Revision TKR May 9 2024 Revision TKR - again

[Layla]

It is Day Three today, Jen, only adding this because you questioned it in an earlier post. The day of surgery is not counted. I am sure you found from previous surgeries that it gets easier when you can count by weeks, as opposed to days, then naturally by months.

Waking up only once this early on is fantastic! Look at you up and cooking already, pretty impressive.

I am not a good one to advise on the medication. I was the same and wanted off the Oxy and only ever took 4 total, two were given to me at my surgery site and I took two at home and was done, but I did have other non opiate medication on board for the first week so I did well. After that it was Extra Strength Tylenol and LOTS of ICE!I am sure others will stop by to share also. Wondering what your surgeon advised?

@Jen53014

 

[Jen53014]

It is Day Three today, Jen,

Ahhhhhh thanks! I kind of thought surgery day was 0

Doc just gives general guidelines- up to and as needed. I took 2 this AM and next dose I’ll take 1 and see how it goes. I cannot believe you used so little! You must have an amazing pain tolerance!

I had an amazing sponge bath and put on clean clothes. Sometimes in these early days it’s the little things.

 

[sistersinhim]

It definitely is the little things that matter so much! What is nothing to someone else, is a major thing for us.

 

[Jen53014]

Day 4 another good overnight - only up once for meds and bathroom. I do some icing at bedtime and by morning the knee is super stiff. I keep the leg elevated all night and this morning about an hour before I got up I took the leg off and gave it a good stretch - not quite as delightful as I anticipated

I am able to move my knee side to side, very short heel slides and no go on straight raises. I can easily navigate a few steps. I mostly keep the walker near, but don’t need the support as much and often navigate around without when there are other support surfaces available.

I went down to 1 pain pill every 5 hours along with Tylenol every 6 hours and a daily meloxicam plus twice daily 81 mg aspirin. Saturday I thought I’d run out of pain pills because the pain was unrelenting. Let my tale be a caution to you about staying up to date on pan meds.

Some information on the actual surgery. I was in the OR about 2 1/2 hours start to finish and the surgeon worked on me just under an hour. The assistant surgeon told me they spent extra time cleaning up scar tissue - well this was my third time on the same knee so that’s not surprising. The nerve block was given in the recovery room and the hospital nurses (and confirmed by ortho doc) told me they now see many knee patients having the numb foot for some time. Too bad the nerve block fades from the knee before the foot As someone that has been through this before I can honestly say this is different from my other 2 times - the nerve block was done before the surgeon closed and never effected all the way down my foot. I will get more details on how everything looked inside when I see the ortho for a follow up (3 weeks post surgery).

I would like to try a shower today, but I need to make sure my hubby is on board because the worse part is getting the sausage back in the casing (the tights and wraps) - it is hard to do that yourself when you can’t really bend or move the leg around well.

 

[mendogal]

I would suggest alternating one pill dosage and two pills dosage in a way that has you taking two pills at bedtime.
Most of us did need that extra boost at bedtime (when fatigue and quiet makes our experience of pain so much harder) for longer than during the daytime.

 

[Jen53014]

I would suggest alternating one pill dosage and two pills dosage in a way that has you taking two pills at bedtime.
Most of us did need that extra boost at bedtime (when fatigue and quiet makes our experience of pain so much harder) for longer than during the daytime.

I had the pain pills right by my bed n case I did need the second one! Last night was good, but I’ll be n the lookout for sure! Excellent strategy.

 

[Jen53014]

Day 5 - another good overnight sleep. This amazes me as I always had an issue sleeping after my previous 2 knee surgeries. Last night I iced my knee about 40 minutes while resting on a nice wedge. I removed the wedge and slept with my leg flat. It felt like I could stretch it out more, but didn’t make any difference in the stiffness this morning. I don’t remember this much stiffness from the other two, but I’m skeptical about my memory

I tried my recumbent bike yesterday and stopped after about 30-40 seconds. Just gentle back and forth - nothing over the top. Did some small other moves - no straight leg lift yet. Today is my first post hospital PT.

