TKR One knee done in March; other one in August

[Beckadeez]

Great to hear! Hope you get to go home tomorrow. It’s so hard to recover while in the hospital. I stopped using my CPM a few days after going home. It didn’t really help me, plus it was annoying. I hope switching to Tramadol helps you.

 

[sistersinhim]

Going home will be so good for you. I hope tomorrow's your day! I have never used a CM machine after any of my surgeries. I'm glad, I don't like being tied down to anything and want to be in total control! It's good to hear you're switching to Tramadol. It worked well for me when taken with Tylenol:

The first is for 4-hourly doses and the second for 6-hourly:

 

[Celle]

If you move on to the Tramadol-Tylenol regime, do check to make sure that you are not taking any other drugs that contain Tylenol (Acetaminophen). You need to stay within the safe limit of 4,000 mg of Tylenol in 24 hours so, if any other medications contain Tylenol, add their amount into your daily calculations and reduce another of your doses, so you stay within those limits.

 

[SusieShoes]

Hope your blood pressure treats you well and you have a smooth transition to home. Home is soooo much better! Quieter, and you have all your stuff and you can set your own routines. You’ll find that it’s totally true about there being no place like home.

I never used a CPM either. My OS was all about the knee moving under my own power, so it was the same with PT, just what I could do, not what the therapist could make my knee do. I really appreciated the PT in the hospital, about doing stairs, getting in and out of cars, even how to get up from chairs. It was really useful for being at home and taking care of myself.

Keep up the good work and spirits!

 

[yesyvonne]

Came home from the hospital in late afternoon today. Guy delivering the rented CPM arrived then too. He said I may well be done with it before the three weeks of the rental term are up. We’ll see.

PT is coming to see me at noon tomorrow. I’m glad I’m familiar with the bone smart philosophy so I can keep it simple and gentle.

Switching to Tramadol seems to work better for me than using Norco. I’m not quite clear why I would take Tylenol, too, along with it.

I was also given Midodrine (ProAmatine) 2.5 and told to take it one with each of three meals as long as systolic bp is under 120.

 

[SusieShoes]

You may well not need the CPM before long. As with everything else in this recovery, just go with the flow. If you like the CPM or it's doing you good, you can always keep with it. I mean, I still put an ice pack on my knees after a long walk or vigorous exercise, not because I need it --my knees don't hurt after doing those things-- but because I like it. Knowing the BoneSmart philosophy helped me a lot with making decisions about PT. I did outpatient PT for a while and found it helpful, but I refused my therapist a few times on what to do. Knowing you have control over how your knee recovers removes a lot of stress.

If Tramadol alone is working for you, that's great! If you need a little more pain relief, though, the Tylenol adds an effective pain-killer to the mix. That's good to know in a pinch.

Hope your blood pressure is treating you well and you're enjoying being at home.

 

[yesyvonne]

@SusieShoes, I was realizing today that the main reason I’m liking the CPM is for the elevation. My Lounge Doctor is on its way from Amazon but not here yet.

PT Brad visited today and he’s great. Brought out my sense of humor. Maybe he’s a BoneSmart schooled PT because we did no exercises at all today. He wanted to see how I’m walking (great, he said (I’m intentionally trying to get rid of the limp)) and how I deal with sitting and with getting the leg up into the CPM. He made some helpful adjustments to the settings shaping the leg rest. He’s coming two more times this week and three times next week. Then I’ll start outpatient PT.

Blood pressure is still low and I’ll stay on the Midodrine as long as that’s so.

Four days post op and I’m starting to feel hopeful. Brad encouraged getting walking sticks, and I’m looking forward to having healed enough to get out with them!

 

[sistersinhim]

It sounds like you have a really good pt! That's good news. Many people like the walking sticks. I used a cane, so I can't comment on them, except I use them when hiking in the mountains. I bet they're work for you really well.

 

[Jockette]

Many people like walking sticks but I did not feel secure with them, I preferred the cane.

As my uncle often said, that’s why there’s chocolate and vanilla!

 

[kneeper]

Congratulations on being home!

 

[lovetocookandsew]

Congrats on your new knee and being home! I used to live on Cherry Lane in Walnut Creek, and have been to John Muir a time or two to visit friends.

