TKR I Feel Like the Tin Man these Days

[Laurenkate]

Well, the physical therapist showed up this morning which wasn't great timing. Last night was really bad and I didn't need lectures from her. Leg is really swelling and turned into an over-ripe eggplant overnight - very bruised. The P.T. asked what they did to me in surgery because she'd never seen it so bad and was surprised when I said the first one was worst. Anyway, she started in about my ROM and how the scar tissue was going to settle in, blah, blah, blah. It was all I could do to not say "so what? It's my knee; it's better than it was before surgery because the bone on bone pain is gone and OBVIOUSLY the ROM isn't good because it's so swollen". Then she started in on my blood pressure which was a little high for the first time but she didn't take it properly and considering the pain, swelling, lack of sleep, not surprising.

I'm beginning to wonder if p.t.'s get paid a bonus based on the ROM numbers change during their 3 week visits.

If I'm going to whine, also going to try to think of one bit of good news. The nurse in the doctor's office called in a prescription for Tramadol and the pharmacist called to tell me it was ready about 30 minutes afterwards. Bless his heart. When I told him I'd only had 6 Tylenol (a day) for the past 3 days, he said he could understand why I sounded a bit cranky and out of sorts. It's just nice to hear someone (who hasn't been through this surgery) acknowledge that it must be rough, isn't it?

 

[sistersinhim]

The weather here is humid and rainy which always gives me a sinus headache too but can't take my usual medicine.

I'm here in Virginia also, and had to fight sinus headaches. I don't know if the allergies are any worse, but the mold count is up. That could be adding to your headaches.

I'm beginning to wonder if these people get paid a bonus based on how much the ROM numbers change during the 3 week home visits.

It sure wouldn't surprise me! Stay your ground and do not let them hurt you in any way. It IS your knee and you have to live with the results of an uncaring PT.

Hopefully all this will convince my husband he doesn't need to get up with me every time he hears me stirring around.

Can your husband sleep alone for the next few weeks? That would be a big help to both of you.

 

[Laurenkate]

Oh, Sisters, the humidity has been terrible hasn't it? I hadn't thought about mold count but bet you are right about that.

We haven't shared a bedroom except on trips since my first tkr last year. He needs his sleep and the idea was that I wouldn't disturb him when I got up, etc. However, our bedrooms are right across the hall from each other and he hears me when I'm up, stirring around, etc. He's becoming exhausted though so hopefully he'll start sleeping through the night unless I call him. I should probably start sleeping downstairs but it feels very isolated and the bathroom isn't as big as the one upstairs. Last night was complicated by the fact that a thunderstorm rolled through and just as he was falling asleep, the dog started standing in the corner, scratching the wall and whimpering like he does during storms. Hubby said he wasn't sure if it was the dog or me when he first heard it.

 

[Jockette]

You should have gone ahead and said all that to the PT.

I will not have that hassle with my next replacement, I will not be allowing any home PT and if they do show up anyway, if my husband knows what’s good for him, he won’t even answer the door.

 

[lovetocookandsew]

I am convinced that PT after this surgery is more often harmful than it is helpful. I'd have shown that PT the door about 2 minutes after she arrived. You can call and request a different person if you're planning to allow them to keep coming, and tell them exactly why. If they won't change to a new person, then don't let Debbie Downer back in your home. I let them send one out one time only because they wanted to check on me and take my vitals along with the PT, and then when she called to come back I told her thanks, but no thanks. She already figured I was done as I was very clear with how I felt about PT when she was in my home. The same with outpatient PT, I told them I wasn't going to do it. They tried the threat of tattling to my OS, but I told them to go right ahead.....Threats only make me stand my ground even more, so it backfired on her. I'm doing really well and my recovery is fairly smooth. I don't need any therapist to set me back or try to get me to do things I won't do and get into a conflict over it. It's my recovery and I am choosing how I want to do it, and you can too.

 

[Laurenkate]

Y'all are right but I'm going to see how the next visit goes. Today was bad and to be fair, she said she didn't want me to do any exercises because I was obviously exhausted and in pain. I'm going to do what I want to do but didn't want to get into it today because I was feeling extremely ugly.

