TKR Carole’s recovery thread

[Carole4815]

@sewhat , it is wonderful to be home, you're right, and thank you for your prayers. And woo-hoo, you got the bed set up in your recovery "nest"!!!! That is wonderful news. Do you need to find special sheets for it? I love my new haircut and I'll bet you love yours, too. It's so much easier to take care of shorter hair in the summertime.

As for sleeping, yes, I spent last night sleeping in my lift chair and got a wonderful night's sleep. The PT didn't seem at all interested in showing me how to stand from my bed, and said that if sleeping on the recliner was not a problem then to just keep doing that instead. I haven't been elevating my leg much yet, other than what the recliner will do. In other words, not over my heart really. But I have a lounge doctor pillow thingie (which I actually have not used yet) and I should start using it. Once the meds from shot in my knee (during surgery) wear off, I will probably be more motivated to use it and to elevate.

 

[kneeper]

Yes, definitely use something to add elevation to what the recliner does.

 

[Carole4815]

I had my first appointment with Home Health today, and then my first PT appointment. Medicare and/or my insurance are paying for all of this. I am wary about PT but my wonderful surgeon thinks it is important so I will give it a try. But I won't let them push me too far.

1) Home Health - - this was a really nice nurse. She had me sign a bunch of paperwork related to insurance and similarly boring things. Then she checked my medication bottles to get the dosages, since somehow that didn't get recorded for the hospital and she wanted to make sure I had the right dosages. She examined the surgical area but visually only, without touching anything or removing any coverings. We chatted happily for probably 45 minutes or so, and in the process she found out that I am doing great and everything is going smoothly. She says on Monday another Home Health nurse will come and remove my dressing and I suppose change it or something.

2) PT - - he was pretty nice too. He showed me some exercises to do, but instead of saying something like "you must do 50 of these each day", he said "your goal is 50 each day, but do what seems reasonable to you." I like that attitude. He had me walk around the house for him, and I walked into all rooms but one (in my 1500 sf house) but that was about all I could do. My limitation in how far I could walk today was stamina, not knee. My stamina is very low due to years of limited mobility from knee pain.

The PT said my walking was more than he expected, given my severe mobility problems before surgery. He also liked my technique for rising from my lift recliner (use the "rise" button, and then push myself up the rest of the way using the recliner arms). And he liked my walker technique. He said I should try to walk a little bit every hour, even if it was only 6 feet away from the recliner and back. That makes sense to me for increasing my stamina, given that I am recovering from an extended period of mobility issues. I have another PT appointment tomorrow, which is a little ridiculous but apparently I was supposed to get two done this week and the week is almost over. Tomorrow it will be another guy, subordinate to this guy. I will practice saying "NO" if he pushes me farther than I think I should go.

The only thing the PT did that distressed me, was he said I should not use my ice machine for more than 20 minutes and no more than 4-5 times a day since it cuts back on circulation. I was very upset but said nothing. Later my sweetie, who was there observing, told me that he got the feeling that the guy meant this was company policy but he did not agree with it and "do what you gotta do" and he would not care. I draw the line at cutting back on icing. I am NOT cutting back on icing, no way. It is tremendously helpful for me in many ways, including range of motion and weight bearing. There are times when we must say "NO" and this is one of them.

 

[sistersinhim]

he said I should not use my ice machine for more than 20 minutes and no more than 4-5 times a day since it cuts back on circulation.

I iced the whole time I was sitting or laying down for the first 6 weeks or so. I had 2 ice machines and set one up at my bed and one up at the recliner. I'd sleep for a little while in the bed, then have to get up and get in the recliner and sleep a few hours there. I don't believe that you can ice too much unless you don't have a cloth between you leg and the ice pact. Ice helps to keep the swelling and pain down.

 

[Carole4815]

@sistersinhim , thanks. I am going to do what you did. It makes no sense to me to cut back on icing so I am glad to hear that you kept icing a lot and it helped you too. I use a big scarf between my skin and anything cold when icing. Like you, I have 2 ice machines and have one set up at my bed, and one at my recliner.

