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TKR Recovering in Canada

traceys

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Thankfully my OS is very understanding about opioids.
His theory is he would rather have a patient comfortable and able to comply with treatment and deal with the small chance of addiction than someone in pain and using stiff he doesn’t know about and not doing therapy.

It’s a shame society is so afraid now

Here in Canada isn’t as bad I find compared to friends of ours in the US.
 

donnag1108

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Sorry to hear of your difficulty getting meds. My OS has been so awesome when it comes to that. Grateful he is all about comfort and pain control for his patients.
 

Mom2Lucy

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@SnowHare , I’m in Alberta, just south of Calgary. My surgery was done in Calgary.
 

Breadman

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Hi @SnowHare. I got extra meds from the pain management nurse before I left the hospital and also from my family doctor when I had my staples removed. I have plenty left over. I didn't need as much as I did before surgery. I don't take anything now. Maybe a Tylenol if I'm going to be out all day.
Had my surgery at Markham-Stouffville hospital.
 
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SnowHare

SnowHare

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I am in Edmonton, which has an excellent system. They developed it a few years ago to speed up wait times. It's like a conveyor belt. I think that this system is used province wide. My surgery was done at the Royal Alexandra. They built a new ortho surgery building, mostly just for joint replacements. They sent 14 people home the day I went home.

Went to physio today. My physiotherapist was very gentle with lots of rules for me to follow. He did my pre surgery physio on my ankle, so we know how I operate. Instead of doing bed slides, he told me to get a small Swiss Ball, because I will be using it for more exercises down the pike.

The rules are simple. Try and not let the ankle flop to the side. Try and get the leg lifting. Longer strides with the walker. Take is gently with the exercise. He also showed us where to put the tens machine leads for both my back and my knee. Not to use on knee until staples are out. No picking anything up off the floor, even though I can do that quite easily.

Sent a message to my GP. Told her how much I'm taking and how often. I have kept a record of dosage and times. She said to let her know when I would need more, and she would prepare a prescription for my husband to pick up. I had to sign a special form, as these are restricted meds. He's her patient too. I'm working my way down from the morphine to the codeine. I'm not in a rush.
 

traceys

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Wow - the Royal Alex- that brings back memories of some good days for me.

Glad to hear your pt is taking the path you are comfortable with. That makes all the difference when everyone works together.

Look forward to seeing all your victories now.
 
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SnowHare

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Saw my BP today to discuss meds. She asked me why I was there, as my DH was supposed to show up, not me. I told her that her front desk staff said I had to be there. She said that next time, just the DH was to come.

She looked at my knee. She thought the knee looked really good. Just a little swelling still. More Dylaudid, and I can take it as I wish, interspersing with the Tylenol 650.

It's taking less time to get through the snow to the car. Tomorrow's outing is to get my staples out. Yay.
 

sistersinhim

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Getting those staples out will be a big relief! No more pulling from them!
 

Jockette

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I had stitches. I hope I never get staples! :scaredycat:
 
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SnowHare

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Staples are out! Steri Strips are on. Evidently, everything looks just fine.

Pre-op flexion: 111 Current flexion: 75

Pre-op Extension: 111 Current Extension -15

Phsyio at the Bone & Joint Clinic said the flexion is excellent, the extension - well, not so much. I am to focus on the extension.

Precautions for up to 12 weeks:
* No forced flexion
* No pivoting
* No pillow crosswise under the knee
* No resisted open chain exerises

I've been given the all clear to sleep on my right side with my body buddy pillow.

@donnag1108 There were a few staples that seemed to snag. It was mildly annoying, but maybe that was the dilaudid talking.

The worst part was the very, very long walk to the clinic. It's in the middle of a mall. Go figger.
 

donnag1108

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Glad you got the staples out. Most of mine came out easily but I had one that seemed to snag as well. Hopefully you have a good night's sleep.
 

Celle

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Saw my BP today to discuss meds. She asked me why I was there, as my DH was supposed to show up, not me. I told her that her front desk staff said I had to be there. She said that next time, just the DH was to come.
I don't understand this. Were the medications for you or for your husband?

