Lounge Doctor

TKR Amazingly better experience with knee #2!

BBCG

FORUM ADVISOR
Forum Advisor
Joined
Aug 6, 2016
Messages
745
Age
70
Location
Eugene Oregon
Gender
Female
Country
United States United States
Hi all, resting in hospital after my RTKR early this morning. I had an awful experience... well, many... with knee #1 but this has been so much better!

With knee #2, I went in far better prepared, way more positive about what will be the road forward, had a couple of bodywork sessions the week earlier, and OS procedure changes, and medication used changes are all making a huge difference!

I’m very curious as to what to assign % of better results to what, but in reality, I probably won’t know!

I had a spinal and general anesthesia for #1, but no spinal and just Fentanyl this time. I was given doses of Oxycodone from the beginning last time, but only Tylenol with either Toradol (in the IV) or Tramadol this time. This has all made a huge difference in pain levels (at most a 3 this time), whereas last time I couldn’t sleep, I was very anxious, I was depressed, and more.

I hope one of our moderators pop in to respond to see if they have any input or can point me to resources... I did some research before this new knee and my symptoms have some correlation to opioid allergy or reaction, but what other factors are involved? (And I need to add my signature, I guess!)

My sleepiness is creeping in now!

I already have about a 70-80 degree bend, straight seems far better than at this time last knee, and I’m walking well when I can wrangle an accompanying CNA to walk the hall..

What an incredible difference! Pain levels max at about 2-3 this time...

I am so very grateful! Night-night all!
 

Celle

MODERATOR EMERITIUS
Moderator
Joined
Nov 19, 2011
Messages
46,131
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
Welcome to your second knee recovery @BBCG .
I'm glad things are going well so far.

Don't be surprised if your flexion decreases for a while, because your knee is going to swell a bit more.

Here are our recovery guidelines for you:
Knee Recovery: The Guidelines

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help, but YOU are the final judge as to the recovery approach you choose.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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. Try to follow this

6. Access to 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 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.
 

Sara61

FORUM ADVISOR
Forum Advisor
Joined
Oct 1, 2019
Messages
1,640
Gender
Female
Country
Portugal Portugal
What a great update, I'm so glad 2nd time is so better for you, I think the first replacement is always more daunting ...the unknown :flabber: but on the 2nd knee one is slightly better prepared with more knowledge just like you mentioned, one can prepare well in advance, know what medication works and also know what one can and can't do afterwards. Plus knowing what and why helps I think for a less stressful recovery. Hoping sometime soon, I too will be joining the ranks of 2nd new knees.
Rest, plenty and wishing you a good recovery xx
 
OP
OP
BBCG

BBCG

FORUM ADVISOR
Forum Advisor
Joined
Aug 6, 2016
Messages
745
Age
70
Location
Eugene Oregon
Gender
Female
Country
United States United States
Thanks so much, Celle and Sara61!

I’m so glad I’m only here in hospital 1 night, as one is awakened nearly hourly!

Right now they have me taking 50 mg Tramadol at night ev/6 hours with Tylenol in day perhaps the same ev/6 hours, but I didn’t keep good track in the early hours when my husband and friend were here. If the discomfort awakens me, it is working to do my ankle pumps a semi-heel-slide! Such a different experience and I feel so very blessed!

Sara61, I hope you are equally fortunate for baby knee #2, too!

I’m to go home tomorrow once PT releases me: they apparently hold the cards to release. My nurse just told me they begin rounds around 8am, so my hope is to firmly impress them! It makes so much difference that this is not my first rodeo!

When I asked the timing for when the surgery theatre drugs would be gone from my system, thinking they could still be informing my pain levels, my nurse said they would be gone by now, 12 hours later, so I am heartened that this may indeed be so do-able!

Will report back in the morning... we’ll, never mind: something started beeping!

They informed me here that my legs need to be flat, not elevated, and in fact, the lower bed “up” button does not work! Sneaky dickens! So, I have my 3 pillow set-up ready at home, my friend the recliner, the official kitty pillow next to me (to prevent her from wanting to sit upon me), the ice machine, a view into the yard with freshly-filled bird feeders, so home will be a welcoming place!
 