 

[amymj]

Hi Yvonne! I'm like you, with my surgeries and the meds. I get very dizzy and this last knee surgery (Jan. 15) I had quite a bit of nausea. Its hard when you feel so badly like that. But it will pass. I had thigh pain not only from the adductor canal block injection that I had but also from the tourniquet! That was a shocker! I thought that hurt more than my knee!! Each day will get better, hang in there. I hope you have a very positive experience and when you need, come here there is always someone to offer comfort!

 

[Celle]

Many people like the walking sticks. I used a cane, so I can't comment on them, except I use them when hiking in the mountains.

I think that there is some confusion about the difference between walking sticks and canes.

It's a difference in terminology between the UK and the US.

In the UK and NZ, a "walking stick" is the equivalent of the US "cane".
The US "walking stick", sistersinhim described would be called a "hiking pole" or "trekking pole" in the UK and NZ.

So, when some of us say we're using a walking stick, we don't mean the extra-long sticks that are used for hiking.

To me, raised in the UK and now living in NZ, a "cane" is something you use to support tall plants in your vegetable garden.

Walking stick/cane on the left. Hiking/trekking pole on the right.

Confusing, isn't it?

 

[Jockette]

The US "walking stick", sistersinhim described would be called a "hiking pole" or "trekking pole" in the UK and NZ.

This is the type my surgeon prefers and told me to get. I bought one but didn’t like it, I didn’t feel secure with it so I switched to the wrist height stick/cane, which I liked much better.

 

[Jockette]

My taller hiking stick actually looked like a stiick, it was brown and crooked, ( and the crookedness drove me crazy!) I made a short trip to the mall with it early in recovery and a little 3 year old boy was fascinated with my stick so much that he almost walked into a sign because he was looking back at my stick! Thankfully his mother was watching him and kept him away from the sign.

 

[yesyvonne]

Hi all, yes, trekking poles is what I meant. Many choices available; I still haven't chosen but I intend to get some for when my walking picks up.

It's been a while since I posted an update. Here's where things are, 11 days post-op.

• No longer using the walker, only the cane, and sometimes not even that. Depends on how tired and shaky I feel. Usually cane, I should say; rarely none.
• For pain, I'm pretty much off the Norco now, relying on Tramadol and Acetominophen. Depending on how I'm feeling when I take it, sometimes 2 Tram50s plus 2 Acetomin500s, other times just one of each, or one Tram plus two Acet. Pain seems pretty well controlled *except* upon awaking in the a.m. when it is worst (often ~5 or 6 pain score) after a night of unsuccessfully trying to find a comfortable position for my legs in bed. Until today, I've taken another dose of pain meds when awakening in pain around 5 or 6 a.m., then back to sleep for another four hrs or so. Today I got up earlier and took my pain meds with breakfast, and then the pain level abated.
• I've had a problem with itchiness and rash since when I was in the hospital and I've been taking oral Benadryl at bedtime for that. It is gradually clearing. Am told could be reaction to harsh detergents used on hospital linens, or could be reaction to anesthesia or pain meds, or who knows.
• Before leaving the hospital, any problem with constipation was over and I quit using the stool softener and Miralax that had been prescribed.
• With a leg "sleeve" covering my right leg from above the incision down past my toes, I've been able to shower, successfully stepping over the tub wall. Showering every other day ever since I came home from the hospital.
• My Fitbit is reporting 1405 steps so far today, walking just around home and a little bit outside. Previous days in backwards order: 1127, 1863 (overdid it that day including several times in and out of the car and sitting in a restaurant for about 90 minutes at about 90 degrees flex; paid for all that with pain later and overnight), 1403, 2098 (I don't remember paying a pain price that day), 1026, 908, 836, 675 (that's the day I came home from the hospital).
• I've had gentle inhome PT, three times last week and then today. Tomorrow and Friday he's coming again, and then that's done. Will be thinking about whether to do outpatient PT.
• I've been using the CPM pretty regularly until today; didn't use it at all today, just elevating and icing on the advice of my PT. But before this, I'd achieved 0-100 with the CPM settings and no pain at those settings. I now have my Lounge Doctor and am using it often. Same with Polar Ice machine. Elevating and icing helps a lot.
• I've been blessed by having a helper at home who is a nurse -- from when I came home from the hospital until today when she flew home. It has been SO helpful to have her company, her support, her advice.
• Also blessed by a steady stream of friends visiting, a few nearly every day, bringing meals, flowers, songs, loving & caring presence, encouraging and helping in various ways. Still, when my inhome helper left this morning I was in tears, feeling the blues I've read about here in this forum. Telling myself to be a patient patient, but still sad.
• I have my first post-op appointment with my surgeon tomorrow morning. Will be interested to hear what he thinks about my progress and what he'll do if anything with my incision. It's held together with dissolving sutures and steri-strips. Not sure he can see much about how the incision is healing without removing the steri-strips; will see.

