TKR Post-op Spasms

[Layla]

Hello BionicMama,
Stopping by to say Hi and I hope you’re doing better since you last posted. Please know that we’re here for you if you need support. Sending a hug and best wishes.
@BionicMama

 

[BionicMama]

It’s been a while….

I’ve not been here in a bit, still working through physio and trying to gain back my strength and endurance. I’ve achieved good flexion, my extension isn’t where it should be though, so I have been focusing on that.

My incision remains stubbornly not healed in three small places. Just little scabs at this point but it seems to be taking forever.

The big news is despite the complications I’ve experienced, I have surgery booked for my left TKA on October 13th!!! I’m apprehensively excited. Because of the wound issues, I have been able to test out a dressing that so far has not caused a reaction from a sales rep at my work. It’s the Smith & Nephew PICO 7 which is silicone based. It has a small amount of negative pressure with it through a portable VAC that is attached specifically to help with delayed wound healing. The only issue is that it needs to be bordered with fixation strips to keep it from rolling up and the strips that it comes with caused blistering within 8 hours of application…..so I’m now trying out other options. I think kinesiology tape may be the best bet as my skin doesn’t seem to react to that.

I’m also going to request that the surgeon use a different type of dissolvable stitch than before in hopes my body just dissolves them and I don’t develop stitch abscesses like this last time.

Just praying that after this surgery things will good as smoothly as they can and I will be able to return back to work in the new year!

I appreciate everyone’s support this last four months. It’s been a rollercoaster and being able to vent to this community has been most helpful. Thank you!

 

[Layla]

I am sorry you continue to deal with that pesky healing incision. I will pause and lift a prayer for your upcoming surgery and perfect healing. Stay in touch, we’ll be here following your journey.
@BionicMama

 

[Jamie]

You’re very positive and determined and that’s half the battle. We’ll always be here for you and it’s great for us to hear that BoneSmart is helping you.

 

[Layla]

BionicMama,
Getting close to your big day. Tomorrow we'll be in your surgery month with only 13 days to go.
Wishing you comfort as you wait!
@BionicMama

 

[dotski]

Best wishes BionicMama (love the user name)! I think I too overestimated my ability to recover quickly. I should know better, as I’ve seen young patients struggle just as much, or more with gaining pain control. It’s a humbling process to say in the least…as I lay awake in pain tonight….

Not sure if the restless legs are still an issue, but FWIW, wearing graduated compression stockings all day cured me of mine many years ago. That plus taking daily magnesium supplement. For some reason my mg often is low, so I’m on it for life now. The “bisglycinate” form doesn’t cause the runs/digestive upset. Low ferretin can cause muscle twitches also (btdt).
Compression therapy can aide wound healing by enabling circulatory return of waste products, lymph, etc….in case that hasn’t also been explored yet.

 

[Layla]

Best Wishes tomorrow!
Hope to hear from you once you're home and resting comfortably!
@BionicMama

 

[BionicMama]

Best Wishes tomorrow!
Hope to hear from you once you're home and resting comfortably!
@BionicMama

Thank you so much Layla for being so supportive during this process. It meant so much when I logged on and saw that you remembered by surgery date. This community is truly incredible.

My surgery went as scheduled on Friday October 13th. They were so good with being trauma informed and allowed me to again have the GA and have the peripheral nerve block afterwards before reversing my sedation. I was in recovery a little longer than expected because my stats kept dropping due to my sleep apnea. Strange that they didn’t do that the first time, but in looking up the visit record, they did not hold back with sedation this time, so I was probably groggier than previously. I had a really hard time staying awake in PACU and afterwards. Despite that hiccup, I was able to go home just after 6pm. Physio said they were quite impressed with my crutch walking ability, which I guess is a skill I have mastered after the last time! Lol.

