PKR HippieGarden's Recovery thread

HippieGarden

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Right medial partial knee replacement today 1/20/22. I'm feeling good at least for the next 3 days thanks to the pain pump that's bathing my femoral nerve in local anesthetic.

Another thing making me feel good is that my surgeon is of the "why would you torture yourself for no good reason" school when it comes to PT, and doesn't clear patients for PT until after the postsurgical visit 2.5 weeks out. He sometimes delays more then based on how much swelling he's seeing. "You can't bend the knee because it's swollen. You're just pulling on the stitches. Just relax for a couple of weeks, let it heal, bend and straighten a little if it's comfortable to do that." So nice to hear that after everything I've read on here.
 

Sara61

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:welome: to BoneSmart

Good luck with your surgery today x

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.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose

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 Care In Hospital


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.
 

Freya34

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Good luck with your recovery!
 

eaglemom

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Your surgeon sounds wonderful.

Happy Healing
 
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HippieGarden

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Well, it's been an eventful couple of days, but I'm still feeling ok.

Short version:

1) Instead of putting on a waterproof surgical dressing and sending me home with one or two extra, the surgical center put a nonstick pad over the incision, held on with cotton roll and some kind of ace bandage like thing. Not waterproof at all, pretty much the opposite of waterproof, and also not great as a surgical dressing. I didn't realize this before we left the surgery center--I assumed the actual dressing was under the ace bandage thing somewhere. By the morning after my surgery, the whole thing had slid down far enough to prevent me from doing ankle rolls and the pad was no longer covering everything. My surgeon normally operates at a different facility--the surgery only got moved to this one because of COVID.

2) Perhaps relatedly, I developed cellulitis that night and after waking up in crushing pain, ended up going to the ER with lightheadedness, cold sweats, and extremely low blood pressure. The ER gave me IV morphine, IV antibiotics, marked the borders of the infection for monitoring, dressed the incision, took blood cultures, and gave me a prescription for oral antibiotics. Blood cultures will be back early Monday, but the antibiotics seem to have knocked the infection out -- the skin is all now normal appearance and temperature. My pain is minimal. I got great sleep last night and had a pretty active day today.

3) Also because of COVID, the ER didn't let my husband come back to the room with me, and then after two hours hospital security wouldn't let him stay in the waiting room any more. We came in via a cab the EMTs put us in after making sure I wasn't having a heart attack, so he really had nowhere to go--it wasn't like he could go wait in the car. I completely broke down at the thought of having to take another cab home by myself, sick, in pain, 30 hours after knee replacement surgery. Like literal loud "hear it in the hallway" sobs of frustration. The nurse taking care of me decided that was enough to bring my husband back to the room since the COVID visitor policy has an exception for patients needing help making medical decisions, and I was obviously not doing well. It's normally my tendency to tough things out, but I'm glad I didn't.

But for the past 40 hours I've felt great! Trucking around with the walker, stretching, pain is maybe a 2.
 

FourCats

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The EMTs put you in a cab??!!

What an ordeal you had to endure! I’m glad you’re home and feeling better!
 

MoragsMum

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What a saga you've endured - take the best care of yourself and rest loads!
 

Susie-Q

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Holy Cow! :flabber: What a traumatic experience! I can't believe the EMTs put you in a cab! Glad you are home and resting. Keep us posted on your recovery.....:prayer:
 

patriciad

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Wow what a crazy few days!! Must have felt awful. Glad your wound has been treated and sounds like you are doing well at home. Take it easy and heal well.
 

Sara61

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Glad to hear you are safely back home, what a traumatic ordeal. Plenty of rest for you now x
 

hawk2go

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wowza! I've heard a lot of strange things never that EMTs who thought someone needed to be seen at the ER put them in a cab. Just wow.

@HippieGarden, I'm glad you're home and comfortable. You deserve an extra treat for yourself - just do it (whatever "it" may be), while you ice and rest.
 
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HippieGarden

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I'm cracking up here because the whole "EMTs called us a cab" thing didn't seem that outrageous at the time. Some context is that we live in an area of town that's currently partly cut off because a major bridge is out, so the next ambulance was 45 minutes from picking us up while a cab could arrive in 10. Since the EMTs were seeing a normal EKG, I felt safe getting in the cab, partly because it would get me to the ER a lot sooner.

(Now, the whole "we're kicking your husband out of the ER waiting room at 5 am, guess you can get yourself home" thing? THAT was outrageous!)

