TKR Nanners adventure to the other side

[kneeper]

I'm so sorry for the rough start, Nanners. I like what was said above--kind of start over now. (((Nanners)))

 

[Dulcimer Diva]

Your description of your nursing/rehab center fit mine to a tee (except my therapists were much gentler). Are you sure we didn't go to the same one? Even those three nights in-hospital post-op, despite the intense pain, get one spoiled for the constant nursing attention and the fact that you know at all times who your care team (RN or LPN plus "patient tech" or nurse's aide) will be. When you get to the rehab center, it comes as a shock to find out that there's usually no more than one actual nurse per floor (and you might not get the same one every night), and the mostly unskilled aides have little authority to give you what you want or need. That call button in the hospital gets you near-immediate results; in the nursing home, it's not unusual to wait 5-10 minutes for a response and then up to half an hour for your request to be relayed to the nurse if necessary, much less have the nurse respond. A lot of them are freelancers and incredibly overworked--even when they're nice it's not unusual for there to be miscommunications. And in-hospital your OS and sometimes even your PCP visits daily and the place is crawling with doctors (especially in a teaching hospital, where there are fellows, residents and med students); in a rehab facility, it's not unusual for there to be no full-time or even part-time doctor around--and to be visited by him/her (or their PA) perhaps once or twice during your stay. Your OS is highly unlikely to visit you--it's vice versa (and a PITA cab-transfer-with-escort) should you need to see him. (The exceptions are rehab facilities attached to hospitals--e.g., R.I.C. and Bowman in Chicago and Rusk Institute in NY, and even then you're seen by a physiatrist--a specialist in recovery from trauma/surgery/stroke--rather than your OS. These days, only the most serious and complex cases get sent there, as well as high profile patients such as stars and politicians).

Oddly enough, the furnishings and amenities in my rehab facility (about the price of a high-end hotel room) were nicer and more modern than in the state-of-the-art teaching hospital where my surgery was done. Flat screen TV, nicer furniture, good climate control. One thing in common, though, and I think it's universal: ICKY FOOD! Starchy, bland, often processed and usually sparing and off-brand when it comes to condiments.

 

[Nanners]

Dulcimer Diva you reminded me of the night bell terror too. I have a inflammatory bowel disease and when I have to go, I have to go now. Plus just taking the catheder out meant I had to pee alot more too.

I would push the call light and it would be a minimum of 5 minutes but on average 10-15 min before they came. I think thats how I got so good on the walker. Cuz I eventually got myself out of bed and using my walker made my way to the bathroom.

I am just doing the stuff at home. Its not as good as at the therapy, but I am keeping things moving. And finally after being told a gillion times they would give me walker, I still have not gotten one. Had to steal one from the rehab. I get my staples out on Thurs.., so hopefully they will have a new one for me then. Doesn't it sound like I have been having a blast.

Lizzy, the fibro has been doing pretty good surprisingly. But the Crohns is most definetly acting up with explosive diarrhea and loud intestines. Thank you all!

 

[bottomshollow]

'cause you both need and deserve them. Only good thing about an awful start to recovery is that it can all be up hill from here. You may find to your surprise that the PT you're doing on your own turns out to be much better for your knee than what you were getting. Take care, keep us posted, we care.

 

[Jebsw]

I'm glad to hear from you, but not glad to hear your tale of woe. It's bound to get better now that you're out of that nasty place.

 

[KathyH]

Oh so sorry to hear of your nightmare start to recovery, Nanners. As Judy and Jebsw say above, things can only get better from now on

 

[Nanners]

Lets hope so! I know that now that I am home I am feeling better tummywise. Still have some explosive diarrhea (sorry tmi) but its not as often as it was in the hospital. And eating better and getting back to my special diet is really helping. I really think I do need to nap a bit more, becuz I still feel really tired.

Knee is still pretty tender and tight, and I am icing all the time. I am hoping that getting the staples out will help things to not feel so tight and stretched all the time. Also, on the same day I get my staples out, is the same day I can stop the Lovenox shots too. Whoo Hoo!!

Oh and not sure if I told you all before, but I got a puppy I have been wanting forever. He is a Maltese/Chihuahua mix aka Malchi. I am head over heels in love with him, and he is such a sweet little guy. Its a little hard for hubby though, cuz he is caring for me and trying to train the puppy in the same time. But so far he has been a trooper.

