PKR NanaBeach 7 Months Post-op

[NanaBeach]

@beachy, only you know what you need! I've made far fewer phone calls and have been opting to send updates via text instead. Happy belated birthday to you, by the way!

My daughter and I are very close and I can't wait for time alone with her today. I know it was stressful for her to be 1000 miles away during my surgery/hospitalization. This first-Disney-World-visit for granddaughter was planned in February, with my husband and I supposed to have been joining them. When it turned out that I needed to get my knee replacement surgery ASAP (and then especially once my surgery was postponed), I strongly encouraged them to keep their plans and go anyway.

As things turned out, they had a marvelous, magical week! My husband said he thinks even with the best circumstances, we would have slowed them down and that's probably true. Obviously, there was absolutely nothing she could have done to help while I was in the hospital. The best news is they had an amazing vacation, and my post-op recovery is coming along great! I hope the same is true for you.

 

[beachy]

Oh wow! That had to be hard for you that you couldn't go to Disney with them! But, we do what we need to do, right? I'm glad it worked out for everyone.

Yes, I'm pleased so far with recovery. It could be a lot worse. Happy that yours is good, too! Thanks for the birthday wishes. We will celebrate more next year. I could have cared less this year.

 

[NanaBeach]

So here we are in the "middle" of night #4 at home (which is within Day 7 since my surgery). Yesterday was a pretty busy day, including a much wanted and extremely enjoyable visit with my daughter. She brought her iPad and phone to show me over 500 photos and about 10 videos from their week at Disney World. I loved it... and seeing all of this definitely helped me feel that I had experienced some of their joy from this trip.

Our granddaughter and son-in-law got here around 4:00. Rather than a brief whole family visit and an early departure, he left after about 20 minutes and the rest of the family stayed until 5:30. Part of this delay was my/our fault, since first of all, both my husband and I had missed seeing our granddaughter. Each of us had some time with her separately, but I simply didn't have the energy to enjoy this after a while. We had planned to share some of the delicious leftovers we had from friends bringing meals since Friday, so it took a while to get all of that packed up.

Meanwhile, here I am going on fewer than 6 hours sleep and also overdue for pain meds. By the time my husband set the table and heated up our dinner, I was exhausted. We didn't finish eating until almost 7:00 (late for us) and knew it was too soon to get into bed! We watched TV for 90 minutes or so, then moved to the bedroom/bathroom to get ready for sleep.

I forgot to mention another thing that's been going on. During Saturday morning, I noticed some small areas of redness at the base of both palms. This is the area where I've been holding on to the grips on both sides of the Walker. It almost felt callused, which made sense since I've used the walker so many hours in the past week. I took pictures of both palms yesterday morning, with the left one more involved. All day yesterday, this felt itchy too. By last night, there was an actual rash on both hands, with the left one showing small poison ivy type bumps and tiny blisters. What is going on with this???

Between the itchy/burning feeling on my palms, indigestion from lying down too soon after dinner, inadequate ice (wrap around ice pack stays cold 60 minutes or so) and having almost NO pain meds in my system at 11:30, it was time to get out of bed and settle back in the recliner.

It also turns out that much to my surprise, my husband wants to go back to work this morning! He typically makes breakfast for us (yes, I know I'm lucky) at 5:30 and leaves a little after 6:00. He's supervising construction of a building with 80 apartments and it's important to be on site when the sub-contractors arrive around 7:00. He told me he's planning to come home around 4:00, so I'll only be alone for 10 hours.

In the midst of this day alone is my PT appointment (first one after Friday's evaluation) from 1:00 - 2:00. My expectations are fairly low for this right now, especially since I'm not getting much sleep. Speaking of that, I'm going to put down my phone and see if I can get comfortable enough to fall back asleep.

Thank you for reading this! Any suggestions are always welcome. I'll try posting pictures of both palms from 5 hours ago. I put on a little bit of cortisone cream at bedtime to see if that would help the itching. No improvement so far. Is this one of those setbacks I've read about?

 

[NanaBeach]

My first attempt at uploading a picture of my left palm taken around 9:00 PM on Sunday, Oct 21 (about 5 hours ago) was unsuccessful. The file seemed to upload, but then I got an error message. Any administrators know how to fix this?

 

[Jockette]

Can you wrap something around the handles of your walker to cushion it a bit? A wash cloth, or something softer?

I had to tell myself not to grasp my walker so tightly, I could feel it in my hands and shoulders. I really didn’t need the death grip I had on it!

I’m glad you had a nice visit with your family, but yes, it can be exhausting at this stage.

Set a timer or alarm for your medicine and interrupt what you’re doing and take it.

If you are not up to PT today just visit with them. You don’t have to do anything with them you don’t want to. Don’t let them pressure you.

Because:

Keep in mind, it’s not exercising that gets our range of motion back, it’s Time:

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

 

[NanaBeach]

Thank you, @Jockette
Your reply is exactly what I needed to read, especially since today's PT visit is just over an hour from now. I'm SO tired and not focused on achieving any meaningless goals of specific numbers for flexion and extension.
The PT was very pleasant when she did my intake evaluation on Friday so I'm feeling good about that part.
With the irritation on my palms, I already cut one of the elastic bandages in half and wrapped each handle with one piece. Besides covering up whatever caused the rash, it does give extra cushioning too as a bonus.

