Bilateral TKR jbrooklyn recovery: short-term loss for long-term gain.

[Celle]

If the pain meds upset your tummy so that you feel sick, do make sure that some anti-sickness medication is prescribed.

By the way, you shouldn't take pain meds so you can do your PT - because the PT should not hurt. If you mask that pain with medication, you are masking a warning sign that the PT is too much for your knee.
You should take the pain meds so that you are not in pain. That's the reason for them - not so that you can do PT.

 

[MsBlue]

Over summer vacation 2 years ago, I met a PT who'd recently had one knee replaced. She told me that she was shocked at how much harder it was than she expected. I think she was about 4 weeks out at the time. She told me - rather ruefully - "I was always the one pushing patients, and now there's someone pushing me." It was clear that she didn't like be on the receiving end one bit. So, you're going to have to tell Mr. Cheerful - and that obstructive PA, if you get the chance - that, if they haven't been through it, they don't know what it's about. It's YOUR recovery, and they are supposed to there to help YOU through it. You certainly aren't there for their benefit.

I'm a bit surprised about the 5 days in the hospital. My doctor seems to think it will be 2, and I am expecting 3. I'm hoping, for a variety of reasons, that it doesn't go to 5 in my case. I do plan to go to rehab. I have been firm about that since I talked to other BTKR patients. It was clear to me that I will need that.

 

[Rob 68]

If the pain meds upset your tummy so that you feel sick, do make sure that some anti-sickness medication is prescribed.

By the way, you shouldn't take pain mes so you can do your PT - because the PT should not hurt. If you mask that pain with medication, you are masking a warning sign that the PT is too much for your knee.
You should take the pain meds so that you are not in pain. That's the reason for them - not so that you can do PT.

Good reminder about the anti-nausia, but I have a question about the meds before PT. Thought I had read here or elsewhere that one should take pain meds about 30 minutes before PT to stay ahead of possibly increased pain levels afterward. Is that erroneous? If so, how should we try to schedule PT sessions around our meds - in the middle, or something else? Hope this isn't a dumb question.

 

[Slainte]

Good question @Rob 68. I wondered the same thing.

 

[Braunzie]

I'm a bit surprised about the 5 days in the hospital. My doctor seems to think it will be 2, and I am expecting 3. I'm hoping, for a variety of reasons, that it doesn't go to 5 in my case. I do plan to go to rehab. I have been firm about that since I talked to other BTKR patients. It was clear to me that I will need that.

... I'm scheduled for outpatient.. This will be interesting..

 

[MsBlue]

@Braunzie - but not for both knees, right? There is a doctor here in Chicago who does single knees as outpatient, so, it's definitely possible.

 

[snowleopard]

So sorry, Brooklyn, to hear of your pain mismanagement. I was impressed overall at how well the team kept me in the loop. I was even educated about and consulted as to whether I wanted the nerve block before the surgery, and then again about whether I wanted it out on a given day. Talked it over and decided to take it out the day before I went home so I would have time to see if the oral pain meds were doing it for me, and warned that once it was out, it wasn't going back. I had the pump, and was encouraged to use it more than I did, but overall my pain stayed between 0-3 for the entire hospitalization. Infuriating to hear that you were so miserable when I know how well it can be managed.

Absolutely let them know about it. It won't help you, but you might be helping scores more who come behind you.

Rob68, best of luck to you in your surgery.

Braunzie, it will be very interesting to hear of how you do as an outpatient. Personally, I was happy to stay there from Friday (surgery mid-afternoon) to Monday (mid-day discharge).

 

[LHop]

I've tried a few meds to move the digestion system along, but haven't had luck yet. I'll be moving on to laxatives next. The joys of pain meds.

 

[iivesfam5]

@jbrooklyn and @LHop did either of you have the nerve block?

 

[Rob 68]

I've tried a few meds to move the digestion system along, but haven't had luck yet. I'll be moving on to laxatives next. The joys of pain meds.

Hey, LHop, we've been looking for you. How did it go? Have to admit I'm getting very jittery the closer we get to the big dig. Even thought briefly today about cancelling. Wife talked me out of it. Anyway, when you feel up to it, give us an update and any tips you might have. Congrats.

 

[iivesfam5]

@Rob 68 Lhop started her own recovery thread....... I know how you feel my knees are knocking with nerves!!!