I sat outside about 10 minutes twice yesterday, but my leg does not like hanging down - soreness and throbbing.

I have a full cast cover that allowed me to leave all my wraps and bandages on my leg as there’s no way I could maneuver enough to get those back in place. And hubby doesn’t have enough hand strength to get them on either. Personally I think those things are the main hinderances to recovering on your own. My shower was lovely and I washed my hair too. Took a break after because it also felt like a big effort - worthwhile effort though!

I’m not getting any sharp pains - more soreness and throbbing and of course stiffness. When I was on the bike I heard this squishy sound - didn’t hurt but sure sounded weird - I think it’s swelling liquid. Hoping that starts to go down soon.

Will report back after PT later.

 

[Layla]

You're doing really well with the sleep and it's so important as our body heals best as we sleep.
Good Luck with PT today. Take it s-l-o-w and easy and don't let them force you to do anything that hurts.
Just say, NO
Happy Tuesday, Jen!
@Jen53014

 

[Jen53014]

Day 5 PT update. I was on schedule for a pain pill 30 minutes before my scheduled PT start time so I made sure to take as I didn’t want to be on the back end. I was able to do tip toes, walking without assistance, getting both legs on the table without aid, heel slides, side to side slides, glute and thigh contract. She put the roller under my knee for extensions, but I only did 3 as they were plenty hard.

Measurements
Hospital May 10th ROM 10 and Bend 80 degrees
PT today May 14th ROM 13 and Bend 76 degrees

I wasn’t surprised the numbers were a bit less today as the swelling definitely seems much more than when in the hospital. I spoke with the assistant surgeon today (I keep running into him at the hospital!) and asked him if it was more swelling or my imagination. He told me definitely more as every time they go in the same area there’s more scar tissue and clean up leading to more bleeding and swelling. He also mentioned my knee was sooooo loose before surgery they thought the post would be broken, but it was damaged - not broke off.

 

[mendogal]

I would strongly urge not doing leg extensions on the roller until the 6 week time for muscle healing has passed. Your quads aren't ready for it!
Doing "quad sets" is a safe alternative.

 

[Jen53014]

Day 6 - well overnight sleep was not great. Definitely felt the leg much more and logically I know I can attribute that to the dedicated PT. Much like finding moderation in exercise you don’t know you’ve gone over until you’ve done it. I took a pain pill overnight (as I have been doing) but laid awake wondering if I should have taken two. I vacillate because the pain isn’t sharp or constant and figure oh I can get by with one. Its mind boggling to me that I STILL second guess myself even though I know taking meds is temporary and ultimately pain relief leads to recovery.

My plan today is to do 2 home PT sessions - trying to push but avoid too much. I’ll need a few naps because of the poor sleep, but honestly I love naps. Feeling a bit of the post surgery blues, but I know this to shall pass.

 

[Jcx]

Hope you have a speedy recovery and your rehab goes well. Take care jcx

 

[mendogal]

Please consider doing one home PT session, divided into several mini sessions. It's MUCH better for your healing and not provoking increased swelling.

 

[Jen53014]

Please consider doing one home PT session, divided into several mini sessions. It's MUCH better for your healing and not provoking increased swelling.

Don’t be impressed…my 2 home PT sessions are not long. I took out the extensions. I did about 5 min of rocking on my bike - that felt like a nice stretch and I didn’t push too far. The side to side and heel slides are challenging and so far I’ve done 7 to 10 each time. I did 2 straight leg lifts and only 1 in the afternoon session - those felt like fire on my quad and yesterday I couldn’t even lift. That was a too much pain - no thank you As to more frequent and shorter sessions - I periodically do some exercises through the day with no goal only to keep limber. My calves are very tight and my knee cap feels bruised and swollen and of course the quads are sore. I might try some stretches (gentle) tomorrow for my calves and hammie….maybe.

My plan tonight is to pop 2 pain pills before bed as I accompanied my husband on a drive to pick up supper, but that was too long with my leg hanging down (35 minutes) plus a bad night sleep last night and I want to make sure it’s a good night! The supper was delicious!

