PKR I'm Here.... PKR left lateral complete!

[mcirish]

I will wait until my daughter wakes up and we will go together. I was able to hobble over to the bathroom and was fine after the vertigo passed but I quickly became dizzy and fatigued. I tolerate opiates just fine. Never had an issue with them really. Some nausea is about all on occasion but I am taking a motion sickness pill. That's been of minimal help this time.

 

[mcirish]

So sorry mcirish. I think I would go to the ER - is that what you mean by urgent care? I think an ER would be better equipped to deal with post surgery issues. Keep us updated.

Will do. Here at the local hospital the ER is both urgent care and an ER depending on how you are triaged. There are privates too but no place that I would trust.

 

[Minna-min]

Hi mcirish! Glad you're here and made it through! Sorry to hear of your complications. Let us know what the ER says. Good luck!

 

[bottomshollow]

Hope you and yours have had a wonderful Christmas holiday with lots of family fellowship and sharing of gifts and lots of good food to eat.


I’ll be looking for you at the BoneSmart annual New Year’s Party. It’s been a very eventful year for most of us---and will be a very eventful year coming up for others of us looking forward to surgery in the new year.


Remember to bring food and drink to share---and pictures are always appreciated and loads of fun to share.


SEE YOU AT THE PARTY!!!!!

bottomshollow

 

[mcirish]

Started feeling a little better and decided to wait it out. My vitals were within normal ranges so instead of going to the ER, getting charged a a bunch of money to have them observe me for another hour and then send me home and say call us if it gets worse... we just skipped to the last part and will call them if I start circling the drain lol. Looks like I will live. Just scary not knowing what is going on with my body.

 

[icep707]

Holysmokes. Thats came out of left field. You were doing great. First thing first. You said no pain in knee 12 hours since norco. Thats amazing. However I should caution you. I have read you need to stay ahead of pain and meds by the clock. So preceed with caution! Did you end up going to ER. ? Now I have concerns about epideral or GA.. keep us posted . Best of luck. !

 

[kneeper]

Hope you are doing ok now.

 

[mcirish]

@icep707, @kneeper

Thanks checking in guys. Ended up not going to the ER. By the time my daughter woke up I was showing signs of improvement. Plus I could tell that my supporters (family) were just exhausted so the general attitude was like "we love you and we'd happy to take you, but if we have to wait at an ER for 4-5 hours and you're not dying? We will probably just leave you at the ER!" lol A man has to look in his soul at that point to see if he is in fact at death's door.

I really believe it was the ill-advised flu shot that really set me back and I would still do the spinal block if I had to do it again. I read up on this and it sounds a little gruesome, but if there is some excess leakage of CSF after the spinal injection, what can happen is that the cushion that your brain floats on diminishes so the brain comes into more contact with the inside of the skull leading to these migraine symptoms, which is what I had. In rare instances it can progress with slurred speech, cognitive impairment and eventually to seizures, etc....so imagine some of this condition mixed with an overzealous RN giving you a flu shot, which can give you "flu-like symptoms"...fever, slight swelling of the brain...not a good combo. Now add this to all the symptoms of recovery from a knee replacement. Not a happy place!!!! lol I think I was in danger of crossing over since my speech was slurred and I was having trouble talking. The articles say to rehydrate as much as possible to counteract the symptoms and to drink caffeine (stimulates CSF production).

My advice is to opt out of the flu shot if your healthcare provider is irresponsible enough to recommend one after a spinal block.

Other than that, I seem to have just begun to turn the corner. I was able to lie beside my daughter and read for about an hour this morning before hitting the wall. Appetite is returning enforce. Knee feels sore, but i can tell that the joint is tighter. I am purposely taking it easy on the home PT right now as I am getting fatigued quite easily and still have slight flu and migraine symptoms.

 

[jeano]

@mcirish Glad you are doing better. I had a moment last night where I was envisioning you and your little girl staggering out of the house to go to ER together--not a pretty thought.

