TKR Recovering in Canada

[SnowHare]

It's Day 3. I've been home from the hospital since Day 2. The OT decides when you go home. i guess I was their star patient, so I was the first to leave.

I have my command centre adjacent to the settee. I have a date book with all the times for each of my meds, a bag with the dressings from the hospital, my needles, my "aids" Getting comfortable is the hardest thing.

I still can't lift my leg off the bed, not even a centimeter. I've been through this before, so I know it will come. My foot is puffy, and I am trying to keep it elevated as much as possible. I removed my dressing. A little dried yellow ooze, so I'm going to air it out and re-dress.

I'm on hydrocortisone and a typenol type pain killer. The doctor kindly let me decide how much to take. I have enough for 2 pills a dose, but if things go sideways, I have the third pill if necessary.

My DH is in charge of making me do my exercises, and doing the count downs. He's a saint.

I have a knitting apron strapped to my walker, and it holds water bottles, phones, odds and ends.

Now, it'e nap time.

 

[Jockette]

Welcome to the Recovery Side!

My DH is in charge of making me do my exercises, and doing the count downs. He's a saint.

That’s awesome that you husband is helpful, we all need that at this time. My husband was awesome, also.

However, too many “exercises” at this very very early stage are not necessary. Make sure anything you do is gentle and does not hurt. If it does hurt, don’t do it.

Right now your main goal is healing and doing what you can to address swelling.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: 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. Here is a week-by-week guide for

Activity progression for TKRs​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[sistersinhim]

Welcome to Bonesmart! Icing, elevating, resting and pain meds is all you need to be concerned about for the next month. Your infant knee having to endure exercises right now is counterproductive. It will keep your knee inflamed and swollen. Just doing your daily activities, such as walking to the bathroom, kitchen and bathroom. Bathing, brushing your teeth, washing your hair. All these types of things is all you should be doing for the first month or so. Please read the articles left for you by Jockette. These were developed by the combining the experience of 1000s of knee replacement patients. Following these guidelines will be very helpful in having a less painful recovery.

 

[SnowHare]

@Jockette, The exercises are pretty small, just some functional ones to support lifting my leg, as well as some very gentle range of motion. We are finished in about 5 minutes followed by ice. The rest of the time, he fetches things and makes sure I have everything close at hand.

I find this all very, very difficult, as I am used to doing everything myself. Having to have assistance is hard for me to swallow. I'm usually very independent.

 

[sistersinhim]

Now, is the time to lay back and let your hubby take care of you! I bet you have been taking care of him for years! It's your turn now!

 

[Pumpkin]

I find this all very, very difficult, as I am used to doing everything myself. Having to have assistance is hard for me to swallow. I'm usually very independent.

It is common to feel this way when you have to let someone else do what you consider your job.
Nurturing mother: how to let go and accept help

Your job right now is to heal.

 

[Jockette]

I’m glad to hear your exercises are short and gentle.

I know it’s hard to let go of things we are used to doing ourselves. But it’s temporary. Try to hang in there, vent here all you want, we know what you’re going through, we’ve been there!

 

[traceys]

Hi from another Canuck @SnowHare

I’m a mama bear myself - everyone else first and if time left over then me.
I learned something pretty quick though.
If they don’t take of me now... I can’t take care of them later. And you are going to need all the support and assistance you can get over the next while cuz this is a heck of a journey!
Come say hi anytime!

 

[Mom2Lucy]

Hi @SnowHare!

 

[Dolly Girl]

Welcome home, I like to everything myself too, but had to give it up for now. My husband is up for sainthood.

 

[SnowHare]

I have yet another enlightening appreciation for people who have mobility problems. I've had them in the past, but this is something else.

Not, walk a mile in my moccasins, but walk 10 meters, through the snow with my walker.

Went to get bloodwork done today. I left an extra 20 minutes to get there. I should have left an extra 45 minutes.

Last night's shower in the tub was a DISASTER. I think I will go dirty, or wash at the sink. My hair will be a different problem.

MY husband has started the resentful looks. I've taken over his chair, and he is quite displeased. He can say things oh so loudly without so much as a micro-decibel of sound. I'm afraid to ask for anything. I just want to move my equipment, medications upstairs and live up there. All he needs to do is prepare and deliver my meals. His mother was not a very compassionate woman, and she did not teach her kids compassion.

Learned to date:

I didn't realize my shoulders and back would hurt so much.
THANK YOU to the person who recommended benydryl for itching.

