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[TKR] Grace's (CAdesgirl) recovery

Discussion in 'Knee Replacement Recovery Area' started by CAdesgirl, Jan 9, 2019.

  1. CAdesgirl

    CAdesgirl member
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    I have to be at the hospital at 5:15 for my 7 a.m. surgery so I'm starting my thread tonight.

    Thank you all for the kindness, support but mostly just for sharing your stories. I know that, for as nervous as I am, it would be much worse if I hadn't found this group.

    I'll see you on the other side. :)
     
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  2. donnag1108

    donnag1108 senior

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    Best of luck for a successful surgery and a smooth recovery. We will be here when you come out on the other side. You will do great!
     
  3. ebungalow

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    Will be thinking about you - best of luck!
     
  4. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    We're praying for you!
     
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  5. maryo52

    maryo52 FORUM ADVISOR Forum Advisor

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    You've been through a lot! I hope this turns out well for you. I just had revision and feel amazing. I picked a world class surgeon. Worth it. And boy do I relate to the nervous anticipation before hand.
     
  6. CAdesgirl

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    The surgery went well. The nerve block didn't work so well. I started feeling pain within an hour of getting into recovery. We ended up chasing the pain for about 4 hours. I was up a few hours after getting into my room for a short walk. Yesterday, I walked about 250 steps 2x and I've done hundreds of heel slides. The pain has been manageable. It's a different type of pain that the pain before surgery and it seems to be more manageable. I'm expecting to be released today. The only thing that could delay it is there is more leakage that they'd like to see. They are going to change the dressing after morning PT to see how it looks.
     
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  7. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I suspect all those heel slides could be a factor in the leakage.

    I know this is probably totally opposite of what they are telling you, but, keep in mind, it’s not exercising that gets our range of motion back, it’s Time:

    Time to recover.
    Time for pain and swelling to settle.
    Time to heal.

    Our range of motion is right there all
    along just waiting for that to happen so it can show itself.

    In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

    Many of us have found this to be true.

    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: 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
    5. Here is a week-by-week guide for

    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.
     
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  8. maryo52

    maryo52 FORUM ADVISOR Forum Advisor

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    I feel so lucky to have had a gentle PT guy in the hospital. For instance, one exercise involved 10 repetitions, three times a day. Just enough to support movement but without aggravating the surgical area. I cannot imagine what could be gained doing 100s of heel slides. I hope it's didn't set you back in terms of swelling and pain.
     
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  9. CAdesgirl

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    Right! I know but I forgot when I got the praise for how well I was doing. I'm home now!

    Hubby will be here when the therapist gets here tomorrow. I've sworn off of anything anything more strenuous that getting to the toilet for tonight. I told him to make sure I go easy tomorrow and lay down the rules when he/she gets here.
     
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  10. CAdesgirl

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    Outpatient PT came today and just check to make sure I knew how to do heel slides and quads. He said to only do a couple of reps of each and never to the point of pain. He changed the dressing because the ride home yesterday caused bleeding that soaked the honeycomb dressing. The bleeding is from around the muscle flap/skin graft which is good news I guess because the OS wanted to make sure that there is healthy blood flow to that area. That was his one concern about doing the surgery - he couldn't do a straight cut, he had to go around that area. When I saw him on Friday, he said my surgery wasn't routine but there were no concerns (and that I had the smallest patella he'd every seen).

    The pain yesterday and today have been worse than the first two days but the only time it was truly horrible was 2:00 this morning. Mike said he knew I was crying on the inside. With the exception of the shower and the visit with PT, I have done two loops around the house today. I may do one more later but I feel like I've had a productive day because I've kept the pain managed and the swelling contained.

    Oh, and I don't want to make anyone too jealous but I slept in bed last night.:egypdance:
     

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  11. Jockette

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    It doesn’t look like you have excessive swelling. Yay for sleeping in bed, I was able to sleep with in my bed every night, too!
     
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  12. maryo52

    maryo52 FORUM ADVISOR Forum Advisor

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    My surgeon said the often the incision for revisions is tight and wanted me to keep my leg straight except that I can bend it (not crank it) three times a day total. You are a day after me and looks and sounds as if things are on track. We have quite a few miles more to go, but I can only think about today.
     
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  13. sistersinhim

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    You are doing a get job keeping your swelling down! Good job!
     
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  14. CAdesgirl

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    @maryo52 - I keep telling myself that it's a marathon not a sprint. I am taking Percocet for pain so your pain level is Amazing. I am really happy with my recovery so far and so glad that I got it done. When I woke up a 6:00 this morning and held still, I felt no pain. that changes as I move around but I know I'm going to heal and do well.
     
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  15. CAdesgirl

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    The journey continues. I could use some advice on pain management. I'm currently taking Percocet 5/325 every 4 hours. I'd like to see if adding some Tylenol (understanding it has acetaminophen in it). Would it be safe to add an additional 500 mg every 6 hours? My math says it would be okay but I don't trust my math right now. I'm assuming that @Josephine would be the one to ask.

