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Revision TKR Lovetocookandsew’s long road to recovery

lovetocookandsew

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Well, I had my surgery early Tuesday, and am still in the hospital. They are having a tough time getting my pain under control, so tomorrow I am going to be sent to a rehab center. It's been a painful process; I had no idea it would be this excruciatingly painful, I've actually done quite a bit of yelping in pain. Tonight is the first time I've been up to sitting for more than a minute or two. I ended up having to use the dreaded bedpan, until this afternoon when I made it 5 more feet to the restroom. Glad to get rid of that-I hate it because it always spills and it's hard to relax and go on the bedpan. They have me on 6 mg oral Dilauid every 4 hours and toradol every two hours, I believe. My OS said my knee was totally bone-on-bone. None of us had any idea how bad it was until he got in there as the x-rays didn't look that bad. He said it a was an ugly knee, and the kneecap was also way off from where it should have been. In hindsight it's a good thing I did it now instead of down the road as I'd have been in a wheelchair or on crutches. So, here's hoping it gets smoother from here on out. I hope the rehab center is a good one.
 

pippi

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You made some very good points about the shape your knee was in and the lifestyle you would have had without the surgery. Hold on to that thought as it will get you through the pain you are feeling knowing you are heading toward your recovery with new choices for the new knee....like whether to cook or sew... Both things you love to do. Keep us updated.
Pippi


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lovetocookandsew

lovetocookandsew

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Hi everyone. I had my RTKR on Tuesday. I knew there would be pain afterwards, but I had no idea it would be this excruciating. I am on 6 mg Dilaudid every 4 hours and not a minute sooner. At the hospital, they were also giving me Toradol in the hep-loc.

They sent me to a re-hab facility as I'm not doing as well as I should be. I can't sleep nor rest with all the pain and commotion. I need more pain control as the best result I get brings me only to a 5-6. the Dilaudid alone only gets me down to 7-ish. and I can't do PT, or anything else, with that much pain. Also, I am very limited on what I can take for pain, so it looks like it's going to be damned if I do, damned if I don't.

Today I was in tears a good part of the day (I don't cry!) with all the pain. I'm not able to think clearly or remember a train of thought. I've been dropping and spilling everything all day and can't pick anything up, so have to call someone and pester them to death to fetch or clean-up my messes. The pain, frustration and loss of short term memory has turned me into a whiny fussing baby.

The food here is the same meal for everyone, no personal choices, and so far they're batting zero - I can't eat fish (lunch meal), the faux burger (dinner) was rubber, so I didn't eat it. Hubby got me something, but I had to force myself to eat 5 bites; I have to eat or I'll soon be vomiting violently.

I'm not a happy camper, and need advice. How do I get the doctor to either up the meds, or move the times forward or something? Because I'm at a SNF, I have to use their doc, who I've yet to even see.
 
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Jozilla

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You absolutely need help with pain control. Can you speak with your OS? How about ice - are they giving you ice? It was my best friend for many weeks. You should not be suffering so much and need help. I had pain but with medication it was about a 3. Can you or your husband insist on speaking with a doctor? I don't know what you can take but there are many medications they can try! Or maybe give you your dilaudid every three hours would help. I am do sorry you are going thru this and pray you get some relief.


RTKR - 9th December, 2013
 
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lovetocookandsew

lovetocookandsew

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Yes, they are giving me ice, but it's the kind where you squeeze the ice pack to activate it. It isn't as cold, nor does it last as long as, real ice or blue ice. I can't reach my OS until Monday, but I think the people here can if necessary. My pain has yet to get down to a 3-except when I had the nerve block. I'm going to try to move to a different SNF today-I don't like this one. The problem with meds is on my part-I can't take anything except Dilaudid. So, I am about to flip out and will call someone somehow today. Also, I'm running a little temperature today, so they have to keep an eye on that too. I keep telling myself the day will come when I'm glad I did this....................Kim
 

kneesrus

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Hi Kim, my first thought is the meds are not working for you. Medicine only works in about 60% of the population. My suggestion is to go home. You and your husband come up with an icing method, you will eat better, and your mental health will improve.
They have given you some initial exercises which you can handle. start re engaging back into life in small amounts. You are not sick, you cannot hurt the surgery, just do what you can do.
Being home helps a great deal, it is a safe zone. You have too many negative events going through your head.
Go home, eat well, get dressed everyday, ice, do your exercises and start walking around some. Go for a car ride, you will not hurt your knee.
Remember to elevate your leg, toes higher than your nose, to control the swelling. Surround yourself with well people, not sick people.
Best of luck,
David
 

daughter stalker

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Oh dear! :console2: I am sorry to hear you are in such pain. :cry:Either you or your husband insist to the director or person in charge of the rehab place and demand that someone call your OS. :hairpulling: You shouldn't be in that much pain. Also if your husband can have him bring in some real ice to you. :ice: As for eating, hubby can bring you snacks (i.e. crackers, meal bars or protein bars) that you like so that you won't be nauseated when you take your meds. I know you are having trouble thinking right now. Some of us have been there, but it seems that you will need to be your own advocate and insist on what you need. I will tag @Josephine for you.

