TKR Joy's Recovery thread<

[Jockette]

Hi, Joy, Welcome back. Great news that your first knee was such a success.

Here’s a reminder of our Recovery Guidelines. I’ll also get someone to add your new surgery date.

Best wishes for this second recovery!

Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

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.

 

[DLR]

@Joy77 following your journey, my 2nd knee was supposed to be done Feb 5 but got cancelled that day due to lack of beds, now booked for April 9. My first was Aug 16, how is your recovered knee holding up? That is my concern whether it will start to swell again as it takes on major role.

 

[Joy77]

Hi Spex... yes.. that’s what I keep telling myself... “only 4 months from now...”. I keep focusing on the goal.

Overall, I was somewhat looking forward to getting my right knee replaced. I was excited about the goal but know how painful it would be and the work that was ahead of me. But... things happened, not as planned, and I was thrown a curve ball.

Surgery day went as planned. The same nervousness and concerns but knowing what to expect really helped everything. The first time I spent one night at the hospital, upon my request (they wanted me home the same day) but my surgeon scheduled me for one of the last surgeries for the day so she could justify keeping there. I appreciated what she did.

BUT, this time she really said there’s no reason to stay since I handle surgeries well. I agreed with her and let her know I was looking forward to going home. They would be sending a nurse to my home an hour or so after I got home to check my vitals and to be sure I was stable. My surgeon said they really want patients to avoid the germs that hospitals carry. A few differences, this time they gave me my nerve block in my leg in recovery which bought me an extra few hours of it working while I was home. Also this time I they added Morphine to my regime along with the 10 mg of Percocet. Last surgery I just had 10 mg of Percocet.

My first night was uneventful. I’m sure I was still enjoying the effects of the anesthesia, the spinal and the nerve block. The nurse arrived as scheduled (Monday). He checked to be sure I had no tripping hazards, checked my vitals, went over my medication regime, answered any questions I had, made sure my husband was all set, etc. It was a great visit. On my first full day home (Tuesday) I was visited by my Physical Therapist (the same one I had for the last TKR). It was good to see him and I knew he was very gentle and never pushed me. My physical therapy appointment went well. He took my vitals, assessed how I was feeling and didn’t push any type of movement. I showed him what I could do and he just let it be. The nice thing is, this time, I was at a 90 degree bend right away. Not sure why this time was different but I enjoyed the nice bend. All was going well.

Now we get to Wednesday. I’ve been taking my pain medication exactly as prescribed and I never waited until anything hurt. I think last time I tried to stretch the medication out. I’m not doing that this time. I’ve been taking everything exactly as I should and it’s really helped a lot more this time. Of course I have pain but it’s manageable.

Here’s where things change. It’s Wednesday and I’m waiting for my Physical Therapist to arrive. All of a sudden I felt nauseous and thought I was going to vomit. I got my walker and headed for the bathroom. I couldn’t throw up but I really wanted to. I was getting so sick. My husband was in the main family room and I was in my bathroom with my walker. I felt miserable. Then out of the blue I remember crashing into the shower door, face planting right onto the tile shower floor. I remember hearing my husband yelling, “did you fall!”. I recall moaning. He was there in a flash and I recall opening my eyes and blood was everywhere. He was having a heck of time getting me up as I was somewhat still passed out with a leg that doesn’t work. He pulled me up, I barely recall standing with him holding me and down I went again. This time he had a hold on me so I went down a little softer. I was so confused and didn’t know what was happening. He tried getting me up onto the toilet (closed lid) just to get me a little higher so he could get a better grip on me. I passed out a third time. I stayed on the floor for a bit. I opened my eyes and asked him just to let me crawl to the bed then he can get me on the bed. We then heard the Physical Therapist at the door and my husband screamed for him to come in. They got me on the bed and I took some of the anti-nausea medication. It worked pretty quickly and I felt better.

The Physcial Therapist had the surgical nurse on the phone and she said she was contacting the physican who was on call. I was told to immediately stop the Morphine. The nurse was asking what I hit, my head? I told her my face/nose hurt. I touched my face and I felt blood everywhere. My husband was trying to clean me up when I asked for a mirror. OMG, my face! Mainly my nose was a mess. Bloody and it appeared crooked. We determined I felt flat on my nose on the tile. I was holding my walker at the time and it was a bent up mess. But, I think it broke my fall. I spent the evening in bed, hurting all over but mostly my nose hurt. My surgical knee hurt but everything hurt so bad I didn’t know what hurt worse. The Physical Therapist took my blood pressure which was very low. He treated me with whatever the nurse told him to do. It’s all a blur to me. I went to an emergency appointment that night back to the hospital. My face is starting to swell, bruise and I’m a mess. My physician made a stat appointment for me to see a head, nose and neck specialist. I wasn’t sure if my nose was broken.

The next day I woke up to a black eye, swollen and bruised nose, swollen check, my left arm bruised etc. I get a call from the Specialist who said they can’t see me until the swelling goes down. So I have an appointment next week to see if I have a broken nose. My face is scabbed up where I scraped it on something. I look like a monster! The surgical nurse phoned me to share that a side effect of morphine is sudden drop in blood pressure and they think that’s what happened. So, No More Morphine for me! My knee seems fine other than regular surgical pain.

