PKR 11 months post op problem...

[Dlekapj]

Surgery was yesterday morning and this is really the first time I've felt up to trying to post. The surgery went well, it lasted 2.5 hours. I was surprised at how little pain I was having last night. They put me on a morphine pump and it made me very sick to my stomach. I vomited all night long and then I said I couldn't deal with the morphine anymore and they gave me Percocet. Which was fine..until all the anesthesia from surgery wore off and I realized that I wasn't some medical miracle not experiencing terrible pain. The pain hit full force and I still had another 3 hours until they'd give me the percocet again. The doctor wanted to try toradol one time and then give me a new nausea medicine to try and put me back on the morphine pump. So far it seems to be working ok and I'm not getting sick to my stomach. They've had me on a thing that I didn't ask the name of, that starts my leg at a -1* angel and slowly bends it to a 70* angle. I call it the torture device. They really haven't given me ice for it or even elevated my knee to speak of. I asked for ice today and they did give it to me then, but it's kind of rough to get it past all the bandages. I still haven't had the dressing off so I haven't a clue how my scar looks. I've been up with the walker to go to the bathroom. I won't say it didn't hurt, but I did it. I go home tomorrow morning and I'm actually quite nervous abut dealing with the pain if all I'm getting is percocet. But, others have survived and I know I will too.

 

[meechmom]

Congratulations on making it through the first night! I won't lie, it's not easy but day by day, you will get a little better. I'm 3 weeks post op with a LTKR. My RTKR was in January 2013. This was one was a little different because of a prior surgery in 1980 for an ACL. The surgeon had to cut through my old scar and make a half circle to fit my new knee in. I'm only at 80 degrees and the doc says this knee recovery will be tougher because of all the scar tissue. I've been doing my exercises 4 times a day trying to get the bend back, it's been tough!

You hang in there and the Percocet is what I'm taking (2 every 4 hours) and it works well for me. Just remember to ice, ice and more ice and take your meds and you will be fine! Promise!


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[Jamie]

Welcome to recovery!!! You made it!!! It sounds like you are doing just fine. Do not hesitate to tell your medical staff when you are hurting, though. You want to stay ahead of the pain, so ask for pain meds on a schedule. A lot of times their protocol is to wait until a patient asks. And then patients feel like they should wait until they are really in pain. But by then it's too late and you'll be playing catch up. Better that you take something every 4 hours.

Here are some recovery articles for you to read in your "awake" times. Let us know if you have any questions or concerns. We're here for you.

First are the BoneSmart mantras ....

- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles

The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And finally some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM

 

[Dlekapj]

Thank you for the awesome information.

I'm home now from the hospital. It was a long day. I spent a little over 2 hours on the CPM torture machine and then had to use the walker to go to the bathroom and almost immediately after that PT came and wanted to go for a short walk down the hall. I was exhausted but I wanted to get it over with, so I did.

But afterwards, I could hardly keep my eyes open. It turns out that I have very low platelets. I don't know why they didn't give me any but I want into surgery with a level of 90, out of surgery with 80 and sent home today with 57. I'll be making some green smoothies to try to boost my vit. k level and see if I can help myself with this.

Also, I'm finding that I just don't do well with Percocet. I can function so much better with the Ibuprofen 3 and it helps just fine with the pain right now. I'll probably take the Percocet before bed, not caring what it does to my head then. I still haven't seen my battle scar without a dressing, but this is what I have to show so far.

 

[Lauramacky]

Isn't it good to be home? . I got home yesterday. I need to post a pic too. Good luck with your recovery and I'll look forward to hearing your progress!


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[Josephine]

Also, I'm finding that I just don't do well with Percocet. I can function so much better with the Ibuprofen 3 and it helps just fine with the pain right now.

You may find that now but you are only 3 days out. By the end of the first week, you will realise you need something more than ibuprofen, a small dose of codeine and probable a small dose of Tylenol. If Percocet doesn't agree with you, I suggest you ask either your surgeon or your GP if they will prescribe you Tramadol instead which you can take with an appropriate dose of Tylenol. Out of all the meds on the market, we (in the UK) have found this combo to be far and away the best of all meds for TKRs.

 

[tiredwife]

@Dlekapj Glad you are home, remember to elevate and ice to keep the swelling at bay. One of my husband's nurses told us in the hospital that the length of the incision has something to do with the girth of your thigh! Don't know if that is true or not. Don't let the pain get out of control.

