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TKR Left TKR Recovery---Now I Have a Matching Set

Rockgirl4

Former BoneSmart staff member
Joined
Sep 3, 2018
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Age
52
Location
Missouri
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I can't believe it's been 5+ years since the Right TKR, but I'm back for the Left TKR and eager to see how the rest of you are doing as we recover together. :yes!:
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I made it home by 10:30 yesterday, after spending a wonderful night in the hospital. Surgery day was definitely eventful. I have high blood pressure and anxiety, and both were very out of control. My numbers finally came down after they gave me the happy juice through my IV. That was after a lot of cat and puppy videos and deep breathing exercises. :puppysmooze: I don't remember the spinal, but they unfortunately had to convert me to general anesthesia in the middle of the surgery. My oxygen SATs kept dropping into the 80s, and they gave me a lot of albuterol to open my airway. My allergist thought we had ruled out asthma last year, but I keep having some weird episodes like this, usually in the late summer/fall, so we're going to revisit that in a few weeks. Oh, and I kept crying and telling the nurses everything....and I mean everything about our stressful last 2 years. My husband warned them that general anesthesia is basically truth serum for me.:shrug:

I am pleasantly surprised with the pain control though. Like SHOCKED!!!! I was told the blocks/meds in my knee would last 48-72 hours, and mostly all I'm feeling is the burning/tightness where the tourniquet went. I haven't gone above a 5 on the pain scale yet. I can get by with the Tylenol and Tramadol so far, only taking one oxycodone before bedtime (at the drs/nurses recommendation). I keep wondering when the "Oh my Gawd" pain is going to set in and don't want to get my hopes up yet that this time around will be easier.

As for the actual surgery, I was able to have the Press-fit implant to match my other knee, as my bone was still strong. Since I'm only 51, it's supposed to last a lot longer than the cemented knees. Time will tell, right??!! The surgeon also injected all sorts of local anesthetics in my knee, plus the strongest IV anti- inflammatory (Toradol) because of my history of severe swelling. They even gave me 2 steroid shots in the hospital, and it sounded like that was for swelling prevention too. All in all, I felt VERY well taken care of. Washington University Orthopedics in St. Louis has been wonderful for our entire family, and their nursing staff is the best I've experienced after 12 knee surgeries, an ankle surgery, and having a baby. I'd recommend them to anyone, as 2 of the surgeons are revision specialists too. My rheumatologist won't "let" me go anywhere else. :)

I'm still really groggy, so I'll stop here before I fall asleep typing again. My poor husband must be exhausted too. He's a great caretaker, but I feel bad that he hasn't sat down all day. I'll check in with you all later and see where everyone else is at in their recovery.

--Lisa
 
Thanks for joining us again, Lisa. Thankfully the pain is well controlled.
Oh, and I kept crying and telling the nurses everything....and I mean everything about our stressful last 2 years. My husband warned them that general anesthesia is basically truth serum for me.:shrug:
This made me chuckle. One can only imagine some of the stuff the nurses hear from patients in recovery. :heehee:

I will leave the Recovery Guidelines with best wishes as you begin healing. Happy Saturday!



KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

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

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?

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

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.
 
I can't believe it's been 5+ years since the Right TKR, but I'm back for the Left TKR and eager to see how the rest of you are doing as we recover together. :yes!:

--Lisa
Hey Rockgirl!

Looks like we are synchronized on our TKR's :friends:

My right TKR is 5.5 years old and my left TKR is 18 days old.

Sounds like your surgical team was like a NASCAR pit crew!

Glad to have you on the recovery side again and my best wishes to you for an excellent journey!
 
Today is Day 3, and it's safe to say the blocks have completely worn off. Whatever numbing medications were put into the knee have mostly worn off too. I knew the last 2 days might be a honeymoon period. Thankfully, I'm not in excruciating pain like the last time around. I really like the medical cocktail my surgeon's office put together, where I start the day with 2 Tylenol and 2 Tramadol. That let me go back to sleep for another 4 hrs.

I need to figure out how to quote here again, but YES----my surgical team was a like a well-practiced pit crew, and the nursing staff was the kindest EVER!!

As for other random stuff-----I bruised horribly with my first TKR, but I have almost no bruising this time. My leg isn't nearly as sensitive either, and I can put my whole foot on the ground when walking with the walker. Last time, I couldn't walk flat-footed for a good 2 weeks. No fracture blisters either yet, which is a HUGE relief. I saw something after the surgery showing what all he put INTO the knee, and it was at least 4-5 things such as local anesthesia and meds to prevent/limit swelling. I'm thankful he took my medical history of Psoriatic Arthritis into consideration and tried to be proactive instead of reactive.

