Bilateral TKR LauraLeigh's NEW knees!
- Thread starter LauraLeigh
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msmechanic58
post-grad
I got no elevation or ice at the hospital. Catching up now. 
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LauraLeigh
member
Well , I had a bit of a setback today. I was doing pretty well with the pain under control...and then the physical therapist arrived. I don't like him at ALL!!! He told me that the two other patients my OS operated on Tuesday were both up and walking 200 feet by themselves. Of course I asked if they also had BTKR and they didn't - so I don't really see how that story was supposed to motivate me. Then when he had me doing short arc quads and I told him where it was hurting, he said "well, that's just metal - there's nothing there to be in pain". Well, dude, I don't know what to tell you other than it hurts!
He also said I should have a coach up here 2-3 times a day to help me with my exercises in between PT sessions. He suggested a friend, neighbor, someone from church, a troop of Boy Scouts...that's not going to happen either. My friends are my coworkers who are at work right now, I barely know my neighbors, I don't go to church, and Boy Scouts? Seriously??? I wouldn't want to put my husband of 25 years through watching me do this, much less teenage boys I don't even know!
He finally left and after a while
I did my exercises by myself. Later the occupational therapist came in and helped me change from the hospital gown into a t-shirt and skort. Then she offered to help me stand - I decided I'd be better off with her than the mean PT guy so I figured I'd try. We managed to get me on my feet and I stood for about 10 minutes, just shifting side to side - I couldn't lift my feet off the floor. She sat me down on the side of the bed and asked if I wanted to stay there for a little while to wait for the PT guy who was supposedly just next door. I foolishly agreed, then waiting in agony for more than 30 minutes for someone to help me get back into bed. I hit the call button after about 15 minutes but no one showed up. I couldn't call them on the phone because without my glasses on, I can't see the board across the room with the contact numbers. So I just sat there, sobbing uncontrollably for a really long time. And let me tell you: I'm pretty tough and rarely cry from pain but this was a whole other level that I really don't ever want to get to again!
Tonight they're taking out the catheter (so now I'm regretting changing out of my hospital gown) and they're bringing me a bedside commode, which I'm not sure I'm going to be able to use. Just the thought of bending my knees to that degree again brings tears to my eyes. But I've had my Percocet and will get another dose of Toradol before they do anything so hopefully it will go okay.
As for going home, that's not happening just yet. Since I can't walk on my own, I'm going to have to go to rehab for a while. Oh well...I guess it was a long shot that I'd be mobile enough to go home 3 days after a BTKR. Such is life...
He also said I should have a coach up here 2-3 times a day to help me with my exercises in between PT sessions. He suggested a friend, neighbor, someone from church, a troop of Boy Scouts...that's not going to happen either. My friends are my coworkers who are at work right now, I barely know my neighbors, I don't go to church, and Boy Scouts? Seriously??? I wouldn't want to put my husband of 25 years through watching me do this, much less teenage boys I don't even know!
He finally left and after a while
I did my exercises by myself. Later the occupational therapist came in and helped me change from the hospital gown into a t-shirt and skort. Then she offered to help me stand - I decided I'd be better off with her than the mean PT guy so I figured I'd try. We managed to get me on my feet and I stood for about 10 minutes, just shifting side to side - I couldn't lift my feet off the floor. She sat me down on the side of the bed and asked if I wanted to stay there for a little while to wait for the PT guy who was supposedly just next door. I foolishly agreed, then waiting in agony for more than 30 minutes for someone to help me get back into bed. I hit the call button after about 15 minutes but no one showed up. I couldn't call them on the phone because without my glasses on, I can't see the board across the room with the contact numbers. So I just sat there, sobbing uncontrollably for a really long time. And let me tell you: I'm pretty tough and rarely cry from pain but this was a whole other level that I really don't ever want to get to again!
Tonight they're taking out the catheter (so now I'm regretting changing out of my hospital gown) and they're bringing me a bedside commode, which I'm not sure I'm going to be able to use. Just the thought of bending my knees to that degree again brings tears to my eyes. But I've had my Percocet and will get another dose of Toradol before they do anything so hopefully it will go okay.
As for going home, that's not happening just yet. Since I can't walk on my own, I'm going to have to go to rehab for a while. Oh well...I guess it was a long shot that I'd be mobile enough to go home 3 days after a BTKR. Such is life...