 

[snowleopard]

I was giving serious consideration to getting off the table and walking out of the hospital in my gown. Then I remembered that I really couldn't walk. First thing that went through my mind when I woke up was enormous relief knowing I didn't have to face the decision anymore. Chiming in here on your question. I had the nerve block. I thought it was great. Only thing that bothered me about it was the person doing the block had to get WAY up close and personal, and he was so pretty you couldn't look straight at him without giggling stupidly. Then the nurse who lowered the end of the bed where my table where my legs were elevated did it with no warning and went from about 40 degrees to zero with a bang! I think it actually broke off some bone spur, because I could finally straighten my leg. I don't recommend it. I think the loud yell that ensued will encourage them to manage that a little differently in the future.

 

[Rob 68]

@Rob 68 Lhop started her own recovery thread....... I know how you feel my knees are knocking with nerves!!!

Just visited her thread on the Pre-Op side. Very detailed, so she has had time to get her wits back. Mine have been fried for a while. Funny thing, my knee hasn't been very painful since I last played tennis (last October), but it has been getting worse the last few days when I shop or walk our puppy. I know it's time, but damn, it's taking forever to get there.

 

[Braunzie]

@MsBlue - You're right.. I'm not having a bilateral.. missed that.. Sorry! If I were having two done at the same time, I wouldn't even THINK about coming home the same day. Wishing you the best!!

 

[Celle]

Good reminder about the anti-nausia, but I have a question about the meds before PT. Thought I had read here or elsewhere that one should take pain meds about 30 minutes before PT to stay ahead of possibly increased pain levels afterward. Is that erroneous? If so, how should we try to schedule PT sessions around our meds - in the middle, or something else? Hope this isn't a dumb question.

No, it's not a dumb question at all. You didn't read here on BoneSmart that you should take the meds so soon before PT. You should never take pain meds to mask the pain of PT.
Remember that PT must not hurt, either during your session, or after it. If it does, the therapy is too intensive.

Try to get on a regular schedule where you take your pain meds about an hour to an hour and a half before your PT session, so that you are covered during the session and you are not desperate for pain relief soon after the session ends - but don't take the pain meds so you can do PT.

The correct motto for recovery from a TKR is not " no pain, no gain", but "No pain, More gain."

 

[jbrooklyn]

Hello-
Hoping everyone had a good 4th of July. It was good for me because I caught up some on sleep I'd missed previous 4 days. Useful tip: Bring a sleep mask and earplugs to the hosp with you.

I'm on dilaudid, toradol, and tylenol--an effective combo. Highly recommending the toradol, an anti-inflammatory that seems to have great "normalizing" powers. Now that I'm on this, swelling isn't crazy, and I can do the knee press (extension, pressing back of knee into bed) more easily.

Still haven't walked out of the room, just a few steps around . . . but probably today.

Cannot wait to take a shower, and cannot wait to use the lav without calling someone to help.

Cheers and have a good day, all--

 

[iivesfam5]

@jbrooklyn how are you doing today? When are they letting you go home? Or are you going to rehab? I hope every day is better than the previous for you!!! Best of luck and happy you are on the other side!!

 

[jbrooklyn]

Hi, @iivesfam5. I walked down the hospital hall for first time today, felt fine. Tomorrow I will leave hosp for home (if I can tackle stairs in PT tomorrow) or a rehab (if it's too soon for stairs). I feel strength and energy returning for sure--which is great. My legs are swollen out to here, which is a drag, but not unusual and not unexpected.

This is my 4th day in the hospital, and while most people here are so nice, there are some for whom it's a job, and it feels like a ding to one's dignity to have to have them help you off the throne, etc.

I miss my kid and doggy. All told, quite eager to be home.

@Rob 68 and @iivesfam5: Hoping you are in a state of optimistic resolve. I felt like my part of the bargain was to be organized, calm, brave, and optimistic. An image that helped me going into the surgery was diving under a big wave and popping up safe on the other side. It's not really the operation that is most daunting--the docs have this surgery figured out. It's the long, slow recovery. But it's temporary, and then things will be way better than before. Short-term loss, long-term gain. I'm virtually certain we will all be delighted in 6 months.

 

[jbrooklyn]

@iivesfam5: yes, nerve block, epidural, and something to knock me out but not enough to have a breathing tube. It was good/effective. I felt nothing and remembered nothing. Thumbs up.

 

[kneeper]

Sounds like things have drastically improved since your friends advocated for you. I know what you mean about Mr. Cheery. Sometimes people are a bit too much.