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[REVISION TKR] Hmm. Not thrilled with the revision yet<

Discussion in 'Knee Replacement Recovery Area' started by eaglemom, May 27, 2017.

  1. eaglemom

    eaglemom senior
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    I think this surgery is going to happen. Things are falling into place, specifically insurance approval. Today (Mon) I had my hospital pre-op. Multiple vials of blood taken and a zillion questions asked. I'm surprised by how quickly its happening.

    I wore myself out "nesting" over the weekend. If it's not done its not getting done!!!
     
  2. eaglemom

    eaglemom senior
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    Just waiting to leave for the hospital. Insurance is dragging the approval for the surgery. But they've approved Home Health after surgery but not the surgery. I'm just hoping it all falls properly into place, I'm ready to begin healing.
     
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  3. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hugs and prayers. :console2:
     
  4. eaglemom

    eaglemom senior
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    Home from the hospital and my surgery. One thing I was very impressed with is that my surgeon can to check on me 5 times and his PA one. That shows his determination & commitment to helping me I believe.

    In my groggy state I don't know 'exactly' what all he did. I do know I have a new spacer and he used the words chiseled some bone (tibia maybe) for a better groove. Oh and he 'released something' I'm guessing scar tissue. He also put me in a brace with only 10% bend. I'm to be icing, elevating, a 5 minutes around the house walk, and doing heel pumps only. Brace is to be on 24-7 for two weeks. Limiting the knee movement to heal. And I'm only to be out of the bed in 20 minute segments at most. (What was funny was it took me 20 minutes to even get to the bathroom) but such is life.

    I will say the initial pain for the surgery is not there - that stretch. Of course I have other pain. I am worried about a shower - if the brace is off I know I'll bend the knee. The hospital nurse said sponge baths because you're in bed and wash your hair in the kitchen sink. Frankly today I don't care about either one of those - getting a muffin and heading back to bed.

    You will be proud of me because home health called about setting up visits. I agreed the nurse can come and evaluate me - but she's not taking the brace off. Then they wanted to set up PT. I refused - I am not to do anything to bend the knee and that's just how it's going to be. I was quite pleased for myself!!! Saying no is difficult for me.

    Thoughts, idea's?
     
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  5. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    So if the PT came, what would they do? Doesn’t sound like you need them right now, good for you for declining.

    I’m glad you’re home and I hope you have an excellent recovery this time! :console2:
     
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  6. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Welcome home, @eaglemom .
    Well done for speaking up for your knee!

    It's been a while since your last revision, so I'll give you a fresh copy of the recovery reading:
    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
    5. Here is a week-by-week guide for Activity progression for TKRs


    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

    Please don't be overwhelmed by the list. The articles are not long and they and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

    We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish.

    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.
     
  7. eaglemom

    eaglemom senior
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    Here is the crazy thing about Home Health - they were trying to bully me into PT. Obviously that didn't happen, thanks to BoneSmart letting me know I was in charge. The lady for Home Health called 2x's then I received a call from the manager that I was refusing 'treatment.' She threatened to call my surgeon whom I said go right ahead.

    Fast forward about 45 minutes and my PCP's office called. They received word I was refusing treatment (from Home Health)and were telling on me. I felt like I was in 3rd grade!! My PCP told them I was following doctor's orders.

    The next call was Home Health and I just didn't answer. Then came a call from insurance office asking why I was not being cooperative. I told them everything the surgeon had told me and was following his direct orders. To which insurance said "it's right here - patient in lock-down brace for 2 week then will reevaluate. Ice, elevate, medicate & compression therapy is all I'm to do. Can do 5 minute walks around the house.

    Home Health was really being pushy - If they were to come huge damage would have occurred. Took a 3 hr nap this afternoon. And now heading back to bed. Thanks BoneSmart for educating me.
     
  8. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I’m sorry you had to go through all that. :hairpulling:
    I hope you sleep well!
     
  9. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    That pushy Home Health Care was being a huge nuisance. Your first "No, thank you." should have been enough. What these people won't do for a dollar! I'm so glad you stuck to your guns. This isn't your first rodeo and you know how to rehab your knee without any help from anybody but yourself! Good girl!:yay:
     
  10. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I’m surprised your insurance company got involved.

    Is it hard to ice with the brace? Can the ice actually touch your leg?
     
  11. eaglemom

    eaglemom senior
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    Yes its difficult to ice with this brace. I've finally figured out I can loosen one strap on the brace and the coolness gets to the knee. Its not ideal but its better than nothing.

    I'm most comfortable in bed. I can sit on a chair but I'm sitting on the very edge of the chair with my leg sticking out in front of me. Without being able to bend this has taken some creative thinking!!!

    Today I'm got to try and wash my hair in the sink. That alone should make me feel better. Or maybe I'll put it off another day!!! I'm always amazed how little energy one has after surgery.

    Thanks everyone for the encouragement and support.
     
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  12. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    I got a friend to help with my first hair wash and it still wiped me out, but I sure did feel better. It's something about a clean head! :yes!:
     
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  13. eaglemom

    eaglemom senior
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    I didn't have enough energy for the hair yesterday - so today it will be done.