 

[Jen53014]

Day 7 - week 1 recovery
I planned my pain pill schedule to have 2 right before bedtime last night - alas I must have been over tired as it took me close to 2 hours to fall asleep. I did watch a couple episodes of a show as I’m not one to just lay in bed and my mobility precludes me from hopping out of bed for a bit. Once I fell asleep I awoke at the exact (within 10 minutes) time for next med dose - your body does know the rhythm. I right back to sleep and didn’t get up until 5:15 am. First night I’ve not had to get up for potty!

Nothing planned for today - regular PT exercises at least twice. We’re expecting rain most of the day here so I’ll just keep my spot on the couch warm and switch it up by laying in bed

Here‘s my question of the day! For those of you alone how do you manage to take off the circulation stocking and ace bandage wrap? I guess the real question is how do you get them back on? My husband does not have the hand strength or dexterity and I can’t maneuver the leg around enough - right now I’m not planning to take off at all, but in my mind a nice breather would feel good!

 

[Layla]

right now I’m not planning to take off at all, but in my mind a nice breather would feel good!

I suggest you phone your surgeon's office to ask if you're able to leave them off for a period of time during the day and if you're mobile enough, they may agree to it. Also, mention that you don't really have a way to get them back on, unless you have a friend, family member or neighbor willing to assist? It's worth a try, many surgeons don't even recommend them these days and they may just let you off the hook.
Have a great rest of the day!

 

[Jen53014]

Day 7 update - I used my cover but there was water from the other day (it was not hung upside down to dry) so my compression sock was soaked. I ended up taking the wrap and sock off. Here’s a picture. I’m quite surprised at how little bruising remains as the inside sure is sore. I managed to get a new compression sock on - very slowly and bit by bit. The wrap was easy.

Did some easy PT today. Leg felt better today. I also didn’t notice the time when pain meds were due. Definitely an improvement day!

 

[Jen53014]

Day 8 sleep just okay. Feeling less pain and more achy soreness. Didn‘t rush to get a pain pill after PT today. Starting to feel like I don’t need to be on a schedule during the day. Will stick with a bedtime one still. Took 2 walks outside today - maybe a block each time. Very slow! Haven’t used my walker in a few days.

Progress seems really good - just need to get that swelling down.

 

[Jen53014]

Day 8 update - I ended up taking a pain pill about hour 7 and I’ve been going regularly around 5 hours (or even 4) up to today. I was sitting on the sofa watching a movie with hubby and felt myself trying to stretch and rub my way out of some beginning pain. The lightbulb went on and I went and took a pain pill. Within about 20 minutes the pain mellowed quite a bit. I’m now laying in bed with ice and elevation with a dose on my table for midnight. Not as close to stopping as I thought and that’s okay!

 

[Jen53014]

Day 9 - another night of less than stellar sleep. The pain is more achiness in the overnight and I find myself with restless leg syndrome - I interpret that as trying to stretch the constriction out. Last night I swore I had left a tight ice wrap on or something…it just felt constricted. Definitely feeling more pain in the kneecap area and deep in the thigh. Since the revision focus was replacing the upper and spacer that makes logical sense.

I did all my home exercises and bike loosening. I was able to do a straight leg lift today without excruciating pain - so I did 3 of them - woo hoo! Went to the store this morning and can lift my leg in and out without the lifter - it’s work, but doable. Might take an afternoon walk to absorb some sunshine. My pup (5 year old black lab) is so accommodating - he slows completely down to walk with me We’ve been playing some hide the treat games - I hide the treats in a bedroom and he seeks them. We have been having rousing games of tug which I always lose - boy he’s strong - I think we’re both strengthening our core! And we have several games of fetch the monkey. At night he crawls in bed with me - waits for me to get situated and then snuggles in. He only stays about 30 minutes, but it’s a lovely snuggle.

I will say that I’ve read some people experience decreased appetite and I am NOT one of those people. I am eating everything and then adding candy and other desserts. The only “health” concession I’ve made is to add in 3 prunes everyday (okay today is the second day) in an effort to add some regularity.