Bilateral TKR BTKR ~~ May 13, 2013 ~~ Post-Op

[izzie]

Hi Diana, I’m trying to find the right combination of pain relieving drugs to stay in front of the pain. As everyone has told us, stay in front of it, don’t let it get to the point that you are hurting too much before you try to control it. Today was better.

That crazy recliner! No one will do anything to make it more comfortable, so today, after complaining to the doctors, etc., I only sat in the recliner when I absolutely had to. The bed is so much more comfortable. With the head of the bed up, I can straighten out my legs and do my little exercises and get much better movement than in that recliner. If they tell me they don’t want me in bed, I’ll just explain why, but I’m not going to spend any more time in it.

Your husband’s saying is perfect, I will keep that in mind. Thank you.

I don’t have a CPM machine. The therapists have explained to me that it is a passive motion which they are not fond of. Building the muscles that support the knee is their top priority. And, according to my level of pain, they are doing a great job!!!

Thanks for always checking in on me!

 

[izzie]

My way, The torture chamber recliner did not get much use from me today. I was very busy in PT and OT most of the day. And, I decided to stay on the bed with the head elevated. It’s much more comfortable and I feel the circulation in my legs is much better.

Pants! Yes, for sure. Otherwise, the paparazzi might get a photo!!!

 

[izzie]

Tuesday ... Today, in PT, something new - I used the recumbant bike. Just moving back and forth, not making a full revolution. It was a good stretch and bend. I've done a lot of walking on my own and I think tomorrow they may give me the "okay" to be unattended. I'm able to get out of the recliner and the bed on my own. It takes a little while, but I manage. OT took me into their kitchen to show me some little tips and tricks -- and spent a lot of time working on upper body strength -- also did a load of laundry. I've gone back to using Percocet because it gives me much more pain control than my other options. Hydrocodone and Tramadol are on stand by if I need them. Since my insurance does not pay for medical equipment, I found a walker and 2 canes on Craigslist. The boys can pick them up tomorrow and I'll be set for that part. At Sams Club online, I found a raised locking toilet seat with arms which is very affordable. Going to try to go to sleep a little early tonight with the help of Lunesta and hopefully will sleep most of the night That would be great!

 

[Midwest knees]

Hello Izzie, sounds like you are making good progress for having both knees done. I went out today for the first time (15 days since RTKR) to my post op doctor appt. He was very pleased with my progress so far and says I'll do great. He has prescribed a mix of meds for the pain, so far I've only taken hydrocodone and an occasional muscle relaxer. Now I will be taking hydrocodone, Neurontin and something else I can't remember the name of (mush brain). I'm still giving myself an injection each day of lovoquin, the blood thinner, I have 7 more days of that and then I'll take 325gr of aspirin for 4 weeks. Like you, each day is different, I'm happy for the occasional lucid couple of hours to spend with my husband watching tv or just talking. I have to get lots of naps because my sleep is so broken up during any 24 hr period, I don't fret about that, I know it will sort itself out when I am feeling less pain.

I rode in the passenger seat of my minivan, put the seat as far back as it will go and tilt the seat down just a bit and it was fine, I hope your ride home won't be a long one. That first time you lie in your own bed is just heaven! Have a good night.

 

[schipp4me]

Keep plugging along Izzie, its only been 8 days..........tomorrow for me I'm off to Pt. after a short drive in my car. so I can only hope they aren't out to kill me......lol............

 

[new knee in June]

Good Day Izzie,
I hope you are having a "good day" Good for you for telling them you are not using
the recliner It sounds horrendous. Always stick-up for yourself it feels soooooo good!
Today I had my pre-op stuff done. I will be having GA, femoral block & pain pump. They don't like pain above a 3 or 4 so I think I'm covered. Also, they just opened up a new orthopedic suite & I will be one of the 1st
patients to use it. I'm so happy.....this is really going to happen We'll see how I feel next week
Take Care,
Diana

 

[schipp4me]

New PT was great, now I have appts lined up for the next 6 weeks.........Rom around 130 now. I even went to the grocery store afterwards, and shopped........I can only hope for all of you that your success is as great as mine..........we are all different, and just have to keep plugging for the goal of complete healing......