I remember the dreaded spinal headache bugaboo from nursing school a zillion years ago--we were supposed to not allow patients who had had spinals to sit up for a certain number of hours--hence my suggestion that you lie flat and see if that helped--didnt know about the caffeine, but must have had an instinctive grasp of this concept since the last thing I said to the DH when they were wheeling me into OR was words to the effect that the next time I saw him he'd better be clutching a Starbucks latte for me. Which in fact was the case. Best cup of joe after the best nap ever, for me.

 

[mcirish]

@mcirish Glad you are doing better. I had a moment last night where I was envisioning you and your little girl staggering out of the house to go to ER together--not a pretty thought.

I remember the dreaded spinal headache bugaboo from nursing school a zillion years ago--we were supposed to not allow patients who had had spinals to sit up for a certain number of hours--hence my suggestion that you lie flat and see if that helped--didnt know about the caffeine, but must have had an instinctive grasp of this concept since the last thing I said to the DH when they were wheeling me into OR was words to the effect that the next time I saw him he'd better be clutching a Starbucks latte for me. Which in fact was the case. Best cup of joe after the best nap ever, for me.

Scary thing is she would have probably drove since I was in such sorry shape lol. I think at that point it was going to be 911 or bust. That is so funny about the Starkbucks! The hospitals coffee was SO BAD I didn't drink more than half a cup while I was there....I think I said I would kill for a Starbucks...or maybe I said die without one something like that....I definitely laid flat, had no choice or else i would have thrown up. Regarding the spinal, like I said, I would probably still do it again just because I have this irrational fear I WILL FEEL EVERYTHING if I don't. Plus I don't want to accidentally twitch during the procedure.

I am fully convinced that if I hadn't had the flu shot we would be having a different conversation right now. I will definitely have a conversation with my OS and the hospital admin about what happened. The nurse should have never pushed that without clearance from my doc.

 

[jeano]

Putting my nurse hat on, here--as regards the nurse "pushing" the shot, surely she wasnt just standing around with spare flu shots and deciding to get rid of them, at least I hope not. There would be either a specific order or a standing order to offer flu shots. If your OS didnt know about this order or policy, I'm sorry, he SHOULD have known, and could have countermanded it. And you couldve said no. You would certainly have grounds to raise all kinds of hell if she gave you a shot without an order, or after you said sorry, dont want one, or after mistaking you for another patient who DID have an order.

Dunno how it works in CA but here I couldnt get my family doctor's nurse to give me a flu shot without him first ordering it, and her giving me an exhaustive info sheet and consent detailing risks/benefits etc etc.

FWIW, I resisted getting a flu shot for years. Didnt need or want one. Never got the flu. Then last February my DH, my then 88 year old mother and I ALL came down with the flu at the same time. This year we all lined up as soon as we could for our shots!

 

[mcirish]

Putting my nurse hat on, here--as regards the nurse "pushing" the shot, surely she wasnt just standing around with spare flu shots and deciding to get rid of them, at least I hope not. There would be either a specific order or a standing order to offer flu shots. If your OS didnt know about this order or policy, I'm sorry, he SHOULD have known, and could have countermanded it. And you couldve said no. You would certainly have grounds to raise all kinds of hell if she gave you a shot without an order, or after you said sorry, dont want one, or after mistaking you for another patient who DID have an order.

Dunno how it works in CA but here I couldnt get my family doctor's nurse to give me a flu shot without him first ordering it, and her giving me an exhaustive info sheet and consent detailing risks/benefits etc etc.

FWIW, I resisted getting a flu shot for years. Didnt need or want one. Never got the flu. Then last February my DH, my then 88 year old mother and I ALL came down with the flu at the same time. This year we all lined up as soon as we could for our shots!

