LTKR -a few questions

[VW54]

Am scheduled for May 31st /June 1st.
As posted before, am quite jittery. Reading many recovery threads and advice has helped quash some of this temporarily.
I do have some questions.
I've got a cough. No fever. It's better but not gone. I noticed it seems to be worse, that is I get a coughing attack when I'm more nervous.
Assuming I'm still coughing when due for surgery, will it affect GA? Would a spinal tap be better? When I cough, the whole body moves...that means my legs also.

Next question: my dear MIL has lent me one of her walkers. (she lives 4 hours drive away) and had it sent to me yesterday w friends who were driving here.) I've read elsewhere that a 4 wheel walker is not good. Why?

Question 3:
How long can one or rather, may one stand after a week? I know it varies...but at the patient info meeting the nurses there said we HAD to use crutches at least 3 weeks long.
Am thinking of how I will shower in our tub.
A bench we have fits in the tub ...but the idea of sitting while showering sounds weird at this moment.

I read somewhere else that sitting in the sun is not good for scar. Is that so? And why?

Q: I have to use a lotion the night before and the morning of surgery, including hair. Will it affect the hair dye? I was thinking of coloring my hair this weekend.

Q: I have a bed ( almost like a hospital bed) where I can raise the legs section. I read that's good to have. Yet at the patient info they said we should sleep with our legs straight for as long as possible.

Also they said: no stretching up. Anyone know why? I can imagine why no bending down. But why not reaching up for something?
Thanks ahead of time for any tips, replies.

 

[SusieShoes]

You should mention the cough on your pre-op evaluation. It could be important, but you will need to have medical personnel figure that out. It may or may not impact your anesthesia. My OS used spinal because, as he put it, "I don't want you to move at all." So spinal. GA was an option if needed to keep me asleep, but the spinal was for the surgeon's benefit. Cough or no cough, you won't be able to jerk.

At one week out (I had both knees replaced) I could stand for maybe ten minutes to brush my teeth and do my morning hygiene. Make a sandwich. Pot some plants (yes, at rehab I potted some plants). After ten minutes I probably could have stood a bit longer, but my knees were saying it was enough and for me to sit down. At two weeks out, I can stand about twice as long before having to sit. My stamina is as much a function of my post-op general weakness and need to recover as it is about the knees themselves. The knees are willing... the muscles and tendons and flesh are all kind of weak.

A shower bench is a wonderful thing if you are dealing with a tub/shower combo. I too had doubts about the bench I bought. I'm glad I have it. I can wash myself with comfort and then stand for just a minute or two if needed for some spots. But with the bench it's easy in to the tub and easy out. Unless you have a set of grab bars, getting in and out of a tub can be difficult. (Again, I had both knees replaced, so it's twice tough for me.)

Your scars are brand new baby skin. Exposure to lots of sun might burn them. Not good.

They want the legs to stay flat as possible to work on extension. Flat can be uncomfortable, though. I use my bed, which is like yours, to raise my legs part of the time. My extension is good, and I work on it in other ways through the day (exercises). Talk with your doctor about this.

I have no idea about the stretching up, the walker, or the lotion and hair dye. I'm sure other folk will be along who might have more answers for you!

 

[VW54]

Thank you SusieShoes. ( have been reading your thread)
The bench in the tub: I guess I'll copy the Japanese method. Wet all over then sit and soap up then rinse all over.
I was inspired today by that wedge of yours. I went and made my own.
I used a cotton throw blanket, bundled up 3 pillows of various sizes and sowed them into the folded blanket. If anyone is interested, I could take a photo.
I suppose I'll wear an apron over my shorts when I sit out on our balcony to cover the scar.
Ohyes... by the way, an apron with pockets is great for when one wants to carry things and the clothes have no pockets.

 

[Celle]

I've read elsewhere that a 4 wheel walker is not good. Why?

Unless it has brakes, it is likely to roll forward when you lean on it for support. Initially, you need something that won't move. As you progress, you may be able to move up to the walker with wheels.

How long can one or rather, may one stand after a week? I know it varies...but at the patient info meeting the nurses there said we HAD to use crutches at least 3 weeks long.
Am thinking of how I will shower in our tub.
A bench we have fits in the tub ...but the idea of sitting while showering sounds weird at this moment.

You'll be glad of that bench in the shower. At first, you'll feel weak and tired and having a shower will exhaust you. If you have a secure rail to hold onto, you should be able to stand for long enough to wash your nether regions, but you'll be glad to sit down again. It's also a good idea to have a chair outside the shower, so that you can sit down while you dry yourself.

I have a bed ( almost like a hospital bed) where I can raise the legs section. I read that's good to have. Yet at the patient info they said we should sleep with our legs straight for as long as possible.

You don't have to keep your legs straight all the time and that bed sounds like a good idea. You don't even have to elevate with your legs completely straight - it's so uncomfortable! - and a slight bend is OK. Like this:

Also they said: no stretching up. Anyone know why? I can imagine why no bending down. But why not reaching up for something?

I've never heard that one before!
I can think of two possible reasons though. One is balance - you don't want to lose your balance and risk a fall.
The other reason is that you might try to rise up onto your toes, which is really hard on a new knee.

 

[SusieShoes]

@VW54, Celle just posted where I got the idea for the wedge I use. I saw it first here on BoneSmart. And as you can see, your homemade one will be just as good!

I like your apron idea! Does anyone make walker aprons, I wonder? Hmmm. But carrying things with a walker is a challenge and an apron is a good idea for transporting bottles of water and other items.

