TKR 70somethingsusa in recovery

[70somethingsusa]

Well here I am with my new silver knee (titanium).
I thought I was here for one night, in hospital, still here, which is a good thing.
I have a movement disorder, known as orthostatic tremor, so it has challenged the steadiness of the body.
IV morphine and Ketorolac were stopped this morning, I was started on Dilaudid .Not sure of the frequency yet.
Already met a physio who thought she should press on my knee or straighten it....I think not!
Have walked to the bathroom once..it's heaven to have privacy in the b.r.
Knee dressing off today, will get a look at surgeon's handiwork!

 

[Pumpkin]

@60somethingsusa
Welcome to the Otherside!
Glad they kept you extra time to be sure you were stable with your orthostatic tremor on top of a TKR.
Sounds like you are doing well otherwise, kudos for standing up for yourself with the PT and protecting your newly operated knee.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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:

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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

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the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity progression for TKRs​

6. Access these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Sisterpat]

60something, WELCOME to BoneSmart! Congratulations on your new knee and your ability to insist on gentle PT! Keep up the good work.

 

[Jo Wo]

Hope they get everything sorted out for you so you can be recovering comfortably at home.

 

[70somethingsusa]

Today is 6 days postop.I guess really 5 days, cause OR day is day 0. lol
I have been following Bonesmart guidelines, for the 1st week.
Yesterday I walked a bit extra, knee is more swollen today, trying to walk heel to toe, when I walked to B.R.So backing off today.
I have been prescribed Hydromorphone 2-4 mg q6h,if needed.
I followed the regime, but even taking 1 mg.,I was stoned, and couldn't fall asleep till after midnight, with weird dreams.
Today, and for the next 24 hours will try Tylenol#1(Tylenol with 8 mg codeine) every 6 hours and ibuprofen 200mg and see how it goes.
I have received a phone call to register for physio (I agreed b4 discharge), but will depend on their protocol.
The bonesmart way makes so much sense to me, the body has served me well for 69 years, and will continue through recovery..

Susan.

 

[Jo Wo]

@60somethingsusa glad to hear you are ok, I hope you find the switch off morphine more agreeable.

 

[70somethingsusa]

Here I am, at day 16. I certainly have realized I have been overdoing it, knee remains swollen, calf swelling is gone. Staples were removed on Junec15, .The incision ended up bleeding, as did the staple insertion sites.Now I have 72 little puncture sites, and an incision that is not well approximated. Another wound to deal with ...doing wound care, walking every hour or so.
Physio canceled for this week, doing gentle stretches twice daily.
It is what it is, have to take each day, with no expectations.

 

[Jockette]

I’m sorry you had such a difficult time getting the staples out. (it makes me glad my surgeon used stitches when I read about some of the staple removals)

You‘re right, one day at a time. Take things as slow and easy as you can.

 

[70somethingsusa]

I really think the G.P. had never done it before.
As a retired homemade R.N., who has removed hundreds of staples in her career, I was shocked at how it was done.
The pain from the removal was worse than I could have imagined.
I never told her to stop, or grabbed the staple removers from her!
I think I was so traumatized I could/ didn't think with any clarity.
I need to use steristrips now to hold wound edges together.

 

[Jockette]

Wow, again, I’m sorry it was so bad. I hope she perfects her technique soon! My surgeon had his assistant take my stitches out because he said she was so much better at it.

 

[Sisterpat]

My OS automatically puts steri-strips on the incision after staples come out. 72 staples??? Both my incisions were in the 40’s! Maybe yours were so close together they couldn’t help but hurt coming out! OUCH!

 

[70somethingsusa]

My OS automatically puts steri-strips on the incision after staples come out. 72 staples??? Both my incisions were in the 40’s! Maybe yours were so close together they couldn’t help but hurt coming out! OUCH!

No 36 staples, with two sides!

 

[Sisterpat]

Oh, okay! Glad you clarified that !

 

[NightQuilter]

So sorry you had to deal with this @60somethingsusa . My surgeon used stitches which, for the most part, dissolved on their own. I had one funny little thing sticking out for awhile on one knee, then decided to pull on it. ta da and it was gone. I hope the incision is holding together and finally healing properly. How is your swelling coming along? It is really important to be sure to rest, ice, and elevate. I actually laid on the couch for hours reading with my feet up on the wall for maximum gravity! It must have been a sight!

 

[70somethingsusa]

Thanks! I know there are retention sutures under the skin..so that's reassuring!
The incision at the top to middle so far is starting to look better. I showered yesterday, covering the bottom half of the incision..steristrips( butterfly enclosures) seem to be working.
I will shower tomorrow, which will remove the dried blood ,so I can better assess the lower wound margins.
Swelling was done yesterday, increased today.
We bought a recliner for this journey! Feels like I'm lying on my head

 

[BBCG]

Hi 60somethingsusa,

Yes, recliners make this recovery much easier I think, too... I got one before my first TKR. My old kitty thinks she needs to lie on me when I'm lying back in mine!

Gosh: the staple removal sounds worse than the surgery; at least you're asleep for that, eh?! Here they use dissolving stitches and I found one, maybe three weeks post-surgery, a week after the honeycomb/foam and "plastic wrap" dressing had been removed. Just pulled it out too, like you...

For me, getting the swelling to go down seems dependent a tad more on the reclining than the ice...as I stopped icing before I stopped reclining. I also find my leg is so much less swollen in the mornings after being tilted up all night on my bed base that lets me incline my legs upward... but last time, I used a stack of 3 pillows like others here have mentioned...

Sending you soothing, decreased swelling energy!

 

[70somethingsusa]

Hi BBCG,
Seems like your kitty knows a good thing, all snuggled and warm with its human!
The staple removal was very painful, and I just need to let it go and move on!
I am finding that triple pillow stacking ,ice and elevation sure help with swollen knee, although am noticing an increasing sensitivity to ice, needing to remove it sooner.Theres a fine line between pleasure and pain.!
I read about the skateboard idea on here for passive exercises...realized we had a little alphabet block box on wheels from our 2 year old grandsons toys.
Removed the blocks, and used it for passive knee bends yesterday...knee was more swollen last night, but decreased during night. No pain, just swelling.
Hopefully can add that to other passive stretches.

 

[kneeper]

I definitely took breaks with the ice. Neat use of the grandkid's toy!

 

[70somethingsusa]

Here my new knee is at one month old! It has been an interesting journey so far! Stopped taking Dilaudid, after the first week or so, opting for Tylenol on a regular schedule, I hated the effects of the narcotic, constipation, inability to fall asleep.Instead I opted for CBD gummies(legal here in Canada) and work well for pain and relaxation.
I have been attending physio each week, doing gentle stretches., until yesterday, when more active physio was introduced, I haven't decided which ones I will do. Have been doing gentle stretches twice daily at home, walking in the house every hour, Stiffness sets in if I sit too long.Using a cane now, often forgetting where I left it!
We have been in the midst of a unpresedented heat wave, cooling off a bit today, finally cooling off today
This new knee certainly calls the shots!.
Each day presents different sensations, increased/decreased swelling depending on activity levels.
Ice and elevation continue to be the norm.

 

[Sisterpat]

60something, are you working with your surgeon and/or GP when using CBD gummies? There are potential interactions with other medications or supplements you might be taking. All products should be discussed with your doctor - prescription meds, herbal medications, and anything sold over-the-counter. Just want to make sure you’re safe!