    Other than having a bit of issues with pain management which I'll discuss with the OS tomorrow morning, I think I'm doing okay. My extension has been between +5 and 0 since the day after surgery depending on if it's been stretched. I am stretching it laying the leg flat and gently pushing down. I do that 2-3x a day about 5 times and it gets to 0. Flexion is only about 40 which I'm sure isn't going to make the doctor too happy. I'm just gently hanging the legs over the end of the bed for about 5 minutes about 5x a day. I don't see a real improvement doing that but when we tried to get more, the staples separated and I had some bleeding. My issues with the incision are all around the muscle flap/skin graft. I'm not that concerned yet. We'll see how it looks without the dressing on. The doctor uses a honeycomb dressing which is really stretchy but I can't see the incision very well. It's probably best because I don't want to obsess over the healing.

    The poop fairy didn't want to come so I ended up using magnesium citrate. She showed up at 2:00 this morning and then didn't want to leave.

    I've lost my appetite but I'm trying to snack 3-4 x a day. My MIL came by at lunch to make me a sandwich and was a little disappointed that I could only eat 1/2. My best friend came over an hour later to see what I needed. Thankfully, I needed fresh ice for the machine so everyone got to do something for me. LOL!

    Oh, I forgot to mention walking. I have a medium size house so walking to the front door and back is a good haul. It's a straight shot once I get out of my bedroom. I have got my gait going pretty good, my foot turned straight and can do that 2x 3-4 times a day.

    Other than that, I'm icing and elevating in my next in the bedroom. My adjustable bed has been perfect. 9 months ago when we bought it, I argued with Mike that we didn't need the adjustable part. Boy, am I glad now that he wanted it more than I didn't was to spend the money on it.
     
  16. maryo52

    maryo52 FORUM ADVISOR Forum Advisor

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    The way to go about the medication issue is to take oxycodone as a separate drug on its own schedule, and tylenol on its own schedule. So I'm taking 1000 mg of acetaminophen 3 times a day. Fortunately I've taken hardly any oxycodone but can take 1/2 to 1 tablet every 4 hours.

    I guess we both have incision issues and so I'm still on straight leg protocol except for my three allowed bends, morning noon and night (one bend each time). This is a hairy topic for me because my original TKR didn't bend past 90 degrees until weeks after my arthroscopic lysis of scar tissue, which was after the manipulation. In other words, I didn't bend past 90 for about four months. So that's my bug-a-boo fear but I just feel entirely different this time.

    My other trick from the first go-round was using metamucil once or twice every day. Sounds like you are getting through your challenges just fine. You and I can race in slo-mo!!!
     
  17. CAdesgirl

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    Racing in slo-mo sounds great, @maryo52! I'm in no hurry.

    Thanks for the response regarding the Tylenol. The way I figure, I can take 2000 mg of Tylenol a day so I'm going to add 1 every 6 hours to see if that helps.

    I had wound issues last time but I am not borrowing problems. Hubby did take pictures both times they changed the dressing and he's going with me tomorrow so he can see it again. I'm allowing him the freedom to obsess if he needs to (and apparently he does) but I'm going to be convinced that I may heal slower because my incision looks like the top half of a question mark but I will heal with no major issues.
     
  18. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    If you're taking the Percocet every 4 hours and assuming this if throughout the 24hrs, that's 6 doses per day which is 1,950mg taken. The maximum dose per 24hrs is 4,000mg which means you have another 2,050mgs to take or 6 tablets of regular Tylenol at 325mg each. You could also take one or two regular Tylenol with each Percocet if you wished. Just keep a sum of how much you are taking each day and ensure you don't exceed 4,000mg per 24 hours.
     
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  19. maryo52

    maryo52 FORUM ADVISOR Forum Advisor

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    How's it going?
     
  20. CAdesgirl

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    Thanks, Josephine!

    I had my followup appointment with the OS today. He said I was doing good. He wants to see me again in 3 weeks. He's keeping a close eye to make sure the incision is healing well. He changed the dressing today and it looks pretty good. There was a lot of dried blood but it all looked fairly old so he had no concerns. Of course, Mike took pictures with his cellphone, which he does every time it's uncovered, so he can compare them. He is hoping when I go back in 3 weeks I'll be able to lose the dressing.

    PT also came this afternoon and he said I was doing "great". My range of motion is at 90/0. I don't have the best gait but nothing major. I'm just not as smooth as he'd like. He's coming back on Friday when we're going to try the cane and, weather permitting, maybe doing some walking outside. He didn't try to "assist" me with any of the exercises and told me that I should go down to 1 rep of each exercise rather than 2 because my pain level is fairly high and I've met my range of motion goal. He said "The rest will come as you increase your daily activity level". I was ready to have a fight with him for no reason. I hope he's the one that they keep sending. I have an HMO and there are 5 PT that work directly for the medical group so I may not always get him. He did note everything in his tablet.

    All in all, a good day. Now it's time for a nap.
     
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