 

[Josephine]

Assuming I'm still coughing when due for surgery, will it affect GA? Would a spinal tap be better? When I cough, the whole body moves...that means my legs also.

Not spinal tap - that's a pop group! You mean a spinal or spinal block. Most places nowadays use spinals routinely with sedation which from the patient's point of view is pretty much like having a general but a lot, lot safer.

However, so far as the cough is concerned, so long as it's not a productive cough - meaning you're not coughing anything up - it should be okay. And once you have the spinal, nothing will move, trust me!

I've read elsewhere that a 4 wheel walker is not good. Why?

What Celle said!

Am thinking of how I will shower in our tub.
A bench we have fits in the tub ...but the idea of sitting while showering sounds weird at this moment.

You just need a bath shelf that sits across the bath. It sticks out a bit one side so you can sit on it, slide yourself back and bring your legs into the bath. If it's difficult to lift the operative leg, use a leg lifter. Then you shower while your sitting. And trust me, you will be pleased to be sitting as you'll find it tough to stand!

You'll find both things in here plus things like a plastic legging to keep your dressings dry - should the need arise!

Recovery Aids: A comprehensive list for hospital and home

How long can one or rather, may one stand after a week?

That's what I tend to call a "how long is a piece of string" question! Most people can stand the next day and walk. No problem.

I have to use a lotion the night before and the morning of surgery, including hair. Will it affect the hair dye? I was thinking of coloring my hair this weekend.

I seriously advise you not to! You don't want it to leak all over the drapes in the OR, do you?

Yet at the patient info they said we should sleep with our legs straight for as long as possible.

That's a myth! Keeping legs totally straight all the time after a TKR is painful and unnecessary and causes pain because it's unnatural. Look in here and see the do's and don'ts of this Elevation is the key to controlling pain and swelling

Also they said: no stretching up. Anyone know why? I can imagine why no bending down.

Same answer as above. A myth! Take no notice. I've no idea where these girls get these silly ideas!

 

[Pheebs52]

When you say you need to use a lotion the night before, even on your hair, is it an antibacterial wash? If so, no it won't affect your hair color. I color my hair, but I wouldn't do it the week before surgery just in case it should burn the scalp; it happens. You'll have plenty of time for color post-surgically.

 

[VW54]

Thanks for replies and links (have read those now all over again)
Re bath shelf: wouldn't work chez nous because one side of bathtub is so very close to the wall so shelf would just slip off one side: Hence putting the bench inside tub solution. I'm glad we have a hand held shower so that rinsing all over while sitting is no problem. We have a bench outside tub too (doubles for storage)

Re dyeing my hair: glad to know desinfectant lotion won't affect it. My hair is so white now/ I'm way past due That is, roots are showing, that I shall do it now. I just didn't want that lotion to turn dark blond into bright green.

Am having weird dreams related to this upcoming surgery. The latest one quite Kafkaesk : whereby I dreamt the hospital was running a lottery as to who would get what surgery And I kept saying: no, no, that's not how socialised medicine works! Woke myself up yelling.

 

[Pheebs52]

VW54, my hair is colored a light ash blonde and did not turn green, blue or any other funky, rainbow color. I will say it didn't feel nice, rather straw-like, but....c'est la vie.

Sounds like some stress dreams. Maybe a calming routine before bed would help? Some sort of soothing music, chamomile tea, lavender sachet in your pillow or just plain old meditation in bed starting at your toes and working your way up. Envision a warm, golden healing light enveloping all. Sweet dreams.

 

[VW54]

Thanks Pheebs52.

I just wrote an email to the OS to let him know I still have a bit of a cough and that I was ill 2 weeks ago, mentioning that I have had no fever for the past week now. I noticed on other surgery related websites that for patients with breathing problems such as asthma, allergic bronchitis, COPD, they select a spinal block.
I bet that is what he will suggest, though the anesthesiologist at the patient evaluation (19. May) said she would be recommending GA for me. To be continued...

I made my husband of 38 years (next week) read all about what is expected from carer and aside from : "of course I know all of that!" he also added: " but you will be walking around the house anyway, they won't let you out of the hospital until you can walk"
uhmmm yes, there's a sign he will be on a steep learning curve.

 

[kneeper]

:D In the first few days walking to the bathroom will be a trip for you.

 

[VW54]

I just wrote an email to the OS to let him know I still have a bit of a cough and that I was ill 2 weeks ago, mentioning that I have had no fever for the past week now. I noticed on other surgery related websites that for patients with breathing problems such as asthma, allergic bronchitis, COPD, they select a spinal block.
I bet that is what he will suggest, though the anesthesiologist at the patient evaluation (19. May) said she would be recommending GA for me. To be continued...

He just wrote back. Am pleasantly surprised as it is a Sunday of a long weekend here. I didn't expect a reply today. Basically he wrote: "If you are healthy on the day of operation, there is no problem. Spinal block is fine too. I checked the newest Xrays, and it is time."
hrmph. That leaves it up to me to decide how healthy I am on Weds morning. OK.
I've experimented this afternoon and taken more anti-histamine than I normally do. That has taken away some of the "nervous cough" or constant throat clearing. Probably a post nasal drip thing that keeps tickling and causing me to cough.
So I went from a real cough to allergic cough.
A physician friend said last night: "the antibiotics they give you on day of operation will start working on whatever nasty bug you had that might be malingering."

 

[Celle]

They will check your chest on Wednesday, when you go into hospital, so if you have any lingering doubt go to the hospital and let them make the final decision.