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TKR Dec 9, 2019 And so it begins....

skill1234

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Starting postop thread about 12 hours after surgery. 3 AM in the hospital awake because I can’t sleep. Pain is OK but having the ants crawling all over you feeling keeping me up. Anyway as a quick refresher 46 years old, Full mako tkr on the left knee In Littleton CO. A result of many years hard sports, and several acl reconstructions and other cleanup surgeries. I’m going to try to do a video blog on YouTube as well as those really seem to be very informative and helpful for me. Hoping I will get to go home tomorrow morning, I will just have to see how it goes.
 

Lovely

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Congratulations on your new knee and welcome to the other side! :welome: Sending healing thoughts and best wishes from Texas during your recovery. Cheers!
 

jaybird

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Hi there! I’m just five days ahead of you. Welcome to the other side.
 

Helizabug

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Oh gosh, those ants are annoying!:spider:
 

Jockette

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Welcome to Recovery!


I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

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
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. At week 4 and after you should 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.
 

lovetocookandsew

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Congratulations on your new baby knee and welcome to the other side! I hope that "ants crawling on you" feeling goes away quickly as it's no fun. Let us know how you progress through recovery and remember we're here for you when you have questions, need to whine or share your progress. Good luck!
 

Celle

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Hello @skill1234 - and :welome: to recovery.

I see, from the X-Ray you posted before your surgery, that you have screws in your knee from a previous operation.
Please will you tell us what that surgery was, and its full date, so we can add that to your signature for you? Thank you.:flwrysmile:
 

Sara61

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:welome: whatever you may feel at this stage the good news is that it really does get better with time, this is not a race nor competition everyone heals differently and at their own pace.
Read everything the moderators send your way these guidelines are here to help you when you need to vent /scream/cry or just have a laught there is always someone on this huge network around the world awake and online. Participation helps you move forward and know you are not alone , there are good days and bad days it can be a rocky year- however many many success stories.
Wishing you a good recovery- sending virtual hugs to you :flwrysmile:
 
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skill1234

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Ok - 9 days post op - a few issues, problems, observations. Have no idea if mine was typical or worse as I talked to the doc for maaaybe 3 min since then.

Went home the day after, a Tuesday afternoon. Wednesday sucked - first full day at home. Watch out for that day it can be rough - fully off the hospital meds/blocks whatever, takes time to kind of recenter at home.
Had first PT that thursday, 3 days after surgery. Pretty gentle, the person was much easier then the lady at the hospital, gave me a break on the quad exercises cuz they were just not happening at all. all in all it was encouraging.

Days 3-5 were just pushing the walker around the house, playing nintendo, eating frozen food.

Monday was 1 week, had another PT appt, this on they started up on the stretching. Extentions hurt more then bending for me, maybe because i haven't been able to straighten my leg before this for years anyway.

Day 9 now - had another PT appt - more pushing etc. range of motion at about 5%-90%. Fully off the walker just using a single crutch - driving aroung myself, went to sons basketball game monday night. Have yet to sleep for more that like 2hrs at a stretch.

So all seems to be progressing ok on paper - but have a few big nitpicks.

1) Pain Meds - lemme know if anyone else had this problem. When i went home on the 10th, i had a prescription for 60 x 5mg Oxycodone tabs. Now I have had a bunch of knee surgeries, lots of prescriptions, never had any addiction probs or anything. But they flat work for me for pain so I am not afraid to use them. They say take 2 every 4 hrs for pain. Well - for the 1st 4 days , I am taking those on the button, plus overnight as it hurts worse then. So I went through 40 of those in 4 days easy on steady dosing.

At that point PT starting, weekend coming up, I could have started milking those remaining 20 if i needed to. But used them during the night and after walking around, under the impression that it's best to "stay ahead of the pain", and I would "call my care team for a refill if needed". Guess what - I
call on Tuesday morning when out, get a refill prescription, try to fill it, and am told by law they cannot fill it until the 20th. .. .. .. That means those 60 tabs needed to stretch 10 days - only no-one told me this at all! I am totally out of luck until Friday now, stuck taking Tylenol and icing it - means no sleep at all cuz it aches so bad. Law is Law - but I am annoyed. I sit up at night hurting because no one warned me about it at all.