I need to comment on this RomTech PT bike too. I have a love-hate relationship with it (ha)!!!. I like that it makes my leg less stiff, but I worry it's going to cause extra swelling. The last 2 days have been easy, but if today's sessions aggravate my knee, I'm cutting back. I'm also only doing 1 set of the PT exercises on the sheet they gave me. 1 set was hard enough yesterday. 3 sets is too much right now.

Thanks to everybody for the good thoughts and kudos too. I'm still so groggy that I couldn't stay awake last night to read anything. I'm off for another nap and will be back later.
 
Il still pretty groggy at times too. I’ve tried reducing my tramadol dose this afternoon. Definitely less groggy but much sorer so not sure that will work. Still it was worth a try. The first few days are definitely challenging !! Take care and rest.
 
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During the initial weeks, my ortho team's united message was Less Is Better.

So I never did multiple sets. I just did a random few ankle pumps and quad sets throughout the day (quad sets help wake up quads, increase circulation, and gently help extension, and they don't stress the knee if not done too much) .

It's pretty common among our members, me included, that lying down heel slides are a misery and really stress the knee. I learned my lesson quickly on knee number one, and on my second didn't do any until I could slowly do them while seated in a chair.
 
@mendogal Thanks for sharing that. I've not done a single heel slide yet, as I know how badly that will aggravate my knee. I've just listened to my gut AND gone by past experience, knowing it will be too much.

I actually forgot to mention that my surgeon and I had a VERY long talk right before the surgery. He had considered immobilizing my leg for 2 days post-op because of my inflammatory history. His exact words were "please avoid aggravating the knee with TOO MUCH bending and movement"-- (which ironically is what the PTs are always nagging us to do more of!!). It made my husband and I feel better that this Dr was worried more about ME than numbers.

When he spoke to my husband post-op, he said he thought about it the whole time and decided against the immobilizer. He knows we've been through knee recovery 11 times before, so we know how to be careful. Plus, he knows I make scar tissue quickly and have arthrofibrosis in the other knee due to a straight leg-brace years ago. He went with the idea that some movement is okay, but don't force it---but don't keep it totally straight either.:whistle:

No matter what, this recovery is already easier in terms of pain and movement, so I'm staying optimistic that our "slow and steady" philosophy will work just fine.

Now if I could just stay awake to read everyone else's threads. @Toothfairy I regretted taking only 1 Tramadol last night and got behind the pain, so I'm not brave enough to try it again yet. I completely understand the struggle of staying awake though. This is my first time ever taking it, so I had no idea what to expect. Now I know it's the cure to my menopausal insomnia. :heehee:
 
Today began with a figurative walk down memory lane!! I'm starting to remember all of the little aches and pains that show up out of the blue. I woke up to a burning across the bottom of my thigh, which is also the top of my incision. It feels like I have the worst sunburn ever across that part of my leg, but there's nothing unusual to see. It's very bizarre and changed in intensity throughout the day. I'm sure it's just the healing process for all of those ticked-out nerves/muscles/etc.

I was definitely sore this morning when I woke up, like "all-over" sore. We were up very late last night looking for something important my son had misplaced, and we were all 3 out of sorts this morning. On that subject, my son turned 18 today, and it's been surreal. He's our only kiddo, and we've never wished a day away. We're hip-deep in the college application cycle, so I'm still not wishing a single moment away----even if it HURTS!!! I know at this time next year, we'll be alone in the house while he's off at college, so I'm trying to enjoy this last year when he's home a lot.

Last but not least--the RomTech PT bike. I've used it 3X a day like I'm supposed to, but it doesn't fit my body well at all. I'm very short-waisted, and I keep having to use pillows to situate myself. I tried to increase the setting for more bend today, and that HURT!!!. I turned it off and quit. I can tell my leg is moving/bending though, and that's much better than the 1st TKR 5 yrs ago. I'm taking it as a win! I can move around the house easily with the walker, and I can put most of my weight through that leg/hip too. I've had 2 showers which were fairly easy too. All together, these things makes me think this recovery is going to be SOOOO much faster/easier. I still have a lot of swelling and need the bike to loosen me up, but I know that takes a lot of time to go away.

I almost forgot----we've had a ton of people bringing food/snacks for us, plus stuff for Owen's birthday. Everything was a hit until tonight's dinner of dressing and pork chops. I gave up after 3 bites and left it for the guys. We get meatloaf tomorrow from a dear friend, and I'm really looking forward to that. I hope everyone else is hanging in there. I'm off to catch up on my fellow recovery buddies.
 
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