TKR Conscious sedation memories?<

[Jamie]

@MeganAC ..... please make sure you read those articles that Celle left for you in Post #2 of this thread. You may need to reread them several times throughout your recovery, because the information is so important.

It's easy to forget how traumatic this surgery is. You are just barely 4 weeks out and that's really early in the recovery process. Please don't hurry yourself too fast to be be normal again. It's going to take a while. Your body will be your best guide to your activity level. If you do something that causes pain the next day or so, you're not ready for that level of activity quite yet. Remember....all this is just temporary and your new knee is worth the wait to let it heal completely and on its own terms.

 

[MeganAC]

Thank you, @Josephine

1. Current pain level at 5-6.

2. Current Medications:

hydrocodone 5/325 up to 4x daily, currently taking 2x daily as
tramadol 50 mg, up to 4x daily, currently taking 2x daily, opposite hydrocodone
naproxen 500 mg, 2x daily
acetaminophen 625 mg, 4x daily
aspirin 81 mg, 2x daily​

3. Swelling is moderate

4. ROM measured on Tuesday at PT 96/4 degrees

5. Icing using polar care, approximately 6x daily for 20-60 minutes, as tolerated

6. Elevating off and on all day, if I am sitting or laying down I am elevating, always when icing

7. Activity level varies, walking to and from bathroom, walking around house, occasional preparing meals for self, cleaning up kitchen, etc. Occasional trip to restaurant using cane or crutches, elevating in booth or on chair; grocery with electric cart; PT 2x weekly

8. These are the assigned home exercises:
straight leg raises, assigned 2x10 reps daily, actual 10 reps maybe 1x daily, if I feel like I need to move
standing calf raises, assigned 2x10 reps daily, actual 10 reps 2x daily while brushing teeth
seated single leg extensions, assigned 2x10 reps daily, actual 10 reps, maybe 2x daily, if I feel like I need to stretch
standing hamstring curls, assigned 2x10 reps daily, actual I haven't been doing these
side lying hip abduction, assigned 2x10 reps daily, actual maybe 10 reps 1x week
short arc quad, assigned 2x10 reps daily, actual maybe 1x10 reps every couple days
sit to stand, assigned 5 reps slow tempo up and down, actual I haven't been doing these other than trying to stand slowly and without hands and sit without plopping when I rise from sitting

Physical Therapy exercises: I don't know, I have only been once for evaluation where he did some measurements, light stretching and we discussed goals of balance and gait, I have scheduled 2x weekly for next 7 weeks.

 

[Josephine]

1. Current pain level at 5-6.

That seems about right for 4 weeks out.

3. Swelling is moderate

Do remember that moderate swelling adds 4 points to your pain score making it 9-11!

2. hydrocodone 5/325 up to 4x daily, currently taking 2x daily
Tramadol 50 mg, up to 4x daily, currently taking 2x daily, opposite hydrocodone
acetaminophen 625 mg, 4x daily
naproxen 500 mg, 2x daily

So you are alternating the hydrocodone and Tramadol, is that what you mean?
I think you might find it better if you took 500mg Tylenol each time you took the Tramadol. They work well together. But make sure you don't exceed 3,000mg her 24hrs - that's the 500mg and the 325mg that's in the hydrocodone.

4. ROM measured on Tuesday at PT 96/4 degrees

That's okay. Plenty of time to have that improve.

5. Icing using polar care, approximately 6x daily for 20-60 minutes, as tolerated
6. Elevating off and on all day, if I am sitting or laying down I am elevating, always when icing

You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.

7. Activity level varies, walking to and from bathroom, walking around house, occasional preparing meals for self, cleaning up kitchen, etc. Occasional trip to restaurant using cane or crutches, elevating in booth or on chair; grocery with electric cart; PT 2x weekly

Did you read the articles left for you in the second post of this thread? Specially this one Activity progression for TKRs. If so, I suggest you read them again as you will then find that you are doing just a little bit too much for 4 weeks out!


home exercises:
straight leg raises, 10 reps 1x daily - actually, once you can do these, you don't need to do them any more!
standing calf raise 10 reps 2x daily - not sure these are wholly beneficial
seated single leg extensions 10 reps, maybe 2x daily - nor these
side lying hip abduction 10 reps 1x week - these are not applicable for knees!
short arc quad 1x 10 reps every couple days - and these are just not applicable!

Did you read this article in that other post? BoneSmart philosophy for sensible post op therapy

I suggest you stop your daily exercises and decline any others the PT gives you. If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?

In the meantime, I notice that your doctor is willing to prescribe you Tramadol, just not hydrocodone. If this be so, then I suggest you speak with him and asked to be switched to Tramadol. The reason being that Tramadol is actually very effective for TKRs and especially when taken with Tylenol as I suggested previously.

 

[Poctdb]

@MeganAC
I have had conscious sedation over 15 times. I have very bad teeth courtesy of my mother, and a fear of the drill noise. I have come out of sedation the last three times I have had it. The dental school has tossed me out of the practice due to my lack of response to the drugs. If I have to have restorations (fillings) they will send me to an oral surgeon under general anesthesia.

I was able to repeat entire conversations those in the dental procedure had during the surgery and recall asking the dentist questions that he confirmed later.

I can’t imagine that for a TKR. Horrible.