Tuesday I find out if I have a broken nose. I don’t think it is because I think it would be very painful. It does hurt but it’s not that painful. My face looks horrible though.

Well, I’m on day four today. I still have 90 degree bend and I can lay my leg flat. I take my 10 mg. Percocet every 4 hours. I can’t wait for this to end. Rough start!

I hope all of you are having a great day!

 

[Joy77]

Hi @Jockette! Thanks for the information. It’s a good reminder of what to follow and how to manage my recovery.

Hi @DLR .. My first knee is holding up very well. I feel much more stable. I have little to no pain in my first surgical knee. I continue to baby it a little but I’m also letting it do it’s job. I’m only on day four so we’ll see how it does over time.

I can imagine how disappointing that must feel to have a surgery cancelled. Our dates are very similar. I’m sure you’ll do well. Just remember to let your new knee (past surgical knee) do the work it’s supposed to. I think you’ll be very pleased.

I will follow your journey as well!

 

[sistersinhim]

What an absolutely terrible Wednesday you had. I pray your nose isn't broken and that everything heals quickly. I had no idea Morphine would do that. It good to know for any others that might be prescribed it during their early days. Thank God your husband was there to help you. How are you feeling now?

 

[DLR]

@Joy77 oh my goodness..what a time for you..and your poor husband. Hoping your nose is okay

 

[Joy77]

Hi @sistersinhim ... How do I feel.. hmm .. well the bridge of my nose hursts. It hurts to wear my glasses but I need them to see so I wear them. I have scabs on my upper lip, side of my nose, top of my nose and my left arm. I have a black eye and the bruise if moving down my face turning to a lovely blue/green color. But with all of that my knee / thigh hurts worse. I have my alarm set every 4 hours around the clock to take my 10 mg of Percocet. It really helps. When I sleep I sleep soundly so I’m grateful for that. I don’t hesitate to take a nap. My knee is swollen as expected. I keep it raised the best I can and iced.

As soon as the Morphine was out of my system I felt better. It was the 12 hrs extended release. But it’s gone now so I feel improved. What’s odd is.. I tend to run low in regards to my blood pressure... 110 - 112’s over 60 - 70 on any given day. Seems odd they would decide to give me Morphine with my Percocet in addition to Inderal (lowers blood pressure but I take it to reduce my migraines) all at the same time. It seems the combination was not good. I never took Morphine with my last knee and surprised I got it but was grateful if it reduced pain. I didn’t know it reduced blood pressure... now it all makes sense. I’m going to discuss this with my surgeon when I see her at my 2 week check up.

I think since I know more of what to expect in regards to my knee surgery it’s all more bareable. I believe in positive psychology (I’m a psychotherapist / hypnotherapist) so I focus on the goal. I know that in two weeks I will see improvement - no walker, just a cane). I know my face will heal - the bruises will be gone and my nose won’t hurt any more. I know in 6 weeks I’ll be driving and back at work. I know in 4 months when my son gets married I’ll have two new knees which will let me dance in celebration. Those are my goals! Those goals are based on my successes from my first knee so I know they are all realistic.

 

[Jockette]

What an awful and scary time! Just, wow!

 

[sistersinhim]

I can't take Morphine, either. I don't know if my BP drops or not, but Morphine makes me violently sick. Since yours started with nausea like it treats me, my blood pressure might have dropped, too. I was in bed each time the sickness came, so who knows?

I'm not surprised your leg is hurting. It's no telling how you moved it when you passed out those three times. Your implant is probably fine, but those poor soft tissues, who were already inflamed, just got angrier. Please ice and elevate as much as you can. That will help with the pain and swelling. Have you peeked at your incision?

Your positive attitude is a huge help in your recovery. Looking forward to just small improvements in a couple of weeks is a wonderful way to do it. Most of us expect way too much way too soon. Each baby step forward should be accompanied with a celebration!

 

[Joy77]

Day 5 - The mornings are the worse for me. Must be because of the semi-stillness through the night. I do get up every four hours to take my 10 mg of Percocet then slowly maneuver to the bathroom, then back to bed. Such a seemily simple process is like wading through quicksand with knives in my thighs. Lol (what a visual) This morning I had a fleeting thought of “oh screw it, I’ll just pee in my bed because the pain is to bad to make out of the bed”. Lol. But of course I didn’t. I know it’s good for me to get out of bed and get some movement in.

@sistersinhim thanks for mentioning icing in your post to me. As I lay here I realized I was elevated but my ice wasn’t on. So I immediately wrapped the cuff around my swollen knee and plugged it in.

I haven’t looked at my incision yet as it’s covered with a strip of bandage. My Physical Therapist told me he’ll take it off on Monday. But from what I can see around the bandage there’s minor bruising but nothing out of the ordinary.

Today is a new day, a day of further healing. I hope everyone has a good day.