TKR Recovering from December 2, 2019 Left TKR

[Suz]

.. as close to the Bonesmart Mantra as I can! It's been a painful 1.5wks which I expected even though I forbid anyone to schedule me for PT the first week out. My Insurance Co. requires PT so I have to make an effort. But taking my first week off due to discomfort should be acceptable! I've learned a lot from Bonesmart having had my first Right TKR in 2016.

I met with in-home PT yesterday to let her know how things were going to go in my recovery. She said, 'sure- you'll do just fine'. We'll see how 'she, the PT' does! This afternoon she is receiving my call to cancel tomorrows session due to uncontrolled pain I'm experiencing. This is because I've been demoted to 1 hydrocone/acetaminophen 7.5 325 T, every 12hrs!! That's what I was prescribed when I called for a refill on the script of oxycodone I left the hospital with.

I'm absolutely amazed at how surgeons here in the US expect their patients to bounce back from a TKR with a prescription of aggressive PT, beginning hours after surgery, and uncontrolled pain.

I live in a rural mountain town and I like my ortho surgeon even though he is unrealistic in his recovery protocol. I gave him the information to what I believe the most profitable PT protocol Bonesmart promotes 3yrs. ago. He didn't adhere to it. Just think of the better recovery his patients would receive had he.

Prior to my second knee replacement I discussed with him my low tolerance for pain and he assured me he would take care of me. I'm at 1.5wks post-op today and was managing ok until his prescription for 5-10mg oxycodone every 6hrs for 7-days ran out day before yesterday. Now I'm taking over my recovery! I will continue to follow the Bonesmart prescription for PT instead of his. He's now left to accept my 'uncontrolled pain' reasoning to my choice of no painful PT this early in my recovery.

One thing I've got going for me is the Osscur Cold Rush Ice therapy machine I learned about through Bonesmart. Woah! I can't praise it enough! It's my Christmas Present that I saved for and bought myself. Yes, it was $200 but I canNOT imagine it not being by my side right now. It's my primary pain medication in my view of things. If you would like to learn more about this, the BS Administrators and Moderators have links to recovery equipment in their signatures. By reading up on it through one of their links, Bonesmart will receive a portion should you decide to purchase. The support this site gives so many is absolutely invaluable.

I'm one of those who reads reviews on products for hours and hours. You may pay $50 or so more for the Osscur Unit than others use, but it pays for itself in only a few days of raw recovery pain! It was designed holistically, with unique features like a locking lid to help prevent spills and insulated walls for improved cooling. I have received 5-6hrs of sound sleep at times from using this ice therapy to control my pain. In my first week post-op! I'd buy it all over again tomorrow for what it has done for me this past week!

I'm rambling- sorry. But at least my recovery thread is now relocated to the proper place!

If nothing more than a hug and happy picture, I'm looking forward to supporting others here in your recovery challenges! And learning also as I do everytime I come here!

Let's DO this!

 

[Helizabug]

So glad to see you on this end of the surgery now!

I was wondering what part of NC you were in. I’m spitting distance from Duke and UNC.

I have one of those ice machines too. I swear by it. Did anyone tell you to freeze water bottles to use in it? Freeze two batches and swap them as you go? Probably, but just in case, I thought I’d toss that in there.

I was only prescribed Oxycodone for a week, and I was really wigged out by that. But then, when the oxy started hurting my stomach, I switched it out for ibuprofen, with doctor’s permission, and that with the prescribed big doses of acetaminophen has helped. I still have some bad patches, but not too many. i hope my kidneys can handle it, but I used to take this much ibuprofen for the arthritis, so I feel okay doing it for a while.

Good luck handling that pain, keeping your spirits up, and managing your healthcare team.

 

[Celle]

Hi again @Suz - and to recovery again.

I'm sorry you're having so much pain and I hope it soon settles.

You probably remember most of this, but here's your copy of the Recovery Guidelines and some helpful articles:

Knee Recovery: The Guidelines
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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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.