2) My 2 weeks post op was supposed to be the 23rd. But the scheduled it in the 30th for coverage. Got a call yesterday they have to reschedule to Jan 2nd. This means I'll have my staples in there for almost 4 weeks, which is gonna suck when they try to remove, but also I am into 2020, under new year deductible, so its gonna cost me another 150 bucks or something. And my PT guy said i shouldn't bend it much past 90 with staples, so its gonna limit my recovery.

Beyond those 2 things hacking me off, I am OK with recovery so far. Getting around much better on the crutch, quad is starting to work again tho it hurts bad, and cannot sleep at all because it just aches so bad overnight.

Welcome questions/comments, anyone needing a shoulder.
 

tlfiore

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I am so sorry you are (already) having to deal with the narcotic refill nightmare. I went through an awful time with that and I feel for you.

I'm confused how the pharmacy can "over-ride" an order placed by your orthopedic surgeon. I understand (to a certain degree) how pharmacies can control, or prohibit what they think is "excessive" purchasing of pseudoephedrine, or any OTC (over-the-counter) medication. I mean, my local Walgreens or CVS is where I go to purchase pseudoephedrine to mix up my meth, right ...RIDICULOUS! So, I "sorta" follow the reasoning, etc...well, not really. No one in their correct mind can actually believe controlling the dispensing of Claritin D impacts the mis-use of methamphetamines, or the production of crack in this country, IMHO. It's a ridiculous notion.

Anyhow, the thing here in Michigan with narcotics is a narcotic refill can be had at any time but it requires a direct written prescription by a physician...no wiring in, no calling in, no telephonic refills, no Internet ANYTHING...nada. A refill written by a licensed MD, or NP, or PA is honored but the pharmacies require the hard copy written order, presented with at least one form of "patient" ID. Now, I'm currently in a very small town outside of Ann Arbor and they've been a bit inconsistent about the pick-up. One time, they allowed my neighbor/friend to fetch the RX for me with two forms of MY ID and one form of hers. Another time they allowed my husband to fetch with his Driver's License and mine, blah, blah. It's insanity.

For changes, adjustments, additions...10 days out, 20, 90...doesn't matter. In most cases, show a written order, get the change or refill honored.

I just want to make certain you've clarified the exact problem with the pharmacy. It's awful, stressful and frightening, isn't it? C'mon now...a post-surgical TKR patient who is a few days out and you've gotta "wait for pain meds?" Gimme a break!

Please recover well and please keep us posted! Hang in there.
 
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sistersinhim

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Is icing helping your pain? I found it to be a good pain reliever.

Pain at night is an indication that you are doing too much during the day. Try slowing down and resting more. Let your knee heal. As it heals, you'll have less pain. There's no rush to recover. It will happen. You will find that being gentle with your knee and just doing daily activities around the house will be much less painful and will allow the knee to calm down, reducing inflammation and the swelling. All this aids in healing it. Aggressive exercise and movements increase inflammation and pain and slows down healing.
 

Celle

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Now I have had a bunch of knee surgeries, lots of prescriptions, never had any addiction probs or anything.
Please will you tell us what those surgeries are and when you had them? It's important that we know, because your knee's past history can affect its current recovery.
For instance, you said
Extentions hurt more then bending for me, maybe because i haven't been able to straighten my leg before this for years anyway.
That means full extension could take longer for you to achieve than for some other people.
We, and your PT therapist, will need to make allowances for that, knowing that the structures behind your knee will have shrunken, so they will need time and gentle treatment, to stretch them slowly.
 

Celle

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2) My 2 weeks post op was supposed to be the 23rd. But the scheduled it in the 30th for coverage. Got a call yesterday they have to reschedule to Jan 2nd. This means I'll have my staples in there for almost 4 weeks, which is gonna suck when they try to remove, but also I am into 2020, under new year deductible, so its gonna cost me another 150 bucks or something. And my PT guy said i shouldn't bend it much past 90 with staples, so its gonna limit my recovery.
Almost 4 weeks is far too long to have staples in. Did the person doing the re-scheduling realise you still have staples in? Possibly not.

Can you phone your surgeon's rooms and point out that the re-scheduling will put you in this situation? Ask if there is any way of having those staples removed sooner - it's bad practice to leave them in for so long.

