In training for TKR 15th December 2014

[Holly]

And that is the most important aspect!

 

[Holly]

Thank you "Biscuit" for information on your progress, that is very positive for me.

 

[Holly]

Well I am 38 days away from my left TKR and feeling great, my training and build up for this surgery is going really well, I am eating very well, lots of protein and vegetables, no junk food and am feeling great, no sluggish feeling, just feeling really healthy. Worked hard on my weight training this week, especially on my arms, shoulders and core, and also leg, but protecting my injured knee. Enjoyed my yoga classes and flexibility is good except for the injured leg which I protect. I did hundreds of crunches, press ups, medicine ball throwing and core work, all overseen by a physical therapist that runs the class. I feel in great shape and very positive about this TKR, my mindset is to prepare well, go in positive with no negative thinking, if I have setbacks I will deal with them in a positive way. So glad I found this forum. Holly

 

[Holly]

Just wondering could anybody explain to me the medication I should be expected to receive from the Hospital and also when I return home after my TKR. I would like to know the names of the pain medication etc, so as when I have my pre meeting with the Hospital Physio and nurse I will have some knowledge of what medication is the norm and I can then ask questions if it is different. I will be recovering over Christmas so want to make sure the pain meds are correct and I have ample supply. Thanks Holly

 

[referee54]

Different OS's have different pain med protocols. I was on Oxycontin for some time. Most patients will have, in the early days of recovery, a strong type of narcotic pain med.

I would discuss this your OS or his PA---you want to make sure that you have enough---I ran out of Oxycontin, and, since it is so strong, the OS's office could not phone it in to the pharmacy---and he was out of town. That was indeed a miserable few days.

Do not worry about becoming addicted to the pain meds---take them as long as you need them---many folks try to cut them off too early and with not-so-nice results.

It is also very important to take the meds "on the clock"---at the prescribed times---before you begin to hurt. Too often, people wait until they are in pain to take the meds, and, by then, it is too late and they hurt. Take the meds according to the schedule and you will eliminate a great deal of the post-surgical pain.

 

[Holly]

Thanks Tim

 

[referee54]

While in the hospital, I had a pain management pump---and the nurses went out of their way to make sure that I wasn't in any pain.

I find it very interesting that the OS's each have their won protocol for pain and for other aspects---CPM's, staples vs. steri-strips, etc.

 

[Holly]

I don't think the hospital I am going to use a pain management pump, think I would prefer it, but I presume oral medication would be equal to the pump. Holly

 

[referee54]

The pump allowed me to, within a certain time period, press a button to release more pain meds. It would never allow me to OD on it, or to give myself too much, but it was great in the early days of recovery.

Then the nurses were exceptionally professional and timely about getting me the oral pain meds. It was not until I got home that I learned the importance of taking the pain meds on schedule. Now, there are smartphone apps that will remind you when to take the meds and what meds to take.

 

[Holly]

I had my pre-assessment last Thursday and everything went ok, I was very nervous going into the hospital for this, so I can imagine how nervous I will be on the 15th December for the TKR. The assessment nurse was very nice and all my test came up very good showing I was very fit and healthy. I also met with the Physio who gave me some exercises to do pre the operation and she also said that I should have a very good recovery as I was very fit. I hope the is the case for me, I am still doing my weight training and core exercises and feel really good, and my diet is excellent and feel in great shape, though my knee is really deteriorating and I have very little movement in it now, I am kind of glad as I now know that I am making the right decision. I am also trying to read more of the positive outcomes on this site and am trying to not read the negative ones, though I do hope that anybody that is having setbacks with their recovery will eventually end up with a positive outcome. I was also told that I will have the staples removed 10 days after surgery, this will be on Christmas Day, so was told to go to the surgery on Christmas eve (9 days) and if they were not ready to come out that they would leave them in for 13 days, I presume this will be ok and not a problem. I am sure I will get more and more anxious over the next couple of weeks, then I can start this journey and begin my recovery. Holly

 

[Holly]

Hi, can anybody please help me, I attended a local dentist yesterday and ask him to check my teeth and especially my gums as I have suffered with gum disease in the past and have some teeth removed due to this and also two implants. I had a problem with two teeth a couple of months ago and eventually had them out to make sure I had no problems with the teeth for the TKR surgery.

The dentist was quite aggressive with me yesterday especially when I told him I was due to have a TKR on the 15th December, he said I left it very late and that I had problems in my gums, disease was still there and that also the two implants needed to come out along with other teeth, and said that I should not have had implants with gum disease. After going on to give out to me about cleaning the gums and teeth etc, he said he would try and save the implants or if lost he would put new ones in a total contradiction to what he said first. When I questioned him on this he shot me down. I left the surgery shaking and in panic that my surgery would not go ahead on the 15th Dec. I was due to go back to him today, but could not face him.

