TKR On the other side!!!<

[KateRVN]

I shouldn't say hahaha.....not really funny what I'm about to say, but this I what my surgeon told me when he came to visit me after my surgery.....

"I didn't use a tourniquet because of your thighs size, we didn't have one big enough to fit you. You are incredibly small boned and I had to use the smallest of instruments to do your operation."

OMG I could have thumped this guy there and then for his derogatory comments. This is why I was laughing.......embarrassed I was and appalled. How dare he!

Anyway, this is all water under the bridge now.

I couldn't have a spinal because I hurt my back before the op in a car crash, only just 10 days prior to my surgery!!


Kate
Retired VetNurse
::Op date 20/07/15:: RTKR - awaiting LTKR

 

[Alta]

@ Celle I'm sorry if I'm coming across anything but informative so I apologize if it came out wrong

 

[KateRVN]

Hey Alta!

That's the problem when stuff is written, you don't get the proper sentiment behind it, therefore interpretation can be wrong.


Kate
Retired VetNurse
::Op date 20/07/15:: RTKR - awaiting LTKR

 

[Celle]

@ Celle I'm sorry if I'm coming across anything but informative so I apologize if it came out wrong

Hey, that's OK. No offense taken.
You're allowed to express an opinion. And it's true that some surgeons aren't using a tourniquet.

 

[Alta]

Well the verdict is in Neurontin is unbelievable I slept awesome ,and all that deep annoying radiating pain has dissipated .I'm feeling so much better than yesterday ,and all because of a little pill!!!! I hope everyone has a good and problem free day.

 

[Celle]

That's great to hear.

 

[gizmotto31]

Happy for you! The fact she got your script for you is sweet too. I should have went home PT route. I wanted to start with it, but the PA and my sister (who works in home health as a speech therapist and used to manage hospItal rehab floors) advised against it. They thought I would get pushed harder and recover faster. I tried to explain to my sister what some of this philosophy is about working smarter not harder. She was stubborn at first, and I even was on the fence, but after 1 session I am a believer. Some of the things I did at 4 days out of surgery are crazy, and now I am setback at least a week or possibly more. Cant walk, surgeon said stop everything, and see him. Hoping she didn't do anything too serious to me.

 

[Alta]

@gizmotto31 A swollen knee will not bend!!!The swelling in my leg has gone down a lot and still my pt will not try to bend past 90 because of me still having the staples in.I start out patient on April 4 and get my staples out on April 1 st. After I work with pt she has me walk up and down the hallway with my cane and it feels really good.I walk after dinner up and down the hallway and I usually do a lot worse because everything is tighter and more swollen. Keep up the fight toes above the nose, and ice that knee!!!!I hope the surgeon can get you back on the right track...

 

[Josephine]

He said he used exparel and Marcaine and not sure what the other one was.

I had that and it was magic!

I'm aware of how much damage a tourniquet can do to soft tissue and it can take up to 6 months to recover from just the tourniquet alone.

Oh that is so not true! Tourniquet pain A very few people get but it usually wears off after a few hours or days. I had it, it was agonising but was totally gone by day 4.

 

[Josephine]

I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery! ) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. how swollen is your leg?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. what kind of PT exercises and exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example

Exercises done at home: 3 sessions a day
Heel slides x10 (reps)
Straight leg raises x10
Steps x10

At PT
Squats x5 (reps) x2 (sets)
Wall slides x5 x2
Clamshells X5 x2

 

[kneeper]

Sounds like you're doing really well. Great that your PT helped you get the meds.

 

[Alta]

pain levels: My pain goes from 2-7 I get soreness burning stabbing. I have zero pain in my knee joint.

pain medications: 5 mg of oxycodone every 4 hours I also take Gabypentin 300mg 3 x daily also 3 Tylenol every 6 hours Celebrex 1 daily and 2 aspirin 325 mg daily

icing your knee and for how long? I ice 4-5 times a day 35-40 minutes at a time

elevating: I elevate my leg 4-5 times a day for 30-45 minutes

ROM:90 and 0

how swollen: Medium

activity level: I walk every hour down my hallway for 5 minutes

PT/exercises:
I'm doing stretching with my home pt 1 daily which consist of angle pumps while leg is vertical quad sets and bending all in one motion if that makes sense.

clamshells x5 x3
quad sets x10 x3 sets x2 times a day
heel slides x10x2 twice a day
I can't do any leg raises quad still really painful
calf raises to toe extensions
I'm sure I'm missing some things
Today I walked 1500 ft outside first time I've walked with just a cane that far in over a year

 

[newlybionic]

Ouch! Squats would probably hurt me so much! I didn't even try them last time at all and I don't have any plans to do them anytime soon. You are also doing so much exercising every day. I'm 4 days behind you and I'm happy enough to do some ankle pumps, attempt straight leg raises and a few heel slides every time I think of them. My main exercise is getting to the bathroom and back.

