Revision TKR Against the wind

[skippyhak]

Fire away on ?'s!
Thanks for changing my title....I feel like its a badge of honor.

 

[Josephine]

Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[flyaway79]

I came home with a pain pump as well. Between that and the nerve block during surgery I really had minimal pain when I went home. By the time those two modes wore off I had the oral meds in my system and I never had a day of extreme pain. Lots of discomfort sure, but none of that awful pain that many talk about. All surgeons should use them!!

 

[skippyhak]

1. 3 to 4
2. 5 - 325 mg oxy-Acetm. 1 to 2 tablets every 4 hours. I've been taking 4 to 5 tablets per day.
3. moderate
4. flexion 92 degrees and extension was at 2 degrees. I'll be measured today when I start rehab.
5. been icing 5 times yesterday for 45 minutes.
6. I elevated leg yesterday for about 8 hours.
7. Nothing yet, other than personal hygiene, trips to fridge for water and snacks.
8. Ankle pumps - 25 to 30 reps. Doing them hourly.
Heel slides - 10 reps done 3 times.
Leg raises - 10 reps done 3 times.
Pressing knee into mat - 10 reps done 3 times.
Walking with walker around house 5 times for 6 minutes each time.
9. No Pt yet. 1st session later today.

 

[skippyhak]

Thanks! So far this has been much easier versus the other 2 surgeries. Last one was the worst but that was a botched job. basically the wrong size appliance. I had 2 nerve blocks and general anesthesia, no spinal. Also without spinal I didn't need a catheter. My surgeon loved how I came out from the procedure. 1st time he used 2 nerve blocks and no spinal. So I'm thrilled with how this is starting out. 5 surgeries in the last 4 years is enough. Ready to get healthy again!

 

[Josephine]

1. 3 to 4

Gosh that is mild for less than one week!

2. 5 - 325 mg oxy-acetaminophen 1-2 tablets every 4 hours. I've been taking 4 to 5 tablets per day.

Make sure you increase it if the pain increases

3. moderate

Okay

4. flexion 92 degrees and extension was at 2 degrees

That's okay for this early out

5. been icing 5 times yesterday for 45 minutes.

Well not bad but 40-60mins and more than 4 times a day would be better

6. I elevated leg yesterday for about 8 hours.

Excellent!

7. Nothing yet, other than personal hygiene, trips to fridge for water and snacks.

Jolly good!

you haven't told me how many sessions you do per day
Ankle pumps - 25 to 30 reps. Doing them hourly - a little OTT but they are anti-clot exercises only so as time goes on and you get more mobile, you can slack off and stop them, For now you only need to do 5 every hour or so
Heel slides - 10 reps done 3 times - 30 reps at a time is not a good way to do heel slides. Read this Heel slides and how to do them properly.
Leg raises - 10 reps done 3 times - again, 30 at a time is far too much and will cause pain in your quads and other places. I suggest you do 3 each morning and that's it! And once you can do them, you don't need to do them anymore!
Pressing knee into mat - 10 reps done 3 times - again, 30 is far too many. Do 3 once or twice a day
Walking with walker around house 5 times for 6 minutes each time - don't be obsessive about this. Confine your walks to 'as needed' things like trips to the bathroom and kitchen and that's it.
9. No Pt yet. 1st session later today - I suggest you put them off. You've no need for it.

All of this is far, FAR too much. You risk getting your knee angry and sore, even more so than the surgery has made it. Also decline the PT sessions. There are many on here that got through their replacements getting excellent outcomes yet we did no exercising at all. I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)

 

[sistersinhim]

I also did no PT or exercises. I just used my knee as I needed it in my daily living and I had a good recovery!

 

[skippyhak]

Thanks for the review. I did too much Wed and Thursday. You're right. More ice, rest, elevation!

 

[jaschembra]

Sounds like you're on the road to a successful recovery and that active lifestyle you've been missing.

 

[sistersinhim]

You need to be really careful to not overdo. It's such an easy thing to do, unfortunately. You are doing the right things...ice, elevating and resting!

 

[skippyhak]

Feel like I'm on the pain and pill train. Pain is relentless but manageable as long as I take the 325-5 about every 5 hours. The pills make me sleepy, groggy so I'm dozing on and off all day long. I'm still worn out since the surgery, blood pressure slips down on the low side a few times a day. Still dehydrated according to my family experts.

 

[sistersinhim]

You are still in the very early stages of recovery and it's nothing unusual to need pain meds on up into your second or third month. Your knee is just a week old, a newborn baby, and it's going to be very cranky and fussy. Follow the Bonesmart guidelines very carefully and you will have a much quicker and easier recovery.

 

[skippyhak]

Thanks! Icing 45 minutes on 30 off today. So ice, elevate, resting. Sleeping about 15 to 18 hours per day. Longest stretch about 4 to 5 hours during the night. I'm lucky the pills are working well at moderate levels and able to sleep and rest. Last June of 2016 original RTKR my levels of pain meds were double. Medical assistants were brow beating me "you taking too much"! Awful....in so much pain and my medical people telling me "I shouldn't be having that much pain." It was a bad time. I had to beg for refills. At the end of 2 months or about the pain finally reduced to manageable levels where I take 1 to 2 pills daily. I' never had any problems of stopping prescription pain meds once the pain went away.

 

[Josephine]

Feel like I'm on the pain and pill train. Pain is relentless but manageable as long as I take the 325-5 about every 5 hours.

At only one week that's an essential!

The pills make me sleepy, groggy so I'm dozing on and off all day long

There is a reason for that - with some of you chaps, it's the only way we can make sure you rest plenty - short of nailing your feet to the floor!

Icing 45 minutes on 30 off today

Much better would be at least 40-60mins and more than 4 times a day.

 

[skippyhak]

Good morning! Starting my 2nd week. Went from 10:45 PM until 5:45 AM on my pain pills. Slept about 6 hours! That was great but wow was I sore when I 1st woke up. Fell behind by 3 or 4 hours on my meds schedule.

 

[SusieShoes]

Isn't that one of the worst parts of early recovery? You need (really do need) your pain meds... and you also need your sleep. But if you get in a good solid five or six hours of sleep, you disrupt your pain med schedule. It's enough to make a person tear their hair out. Can you have someone, or maybe set a gentle alarm for yourself to, wake you up? You could take a pill, and with any luck go right back to sleep.

 

[skippyhak]

I've been able use "my pain" as my alarm. Thought about setting a alarm and thought my body would take care of it. Now I'm sitting "getting drowsy". In spite of the extra sleep it looks like I need more extra sleep. Not going to fight it. Thanks!

 

[Celle]

It's still such early days. You should be doing little else except resting and sleeping. By doing that, you're giving your knee the best chance to heal.

 

[skippyhak]

Thanks! I'm really trying hard to focus on rest, ice and elevate these 1st 2 weeks. I've need to push myself to rest! I'm always trying to push myself with "get up and do something." I've had more problems in my rehabs (or re-injuries would be a better name); with overdoing exercises and activities.

 

[sistersinhim]

When you're sleeping, your knee is actually healing more than when you are awake and moving around, so that's a good thing. Your knee needs that sleep time, not to mention your whole body!

6 hours sleep at 1 week is unheard of! That's outstanding! But, playing catch up on managing pain is no fun. Probably setting an alarm is the better thing to do at your stage of recovery.