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TKR Lovablenut's Newbie Adventure

Lovablenut

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Hi everyone

I'm beginning this on behalf of my husband, a 74 year old, who had TKR surgery on the 6th of February. I'm trying to support and encourage his post-op experiences, but having found this forum, and begun reading in the wee small hours of the morning, I have a feeling that rather than helping, I may have been unwittingly impeding. :oyvey:Please bear with me while I explain.

We were expecting the post-op would be painful, but in reality had no idea how painful. My hubby had the op on the 6th of Feb, and was discharged on the 7th - pretty standard so far. He was very unsteady on his crutches and in a huge amount of pain. On the 8th, he took a nasty fall at home, whilst in the bathroom. He was concussed and disorientated. I couldnt get him up, so had to make him comfortable as best I could, and call the paramedics. They came out, gave him a bag of IV fluids, and were able to get him sat up. His blood pressure kept plummeting however, and his heart rate was very erratic, so it was back to our local hospital where he was re-admitted to get him stable (not the hospital where the op was performed). They x-rayed the knee to make sure he hadn't caused any movement of the joint.

They allowed him home on Sunday 9th Feb, this time with a walking frame, which was much more supportive.

I work full time, but obtained permission to work from home this week just gone, so I could monitor how he was. They had emphasised from the outset the importance of getting mobile, and doing his exercises, but he was finding it too painful. All he wanted to do was sleep and rest.

This is where it gets embarrassing. I had read the post op leaflets, spoken with the physio and with the hospital staff, and was badgering him to get up and walking, with the aid of the frame. The stairs, which had been a major issue, got better once we realised he's been approaching them all wrong, and he is now moving about and tackling the stairs much better.

Yesterday (14th Feb) we took a run out to the shops, and he attempted a walk round Asda. We had to abandon it halfway through. I was fortunate enough to be able to get a hired mobility scooter in the shop. Once home, his leg was very painful again. I noticed in the evening, the ankle on his operated leg was tight, shiny and swollen. We put his ice pack on his knee, and he took his pain meds (currently gabapentin and paracetomol during the day, and oramorph for breakthrough pain).

Neither of slept well last night, and I was worried we'd pushed things too far (too much too soon) and I began searching the internet to see what actual post op feedback I could find from real people who'd undergone the op. I found Bonesmart and began reading.

What a revelation. And what a huge help to read actual and real-time accounts from post-op patients. I can see far from helping him, I've inadvertently been pushing him to exercise and move about probably way too much too soon.

I've apologised profusely and explained that I would register an account here, with the hope he can begin to chart his own recovery, and contact others who are going through the post-op recovery.

It's daft things a lot of the time, such as how and when do we get repeat prescription meds which were originally given by the hospital - so far he hasn't had any callback about the op itself, just about his readmittance (different hospital) following his fall. How much exercise is too much exercise etc etc. How much swelling is normal?

As I have to return to work on Monday I'd feel better knowing that he has a resource at hand online, as much for company as anything else. I really want this op to be successful for him, knowing how much pain he had before the op. I dont want to be the one who made it worse through good intentions (paving the way to my hubby's own personal hell, obviously!) Knowing what other people have experienced is so helpful.

We have 3 Cats who are very keen to see their Cat Daddy return to good health, and are much better at nursing than me. Much snuggling has been administered by Cat No 1, Cat No 2 and Cat No 3. Thankfully, they don't do nagging. :no-fin:

I hope I've posted this in the right place, and thanks for reading. Hopefully Loveablenut will be along on his own account in time. He's not used a forum before, but fingers crossed!
 

sistersinhim

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@Lovablenut, welcome to Bonesmart. :flwrysmile: You've come to the right place to learn all about knee replacements. You'll also find those who have had surgery around the same time as your husband's was. I will add you to the February Valentine Team Thread: https://bonesmart.org/forum/threads...having-knee-surgery-in-february.57148/unread4

Which knee did you husband have replaced?

The following are our basic guidelines and should help get you started. As you read more on other members recovery threads, you’ll get a better perspective of what to expect and what not to do, especially regarding PT.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​
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.
 

Jockette

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Hi and Welcome to Bonesmart!

My husband also “helped” me with ROM, like he was told to do, which was excruciating. I didn’t find Bonesmart until 4 weeks post op. I was thrilled to find a much more sensible and gentler approach to this recovery, and I was a bit angry that my medical team didn’t feel the same way as Bonesmart.

As you continue this recovery journey, and read the experiences of our other members, you will find many differences of opinions, about how to recover. Since there are so many different opinions, your and your husband’s opinion counts the most, and your husband has every right to do what he feels is in his best interest.

We are glad you joined us and we are here to support you every step of the way.
 