The ortho team were so invested in working to prevent any wound complications like I had last time. They had the PICO 7 dressing available and the small vac suction is working well with no signs of irritating my skin so far. Instead of staples this time, they used dissolvable stitches to close the top layer which was a surprise to me. I’m a little fearful that because of the various layers of dissolvable sutures, that the site may be more prone to dehiscence if I bend my knee too far. My surgeon is going to take the dressing off in two weeks himself so he can view the site and if anything needs to be done then it can be dealt with immediately. Fingers crossed that this time it just heals without any further issues. My first incision still has two small open spots!

Again, thanks for providing this space to record our experiences as well as the support you provide. It makes it so much easier to deal with when you second guess yourself in the middle of the night when you cannot sleep or are in a great deal of pain.

 

[Layla]

You're welcome BionicMama. Sounds like you're receiving very attentive care. I'll bet it feels reassuring.
I hope your incision heals without incident and your recovery is an easy one. We'll be here for support whenever you need us, please stay in touch, we'd love to follow your healing journey.
@BionicMama

 

[mendogal]

Post op YAYYYYY!!!!!

 

[CatieViv]

@BionicMama
I am 18 days post op. Hang in there! It will get better

 

[BionicMama]

For the last week I’ve been feeling little pain. Barely taking my breakthrough pain meds. My long acting medication just finished Friday morning along with the Celebrix, and for the last 24 hours the pain has gotten to the point that there appears to be no comfortable position to lye in and the breakthrough pain pills do not seem to touch it.

Nothing has changed in my overall recovery, so I’m not understanding why it’s been such a shift the last two days. I’ve been ambulating around the house - even switched from crutches to a cane before the end of week 1, sometimes moving through the house without the cane. I spend the majority of my days with my leg elevated and icing it hourly. Only been doing the gentle stretches and stop when it becomes uncomfortable.

What am I missing? Any suggestions for what to do to help alleviate this pain!

 

[Jockette]

My long acting medication just finished Friday morning along with the Celebrix,

Due to all the trauma caused by the surgery, there will be pain. The fact that up until now you’ve had little must be because the medication was controlling it well. Now that you’re using less medication the pain is more noticeable.

If your body can handle Tylenol on a regular schedule, and your doctor agrees, it might be very helpful.

 

[Layla]

even switched from crutches to a cane before the end of week 1, sometimes moving through the house without the cane.

I think each of these can cause a slight change in gait, possibly not enough to ramp up the pain, but you never know. I am sorry you're dealing with this increase in discomfort.

You may consider a schedule we often recommend, which is Extra Strength Tylenol at 1000 mg, every six hours, but no more than 4000 mg in any 24 hr period. You must also calculate anything else containing Acetaminophen into the 4000 mg so you're not exceeding that amount. This is an option to talk over with your surgeon, or his care team. I hope you're able to get comfortable again soon. Please stay in touch and let us know how you're doing.

 

[sistersinhim]

My long acting medication just finished Friday morning along with the Celebrix, and for the last 24 hours the pain has gotten to the point that there appears to be no comfortable position to lye in and the breakthrough pain pills do not seem to touch it.

I’m not understanding why it’s been such a shift the last two days.

You are feeling increased pain because you stopped your Celebrex and pain meds. Ask your doctor if you can take ibuprofen. It is also an anti-inflammation like Celebrex, but much weaker and available over the counter. If your doctor approves you can take Tylenol and ibuprofen at the same time to increase their effectiveness.

 

[Jamie]

The recommendation from sistersinhim is a good one. Or, you could ask your doctor (your GP is probably a better option than your surgeon) if you could continue taking the Celebrex for a while longer. It can sometimes be easier on your stomach than other types of NSAIDs.

 

[BionicMama]

POD #12

Things have been going fairly well. Pain had taken a bit of an uptick but was settling out and manageable. I had a stomach bug last week which was not ideal when on crutches trying to get to the loo, but it resolved.

Then Monday I had my first physio appointment. I stood strong - no aggressive treatment, I raised my concerns about my incision being high risk for dehiscence since the dissolvable stitches they used to close are already dissolved (which I discovered when I changed my dressing Friday). He heard me, he respected my boundaries and just did light exercises and measurements. Flexion - 85 Extension -8. All was well. That night, my small church group was getting together for our weekly meeting and I decided to attend. Drive the 15 minutes, had to climb about 10 steps and then sat for 2 hours before driving home. It was uplifting to see everyone and other than starting to get uncomfortable sitting for so long, it was good. Came home, went to bed.

