counting down the days.....

[cathyn518]

Wednesday, just a couple days left. I am still a bundle of nerves of course. Just had lunch with a friend last week who had a TKR and she stressed the importance of what I think most folks here would consider "agressive" physical therapy which she credits with a good outcome. She told me he was riding the stationery bike doing full rotations the first week. I though have come to believe the wisdom here about not doing too much too soon and causing inflamation which limits ROM. How did you find or communicate to your physical therapist your limits? How do you know if you can trust them not to push you leg down, etc. I have read some experiences here from folks who said the PT ignored their wishes and did it anyway. Well my ice machine came today so thank you Jeff Bezos for delivering on Sunday. My son and husband will sit down with me tomorrow to go over my lists and protocols. So much to consider, early blight on my tomatoes? keeping my dog happy? range of motion? The list goes on!
My husband and son pledge to do everything to help but I have told them both that we will ALL be sick of this waiting on me hand and foot (or knee more precisely) before long One more question I do have now though is if you do not shower until after staples are out, how do you shampoo your hair? Yikes, I am starting to itch thinking about this! Thank you, I feel like I did when I was on the top of the zip line

 

[Pumpkin]

You'll notice that I have moved your newest post to pre-op, where you will receive more response and support.

• If you prefer a different thread title, just post what you want and we'll get it changed for you.

If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Pumpkin]

You seem to

How do you know if you can trust them not to push you leg down, etc.

You will have to be clear about what you expect from PT. If you feel you are with a PT who does to listen, or is too aggressive. Ask for another PT, or move to another facility.
Saying no to therapy - am I allowed to?

You may want to call ahead to speak to the PT about their approach to recovery, it they are all about ROM, or an aggressive program, suggest you look elsewhere.

 

[Pumpkin]

To help prepare you for your TKR on Wednesday here is a copy of the recovery articles.

Knee Recovery: The Guidelines
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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​

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

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

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 a 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 history before providing advice.

 

[Tmgrl3]

I love the opening handout thread the forum admins give us! Thanks!

I was a wreck for months because I had to wait from July 2108 till March 2019. My husband needed a triple lumbar fusion September 5 after months of pain management. So I got gel injections to hold me 6 months and thankfully the worse pain I had in knees was last July and the gel shots helped. So when my time finally came, I was like all “bring it on!” I just wanted my bilateral knee replacement done.

As for PT...the only reason I went to a rehab for 5 days was because I was in immobilizers for 2 weeks, each leg and each one had about 7 velcro straps which had to be undone during the night by someone so I could go to the bathroom. Since my husband is still working I couldn’t do that to him at home, but as soon as I could undo the Velcro’s myself, I went home.

About 7 days after my actual surgery (and I had 4 blood transfusions before I went to rehab and am 76 years old) PT at the rehab..saw that I was a pusher and a go getter...I have very strong upper body strength and needed it for all transfers since I had no good leg to stand on. Anyhow...about a week in, a PT assistant put 2 lbs weights on each ankle and gave me five sitting in place exercises and said to do a 100 reps. Stupid me did them and right after that my neuropathy and radiculopathy pain in my feet got really bad..I had 32 pounds of leg edema. When I realized what they did and what I did (in my state of fog, and I was only on two tramadol 50s a day)...I went to admin and told them. Never should have happened. So after that I spoke up and when I thought I had enough or was too wiped out to do something, I didn’t do it. by the time I got home about 10 days after surgery I was at 105 degrees flexion and both legs were able to lie flat, but most rehabs expect you to do 2 to 3 hours of OT/PT a day 6 to 7 days a week. I did work hard. I won’t say I didn’t, but never to the point of pain, and never when I reached my limit for the session. After I got home I had 3x PT a week at home and by time I started outpatient PT one month and 3 days after my surgery I was at 130 degrees. My surgeon said that even thought the newer prosthetics can but “pushed “ to 150 degrees, he said we stop at 130...we are leaning from research that there is often breakdown when people think they need to get to 150 degrees just because the newer joints can..so that’s what I did...I am still in PT but now it is all strength work, no real ROM anymore. At 8 weeks, I started driving and my surgeon warned me that for at least the next 8 weeks I would be tempted to “push” myself by driving , running errands and being on my feet too much. I did exactly that. And two weeks even though stopped the tramadol 50s April 24th, I had to go back on one-two at night because my day activities caused pain to flare. So I now plan out my days, am down to one tramadol at night and almost ready for just tylenol again.

