PKR Red Rider's 60k mile tune up

[RedRider]

This morning I made the leap of faith over to the other side...and nailed the landing (figuratively speaking of course)!

Here's my pre-op thread FYI:
http://bonesmart.org/forum/threads/...facing-anyone-had-patellar-and-lateral.22457/

My partial knee replacement was scheduled for 7 am this morning, at an outpatient surgery center in downtown San Diego. All in all, I was out the door at 11:30 am and in my bed by noon; talk about drive thru service!

Doc said everything went great, and he was VERY pleased with the placement of lateral compartment hardware. He was able to assess the PF compartment and found it worthy of an Arthrosurface inlay.

So far pain has been tolerable and my spirits are good. I'm only 10 hours post-op so I don't know exactly what the night holds in store. All I know is that I re-read all the post-op information and am currently elevating, icing and resting.

I'll try and update my blog soon but wanted to check-in first with my devoted Bonesmart family!

http://joshskneeblog.weebly.com

 

[trailspud]

Enjoy those drugs. Ice, ice, ice.

 

[icep707]

Thats great news ! Remember meds on time ,all the time,even if you feel nothing ,take them. Your block or spinal will wear off. Be ready. Resist temptation to wobble around with a walker too soon. Especially since you are a young one. You will be bike riding and enjoying the surf in no time and pain free!! Ill probably be having my left knee done within 5 years. X rays show cartilage lose. But all my ligaments are intact and well. Dont plan on much sleep ,its very elusive. Best of luck ,Iceman

 

[Celle]

Welcome to the recovery side!
Here's your recovery reading list:
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lie down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM

 

[skigirl]

I am glad to hear that you are resting and icing. A partial is just as painful as a TKR and your tissues need lots of rest the first few weeks to get rid of the swelling.

 

[RedRider]

Day #2 and nothing too eventful. I took the wrap off and apparently my knee had swallowed a softball at some point!

Pain management has been good, my only challenge now is the swelling. I made the mistake of elevating with a bent knee. It got stiff enough that I couldn't put any pressure on it. So I rearranged my pillows for more of a straight-elevated knee and I've been habitually icing since I got home.

Anything else I should be doing to help get this softball down to a tennis ball? It's concerning but then again, I'm only 36 hours out.

 

[skigirl]

You have answered your own question---you are only 36 hours out. It took about 2 weeks for most of the swelling to leave my knee. I personally feel that if you take this time now and keep the knee elevated most of the time--gentle stretches--no pushing, your swelling will go down so that you can then work a little harder on bending and beginning to work on the muscles.

I spent about 80% of my time the first two weeks in bed with my propped on three pillows. I think it is time well spent.

Elevating your leg to control swelling and pain
Using ice

 

[referee54]

ything else I should be doing to help get this softball down to a tennis ball?

Ice and elevate---repeat it over and over for long periods of time.

 

[RedRider]

2 days out, feeling relatively good. Got the elevation debacle figured out: "toes above nose"! I learned the hard way that having your knee above your heart isn't enough; your foot needs to be elevated as well. The reference here on BS suggests a slightly bent knee during elevation, which worked well for me.

Took a few conservative strokes on the stationary bike, not much pain but really tight. My grapefruit is now a small softball, which is good. Overall this morning has been a success.

On another note, for some odd reason, oxycodone makes me very itchy. Has anyone else experienced this?

 

[skigirl]

Itching is common from opiods---you can ask your doc for something else. I was nauseated on Lortab or hydrocodone but not on oxycodone. So, you can call your doc in the am and get a different med right away before you drive yourself crazy itching!

 

[RedRider]

Thanks @skigirl I'm running about 80% as well and it seems to be working well for me. The constant itching is tolerable, I'm just glad it's not uncommon.

Today was pretty lax. I got up this morning feeling pretty good so I hopped on the stationary bike for 20 min. It was still pretty tight, but again, not very painful.
I had a little trouble when I took an extended nap this afternoon and missed my meds. It wasn't bad but it definitely made me appreciate how much pain is being alleviated. From now on, I'm gonna start setting alarms before I go to sleep.
Question of the day: now that I'm walking around more freely, I've felt some slight movements within the operated area. Nothing audible, but it feels like something's shifting around in there. No pain from it though. Is this normal?

