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[TKR] Post op complications^

Discussion in 'Knee Replacement Recovery Area' started by smatsmax, Jun 4, 2019.

  1. smatsmax

    smatsmax new member
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    Thanks supersonic
    It may be an option, your right, she needs constant reassurance
     
  2. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    I think your mom needs a super understanding PT who’s willing to work with her lack of confidence and anxiety concerning her own mobility. The spasms can be surprising, but it seems to me if she’s using the leg consistently the spasms will eventually become less and less. Walking around the house every hour is suggested here on BS. Is someone at the hospital getting her up and walking that frequently?
     
  3. smatsmax

    smatsmax new member
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    She has to have the in-house physio at the hospital, we're not allowed to bring in outside pts. But she is getting it nearly every week day. I told her think of the number of spasms as a finite number and the more she has the less she will have to come.

    It's hard for the nurses to find time to walk her but she's starting trying to use the toilet again rather than a commode so is walking a bit more. And my brother and I walk her when we visit but she often chickens out.

    It's a hard balance trying to get her to move but not bully her into it.
    Fingers crossed she starts improving soon. Thanks for all your help.
     
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  4. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    Has she tried the stretching Josephine suggested?
     
  5. smatsmax

    smatsmax new member
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    Hi KarriB
    She has no quads so finds it difficult to stretch it straight

    I'm just going to have to hope things get better soon, at a complete loss now. She complains when she doesn't have physio and now she is having it every day shes complaining that it's too much and she's in agony. Poor nurses can't win....
     
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  6. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    This is a very tough recovery for all of us.
    Too much PT can indeed be agony, been there, done that that. Not all therapists are the same. She needs mobility movements, not lots of exercises that cause her pain.

    I am going to tag @Josephine to come and advise you about PT.
     
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  7. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    She's 8 weeks out - what some would say is the peak of the painful period.

    If I ask you some questions about her recovery, would you do your best to answer them?
     
  8. smatsmax

    smatsmax new member
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    Of course. Many thanks
     
  9. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Here y'go then!

    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 forget to factor in 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 swollen is your leg compared to these?
    ai63.tinypic.com_eta39s.jpg

    4. what is your ROM - that's flexion (bend) and extension (straightness)

    5. are you icing your knee at all? If so, how often and for how long?

    6. are you elevating your leg. If so how often and for how long?

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

    8. are you doing any exercises at home? If so what and how often?
    This is the most crucial question so please help me by using the format I have left as an example
    (which means please make a list and not an essay!)

    Exercises done at home
    - how many sessions you do each day
    - enter exercise by name then number of repetitions of each
    etc., etc.

    Anything done at PT
    - how many times a week
    - enter exercise by name then number of repetitions of each
    etc., etc.
     
  10. smatsmax

    smatsmax new member
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    Thanks Josephine
    I'll try and answer for mum as best I can
    I will double check meds when I go and see her in hospital later on today.


    1. 6 or 7 normally but up to 10 with a spasm.

    2. Paracetamol 500mg 4 times a day
    Codeine 60mg 4 times a day
    oral morph when needed.
    Topical ibuprofen gel
    Diazapam 5mg
    Was on ibuprofen 400mg 3 times but been stopped in favour of the topical gel.

    3. Moderate swelling

    4. what is your ROM - that's flexion (bend) and extension (straightness)
    65 degrees

    5. Yes, I've packs on and off most of the day

    6. Only on the bed, not elevated above that. We were elevating at home but not now In the hospital.

    7. None, hardly able to walk to the toilet. Often having bed pans instead.

    8. Exercises done

    Quad squeezes 5 -10
    Heel slides 10
    Ankle flex 10
    Towel under ankle 5

    Varies wildly depending on pain levels, sometime just a little walking , before the fall she was walking down and up steps very well.
    A couple of sessions she's not been able to get to, usually after a particularly bad spasm that leaves the leg very painful. Even a small jolt in a wheelchair can start a spasm. She is terrified of the spasms so now does very little.
     
  11. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    More detail required - sorry

    How often is that?
    How often is that used?
    That's only flexion. I did ask for extension as well - if you can get it.
    Yes but how often is that and for how long?
     
  12. smatsmax

    smatsmax new member
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    Oral morphine not sure what dosage only available in the hospital here in the UK.
    Not sure, only when she's in lots of pain usually after physio. Which she is having a break from now.
    Not sure as I don't have access to her meds file
    65 degrees is all I know, what measurement is it for flexion?
    Again I'm not sure as I'm not with her 24/7 anymore.

    Sorry, I'm not much help am I?
    Meds seem to change daily, with what she feels she needs.
     
  13. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Okay, hope you didn't mind me asking.
     

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