Qdogpa

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1 week after post op, he was walking around a store? Wow...1 week after post op I was sitting, leg up, with ice...glad to hear he is getting some sleep, as sleep has been miserable for me, and I am just about 4 weeks post op...

i had a lot of swelling and some bruising the first two weeks, and only in last week has swelling come down, still swollen though.brusing just about gone.

i go to PT twice a week, and do some PT exercises at home, but not what they suggest..just moving about , walking a bit, normal,day to day life , will get the knee to where it needs to be.

time is your husbands friend, no need to force the issue
 

Helizabug

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I’ve been in your situation and your husband’s. Both are tough and you’ve come to a great place for help and support.

Do you have strategies for him to look after himself for the time you’re out of the house? A thermos for tea or coffee, with a favorite mug to portion it out into? A collection of healthy eats to be kept in a cooler or a box, easy to reach? Ways for him to feel useful at home if he can’t revel in idleness, like clothes to fold, accounts to balance, letters to write, and so on?
 

Roy Gardiner

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Hello and :welome:

Please don't beat yourself up. You have (unwittingly) learned the hard way and learned something of the BoneSmart way, less is more!

In my experience I was happy to sit around all day watching telly, reading, dozing, following this advice: When you are icing and elevating and watching telly you are not 'dossing around' you are 'engaging a carefully considered proactively designed heuristically programmed dynamically structured recovery programme'.

A chair from which he can rise is of course essential. I jacked one up with books (Encyclopaedia Britannica, no rubbish) which worked well.

If he can make it to the bathroom and to the kitchen to prepare/reheat lunch, he'll be happy, hopefully?
 

Jamie

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Your hubby doesn't have to start another account. He can use this one you've set up to ask questions and talk about his progress. I'm so glad you found us!

If you need refills of pain medication, you should be able to get them through your primary care doctor. In the UK, it's my understanding that the orthopedic surgeon turns the case over to them once surgery is done.

Lots of rest, ice, elevation and taking of pain medication on a schedule should be his first priority until the pain and swelling are under control. He needs to do gentle bends and stretches with the knee throughout the day and get up to walk about for 5 minutes every hour or two to keep things mobile. But definitely not trips anywhere!

Read all those links to articles and you'll have a better understanding of how things will work in recovery.
 
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Lovablenut

Lovablenut

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Thanks so much for the warm welcome and the helpful suggestions and info.

Hubby has had left leg operated on. He needed both doing but left leg had become so stiff it permanently stuck out, making stairs a real difficulty.

I've shopped for next week and got a series of dishes prepared he only needs to heat ready - I can take out of the freezer the night before. He's managing to make himself a cuppa without too many issues, and he's even taken over some cat duties from choice (food treats and cuddles).

I suspect he will spend time sleeping and thankfully I now realise that's perfectly normal and in fact necessary.

The guidelines - brilliant. So helpful to refer to. Wish we'd known about these before the op but so glad to have this reference point now.

I can't fault the hospital care given but post op seems to be a bit vague and - wisdom with hindsight - a tad optimistic in terms of realistic accomplishments. Will show your replies to my husband.
 
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Lovablenut

Lovablenut

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Jamie - thanks. I will call our GP tomorrow re further supply of pain relief. They're pretty slow to respond so sooner I can get this organised the better. He has pain relief to see him through tomorrow but after that hell have to rely on paracetamol and I can see that won't be enough.
 

Celle

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Do try to make sure that your husband is elevating his leg while he's sitting in a chair - like this:

1581793855165.png

Sitting with knees bent and feet on the floor gets uncomfortable quite quickly, and it can also increase swelling in knees and ankles.
 

sistersinhim

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Keeping the knee totally straight for more than a few minutes is also uncomfortable and unnecessary. Keeping a slight bend is much less painful.
 

kneeper

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Glad you found us!
 
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Lovablenut

Lovablenut

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Thats great guys, thanks - the elevation picture is very helpful. We weren't told about that. :umm:
 

Rubyroo

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Glad you all found BoneSmart! Great resource for info, venting, encouraging etc. Sending healing vibes your way!
 

jellycats

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Greetings to you and your husband from me and my four fur babies! I tell people the prescription read “Apply one cat to knee every four hours.” They think I’m kidding.....

Though you guys had a tough start, you’re now in the right place! My surgery (right knee) was also Feb. 6 so your husband and I are on the same calendar.

Rest, ice, elevate; drink lots of water; cuddle those cats. Take pain medications as prescribed to stay ahead of the pain and be comfortable. Don’t ever feel rushed—your husband’s new knee will tell him what pace is best.

Sending healing thoughts to you both.
 
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Lovablenut

Lovablenut

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Jellycats - :kitty::catdance:Love it. :heehee:

Ruby roo - thank you. Am glad we found it too. It's certainly helping me understand more about the op as nd the healing process. Just elevating his leg yesterday helped so much. No mention of that at th e hospital - just exercise, exercise, exerc
 
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Lovablenut

Lovablenut

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Sorry for the typos. Typing this in bed at 3 am uk time, listening to Storm Dennis playing havoc outside. Got to be up for work in 2 hours.......
 

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