 

[My way]

Too bad if they weren't happy about you not sitting in the recliner. You weren't too happy having to sit in it! If they expect people to use them they should get some user friendly ones. I fail to see the difference in reclining in a chair or reclining on your bed. It's not like you are laying there all day eating Bon Bons, giving yourself a manicure and not working on your program. Does sound like a plan though, I suppose that would drive them to a real

I hope things are still improving and maybe you treat yourself to the recline with Bon Bons and the manicure when you go home. Just one day once in a while though!!!

 

[izzie]

Hi Liddie,
Congratulations! It always makes us feel good when the doc says they’re pleased. Is the combination of meds you’re on now working for you? I still haven’t gotten it quite right, but almost there. Each day, I’m getting an injection of Lovenox blood thinner which I will be giving myself for about two weeks after I get home.
Has your doc given you anything to help with sleep? Since I’ve been taking Lunesta, I’ve been getting decent sleep even for being in the hospital. It would be nice if you could get a good block of sleep at night.
My ride home isn’t long, not exactly sure how to handle it yet, but I’ve been given some great suggestions.
Take care Liddie, sounds like you are right on track!

 

[izzie]

Hi schipp4me, I know it must be great to be driving. Your PT results are amazing and shopping afterwards -- You are doing so well!!! Love to hear your encouraging reports. I feel like I’m doing well for the short time it’s been since my surgery. Each day gets a little better. Congratulations, keep up the good work and take care!

 

[izzie]

Hi Diana, Everything sounds great! You are so fortunate that you know in advance the type of anesthesia you will have. New orthopedic suite sounds wonderful and will be brand new. The worst part is prior to surgery. We just don’t know exactly what to expect no matter how many people try and explain it. The best part is that you will be looking toward a future with a brand new knee and no more pain! Great news!

 

[izzie]

Hey My way! I sat up in bed with my legs extended whenever there was time to rest today and no one said a thing. Things are improving. Today, I was pushed really hard and definitely felt it. It’s okay though. I need to push as much as I can -- not go crazy. I feel better the day after, so I know pushing, in my case, isn’t necessarily a bad thing. Bon Bons sound good!!!

 

[izzie]

Wednesday ..... This morning I was sent to Radiology for a Doppler ultrasound of both legs. One of the docs in charge of patients in rehab didn't like the swelling and tenderness in my legs and said he'd rather be safe than sorry. Me too! Everything turned out just fine, thank goodness.

I am going to be wearing the TED hose, at least most of the day. My ankles are always very swollen. Never in my life have I had swollen ankles, but this is a very unusual circumstance, so I'm not surprised. The PT wanted me to stand without the use of my walker, she showed me exactly how to do it, but when I tried, I really hurt myself. The pain was intense and I cried a little. She was very sweet and apologetic. She showed me some ways to try to work on getting to the standing position, but she took it easy on me in the second PT session today. In between, I iced and took pain meds.

My quads are very weak. During the last ten years, I have relied more and more on my arms to push me up from a sitting position. I've been compensating for a very long time and my quads have atrophied, so there will be lots of extra work for me to do to regain strength. Otherwise, I will not be able to improve.

My walking is improving and I went up and down the 6" stairs 3 times today - not perfectly, but getting better. This evening, my emotions got the best of me. I had a good cry, tomorrow I'll be just fine. At, this point, I am really looking forward to going home. I wish it was tomorrow instead of Friday - just getting sick of being in the hospital. I will use the next couple of days to do my best in PT, working on those quads and be stronger for going home.

 

[Kavan]

Izzie hang in there. You are doing great. The fact you are getting closer to standing without a walker is a huge victory in and of itself. I bet you'll be standing unaided before you know it. I'll keep you in my thoughts as you undergo therapy tomorrow.