Now at 12 weeks, I am glad I had bilaterals done. I am no longer severely anemic , although still some depression and nausea but I see a whole new life ahead of me with these two new knees. I believe, though, that doing the work every day whatever you can do, as far as PT/OT is important. The 10 weeks of insomnia were because I was stuck on my back ...
Also, take pain meds as needed and as prescribed. I hadn’t taken a narcotic in 30 years and I don’t drink so I didn’t do the PCA (push button self administered pain meds) I asked for what I needed and the tramadol while not as strong as some of the others doctors love to use, took my pain down to a manageable level while not making me sick. PATIENCE for the ups and downs of this recovery helps and it’s not a strong point of mine but when I am reminded that this is going to take up to a full year to feel normal, I ease into the day. I don’t do any formal exercises at home since my ROM is good. I am often on my feet for hours, and I can now do 15 minutes on my eliptical.

Good luck to you! I had a hip replacement 10 years ago and it changed my life so now with my knees done I am looking forward to traveling again and actually being able to step up a curb or a stair without my legs giving out. I got a chair lift which I use all the time to carry heavy things upstairs, but I can climb stairs just fine!!

P.S. I had pretty good range of motion when I woke up from surgery...could sit on end of bed with legs at 90 degrees, so maybe for me, the ROM progressed more quickly. Also, I have been in sports all my life, done weight training too. Building up upper body strength before knee replacement helps with pushing yourself up.

 

[luvcats]

I don't know what others do, but a you might consider a combination of dry shampoo and salon visits. And by salon visits, I mean any old cheap hair cut place. I live in the DC area where everything is super expensive and I can get my hair washed for $5 plus tip. I learned that after a previous surgery when I couldn't be in the shower long enough to wash waist length hair.

I'm about 2 weeks behind you. My TKR will be July 1. Nice to 'meet' a recovery buddy.

 

[Celle]

How did you find or communicate to your physical therapist your limits? How do you know if you can trust them not to push you leg down, etc. I have read some experiences here from folks who said the PT ignored their wishes and did it anyway.

As the others have said, you set the limits with your PT . Tell them: No exercises that go beyond discomfort into pain; no excessive repetitions; no pushing or pulling on my knee; no weights; no bands to pull on my leg; no manipulating; hands off my knee, except to massage gently or to measure.

If your PT can't accept your limits, leave and either exercise at home or find another PT facility.
If a therapist ignores your limits, get off the table and walk out = remove your knee from harm.

My husband and son pledge to do everything to help but I have told them both that we will ALL be sick of this waiting on me hand and foot (or knee more precisely) before long

They won't have to wait on you hand and foot. You won't be a total invalid. By the time you leave hospital, you should be able to do most things by yourself, with just a little help. Cooking, providing meals, cleaning, and shopping are what they'll need to do, as well as providing transport to appointments.

You'll be able to look at your tomatoes and ask one of your men to treat if ther are any signs of bight. THey won't need to do anything to help with your range of motion.

One more question I do have now though is if you do not shower until after staples are out, how do you shampoo your hair?

I washed my hair under the tap at the kitchen sink. If you don't have a tap that is high enough to put your head under, fill the sink with water and wash your hair that way. It's helpful if someone will pour a jug full of water over your hair, to rinse it.

 

[cathyn518]

again, the advice I have gotten on this site is golden. I will put on my big girl pants and be assertive with the PT that they do not force me and cause me pain! I am also fairly active and have spent many hours in the gym doing prehab so I hope that helps. The suggestion about dry shampoo and just going to a cheap hair salon for a wash is great! Can't wait to swap recovery stories with folks soon, god speed to you BatSpit!

 

[Celle]

The suggestion about dry shampoo and just going to a cheap hair salon for a wash is great!

I don't think you should go out to a hair salon in those early days - you should be mostly resting at home, and just walking around the house. Going out for the amount of time visiting a salon would take, as well as two journeys in a car, would be far too much activity for you.

 

[cathyn518]

I don't think you should go out to a hair salon in those early days - you should be mostly resting at home, and just walking around the house. Going out for the amount of time visiting a salon would take, as well as two journeys in a car, would be far too much activity for you.

Good point, I will resign myself to bad hair days and dry shampoo. I quite doubt my hair is going to be a priority for me. Right now I am trying to soak off the last two ANC nails as no nail polish is allowed. I am not the nail polish type but my daughter got married 2 weeks ago and it was required. I am much more likely to have dirt under my nails from gardening. Thanks again for the support

 

[Tmgrl3]

I don't know what others do, but a you might consider a combination of dry shampoo and salon visits. And by salon visits, I mean any old cheap hair cut place. I live in the DC area where everything is super expensive and I can get my hair washed for $5 plus tip. I learned that after a previous surgery when I couldn't be in the shower long enough to wash waist length hair.

I'm about 2 weeks behind you. My TKR will be July 1. Nice to 'meet' a recovery buddy.

Great idea about going out for it ...super expensive here in NY, too.

Hair: I had someone come to my house for first month home, wash my hair in the kitchen sink and then help me shower. I have a walk in shower and a shower chair. I had to step in then she put chair behind me. I already had handicapped bar on wall and chair and three commodes at home...kept one by my bedside for night time bathroom..so just stand and transfer.