And one last question, did your bruises itch? As mine are healing on the surgical leg it gets really itchy. Just wondering if anyone else experienced that.

Feeling sleepy so gonna try to rest a bit. Talk to all later. Hugs!

Gail*Nanners*

 

[Titianlady]

Oh, my gosh, Nanners!! I am so glad you are out of that place!! After this trying surgery, the last thing you needed to recuperate was treatment like that..it almost made me cry thinking about you there. You are home now and no one will mistreat you again.
What a terrible start you had. But now, every day will be better. I'll be sending you hugs and good energy dear heart.

 

[Nanners]

Thank you Titianlady! Believe me, I was crying almost every day too. It was horrible, I just felt like I was trapped in a strange nightmare and couldn't wake up. I honestly think I will have to see my therapist after all this. Think I even have a bit of PTSD after that!

I am taking everyones advice to just start over. Begin fresh! I am not even calling for PT appts this week, I am just giving myself a litle break for a bit.


Thanks!
Gail*Nanners&

 

[Titianlady]

Nanners, I was bruised from the bottom of my butt, to my ankles on the back side of my leg. It looked like I had been hit by a truck.
YES, as my bruises were doing their thing healing, it itched. I guess that was the blood being reabsorbed. It took about a month for all my bruising to go away.

 

[Titianlady]

Good for you!! You need to take a nice, long rest after that terrible treatment. I wouldn't even think about PT. thatl place stressed you, body and soul, and you need time to recuperate. I would raise holy hell with my Dr about your experience.of course not now as you need to put that behind you. All my good thoughts are with you. I'm so angry you had to suffer such ****!

I would love to see a picture of your new puppy!! He sounds like such a sweetie pie. You just hug and love on him when you feel bad, and everything will brighten up. Hugs for you my dear.

 

[Nanners]

If I can figure out how to upload a pic, I will post one. He is the cutest little thing!!!!! Thanks for your support, it means alot!

Hugs!
Gail*Nanners*

 

[Jacky48]

Oh Gail, I am so glad you're out of that ugly place! Not at all what you needed after going through such major surgery, you needed tender, love and care, but instead you got hate monster! Please report them to your OS and the hospital if they call to check on your progress. They all need to know not to send people there or at least warn them.

Please rest and ice often and sleep, sleep and sleep some more.

I wish you a speedy recovery! Stay well my friend! I look forward to seeing your new baby! Get plenty of puppy love!

 

[Janet2012]

What an awful experience! It's over, which is the best you can say for it. I hope this next week at home things start settling down and improving for you. Just being home is an improvement!

 

[Nanners]

Feeling so confused....I was giving some exercises to do at home. I tried doing them with my husband the day before yesterday, but afterwards I was just more swollen and in pain. I am taking the Dilaudid 4 mg every 3 hours around the clock, and sometimes especially at night I have to take a Percoset for the breakthru pain too.

I am not doing much, other than getting up to go to the bathroom or sometimes to the kitchen to get something to drink. Other than that I am icing, elevating, resting per the Bonesmart mantra. But am I doing harm by not doing any PT right now? Should I be doing a little something? Last night getting up to go to the bathroom was so painful. I can walk flat footed but I am limping alot. Then this morning I accidently bumped the surgical knee against my toilet riser. OUCH!!! That brought tears to my eyes.

Even as painful as things were at that rehab center, I felt like I was improving some. I can lift my leg straight up, I can get in and out of bed no problem, I can at times move about without the walker, but feel more comfortable with hit. So I am doing okay, but wondering if not doing anything but resting I am setting myself back.

Anyone give me some advice? Am I just being too hard on myself. Any words of wisdom? If now is not the time for some PT, when is the time to start it up again? Tomorrow will be exactly 2 weeks from my surgery. Thanks and big hugs!

 

[Josephine]

I just kept hearing Jo saying r..... no pain, no gain BS mantra.

THAT's not the BS mantra! It's "no pain MORE gain"!

And one last question, did your bruises itch? As mine are healing on the surgical leg it gets really itchy.

There is a treatment for that in here Bruising after surgery.

