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[PLC/LCL Reconstruction] Tzed recovery thread

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tzed

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I had my PLC/LCL reconstruction done two days ago. I'm starting recovery and it's feeling rough so far.

The first night I forgot to set my alarm and I woke 2hrs later than I had hoped in significant pain. I immediately took a demand bolus from the nerve block and a 1x5mg oxy. However the pain kept increasing, so I took a second oxy. All in all the pain increased for 40-45min after I woke up until it finally started to taper off.

Yesterday I went to PT and with just a little kneecap manipulation I started to go into shock(uncontrolled breathing, numb face, cold, crying). Not so much from the pain I think(though I was a little late with the dose just prior to the PT and then decided to go for 2x 5mg rather than the 1x5mg I had been taking), but more so I was really scared to have anyone touching the area.

This past night was a bit better, I am waking about 20min before my alarm(set to make me every 4h for 2x5mg oxy and 1x500mg acetaminophen).

Right now it is just about 6am for me and my leg is pulsing with muscle spasms. I would love to use the ice machine but it's very difficult and uncomfortable to get up and hobble three rooms away to the freezer for frozen bottles so for now I'm waiting it out.
 
Hello and Welcome to recovery. Great news you were able to have the surgery as scheduled!

I am sorry you're dealing with so much pain currently. It is important you take your meds on schedule without altering doses unless first approved by your surgeon so you're not dealing with the type of reaction you described above. When you say you're waiting it out in regard to the ice machine, I am not sure I understand. Ice will help immensely, you need it now. It will help with swelling and pain and you can ice as often as you want, for as long as you're comfortable doing so, always placing fabric between the ice source and bare skin.

You don't need PT right now, you need rest, ice, elevation and short walks around the house every couple of hours, Usually a bathroom break or trip to the kitchen to get something to eat or drink will cover that. The walk you need to take right now to get the ice machine should have you covered for a couple hours.

I will leave our Knee Recovery Guidelines. Read the articles on ICE, ELEVATE even if you don't make to through all of the others today.

Wishing you lots of comfort as you begin your healing journey. It will get better and likely more quickly than you're anticipating.

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

2. Control discomfort:
rest​
ice​
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
Thanks, I should clarify a few points:

I have the ice machine next to my bed, and it is now filled with ice and running.

The dosage of the oxy was 1-2 pills every 4-6hours. I was taking the lesser of the dosage for the first 12 hours, but after speaking to the PA of my surgeon at 10am yesterday we agreed I should move to 2 pills every 4hr.

I'm struggling with wanting to get out of bed as my leg aches much more when I'm walking on crutches or sitting in a chair. I am getting up to go toilet, but I'm spending lots of time laying down, either with the ice machine on or off.

Regarding PT, my surgeon asked me to start PT the day after surgery. I am also scheduled M, W, F this coming week.

Thanks for the resources, I'll read up
 
Good to know! Thanks for clarifying. It was troubled by you not making use of the ice machine because I believe you will notice that it brings relief from the pain.

Also happy to read that you're in contact with your surgeon's care team regarding meds. You're on top of it!

I wouldn't worry about not moving around much while you're in the amount of pain you described. Unless you're opposed to it, I'd ice more often than not.

Please do not allow them to push you in PT, manipulate your leg, force you to do anything that causes you pain. Let us know how it goes.

I hope your day ends better than it began. Best Wishes!
@tzed
 
Hi Tzed. One of the things i did at my early stage, was to bring a cooler with frozen small juice bottles. I could put in new bottles in my machine without having to trek down to my kitchen saving steps. Just a thought.
 
An update. I am now 8 days out from surgery. Went to my post op today. As well my third PT visit.

I am managing pain well during the day(sitting in bed or couch with ice machine), but have significant pain when I stand up for more than a minute. I am only using Oxy to sleep.

I got a hinged brace at my post op today, it presses uncomfortably into my calf, but it's not as painful on my knee as I expected. And it's nice to be able to bend my knee again wearing a brace!

I got to 52* ROM with wall slides at PT today. My hamstring set exercises are excruciating. I am starting to see a little more definition with my quad set which is exciting.
I think the toughest part is I can only manage about 4 wall slides before my knee gets really stiff feeling.
 
tzed said:
got to 52* ROM with wall slides at PT today. My hamstring set exercises are excruciating. I am starting to see a little more definition with my quad set which is exciting.
I think the toughest part is I can only manage about 4 wall slides before my knee gets really stiff feeling.
Click to expand...
That sounds really tough PT for do early on.
I am 20 weeks with really good ROM (130-140) and I am only recently doing wall slides with my pilates teacher. I don't think you should be doing anything that causes excruciating pain.
 
Ah, maybe my terminology is wrong, my PT calls it wall slides, but when I look up wall slides that shows something completely different.

I am laying on my back with my heels against a slick wall and using the uninjured leg supporting the injured leg and bringing the heel down until I have too much pain/resistance.
 
It is one month to date since surgery. How are you doing? Hopefully well and enjoying progress.
Please consider updating when you have time, we'd love to hear from you.
Happy One Month Anniversary! Best Wishes as you continue healing!
@tzed
 
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