 

[Tmgrl3]

Good point, I will resign myself to bad hair days and dry shampoo. I quite doubt my hair is going to be a priority for me. Right now I am trying to soak off the last two ANC nails as no nail polish is allowed. I am not the nail polish type but my daughter got married 2 weeks ago and it was required. I am much more likely to have dirt under my nails from gardening. Thanks again for the support

Oh...I was told to cut my nails super short, which I did because they are haven for bacteria...I also had three day Hibiclens showers ...3 nights before and one am of surgery.

 

[Renmusical]

Cathyn518-

I know what you mean about getting nervous with surgery being so close. I'll be 2 days behind you as my surgery is Friday June 21st. I've been spending time looking at cold therapy machines, thinking that may be the smartest thing to get for recovery. Do you mind me asking what machine you decided on from Amazon? There's so many choices! If all goes as planned I'll go home same day as surgery and have my husband home with me over the weekend. I'll be my own during the day starting that Monday after surgery during the workweek. I like the idea of not having to have lots of ice packs in the freezer and have to keep swapping them out every hour. If anyone else has decided on a cold therapy machine I am interested in as many opinions as possible.

 

[luvcats]

I will resign myself to bad hair days and dry shampoo. I quite doubt my hair is going to be a priority for me.

I don't know. I always feel better when my hair has been brushed and is clean even when I otherwise feel really terrible.

I was getting my bath wipes and I found a product that was recommended to me in the hospital by several people. I didn't use them, but they might work for you. Ready Bath rinse free shampoo cap.

 

[cathyn518]

Cathyn518-

I know what you mean about getting nervous with surgery being so close. I'll be 2 days behind you as my surgery is Friday June 21st. I've been spending time looking at cold therapy machines, thinking that may be the smartest thing to get for recovery. Do you mind me asking what machine you decided on from Amazon? There's so many choices! If all goes as planned I'll go home same day as surgery and have my husband home with me over the weekend. I'll be my own during the day starting that Monday after surgery during the workweek. I like the idea of not having to have lots of ice packs in the freezer and have to keep swapping them out every hour. If anyone else has decided on a cold therapy machine I am interested in as many opinions as possible.

Hi Renee, I bought this machine from Amazon

Vive Cold Therapy Machine - Large Ice Cryo Cuff - Flexible Cryotherapy Freeze Kit System Fits Knee, Shoulder, Ankle, Cervical, Back, Leg, Hip and ACL - Wearable Adjustable Wrap Pad - Cooler Pump

My son set it up for me and I tried it. Cold water circulates around the knee. You do need to put ice in the base along with water. I am going to use small frozen water bottles instead of ice cubes for ease. One drawback is that it only runs for 30 minutes before it shuts off and beeps. Pretty simple to push the restart button but that won’t be much fun at night So not sure if this is the best option,others might know but I am going to hope for the best.

 

[Renmusical]

Thanks for the info!

 

[cathyn518]

So tomorrow is D-Day or rather knee day waiting for the hospital called to tell me what time to get there. Very nervous today of course don’t feel like eating anything I’ll try to eat some yogurt in a bit. Yesterday I had to bring my MacBook to the Apple Store because the screen cracked when I put my glasses down on the keyboard and then leaned over it with the top down so now I won’t have my laptop for a few days.There is another hundred dollars and that is with the extended warranty that I have but it was “an accident” I do have an iPad which I don’t find as easy to use but I will be checking in after surgery. Thanks for all of you for being here friends and family try to be supportive but don’t really know what this is like. I do you live in a two-story house and I want to get upstairs to my bedroom after surgery and I plan on staying put on the 2nd floor. I am a bit concerned about getting up the stairs but my 25-year-old son who is extremely strong will be here to help me as well as my hubby (who is not so fit) I am lucky that my son is here he’s living here while he finishes grad school but I also worry that I am going to burden him as well as my husband but they are both assuring me not to worry

 

[Jockette]

They will show you how to do stairs, it’s very doable, with a new knee, biggest thing will probably be how tiring it will be, soon after surgery. Staying up there for some days is a good idea.

When you go up the stairs that first time maybe have your husband in front of you and your son behind you. Hold the railing, and use a cane for in the other hand. Take your time. It’ll be fine.

You won’t “be a burden” for long. You’ll start navigating again. Helping you through this recovery is what we do for each other, you wouldn’t think twice if it was one of them having this surgery.

It’s all going to work out fine.

 

[luvcats]

Caring for someone you love is a privilege. Yes, it can be exhausting, but it is also an opportunity to show love and deepen bonds. Let them worry about you for a change.

I learned all this as the sole care taker when my husband had quadrupal bypass surgery a few years ago. They love you. It will be fine.

 

[cathyn518]

OK hospital called I need to be there by 7:30 surgery is scheduled for 930 yikes why do I feel like I’m a cliff diving?