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[TKR] Kath0427 Recovery Begins Today<

Discussion in 'Knee Replacement Recovery Area' started by Kathy0427, Aug 14, 2018.

  1. Kathy0427

    Kathy0427 junior member
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    Sorry it has taken until tonight to your response to me. Tomorrow is my big today - actually today and I feel quite frightened. Like you, not knowing FOR CERTAIN I will have less pain or more; I am also quite afraid of the narcotic pain relievers. My son in law has an addiction, so I am especially wary as I have seen what his addiction to opiates has done.
    My last hip replacement surgery had some odd twists - for example, being switched to general anesthesia without an explanation, plus a severely sore throat afterward!- but, in all, the old terrible pain faded and I would say I would do it again . In fact I am, haha!
    I will certainly keep you in mind and prayers tomorrow. Hopefully, I’ll be able to write you “ hey, I made it and so far so well. It’s not as bad as we feared.”
    I was sorry to hear about your previous experience down this road not going so well; but I hope you - like me- are due for a really good outcome this time!
    Best of luck, DLR. and I will let you know how things went tomorrow.
     
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  2. Kathy0427

    Kathy0427 junior member
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    @chrism, was wondering how your surgery went today? Hope well! Mine is tomorrow; can’t sleep just thinking about it .
    Drop us all a line and let us know how you are doing .Kath0427
     
  3. skigirl

    skigirl SUPER MODERATOR Moderator

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    Kathy, we noticed that you did not have a recovery thread of your own and so, I started one for you. I hope that your surgery is over and that you are feeling better with that behind you. Recovery is ahead of you. I will leave our Recovery Articles for you to read. There are a lot of them, but all of them are short and easy to read---the information will be useful to you especially in the first few weeks of recovery.


    Knee Recovery: The Guidelines. Don’t worry:

    1. 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
    5. Here is a week-by-week guide for Activity progression for TKRs


    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 a 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 history before providing advice.

     
  4. DLR

    DLR senior

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    Hi @Kathy0427 , thinking of you hope all went well today and you are resting comfortably. I am getting a bit nervous as tomorrow approaches. Looking forward to hearing how you’re doing
     
  5. Kathy0427

    Kathy0427 junior member
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    First wanted to thank everyone who answered my pre-op questions and responded to me in general.

    My biggest impression thus far - after having undergone a LTHR in 2017 - is what a difference in your mood and attitude that having a good surgeon and staff makes!!

    My last experience at a different hospital with different doctor and staff was very upsetting. The surgeon ended up yelling at me about the anti-coagulation regimen my hematologist had wanted them to follow. Said “ it will kill you” and then proceeded to question whether I should even go on with the surgery. I did and he did a good job with my hip; but I did NOT want to go back there again.

    Now switch to today: This time, everything went smoothly, and in an “upbeat” manner. Doctor, staff, PT all seem to lay out a well thought out plan to help me recover. It just inspires so much more confidence in their actions and decisions when your surgical staff act as a team and answer all your questions in a patient and understanding manner.

    The pain control medicine appears to be quite adequate and the demands of PT not too overwhelming. The pace of the post operative activity felt very inspiring. I can only hope it portends that my new knee will help to give me a new and more active life.

    Important, also, are the presence of a loved one or two to just help you in the process, someone to remember all the details like the initial setting on the passive action machine I will be going home with to gently encourage ROM.

    I am so happy this day has finally come and gone and I got through it with minimal pain, and an intact vision of a better tomorrow.

    I have read many, many threads on this site and realize many surgeries have unplanned issues, mistakes, over or under medication, tough as nails PT requirements, etc., all coming together to dim this dream of ours for a better, pain free life. I am here today to say that (at least on the first day post surgery) that our SPIRITS play a big part in our recovery. And when the doctors, staff, hospital protocol and cleanliness all inspire confidence in your ability to have a steady and progressive recovery, I really believe it makes our journeys have better outcomes and helps restore our faith in better lives for us all.

    So far, I have nothing but good things to report. Took the traditional walk post surgery and maneuvered quite well.

    Hope all the August group have wonderful outcomes and have faith in that better tomorrow.
     
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  6. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi Kathy, Welcome to recovery! It sounds like you are doing great!

    Best wishes for smooth sailing!
     
  7. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

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    @Kathy0427, I also want to extend a welcome. I, too, am a firm believer that ones attitude, spirit, outlook, call it what you want has a definite impact on our recovery potential. Even when things are not looking all that bright and rosey, keeping as much a positive attitude goes a long way.

    Good luck and keep us posted.
     
  8. gaiaGG

    gaiaGG new member

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    I hope you don't encounter more crappy "bedside manner" episodes like the one you discovered. I personally don't care much about things like that but it certainly doesn't help when your doctor is yelling at you. In the end, the results is all that matters but if a good surgeon is not being very nice that may push people to look for a "nicer" but less skilled one that inspires more confidence in them. And as you said, good spirits play a large role in any recovery, not just surgical one :).
     
