TKR Ortho dr or How I Learned to Stop Worrying and Love the Knee!

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Brithael, I'm so happy to hear your recovery story. I've been watching for you. Welcome to the healing side. Congratulations!!
I think my appetite came back around day 9. Until then, like you, I are enough to stay healthy, hungry or not. I drank a lot of water for the dry mouth but I had the Foley for 2 days post op. I'm hoping things continue to progress nicely.

Nancy
 
Yeah. so glad you posted. I was about to walk the streets of Homewood with your picture in hand looking for you!! It really sounds like you are doing well. Weird question; did the make you go to the bathroom before you left for home and if so did they check that you were telling the truth. My hospital made a huge deal of this; you will NOT go home unless you go; being constipated a lot this has me quite worried
 
Last year, before Northwestern Memorial would release me to rehab for my RTKR, not only did they require I'd had a movement but they administered a suppository (while the medi-car driver was waiting!) to ensure it! This time I made sure to take care of that my second inpatient day at Skokie lest I literally "get the bum's rush."
 
More of the recovery diary details . . .
July 12 - Friday a.m. I discover today that I have to give myself a shot in the stomach area for the blood thinner required. The nurse does the first one, but after that, it will be me. It’s given much the same as an insulin shot which I am familiar with, although since my husband has an insulin pump, he hasn’t had to do that in years. They’ll send me home with prefilled syringes to use for about the first two weeks.
I feel really rotten. I tell my nurse that I think I have a bladder infection and also report to my surgeon. He says he’ll order a sample done and see me in therapy where his P.A. is going to remove my big bandage, so I’ll get to see the Bride of Frankenstein’s leg for the first time. It doesn’t look too bad for 8-10 inches of staples down the front of your leg. They put some gauze and plastic wrap over it, and I’m cleared for showers which I hope will be today at home. Jury is still out on my leaving today with possible bladder infection, and the fact that the in home therapy has not been scheduled. The PA is working on it.
The TED stocking for the right leg is gingerly put on. If they’re going to make me wear these thigh high stockings, they should at least have some sexy garters. I do some parallel bar walking, but the PT can tell that I am wasted. She ices me and sends me back to my room.
Back in my room and the PCA is removed and I am now officially on Norco every four hours. What a pleasure to crank up the walker and go to the bathroom unaided. I may take a while, and I may be out of breath when I finish, but by golly, I’m doing it. Still no BM, I having Miralax as well as the stool softener. Something eventually will give. I’m using an extra TED stocking to loop around my foot to get it off the bed. I can raise my leg slightly now, but it takes a lot out of me.
Urine sample is taken, but comes back negative for bacteria. I’m still having burning, so (due to my vast medical knowledge,) I decide it must be from trying too vigorously to pee after surgery. I try to relax more when evacuating.
Dry mouth has eased, appetite is still gone. Somehow I got put on a cardiac diet, so the food has little seasoning. Combined with my lack of appetite, not many calories going in.
Getting in and out of bed is slow, but not too painful, as long as I take it slow. Walking is getting more confident. There is still a strong pull on the back of my leg that needs to be worked through. No therapy this afternoon, so I practice ankle pumps and quad stretches as much as possible.
P.A. tells me I have to stay through the weekend since the snag with in home therapy has intensified. My insurance wouldn’t approve it. Don’t know why yet. They’re looking for outpatient PT close to my home. I’d give a lot for a computer and internet right now to do some research on this, but I’ll have to wait. Hubby goes home as he and the puppy have been staying in a hotel on base hoping that I would get to come home today.
During my numerous trips to the bathroom, someone has been coming into my room and replacing the filling in my mattress with doorknobs. Every day it becomes harder to find a soft spot around the doorknobs. And I have to be here three more nights! AARRRGGHHH!
 
Hang in there, Brithael. The cardiac diet is most likely "no added salt" to help reduce the swelling in your leg. Can't believe your insurance is cheaping out on home PT, since it would likely shorten your length of time in outpatient PT by more than the duration of home PT and therefore reduce their total outlay. I hear you about the mattresses getting lumpier and lumpier--your leg and rump are getting more sensitive as the residual stuff from the PCA fades away and all you're on is Norco (2x 10/325, I hope).
 
Brithael, earlier this week I ordered a new mattress. I was due for a new one anyway, but my existing mattress was simply no longer comfortable... those horrible doorknobs attacked my bed too....:sigh:

Nancy
 
Brithael,

Hope you're home by now and have your PT situation straightened out. Don't need difficulties when you feel bad already. Your loss of appetite is pretty normal due to anesthesia and the meds you're on too. I have to tell you, do the miralax 2-3 times a day for " action". Lol. Pain meds shut down your digestive and elimination systems. No fun but you might even need an enema. Yuck! This too shall pass.