 

[Suz]

So glad to see you on this end of the surgery now!

*Thank You Helizabug*! Love your BS name! As some here will agree, I'll get chattier on into my recovery,..

I was wondering what part of NC you were in. I’m spitting distance from Duke and UNC.

You're in a busy but nice area! I live with my husband and daughter in Sparta, NC! We have purchased land within 5 miles of Stone Mountain State Park and are building a farm there. Now that the barns are all up and animals are settled, we hope to build a cabin next. We've lived in the Applachian Mtns for 12yrs so getting down in the rolling hills is nice! In only 20 minutes we can be back in the sharp curves, but our honeybees are loving the sourwood trees on the new farm!

Good luck handling that pain, keeping your spirits up, and managing your healthcare team.

Definitely appreciate any luck I can get! I'm hyper-sensitive anyway so pushing back on professionals, especially these young, interestingly knowlegable PT's, is a huge challenge for me! I was raised to believe Doctors & Preachers were 'all-knowing' and to never question their words. My ortho surgeon told me during our first discussion of a knee replacement back in 2016 that I would absolutely despise him for 6wks post-op. But would forgive him 1yr. out. And he's defintely been right on that front! He does remarkable joint replacements with low instances of infection or other post-op problems. He's just got some 'learnin' to do on better recovery practices! I so wish orthopedic surgeons promoted the correct way of recovering from such a traumatic surgery. Maybe one day. I learned recently that the Mayo Clinic now recommends no PT for the first week post-op. It's a start! Maybe one day more in the medical field will learn what those who support the Bonesmart approach to recovery knows! I do like that this time around- I know exactly how to converse with these, ahem, professionals, about how we're going to do things with 'my' recovery. It seems I leave most of them in a trance once I'm done,..

 

[lovetocookandsew]

Congratulations on your new knee, Suz! While I'm sorry you're having to go through this again, and with more pain due to not enough pain meds, I am glad to see you again. You're always such a positive encouragement to others, so I hope we're all a comfort and encouragement to you as you travel this recovery road. I hope your doctor will see the light about pain relief, if not, maybe your primary care doctor can be of assistance. I'm so glad you have an ice machine this time around; I used one after my revision (actually several, but that's a different story) and the relief it gave was night and day from the ice packs I used after my original TKR. Good luck and please keep us posted on your recovery.

 

[sistersinhim]

I've been demoted to 1 hydrocone/acetaminophen 7.5 325 T, every 12hrs!! That's what I was prescribed when I called for a refill on the script of oxycodone I left the hospital with.

Things were so different in 2016 when we could get pain meds as long as we needed them. Not so now. Post-surgical patients have to beg for pain relief and are then made to feel like druggies. Thank God ice is a good pain reliever. We'd really be hurting with that!

 

[pamsknees]

Hi Suz
I’d love to hear more about your ice machine. I’m having bilateral TKR in Mar & am researching everything. I asked my surgeon about an ice machine at my consultation & he said ice packs work fine. I’ve heard so many people rave about ice machines that I think I want one- anything that will help my recovery! I know everyone seems to be limiting narcotic RX - as an optometrist I’ve gotten the letters from the board & from insurance companies. It’s sad that because of abuse those who need it are hurt. Hope your recovery goes well!

 

[Jockette]

Hi, Suz, welcome to Recovery again!

I look forward to following how you keep those professional young whippersnapper PTs in line! I had a very tough time with PT when I had this partial done, in March of 2017. I have not had a good outcome, so there will eventually be a revision (if some kind surgeon would take the time to find out what’s wrong.) and now that I’ve found Bonesmart, the next recovery will go very differently!

Tell me what your insurance requires about PT. I don’t ever want to go to formal PT again, and I’d be really upset if my insurance forced the issue.

Best wishes for your recovery!!