Anyway, I found it SO HELPFUL to read everyone's recovery stories on BoneSmart that I swore I'd tell mine even if it was boring, and since the weekend it's been pretty boring.

On Monday (day 4 post surgery), we went to the surgeon's office so he could make sure the incision looked OK and put on the waterproof dressing I was supposed to have in the first place. Incision looked great, knee was at about 3 degrees extension and 85 flexion--no pressure, just the easy range of motion.

From the ER photos and current condition of the incision, he wasn't sure whether my low blood pressure and pain was caused by cellulitis. His theory is that the local he put in when he closed the incision wore off suddenly and I had a vasovagal syncope (fainting) episode from the pain, which would explain the cold sweats, lightheadedness, and very low blood pressure and heart rate combo (73/50 at 60bpm). This was kind of what I kept asking the ER doc -- could this just be a reaction to the pain?

{This actually sent me down a research rabbit hole on fainting. Did you know that endogenous opitate levels spike during a fainting episode, that those lower blood pressure, and that all of the other chemicals that cause the low BP during a fainting episode also modulate pain? My knee actually had zero pain when we were waiting for the EMTs and while they were here. Pain didn't come back until about 90 minutes after the episode started. Also, very little direct research is done on the whole fainting-from-pain thing, because you can't really subject research volunteers to extreme pain and see what happens when they faint. I'm now wondering if the body just overdoes it on the pain relief mechanisms and ends up affecting BP and consciousness.}

Sleep
Since Day 3, I have been able to sleep well, and sleeping a ton. Like, 11 to 13 hours at night with a nap in the afternoon. I wake up every 4 hours to keep the schedule on the pain meds, but I'm out again within 5 minutes. I consider this my job!

Range of Motion / Swelling
As of today (Day 6 post-surgery), the knee is not quite at zero degrees extension, but it's close. In flexion, it's past 90 degrees. Swelling is minimal -- about 1/2" circumference compared to the other knee. I've been sitting with the leg propped up on an ottoman mostly straight for a couple of hours a day, but sleeping with it bent.

Elevation & Icing
I've been having trouble elevating because it's aggravating some pre-existing low back pain. I have prescription compression stockings for another issue so I asked the surgeon if I could wear them to manage swelling instead and he said that was fine.

I've been icing 2 or 3 times a day, especially right before sleep, sometimes during a medication break if the pain is bothering me at night.

Pain Medication
My surgeon's instructions were to lay down a base of 3000mg Tylenol a day, then add either Tramadol or Oxycodone to that as needed. I also had a nerve pain pump for the first 72 hours. I had to switch from 2 Tramadol to 2 Oxy the first day after surgery as the pain increased. My pain got better on Day 3 and I considered switching back to Tramadol, but the pain pump was about to come out, so I decided to stay on the Oxy until I could see how I did with that. I needed to stay on the Oxy for the first 36 hours after the pain pump was done, but switched back to Tramadol on Day 5 and reduced from 2 pills every 4 hours to 1 pill on Day 6.

Showering
The shower is on the second floor up 17 steep steps, but I think I will try it tomorrow.

Know any good but undemanding TV shows?
I had all these great shows saved up to watch, but with the pain drugs, my concentration just isn't up to following the twists and turns on "Succession." Today's discovery was "Aristocrats" (BBC miniseries set in the 1700s), which was about right -- pretty costumes, pretty hair, simple plot. "Ted Lasso" was great except it was so good I was stressed about missing any if I fell asleep.
 

Sara61

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Sounds like you know what to do, plenty of rest, ice, ice, & more ice :ice: lucky you getting such great night's sleep, it rare so cherish it, your recovery sounds wonderful.
Funnily I had a whole bunch of movies, series on Netflix I wanted to watch, but just haven't had the patience to sit through them, which once I'm eventually back at work I will regret:heehee:.
Have you watched "Stay close " by Harlan Coben, it's had good reviews it's on my watch list, I also enjoyed - The Maid, Peakey Blinders, Bridgerton, The Crown, Call the Midwife. Grace & Frankie is fun.
Also worth watching Ratched, also the I'm a killer series is fascinating, again it all depends on your taste.
 

Susie-Q

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The Maid, Peakey Blinders, Bridgerton, The Crown, Call the Midwife. Grace & Frankie is fun.
These are all great shows. Stay Close was good too. I'm currently watching season 4 of Ozark. If you like semi-dark stuff, Ozark is great. I enjoyed After Life too, heartwarming if a little crude in parts.

I had a hard time concentrating on watching anything in the first couple of weeks. I think it's the oxy....
 

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