I want to be careful about ranting as I have been known to do from time to time, so at that risk, who is responsible then? An uninformed, post surgical, loopy layperson under the influence of heavy doses of morphine or any one of the 3 RNs/trained medical professionals who told me it would be a good idea to get one and did so without the consent of my physician? And I did not mean "pushing" in the street sense. I meant pushing in the normal sense like someone selling something (legally). Now that you mention it, there seemed like some kind of mandate going on since I was approached by more than one RN. In fact, i had originally said no, but then they started asking things like "do you have children at home", etc.

I am not trying to pick on RNs by any stretch. Maybe I should have just said medical professional, but typing RN was easier and accurate. I highly respect most RNs and their expertise. I was just commenting on my experience in this particular instance.

Also, this hospital is in an urbanized area in Los Angeles, so there is probably a higher concern to prevent the spread of contagions, especially in a hospital setting. Several of the nurses were wearing face masks while they were on the floor.

 

[kneeper]

I'm a big advocate of flu shots--for yourself and to protect others around you. But it does sound like the timing on this wasn't the smartest thing. I'm glad you are ok @mcirish.

 

[mcirish]

....anyway I just reached a pretty good milestone. Had 4 slices of pepperoni pizza with a strong cup of french roast for lunch and I didn't get sick! Progress!

 

[jeano]

Didnt think you were picking on RNs, but wanted to point out that odds are they were doing their job in good faith, and again, if your surgeon didnt know you might get offered a flu shot and say yes AND he objected to you or any of his patients getting one in similar circumstances, then he was remiss for not knowing this was policy or that SOMEONE had ordered the shot, and not specifiying no flu shot.

Being offered a flu shot certainly wasnt something that happened to me post op, but then again, I probably told someone I was current when I did the preop stuff. If in fact it was SOP at that hospital seems to me like they couldve jumped on you to get your flu shot BEFORE you had the surgery.

As regards your being drug addled to the point where you couldnt give an informed consent or that you were unmercifully badgered into saying yes when you meant no--that might be a hard one to argue from either side.

And the question about having a young child at home is valid. Kids your daughter's age can and do die from the flu, not just have a bad day or two. They die. Old people like my now 89 year old mother arent just miserable and inconvenienced by the flu, they croak from it. (Which is why last winter when I realised my mother also had it, I hauled myself off what felt like my deathbed so all three of us coud go to the doctor, rather than trying to just ride it out with my fingers crossed that none of us would go into pneumonia.)

Try to look at it this way, maybe you got a shot you didnt want and maybe it made you sicker than you would have been otherwise, but maybe your having that shot means some little kid or that little kid's grandma doesnt get the flu and get so sick they cant get well. Urban setting or otherwise, flu can reach epidemic proportions in any health care setting, and good on the nurses there for wearing masks when they should (to prevent giving what they have to their patients, or to prevent carrying what their patients have home to their own families.)

Thus ends MY rant on your thread, for which I apologize--and I am really glad you are feeling better.

 

[mcirish]

Didnt think you were picking on RNs, but wanted to point out that odds are they were doing their job in good faith, and again, if your surgeon didnt know you might get offered a flu shot and say yes AND he objected to you or any of his patients getting one in similar circumstances, then he was remiss for not knowing this was policy or that SOMEONE had ordered the shot, and not specifiying no flu shot.

Being offered a flu shot certainly wasnt something that happened to me post op, but then again, I probably told someone I was current when I did the preop stuff. If in fact it was SOP at that hospital seems to me like they couldve jumped on you to get your flu shot BEFORE you had the surgery.

As regards your being drug addled to the point where you couldnt give an informed consent or that you were unmercifully badgered into saying yes when you meant no--that might be a hard one to argue from either side.

And the question about having a young child at home is valid. Kids your daughter's age can and do die from the flu, not just have a bad day or two. They die. Old people like my now 89 year old mother arent just miserable and inconvenienced by the flu, they croak from it. (Which is why last winter when I realised my mother also had it, I hauled myself off what felt like my deathbed so all three of us coud go to the doctor, rather than trying to just ride it out with my fingers crossed that none of us would go into pneumonia.)