Do you have an icing machine with the cuff tat attaches to your knee? Hope you do. It's a real help especially at night. I went to sleep with it pumping ice water around my knee and my hubby would refill my ice around 1-2:00 am. Ice, elevate and do the ankle pumps. Te more swelling you can get down, the better PT will go. Good luck!
 
Although it sounds like you're doing well, I'm sorry to hear of all of your "mess up's" while you were in the hospital. Lexismom and I were about to issue an APB on you in Homewood! Heck, I was going to drive over and help her! (I've been driving a week now, so I sure could have!) Yuck about the shots in your stomach :eeeuw: but I have heard that people have to do that. I just had to take aspirin for three weeks. Once again, such a difference in doctor/hospital protocols. I'm hoping our very own Dulcimer Diva will be preforming at the Homewood French Market this summer and we can all meet up! My second surgery is fast approaching, so we'd better get on it!
 
Forgot to say that I still don't have an appetite. I truly have to force myself to finish a piece of toast or a carton of yogurt for breakfast. There was a time I would have loved to have no appetite. When I went for my post op/pre op appt yesterday, they told me it wa no doubt the meds. I had been off pretty much everything, but when my back started acted up, I was put on a muscle relaxer and back on the Norco. The nurse said the Norco especially acts as an appetite suppressant. Back to the Extra Strength Tylenol and the muscle relaxer for me! I sure do miss eating!
 
Tennis Nut - I do have one of those ice machines. They are a gift from God!
And now a blast from the past as the hospital details continue:
Saturday, July 13 The food service has been pretty decent until now. They have a Room Service menu, you call Room Service, and they bring you what you’ve ordered. Except for the fact that I’m on a cardiac diet and have no flavor, the food is OK. Today, that changed. I called and called the number for room service and no answer. Evidently something is wrong with the phone system. About two hours after I had taken my pain med, I still had no breakfast and started to feel a little nauseous. The nurse gave me some juice and crackers, and I felt OK. I had been going to wait till after breakfast, but Room Service called me for my order, and it was going to be 45 minutes so, I finally took a shower! Zing, what a feeling! By the time I had finished, dressed, and gotten back into bed, my breakfast and therapist showed up. I was so exhausted by the physicality of getting clean, that I asked the therapist if she could come back later, and tackled breakfast. I’m not a huge cereal fan, but had ordered Cheerios with a banana, and they left the banana off. I just couldn’t eat naked Cheerios; so I just had toast and yogurt.
I am giving myself my belly shot with aplomb now. The urinary burning is definitely subsiding, but other areas have yet to make an appearance, so still taking Miralax and stool softener
The therapist came back and we did some simple walking around the room and holding my leg up etc. The stretch at the back (hamstring?) is still tough. My OS came in for his check and asked me about pain now that I’ve been on the Norco about 24 hours. I told him the Norco was certainly not as comprehensive as the morphine, but I still only had twinges of pain that would travel over the 3-4 range. That was then.
The problems began with my inability to get in a comfortable spot. Before, I could always adjust something, and the pain would go away, but not today. I am beginning to think that a shower and therapy was just too much. I get a little depressed thinking that maybe this surgery was not such a good idea. My afternoon is not made better by the fact that Room Service is totally shot. They finally bring me a lunch similar to the old hospital types of lunches. – “You vill eat this and you vill ENJOY it!” It has fat free milk which I cannot stomach - One per cent fine – fat free – NO! I’m able to get some of the sandwich and the fruit down. Same thing at dinner – salad with fat free Italian dressing, broccoli with Mrs. Dash, sliced turkey and mashed potatoes with gravy – “Can I have a side of flavor, please?”
OK, I know I’m just in a crummy mood, but sometime after dinner, everything changed. Suddenly, I was able to get in a comfortable position, the depression hammer was lifted, and I felt pretty good. It was almost like turning a corner from a gloomy, shadowed side street to a bright, cheerful flowered boulevard. Glad that’s over with.

Sunday, July 14 Today I feel like singing the Act I closer to Les Misérables – One More Day! I have truly enjoyed this as much as I can stand and despite the really good nursing, I am ready to break out. After all, how can they miss me if I don’t go away?