 

[Mom2Lucy]

@SnowHare , I’m so sorry you’ve had some tough experiences with basic living. It can be so very challenging in the early days.
As to your husband , wow, your surgery was only a few days ago. He better put on his big boy underwear and brace himself...there’s such a long ways to go yet! He better watch a video of tkr, there’s lots on you tube. If he’s not compassionate, logic may help. Nothing like a dose of reality!

 

[SnowHare]

@Mom2Lucy, The DH is still smarting, but I think he's received the message.

Made me a nest up in the spare room. I have a table for the ice machine a table for necessities, a chair with arms for dining or sitting up. I leave the room to use the toilet, then I do a loop through the upstairs rooms. Dh keeps me hydrated with 3 water bottles filled.

Trying to cut down on the hydrocodone. Mostly, it works with 2 tablets, but then sometimes it doesn't. I've been in considerable pain for years, and you'd think I'd be used to it. Nope.

Still have some yellow ooze from the incision. My calf is bruising. Is this from all the swelling? Back hurts and I can't get comfortable. The shoulders are getting better.

Learned to date:

I didn't realize my shoulders and back would hurt so much.
THANK YOU to the person who recommended benydryl for itching.
This is going to take time and patience.

 

[traceys]

@SnowHare yay for a nest!!!

We all have a version of it and it truly does make a difference. Add in some magazines, treats and snacks and music and you have it all!!

The bruising is very normal. I looked like I had on one technicolor sock for a week or two as all the bruises kept coming to the surface. Every day was like an Easter hunt when I woke up to see where I could find a new color from the day before.
Watch the oozing. If it’s really warm or red or anything that looks odd don’t hesitate to call the dr. Better safe than sorry. @Josephine is always there too if you ask her and post a pic.

Don’t worry about cutting down meds right now. You need to be comfy and they were prescribed a certain dose for a reason. It’s about you getting thru this - not impressing anyone with how little you take. Drink a LOT of water for many reasons. Also forces you to get up for a little bathroom walk.

Glad to see you are a bit better mentally. Look forward to hearing how you are coming along!

 

[Mom2Lucy]

Oh the bruising...yeah, spectacular colours and mine was from mid thigh at the back, to all through the calf and ankle.

I took a photo everyday of my incision and area, and then one of the back of my leg because of the bruising.
It makes it easy to look for any change, especially at the incision.

I’m very glad you’ve created yourself a nest , that’s vital to your comfort! Have a set up for anything that needs charging, it’s very handy.

I have the back pain, I’ve been told it’s very normal as the body realigns after the surgery. And think of all those damaged nerves in the leg, everything’s connected!

Stay with the meds as prescribed, the body needs rest and healing, and the meds are needed. I wish I had been prescribed more, because pain is debilitating and sets you back.

 

[Josephine]

Don't worry about the bruising. Take a look at these specimens! Bruising after surgery

 

[sistersinhim]

I've been in considerable pain for years, and you'd think I'd be used to it. Nope.

Arthritic pain and surgical pain are two different things! What's good though, is that the arthritic pain gets worse, but the surgical pain lessens! You are on the other side of that pain for arthritis and will soon be on the other side of the surgical pain!

 

[SnowHare]

@Josephine Wow! What a colourful display!


@Mom2LucyMy GP told me to let her know when my meds run out, and she will write a prescription for what I want. The back pain is worse than my knee, unless I am giving it a wee bit more of a stretch.

How long did your pain go on for until it was tolerable?

My foot is no longer a huge sausage, with 5 little Vienna sausages sticking.

 

[Mom2Lucy]

The pain was more tolerable after the first month, I guess, with some ups and downs.I feel the opiod crisis has caused many doctors to underprescribe.

 

[SnowHare]

@Mom2Lucy
Thanks for your reply.

They are really careful now. When I was in the hospital, and the doctor was arranging my prescriptions, he asked me how much I took. I said 2 - 3 mg. He agreed to prescribe enough so I could take 3 mg as necessary. He also reminded me to cut down as soon as I can.

Having taken percoset for 2 months, and not develop an addiction, I am comfortable that I won't develop an addiction now. When I need more, my GP will prescribe. I call, my DH picks up prescription, and all is good. She knows I need much more painkiller than most people. Heck, much more of any drug. I have a very efficient liver.

A month, eh? That's about what I'm thinking, but it depends on how physio goes. My exercises are 1 step forward, half a step back.

Where abouts are you in Canada? I'm interested in how other jurisdictions organize their joint replacement surgeries.