Dealing with this home health care has been another thing which is radically different this time around. It's the same one as last time but their scheduling, etc. has been really nuts - too hard to explain. Last time, it ran like clockwork, we received the schedule ahead of time, knew what to expect, etc. I'm going to be here so it probably doesn't matter but it's very unprofessional and confusing. Again, suppose I was on my own, didn't have a computer or was slightly confused to begin with? The hospital and home health agency are going to get "constructive" letters from me in a few months. Hopefully they won't ask for the equivalent of a "yelp" review.

Maybe I'm just getting old but I feel like the entire world (or at least everyone/thing in this country) has gone kaflooey in the past 2 years.

 

[SusieShoes]

I'm old too, then, because I think the world has gone kablooey too.

PT can be useful and sometimes fun if one has a mind for exercising control. I liked my PT guy and he did give great knee massages, so I stayed with him. He had a thing for leg presses, though (so much so I wondered it he was paid bonuses for leg presses) and every visit meant he would try to get me to do them. Having already decided I would never do them until my knees were fully healed, I turned my refusals into a game. I even looked forward to trying out new ways to say no. I kind of got a kick out of it, to be honest. I know, I'm a horrible person. But protecting the knees was important; making my PT guy happy was not.

This therapist of yours may yet work out. It's good she recognized you were not in a good place for exercises. If you can find a mutually satisfying way to work together, that would be great. But if not, you can ask for someone more suited to how you wish to recover.

 

[sistersinhim]

Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard as my knee allowed me to do. As I healed, I did more. But, my knee was always in control! This was enough therapy for me and would be for any tkr patient. All the awful pain of PT is so unnecessary.

All you have to do is use it in your daily living! Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new! You have to be patient, though, it doesn't happen quickly! ADL,(activities of daily living), going to the bathroom, brushing your teeth and bathing, fixing a light meal, getting something to drink and or a snack, those kinds of things will be all the exercise your knee needs. If you just use it daily in your living, you can have a less painful recovery. We know what works, we've been there!

 

[Thesoutherncook]

Just a note to say that I had TKR #2 as outpatient one year ago this week! I did MUCH better than the 4 days in hospital with #1! The next day, I showered and went out to PT! 6 weeks ago, same surgeon did my THR as outpatient! I went to PT a week later and with hip only went 3 times! All that to say, the new protocol works like a charm for some of us! Granted, it is not for everyone. Just wanted to chime in with 2 very positive experiences! Best of luck to you in your recovery. Each of my knees was very different BUT the common factor was that they required much PATIENCE and LOTS of ice!

 

[Josephine]

The nurse in the doctor's office called in a prescription for Tramadol and the pharmacist called to tell me it was ready about 30 minutes afterwards. Bless his heart.

That was nice of him.

FWIW, this was my programme for using Tramadol. You HAVE to take Tylenol with it to get the best out of it.

 

[skigirl]

No wonder you are crabby, you are in pain. Swelling is another thing that happens with pain, so you really do need to get the pain under control. Also your restlessness is a real symptom of pain. Hopefully the tylenol and tramadol will do the trick and you will be able to get some rest and relax a little. I would not worry about hurting the Pt's feelings---if she is nattering on about "scar tissue" at day four, she does not know the modern thinking about TKR rehab and frankly she has not kept up with her profession. She is like the stylist who still uses rollers!!! Just ignore her and ask for someone who has had training since the year 2000!!!

 

[Laurenkate]

Thanks for the reminder Josephine. The combination helped me sleep but 100 mg of Tramadol every 4 hours made me extremely dizzy and shaky. Cut it back to 50 mg today and it seems to be taking care of the pain and I don't have quite as much dizziness.

Removed the Aquacel and bandage over my incision today and felt vaguely faint after seeing the number of staples in it. The doctor used stitches last time and I was hoping I dreamed someone told me there were staples in it this time. It didn't help yesterday when the p.t. said "oh, if you have staples, we (meaning home health care) have to take those out. THAT isn't fun". Need to research how that is done but is it as bad as it sounds? The staples are much smaller than expected too; there are just so many of them!