All body systems are now go (no more Miralax,) but Room Service is broken. Today they brought me oatmeal for breakfast. I have a love/hate relationship with oatmeal. I would love to like it, but I hate it. Can’t stand the texture mostly, and I blame my younger brother for this. He loves oatmeal and used to make a big pot of it. This is WAY before those little microwave packets. He would eat most of it, and would put the pan into the sink to soak when he was through. As the female (remember this is the 50’s and early 60’s,) I was expected to wash the dishes. The sliminess of a cooked oatmeal pan is beyond belief. Turned me off oatmeal now and forever. So I managed to eat half of a bagel, and some fruit.

It’s amazing how much better I feel today. The dark cloud has lifted, and I’m ready to get on with my life. There’s no therapy today, but the nurse and I walk down the halls with my walker. This is when I find out that all the other rooms are regular hospital type rooms; I’m the only one who lucked out with a suite because it’s usually used for pediatrics.

The word is out that the Room Service system will be fixed by dinner. Callooh! Callay! I ordered a grilled pork chop with mashed potatoes, gravy and corn. I can’t eat it all, but even without salt, it tastes so much better than the stuff they’ve been choosing on their own.

I’m really happy, and settle in for what I hope is a good sleep in spite of the doorknobs.
 
Ah, dishwashing duty as a kid was what turned me off about smoking. Just as you were grossed out by slimy oatmeal pots, for me it was cigarette butts on the plates and in the dishwater (and in the NYC of my youth garbage-disposals were outlawed). I got sent to my room after telling my mom, "Let's make a deal: you won't put out your cigarettes on your dinner plate and I won't eat off your ashtray." I was so disgusted that I swore I'd never touch the stuff.
 
You two are so entertaining! I learned to like oatmeal about 10 years ago when I was asked to be part of one of those consumer surveys. I probably got $50 to eat oatmeal an discovered it wasn't so bad! Now, cigarette butts! As I kid one of my jobs was cleaning ashtrays. Yuck! Like you, Sandy, never smoked!
 
Brithael

Keep taking the miralax every day as long as you are on the pain meds. Trust me, you need to do that. The "issue" returns. Glad you feel better but curious as to why you're still in the hospital. When do you get out? I'm sure you're ready for some homestyle food.
 
I made the cocktail I read about in the library-milk of magnesia, prune juice, And 7-up. It worked the next day. Instead of concocting it all together, I drank one element at a time.
 
Dulcimer Diva; you are so funny. Maybe that was your mom's master plan that you would never pick up smokimg!
It seems that you had your sassy little humor even as a child!
Britheal: Are you home yet; how does that bed feel. I was sad when I read that you wished you had never had the operation; do you still feel that way and why? Did you find an outpatient therapist by us; let me know who it is if you like her/him. I just read that post now, but if I had read it earlier, I could have done some research for you around the area. I know there is one close to your house around 185th and Dixie. but I don't know how good they are. Hope you are home now and eating something that more resembles food!
 
I too swas on the look out for you! I'm glad to I have found your thread and see you're now doing well! Thanks for posting!
 
Oh, another question I forgot to ask; why do you have to do the shot instead of the pill; due to the diabetes?
 
Oh yes, I've been home since Monday, but I've been catching up on my hospital stay in the thread since I didn't have a chance to post. I've been trying to write up everything as quickly as I can, but you know how it is - got to get those naps in. I'll be trying to catch up to present day tomorrow. I'm not sure why the shots over the pills. I just do what they say, and the shots are easy.

Diva - I know what you mean about the cigarette butts. My mother smoked, and I grew to loathe, detest and abominate the sight and smell of cigarettes. Therefore, I never was tempted to try smoking, so "it's a ill wind" as they say
 
More catching up on the hospital stay . . .
Monday, July 15 Well, a good night’s sleep was not in the cards. I slept for a little bit, then was wide awake. I was taking my pain meds which usually made me sleepy, but for whatever reason, I could not fall asleep. I finally turned on the TV and watched lots of mindless television hoping to bore myself to sleep. I’d drift off for a moment, and then be back awake. Maybe it’s because I’m so ready to get out of here. Maybe it’s because my bed seems to be made entirely of doorknobs. At any rate, not a good night.

Therapy scheduled for 8 a.m., so I wanted to take my pain pill about 7ish; however, breakfast had not shown up, so I took the pain pill at 7:15. Breakfast finally shows up about 7:40. I can eat about a third of it, when my appetite just shuts down, so I decide to get ready for morning PT.