 

[Alta]

Besides the walk it takes me 15 minutes to do those sometimes I only do exercises 1 time a day with my home pt.She does a lot of stretching with my leg on her shoulder loosening it up doing quad sets with my leg in the air. I'm not doing squats I tried them a couple of days ago and it was to painful. My leg is definitely different at night than in the morning. The one exercise I like is doing ankle pumps while my leg is in the air leaning on my pt shoulder I can feel the swelling going down.We do this for 15 minutes before I go for a walk. I took my first shower tonight no more sponge baths I'm sure my wife is happy and it felt awesome !!!!

 

[Josephine]

pain levels: My pain goes from 2-7. I have zero pain in my knee joint.

Well, of course you have zero pain in your knee joint! It's all metal and plastic now!
As for elsewhere, that's to be expected at only one week out.

pain medications:
5 mg of oxycodone every 4 hours
3 Tylenol every 6 hours
Celebrex 1 daily
Gabypentin 300mg 3 x daily

Is that Tylenol 3 or three tablets of regular Tylenol? I did ask for mgs
Nevertheless, that should be adequate pain meds.

I ice 4-5 times a day 35-40 minutes at a time
elevating: I elevate my leg 4-5 times a day for 30-45 minutes

That's not enough.. Ice for at least 40-60mins and more than 4 times a day.

ROM:90 and 0

Not at all bad for one week out!

how swollen: Medium

Not bad

activity level: I walk every hour down my hallway for 5 minutes

It doesn't need to be every hour. Just on an as needed basis to bathroom and kitchen is sufficient.

My comments in bold
I'm doing stretching with my home pt 1 daily which consist of
ankle pumps while leg is vertical quad sets and bending all in one motion if that makes sense - not really but do make sure it NEVER hurts you.
clamshells x5 x3 - clamshells are for hips not knees
quad sets x10 x3 sets x2 times a day - that's 60 a day - far too many. Do 5 sets once a day
heel slides x10x2 twice a day - heel slides are very easy to do badly and doing 20 twice a day is badly! Read this Heel slides and how to do them.
I can't do any leg raises quad still really painful - good, you don't need to yet!
calf raises to toe extensions - don't do these, they are very hard on the knee and you're too early yet
I'm sure I'm missing some things - well, whatever they are, you don't need them!
Today I walked 1500 ft outside first time I've walked with just a cane that far in over a year - at one week out? That's crazy and far too much! Follow this Activity progression for TKRs.

So my summary is that you are already doing far too much. Stop the exercising.Don't let your PT make you do anything that hurts you in any way, however small. Your main focus now should just be on rest and the mantra. Read the articles I left for you in post #3. You need to take care of your knee and yourself now. You've just had very major surgery and cannot be expected to do so much while your knee is still healing.

I also recommend you read my recovery threads to see how little exercising I did!
First knee. Knee recovery - UK style
Second knee. Josephine's 2nd knee story - short version where I did even less!

 

[kneeper]

My PT had me start with only about 5 leg lifts. It sounds like a lot of the exercises you have been doing are for much farther out in the recovery--if at all. I learned to say no to squats (even wall squats) because they are really hard on your knee & quads, as I found out the hard way. And they didn't even have me try those until maybe week 4.

I found a good rule of thumb for the first several weeks is to elevate almost any time you're not moving.

 

[Alta]

@kneeper I can't do leg lifts standing or laying down it hurts and if it hurts me I don't do it!!

 

[Timetolive]

Yay! For showers!!! The best thing after surgery.

 

[Josephine]

You will in time. It's still very early days.

However, why don't you get a leg lifter? It was a Godsend to me when I had that tourniquet pain.
I was able to get my leg in and out of bed painlessly, for one thing!

 

[Alta]

@Josephine i do have one since this is my 4th knee surgery in the last year. Thanks for the suggestion!