 

[icep707]

Oh boy , stationery bike already. There may be a price to pay for that ! And of course set a alarm to take meds around the clock and yes toes above nose,leg straight etc. Ice all day. You are doing great however while pain is minimal we have the tendacy to overdo it. i know i did. Keep us updated, best of luck , Iceman

 

[skigirl]

20 min is a lot to ride a bike right now. My PT would only let me ride for 5 mins. Then, I could add a minute every few days. It was boring, but the time did pass!!

Things feel loose because they are---I bet your quad is not working 100% and some of the soft tissues are still suffering from surgery. Be careful not to overdo, I did it and spent a night in agony.

 

[RedRider]

(RedRider inserts foot into mouth here)

Well @skigirl and @icep707, you're both welcome to an "I told you so" which was inevitable after yesterday.

The perfect storm started around 11pm last night. I got up to use the restroom and when I returned to bed, the throbbing started. At that point it was difficult to get comfortable, and all that moving around wasn't helping the situation either. It was a rough night to say the least. I finally got things under control about an hour ago, but the last 8 hours were pretty brutal. I feel like such a rookie. It's also a little embarrassing too since I've read so much about post-op "do's and don'ts" yet dropped the ball on my own recovery.

Lesson learned!

In other news, my co-worker brought me all the seasons of Game of Thrones. I've heard so much about it so I'm excited to start watching them.

 

[TexasTee]

@RedRider Congrats on your recovery so far! I think you might have broken a record though to achieve the over did it club on day 3 I have a feeling I'll be in a similar boat - I'm not known for being a patient patient. Hope Game is good - I have it on my list to watch during my recovery, as well!

 

[billingcl]

@RedRider . I hope the recovery is going better. It seems like your bouncing back wonderfully (even with a little set-back of getting over anxious). I've enjoyed reading your posting and looking forward to the recovery period update. From all I've read you certainly did your research in advance. I thought I thoroughly researched the process and have since realized that I should have asked so many additional questions. Had I done so, I think my selection of a surgeon would have changed & the overall recovery would have been a lot less painful. Wish I would have found this site prior to my surgery. Bonesmart has been my saving grace during this recovery period and provides so much useful information and inspirational support.

So now that your a couple weeks post-op do you think the pre-therapy exercise has made a difference? I wish I'd known in advance to try and work through the pain to strengthen my quad prior to surgery. This is my hardest stumbling block at this point. PT said she's getting a bit concerned that it's taking this long for my quad to start responding. At this point I can't put much weight on the leg. I never had this problem with prior surgeries...but I think age may be playing into the recovery and not using my bad leg for almost 2yrs prior to surgery. Prior to that I was walking 4 miles a day and in descent shape. How quickly it goes away.

 

[skigirl]

Well, I have already confessed to doing the exact same thing, so only empathy here. It was hard for me to believe that I could have that much pain just from doing too much. But, really, you are not doing your knee any favors ---making it more inflamed and painful is not part of the deal. rest, Ice in a few weeks, you will be beyond all of this.

 

[RedRider]

Nearly 7 days post op and I must say that my recovery has been almost "textbook" up to this point.

I've read so much about energy drain but have yet to experience it. Yes, the restless nights have have made me tired, but I feel like I have an overload of pent-up energy from laying around all day. Maybe someone is infusing energy drink into my meds.

After my "overdoing it" incident, my activities are better managed now. Still hitting the stationary bike and walking around the house occasionally. Flexion is very good and extension is almost fully straight. Swelling has decreased, but is still lingering.

So thankful for all my pre-hab exercising. My leg muscles, although still shaken up, are firing very well. All the core/upper body work has helped with stability and stamina as well. I highly recommend it.

Overall I'm feeling really good about my progress. There's been a couple hiccups but otherwise smooth sailing!

Question: all the bruising from the surgery is stating to surface. I've got a long strand of bruising going from the surgical site up the side of my leg almost to my butt. Is this normal or did I accidentally drop off the operating room table?

 

[Roy Gardiner]

Yup, you only need to ride the bike for 2 mins, just enough to loosen up knee a bit. No hard pedalling, mind.

 

[Celle]

Yes, the bruising is normal. Some of it will be from the tourniquet that was placed high on your thigh.