PKR Raffs' Recovery Thread<'

[Raffs]

Some questions:

How long do people ice for? Keep being told different things in hospital about how often/long.

If you have a cryo cuff, how often do you refill the cuff? I'm finding that I'm doing it every 30 mins or so because it has been so warm this week.

Do you ice throughout the night?

Do you elevate whenever you are resting? I've been told that rest time should be split between lying down and sitting.

I've read the articles on icing and elevating on here, just interested to hear what people have found works for them.

Thanks.

 

[Hopper]

Glad all is well @Raffs.
I iced and elevated constantly with my right knee as my American OS and physio advised but this time around I found the UK hospital and OS didn't particularly push ice or elevation. However, I like ice and elevation as it helps so I requested ice in hospital frequently and always had it on hand at home but I've not needed to use it as much this time.
It strikes me how different everyones treatment and experiences are and how we all recover differently. As long as the final outcome is good I guess it is just 'horses for courses'.
I had a block first time around and the day after my op my quads were firing and I could do straight leg lifts. I didn't have a brace. This time I did leg lifts the same day.
However, if I had to get a flexion of 90 before I left hospital - well, I'd still be there! Like @SuperSnapper I my physio the first time around felt extension should come before flexion.
This time I had a flexion of 50 to start with, but its climbing up each day - 62,71, 80 and I can tell its improving. My bonus with slow improvement is no pain and therefore both times I've needed no pain meds that make me so poorly. Extension is now at 5. My gait is now apparently very good - no limping and I'm raring to go but holding back as per physio instructions.
Hopefully they will let you escape very soon and you can settle into a routine at home. Onwards and upwards!

 

[Raffs]

Thanks @Hopper. Yes, it is interesting that there are so many different protocols and approaches to knee surgery and recovery. I got a different answer to most of my questions from people who work in the same hospital!

I'm home now. Want to get myself settled into a routine and find what works for me. Pain meds might be a trial and error issue as they wouldn't give me anything stronger than co-codamol to bring home which I need to take along with ibuprofen. I have some Tramadol if things get tough. Flex was up to about 80 and extension pretty much 0 when I was discharged. Still can't do a straight leg raise or short quad lift!! @jacs65 and @JennyLynne - do you reckon us patellofemoral gals have probs with these that other PKR or TKR people don't have? Probably not, just wondering?!

 

[Raffs]

Forgot to ask earlier - who elevates during the night?

 

[JennyLynne]

My home PT guy said that he has had a few other pattellofemoral patients and all had major quad lag. He believes there is more direct trauma that with standard TKR. That's just his opinion, of course.

Regarding night elevation, I slept with one big fat pillow under my leg for the period of time that I had to sleep on my back.


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[snowleopard]

Hi Raffs,

I'm five weeks out, and still icing. I have to refill my cryo-cuff frequently when I first put it on, but as the leg under it chills, not so often. I really wish I had a pumping one so I could ice overnight, but I think there's probably such a thing as overdoing the icing, too.

I have been doing better at night since I devised a means of elevating without my leg rolling off the pillow. I found two old, broken-down pillows, and stuffed them side-by-side the long way in a large, zippered pillow case. It creates a groove between the two pillows that cradles my leg. Very restful. I start out the night with a cryo-cuff and try to remove it before I fall asleep, or it heats up my leg as it warms.

I can't sit very long or my leg starts to swell and ache. I am spending 80-90% of my time in bed. Moving frequently, then hey-ho, back to bed I go. More and more I'm trusting what I read here and what I experience vs. the 3-month-window, must-push, must-hurt philosophy, because the times I try that, I loose a day or more to swelling and pain.

 

[KarriB]

I elevated constantly and should've iced more often. I only iced after exercising, but then it was for at least 45 minutes or longer.

 

[Raffs]

@JennyLynne that's interesting -I'll ask my PT guy when I see him on Friday.

@snowleopard I've made myself a Snowleopard Leg Supporting Pillow and it is great! Will definitely use it tonight. I try to sit in a chair when I'm eating but it hurts after just a little while so I'm then going back to lying down and elevating.

@KarriB I'm going to elevate much more I think. The hospital would only allow me to elevate for half an hour at a time, a couple of times a day. They said that my OS doesn't like too much elevation because it stops the leg being fully extended.

First night at home not too bad. Managed about 6 hours sleep on and off. Today is going to be a day of rest, snoozing, icing, elevating, bit of gentle exercises and some short walks around the house.

 

[snowleopard]

That's right--I'd forgotten that we'd already discussed that. I'm glad it's working for you. Too funny! I am immortalized by an unvention whose directions start: "Take two old, ratty, broken-down pillows that you really should have thrown away years ago . . ."

Six hours of sleep sound blissful to me! Well done.

 

[Raffs]

You should make up a few and sell them on Etsy or EBay @snowleopard !! We'll have to come up with a snappy name for it!

 

[SuperSnapper]

I used to straighten my leg about every 15 minutes when elevating. Just working the quads really and that pull the knee back. In fact my legs used to move on their own eventually. I know it sounds daft but I would end up doing quad exercises and bends in bed when I wasn't even thinking about them! Keeping the knee moving but gently is really the key, I decided.

Re your icing question. I iced almost all the time I was elevating my leg and that was multiple times a day for long periods. I used to go to sleep at night with a gel pack on my knee ( cloth between it an skin!) even though I had a cryo cuff, the gel packs were better.