Try to look at it this way, maybe you got a shot you didnt want and maybe it made you sicker than you would have been otherwise, but maybe your having that shot means some little kid or that little kid's grandma doesnt get the flu and get so sick they cant get well. Urban setting or otherwise, flu can reach epidemic proportions in any health care setting, and good on the nurses there for wearing masks when they should (to prevent giving what they have to their patients, or to prevent carrying what their patients have home to their own families.)

Thus ends MY rant on your thread, for which I apologize--and I am really glad you are feeling better.

Thanks jeano, please "keep it real" as they say. I know that is your style and I like it. No problem. I love discussing or debating topics. I know this may or may not be the appropriate forum for it, but it's so much more interesting for people just to open up and voice their opinions....in a respectful manner, so I hope this exchange was exactly that and I appreciate your views. I guess my basic point is similar to what kneepers said. The timing wasn't ideal. Unless there is a compelling reason to do it, should not have happened after a spinal block, given the complications, in my untrained opinion. I still want to at least let the OS know about it very pointedly since this is one of the hospitals he uses to perform his surgeries. Other people who get nerve blocks should be aware of what could happen. Funny, I talked to one of his medical assistants the day I came home and had all the complications. She was so nice and friendly and let me know that she has heard other things about this particular hospital and that Dr. Sisto prefers to do his procedures at 2 other local hospitals, but since it was the only one that was in my network, well I didn't want to go 50% OOP so I went with Northridge. Our wonderful insurance system at work!

 

[mcirish]

Okay, let go back on topic again. I have some questions and concerns.

1. Most of the pain I am having is behind my kneecap. I was advised that with a PKR sometimes the patellar tendon is cut in order to slide the kneecap over to gain access to the affected compartment. Anyone else experience this? Right now I am nearly fully mobile. I can "cowboy" my way around the house and I am no longer using crutches. The pain at the site where the hardware was implanted is minimal, with most of it being on the surface of the fibula where the base was implanted, but again, it is minimal.
2. I definitely feel some laxity and a gap in the implant site. When my leg is loose some times and I raise it to take a step, I can feel a small "click" or "pop". Another member with a TKR said this is normal as the muscles are weak and the joint is still in a state of flux with the swelling and bleeding. I was very concerned as I noticed this during my first in-hospital PT session, but kept it to myself knowing that swelling and muscle tone can do tricky things.
3. Also, at what point do you change a waterproof dressing? I have a 14" Aquacell that does a great job of keeping the "oozing" under control, but the bottom 1/5 of the gauze is more than a little saturated with blood and parts of the other portions are soaked too. The nurse said it is a "10 day freshness guarantee" lol....so I guess it's gtg for 10 days. Just the though of the blood pooling in one spot for 10 days kind of grosses me out though. I guess I can really infect myself with my own blood so it is probably a dumb question.
4. 8-10" scar for a PKR??? Almost made me think the OS did a TKR by mistake, but that's not possible....right? JK....he told me he was going to "borrow" my existing war wounds to create an incision. I had an existing 6-8" cut from my original ACL surg. when arthroscopic surgery wasn't an option. That one healed VERY badly and left about an 8"x 0.25" beauty on the medial part of my knee I also has a 3" scar from my patellar graft for my second ACL. He said it should look thinner and will have kind of a weird lightning bolt pattern....hmmmm potential. Will post a pic when the staples come out.

....let's see, was at full extension last night, but it fluctuates with the swelling. Flexion is still around 95-100, but I am not worried about that....swelling is really going down. I really don't ice it that much, maybe a total of 2-3 hrs. per day, mostly in the morning first thing and evening before I go down for the night. Kneecap still looks softball like though. Thought about posting a "knee pic", but you can't see the staples with the dressing on so what fun would that be???

 

[jeano]

@mcirish Re my rant: No worries, I think we are good. I have been described as subtle as a truck, and certainly wasnt offended by that characterization.

Re your questions--here goes my straight shootin' replies, for what they are worth. Remember, you asked!