Y'all were right about the Lounge Doctor. It is insanely comfortable although I like the pillow stack too. Thought my feet hanging over the edge would be annoying but it isn't; now I just need to figure out how to get on and off of it. There must be a rule that as soon as you get into your nest, elevated, iced, pillows just right, lightweight blanket on feet, then you have to go to the bathroom AGAIN? Any suggestions about ways to get on and off the lounge doctor other than picking up my leg with a lifter, crutch, or blanket? Trying to roll off of it might be a mistake. Will that count toward "quad exercise" the next time the p.t. asks me if I've done those?

My husband said I was pressuring him earlier by insisting he get out of here, go to the gym, etc. for a little while. We've been married for 140 years and have spent much of time apart because he's always worked long hours, etc. Since retiring in January, he's had a lot of projects so we hadn't been together in our very small house all day like we have since this surgery and he's getting a little stir-crazy. He makes a lot of noise while bustling around in the house and stomps up and down the steps like he weighs 250 lbs (he doesn't) so the quiet is nice.

Hope all of you are having a good day.

 

[lovetocookandsew]

There must be a rule that as soon as you get into your nest, elevated, iced, pillows just right, lightweight blanket on feet, then you have to go to the bathroom AGAIN?

Lol-read my whine from today on my thread-it's almost exactly what you said about it!

I don't have the first days problems you still have, like dead quads, but it's still a workout getting on the LD. Not to mention arranging pillows, ice machine, blankets, etc!

I'm so glad my hubby still works; although he is extremely helpful, I still really love and need my solitude and quiet time. But, if I need a break from the hustle and bustle I just shut my bedroom door and he knows that's my signal to him to pipe down and let me rest. Just as I'm extra quiet when he's taking his afternoon naps, he knows to return the favor. I think we're more sensitive to noise and bustle for a while after this surgery, which leads to many frustrations with others in our homes who are not really being louder than usual, but we are more disturbed by it, especially since we're resting much of each day instead of being up and about ourselves.

 

[sistersinhim]

I had 35 staples and 34 hurt when she removed them. But, it was almost 3 weeks after my surgery and my skin had grown over them. It wasn't an awful hurt, just like pinches. I hope next time I'll have glue!

The best way I found to get my tkr let up was to use my other leg under my tkr leg and lift it with that up and over whatever it needed to be lifted over.

We've been married for 140 years

Wow, y'all must age really well! Are you on well water?

 

[lovetocookandsew]

I had staples with my first TKR, and had something like 43 staples. I don't remember how many days after the surgery they were removed, I just remember how much they hurt and how much I cried with each one. Mine had scabbed over also, which is why it hurt so much to remove them. This time I spoke to my OS about it and he said he really doesn't use them anymore as his patients don't like them (ya think? lol). I'm glad he listens to his feedback and is willing to make changes where he can. I only have glue and steri-strips this time, although I am wondering why he used something like 17 of those suckers and why he had to have used gorilla glue to stick them on!

 

[Mumu]

About the staples: I had them for TKR #1 last year, and it did not hurt when they were removed on Day 12. This year I had glue, which was great.

 

[Josephine]

but 100 mg of Tramadol every 4 hours made me extremely dizzy and shaky.

Oh for pity's sake! Do take only 50 at times! I should have said.

Thought my feet hanging over the edge would be annoying but it isn't

Doing that makes sure you don't get sore heels!

We've been married for 140 years

Was that a typo?

About the staples: I had them for TKR #1 last year, and it did not hurt when they were removed

That's because you had a nurse who actually knew how to take them out! I removed thousands of them in my time and not one patient ever winced or said ouch!

 

[lovetocookandsew]

@Josephine My nurse was really careful, but due to my body's having scabbed over them really quickly, there was no way to avoid the pain. Maybe you guys remove them earlier over there than they do here? But many doctors have stopped using them to close wounds and are instead choosing other options, which is wonderful.

 

[Dzina]

I had staples last year which were removed at 12 days and I barely felt a thing. Was carrying on a conversation with the nurse as she was doing it and the next thing I knew they were all out. Had glue this year and @ 2 months the incision looks so irritated I wish I had had staples.

 

[Josephine]

No, I had patients where they had scabbed. I just spent some time gently swabbing off the scabs, that's all.