 

[sistersinhim]

My experience with ice packs was they stayed cold only about 30 minutes. Ice machines stay cold for about 4 hours. The first few weeks you will need to ice at least 45 minutes out of every hour. The packs just don't last long enough, especially when you want a nice night's sleep or nap. The ice machine is well worth the money.

 

[Suz]

Things were so different in 2016 when we could get pain meds as long as we needed them. Not so now. Post-surgical patients have to beg for pain relief and are then made to feel like druggies. Thank God ice is a good pain reliever. We'd really be hurting with that!

Amen!!

And I love how ice is so much better on our tummies! All I intend to do going forward is hang out with my ice machine and pamper my brand new knee!

I am feeling better today. I was lying here earlier with my knee as elevated as it's ever been, thinking how welcoming my surgical staff was prior to the procedure. Then how it seems they went cold and unavailable afterwards, lol! Post-op patients begging for help must be what they experience daily. How sad.

Having been here done this before, I do know better days are ahead. That's 1/2 the battle I think! Had I not been through this, last night would have scared me crazy. It felt as if my entire left leg was going to explode. Thigh, knee, ankle & toes, all at once! Hour after hour. When I called to cancel tomorrow's PT appt., my sweet little therapist said, 'if you get to feeling better give me a call and I will be happy to come tomorrow'. I replied, 'please don't take this personally, but if you come and we do PT, I'll hit the wall of agony again. Something I hope to never do again. Now visit with you anywhere else once I'm recovered would be fine'.

 

[Suz]

My experience with ice packs was they stayed cold only about 30 minutes. Ice machines stay cold for about 4 hours. The first few weeks you will need to ice at least 45 minutes out of every hour. The packs just don't last long enough, especially when you want a nice night's sleep or nap. The ice machine is well worth the money.

Not to mention you gotta hobble to the kitchen to get ice packs every 30 minutes if no one is awake! Not fun when your recovering knee is raw pain in the early weeks & months!

 

[Suz]

Hi, Suz, welcome to Recovery again!

I look forward to following how you keep those professional young whippersnapper PTs in line! I had a very tough time with PT when I had this partial done, in March of 2017. I have not had a good outcome, so there will eventually be a revision (if some kind surgeon would take the time to find out what’s wrong.) and now that I’ve found Bonesmart, the next recovery will go very differently!

Tell me what your insurance requires about PT. I don’t ever want to go to formal PT again, and I’d be really upset if my insurance forced the issue.

Best wishes for your recovery!!

Thank You Jockette! I have Private Pay Insurance through my employment and I've learned in the past never to give any private pay insurance company cause to deny coverage. Even when you are careful to jump through the hoops- months later bills show up in the mail stating you were non-compliant with policies thus the outstanding bill. If they feel you don't cooperate with post-op guidelines, they have reason to opt out of their portion of the costs. Especially if you have 'issues' following the procedure that need additional coverage. I hope I'm explaining this correctly! My employment's Resource Person strongly urged me to follow all recovery guidlines so there would be no problems with receiving coverage.

 

[Jockette]

Ok, thanks, I understand. I do hope you will be able to stay in charge and do what you know is right for you at PT, and still be considered compliant.

 

[pamsknees]

Would your ice machine work for bilateral or would I need 2 machines?

 

[sondrals]

I rented a game ready ice machine and it has an adapter for dual cuffs

 

[Suz]

Hi Suz
I’d love to hear more about your ice machine. I’m having bilateral TKR in Mar & am researching everything. I asked my surgeon about an ice machine at my consultation & he said ice packs work fine.

You will hear that here too! I used packs with my first replacement and am now using the ice therapy machine for my current replacement. There is no comparrison, in my humble opinion. Some feel the packs are cheaper alternatives and they are. But after what my ice therapy machine has done for me, now 9-days out from a single knee replacement, I would sell anything I own that doesn't breathe, to have one by my bed. I really would!

And Pam, please listen carefully my new friend, lol. If I were having bilateral TKR's, I would do whatever it takes to have one for each of my recovering knees. With what you are facing, $400 is a small price to pay for the relief I assure you WILL receive.

