TKR Revision #2 Journey

[celynda]

Still in Recovery Room at 0123 EDT. Another 90 minutes to go before getting to my room. I’m very tired but can’t sleep for more than 20 minutes at a time due to beeps from the various machines and the compression thing on my good leg.

It’s now 1:32 and I’m having trouble keeping my eyes open. I pushed the button and got a dose of Oxy. Hopefully, I’ll be in my room for next dose.

 

[celynda]

Post-Op day 1 Update

Surgery last 6 hours and was more complicated then expected. Haven’t seen OS yet for all details. This is what he told my brother:

surgery went well and the results are good. The lower leg bone was securely attached to the device, so they took their time separating them which took a little longer. All is good though.
The femur had some lower bone damage and so they remove that and secured the new device to good healthy bone. They included an additional mechanical piece to compensate. All good there also.
You should be in the hospital for a few days, so maybe through Sunday to ensue the healing begins correctly. Then a couple weeks in a NY recovery and rehabilitation center prior to returning home.
Said the physical therapy is important to be done and to observe the weight bearing limits as allowed, but to do the weight bearing as it increases.

Survived 1st PT session. They’ll be back this afternoon. I can only bear 30% weight on R side and will wear brace for two weeks. Originally it was only one week.

Not having any fun yet.

Pain is controlled. Time for a nap.

 

[celynda]

I’ve been using ice. With the brace on, I’m not really feeling it. They don’t let me elevate the bottom of bed. One pillow under knee is only option.

Off PCA, relying on Oxy, Tylenol and Roboxcin. Pain is at 7/8 which was pre-op level. Will talk to RN about getting more pain medication. I figure I should be at 5 post-op.

PT was a failure as I’m 30% weight bearing and I cannot balance on the other leg as I also have cerebral palsy. Will probably go home in wheelchair. Not use a walker until I’m at least 50% WB.

I am very pleased with HSS so far.

 

[Ghostpipe]

Can’t believe that they won’t let you elevate, I suppose they have their reasons. Wishing you good progress.

 

[celynda]

I think it’s how the elevation hits the knee.

 

[Pumpkin]

I agree, elevating with the bed can extend the knee too much (even healthy knees do not like this), and/or put the knee in a position of too much flexion.

Happy to hear HSS is taking good care of you.

 

[celynda]

HSS is great and the food is good which is really nice.

 

[celynda]

Post-Op Day 5 Update…

The pain regimen of Norco and Robaxan is working and it only took 2.5 days to get it sorted out. PT just left. We working on sit/stands to strengthen the “good” leg so maybe I can take a couple of steps. Right now, it’s not possible. The WB restrictions could last 6 weeks while the brace comes off on day 14 (June 7)

The US Holiday weekend means it will be at least Tuesday, before I know about Rehab. This could be a battle as the OS said two weeks where the insurance company generally approves 5 - 7 days.

For anyone considering HSS, I highly recommend it. With one exception, the service, staff, and treatment has been fantastic. The negative was treatment in PACU (recovery room) post op. My OS has his patients stay overnight for closer monitoring. Well, my med was at 6p from the nurses station and as the night went on, they consolidated patients and then the staff gathered at the station and talked and talked and talked. I was told I’d be in a room by 0300 but is was closer to 0530. I learned from the OS, that an overnight stay was protocol for patients with complex revisions. I didn’t care for being led on.

I lost 500 ccs during surgery and my blood numbers have been trending down so I got a blood transfusion yesterday. I may need another one as I don’t see the numbers coming up,

Lunch should be here any minute and then a nap is on the schedule.

 

[Jamie]

This all sounds good, with the exception of your PACU experience. I’m glad you’ve gotten pain under control and are resting well in the hospital. When the surgery is very complex, it is possible to have a blood loss, so the need for the transfusions isn’t surprising. The hospital should be able to get your numbers up fairly quickly and I’m sure your surgeon is closely monitoring this for you.

 

[celynda]

The team is very pleased the poop fairy visited.