I actually found that sitting was very uncomfortable at first and for the first 10 or so days limited it to a few minutes then gradually built up to longer periods but it was a few weeks before I could sit comfortably.

 

[KarriB]

@Raffs most of the time I sat, I elevated my leg. Sometimes toes above the nose and sometimes just even. I have a chair with ottoman, every so often I would move out the ottoman and let my leg bridge between the chair and ottoman. It didn't hurt and I think managed to help my extension because I didn't do anything else to answer for the extension have. I did this while in my imbolizer after the 2nd infection surgery, also.
Like @SuperSnapper I would find myself doing quad flexes, ankle pumps while I was relaxing. My quads were nonexistent before surgery so I needed all the help I could get.

 

[PolarBear60]

Like SuperSnapper and KarriB, my legs do what they need to do to feel better.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005

 

[Hopper]

I agree with the others - do what your leg likes and elevate and ice as you like. If it feels good....
I love sitting on the sofa with legs up and a bit of extra elevation on the newer knee.
In bed I elevate if the leg likes it and I do use more pillows to raise my head a little more as its more comfortable - I guess thats a bit like a recliner position.
I'm aware that the leg needs to be extended and just make sure I stretch it out from time to time, sometimes raised but unsupported underneath to help the extension.
You will just increase your sitting at the table time gradually and without even realising - suddenly it will become ok.
I've done things slightly differently this second time around and my physiotherapy is very different indeed but I don't think it matters really. The progress is still fine and I'm sure yours will be good too.

 

[Raffs]

Day 6 - cannot believe it has nearly been a week since the surgery. I think things are going ok. Am mainly resting, icing and elevating. Doing the exercises the PT gave me 3 times a day. Walking around for 5-10 mins every couple of hours or so during the day. Trying to walk with a good gait using 2 crutches. Knee is stiff, of course, and swollen but I don't think anything other than what is to be expected at this stage. Pain seems manageable at this level of activity. Would love to cut back on the meds as they generally make me feel yucky but I know it's way too soon so I'll persevere and keep taking anti nausea meds if I need them. Been eating lots of high fibre foods and prunes but no action yet in that department so I think I'll start taking a stool softener today. Sleeping for about 2 hours at a time at night, then wake up for a while so I go to the bathroom and ice then try to go back to sleep. Only had one nap during the day yesterday so will try to increase that today. Am exhausted but, again, know that is totally normal. Had a mini pity party yesterday when I realised just what this recovery means but it was short lived. Have a terribly stiff neck from sleeping on my back in strange positions propped up by pillows so hubby is going to the pharmacy today to see if they can recommend something to rub in. May also try an ice or heat pack. The rest of my body aches in various places but I know that this is also normal.

Thanks for your advice re icing and elevating.

Hope everyone has a good Monday.

 

[snowleopard]

Sleep is tough. I've found melatonin helps me get a few solid hours at least. Hang in there. Hoping it gets better for you soon.

 

[Raffs]

Thanks @snowleopard I think I'm doing ok, hard to know if where I am at is "normal" for this part of the recovery or not.

Hubby said to me last night "do you want your Snowleopard pillow" as we got into bed!! I'm going to avoid taking anymore drugs for the time being as I don't think my body can cope with anything else just yet but I think I have some natural/herbal sleep aids somewhere which I may try.

You're awake late - what's the time difference Alaska and London? It's 9.40am here right now.

 

[snowleopard]

I think it's 15 hours. It's 1:40 a.m. on Monday here. Running my CPM machine for awhile, and finishing a movie I found on youtube. Hoping to get some sleep after that.

I go back and forth like a pendulum--no drugs--some drugs--some more drugs. There was no way I could handle the amount of drugs they had me on, though. I made it through the anti-coagulant, but when I switched over to the enteric aspirin, I got so nauseated and heart-burny. It took about three days to get over it. I was on antibiotics as well, but I've been aspirin-shy since then. I think I'll call the surgeon's office, and ask if I can quit the aspirin.

You might get a kick out of this. I really wanted a little fresh air, and to sit out in the cool of the evening a few minutes ago. So I took the walker out and was sitting with my leg elevated on a thera-band tied around the front of the walker, and was bouncing and stretching my leg on it. Whang! That walker shot off the porch and there I was, sitting stupidly and looking at it. Limped into the house, grabbed a crutch and snagged it and brought it back inside. Thus ended my adventure for the evening. Still light out at night here, but we've passed solstice, so it should be getting dark for awhile at night in a few more weeks. About mid-August it gets dark enough to see the moon again.

 

[Raffs]

Hope you're asleep now @snowleopard.

I'm on anti coag injections and then nothing for blood clot prevention apart from the attractive white TED stockings for 6 WEEKS!! I know some people take a small dose of aspirin every day if they are prone to clotting but they are hard on the stomach.

I did get a kick out of that - how funny! - thanks. You live in a beautiful part of the world, not that I've ever been to Alaska but I've been to the movies and watch TV! We have long days here too at this time of year but it does get properly dark for 6-7 hours. I can't get outside into my yard yet - three very steep steps and no handrail - but I hope to at some point soon.

Haven't read your entire thread yet so hopping (pun intended) over there now....

 

[Raffs]

Anybody else find it difficult to do normal little daily things when on two crutches? I don't have a walker and am not anywhere near ready yet to go down to one crutch. Just trying to carry a magazine, open a door, flick a light switch, close the blinds - I'm struggling! Am I missing a trick??