I get up on my own using the walker, deal with the toilet area, and I remember just feeling so tired that I rested my head on the walker arms. I moved over to the sink for teeth brushing etc., and it hit me like a wall. I felt dizzy, nauseous, cold sweat, trembly – you name it, it was not a pretty sight. I managed to make it to the chair in my room and called the nurse. After describing my symptoms, she put a call in for the doctor, and the technician gave me a cold compress and some ice chips which helped. We decided that it might be taking the pain meds before breakfast since I had had a problem with that when my breakfast was delayed on Saturday. I did ask her if it could be a low blood sugar since I had not been eating well, and I’m pretty familiar with hypoglycemia as my husband has been a Type I diabetic for almost 42 years. The nurse didn’t seem to think so since I had eaten some breakfast.

The longer I sat, the better I felt, although my hands still trembled. I continued to sit in the chair, elevating and icing. I felt that if I returned to the DoorKnob Throne, I could not be responsible for my actions.

After about an hour, I felt in control enough to finish my morning ablutions. Just that simple act, wore me out, however; and I returned to my chair (which also happened to be a recliner.) My husband was supposed to head out today to bring me home, so I called him and filled him in on the latest wrinkle. I told him I wanted him to proceed as if I was still being discharged. I was so depressed by the turn of events that I couldn’t help crying as I rung off.

The Social Worker appears as I’m in the throes of the crying jag and is appropriately sympathetic. She’s still working on the home therapy, and I ask her why it was denied since practically every other insurance company approves this. They told her it was because I wasn’t “Home bound.” Well, the depression left immediately and anger took its place. “Excuse me,” I said. “Not home bound? I can’t drive. My husband is 100% disabled and can only drive short distances. Let me at ‘em.” She was unaware of my husband’s situation, so she said she’d take it on from there.

My surgeon comes in and is apprised of the new wrinkle in my health. He seems disappointed that I was unable to make it to therapy, as they wanted me to have two more therapy sessions before discharging. His disappointment does not equal mine.

The day moves on with positive breakthroughs in the insurance covered therapy. Evidently the person who denied the coverage on Friday should not have even been answering the phone, much less denying coverage. Coverage is on, now they just need to find a therapy company who accepts my insurance. I have something called ChampVA which comes from my husband’s 100% service connected VA disability. It’s not as well-known as Medicare or Tri-Care, so a little harder to find facilities with a contract.

I’m feeling much better, making sure that I eat before pain meds. I still feel somewhat wiped out by getting up and moving around, but no dizziness, cold sweat etc. My PA comes in and wants me to stay another night. NOOOOOOOO! I tell him I must go home today. Finally I convince him that if I have a good therapy session, he’ll let me go.

Therapy time comes, and I work on the Nu-Step, do some stretches, walk with a cane instead of my walker, and my therapist says I’m gold. I can raise my leg several feet while lying down, and I’ve got 90 degree ROM. My PA comes down, but still is not convinced to let me go without my home therapy being sewn up. I beg and plead, was close to bribery, and he relents. He goes off to fax paperwork and order meds, and I go up to my room to wait.

The discharge nurse appears and begins having me sign papers. All looks wonderful until a doctor whom I have not seen before, but is identified as the Chief of Medicine comes in. He is most upset that he had not heard about my little incident this morning. He is convinced it could have come from a cardiac problem and wants to run all sorts of test etc. If I could have gotten down on my knees, I would have. I try to tell him that I truly do not believe it is cardiac. At length, he tells me that if it happens again, I’m not to think twice, but immediately go to an Emergency Room. I promise faithfully. Everyone leaves, the discharge nurse comes back and says the pharmacy is really backed up, could be another hour before we can leave, so I better order dinner. I’m so excited (insert sarcastic font here) to have another cardiac diet meal before I leave.

Hundreds of years pass, the discharge nurse takes me down to the pharmacy; my husband goes to get the car. Moments later, I am wheeled to the blessed car, and we head toward home. Of course by now, the Chicago evening traffic is in full swing, so lots of stop and go. I made the mistake of getting in the front seat because I knew I could extend my leg; however, I had not counted on the hours of sitting with my leg down previous to the actual escape. The swelling is palpable. I ask my husband to exit the Tri-State Tollway at the first oasis, so I can remove to the back seat and have my leg up.

It is close to 7 p.m. before we pull up to our house – even the lumps in the driveway look good. Our five month old Cocker Spaniel puppy is in her “playpen,” and greets me with abandon. In no time at all, I’m on our recliner sofa, leg elevated with pillows, Iceman strapped around my knee and totally happy. There is no place like home.
 
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