Bilateral TKR ParamedicGirl on the "other side"

[BigBend]

It strikes me that there are so many reasons each recovery differs from any other: our own bodies and pain thresholds, the skills of our surgeons and how he/she performs the day of surgery, the anaesthesia used and our reaction to it, pain management philosophies and how adequate they are for the patient, the skill of those in the skilled nursing facilities, and very importantly, the wide variance in physical therapists. I follow your story, @ParamedicGirl , and other bilaterals and hope to learn to control those things that are in my control. Best wishes that what you have learned so far, will make the rest of your recovery easier.

 

[ParamedicGirl]

Summary of things learned thus far:

1) exercise and good nutrition vital prior to surgery. I worked out with a personal trainer at my small gym who made it a point to learn the right exercises. Yes, upper body strength is very important.
2) I would have increased stretching that would have increased ROM in the "old" knees which would have hopefully carried over to the "new" knees. Muscle memory if nothing else.
3) Same thing with practicing straight and partial leg lefts. Again, strength but mostly muscle memory.

4) PAIN MANAGEMENT...VICODIN doesn't work for me and apparently not others either. Go above the nurses; have a family member or yourself call the physician. INSIST! Better yet, make sure ahead of time. The most horrific memory I have is when PT tried to get me up 3 hours after the end of my surgery. I was sobbing and just as painful and traumatic as it was for me, it had to be traumatic for my fiance and my friend to watch.

5) start stool softeners right away, drink plenty of water, a glass of prune juice a day, eat fresh food if possible. My hospital food is terrible and I basically nimble on the meal but eat the healthy snacks friends have brought.

6) I discovered today that "gentle" therapy got me a lot further today than the agressive style. I will talk with them tomorrow.

7) research homeopathic remedies and anti inflammatory foods. I have been told my bruising and swelling thus far is minimal. Ha! Watch me blow up like a balloon tomorrow.

 

[maryo52]

Once you get them on your computer, go to the reply to thread text box and look just above the text you're typing at a row of tools. The one just to the right of the yellow smiley face is what you click to add a photo.

I too don't do well with vicodin. It makes me nauseous therefore I required zofran the entire time in the hospital. So when He tried to send me home with a scrp for vicodin, I said, so what about the zofran? Or maybe you could give me percocet? He thinks prescribing percocet is akin to turning regular people into addicts but did it anyhow.

I think back to the gentle approach, and, yes, it's the only way. Those pain receptors DO have a purpose.

I learned to love Metamucil!

I did all the strengthening and stretching before surgery and still had a horrid recovery. These knees are among the many things in life that are determined to make us stronger!!

 

[Karringtyn]

I have just switched to Vicodin. (finally off perc) helps me feel better emotionally....I am also 7 weeks out so pain has lessened. Ahhhh stool softeners. I own stock in them!!!

I worked my legs constantly before surgery..I can't imagine how much more painful it would have been had I not! Keep sharing...sounds like you have a great mental attitude...that's half the battle!

 

[ParamedicGirl]

Last night I requested a sleeping pill instead of the oxy. Slept wonderfully through the night.

It seems I shuffled for so long (trying to avoid bending my knees), I have to use an exaggerated "marching step" when walking with my walker. It's kind of humorous.
Dressings come off tomorrow... Everyone is curious to see the wound below since it has internal stitches and Dermabond was used.
I've started itching. Staff says that's the oxy and is a normal side effect.

It wasn't pretty and it was painful but I successfully navigated up and back down a flight of stairs (10 up and 10 down).

At 3/95 on the right and 0\90 on the left. The left definitely feels tighter.

 

[TracyW]

Hi @ParamedicGirl. Congratulations on getting to the other side. I am so glad that your pain is under control and that your therapy is going better. I am amazed on how lucid you are in your posts. When I was in the last time for my THR, I don't think I could have written at all, let alone with the helpful suggestions. Sending great energy to you for your recovery!

 

[MS Char]

Hi Paramedic, glad to see you have the pain medicene under controll. Keep up the good work.

 

[ParamedicGirl]

My dressings came off on Tuesday morning, and it feels and looks wierd to see the incision across my knees. Neither incision looks the same, and in fact the left knee looks "more angry" (double checked to confirm there is no infection; just heavier bruising). My last couple days in therapy have been very challenging as my knees have felt extremely tight and stiff. To look at them, you do not see them as swollen, but they definitely feel like it. It has taken 15 mgs vs 10 mgs to get through therapy and even that resulted in a few tears. My ROM is 0/90 in both, sometimes up to 95. I've learned to go up a flight of stairs that has 16 stairs utilizing a crutch. That means I'll be able to go up to bed at night and come down in the morning....but for now that will be it.