I am taking the Dilaudid 4 mg every 3 hours around the clock, and sometimes especially at night I have to take a Percoset for the breakthru pain too.

That's right - keep on top of the pain always - take your pain meds by the clock. Read this article Pain management: importance of managing pain after a TKR and the pain chart.

Feeling so confused....I was giving some exercises to do at home. I tried doing them with my husband the day before yesterday, but afterwards I was just more swollen and in pain.

I am not doing much, other than getting up to go to the bathroom or sometimes to the kitchen to get something to drink. Other than that I am icing, elevating, resting per the Bonesmart mantra. But am I doing harm by not doing any PT right now? Should I be doing a little something? So I am doing okay, but wondering if not doing anything but resting I am setting myself back. Am I just being too hard on myself. If now is not the time for some PT, when is the time to start it up again? Tomorrow will be exactly 2 weeks from my surgery.

There is no need to worry - a lot of surgeons don't allow their patients to start any PT until after 3 weeks post op. You need this time to get on top of the swelling and pain. That's your priority right now. Until that happens, you won't get good results from any exercises as they just stir up the swelling and pain again, making that all too familiar vicious circle. And it is vicious! So yes, you are being hard on yourself. You need to read the articles below to educate yourself on what is good and bad in a recovery and how you don't need to do anything much yet except the old ankle pumps, foot rotations (to prevent DVT/clots) and little walks to the bathroom and back - preferably with your walker, crutches or canes. Doesn't matter which but you need something. I was allowed a walker for 2 days and then it was on crutches which remained for about 5 weeks though I dropped to one indoors after about three weeks and eventually none indoors but still used two outside. You might like to read the potted version of my recovery here Knee recovery - UK style.

After that, read all these articles which give you a good all round picture about the best way to do this recovery thing - first tenet of the TKR bible being that you are not in charge of this process, your knee is! Knee is boss - remember that, take note when your knee is telling you its had enough of whatever you are doing and you won't go far wrong!
The importance of managing pain after a TKR and the pain chart
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

 

[Titianlady]

Sweetie, yes, you are being too hard on yourself. My wonderful PT told me to use my walker until I could walk without limping around, or having to "hang on to the furniture while walking without it" he said it is a tool, an aid that we use for a reason. He said it is not a race to see how fast we can get along without it. You can lift your leg, get in and out of bed, and frankly, you are doing well.

I couldn't lift my leg an inch for love or money for 3 weeks!! As long as you are gently doing heel slides and gentle stretching a few times every day, you are fine without formal PT. I never went to Outpatient PT once, and have 146 degree flexation. My PT only came three times a week for 3 weeks. He showed me the proper way to do my heal slides and stretches by myself.

Week 3 and 4 were the most painful for me. My PT warned me ahead of time to expect that as the numbing medication they inject into the knee during surgery has worn off, and the nerves etc are now starting to wake up after having been tramatized. They are starting to "feel " again. There is now a tremendous amount of healing going on.

Take it easy.. You are following the mantra, and this is normal for this stage my dear. Take your meds and relax if you can.

 

[Titianlady]

I wish I could send my PT to each and every one of you. That wonderful man could have been educated by Josephine..he had the BoneSmart mantra down. He even used the phrase, no pain More gain. He scolded me for over doing it and getting too gungho with my at home excersise. He even told my husband that if he saw me doing certain things to stop me immediately.

How I wish I could send him to all of you..it kills me to see so many of you wonderful folks at the mercy of improperly educated, idiot PTs that have no idea how to rehab a knee replacement patient. My heart just aches for all of you.

Listen to Josephine. She is magnificent and her advice is priceless. She is the best PT you could ever have without being in your livingroom showing you herself.

 

[Nanners]

Sorry Jo, drugs were involved with my typing. What I was trying to say I was trying to remember that the no pain, no gain was NOT an option. In fact kept telling them I am willing to have some discomfort, but NO PAIN! Sorry about the confusion.

 

[Limpin'Lizzie]

Hey, Gail....how are you today? I'm hoping that everybody's replies are starting to reassure you. I know how hard it is to follow the BS way of thinking, with PT's and OS being the total opposite. I was so glad to get away from them!
Take care! Liz