All told, for less than two weeks since surgery, I think I'm doing okay, even well. What I'd most like some advice about is how to sleep comfortably at night. Thanks, everyone, for sharing your experiences in this forum.

 

[yesyvonne]

Apologies for the redundancy but I want to lift up out of all I wrote above, earlier, the question at the end: what have you all learned about the best way to sleep comfortably at night in the early days post-op? I've tried using the CPM, using the Lounge Doctor, using the Polar Ice pump machine with the velcro cuff on my knee... and various combinations of those, but nothing seems right. I will very much appreciate your sharing with me what has worked for you. Do you think I should still be waking myself up in the middle of the night, say 2 or 3 am, for more pain meds? I haven't been doing that recently, but then have been waking up around 5 or 6 a.m. in pain. Many thanks for advice.

 

[Celle]

The first few weeks are hard and sleep is often elusive, no matter what you do.
Sleep deprivation is pretty much inevitable - but what causes it?

I just had to accept that I was going to have broken nights for a while.
I moved into the spare room, so as not to disturb my husband, and then I would watch TV during the hours when I couldn't sleep.

To make up for sleep lost at night, you need to take daytime naps. Sleep where you can, when you can, and how you can. All those naps add up to the sleep you need.

Yes, you do still need to wake up to take medications during the night. Allowing yourself to miss a dose only means that you are playing catch-up with the pain, which is never good.

 

[yesyvonne]

@Celle, okay, I get it. Thanks for the link and for the advice. I think I'll try the 8am-2pm-8pm-2am Tramadol/Acetaminophen routine suggested earlier and see how that goes today and tonight.

Today was my first post-op appointment, twelve days after the surgery. Surgeon seems happy with my progress. There was a stitch at each end of the incision that was removed today, and all the many steri-strips were replaced with only about half a dozen new ones. All other bandaging was removed. I'm cleared to shower with it uncovered now, yay. Got a souvenir print of the before and after xrays. He confirmed it's a Zimmer titanium knee.

He did no checking of range of motion yet -- said that's next time, in four more weeks. Laughing, he said he has a medieval torture device he'll use on me if I'm not up to snuff by then, haha. ('Tain't funny, McGee. Yikes.) Referred me to a local PT place near home for 12 sessions, twice a week, outpatient. I'm thinking I may give myself a week of rest and then start that week after next, and see how they approach helping me with my healing.

Asked about using the pool (I miss my water aerobics classes), and he said wait a few more weeks to be sure the incision is completely healed. Asked about driving, and he said any time I feel ready and am off the daytime pain meds. I'm not quite there yet.

Came home to an in-home PT session, second to last visit, and that guy seems really happy with my progress. Showed me an extension exercise of tightening my kneecap and flexing quad muscle that is interesting -- not painful, just interesting, to be able to do that. All the other exercises he had me do today were gentle and pain free. Actually I'm starting to feel more confidence in my new right knee than in my shaky/arthritic left knee now.

Asked the surgeon when does he think I should get the other knee done, and he said let's talk about that at my next visit, mid-April. He said some people have such a hard time with the first knee they want to put off the second one. Others do so well recovering from the first they want to move right along with getting the other one done too. At this moment, I'm there -- let's just get 'em both good so I can walk well and confidently again for the first time in years. And pain free, ultimately, of course. So don't hold me to this but I'm thinking maybe August for the left knee. Or September.

Now with all the walking into and from the surgeon's office today, then into and from the pharmacy on the way home, and then the exercises with the PT, it's time now for elevating, icing, and rest. (What was most painful about today was sitting in the car. Something about the angle of my knee and lack of support made that really hurt.)

 

[celynda]

So glad things are going well for you. We all "know" healing and recovery takes time. Knowing and accepting are sometimes two different things.

Planning ahead is a good thing as well. Keep it up!