  9. DLR

    DLR senior

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    @Kathy0427 glad to hear it went well, I’m just one day behind you. I love my surgeon, he has done both my thr and the revision 11 years later, I was willing to wait for him because I trust him and he is so nice and kind and has a great reputation at our hospital. Hope today continues well for you
     
  10. Minnie's knees

    Minnie's knees post-grad

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    Kathy, Best wishes on your recovery!
     
  11. Kathy0427

    Kathy0427 junior member
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    Well, some of that positive vibe I had from hospital staff and surgeon has diminished a bit. Unfortunately, I hit the double whammy of over-eager PT staff and my own stubbornness about taking narcotic pain relief.

    On the day after my surgery PT had me make two visits; each visit doing 30 reps each of a variety of stretching and muscle strengthening exercises. I cried my way through several of them, taking instruction from a student PT who kept repeating I had to do ALL of them each time. At the end of my second visit I was crying hard, running a temperature, BP was 160/85. All for WHAT?

    I was so angry with myself. Why hadn’t I put my foot down and said, “NO!”.

    This pain has been excruciating. Ten times worse than what I had with my hip replacement. I gave in and took the oxycodone as I simply could not bear the pain.

    (Someone close to me had an opiate addiction problem and I realize my fear of opioids is out of the ordinary.) Since I was a “ failure” at PT, I had all kinds of fears about “why am I in such pain and s/he/ (in the therapy room with me) seems fine”??? So not a pleasant day and a half in the hospital.

    However, in fairness, I still like my doctor and the nurses very much. I was discharged to home yesterday; worried about how my first PT visit at home would go.

    Last night, I could not sleep, even with meds the pain was BAD. Finally got two hours near dawn. I was terrified of what my therapist would have me do. It turned out he was very kind and patient. He seemed to understand my pain and fears. He did very gentle CPM movements and tried to calm me.

    My meds also seemed to finally work as expected and I got a break (just in time for his visit) in terms of the unrelenting pain. The rest of the day has been under control, but I used it to read several very long threads- Jockette, xxxx1980s, a lot of people who have been dealt a lot of issues they never dreamed they would encounter - and I realized how insensitive I must have sounded Wednesday prattling on about the value of a positive attitude amongst the people who are performing this surgery and helping us through it.

    If I sounded insensitive, I did not mean to be. It’s just my previous experience with my hip surgery had been so upsetting, I was just happy to not feel so nervous going into this.

    But - the bottom line is this. Knee replacement is PAINFUL and frightening. It is no minor or simple surgery, much more complicated than the hip. All of us deserve credit for braving into this unknown and trying our best for a good outcome. All of your stories inspire me and give me hope that whatever the direction my recovery goes, I have plenty of you out there with whom to commiserate, cheer on, or provide help should I need it. I am so grateful for all of you and your HONESTY!


    Sent from my iPad using BoneSmart Forum
     
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  12. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    :console2::console2::console2:

    It does get better!
    First off, don’t feel you have to do anything in PT that you don’t feel you are up to. You call the shots. I went into this thinking my surgeon and PTs were authority figures and I had to do what they said. Thanks to Bonesmart, I learned that is not true at all. I learned it is my knee and I call the shots.

    Physical Therapy can be helpful, but is NOT necessary for you to recover from a knee replacement. Not all surgeons prescribe PT. It all depends on their opinion about it. And there are many opinions. Which means there is not just one way to recover. Which then means that you get to choose how you will rehabilitate your knee.

    Many people have not gone to PT but have used the movements within the normal course of their activities to rehabilitate their knee. It’s done as they are able, as they heal.

    I can relate to crying through a PT session. I hadn’t found Bonesmart at that point.

    Thankfully I never had group PT. In the hospital and at out patient PT it was always one on one.

    You and I are adults. We can make decisions. Don’t let the PT dictate what you will do. They are an option, not the requirement we thought they were.

    Also keep in mind, it’s not exercising that gets our range of motion back, it’s Time:

    Time to recover.
    Time for pain and swelling to settle,
    and Time to heal.

    Our range of motion is right there all
    along just waiting for that to happen so it can show itself.

    You are barely out of a very major surgery. Give your body a chance to heal and adjust. :console2:
     
  13. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    I am so sorry you went through this, and it was all so unnecessary. This therapist was obviously very untrained in a tkr rehab. What she/he had you do was causing your knee more harm than good. Don't ever let anyone make you do that again. It is your knee, not theirs and you are responsible for your knee. Protect that newborn infant!

    Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard as my knee allowed me to do. As I healed, I did more. But, my knee was always in control! This was enough therapy for me and would be for any tkr patient. All the awful pain of PT is so unnecessary.