Keep us updated on your progress and I hope things get better quickly. :kitty:
 

Pumpkln

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I am stuck in the hospital an extra day and share your pain. Go home buy a commode chair so you can handle toileting. I agree with David you will do better at home.


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Josephine

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Yes, they are giving me ice, but it's the kind where you squeeze the ice pack to activate it. It isn't as cold, nor does it last as long as, real ice or blue ice.
Those are useless!
I'm going to try to move to a different SNF today-I don't like this one.
Apart from "what's an SNF"? why not just go home? Sounds like being in rehab can be dangerous for your health!
Also, I'm running a little temperature today, so they have to keep an eye on that too.
Don't worry too much about that - it will be caused by being in too much pain and crying a lot!

GO HOME! It's your only salvation.

Your other salvation are these articles ...
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM
 
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lovetocookandsew

lovetocookandsew

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Quick reply-in too much pain..thanks for all the care, concern and advice. SNF=skilled nursing facility. But this one is a re-hab type.
 

Jozilla

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I agree with going home. You should be ok when your pain is better managed and you can ice most of the day! For now I would be screaming until I could talk to my OS. Can you call him directly even if you need to leave him an emergency message. Increase your dilaudid and escape! They are not helping you all.


RTKR - 9th December, 2013
 

VancouverUSAgal

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Oh, Kim, I can relate to so much of what you are going thru. I didn't get good pain control in the hospital and I had a miserable time in "rehab" where I couldn't get ice or other basic items. However, I knew I had to be able to go up one step to get into the house and to be able to get in and out of a car. And I worked really hard to learn those 2 things and then told rehab I was leaving after my post-op surgical appointment. Once you're in the rehab place, you lose control of some aspects of your care. Don't know if it's true, but I was told there could be problems with Medicare paying for rehab if I checked myself out without a doctor's okay. After I threw a couple of mini-tantrums, they began to bring my pain meds more regularly and work with me to get discharged. I was there 9 long days. However, as bad as the care was, I don't know how well I would have managed at home since I wasn't getting around well when I left the hospital. My son had already taken off so much time from work by that point that he wasn't able to stay home all day with me so I quickly had to manage on my own.

I would ask for ice packs in rehab and be told they were out.:hairpulling: So I had my son bring the good ice packs brought in to me and put my name on them and could sometimes get the staff to put them in their freezer and bring them to me, but not on a regular basis. If you are close to home, maybe you can have ice brought in to you regularly. The only thing good about the facility was the PT.

I am at 4 weeks and still don't have much of an appetite and could barely eat anything the first couple of weeks. I managed to get down a few bites each meal and had protein bars brought to me. I think it's not unusual to have no appetite.

Also, I am just now beginning to transition from Oxycodone and have only had pain level down to 3 when I've been sleeping or resting for several hours. The people who have very little pain with this surgery are extremely lucky. People keep asking me how it feels to NOT have the arthritis pain and I tell them that honestly my pain at this point is worse than what I had before but that I know it will get better.

Some people have a pretty easy time, but unfortunately it sounds like you and I weren't that lucky.:sigh: My heart goes out to you and I will be praying that it gets better for you VERY SOON.
 

kneeper

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You're on your way and we're here for you.
 
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Today I am 3 wks, 2 days out and I am turning the corner to feeling pretty good and glad it's done. It would be great if my RA flare would be under control ( waiting for a doctor to return a call) it would be grand. All this to say, things will improve. Patience is the key word. Just as you think you're not getting anywhere, you will notice..I couldn't do that three days ago!

Rest, don't overdo and ice a lot!
 

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Good to hear that you're now on 'the other side'. Members on here are right when they say each day will get better, it's so true. Look after yourself; I'll look forward to reading all about your recovery.
 
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lovetocookandsew

lovetocookandsew

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Thanks, everyone! Had a room mate for a couple of days. She had a TKR 3 1/2 weeks ago. Good to see her walking, but also a bit bittersweet. She could easily get in and of her bed, and was walking without a limp. Something to look forward to. Another day of fun and frolics on the ortho ward.................................
 

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I am so sorry that you are going through this. I agree with the others. ICE, REAL ice makes so much of a difference. So, are there NO other pain meds that can be tried. I had so much pain the first few days and it wasn't until I hung out almost constantly with ice and elevation that I got a break from it. Many prayers and thoughts coming your way.
 

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Although you are in the very early stages of recovery, I can't imagine how this is for you. You should not be struggling like this. I agree with the others. Your pain control meds need to be adjusted. Pain is part of the recovery but not what you are going through. I am in week 11 of recovery and found the first four weeks were very painful but the pain meds allowed me to tolerate it. I hope you have been able to find some resolution to the situation you have been in. I agree that things would be better at home. I was able to tolerate so much more of what my body was going through when I came home (three nights in hospital and four days.). I also felt more relaxed and that helped so much. Please let us know where you are at so we can continue to support you.
 

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I am confused what do you mean you are in rehab instead of nursing home? I do know this, have your husband get with the one in control. Tell them the problem and see if its because of being short staff because of Easter. I do not accept any good reason for being late for medication or neglet. I was in a nurseing home and it was terriable. I didn't have anyone at home so I had to stay. Please remember we care and do keep us posted. Tashia
 

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