 

[InkedMarie]

Sounds like you’re doing great! I iced almost constantly for the first couple weeks.

 

[Carole4815]

Sounds like you’re doing great! I iced almost constantly for the first couple weeks.

Thank you! I am so pleased with how well I am doing so far, too, although it might just be due to the pain shots my surgeon gave me while I was under. They should wear off soon if they haven't already. I will probably ice a lot for the next couple of weeks, and I am glad to hear that others do that too.

That reminds me; I need to re-fill my ice machine with frozen water bottles and ice after this post, because it's about all melted.

Just now I was taking off my compression stockings and leaving them off for an hour, as instructed to do once or twice each day. I hadn't done it yet even once, because I overlooked that in my instructions. Oops. Anyway, the one on the surgical leg is much more comfortable now, yay! I am so glad that I have the sock assist to help me in putting the compression stockings back on because I am terrible at tasks like that.

I wonder what that thingie is that is under the compression stocking, on each foot around the heel. It's sort of like a pad, I guess? I didn't even know it was there until today. Probably I should ask the Home Health nurse when she comes here on Monday, because I wonder if that is even supposed to be there.

 

[InkedMarie]

I iced for a couple months, just not continuously. I really needed that the first two weeks.
I’m unsure what you mean about the heel thingie. Let us know what that is. I’m glad I had my husband to put my hose on & off for me!

 

[Jaycey]

I wonder what that thingie is that is under the compression stocking, on each foot around the heel.

It might be a heel pad. Very fancy if it is. Is there one on each foot?

Many people complain of sore heels post op. You spend a lot of time on your back with your heels touching. Sometimes bed sores start to form. I'll bet that heel pad is protecting you from this.

 

[Jockette]

I’m glad I had my husband to put my hose on & off for me!

Me, too, and he struggled! I could never have done it myself, even with a gadget.

 

[Carole4815]

It might be a heel pad. Very fancy if it is. Is there one on each foot?

Many people complain of sore heels post op. You spend a lot of time on your back with your heels touching. Sometimes bed sores start to form. I'll bet that heel pad is protecting you from this.

I am sure that is what it is, thank you! Yes, there's one on each heel.

 

[Carole4815]

Me, too, and he struggled! I could never have done it myself, even with a gadget.

It was tough, even with the gadget! Especially on my operative leg, because it is (of course) a little swollen so the compression hose are tighter.

 

[szrmom]

he said I should not use my ice machine for more than 20 minutes and no more than 4-5 times a day since it cuts back on circulation.

My os told me the same thing, but didn't limit it to 4-5 times per day, and he prescribed a ice system with a velcro wrap that I velcro an ice pack into the wrap and then wrap it around my knee. (it came with 2 inserts) It also has a pump to make it tight. But, the ice pack has to be put back into the freezer after about 30 minutes. He told me absolutely no ice machine. He said you don't want to fight against your bodies natural healing mechanisms, you have to find a balance.

 

[Jockette]

All differing opinions on icing, do what you think is best for you. Just be sure to have a cloth, or something similar between the ice pack and your skin.

 

[kneeper]

So true about everyone giving you a different story on icing. Instead of 20 minutes of icing, I probably took 20 minute breaks from icing. ;) That was either because it started feeling too cold or the gel pack had warmed up and it took me a while to decide to get up and get the next one.

Sounds like your home health team is a good one.

 

[luvcats]

I'm so glad everything is going well for you!

 

[lovetocookandsew]

There are doctors who tell patients to ice as much as possible, and, on the other end of the spectrum, those who say don't ice at all, and everything in between. My experience with icing is it greatly alleviated what pain I did have, which wasn't a lot after my revision, and noticeably brought down the swelling. Because I only had my ice machine for pain relief, it was a no-brainer for me to use it any time I was not up walking around, including all night long. My OS is a huge believer in icing after a TKR, so much so that he helped get our insurance to cover ice machines for every knee patient. He told me studies have shown that ice machines are much more effective than ice packs, and patients are much happier with the machines than the ice packs overall.