Literally slept for about 36 hours with a few visits to the toilet and my husband brought me dinner which I ate but was barely awake for. The pain in my knee/leg was increased and I had to take pain meds when I awoke. I’d iced my knee everytime I woke up. Only this morning have I managed to remain awake for a few hours. I’ve never experience this type of fatigue before and I’m not sure if it’s because it was only my second time out of the house and just exhausted my body, or if it’s because I lost a decent amount of blood and the low Hb is contributing to this fatigue, or what else.

This morning I awoke to find my husband had placed an ice pack on my knee while I was asleep and left me a tray with breakfast foods and drinks. It was really kind and thoughtful since he isn’t always the most empathetic regarding these two knee replacements. Then I found he’d placed a book on top of my shoebox of items I’ve been carrying around (my cross stitch, a word find, my iPad). It’s one I own but still, it seems to be sending a message from him like he thinks my exhaustion is because I’m depressed and not because my body is physically exhausted. Then I got. Text from him as shown, again alluding to him thinking I’m suffering from a depressive episode.

I’m sensitive on the subject because I have a Chronic Depression with episodes of Major Depression throughout my life time. But I don’t think this is related to those diagnoses. I mean, I know some of the symptoms are reflective of how I’ve been since surgery - poor appetite, not sleeping well, not showering frequently (although I wash my face and do the PTA wash daily), not having interest in regular activities, I cannot even remember the rest. But doesn’t that describe most people who have had a knee replacement in the first two weeks? Am I disconnected that I’m assuming my fatigue and pain are related to the surgery and not a bout of depression? I feel like his attempts to allude to this are making me second guess myself and now Im feeling like I’m losing my mind on top of being in pain and recovering from surgery.

Sorry for the lengthy post - I unfortunately have no one close to which I can air my concerns so I’m grateful for this group who can empathize with some parts of my journey. Thanks for listening/reading.

 

[Jaycey]

@BionicMama Are you driving yourself? You really should not be driving until you are cleared to do so by your surgeon.

In any case, just days out of surgery it is far too early to be going to any type of social event. No wonder you are sleeping that much. Your body is trying to put all its energy into recovery and you are asking it to do even more.

I'm going to leave a couple of the recovery articles here for you to review again. Perhaps your husband will be interested in the one about post op blues.

Activity progression for TKRs
Energy drain for TKR
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it

 

[sistersinhim]

This morning I awoke to find my husband had placed an ice pack on my knee while I was asleep and left me a tray with breakfast foods and drinks

How thoughtful!

. But doesn’t that describe most people who have had a knee replacement in the first two weeks? Am I disconnected that I’m assuming my fatigue and pain are related to the surgery and not a bout of depression? I feel like his attempts to allude to this are making me second guess myself and now Im feeling like I’m losing my mind on top of being in pain and recovering from surgery.

You have had two major surgeries within 4 months of each other and it is natural for your body to be exhausted and needing much more rest and sleep. Don't second guess yourself, what you are feeling in this early recovery stage is normal and not a sign of depression. After surgery blues is also normal, but you sound like you are falling into the normal range of things. Let your hubby read the articles Jaycey left for you.

 

[Jamie]

Good advice in the posts above. This is a time for you to allow your body some grace to recover at its own pace. Don’t feel like you must return to “normal” soon. You’ve been through a lot! Try to eat well and stay hydrated. Sleep as much as you feel comfortable doing. This is when your body is healing at its best, as a majority of your energy is being directed to that. You only have a finite amount of energy and right now you need to use it to heal.

Try to take your hubby’s actions in a positive light. Sometimes our spouses are worried about us, but don’t understand joint replacement surgery and recovery nor do they know how to be supportive. Maybe you can take some time to just talk with him and share some of your feelings about recovery. That, plus reading some of our recovery articles, may help him see that what you’re experiencing is within the range of normal after this very major surgery.