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LauraLeigh
member
So the bedside commode thing was not fun, but I managed it. The first time it took 4 nurses to help me and I have to admit I cried again when they left me there for about 10-15 minutes. The second time I only needed 3 nurses and I didn't cry so I guess it is getting better every time. Of course now I'm reluctant to drink anything because I don't want to have to use the darn thing again! Sigh.
EmptyHands
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Dear @LauraLeigh - I am so sorry to read about your bad experience with the PT today. What an unsympathetic and out of touch #@*^&$! Whenever I work with a new PT, I tell him/her that I don't believe in "no pain, no gain." After they stop giving me the "uh-oh" stare, I explain that I will work to the point of discomfort if necessary, but not to the point of pain. I am very fortunate that almost all of my PT activities have been do-able without pain and that my ROM is improving, so I have been able to demonstrate to them that I am more than willing to participate in PT and my recovery and that I am not being uncooperative. The things that hurt the most happened during my very first PT session during my second day in the hospital: 1) the first time the PT helped me off the bed and stand upright and 2) the 1/2 hour the PT made me sit on a chair after my initial (relatively easy) walk down the corridor. I think he went off to work with another patient and possibly forgot about me. (He never came back.) Thank goodness a nurse's aide came by and helped me back into bed.
BTW: From the very beginning, every nursing staff member who took care of me on my floor gently put their hands under each ankle and supported my legs as they moved them carefully across the bed and down to the floor. They all did the process in reverse to help me back onto the bed. They placed my walker where I could easily reach and hold on to it for support and walked with me -- early on holding the back of my gown -- to make sure I didn't stumble and fall. Hubby watched this maneuver and he did exactly the same hands-under-the-ankles move when he helped me transfer from floor to bed and bed to floor when we returned from the hospital. I got lulled into a false sense of security and discovered that not all hospital staff were trained to do this. The fellow who pushed my wheelchair to hubby's car at discharge dropped my legs as we were making the transfer - ouch! I've taken to providing unknown people with specific instructions about the best way I know for them to help me. Everyone is well-meaning, but their aid is sometimes counter-productive. I try not to sound too bossy or control-freakish, but they are MY knees. I also gratefully express lots of thanks because I sure couldn't / can't do this on my own.
I hope your meds work to help get your pain (back) under control. If not, please speak up. Also, I suggest that you let the nurse in charge know that you needed help getting back into bed after 30+ painful minutes but no one responded for 15 minutes to your call button. Ask for his/her help in dealing with the source of your physical and emotional pain as well as the response time issue. He/she may recommend that you speak to your OS as well.
I'm sure you've read that others here have broken down and cried in pain and frustration - and I'm sure from the fear of being so uncharacteristically helpless in a strange place and in a familiar body which is acting and re-acting in unfamiliar ways. I can't believe that you sat there crying -- long and loudly I assume -- and no one came by to check on you. One evening when two nurse's aides were in my room doing some procedure, a man down the hall started yelling and swearing about how no one was helping him and he wanted out of there. The two aides immediately rushed out of my room as did most of the rest of the staff from the commotion I could hear outside. Two security guards arrived at one point to oversee the situation and provide support. After things settled down and they were leaving, I heard them talking to someone as they passed by my door. One said that the man wanted to call the police to arrest the security guards. Anyway, all ended peacefully as far as I could tell, but I was glad that the staff responded immediately to someone in distress.
I don't want to alarm you but getting on and off the toilet was the most difficult part of my hospital stay and return home. Ask the nurses or the OT for help in trying to find the best, least painful, and safest way to this. At discharge, my OT helped me order a toilet safety rail for our home bathroom. When the technician arrived, what he presented us with was a bunch of rods and fasteners. I looked at the plastic wrapping and said, "There are no instructions or diagrams included here." He said, "It's easy to assemble." I essentially asked him how. He actually wasn't supposed to do the installation by company policy, but he said he would help put it together. He was running late and wanted to get out of there as quickly as possibly. He had no tools with him, so hubby went to retrieve some. He spent some time trying to put the railing together, huffing and puffing, and waving the tools in the air in frustration. When it was finally completed, it didn't fit in the area around the toilet, and he said we could "refuse delivery." At that point I was really scared and wondered how I would be able to use that most essential bathroom feature. All that I would be able to do would be to fall down on the seat from a standing position. Or maybe get a commode or riser at this late stage in the game??? Fortunately, a home health coordinator arrived to save the day. She looked at our bathroom setup and showed me how to push my walker over the toilet so that the handles and the front of the walker formed a little protective cage around the toilet -- pretty much what the safety rail was supposed to do, I think. By using the walker's hand rails plus the sturdy sink counter top right next to the toilet, I was able to lower myself onto and push off the toilet seat safely. It was painful for sure, but less so each week. I am still using the walker for this purpose and pushing off from the counter top, but it is no longer a painful experience. On a future red letter day, I'll be able to get on and off the toilet hands-free. Remember: this too shall pass.