The target date for sending me home is Saturday, so tomorrow will be my last therapy.

I mentioned to my SO he should find bed lifters in order to raise the bed to a height that I can get in and out of comfortably. I'm a little concerned as to what he is expecting when I come home as he just assumed I would be fine getting in and out of the Civic and so took his Blazer to the shop and it will be there until next week. I tried to explain ROM to him, but I am not sure he got it. While I am fairly independent I am still going to need help and will have some limitations.

Time to change position!

 

[Threads]

Good to read your update. You are doing so well, I'm impressed and encouraged even though I have almost 20 years on you ;-) It's also encouraging that you will be able to navigate a flight of stairs in the morning and night, that is what I'll have to do. Lucky we still have the blocks for the bed from my DH's hip replacement.

I'll be thinking of you Saturday as you make your journey home. Can you ask a friend with a more "BTKR" friendly vehicle to drive you home? You don't want to hurt yourself or your new precious knees trying to get home.

Take care and try to rest up tomorrow for Saturday's adventure.

 

[MS Char]

The most comfortable position is the back seat with both your legs on the seat. Someone posted it was easier to go in butt first and scoot backward until you reach the other end of seat. You will need someone to help holding your legs. I found it impossible to sit in front with my leg down. Also pillows might help. It's not an easy ride home. Good luck with it. Glad you are doing so well.

 

[ParamedicGirl]

My apologies for the break between entries. Pain medication makes me just a little lazy… LOL.

I was released today from rehab. We realized when we got home today with the rise on our stairs is an inch or two higher than what I was practicing on in rehab.

I was afeared ...lol.

16 steps later, I am in my own bed (made higher by risers). I cried.

 

[BigBend]

Nothing like being in your own bed @ParamedicGirl ! Healing comes faster in your own environment. I went home after 2 days in the hospital and am so glad I did. With your pain under control and being home, you'll be just fine!

 

[MS Char]

Hi, glad you are home, no place like home. If I ever have my left knee done I am not going to rehab. The food was bad and I missed my Tiger boy, he is my avatar! I have been following you and I think you are doing great. I am a nurse and I worked with a lot of paramedics due to working in ED. I was able to kneel a couple of weeks ago but you may need a foam pad at first. How long do you have off work? I think you will do fine just ice when you can once you go back. I'm sure your coworkers will help you.

Take care,
Charlotte

 

[skigirl]

I see that you have not gotten the post op reading list--the articles are short and helpful.

First are the mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

Next is a FAQ (Frequently Asked Questions) thread.

And then the articles in order of importance .
Group A
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice

Group C
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"

Group D
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
Sleep deprivation is pretty much inevitable - but what causes it?

 

[referee54]

PAIN MANAGEMENT...VICODIN doesn't work for me

Vicodin did not work for me, either---it was like I was simply swallowing a few M&M's.

We realized when we got home today with the rise on our stairs is an inch or two higher than what I was practicing on in rehab.

Congratulations on getting the BTKR merit badge as well as getting home! That is a great psychological boost---coming home!

Please keep us updated as to what is going on and how you are doing!

 

[ParamedicGirl]

Yesterday was two weeks post op. The ride home was unremarkable and I thought for sure that I would fall asleep since I had taken pain meds prior to leaving, but no...wide awake! Sat in the back seat wih my legs up...slid in bottom first, and pulled myself back across the seat. Good idea MS Char!

My recovery at home is developing a pattern: My fiance brings me coffee, a banana and yogurt before heading to work. I do some ankle pumps and heel slides to "wake up my legs" before getting myself out of bed and dressed. Lynn, a friend of mine, comes over between 8 - 8:30 a.m. and helps me down the stairs, and get settled in on the sofa with water, fruit, my meds, etc. But that's as far as the pattern gets...!!!! I've spent a day on the phone dealing with insurance and calls between doctors because my state has some obscure "law" that requires out of state doctors orders be countersigned by an in state doc. Ideally your primary care physician. Whatever; another day with the intake nurse from our local visiting nurses, and later that day a physical therapy evaluation. Plus several other phone calls related to the issue already mentioned. The last two days, the roof of our house is being torn off and replaced. This was scheduled to happen while I was in rehab but the weather did not cooperate. But you don't want to know what's happening in my life but what's up with the BTKR...

