May 15 Left TKR

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Wow you are really preparing! I think a walker with forearm supports would work. Your weight is on the forearm.

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Just another hint. You may need to turn the freezer temp up to contend with the constant freezing of the water bottles. At one point I had 16 in rotation! My machines Breg Polar Cubes only held one size of water bottle so you should try it out in advance. I'd start using the game ready now. Ice may help your knees feel better! Practice makes perfect!
 
Hi Red's Mom,
Thanks so very much for the tips! I will take a look at ordering that model of walker -- it looks like just the ticket for keeping the heavy stress of my wrists.

My DIL (Daughter-In-Law) the RPT was here with the fam and kiddies for Easter- we talked about this very type of walker. She thinks I should definitely get in to see the hand ortho specialist prior to surgery to get clearance or find out exactly the limit of weight bearing I can do without damage. PT can work with any situation- they just need to know the limitation issues & physical boundaries.

She did a walk-thru of the house with me while pointing out any and all "risk" issues and giving alternatives ideas.

She recommended:
- taking the additional thermopedic 2.5 inch mattress topper off the adjustable bed to lower it abit AND to make it easier to 'slide' my legs and body. Those toppers are so dense when you get in the bed you sinks into the lovely cushy-ness, but she said it would cause me undue pain getting in and out, as well as trouble adjusting my leg once in bed, that can lead to less moving and thence more risk

-Using the back garage entry v the front door to go in and out of house. Front has very large semi-circle step with no support to walkway. Garage has two steps with a wall on left that we can add a grab bar to for safety.

-Remove all through rugs- everywhere in the house

-slice open tennis balls to put on walker feet to slide better on very dense bedroom carpeting.

-suggested that since we have a master bath remodel underway right now, do spend for the addt of a handheld adjustable shower head to the planned regular shower head. The vertical bar the handheld showerhead is on also serves as a very stable grab bar as it is setting and mounted behind the walls.

-suggested I NOT take the game ready to the hospital- it is unlikely that floor staff have worked much with these as they are not 'regular' equipment- and it also could find legs and disappear while I'm sleeping or at therapy.

-Put all 'Use every day' kitchen items either in top drawers or on top of counters. Messy, but "easier"

-her main emphasis was always
a) reduce risk of falls/overreaching
b) balance issues will be wonky for a while, between meds +the new mechanical aspect of the new knee which can sometimes buckle till all the muscles and things have tightened up and the swelling is down.To Just be aware - don't overdue. One of BoneSmart's mantras.​

-She also said to keep an open mind about going from hospital to rehab for a few days if I just don't feel I can manage at home right away. When I made a face, she said just keep it as a good option- particularly if the fibro pain mgmt is tough. :umm:Rehab facilities for even a couple of days can get a new knee patient past the hump and more ready to be at home. I still made a face, but said I would keep it in mind.

Her personal opinion on Passive Motion Machines is that she, as a therapist, would rather see patients out of chair or bed doing basic natural movement-nothing fancy- just normal moving- any time possible rather that sitting or lying strapped into a CPM. Even in the hospital.

She encouraged me to be my own advocate as an inpatient- if something is not right for me, to simple decline that item or practice. Just because a nurse/therapist comes in to do something, doesn't mean not to ask 'why' or that I have to submit. I seem to recall this in the BoneSmart advice in some form.

She liked the Game Ready cold/compression machine, she has not personally encountered it in any of the hospitals she has been in, but again, she said that between (or while) usage to be sure I'm not depending on it to "be' the excercise just because there is compression. Normal movement, of any kind, + foot pedaling, foot slides glute squeezes, low leg raises, body stretches like neck rolling, shoulder shrugs, back rolls etc. all help to fight stiffness and ease pain of hospital inpatient.

She's a straight-talker- even to her MIL (mother-in-law). :heehee:

I will be using the Game Ready starting tomorrow after I have a training session appointment on the machine with my ortho PT dept. I'm sure it will help both knees- I can't wait to try it.

Has anyone used a peddled exerciser like this one post-op?

peddler3-vert.jpg
 
Red's Mom,
I just noticed you had a Zimmer knee both times... how was it. Mine will also be a Zimmer (unsure which model) the gender one I think...)
 
I've read of quite a few people who used a pedaller like the one you suggested.
 
How fortunate you are to have such a helpful DIL! BS echoes much of what she said, even as an in patient don't do anything that causes pain to your knee. Sounds like you're prepared!

I wasn't planning on going to a rehab, but a social worker came to see me in the hospital, asked some questions about my living arrangements and suggested I transfer to the in-hospital transition unit/rehab that specialized in surgical patients if they had an open bed. At first I wasn't too keen on the idea, but then I began hoping there was room for me. A few days later they just wheeled me down the hall and through a doorway to the transition unit. The rehab nurses were wonderful, PT didn't hurt me and my pain was managed very well. They even helped with the constipation problem (Miralax) brought on by pain meds. So although it was nice to finally get home, I am thankful for the care I received at the rehab. They made sure I could do 13 steps, the number to get from my garage to the main floor of my ranch home. I went back a few months later to deliver chocolates as a thank you to the staff.
 
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Karri B- yes, she is a peach! And abit of a legend in her own right in the family- she delivered our 12#4.5oz grandson naturally! That's right, Twelve Pounds, 4.5 oz! Thanks for your story about the rehab side of hospital. I will find out the options when I go to the TKR class on May 4 at the hospital.

Thanks, Arttie, for that link, will take a look!

Thanks, Cell, I think I will get that- more PT at home means one less at the PT office! And Game Ready after.

Anybody else spend some time at rehab v directly home? Would like to hear more....
 
A lot depends on the quality of the rehab unit. Some are good, some are not.
Some people have found that the rehab unit was full of old, infirm people and wasn't really geared towards recovery from a knee replacement.
 