Remember, in the end, you choose your recovery path; no one else can decide how you want to recover. You can listen to any advice you wish, and then make decisions based on your knee, your body and your preferences. Anyone who disagrees has that right, but no one has the right to push, prod, manipulate, threaten or force you to do anything you disagree with. Just as you had to agree to the surgery, you have to agree to any therapies, icing protocols, and so on. Just because a surgeon operated on your knee does not mean he now owns all rights to that knee-it's still your knee, your body and your life. If you wish to ice all day every day, as long as you keep that cloth in place, and walk around as suggested in your recovery articles, you'll be fine. Conversely, if you decide to follow the icing guidelines as stated, that's also your right.

As for those compression hose, I never had any prescribed and am glad as I would have removed them and tossed them in the round file day one, especially in the summer heat! I think those are a personal preference for doctors as some prescribe them and some don't and it seems to me the end results are the same anyway; but that's just my opinion.

 

[Carole4815]

Had my second PT session today, but it wasn't too bad. I did the exercises that were easy (like rotating my feet on the ankles, and like the butt clinches). I couldn't do most of the exercises at all, and refused to do them. She said she'd do it and I should just help as much as I could (which was mostly not at all). But she didn't hurt me, and she was very encouraging and said I was doing reasonably well. My ROM is 68 degrees which sounds awful, but she said, "hey, only 22 more degrees to go! And next week you'll show a big improvement". I thought that was so nice for her to be that encouraging.

I asked the physical therapist to show me how to get on my bed (since I have been sleeping in my lift recliner only). It really hurt but thank heavens she "rescued" me by assisting with my surgical leg. I am not going to try that again for a while, even though I have a leg lifter thingie from Amazon. I am doing fine sleeping in my lift recliner until I have recovered a bit more.

Prunes WORK. Just sayin'.... I only ate about five but wow, I don't need any more.

Still very little to no pain (at least when resting and not trying to get onto my bed or get into a car). Looks like I really lucked out as far as pain goes. I am surprised at how crabby I have been, but hope that having the weekend "off" (with no PT or Home Health) so that I can rest and sleep and recover will reduce the crabbiness.

 

[Carole4815]

My limitation in how far I could walk today was stamina, not knee. My stamina is very low due to years of limited mobility from knee pain.

Oh look what I found!
https://bonesmart.org/forum/threads/energy-drain-for-tkrs.11953/
Take a look at the second post in that thread! From what it says, apparently a lot of us experience energy drain or low stamina after TKR surgery. That makes so much sense, but I just hadn't realized it until now. Maybe my low stamina is completely normal and usual.

On another topic, I also decided that I hate, hate, hate my compression stockings because they are insanely tight, so tight that I can't keep them from rolling which makes them even tighter, and they are just awful. So right now I have taken them off, as I'm supposed to do every day for an hour, but this time instead of putting them back on, I am running them through the wash and plan to hang them up to dry and go without overnight. I know some doctors don't require them but I only have two more weeks to wear them so I might as well try to do what my doctor prefers. Maybe an overnight break from them will help. I have been doing lots of ankle pumps to discourage embolisms.

 

[luvcats]

I can certainly attest to low energy being normal. Healing is very hard work even though it is behind the scenes. I went to the store at the end of my second week. Even though I only got in the car, transferred to a cart, picked out only half the groceries, and went home where my Beloved brought everything in and put it all away, I was completely wrecked and hurt terribly that night instead of sleeping. That just doesn't seem strenuous to me, but my body sure thought it was! And that was much less than a normal presurgery day for me.

I had so much swelling right at my knee that trying to wear my compression stockings was horribly, horribly painful. Right around the part of the leg where they drilled a hole and pounded in a spike! lol. I'm only just now beginning to wear my stocking on the surgical leg again. But my doctor didn't say anything about them.