I know I have hit the "blues" wall as I cry at the slightest upset, and this morning it was the pain in my knees and the "ugly" incisions. Luckily my guy is quite supportive. Everyone keeps telling me how well I am doing, yet of course, I feel as if I should be doing more. There is very little self care I need help with, I take walks, do the physical therapy, but I feel there should be more. Even the physical therapist says "pace yourself, you are doing quite well".

Enough of my whining, the only really complaint is the spasms I get in my knees which feel very close to being charlie horses. They are very painful and I am not sure of the cause. In case it is dehydration, I started supplementing my water with coconut water. If anyone has had this happen, I would appreciate any suggestions. They wake me up at night, and make it difficult to get my legs moving in the morning. I mentioned it to my surgeon's office, and all she said was "night pain" is the last pain to disappear.

Time for House of Cards...

 

[ironman60]

This sure is a tough job even for a tough person. Glad you are coming around.
Everyone says that some day we will be happy that we had it done.
I might even cry when that day gets here.
I would try the poptarts & hotpocket diet.
Sleep well.

 

[MS Char]

Hi, glad my advise worked for you! Sounds as if you are doing well for the point of your recovery. I wasn't tearful until lately. Try OTC magnesium 400 MGM for cramps. It is needed for muscles to work well. I used to get them in my rib age and thighs bad and now take it on a daily basis. As Josephine said it's alright to cry! It is hard to do nothing when you are used to being active but look at it as a time to relax and heal. The scar will heal and hardly be noticeable in time. The weather has been horrible this year. The good thing is it only takes a day to put a roof on.

I don't have to worry about insurance problems now as I have Medicare and united healthcare. I do remember having regular insurance and how frustrating it was to deal with those headaches. Hope it settles down for you as that alone could make a grown man cry!

Just go with the flow, this too will pass. Take care, Charlotte

 

[ParamedicGirl]

Today is 4 weeks (28 days) post surgery. I haven't abandoned my walker yet, but do use a crutch (yes singular) to move around the house, and sometimes I ambulate without using anything. Not a graceful walk, but definitely an exercise in balance and gait.

I am still bothered by the "charlie horse" type of pain in my knees at night, albeit when I drink PLENTY of water and take the magnesium, it is not as bad; and in the last couple of days, my kneecaps have started to bother me more. BUT...it dawned on me that I went 3 days without any PT (Sat, Sun and Mon) and so the reason for the new pain, and increased stiffness/soreness is likely due to no PT. I walk quite a bit, but it's just not the same as the other activities. I will not let 3 days go by again without any PT. Lesson learned. If PT scheduling has a 3 day gap in the future, I am going to talk to my personal trainer about using the bike at the gym.

In the book "Total Knee Replacement and Rehabilitation" they write about exercises utilizing a Brazilian futebol. I ordered one and did some of the exercises this morning. I definitely can see myself using this each day.

My incisions look a little better. The Dermabond on my incisions attracted the "fuzz" from my sweatpants I wear, so they look "dirty" although they are not. As I heal and it is clear what is Dermabond and NOT a scab, I am peeling it off...lol. When I shower I gently wash the incisions, but I am afraid to scrub off the Dermabond.

My mom is here, and she has been helpful in driving and fetching things for me. I often feel like she is bored but unfortunately there is nothing I can do about that.

I am normally a very social person. People often stop by our house, or we are off visiting friends, etc. Lately, I really haven't wanted anyone around nor go to anyone else's house. I am tired of talking about the surgery, how "brave" I am to have had bilateral, blah, blah, blah, and so find myself purposefully avoiding social situations. Does anyone else feel this way?

Off to PT!

 

[VancouverUSAgal]

Lately, I really haven't wanted anyone around nor go to anyone else's house. I am tired of talking about the surgery

I understand. I don't want to use my energy to talk about how I'm doing. I do appreciate that people are concerned, but I find myself cringing when the phone rings. I try to give a quick update and then change the subject to hear about what's happening in their lives. For anyone not going thru this or having watched a loved one go thru it, it would be boring (at best) or irritating to hear all the little details of our recovery. Sometimes I feel like complaining but I don't want to seem like a whiner. It does depend on the friend - some I know I can complain to and they are understanding and happy to listen, others don't have a clue and it's just too difficult to try to explain everything in a way they might "get."