If they are for you, you definitely need to be there. It's your body and your knee.

You are in charge of your recovery. Not your surgeon, not your PT therapist, not your GP, and definitely not your husband.
 
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SnowHare

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Made it to week 4.5.

In retrospect, the first week or two were horrible, but I expected that.

I am now much more mobile, and I have made the decision to spend half my day downstairs. I'm doing circuits around the house every 1.5 hours, increasing the numbers of circuits every week. I tried my DeskCycle. Ooh, that was a stretch. Starting slowly. Ten reps of one revolution, 3 sets. It actually feels better as I do more.

The knee bending was progressing along beautifully. My physio was quite pleased. I'm thinking it's regressed, as my knee is stiff as a board. Sleeping is difficult, as I just can't get comfortable. I want to sleep all night all curled up, as that's my normal sleeping position, but it means my knee is bent all night.

Biggest surprise to date. Major, major incontinence. I have no control. No Kegel could stop this flow. My DH dropped by the GP's to pick up my prescription. I had noted that I have spastic bladder gone berserk, so she's thinking infection and sent a bottle home for a specimen. I'm glad I read on Bonesmart awhile ago, to invest in some incontinence pads. I've had a few spills on the floor, as I have no control. Oh well.

Going up and down stairs is challenging, as my former bad knee (right), was actually my good knee. My left knee is super weak, so the last step is always a challenge. I always used my right knee as my lead knee going up and down stairs, and now it's supposed to be babied along. It feels good to be more mobile and being able to do a few things myself, like prepare my tea, although my DH has to deliver it to me.

Monday is physio, part 3. My instructions always read to not go beyond the beginning of pain. My DH does press downs. He presses until I start counting, which indicates when the pain is starting.

I'm starting to feel impatient, but then I remind myself that I would be having to go outside more often, but baby it's cold outside.

Hoping all the other January joint recipients are doing well.
 
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SnowHare

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@Celle The meds are for me. My husband just has to pick them up, as they are a triplicate prescription. I just write a note with what I want, tell her how I'm doing, tell her my plans. She would rather I not go out, because the sidewalks are snowy and icy.

I'm more or less in control of the pain management. I also keep a log, in case she has questions, but so far, it's my call. I just have to check in every couple of weeks, while I'm on the Hydromorphone. She did tell me that I will not be dropping down to Oxycodone, but to something OTC. Evidently that's common here.
 
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SnowHare

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@sistersinhim You are so right. Total misprint. It should have been: Pre-op Extension: -19 Current Extension -15.

My major oops. :heehee:
 

Jockette

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The knee bending was progressing along beautifully. My physio was quite pleased. I'm thinking it's regressed, as my knee is stiff as a board
If your knee gets stiff like this it is swelling and most likely because you are doing too much activity and it doesn’t like that.
My DH does press downs. He presses until I start counting, which indicates when the pain is starting.
You should not allow anyone to push down on your knee (or to push your knee into a bend, either) This is bad for your knee. As you heal your ROM (both flex and extension) will improve. Often extension takes longer but it will happen. But it takes Time. You are very early and in this recovery.
 

sistersinhim

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-19 Current Extension -15.
These should be +numbers. The negative number means your knee is hyper-extending. Here's a chart that can show you what I'm talking about: https://bonesmart.org/forum/attachments/knee-rom-small-jpg.50489/

A good way to check extension yourself is like this:

1. put your leg on a bench, seat, bed, floor or anything similar but preferably something fairly firm.
2. with not too much pressure, press the back of your knee down - use your leg muscles, not your hand!
3. slide your hand, palm down, under the back of your knee
a) if you can get your entire hand under easily, it's probably about +10 degrees
b) if you can get just your fingers under, it's about +5
c) if you can get your fingers under but it's a push, it's +0
d) if you can't get your fingers under at all, it's -5 or more
 
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SnowHare

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@Jockette - the press downs are not on the knee, but on either side, mid calf and thigh. He only presses to pain, or just to a twinge of pain, when I start counting. That's the indication for him that he's gone far enough.

As for the stiffness, I'm actually doing less activity. When I do a bit more, it's not quite so stiff, when I finish.
 

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