 

[NanaBeach]

As things turned out, my husband was able to leave work earlier that expected and he was home by 12:15. That was so much better than an additional 4 hours alone! He made me a little lunch, then I had PT visit, followed by icing and a short nap (30 min). I'm happy to have any extra sleep possible! This brings my 24 hr total to 4 hrs, 30 minutes, so I still have a long way to go before I'm approaching adequate rest.

I'll be alone again most of the day tomorrow, except for the company of our granddog Deja, a 10-pound toy poodle who's a trained therapy dog. My friend next door will be coming over at lunchtime to walk Deja (definitely not something I could do in any capacity yet).

I'm hoping to talk with 2 or 3 friends by phone at some point, but will keep my knee care routine (ice, elevating, rest) the top priority. Thanks again for positive energy, prayers and encouragement!

 

[NanaBeach]

I'm planning to post a longer recovery update sometime over the weekend, but wanted to ask about post-op risks. This is addressed to @Josephine , @Celle and other administrators, but anyone is welcome to reply.

Is there a stage within the immediate post-op period when risk factors start to decline? I'm thinking about things like infection, allergic reactions, DVT and other blood clots, etc.

Today is day 12 for me and I'm all done with anticoagulants (surgeon prescribed 10 days of Lovenox injections since I'm allergic to aspirin). All of my IV and oral antibiotics were done by the time I came home from the hospital last week.

Especially since I'm making progress with gradually adding small ADL tasks and moving around so much better, it does feel like I'm "out of the woods" with the most severe risks (other than falling, of course). It would be nice to have some affirmation about this from those who are more informed and experienced. Thanks for any feedback!

 

[sistersinhim]

I have no idea how to answer your question, but someone with more knowledge will answer you shortly. It sounds like you are coming along really well. Adding those ADL is a sure sign you are improving!

 

[Celle]

I don't think there's any time when you'll be less (or more) prone to allergic reactions.

Once your wound has healed, you're probably less at risk of getting an acute post-op infection, but some people do develop infections later. I have no scientific basis for this, but I think that your risk of getting an infection in the joint declines with the passing of years. However, a peri-prosthetic infection can occur within the first year.
There's no need to worry about getting an infection (although we all do, especially at first). Most infections in other parts of your body are unlikely to spread to your knee replacement, but you should always get treatment for them.

The risk of getting a DVT does decrease as you get more mobile.

 

[Josephine]

Is there a stage within the immediate post-op period when risk factors start to decline? I'm thinking about things like infection, allergic reactions, DVT and other blood clots, etc.

Infection: once the wound is healed
allergic reactions: depends what you are referring to but generally, if a person has a propensity for allergies then never but it they don't, then it's not a problem
DVT: it's circumstantial such as sitting for ages, like on a long haul flight. But mostly nearly everyone has some tendency to DVT, specially if they have other issues such as diabetes, neurological or vascular problems.

 

[NanaBeach]

Thank you, Josephine.

 

[NanaBeach]

Staples came out this afternoon... hooray! Knee is actually a little cranky right now, so I'm in my favorite reclining position with an ice pack. The last time I had staples removed, there was no pain, but rather a quick pulling sensation. This time was a little uncomfortable, including some spots of blood. The PA put steri strips on to cover the full incision. I'm not sure how that's going to impact being part of the testing group for Scar Shield, which I've been enjoying. Anyway, I hope getting those staples out will result in less tightness across the knee.

I'm ready to relax and enjoy the weekend, knowing that each day of healing brings me closer ton moving around without pain again. ,

 

[Celle]

During Saturday morning, I noticed some small areas of redness at the base of both palms. This is the area where I've been holding on to the grips on both sides of the Walker. It almost felt callused, which made sense since I've used the walker so many hours in the past week.

Can you wrap something around the handles of your walker to cushion it a bit? A wash cloth, or something softer?

I got calluses on the palms of my hands from using crutches for 4 months. The only thing that helped me was to wear a pair of those fingerless cycling gloves that are padded on the palms. If you're still having problems, maybe you could try those.

My first attempt at uploading a picture of my left palm taken around 9:00 PM on Sunday, Oct 21 (about 5 hours ago) was unsuccessful. The file seemed to upload, but then I got an error message. Any administrators know how to fix this?

This may help:
https://bonesmart.org/forum/threads/uploading-a-picture-in-a-post.14731

 

[NanaBeach]

Thank you, @Celle . Fortunately, this was truly an allergic reaction of some type with contact dermatitis. While it was very uncomfortable, the blistered rash did dry up and heal within about a week.

 

[NanaBeach]

It's hard to believe that tomorrow will be three weeks since my surgery! I feel very encouraged about how things are going and grateful not to have encountered any major challenges.

My knee was still uncomfortable yesterday, following staple removal and also my first "full" PT appointment on Friday. I was a little bit too enthusiastic about getting some exercise and probably did more than was advised. I'll definitely scale back on this for my appointment tomorrow.