 

[Dlekapj]

It was a good day today. I'm alternating the percocet and ibuprofen 3 every 2 hours and it's working well to control the pain. The physical therapist came today and that really went awesome, as well. I have a 90* ROM which she was really pleased with, and I'll upload a video that I took of a 20 foot (10 up and 10 back) race that she had me do(for a runner, this was exciting . Right now I'm just exhausted and going to be going to bed soon, I didn't sleep well last night. I forgot to put the meds by the bedside and I didn't want to wake up hubby to go get them and didn't feel comfortable getting up and getting them myself yet. So I just kind of laid there from 3:30 or so and cat napped until 6:30 when I went ahead and got up and took the meds, but haven't been back to sleep yet. PT said that they expect me to keep doing very well and only need one week of home therapy, and I should be able to use a cane afterwards!
So, good night and here is a video of my my first race in over a year I can't imbed it in the forum, I guess, but if anyone cares to you can see it here.

https://vid8.photobucket.com/albums/a16/dlekapj/2014-08-17125641.mp4

 

[Jamie]

You're moving really well!!! Keep up the good recovery!

 

[tiredwife]

@Dlekapj Way to go! Looks like you are doing great!

 

[kneeper]

Congratulations and happy recovery. We are here for you if you have questions, want to share progress...whatever.

 

[Dlekapj]

another night another lesson learned. I woke up at 4 AM hot and sweaty. I don't know why, it was plenty cool in the room but I was so uncomfortable with the brace to stabilize my leg and keep it straight that I thought I'd be ok to take it off and hopefully got some more rest. Again, for some crazy reason I didn't take my meds at this time.. I have no excuse. I woke up a little later and then finally took some meds at 6 and fell asleep until 8:30. When I tried to get up, I realized why I should have been keeping it straight. It gave me a fit at first. Lesson learned, I'll wear the brace.
I had an interesting therapy today. The home therapist joked the entire time. Laughed and joked, he was hilarious. He was also very good, pushed me, but didn't hurt me. He told me to do the leg stretching with a towel to assist every hour during daylight hours. It's the worst, but I'll do that...starting tomorrow. No words to express this guy.
I also took my first post-operative shower, that . was. heaven.

 

[tiredwife]

@Dlekapj Hubby didn't have a brace for either leg, Sounds like an interesting therapist! You have a restful night.

 

[trailspud]

You are doing great. Good video and reports including the comedic PT. I loved the CPM...could easily sleep while using (in fact it helped sleep at times), but everyone is different and some machines are just more comfortable than others. Go slow, easy, and short.

 

[sjnyc323]

I don't want to sound dumb but what is done for partial knee replacement ?

 

[Dlekapj]

https://s8.photobucket.com/user/dlekapj/media/2014-08-18151028.mp4.html This is the video of my walk today with my new therapist

I don't want to sound dumb but what is done for partial knee replacement ?

No dumb questions!! The knee is made up of 3 sections. The medial, the lateral and the patelleofemoral (or something like that). The medial (inside) of my knee was bone on bone causeing me to be bow legged, but the rest of my knee was not in bad condition. The doctor thought it best to do a partial and only repair the medial side of my knee, and leaving all my tendons intact and all the bone, cartilage, and ligaments in the healthy parts of the knee also left intact so that healing would be quicker and I'd have a greater range of motion for physical activities. I'm sure someone else can give you more details, but this is the easiest way I know to describe it.

 

[kneeper]

Great walking!

 

[Dlekapj]

Time for a quick update on my knee- 6 days post surgery I honestly feel that I will be off of the walker as soon as the doc gives the go ahead. I'm not going to push it by attempting anything (and I mean anything) without it, although I feel I could. During my therapy sessions on:
Sunday I had for straight leg 9* and could get a 90* bend (not sure what I'm aiming for?)
Monday I achieved 7* and 95*
Tuesday 5* and 102*
So I'm really proud of myself and moving along in healing very quickly. I desperately desire to get off of the percocet, but I really think I still need it especially for when I'm doing therapy. He wants me to do stretches every hour...so.... I tell myself I don't have to worry about getting addicted or anything, because I really don't like what it does to my head.
My family is treating me like a queen (princess??). My house is cleaner than it's been in months and I have more food than I know what do with in the fridge! (still not much of an appetite though).
So typing all this has made me think it's time for a nap or at least to rest for a while. This was hard work!!

 

[tiredwife]

@Dlekapj sounds great! Keep up the good work!

 

[kneeper]

You're doing great!