I hope that you can get some sleep tonight and that tomorrow will be a better day for you. If you're not ready to go home yet and need to spend time in rehab, then that's part of your recovery journey. You do need a strong support system for your recovery whatever your location, so that may be your best option. Stay strong. We're here for you.
BTW: From the very beginning, every nursing staff member who took care of me on my floor gently put their hands under each ankle and supported my legs as they moved them carefully across the bed and down to the floor. They all did the process in reverse to help me back onto the bed. They placed my walker where I could easily reach and hold on to it for support and walked with me -- early on holding the back of my gown -- to make sure I didn't stumble and fall. Hubby watched this maneuver and he did exactly the same hands-under-the-ankles move when he helped me transfer from floor to bed and bed to floor when we returned from the hospital. I got lulled into a false sense of security and discovered that not all hospital staff were trained to do this. The fellow who pushed my wheelchair to hubby's car at discharge dropped my legs as we were making the transfer - ouch! I've taken to providing unknown people with specific instructions about the best way I know for them to help me. Everyone is well-meaning, but their aid is sometimes counter-productive. I try not to sound too bossy or control-freakish, but they are MY knees. I also gratefully express lots of thanks because I sure couldn't / can't do this on my own.
I hope your meds work to help get your pain (back) under control. If not, please speak up. Also, I suggest that you let the nurse in charge know that you needed help getting back into bed after 30+ painful minutes but no one responded for 15 minutes to your call button. Ask for his/her help in dealing with the source of your physical and emotional pain as well as the response time issue. He/she may recommend that you speak to your OS as well.
I'm sure you've read that others here have broken down and cried in pain and frustration - and I'm sure from the fear of being so uncharacteristically helpless in a strange place and in a familiar body which is acting and re-acting in unfamiliar ways. I can't believe that you sat there crying -- long and loudly I assume -- and no one came by to check on you. One evening when two nurse's aides were in my room doing some procedure, a man down the hall started yelling and swearing about how no one was helping him and he wanted out of there. The two aides immediately rushed out of my room as did most of the rest of the staff from the commotion I could hear outside. Two security guards arrived at one point to oversee the situation and provide support. After things settled down and they were leaving, I heard them talking to someone as they passed by my door. One said that the man wanted to call the police to arrest the security guards. Anyway, all ended peacefully as far as I could tell, but I was glad that the staff responded immediately to someone in distress.
I don't want to alarm you but getting on and off the toilet was the most difficult part of my hospital stay and return home. Ask the nurses or the OT for help in trying to find the best, least painful, and safest way to this. At discharge, my OT helped me order a toilet safety rail for our home bathroom. When the technician arrived, what he presented us with was a bunch of rods and fasteners. I looked at the plastic wrapping and said, "There are no instructions or diagrams included here." He said, "It's easy to assemble." I essentially asked him how. He actually wasn't supposed to do the installation by company policy, but he said he would help put it together. He was running late and wanted to get out of there as quickly as possibly. He had no tools with him, so hubby went to retrieve some. He spent some time trying to put the railing together, huffing and puffing, and waving the tools in the air in frustration. When it was finally completed, it didn't fit in the area around the toilet, and he said we could "refuse delivery." At that point I was really scared and wondered how I would be able to use that most essential bathroom feature. All that I would be able to do would be to fall down on the seat from a standing position. Or maybe get a commode or riser at this late stage in the game??? Fortunately, a home health coordinator arrived to save the day. She looked at our bathroom setup and showed me how to push my walker over the toilet so that the handles and the front of the walker formed a little protective cage around the toilet -- pretty much what the safety rail was supposed to do, I think. By using the walker's hand rails plus the sturdy sink counter top right next to the toilet, I was able to lower myself onto and push off the toilet seat safely. It was painful for sure, but less so each week. I am still using the walker for this purpose and pushing off from the counter top, but it is no longer a painful experience. On a future red letter day, I'll be able to get on and off the toilet hands-free. Remember: this too shall pass.
