Bilateral TKR Indigo_bunting’s BTKR recovery

[Indigo_Bunting]

I went into surgery at 1:45 today, woke up in recovery at 4:30 in no pain at all. Now in regular room. On a pain scale where with 2/3 level I can keep working without too much distraction, it got up to 6/7 by the time I was given oxycodone. The delay was because I hadn’t eaten and they won’t give pain meds on an empty stomach out of nausea concerns. So advice to anyone coming along later, if they ask in recovery whether you’re hungry say you’d like some crackers

 

[elainec73]

@Indigo_Bunting thanks for the tip! I cannot remember much about right after the first surgery, but do remember having to get up and walk, do the stairs, go the restroom stuff; it was a blur really, I was only there for 31 hours and was home! lol

 

[Jockette]

Welcome to recovery! Good advice about the crackers!

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[hawk2go]

Welcome to this side of surgery. Keep us posted on how it's going for you.

 

[Sara61]

Congratulations on your two new knees great tip regarding the crackers as pain medication is paramount after surgery. How long will they keep you in hospital for ?
Wishing you an excellent recovery xxx

 

[Indigo_Bunting]

Day one. It’s a roller coaster. Twice I’ve been at the point of tears from the pain, then felt a bit better. They’re switching my pain meds because my blood pressure drops when I try to sit up/stand up - not because my pain isn’t well managed :/. They’re talking about discharge on Friday or Saturday (after a Tuesday surgery). Lining up VNA visits for after discharge. I will have to inject myself in the stomach with a blood thinner.

Had my first PT and feel less scared of standing and walking now. Actually felt less pain after having the chance to move around. PT round 2 this afternoon. I like his approach - it’s Bonesmart-esque.

 

[Jockette]

My blood pressure was also lower than normal, even the day after surgery.

 

[Indigo_Bunting]

Day two. It’s going much better today. I woke up with zero pain! It has crept back a little but it’s way more controlled. Oxycodone does nothing for me but tank my blood pressure.

Had a dressing change. There is some serous drainage on the (way more angry) L side that looks scary but the nursing team is not concerned. They put a compression bandage on it and there will be no bending in PT today, only walking. My L calf was very swollen when the dressing came off but after just a few hours it went down.

Just did first PT walk and I’m back in bed and almost pain free! After yesterday this is huge. Standing is OK, sitting with my feet on the floor is OK. Getting up and down is hard. It should get easier when my legs are more willing to work. Very likely to go home tomorrow.

edit: no second round of PT today because they wanted the
drainage to slow down. Because I’ve missed two PT appts they’re talking Saturday release. I will really appreciate my own bed when I’m in it!

 

[hawk2go]

You are a champion, my friend!

 

[Booger]

Your doin great. Just hang in there. Prayers for ya and good vibes for the knee.

 

[Indigo_Bunting]

Thanks, @Booger. Your positive attitude is inspiring!

 

[Indigo_Bunting]

Day 3. Not going home today. They gave me a blood transfusion because my numbers kept dropping (slowly). This will reverse that and also help with the dizziness I feel when trying to walk more than a few steps. Drainage from L incision stopped overnight. Actually got to do PT today and now I’m sitting in a chair! My R knee is much less responsive but the pain goes away quickly. Once again I’m in a much better place than just 24 hours ago. Clean sheets coming my way!

 

[Jaycey]

@Indigo_Bunting You are doing well. It can take awhile for everything to stabilise post op. I'm glad they are letting you do this at your own pace.

for the clean sheets!

 

[Indigo_Bunting]

Day 4. I’m home!! My labs were good after transfusion and I smashed the PT milestones. (OK more like shuffled past them but you get the idea.) Feeling pretty good pain-wise - things like getting in the car will bump up pain but then it comes down quickly. Walking is very nearly painless but, full disclosure, I am bearing a lot of weight on my arms. I get to get up when I feel like it and wear my own clothes! Doing my own injections like the cool kids.

In the weeks before surgery I did a lot of practicing how to shift my weight around, into and out of chairs, using only arm strength and sliding my legs. This is proving helpful.

It’s a good day!

 

[Sara61]

@Indigo_Bunting Wow, wow, wow you are one to respect, I cannot imagine having two knees done at once, I see the sense in it, only one recovery, am in awe of you doing your own injection, I needed them on my first surgery for 28 consecutive days, fortunately my hubby was able to do them as I think I wouldn't have been able, try to do alternating sides, that way it's not so painful, Fortunately I had a bit of spare flesh in that area so that cushioned it, but don't be alarmed if you have bruising, at the end of my 28 days I looked like I had been in a round with Mike Tyson
Rest, Ice, medicate and elevate, look after those knees, soon they will be looking after you xxx

 

[Taoquest]

Yes! I also found that upper body strength is important, especially in bilateral TKRs where you don’t have a “good leg” to stand on. I administered those daily injections (Lovenox ) for a month before bed. Just pinch some flab and don’t move the needle around, and as @Sara61 said, alternate sides.
I had my ice machines on 24/7 the first two weeks (with a barrier) and elevation with the Lounge Doctor.
I found this site shortly before surgery, and the guidance/advice here was a godsend. There are also quite a few of us bilaterals here, so you’re in good company.

 

[Indigo_Bunting]

Thanks for the support and well wishes! @Sara61 the bruising is impressive, isn’t it? It’s pretty straightforward though. @Taoquest I love the ice machine but the lounge doctor is uncomfortable at the moment. Maybe tomorrow will be better.

New wrinkle: the pharmacy gave an estimate of Monday afternoon (50 hours after the order/after my last dose) before they will fill my pain med prescription. Pain management plan? CVS scoffs at my post-surgical pain management plan. Trying to get this turned around, obviously.

 

[Jockette]

I’m so sorry you’re having problems with your pharmacy. Keep in touch with your doctor about it.

 

[hawk2go]

Wishing you well on your road to recovery. It sounds like your pre-hab helped. Good luck figuring out the pain management. I, too, am in awe of your bilateral-ness.

 

[Indigo_Bunting]

Thanks @hawk2go ! I did bilateral mainly to be able to do things I enjoy that much sooner, but partly because taking significant time off from work twice wouldn’t be great and would probably force me to stretch out the timing.