TKR Hippietoo's recovery

[hippietoo]

I'm lucky that I live too far out in the country for home PT. The OS wants me in Outpatient PT on Monday. The odds are that I'm going to be busy on Monday, and Tuesday, and perhaps the entire week. I'll find one to help with my gait, and record measurements in about ten days.

I did learn how to get in and out of a chair, and a my bed today. But the truth is the nurse taught me how to do that last night. I went up and down a few steps today. It was easy today, but I'm sure it will be worse when the blocks say goodbye.

Right now I'm looking forward to hooking up my ice machine and catching up on my reading.

 

[lovetocookandsew]

You might find yourself "too busy" for quite a long while to go. And what your OS doesn't know won't hurt him, or you! He probably won't know whether or not you go anyway, unless the PT tattles...lol. Even so, it's still your knee and your choice. There's no way you should be going to PT on Monday, especially if you live "far out in the country"! All you have to do is smile and nod when you go to your post-op OS appointments, and let him think your good recovery and ROM are from PT, without telling him you aren't really going. I don't even do that as I have no qualms telling my OS what I think about PT after a TKR, but luckily he seems to agree with my thoughts on the subject, even though I haven't really said anything against PT itself, just that I agreed with him that I don't need it. But if he was a gung-ho PT advocate, I'd let him know exactly where I stand on that subject! I certainly let him know yesterday that the medicine mix-up the night after my surgery was mostly his fault as he forgot to change the usual protocol to our plan for me, and as a result it was a really rough couple of days. Take some time to recover before you even think about going in to outpatient PT. Rest, elevate and !!!!

 

[Josephine]

My nurse suggested that I time my dosage of 7.5/325 Oxycodone so that it occurs one hour prior to PT.

That is such a bad idea, I cannot even quantify it! Pain has a function. It happens to warn you when you are in danger of doing your leg harm. If you block that, then you will be grossly overdoing it with these consequences ...

By the time she left I couldn't raise my leg. I can't raise it now, and it's been 6 hours.

I'll find one to help with my gait, and record measurements in about ten days.

Better yet, DON'T find another one! You don't need to do exercises at all and you can measure your own ROM with my help. Just post a photo of your leg according to these suggestions ROM (range of motion) information and use the advice within the article to assess your extension.

I also recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)

 

[hippietoo]

Thanks Josephine.

I've read your recovery threads, and I'm on board with your protocols.
Thank you for your offer to help.

The PT's expectation is that this morning I will do 30 foot slides in a row. When she told me that yesterday I looked at her and said," I'll do several, and when the pain increases, I'll stop." She said, "We really need you to do 30 for discharge." I replied, "That's nice, but you and I both know that my doctor isn't going to delay my discharge because of a failure to meet that standard." She looked stunned that a patient was actually pushing back. She changed her facial expression a couple of times and ended with a smile. "I'll help you do as many as you can, and then you can go home." I hope her attitude will be helpful this morning.

Thanks again.

 

[uva55]

@hippietoo your PT was really pushy, when I was in the hospital they showed me a few excercises to do at home, they game me a number to try to reach but I could stop sooner if I had pain, they mainly helped me with walking and getting in and out of bed. Even now with out patient PT when my PT tells me to do certain excercises I stop if it hurts and she's OK with that.

The main thing I can tell you is NEVER skip your pain meds even if you feel you may not need them, ice and elevate as much as possible.

Wishing you a smooth and painless recovery

 

[dianehelen]

That's nice, but you and I both know that my doctor isn't going to delay my discharge because of a failure to meet that standard

GOOD for YOU!

 

[hippietoo]

@hippietoo your PT was really pushy, when I was in the hospital they showed me a few excercises to do at home, they game me a number to try to reach but I could stop sooner if I had pain, they mainly helped me with walking and getting in and out of bed. Even now with out patient PT when my PT tells me to do certain excercises I stop if it hurts and she's OK with that.

The main thing I can tell you is NEVER skip your pain meds even if you feel you may not need them, ice and elevate as much as possible.

Wishing you a smooth and painless recovery

Your advice on the pain medications is so true. I've had a number of painful orthopedic surgeries. The most painful was my rotator cuff. I learned from my THR that getting behind the curve is a very bad thing. Newbie patients really need to heed that advice.

 

[hippietoo]

I'm home! Nothing feels better than being in ones own house.

The PT tried her best this morning. Before she started her speech I told her, " This is how it's going to go this morning. I'm not going to increase my reps from yesterday, and if anything hurts I may stop the activity."
She immediately stated, "Well, that's not the way it works, your doctor said... I stopped her mid-sentence. " I honestly am not worried about what my doctor said, this is my body and I'm the only one in charge of it." She jumped back into the fray with, "I'll have to call your doctor and tell him... I stopped her again. "Well call him, it's not going to change anything."

She realized that I wasn't going to just roll over and be compliant. I told her, "Now, let's start with whatever you want to do, and we'll see how it goes. OK?"

She stopped barking and we got through all the exercises without undue pain. I apologized for my brusque opening remarks, and thanked her for her help.

I had an hour trip home which wasn't too uncomfortable. I arrived home, and immediately found the comforts of the shower. My leg is up and I'm about to ice it.

Updates later.

 

[dianehelen]

Bravo Bravo BRAVISSIMO!!! Well DONE!! I hope I have the same muster next month if I need to!

Get some rest, welcome home.. Dorothy said it best..."There is no place like home"

 

[hippietoo]

As many of you have noted, sleep is a challenge.

I propped up pillows and blankets on the recliner, took an Ambien, and fell asleep rather quickly. Two hours later I'm awake and in pain. I turned the cold machine back on and when the pain abated I went back to sleep. An hour and a half later my analgesic alarm went off, so I took a tablet and went back to sleep. I woke up again in two hours and was unable to return to sleep.