 

[Janet2012]

You'll see a big difference in the next week I bet. I never had swollen ankles, but everyone is different. More swelling, more pain, however. I didn't sit in a recliner or chair at rehab or at home for quite a while if I could help it. It's easier to keep the gravity induced swelling away than to get rid of it once there it seems. Glad your doc checked you out for clots. That's always a concern!

 

[bichonmom]

Oh Izzie..I'm so sorry to hear that you had such intense pain at your PT today! Days like that bring you to tears very easily..sometimes those tears can be very cathartic though..which sounds like that may be the case for you..have you read any of Josephine' s posts on this site? She is an ortho nurse from the UK..has been a nurse for over 30 years..she has also had BTKR surgery..so she knows what you are going through..her posts and advise are simply wonderful...I know just reading some of her posts will make you feel much better...it won't be long now until you will be heading home..that in itself will certainly help you! Hope your day is a better one tomorrow..praying for your comfort tonite....

 

[bichonmom]

Izzie..not sure if I'm doing this right..but I want to try and tag Josephine Josephine so she can read your post from today...1

 

[Josephine]

have you read any of Josephine' s posts on this site? She is an ortho nurse from the UK..has been a nurse for over 30 years..she has also had BTKR surgery

Bev, you did it perfectly, thank you! But I only had one knee done and I've been an ortho/OR nurse for 50 years!

My quads are very weak.... and my quads have atrophied, so there will be lots of extra work for me to do to regain strength.

That may be so but now your quads are also injured so go easy on them. Serious strength training shouldn't enter the picture until at least 8 weeks out.

This evening, my emotions got the best of me. I had a good cry

Izzie, I am horrified that I have not been to your thread before this. Heaven knows how I have missed it and I see you've only had one or two visits from other mods as well. I'm pleased you have a good group around you but appalled that no member of staff (including me!) has been diligent enough to give you the recovery articles which I think are so essential to provide the base for recovery. So a little belated but thinking better late than never, here they are ....

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!

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

And 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

 

[new knee in June]

Good Morning Izzie,
I am so sorry about your swelling. It must be very hard to do anything
I am glad you didn't have any blood clots I have heard some of the folks have had lymphatic
massages ( would that help you? ). I can't image doing all you are doing in therapy. You keep fighting
the good fight & you will be home before you know it A good cry is a good thing
Remember: you have all of us on your side, we want only the best for you ! Don't forget your boys & I
hope you keep "talking " to your mom for comfort. ( It really does help ).
All my best to you Izzie, for a pain-free, encouraging day &one step further to being in your own home
I will check back later today if you would like to talk.....
Take Care,
Diana

 

[izzie]

Josephine, I cannot thank you enough for your post. Although I read many of your articles prior to my surgery, I did not remember many important points. For one - elevate the legs in the correct way! As soon as I read the article about proper elevation, I grabbed three pillows, stacked them properly and put my legs up. Amazing! What a relief. The doc and PT's here all have told me to put this little roll of towels underneath my heals. That's it! I know I saw your article on elevation previously, but I completely forgot. In the hospital, with the meds, and doing what I was told .... I should have referred back to your articles. My pain got out of control yesterday after the tough PT session. Last night and this morning was very unpleasant. The day nurse arrived, gave me 2
Tramadol to start and when breakfast arrived, she gave me 2 Percocet. She said if that didn't kick in and relieve the pain she would bring me some hydrocodone. Thank goodness. Last night when I asked for pain meds, I had to wait one hour before the nurse came to my room. I was in tears. For some reason, the doctor does not have my meds "scheduled", so I must ask for them. Today, my ankles, calves, knees and thighs are still swollen. I would prefer going home today rather than tomorrow. I could use a day of rest from PT and at home I can have more control over my pain meds. Also, I can elevate and ice properly. I'm going to ask the doctor as soon as I see her. Again, Thank You Josephine! I'm so glad I decided to turn my computer on this morning and read your post.
Thank Heaven for that!!!