ljrfrm]

I'm sorry this has been so tough on you. It really does sound like you are undermedicated. I have been achy and stiff, but never in such pain as you have been. Being in pain like that will impact your PT and progress, plus cause you to feel miserable. I really hope you can find a way to lower the pain and get more comfortable. When I was one week post-op, my ROM was in the 70's. At 6 weeks, I have finally just gotten both knees into the low 100's (101 and 105). I never could have reached 130 by one month - I just had too much swelling. It makes me sad to hear a doctor putting such demands and pressure on a patient. Please don't get lost in the numbers game (I have been there!!) and just do the best you can. Hoping you find comfort soon!

 

[Big Tuna]

At about 7 weeks I made 127 and I thought that was great. At week 12 I went to my last follow-up with my OS and he took a fast look and declared me at least 115 without pushing it. He was very pleased with that and said I would have no problem making 130 or more by next summer. Judging from his statement he also agrees that ROM improves over time.

 

[Shmi47]

Well thank you all for your weigh in. That explains why the PT gal keeps telling me that I am doing fine and she was SHOCKED at the 130. Perhaps my doctor or whomever made a mistake. Because everyone tells me I am doing just fine. I felt good today and climbed 2 flights of stairs. I decided to wear those hose (for swelling) because I swelled so much the other day. Honestly, they make me feel safer. I don't have as much achy feeling today and I was able to do 4 rounds around the unit. Yesterday and other days I never wanted to. Anyway, I worry I will have another off day, but I can say I am so thankful to all of you and to the rehab unit I am in. I couldn't have done it without you.
PS- I can say, that I am a little jealous of a woman in my rehab. She had bilateral about a week ago, she's about 50?? and cruising these hallways without a cane. I am convinced she was some sort of an athlete/triathalon/runner prior because I need to convince myself I'm not that bad off. Good for her though, right?

 

[meewee]

Hope you are continuing to see steady improvement and are getting the support you deserve. It's so valuable to get such good advice and suggestions from those who have been there. I'm a month behind you in getting my BTKR and wish you the very best.

 

[Shmi47]

So we confirmed with the Dr. office. I need to be to 111-113 by my month check up. Not 130! Phew....

 

[kneeper]

You'll get where you'll get. Wishing you steady progress.

 

[Shmi47]

Hi, All- I AM HOME! I am really happy. However, I had PT every day in rehab and now that I am home 1 day without and I feel stiff, shaky. I am so worried about my ROM- I know you say not to, but one leg is 95 the other is 80. I have to be at 115 by October 11. Is this doable? My PT will come 3x a week for 1.5 weeks and then I tranfer to outpatient rehab. My knees still feel very stiff. I am trying to feel and move around my kneecap as suggested, but it is just a rock. I am resting and Icing and usually have my feet up. I did bustle around the kitchen this morning which got me very tired. I feel confused about swelling, pushing by PT until it hurts or to meet a certain goal, but my R knee wont give. It has always been problematic for me- femoral block never worked and the pain in this knee has always been more than the left. I read the mantras and try to remind myself, but it doesn't stop the anxiety of where I "should be." I also find myself clenching all the muscles in my body or jerking my body awake once I actually fall asleep.Or how to stay warm while I am icing (as I shiver all the way through) It is getting annoying. Any advice would be very welcomed.

 

[Island Girl]

I'm sorry you have had such struggles but it must be nice to be home. Hoping your caregivers are understanding your needs.

 

[Jamie]

Please, please go back and read those recovery articlces that were posted for you.

You must stop thinking you have to be at some magic number place in recovery by a particular time. Your body has a schedule for recovery and not you, not your therapist and not your surgeon can dictate where your ROM will be by any date.

Do not let anyone push you beyond mild discomfort with exercises. That will only make your pain and swelling worse and lengthen your recovery time.

It's a very good thing that you are spending lots of time resting with ice on your elevated legs. This is what you're supposed to be doing in these early weeks. No bustling around the kitchen, though.....housework can wait. Errands can wait. Healing is your number one priority.

If you chill when icing your knees, it's perfectly fine to wrap yourself in blankets and even to use a heating pad. I would place it at the small of your back to relax those tense muscles that are jerking you around.

Are you sure you are taking adequate pain medication? It almost sounds like you might be cutting yourself short in that area. It's a huge change to come home and that is most likely why you are feeling stiff and shaky. You don't realize it, but you're doing more than when you were in rehab and everything was done for you. Plus, you couldn't look around your house and see "just one little thing" that needs doing. Don't let yourself go there! These first few days at home you should be napping a lot.

 

[LondonLady]

Hi, @Shmi47 !
Glad to hear you're doing better than before! I'm a person who is always cold--so while my knee appreciates ice, the rest of me doesn't. Then I tried wrapping myself up in an electric blanket while icing-- my baked Alaska therapy! Actually I find myself doing this even when I'm not icing. Tends to attract the cats, too a.k.a the furry hot water bottles.