I hope that you can get some sleep tonight and that tomorrow will be a better day for you. If you're not ready to go home yet and need to spend time in rehab, then that's part of your recovery journey. You do need a strong support system for your recovery whatever your location, so that may be your best option. Stay strong. We're here for you.
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Wednesday
senior
Don't let the idiot get you down. You do what you are able to do when you are able to do it.
I'd strongly suggest getting a commode for when you return home. For me, that was the one aid I really appreciated. Get one with side handrails. It will make it much easier for you to get up and down.
I'd strongly suggest getting a commode for when you return home. For me, that was the one aid I really appreciated. Get one with side handrails. It will make it much easier for you to get up and down.
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LauraLeigh
member
@EmptyHands, @Wednesday - luckily I already have a toilet riser and grab handles at home. I started using them a couple of years ago when I had ankle surgery and got used to having that assistance. It was so much easier as my knees got bad!
I did use the bedside commode 3 times since last night & it really was easier every time. The worst part is that first bend of the knees to 90 degrees or more to get up on my feet and the darn bed rail pushing into my sore right thigh! But I went from needing 4 nurses to help me to 3 and finally 2 the last time. I'm still dreading PT but I'm not going to let him hurt me this time...and I'm keeping my fingers crossed that the nice guy that I had the first day will come instead of the mean one!
Oh, and I was sobbing pretty loudly yesterday so although my door was closed I'm amazed no one heard me - I could hear voices out in the hall the whole time. If it happens again, I'm just going to keep pressing that button until someone shows up! And I'm writing their phone numbers down so I can have that near the bed since I can't read the white board at all.
Still keeping my fingers crossed that my insurance will approve a rehab facility instead of a nursing home. The social worker said they rarely approve it but since I had a BTKR, maybe they'd come through for me. I find nursing homes horribly depressing and that won't help me get well. Besides which both my mother-in-law and father-in-law have been in nursing homes while recovering from hospital stays and they both have MRSA now. I'd REALLY like to avoid that!
I did use the bedside commode 3 times since last night & it really was easier every time. The worst part is that first bend of the knees to 90 degrees or more to get up on my feet and the darn bed rail pushing into my sore right thigh! But I went from needing 4 nurses to help me to 3 and finally 2 the last time. I'm still dreading PT but I'm not going to let him hurt me this time...and I'm keeping my fingers crossed that the nice guy that I had the first day will come instead of the mean one!
Oh, and I was sobbing pretty loudly yesterday so although my door was closed I'm amazed no one heard me - I could hear voices out in the hall the whole time. If it happens again, I'm just going to keep pressing that button until someone shows up! And I'm writing their phone numbers down so I can have that near the bed since I can't read the white board at all.
Still keeping my fingers crossed that my insurance will approve a rehab facility instead of a nursing home. The social worker said they rarely approve it but since I had a BTKR, maybe they'd come through for me. I find nursing homes horribly depressing and that won't help me get well. Besides which both my mother-in-law and father-in-law have been in nursing homes while recovering from hospital stays and they both have MRSA now. I'd REALLY like to avoid that!
Phil75070
post-grad
@LauraLeigh Sorry to see things are not going as well as at first. However, this phase will be over soon enough. Keep the faith!
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LauraLeigh
member
Thanks, @Phil75070. It's been better today. I went from needing 4 nurses to get me to the commode down to 3 then 2 then 1 so that's certainly an improvement. I will NEVER again take for granted the concept of easily rising from my bed or a chair and going to the bathroom without assistance!
The mean PT guy was back today and was MUCH nicer this time. I didn't cry at all! I'm currently out of bed for the 1st time and sitting in a recliner fairly comfortably. My only concern now is the 3 BIG blisters that have formed on my left incision. The PT guy said it's normal but it's very disconcerting to look at!