Last edited:

Jo Wo

senior
Joined
Feb 28, 2021
Messages
411
Age
64
Location
Long Island NY USA
Gender
Female
Country
United States United States
Hi all, resting in hospital after my RTKR early this morning. I had an awful experience... well, many... with knee #1 but this has been so much better!

With knee #2, I went in far better prepared, way more positive about what will be the road forward, had a couple of bodywork sessions the week earlier, and OS procedure changes, and medication used changes are all making a huge difference!

I’m very curious as to what to assign % of better results to what, but in reality, I probably won’t know!

I had a spinal and general anesthesia for #1, but no spinal and just Fentanyl this time. I was given doses of Oxycodone from the beginning last time, but only Tylenol with either Toradol (in the IV) or Tramadol this time. This has all made a huge difference in pain levels (at most a 3 this time), whereas last time I couldn’t sleep, I was very anxious, I was depressed, and more.

I hope one of our moderators pop in to respond to see if they have any input or can point me to resources... I did some research before this new knee and my symptoms have some correlation to opioid allergy or reaction, but what other factors are involved? (And I need to add my signature, I guess!)

My sleepiness is creeping in now!

I already have about a 70-80 degree bend, straight seems far better than at this time last knee, and I’m walking well when I can wrangle an accompanying CNA to walk the hall..

What an incredible difference! Pain levels max at about 2-3 this time...

I am so very grateful! Night-night all!
so happy to hear that it went well! hope you are healing at home soon
 

Jaycey

FORUM ADMINISTRATOR
Administrator
Joined
Jan 27, 2010
Messages
35,965
Location
Yorkshire
Gender
Female
Country
United Kingdom United Kingdom
Sounds like the changes you made pre-op really made all the difference in the world! Spinal and GA is tough to recover from. I had GA during my spinal surgery and it took days to leave my system.

And the pain management cocktail they are giving you is a good one. Many of our members experience great results with the Tramadol/Tylenol combination.

So glad you are off to a good start with this recovery!
 

sistersinhim

MODERATOR
Moderator
Joined
Dec 4, 2015
Messages
24,548
Location
Virginia
Gender
Female
Country
United States United States
They informed me here that my legs need to be flat, not elevated, and in fact, the lower bed “up” button does not work!
That just is not right. Many doctors and hospitals are getting away from the flat knee, realizing that elevation with a slightly bent knee is much better on the patient and for relieving some of the swelling. I know you will be glad to get back home to your pillows! BTW, welcome to that newborn knee of yours!
 
OP
OP
BBCG

BBCG

FORUM ADVISOR
Forum Advisor
Joined
Aug 6, 2016
Messages
745
Age
70
Location
Eugene Oregon
Gender
Female
Country
United States United States
Thank you so much!
I’m back home now, knee on pillows, ice machine gently humming. Everything went very easily, and, surprisingly, one of the joint replacement department staffers stopped off to ask if there was something they could do to improve anything! I thanked her for asking, and I couldn’t think of anything then...but later I did.
Had an energetic, walking/stair-practicing, exercise-doing in-house PT session in the PT room and hallways and got back in my room where Dan and my friend arrived to come bring me home.

Because of the controlled nature of the medicines, I had to drop off the prescriptions on our way home, and there was to be nearly an hour-long wait.

They dropped me off at home and helped me get settled in the recliner with water, ice machine, etc. before heading back to get the Tramadol, etc. My friend got there and there was a long line. She waited, and she was second in line when they said, “Here is the cut-off, you’ll have to come back after our lunch break.” Sue is a great advocate and said, “That’s not going to work! Our patient just got out of surgery for a new knee and NEEDS these pain medicines!” They helped her out!

So, we got behind in the pain meds due to the long line and the issues they have of being so busy. So, by 2:30 pm I was in alot of pain.

Still had to determine what to take so that tied up another half hour, so my pain was bad by 2:30 when I finally took what was due...

Now, at nearly 2 am I feel like we know the plan and can work it out.
 

sistersinhim

MODERATOR
Moderator
Joined
Dec 4, 2015
Messages
24,548
Location
Virginia
Gender
Female
Country
United States United States
Oh, Barbara, I hate to hear how difficult it was to get your pain meds. Too bad they couldn't have filled it at the hospital before you left. That's what I did. I know you were in agony before getting them in your system again. Thank God you're back on track now.