1.Ice more, ice all the time, ice some at night if you can sleep with the contraption on. Elevate as much as possible, with ice. Did I mention you need to ice that sucker? Ice will help the pain and swelling like nothing else. Josephine will jump on you like a duck on a June bug if you dont recognize the swelling as PAIN and medicate (and elevate and ICE) accordingly. I am approaching 8 weeks out and am still icing probably 6-8 hours a day,to which fact I attribute my "textbook perfect" recovery so far. (Pssst. @mcirish Dont tell ANYONE on Bonesmart that I still have over 80 Lortab left from the script for 100 that was supposed to only take me up to the 2 week follow up appointment, or that I'm riding horses and trimming their feet, because such is the stuff that urban legends of knee surgery recovery are based on, and probably therefore cant be true.) Embrace ice.

2. I havent had much in the way of scarey knee noises, but I have had some, mostly in the first few days post op. I am a bit concerned that you arent using a cane or a walker even in the house. I too was sneaking around with no visible means of support very early, but not quite as early as you are. The inside of your leg needs all the help it can get. The implant is probably fine, the soft tissues not so much.

3. I am the worst possible person to ask about the (allegedly) waterproof dressing since I made sure I changed mine the day after surgery since it was disgusting, not to mention no longer waterproof, since blood was running down my leg when I got home the day of surgery, and had been while I was still in the hospital. This is an area where I KNOW for a fact that the nurses couldve and shouldve done better, since they reinforced the dressing instead of changing it. (See, not always defending my sister and brother nurses. I've worked with more than a few who were sorry slobs.)

Since I was at PT that first postop day and since they had the wherewithal, dressing was changed, and NOBODY DIED. Your mileage may vary. I'd say if there's no drainage on the outside, meaning that the barrier hasnt been breached, you should be ok following orders, but since I am me and have never been able to stand gunky bandages on me or anyone else, I changed mine.

4.Hmm. How do you know it's 8-10" long unless you've been a baaaad boy and peeked under the waterproof dressing you're supposed to leave alone? Or are you extrapolating from how sore it feels and how big the bandage is? I had the standard foot long dressing (closely resembling the nasty thing between your steak and the styrofoam tray it came in) over an incision barely 2 1/2 inches long. I didnt have what amounts to a zipper there for the surgeon to go through, though. I just dont know.

 

[RedRider]

Wow, you're really coming along...way to go! I wish the weather was crappy down here in So Cal so I could say that you're not missing much being confined indoors. It did get below 50 degrees here last night haha. Keep up the good work!

 

[mcirish]

Wow, you're really coming along...way to go! I wish the weather was crappy down here in So Cal so I could say that you're not missing much being confined indoors. It did get below 50 degrees here last night haha. Keep up the good work!

@RedRider Thanks. Beautiful weather we are having for sure. I am learning that what everyone said about this particular surgery is true. Yesterday I was feeling great compared to the previous 5 post op days. So good that I felt I was ready for a walk to the main dumpsters where I live to toss out our trash about 10:00 last night (we live in a nice, funky rural area) I only had a small diaper bag to carry and our small wonder mutt Charlie on a leash. The Mrs. has the bigger bags. Total distance less than 1/8 mi round trip, slight incline....about halfway up I was spent. Had to use my 5'4" wife as a human crutch the last 100 yards home....not a lot of pain when I went to bed, more like discomfort. But I WAS EXHAUSTED. Sounds funny but it took me about 2 hours to fall asleep because the temperature spikes in my body from the fatigue made it so difficult to get comfortable. Plus I was hungry and nauseous at the same time so I had to get something in me before I went down. Ice, protein shake and pain pills and I just flopped down. Needless to say I woke up feeling like **** and my knee feeling somewhat like "kasha", just weak and mushy, but after a big breakfast and a hot shower everything started to "get right". Knee is back on track, but I can tell that my body is upset with me for taxing it like that. Little too much too early.