Still waiting to hear which facility I'll be going to but the lady from the rehab place said she'd be shocked if my insurance approves it so I'm not holding out much hope for that. Oh well - I'll just hope that the nursing home is a nice place and make sure nobody touches me without using hand sanitizer first!
The mean PT guy was back today and was MUCH nicer this time. I didn't cry at all! I'm currently out of bed for the 1st time and sitting in a recliner fairly comfortably. My only concern now is the 3 BIG blisters that have formed on my left incision. The PT guy said it's normal but it's very disconcerting to look at!
Still waiting to hear which facility I'll be going to but the lady from the rehab place said she'd be shocked if my insurance approves it so I'm not holding out much hope for that. Oh well - I'll just hope that the nursing home is a nice place and make sure nobody touches me without using hand sanitizer first!
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LauraLeigh
member
By the way, I wanted to mention to that despite the Percocet, Dilaudid and Toradol, I have had no trouble reading - so far I've finished the book I had started the day before the surgery, read two more and am now working on another. I haven't listened to my audiobook yet - if I want to nap, I listen to my guided meditation for post-TKR and that relaxes me and puts me to sleep.
VancouverUSAgal
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Glad you're able to read. I'm a lifelong reader but couldn't really concentrate on the stronger pain meds.
Don't let the PT push you. At this stage, you don't need to be doing exercises 3x/day - just concentrate on and practice getting out of bed and to the potty and learning to dress yourself. You'll be much happier when you can manage those things on your own.
The rehab I had to go to was really a nursing home (they call them skilled nursing facilities). The PT was good and helped me gain confidence. I'll skip the rest. Let me just say you may need to be forceful in requesting what you need and getting ice, etc. Use the hospital bed to elevate as much as you can.
I think the fact that I had to use the toilet frequently actually helped me to progress because I really didn't want to wait for assistance each time. And I really wanted to go home so I told the PT that my goals were to learn to get into/out of a small car and do steps so I could get into the house. By the time I went home, I had the confidence to handle both those.
I wish you all the best. Everyone here will be glad to lend an ear and offer suggestions when needed.
Don't let the PT push you. At this stage, you don't need to be doing exercises 3x/day - just concentrate on and practice getting out of bed and to the potty and learning to dress yourself. You'll be much happier when you can manage those things on your own.
The rehab I had to go to was really a nursing home (they call them skilled nursing facilities). The PT was good and helped me gain confidence. I'll skip the rest. Let me just say you may need to be forceful in requesting what you need and getting ice, etc. Use the hospital bed to elevate as much as you can.
I think the fact that I had to use the toilet frequently actually helped me to progress because I really didn't want to wait for assistance each time. And I really wanted to go home so I told the PT that my goals were to learn to get into/out of a small car and do steps so I could get into the house. By the time I went home, I had the confidence to handle both those.
I wish you all the best. Everyone here will be glad to lend an ear and offer suggestions when needed.
Wednesday
senior
Reading is good. I'm still not able to totally get into my books. I can knit, though.
I wanted to go directly home, but the PT wanted to make sure I could walk the hallway and climb and descend the stairs before she felt comfortable with that. Because of my anemia, I needed a blood transfusion on the day I was to be discharged, but after the transfusion, I proved I could handle both. I'm glad I was able to go home.
I wanted to go directly home, but the PT wanted to make sure I could walk the hallway and climb and descend the stairs before she felt comfortable with that. Because of my anemia, I needed a blood transfusion on the day I was to be discharged, but after the transfusion, I proved I could handle both. I'm glad I was able to go home.
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LauraLeigh
member
Wonder of wonders...miracle of miracles - I was able to get to the loo by myself TWICE today!
Vast improvement over yesterday. I'm waiting now for the ambulance to take me to the skilled nursing facility. As I was warned, my insurance declined the rehab place. Oh well...at least it's really close to home so it's easy for my husband to come over and visit.
And another wonderful thing: my constipation just cleared up. Hip hip hooray!!!
Vast improvement over yesterday. I'm waiting now for the ambulance to take me to the skilled nursing facility. As I was warned, my insurance declined the rehab place. Oh well...at least it's really close to home so it's easy for my husband to come over and visit.
And another wonderful thing: my constipation just cleared up. Hip hip hooray!!!