Now that you are home, you should be able to take care of your own needs and not have to wait for anyone to do the things you need. Just be sure you don't overdo and don't be surprised if your swelling increases for a few days. That's completely normal because of the added activity you'll be doing.
 

Sisterpat

MODERATOR
Moderator
Joined
Feb 14, 2021
Messages
1,152
Age
74
Location
Arkansas
Gender
Female
Country
United States United States
I, too, had to stop off at the pharmacy on the way home to get my pain med! A shorter wait, but at that point 5 minutes is an eternity with the brand new knee bent in a sitting position! Must be a better way.
Anyway, congratulations on your new knee! Praying for a smooth recovery. Those cats of ours can be a great comfort!

75AB32A5-78AD-4643-96B1-7FA0062C554F.jpeg
 
Last edited by a moderator:

karwask

new member
Joined
Aug 16, 2020
Messages
14
Age
68
Location
Eugene, OR
Gender
Female
Country
United States United States
Hey Barb,

Glad to hear you are back in the comfort of home and, by now, have figured out the pain management aspect so you are as comfy as can be expected. Please don't hesitate to call upon me, till the 25th when I have my LTHR, if there is anything at all you need:). Seeing your experience, I'll be signing up for the meds to beds program that is offered so I can take them with me when I leave the hospital. What a pain in all senses of those words:(
 

NightQuilter

FORUM ADVISOR
Forum Advisor
Joined
Oct 27, 2012
Messages
1,899
Age
71
Location
LA, California
Gender
Female
Country
United States United States
Barbara, I am so pleased you are having a much better time of it with #2, despite the medication mess up. That pre-op prep clearly paid off for you.

@Sisterpat , love your attentive kitty. Mine too, was by my side throughout.
 
OP
OP
BBCG

BBCG

FORUM ADVISOR
Forum Advisor
Joined
Aug 6, 2016
Messages
745
Age
70
Location
Eugene Oregon
Gender
Female
Country
United States United States
@Sisterpat, you’ve got a black & white kitty, too! I’ll get someone to photograph our Magpie on my lap!
Being able to rest here at home instead of the hospital has been wonderful, especially with my dear friend, Sue, staying here with us for 3 nights. She has been a godsend, cooking for us, helping understand how to help Dan help me. She’s surprised at how independent I am already (well, that’s been since I was 4, no doubt!), as was my other friend who stopped by with a stir-fry for us.

I really have only very specific pain in certain areas, that is really quite manageable. I think that this Tramadol Tylenol rotation works quite well, really!

Once I found Bonesmart buddies last time, you all showed me that protocol used there in England, and I switched to that once I could get the doc to prescribe Tramadol. Now, 5 years later, it is the recommended protocol here, although they add in some Hydrocodone, too, initially. As an experiment last night, I took a Hydrocodone instead of the protocol’s Tylenol. The Hydrocodone kept me awake and didn’t work nearly as well! So, won’t take it again!

I am able to move about with the walker although am overall not putting much weight on the newer baby knee leg yet. I am icing consistently, using the borrowed device, throughout the day and most nights.
Trying now, to go back to sleep after a wake up session re-setting the ice machine up after it inadvertently got quite wet! My knee is warm enough I think it will be dry in no time!

... back off to slumber now..
 
OP
OP
BBCG

BBCG

FORUM ADVISOR
Forum Advisor
Joined
Aug 6, 2016
Messages
745
Age
70
Location
Eugene Oregon
Gender
Female
Country
United States United States
Hey Barb,

Glad to hear you are back in the comfort of home and, by now, have figured out the pain management aspect so you are as comfy as can be expected. Please don't hesitate to call upon me, till the 25th when I have my LTHR, if there is anything at all you need:). Seeing your experience, I'll be signing up for the meds to beds program that is offered so I can take them with me when I leave the hospital. What a pain in all senses of those words:(
I had seen about the meds-to-Beds service but it said my insurance might not cover it, plus our pharmacy is not usually so busy! The Covid vaccine shots people have been coming there for have meant a lot of changes, it does appear.
 