I expect to pay my sleep bank back by napping during the day.

My pain meds are doing their job, so I haven't been terribly uncomfortable. The biggest challenge is to make sure I have everything I need close by. Just when I get comfortable I realize I've left something in the bedroom, so I have to get back up. I'm sure I'll learn better organizational skills in the weeks ahead.

 

[uva55]

@hippietoo I'm five weeks post-op and still have problems sleeping, I start out in bed and after a couple of hours go to the recliner, I can't find a comfortable position in bed, I still have to ice at least once during the night, and like you I still forget things and only remember after I am all settled and comfy on the recliner, I still take my afternoon naps.

I'm glad your pain meds as are doing the trick, you are doing great in your recovery!!!

 

[birdwatchr]

Ha!Ha! - I think the "forgetting" and needing to get back up is in our genes! Or our jeans pockets! I have done that too many times too. I still do it! We get better though.

 

[sistersinhim]

I'll be 6 weeks Thursday and I am still not sleeping well and have to take naps. I, also have to ice in bed.

 

[hippietoo]

PostOp day 3

Starting the day before dawn, I tried to enjoy my first full day at home with the new knee. The knee didn't have this agenda in mind. The knee said, "I'm not swollen, I don't hurt, so move around and and we'll be fine." My knee is a liar!

By midday I had the Cold Rush running full tilt, and a mouthful of Percocet. It seems my brain did not store the memory of similar misadventures when I had my hip replaced. So, I relearned an old lesson, and I've parked myself in the recliner.

The pain prevented naps, so I'm hoping the sleep deprivation will assure a better nights sleep tonight.

I found an outpatient PT location nearby and I'm going to check them out on Wednesday. My goal is to document a few measurements, learn the proper way to do a few exercises, and escape unharmed. My ROM at discharge yesterday was 0/108, so I'm not worried about obtaining good ROM. I do want to make sure that my gait is limp free, so I'll ask for that help. I found that to be a challenge with the hip replacement.

So have a good evening, and I'll check in tomorrow.

 

[hippietoo]

Yesterday,(Postop day 4).

Having learned my lesson from the day before, I set my activity goals to move no more than necessary. I performed a few heal slides and quad tightening exercises, but I did no more than 5 of each. The rest of the day I shared the recliner with pillows, a blanket, and the occasional small animal.

The result of yesterday's lack of movement; zero. Zero pain above baseline, zero increased swelling, and zero needs for breakthrough pain medications.

I slept most of the morning, and half of the afternoon, and I managed 7 hours of sleep after retiring. The nightime sleep came in 2.5hour units, but that beats the heck out of waking up hourly.

Today I see an Out Patient PT. Yes, I know... But I'm too remote for home health care. Trust me when I say they'll have no chance of pushing me past my pre-determined boundaries.

Overall, I'm feeling better. The pain is manageable, and the icing and elevation is helping.

I hope the rest of you are having a good day.

 

[hippietoo]

Today was a good day. My pain was very manageable, and I noticed my swelling was half of yesterday's.

My PT appointment went smoothly. I told the PT that I wanted feedback and guidance,but no hands on manipulation. They agreed and said that they have a no-pain philosophy. We went through all of the normal exercises, and recorded my extension at 0 and Flexion at 105. I felt well enough after PT to go a favorite restaurant and have a decent meal.

It was nice to be out and about. I transitioning from the recliner to the guest bedroom tonight. I hope that I can sleep better on a more comfortable surface.

More news as it develops.

 

[lovetocookandsew]

Oh my-I can't believe you can go to a restaurant at 5 days! I went from the hospital to home on day 5. I'm two months out and still haven't gone to one as I'm not comfortable with my leg down for long periods. Good job with the PT and not letting them touch you. I hope you get a good night's sleep tonight.

 

[hippietoo]

I am paying a high price for going out to eat after PT. In the middle of the night I moved from the guest room to the recliner. I was in level 8 pain, and all of the swelling returned. This is what I thought might happen, but I suppose I had to definitively determine if the stove was still hot.

I think the PT was more than likely the largest contributor to the sorry state I found myself in. The restaurant had very wide booths and I was able to prop my leg up for the entire meal. And if we want to dig down to the actual root cause, we only need a shovelful of stupidity.

So, what did I learn?

1. Outpatient PT at 5 days Post-op was a bad idea.
2. Even so-called "gentle" exercises can destroy a day of relaxed, relatively painless, existence
3. Having a bite to eat at a restaurant isn't worth the pain it may generate.

All of the above "learnings" we're clearly available from the stories of countless others participating in this forum. One shouldn't expect to be an exception from the norm.

I'm all RICE today.

 

[uva55]

I started out patient PT at 3 weeks, and that's mild excercises, eating out about the same.

 

[hippietoo]

I don't have the ability to have at home PT. I live in a very tiny town, outside of a small metro area. It's funny when I lived in a huge metro area, no one thought a 45 minute drive was a big deal. Here they think that that drive is equivalent to driving a large distance.

Anyway I'm using OP PT as a substitute for at home PT. I've always believed that recovery is as much mental as it is physical. Moods and attitudes are important. Getting out and about has helped me through a number of very very difficult surgical recoveries.

Spinal fusion was a long recovery for me because I wound up with a very nasty MRSA. Going out to dinner, or lunch, or just for a snack helped me to mentally rejoin my previous life. Isolationism generates too much inward reflection, and the constant rumination about ones condition can lead one to the edge of depression, anxiety, and even agoraphobia.

Sure, we must rest, but there must be some balance between resting at home and returning to pleasurable activities. My goal is to get out of the house again before Sunday, and thereafter once or twice a week, not including PT. Pain will may mediate those goals, but I'm committed to try.