My Osscur machine is providing therapeutic relief to my knee all day and night. I do take a 15-20 minute break by turning it off occassionally. But I leave it hooked up to my knee and have it at the ready the minute the pain zingers & hammers wake up.

My surgeon strongly recommends the ice machines. All of his patients come out of recovery and into their room with a Polar Products Cold Therapy System by their bed. The ice machine is immediately hooked up to their surgical knee.

After much research my decision was between the Polar Cold Therapy & Osscur Cold Rush Systems. I purchased the Osscur before my surgery and made the right decision for me! The Polar Cold Therapy I used in the hospital was still 'much' more effective than an ice pad, that only gives you at best 15 minutes of really cold therapy before needing to be refrozen. And yes, I had many ice packs in my freezer for my first replacement. The good ones average $25. Multiply that by 4 and there's 1/2 your cost for an automatic machine!

It was tideous keeping an ice pad on my aching knee constantly. With an ice machine, it's more consistent. The Osscur keeps the ice colder much longer than others according to the reviews I read. It is unbelievably responsive to the raw pain and it's QUIET!

My surgeon highly recommends 20 minutes out of each hour on the ice machine. I stay on mine 45 minutes out of an hour with no problems. Most nights, when I've behaved myself and not overworked my knee, I'm able to sleep 4-5hrs without coming off the machine by using the low-med setting.

I’ve heard so many people rave about ice machines that I think I want one- anything that will help my recovery!
[QUOTE/]
Not having ever met you, I am certain you want TWO quiet, quality machines! Ok, I would! Unless you can find a situation like what sondrals mentioned above. You want to make sure you have a quiet machine however that keeps your ice water really cold. I've heard good things about the Game Ready machine but I would want to make sure I was receiving the entire amount of cold water one machine delivers in each of my pads!

Having a machine, your recovery will be more comfortable, enabling you to get more sleep which means you will return to your Patients much sooner!

Hope your recovery goes well!
[QUOTE/]
As I hope for you! I met and spent most of my recovery time with so many wonderful Bone-Smarties here prior to and during my recovery. I spent many a night chatting away with my recovering loved ones that understood what I was going through! I wish I hadn't gotten busy with our farm and spent more time here supporting others once I recovered. I've a feeling this time, I won't be leaving!

Please forgive me for my reply being so long. I had a point to make. I hope so much I was successful!

 

[lovetocookandsew]

Suz, just a little tidbit of info I discovered when using my ice machine. We always emptied it out, cleaned it a bit and refilled it in the mornings. When we filled it for the first time each day, we added four frozen water bottles (I had at least 12 in rotation) some water and then some ice to the fill line. Then during the day we changed the bottles when needed. This meant the water was very cold from the start, didn't use much ice at all, and also it meant the bottles melted more slowly so we didn't need to change them as often. It also meant it stayed really cold for up to 7 or 8 hours as I recall, so it stayed cold all or most of each night, and since I slept well from day one, it meant I didn't have warm water on my knee after 4 hours or so, and I didn't have to wake and change it out or take it off. Oh, and make sure to remove the labels if you haven't already so they don't gum up the machine.

 

[Jockette]

Is it easy to understand how to work the ice machine? Sometimes I struggle with reading directions, I do much better if someone shows me how to do something.

 

[lovetocookandsew]

It's actually pretty easy, Jockette. I'm the opposite-I prefer to read the directions myself. Vanilla and chocolate.............lol.

 

[Suz]

Is it easy to understand how to work the ice machine? Sometimes I struggle with reading directions, I do much better if someone shows me how to do something.

VERY EASY! I understand your struggle so much I don't take things out of their package until my husband is there to help, lol! He had the Osscur going in no time! Now all I do is turn it off and on when going to the restroom or taking a break. I like what Kim just posted above however and may have to give hubby some new directions, lol!