Celle is right, I was very fortunate to be in a hospital transitional unit specializing in surgical patients. Do some research to see which rehabs are surgical and which are more of a nursing home, just in case. I've told my family I'm not sure I'd go to another rehab if I couldn't go back to where I was.
 
I should have added that you can get them at any RV dealer's parts dept.
 
Just thought I would share this Cold Pack with the group since affordable Cold /Packs /Wraps are one of the really key supplies.

I have used these for decades and have always bought them by the case of 12 of the 12" X 12.5" They mold nicely to body areas- back, sides, legs, hips

They are called Flexible Polar Pack by Tegrant/ThermoSafe and can also be warmed in the micro for warm wrapping with the surface of the skin always covered either way. Mine seem to be around $60/case of 12 wholesale + ~$15 shipping.

Very good, reusable, last along time . Use a pillowcase or towel around them please.
 
@TMWDeM ... the link you provided is to a pedaler in Amazon. I was not able to find the actual product you are describing, so would you please give us the correct link?
 
I met my new Physical Therapist today who will take me through the whole process- first the left, then the right. I think I may have hit the lottery with this professional. He is a DPT (Doctor of Physical Therapy) Registered PT, and Orthopedic Clinical Specialist (OCS).

Re: Game Ready - he took me through process of setting up the Game Ready unit, fired it up and let me feel the Low and Medium settings. Maximum Time ON = 15 minutes with at least 45 minutes OFF. That is a good ratio of time: cold to remove the heat from TKR knee both pre-op and post-op with the combined gentle pressure to reduce swelling and to best enhance blood flow by the cycling of the pressure pumping.

His mandatory 45 minutes off is to optimize the fresh blood flow to the site and to replenish the cellular blood levels to create healing and to allow the knee to warm back up to normal levels. He also said he never recommends using the High Pressure setting except under very special and monitored conditions, it's simply too high of pressure for most applications and can actually cut off blood circulation quickly where cell damage can occur in even healthy users.

The temperature setting depends on how much knee wrapping is under it in order to get cold to surgical site. 44 degrees temp was what we used in office with just sweats over the knee.

Current flexion in left knee is 110 degrees with gentle assist by me (not him). Encouraged gentle work on that pre-op. I can get full flat extension. I was very surprised when he asked if I had all my post-op PT appts set up already-- their office is very heavily booked out. Oops. I was able to contact my OS office - who also was surprised. Now booked 2XWeek till end of June.

Used the Game Ready tonight 1x on left 15 min on, 44 degrees, Low pressure. I can't tell you how good it felt! Afterwards, I saw an immediate increase in easier flexion (guessing ~10-12 degrees?) An hour later, tried on my very taxed and painful right knee. I was totally chilled after each treatment, even with a blanket on.

The key learning point is that Game Ready is serious medical machine - it comes with has tons of warnings in it as to what can happen if misapplied. But the manual also suggested 30 On- 30 off.

Going with my PT's direction and I'm really glad now that I did wait to be directed. I'm also keeping a usage diary of date/times/ that I use it, the setting, the temp and any notes or observations after each time. That will make it easy for me, or hubby early post-op as it will certainly require help to get in and out of the knee sleeve, fetch ice, water, and frozen bottles- and to make sure I keep the 45 minutes off instruction!

Have a nice night!
 
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Somewhere on the forum, I read someone's account of a "numbing capsule" (?) left in the knee joint that worked for several weeks? (Unless I was just wishing for it when I was reading! :heehee:)

Was that real? Is anyone able to tell me the name of that anesthetic? My PT/DIL has worked with patients with it and said she has seen good results in patients that have received it, be she couldn't name it for me.

I would like to request it of anesthesia.. or my OS.
 
When my neighbor had his knee replaced last fall, he had one. He said it contained morphine and lasted about a week. I'm getting my surgery done next Thursday at the same hospital and I was told during my pre-op consultation that my OS also uses one, but it contains lidocaine and lasts 3 days. Guess I'll find out which it is, next week.
 
TMWDeM - Good luck on your surgery. I had one TKR in December 2015 and the second in October 2016. I will admit the first went smoother than the second. The second there was lots of soft tissue issues they had to deal with - when the soft tissue pain went away I was great.

I, too, have an adjustable bed where the end raises up, rather than the hospital kind where it raises under one's knees. That was my greatest help with both of them surgeries.

When the pain increased, I took an ice pack and went and laid on the bed and elevated the end up and within 12-15 minutes the pain would be gone. I didn't have a leg lifter - I just used the exercise bands PT gives you and looped that under my heel and up the leg went. Even though I had more pain with the second surgery, I didn't need the leg lifter at all.

I didn't have the Cryo Compression system but I was able to use the Ice Man cold therapy machine from a friend's dad after the 2nd surgery. It really did make a difference. I couldn't handle the ice in the cooler so I devised Ziplock bags of water I would freeze and drop in the water and voila! Worked like a charm.

Again, good luck and keep us informed!
 
Hi all, and thanks for the replies on the "pain thingy" question. I have heard of the pain pump, actually had one with my shoulder surgery in about 2001 for A/C Impingement Sydrome and torn labrum inside rotator. It helped a lot- it was lidocaine. Have not heard of the On-Q one, will ask about it. The one I was trying to locate again sounded to me like it was a 'capsule' or something that the surgeon left in the knee compartment that worked for about 3 WEEKS. I could have totally misread this.... I thought it was too good to be true! But they had actually included the name of what-ever-it-is, and now I can't find it again!

But the squeezed bonus of lidocaine was awesome. I was told with my wrist surgeries that the hand surgeon didn't use them. Boy, I wish he had.

Anyone with opinions on General v. Blocks- I've had trouble with blocks before not working right....
 
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