    All you have to do is use it in your daily living! Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new! You have to be patient, though, it doesn't happen quickly! ADL,(activities of daily living), going to the bathroom, brushing your teeth and bathing, fixing a light meal, getting something to drink and or a snack, those kinds of things will be all the exercise your knee needs. If you just use it daily in your living, you can have a less painful recovery. We know what works, we've been there!
     
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  14. DLR

    DLR senior

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    @Kathy0427 this journey is not for the faint of heart. Don’t beat yourself up.you didn’t fail PT. It is your body, your journey. The one thing I have found as I read through people’s stories here is that there is not one path. The rollercoaster takes each of us on its own ups and downs.i am so glad your home physio was gentle. Keep the positive attitude because it will be worth it in the end. Thinking of you today
     
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  15. Laurenkate

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    Heavens to Betsy. You didn't sound insensitive. I bet 95% of people feel like you do right after surgery; the meds are kicking in, you're relieved it's over, you can stand up without that awful pain, etc. The reality usually kicks in a couple of days later especially for those of us who don't think we want the pain medication. As DLR said, this recovery isn't for the faint of heart and it's a long one. Just take each day as it comes, stand your ground on pt and don't let the pain get ahead of you.
     
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  16. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    That's outrageous!
    Yes, why didn't you? You must have read this article as some time whilst browsing those long threads! Saying no to therapy - am I allowed to?
    I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
  17. KitKat64

    KitKat64 member

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    Hi Kathy, I am also a Kathy, lol!! I had a similar experience when I had my RTKR. My OS is an excellent surgeon, with a great reputation. But, his bedside manner leaves a lot to be desired!! He can be rude and arrogant at times, not just towards me, but other people I know who had him do their surgeries. For my LTKR, I had a different OS, and what a difference!! He is compassionate, patient and very funny. I'm glad you had a better experience this time. I think some doctors need refresher courses on how to interact with patients, lol!!
     
  18. DLR

    DLR senior

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    @Kathy0427 how are you today? Keep posting I have been thinking about you.
     
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  19. Kathy0427

    Kathy0427 junior member
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    Hello, all! Last two days have gone better; nights - not so much.

    Home PT has been MUCH better than the hospital PT. Both the “intake” therapist, -who assessed me Saturday - and today’s home therapist - who I will see until graduated to out patient therapy - have been gentler and more reassuring. However, because the doctor, hospital staff, physical therapist are all members of the same “health network”, each defends the other’s practices and techniques. So, you don’t generally get anywhere complaining about over aggressive “in patient” hospital PT because they are all in one big happy family and defend each other. But I do think I got my point across about my aggressive day after surgery PT to both therapists that followed.

    When I tearfully explained my pain; my therapist today - who was fairly benign to that point - said, “ don’t you think some of your emotionality might be due to the oxycodone you are taking, 10 mg is a fairly large dose...” I knew where that was headed. And, no, I am not yet ready to taper. At that point I just thought “Kathy, she doesn’t know you. Just make the most of your time with her.” I did , relaxed, and achieved 100 degree flexion. and I am convinced I could not have done that without some strong pain reliever in my system at this point in my recovery.

    You know, it has to be one way or the other - you either accept I won’t make your expected targets if I am not to use heavy duty pain meds or you don’t set those targets so high, so quickly if I am not to use them. One or the other.

    I can’t remember if I stated yesterday that I had fallen in my bathroom. Hubby helped me up. Scared me a bit, but had no really bad effects on me. It definitely made me feel very tentative on my legs yesterday but I did manage to get on my feet today a bit and I am proud I accomplished what I did.

    Today’s therapist went on to assure me I had the best surgeon in Pittsburgh for my surgery and he had “ the best staff”, I imagine that includes her, but admitted they were “aggressive.” But went on to assure me they had the “ best results” though she did not firmly quantify how she reached that assessment.

    Anyway - my biggest issue right now are my terrible nights - constant heavy duty pain that does not want to respond even to narcotic pain relief. Each night I get no more than three hours of sleep and grab one or two more during the day. I find the CPM machine soothing so I am thinking about going to sleep with that motion tonight at a low setting. I think most of my excruciating pain comes from stiffness during the night.

    Also, finally had that elusive BM today; that is a major relief, but came after swallowing two senna capsules and four Stool softeners

    Lastly, @DLR , how are you doing?

    And @Josephine, ask away... I will try to answer all.

    Thanks to all for your support! This first week is ROUGH! Don’t underestimate the pain you will feel but don’t let it scare you off either. But hopefully, like childbirth, the pain will fade and only the birth of new mobility will be remembered!

    Kathy
     
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  20. Minnie's knees

    Minnie's knees post-grad

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    Hi, another Kathy here. I hope your sleep improves soon. I am having my 2nd knee done on Wednesday. I have been reading your thread to remind myself what to expect as it has been almost 4 yrs since my 1st one. Thanks for sharing your recovery journey.
     

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