OP
OP
BBCG

BBCG

FORUM ADVISOR
Forum Advisor
Joined
Aug 6, 2016
Messages
745
Age
70
Location
Eugene Oregon
Gender
Female
Country
United States United States
Oh, Barbara, I hate to hear how difficult it was to get your pain meds. Too bad they couldn't have filled it at the hospital before you left. That's what I did. I know you were in agony before getting them in your system again. Thank God you're back on track now.

Now that you are home, you should be able to take care of your own needs and not have to wait for anyone to do the things you need. Just be sure you don't overdo and don't be surprised if your swelling increases for a few days. That's completely normal because of the added activity you'll be doing.
Sistersinhim, yes there is more swelling so less bend, as well I remember! Icing seems to really help as does the elevating, which is easy in my trusty recliner, which helped me through knee #1. I have found that a foam pillow I have with a carved out central area (designed for use under ones neck as a pillow) is the perfect pillow for support of the new knee’s leg. It’s very soft, forgiving, and cradles my new knee perfectly!
 

sistersinhim

MODERATOR
Moderator
Joined
Dec 4, 2015
Messages
24,548
Location
Virginia
Gender
Female
Country
United States United States
Sounds like you will recover very nicely. Having a previous knee done is almost always a good training tool for the second one. You have learned well from yours.
 
OP
OP
BBCG

BBCG

FORUM ADVISOR
Forum Advisor
Joined
Aug 6, 2016
Messages
745
Age
70
Location
Eugene Oregon
Gender
Female
Country
United States United States
Thank you, Sistersinhim... I agree that my first knee was excellent training for the new knee! This time I have plenty of confidence in knowing that if I get pushed too hard by PTs, I can just stop going and know that my own ADL will be enough in the long run... they are starting me 6 days post surgery, too, which may be a week before my knee is really ready. My own PT isn’t back to town until 3 weeks out from surgery. I can just wait until she’s back and not go to the ortho center PT that they set me up with...
 

sistersinhim

MODERATOR
Moderator
Joined
Dec 4, 2015
Messages
24,548
Location
Virginia
Gender
Female
Country
United States United States
You already know my feelings on PT! Bad PT is much more harmful than no PT. Finding the right therapist is a Godsend. I think it'd be perfectly OK for you to wait for yours.
 
OP
OP
BBCG

BBCG

FORUM ADVISOR
Forum Advisor
Joined
Aug 6, 2016
Messages
745
Age
70
Location
Eugene Oregon
Gender
Female
Country
United States United States
Thanks for the support, Sistersinhim! I’m curious to see if the PT at the ortho center does any hands-on work, as it seems like other areas not immediately adjacent to the incision want some good attention. But if her style is too harsh, you can be sure I’ll call to cancel!

I’m on day 3 out of surgery, and this afternoon I thought I’d try to see if I’m ready for the crutches... graduating from the walker this soon seems really early, but I’m having none of the awful side effects from last time, from the opioids: the brain fog, forgetfulness, inability to concentrate, inability to focus on a task, sleeplessness, anxiety, etc. Had some of the muscle-nerve twitchiness like last time, but now can solve that! A massage practitioner used some magnesium gel on my leg back then, and I bought one of the bottles and used some tonight. It seems to calm those twitches pretty quickly.

Am just so thankful I read up on the research regarding the side effects of the oxy drugs and said no to them this time!!
Had a few visitors today so heading to bed now...
 
Last edited:

Sara61

FORUM ADVISOR
Forum Advisor
Joined
Oct 1, 2019
Messages
1,640
Gender
Female
Country
Portugal Portugal
Sounds like you have got this well sorted, I'm relieved it is going so well for you xx
This time round I'm hoping to be in better shape physically, I certainly have the time, and my knee seems less painful than the other one- I think it's all the rest from being stuck in lockdown these last few months ...I too found tramadol the best medication offered..wishing you continue success xxx
 

New

OneStep App

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
56,809
Messages
1,458,685
BoneSmarties
34,984
Latest member
Dee1971
Recent bookmarks
0

Top Bottom