In addition to the enema, they also gave me Relistor which is supposed to help with opioid induced constipation. Not sure why they waited so long. I’ll ask. Only thing I can imagine is I’ve not been really uncomfortable. No cramps. The medical team is more concerned about it than I was.

Had a good nap and am dozing watching the idiot box.

Christa

 

[sistersinhim]

Yay for the poop fairy!

 

[Jamie]

Believe me…..this type of consolation definitely IS something to be concerned about, so I’m glad to know you’ve passed this first milestone. If you are still on prescription pain meds, be sure to continue with stool softeners and as much fiber as you can eat.

 

[celynda]

Here’s Post-Op Day 6 written as I’m up about 30 minutes before the next muscle relaxer dose is possible. The muscle spasms have been tough tonight. I felt as is my knee (which is in a brace) bent 90 degrees. Then it bounced all over the bed. This then made everything hurt and the pain meds (10mg Norco) aren’t due until 2a. Just got Robaxin and more ice so going to read a bit to let everything kick in.

Insurance denied rehab request because I only need custodial care until I can put more weight on the revised knee. Until then PT is limited to sit/stands, ankle circles and butt squeezes. By the time, Im 50% or AT WB, in home PT should be able to make progress. Plus, I have another week of wearing the brace to keep my knee straight.

I’m okay with this as I’m ready to see the dogs and my bed again. I friend is there taking care of them and will stay 2-3 weeks. Plus, I’ll have access to at home nursing.

HSS will prescribe pain medication for 90 days and then local PCP will take over. Hopefully, the need for opioids will be greatly diminished by then.

My local PCP will remove staples at three weeks. I’ll probably return to HSS at 12 weeks for follow-up X-rays and appointment at HSS.

The discharge time depends on
1. Delivery of wheelchair from DME (some time Wednesday)
2. PT clearance for wheelchair transfer to/from bed to chair.
3. Arrival of travel companion and flight schedule. OS doesn’t want me traveling solo which I am good with.

I’m thinking it would be Friday or Saturday before things line up. We’ll see how it goes on Wednesday.

As Patient, the HSS experience has been phenomenal and with only one or two negative cases, I can give them two thumbs up.

 

[Jockette]

@celynda
I’m glad to see things are going well for you at HSS. I’m sorry about the rehab facility but you have a good plan in place and “there’s no place like home!”

Best wishes as you travel home.

By the way, I moved this post to your recovery thread, to keep your history all together.

 

[celynda]

Post-Op Day 12 - cannot believe I am still inpatient at HSS. This phase of the journey is almost over. I head for home tomorrow . Medical transportation is picking me up at 0800 for my flight at 1115 from NYC. My wheelchair is here along with a walker and I’ve confirmed wheelchair assistance from check-in to deplaning in Roanoke.Getting home is a 90 minute ride in the back seat of my Subaru Outback.I’ll have my Lounge Doctor, pillows and blankets.

I expect to hear from home health next week about PT and home nursing. A portable commode was sent to the house but I am going to try and use the existing facilities. I will have help from my friend for another three weeks. I need to wear the brace and observe 30% until June 14. I’m hoping to be able to drive before my friend needs to leave.

The OS and I never talked about work/life restrictions so I’ve messaged him for guidance.

 

[Layla]

Good Morning celynda,
I hope you made it home safely and have settled in to your recovery nest comfortably. A peaceful weekend to you as you begin your healing journey.
Please keep us posted.
@celynda

 

[celynda]

@Layla, thanks for checking in on me.

I am home, fresh meds on board, and icing. Travel home was exhausting but uneventful. I was able to use walker to get to the bathroom. The walker is wider than the bathroom doors so getting through is a bit tricky.

After 11 days in the hospital, I’m used to not elevating. Good thing there’s room on the recliner for the lounge doctor.

The 30% WB restrictions and brace wearing are effective until June 14th when the staples are removed. Then restrictions are “as tolerated.”

Rehab until then consists of ankle pumps, glute squeezes, and pressing the knee down.

This is going to very interesting