Meanwhile, last night was pretty good overall, with a total of about 6 hours sleep divided into two 3-hour segments. My husband and I went out for breakfast this morning -- hooray! We chose a nearby restaurant in a shopping center, with easy parking in a large parking lot. It felt great being out and about, particularly on a beautiful autumn morning. This was also my first time using my cane again!! I had my walker in the back seat, but wanted to see how things were with the cane. My husband walked slowly by my side and I held on to his arm for added security.

I've been using only Tylenol for pain control since about day 6, with lots of icing and elevating every day. Yesterday was the first day I could take a shower without my leg wrapped in plastic! Since my stability was much better without that, I decided to see I could finish my shower and shampoo without using the shower chair. I had it in place "just in case" but was able to stand up without difficulty.

All of these little accomplishments feel fantastic! My husband went to play golf for a few hours, so another goal today is to see if I can take care of one or two loads of laundry. Baby steps!!

 

[beachy]

You should feel fantastic about your accomplishments! I'm 4 days before you and I don't think I can go out and sit with my leg down for any length of time. I'm still taking pain meds every 6 hrs except through the night.

I can do some laundry, feed the dog, cook part of a meal. But standing for more than 20 min tops is not good.I

Take it easy with pt. I'm really happy for you!

 

[NanaBeach]

Thank you for your encouragement, @beachy . I know we're all unique and this isn't a competition. One of the most important parts of any healing journey is remembering to "listen to your body" and recognize that there will always be some steps backwards, in addition to those steps which bring us closer to being recovered from this surgery.

This morning my knee isn't feeling too happy, which may be because I skipped my usual icing and elevating in the recliner before bedtime. Both my husband and I were extra tired last night (he played a full round of golf, walking 4 miles or so, for the first time in 3 weeks), so we got into bed early with our books. I used a wrap around ice pack in bed, but this interfered with my sleeping. Back to plan A tonight!! (i.e., ice and elevate in recliner for at least an hour before bed).

I hope today is a good day for you! Please keep letting me and your other BoneSmart friends know how you're doing!

 

[NanaBeach]

Hi BoneSmart friends,
Yesterday was 4 weeks since my surgery, so I wanted to check in here with some updates. Overall, I'm doing really well with my recuperation! The biggest challenge for me has been getting enough sleep and being able to sleep more than 3 hours or so without waking up in discomfort. I was able to transition from the Rx medications (Vicodin and Neurontin) about one week post-op and have been using various doses of Tylenol since then. I'm allergic to aspirin and cannot take NSAID medications like ibuprofen, so I'm making the best of what's available. As the weeks have passed, I've been able to reduce the overall 24-hour totals from about 2900 mg of Tylenol to under 2000 mg now. This includes 1000 mg at bedtime (2 extra strength caplets), so I'm not using much during the day at all.

I still find it helpful to ice and elevate a couple of times daily. While I'm eager to be doing more things and getting back to a more normal routine, I've found that my knee will be swollen and sore when I do too much. That's a good reminder about the importance of "listening to my body" and being patient throughout this recuperation.

I'm going to outpatient PT twice a week and finding that very helpful. My therapy team members (primary therapist with doctorate DPT, and intern finishing her 3rd year of DPT program) are both wonderful. My favorite parts of PT are using the Nu-Step recumbent cross trainer (consistently doing 10 minutes now, which loosens things up and gives a good stretch to begin each session) and the massage that the therapists do around my knee. That relieves a lot of the tension and tightness I've been feeling. I also enjoy doing exercises at the parallel bars, such as heel and toe lifts, side stepping, gentle marching and others. My PT facility is huge and has lots of therapy options, including the Game Ready compression and chilling system for post-therapy use. This seems to be a tool developed for professional athletes and it's awesome that they have two of them available! I looked up this system and it's very expensive (around $2500 US for the basic model), which explains why it's not found in more places.

With each day, I'm slowly adding more ADL to get closer to the things I was doing before my surgery. Yesterday was another big milestone for me (besides the 4 week mark) -- I drove for the first time! Since it's my left leg that's recovering, this wasn't too bad. I'm still using a walker for stability, especially outside, so I was able to fold that up, put it in the back seat and get on my way. Besides driving to PT (my primary destination), I also made a quick stop at the pharmacy. I'm far from being ready to tackle something like grocery shopping, but even getting this bit of my independence back feels amazing!

All in all, I'm incredibly grateful for everyone's support, encouragement and helpful ideas throughout this experience! I know 4 weeks is only the beginning of my healing journey, but I'm very encouraged about regaining my mobility again in the months ahead.

Sending good wishes to all of you!

 

[SusieShoes]

Wow! Sounds like you're doing great. Sleep can be a problem for a while, alas. As long as you're getting enough nap time in, you'll weather this. I didn't sleep through the night, not reliably, for four months. It was the worst part of recovery!

Grocery shopping might wipe you out at first, when you get back to it. Just be prepared. Make the first trip to the grocery store a short-list trip. Eventually, though, the grocery store becomes good exercise!