I phoned the pre assessment nurse and she said she will check with the surgeon and anaesthetist and come back to me on Monday next. Due to the pain and constant attention on my knee I never gave any thought about my teeth or gums until the nurse asked me. Can anybody please help or give me some advice on what I should do now, or is it too late to have the surgery on 15th Dec. I am quite distraught as I have focussed so much on having the surgery and getting through recovery. Thanks Holly

 

[referee54]

I will tag @Josephine, @Jamie, and @Jaycey for you.

Many OS's are concerned about infections anywhere in the body. Some will postpone surgery even if you have the slightest indication or possibility of an infection. Several here on the forum have had their surgeries delayed because of this.

 

[Holly]

Thanks Tim, much appreciated. Holly

 

[referee54]

I honestly would complain to your dentist---let him have it---there is no good to come out of him treating you that way.

 

[Josephine]

There has been some research done on the question of dental treatment and joint replacements and the findings were that there was no connection between that and peri-prosthetic infection. This was also the findings of one Geerhard Maale who has also studied this along with the machine he helped design which identifies the DNA of bacteria. He found that though some PPI might be of the staphylococcus group, they had distinctly different DNA registers so were obviously not the same.

As a result, the dental and orthopaedic associations in both the US and the UK both put out statements affirming that prophylactic antibiotics are unnecessary. Dental antibiotics: Evidence insufficient to recommend prophylactic antibiotics for dental procedures. Of course, some surgeons are still out of touch with this or maybe even refuse to accept the edict but there's not much we can do about that!

 

[Holly]

Thanks Tim, but I have not really got it in me to complain, I think I am a bit too sensitive for somebody with that personality, I am sure he meant no harm, and I was also in shock with the thought of the surgery not going ahead. But will defiantly not go to him again.

Many thanks Josephine for taking the time to pass on this information, my surgeon is from the UK and is quite up to date with studies etc (I hope), so fingers crossed that he will go ahead. I might also email the pre assessment nurse with the information you have given me and tell her my concerns, I know she will pass it on to the surgeon. I am just getting more concerned as I felt last week that I could of done with using a crutch as it felt as if my knee was going to break, though it does feel a bit better today and that bit stronger. Thanks again to you both, I so appreciate this site and the time and effort you are giving to me. I hope that in the future my story may help someone else. A very anxious Holly

 

[referee54]

Holly---that is what we are here for---we will help you through this.

 

[Elizabeth U]

Hi Holly! I thought I'd jump into your discussion. I had a left TKR 8 days ago, so I know exactly how you are feeling. It is definitely a scary and stressful thing to go into, but (at least for me) reality has been much better than what I thought it would be.

First, it is great that you are exercising and preparing yourself for recovery. This will definitely be very helpful as you'll need the muscles from your other limbs to pick up the slack from the operated knee. It is also great that you're thinking ahead on what to anticipate. I did that, too, but was worried I wouldn't remember it all. No worries! You can log into BoneSmart each day and reread areas that are applicable to you. It has been a godsend send for me.

Once you get to the hospital all the questions about pain control will be handled for you--but I strongly recommend that you ask your nurse to tell you exactly what you are being given (dosage and frequency). I didn't do this, so I was a little lost. I had very little real pain, however. Uncomfortable when I had to move around, but not pain.

I went home with a prescription for Percocet (Oxycodone-APAP 5/325)--1 to 2 tablets every 4 hours as needed. I have taken 1 every 4 hours, around the clock. I set my bedside alarm clock during the night. I eat a few crackers or other light snack before I take them so I have never felt nauseated. I've started to stretch it out to 5 hours a few times.

Icing-- I use an ice machine or a gel pack every couple of hours. I keep it on for at least an hour.
Elevation-- most of the time my leg is propped up on 3-4 pillows.

I'm not very hungry, but I'm drinking a lot of water, which leads to many trips to the bathroom with my walker. Lots of exercise

The whole experience so far has not been a breeze, but it has been infinitely better than my imagination thought it would be.

 

[referee54]

I'm not very hungry, but I'm drinking a lot of water, which leads to many trips to the bathroom with my walker. Lots of exercise

i think the pain meds have a great deal to do with the lack of appetite. For me and many others, food had little or no taste.

 

[Holly]

Hi Elizabeth, thanks for your update, it is very positive, I am delighted that you are doing so well. I was very worried about the surgery and now my concern is if they postpone it due to gum disease with I have suffered from in the past and thought was under control. So I will find out on Monday if this will be a problem, my knee is now at the end of its life, not much left in it. Are you back driving or near to going back? Holly