    This brace and I aren't getting long. I can't figure out how its very tight on my leg but stand up and it slips down. The straps go directly across the staples. Not very comfortable.
     
  14. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Maybe it’s not the right size? I’ll tag @Motherbone for you, I think she had this problem.

    @sistersinhim also wore a brace.

    And so did @KarriB

    They may have some suggestions for you.
     
  15. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    I wore a brace for about 4-6 (the last 2 weeks were off/on) weeks. I recovered in a chair with an ottoman. If you have an ottoman or something to put in front of the chair that’ll help with the brace as well as with elevating which will keep the swelling down. I really couldn’t put my leg down for more than 5 minutes the first month.

    My brace did slip slide down, but my dr didn’t really want me walking too much. I only walked around the house and to dr appointments. Can you put something between your staples and the Straps? Also, if you’re just sitting with the leg up can you relax the straps so they’re not rubbing on the stables and you can ice as well?

    I have a lower bathroom sink so I used it to wash my hair and sponge bathe because I wasn’t allowed to shower for 4 weeks. I felt there was no point in PT while I was in the brace so I canceled home service.

    I hope my experience is of some help to you. Keep elevating, icing, and resting.
     
  16. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    Actually, I wore an immobilizer for 6 weeks for each knee, not a brace. It was from my upper thigh to my ankle. These were worn after my patella removals. I was allowed no bending at all during that time.
     
  17. Motherbone

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    @eaglemom Sorry in advance for the length of this post. Brace slippage is such a widespread issue that there is an official term for it: "migration." I discovered this after I googled "how do I keep my brace from slipping?" The person who solves this problem for the industry will become rich indeed!

    My solution evolved over time. Although I did not realize it and was not educated about it by the people who fitted me with it, my brace is a Donjoy brand that is length adjustable by sliding the side support bars up or down one or more notches. I discovered this one day after dealing with slippage for the umpteenth frustrating time. So, I lengthened the lower part (below the knee) to the point where it reached my ankle, making sure the hinge part remained centered at the knee for proper support. There was then no room for it to slip down. With regard to sensitive pressure points, we got some fake lambs wool/sheepskin from a fabric craft store and cut pieces to put between my skin and the part of the brace that was pressing and hurting. This included the area of my incision, which remained sensitive long after the stitches came out, and my ankle, where the end of the brace came to rest on some of the bony parts. We just encircled the ankle and then buckled up around it.

    Before we figured out that adjusting the lower leg length would solve the slip problem, I was trying to rig something that would prop up the bottom of the brace or something that would hold it up. I thought about two leg warmers rolled up on each other to make a sort of tubular cuff encircling the lower leg and acting like a stop for the brace as it tried to migrate downward. Then I thought about a strap with clamps on the end, holding the top of the brace in the clamps while the strap was slung over my shoulder, kind of like a suspender. I don't know how these ideas might have worked since we hit upon our other solution before I tried it.

    If your brace is length adjustable but you are not supposed to remove it, you might have to call your doctor's office and ask if you can come in and have them adjust the length to extend to your ankle so it can't slide down. I was never told not to remove mine, only that I was prohibited from bending the knee. So I got fairly creative, as my recovery thread can attest. I don't want to give you any tips that would contradict what your doctor wants. Funny thing, now that I'm four months out and my surgeon says get out of the brace, I miss it and sometimes wear it if I'm feeling uncertain about my strength and balance. I'm in outpatient PT with a good private PT practice and still have a ways to go.

    I read about your experience with a pain doc and with home based PT with interest. The pain clinic insistence on your having a hip evaluation bothered me. Don't let yourself be talked into interventions that other medical personnel have not found a need for. Something about that did not seem right. I was referred for home based PT once I was cleared to start rehab and the therapist was very pushy on the phone, calling me on Christmas Day multiple times and telling me he wanted to schedule five days a week. When I pushed back and said I would not commit to such a schedule he then said he would refer me for assignment to someone else. All of this took place on the phone without his ever having seen me. When I talked to the home health office the next day, they all of a sudden found reason to question whether I might qualify for home based services at all, citing Medicare restrictions. By then I'd decided I just did not want those people in my home so I declined their services. If someone had labeled me uncooperative, I would have made sure they got an earful and understood that I did not feel comfortable with strangers coming into my home. But then I've never been too shy about quietly questioning authority, LOL. Sometimes I wonder about waste and fraud in the industry.

    I know what it's like to have your hopes for a good result dashed. Feel free to ventilate at any time!

    As I say on my own recovery thread, hobble on! :tiredwheel:
     
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  18. eaglemom

    eaglemom senior
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    Thanks for all the help everyone. Today is day 6 post surgery and oddly by far my most painful. My thigh is muscle sore, my shin is tight and frankly I'm cranky!!! I'm going to try and unhook 2 of the straps on the brace and get the ice exactly where it needs to be. Hoping that will help.

    I love it - hobble on!!! So true.
     
  19. sistersinhim

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    That will make a big difference! Ice is a great pain and swelling reducer.
     
  20. eaglemom

    eaglemom senior
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    A shower. Something so simple but my goodness it felt so good. And exhausting!!! And then a 3 hour nap!!! It's the simplest of things we take for granted.
     
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