Don't worry about your progress at PT if those staples have to stay in - concentrate in doing all the things that reduce swelling (rest, ice, elevation) and you could well find that your knee bends further than you were expecting, once those staples are out.
 

sistersinhim

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I agree that you should take and get those staples out sooner than scheduled.
 

Helizabug

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While this doesn’t work for everyone, and you should check with your doctor first, I added ibuprofen to my pain med regimen and it helped a lot. If I understand correctly, it’s not a pain reliever per se, but the anti-inflammatory effect could help some. Do check with your medical team before adding it, though; it takes a toll on your kidneys and acts as a blood thinner.

And while you’re checking, I’d see if there’s a way to get them to take out the staples. Agreeing with others here. Seems like a long time to be putting up with them.
 

sistersinhim

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I added ibuprofen to my pain med regimen and it helped a lot. If I understand correctly, it’s not a pain reliever per se, but the anti-inflammatory effect could help some. Do check with your medical team before adding it, though; it takes a toll on your kidneys and acts as a blood thinner.
Ibuprofen is an NSAID and can cause ulcers, too. Don't take them with any other NSAID that you're taking.
 
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skill1234

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You folks are pretty cool! Thank you for all the input, I see others with threads in about the same boat I am .

As for other surgeries, I have had 3 acl’s on this left leg. First when I was 21 and blew it out, in that one during surgery to use the patella graft, they dropped it on the floor, then continued after to use the hamstring tendon instead. If I wasn’t so young and gung ho i prolly should have investigated if that was even legal as i had never even heard of the hamstring option until I woke up. Anyway, water under the bridge at this point. That failed after just a few years, next one used the patella from the right knee. The last one about 10 years later they used a cadaver graft. In between were other clean ups and stuff. I am told they pulled one of the old screws out, but left a washer(?) and the other one in there.

Kind of raised a stink about the post op appt and just heard they are getting me in on the 27th, thankfully.

When I go in tomorrow to finally get the oxy refill I will go over with them the rules on that, it’s a Walgreens.

Biggest thing worrying me is my extension. It’s been so long since that leg has ever been straight, it’s scary to think about getting there.

I must say that it is very easy to get discouraged and down in the dumps. At a week and a half the idea of it feeling normal feels so far away. And even though you may have family and friends, it’s hard not to feel really alone. I struggle with those bad feelings anyway.. Just a word of encouragement to others out there with this same bad voice in the back of their heads, believing this will pass and be ok.

the anti-inflammatory is Celebrex, honestly cannot say if it’s any better then the ibuprofen I have been gulping the last few years...
 

Love2cycle

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I had my RTKR on 12/9 as well. I live in Florida and I had issues with refill on day 7, but it was the insurance company that refused the refill before the the full ten days and I was able to pay the full cost and pick it up. I like you took 2 of the 5mg every 4 hours and as I had mine outpatient they went quickly, but were much needed! I am now mainly only taking them at night and after PT days.

I feel your pain with the lack of sleep. Even with the pain meds it just gets stiff and achy after a few hours and I end up in the recliner dozing off and on. It seems to be getting a little better each day and I agree with what was previously said, on the days I am doing more due to the holidays and PT days... I find those are the worst nights. I canceled my PT for today and all next week as I think I will be active enough with Christmas!
I find that I too am feeling the same as you at this point. Today was the first day I was feeling like this was too much and feeling sorry for myself. I think as the overall pain gets better and I still can’t bend my knee to get in the car and still can’t drive... I find the frustration setting in. I guess it is all normal and part of the recovery! Hang in there...We will soon be through this!
 
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skill1234

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OK - adding an update here for others to track and weigh. Today is 2 weeks post op. PT today had me at 98degrees flex, he didnt measure extension - which is gonna be the toughest for me I think. I bet i am at like 5degrees or something. I can get around ok with or without a crutch now. I think mainly its a confidence thing - the idea of swinging my bad leg forward to then roll from heel to toe is scary - like its gonna snap in half the wrong way or something. But - the difference between now and 1 week ago is huge. I did get a refill on my oxycodene 5mg pills. But am cutting them in half and only popping them at night when I try to sleep, which still sucks. So I think I can see a light at the end of this tunnel, although I know there will be some bumps.
 

sistersinhim

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You are doing really well for just two weeks out. Make sure you're very steady on your feet before giving up the crutch. A fall can be very painful.
 

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