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LauraLeigh
member
All of you who warned it would be loud in the nursing facility - you were so right! There's a tv on in the room across the hall at full volume and I can't get up to close my door. My husband is bringing my bag shortly with my earbuds in it - they will definitely be a necessity in this place. But hey - there's bingo tomorrow!
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LauraLeigh
member
Finally got more or less settled in at the nursing home after many problems:
No Percocet - they had to call their on-call doctor and presumably I'll get it by tomorrow. In the meantime, I'll have to handle it with hydrocodone and my ice machines.
No walker- the rehab people give those out and they've gone home for the day. I had to send my husband home to get the $5 one I picked up at a thrift store. Luckily we hadn't cut it up yet! I bought it to use as a therapy tool.
No toilet riser - well, they have one but it has arms that are too narrow for my wide hips. I managed to squeeze in and go once because it was an emergency but never again! I had to send my husband to the store to buy one. We do have one at home but it's attached to the toilet seat so I didn't want him to mess with it.
No bath stool - again, they have one but with narrow arms. Have they never had a fat patient here? We do have one at home so hubby's bringing it tomorrow. Luckily we only live 5 minutes from this place but needless to say my husbands getting REALLY annoyed at all this and I don't blame him. I will certainly bring up all these issues with admin staff ASAP. Hubby is wondering why I'm here instead of at home and right now it's for just one reason: there's a step to get into the house that I can't navigate yet. As soon as I can, I'm outta here!!!
For now I just want to get the ice wraps on my knees and go to sleep - I've been awake since about 6 this morning with no naps today. Tired now...
No Percocet - they had to call their on-call doctor and presumably I'll get it by tomorrow. In the meantime, I'll have to handle it with hydrocodone and my ice machines.
No walker- the rehab people give those out and they've gone home for the day. I had to send my husband home to get the $5 one I picked up at a thrift store. Luckily we hadn't cut it up yet! I bought it to use as a therapy tool.
No toilet riser - well, they have one but it has arms that are too narrow for my wide hips. I managed to squeeze in and go once because it was an emergency but never again! I had to send my husband to the store to buy one. We do have one at home but it's attached to the toilet seat so I didn't want him to mess with it.
No bath stool - again, they have one but with narrow arms. Have they never had a fat patient here? We do have one at home so hubby's bringing it tomorrow. Luckily we only live 5 minutes from this place but needless to say my husbands getting REALLY annoyed at all this and I don't blame him. I will certainly bring up all these issues with admin staff ASAP. Hubby is wondering why I'm here instead of at home and right now it's for just one reason: there's a step to get into the house that I can't navigate yet. As soon as I can, I'm outta here!!!
For now I just want to get the ice wraps on my knees and go to sleep - I've been awake since about 6 this morning with no naps today. Tired now...
EmptyHands
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@LauraLeigh - I'm glad to hear that things are looking up today, although the nursing home's lack of necessary equipment for you is shameful. It's a good thing that the facility is so close to your home and that your husband can get needed items for you, despite being understandably annoyed. You are aware of your in-laws' experiences with MRSA, so I know you will be ultra-vigilant. Hopefully, the nursing facility will help you with the stair ascending/descending skills, etc. and discharge you as soon as possible. Think of this as a great motivator for you, and then you can return home to your own personal space, where you and your husband are in control.
Ear buds are great! I always have to use a pair in the hospital waiting rooms at night when I wait for hubby to be released from recovery. The TVs are always going full blast whether anyone is around or not. When I'm the only person there, I have used my cane to adjust the TV controls several feet above my head. I've submitted several noise minimization suggestions to the facility, but no change so far.
I'm also happy that despite all your troubles, you're still able to read and use your tech tools. Good going, girl! Hope you get some much needed sleep tonight and that tomorrow will be a better day.
Ear buds are great! I always have to use a pair in the hospital waiting rooms at night when I wait for hubby to be released from recovery. The TVs are always going full blast whether anyone is around or not. When I'm the only person there, I have used my cane to adjust the TV controls several feet above my head. I've submitted several noise minimization suggestions to the facility, but no change so far.
I'm also happy that despite all your troubles, you're still able to read and use your tech tools. Good going, girl! Hope you get some much needed sleep tonight and that tomorrow will be a better day.
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