Become an Insider

Knee Infection* Revision #3 Journey

By this time tomorrow, I should be just about finished with surgery. I'm currently on the train heading to Jacksonville. A friend is picking me up for dinner and scrabble. She'll drop me off at the hotel on Mayo property.

After a shower and wipe-down with SAGE wipes, I'll settle in for a good nights sleep. Report time is 10:30 Thursday morning. .

I'm relieved it's happening and hoping for a smooth recovery. I've put the tub chair in the tub; changed the sheets on the bed; put out the cryco-cuff and stocked the fridge.
 
My, you are an organized person! That's a good thing. I hope your surgery goes well and you're back at home quickly with a fine new knee.
 
Best wishes for tomorrow.
I hope everything goes well.

Here is your post-op reading:
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
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

Please don't be overwhelmed by the list. The articles are not long and they and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish.

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.
 
Just dropping in to wish you good luck on your surgery tomorrow. Hopefully you’ll be home soon with a new great knee.
 
In recovery, more extensive. than planned. Implant failed and needed to be replaced. Doing good. No pain. Even fairly lucid as I had a spinal.

Implant was easy to remove as it didn’t stick at all. Not pleased about that.

Waiting on room as it’s shift change. My quads are working and toes are wiggling. Have ice on knee. No cryptic cuff in Hospital. Looking forward to using it when I go home.
 
Take Two Post Op Day 0 Update.

The Depuy Attune implant came right out so was replaced with a Stryker implant. (Not sure which one). I asked to get implant back. Need to remind doc.

Had spinal with IV sedatation. and don’t remember them placing it.

Went to OR around 1:30/2. Work up in Recovery at 7. In room at 8. Had to push for meds. So far have had IV fentanyl which I can ask for every 3 hours. Oral meds include tornadol, tramadol, stool softener/laxative, aspirin. I can also request Oxy every 4 hours. Have set a alarm for three hours.
If fentanyl is working, I’m not loopy like I am on Oxy.
 
Sounds like they have you on a good and sensible med schedule. I know what you mean about oxy. :sick: Not a med I like to visit. Are they helping with icing and elevation? Rest up and stay comfy. The Stryker prosthesis has a good reputation, so you should be golden.
 
Last night was not good. By the time I got to my room, something had worn off and I never got pain under control. At 2am, I insisted the nurse call the on call PA and got the Oxy doubled to 10mg every three hours.

When OS came in today, he was surprised to learn the pain catheter as not put in as ordered. It will be put in this afternoon. I’ve had these before and they do a great job. I can control the amount of medicine being delivered. It will be a blessing on the three hour drive home.

In addition to the catheter, I’ll go home with 50 Tramadol and 50 Oxycodone which should be enough to hold me until the post-op appointment in 2 weeks. I also have a supply of OxyContin and Oxycodone left over from the initial surgery.

The PT came for first visit about an hour ago. She’s definitely in the no pain, no gain camp. The impatient exercises include:

Quad sets: 10 - 20 reps; 3x per day
Ankle Pumps: 10 - 20 reps 3x per day
Hamstring sets: press heel down and tighten hamstring holding for 3 seconds. ; 10 - 20 reps 3x per day
Short-Arc Quad Sets: with rolled towel under knee straighten knee and hold for 3 seconds; 10 - 20 reps 3x per day
Heel Slides: 10 - 20 reps 3x per day. She wanted me to use a sheet to help the bend. I said NO
Straight leg raises: 10 - 20 reps 3x per day
Hip Abduction: 10 - 20 reps 3x per day
Knee Flexion in chair: 10 - 20 reps 3x per day

The initial measurements were Flex 60 and Extension 20.

There’s another session this afternoon and I’m supposed to make I take pain meds 30 minutes before. Since I’ll have the pain catheter in by then, no additional pains required. I’m seriously thinking of firing her or just doing what I know is best for my knee.

I’m not sure why the OS prescribed PT when he thinks walking in best rehab. May be the department policy and he’s too new to buck the trend.
 
I did not have any exercises to do in the hospital. They only took me for short walks. I was only in for 1 night though.

And 10-20 straight leg raises? I couldn’t do 1 for a couple of weeks.

Hang in there! Think of us all in the room with you. We will back you up if you refuse to do what you don’t want to.
 
That PT regimen is way too rigorous for your poor knee. I think you know this, too. I hope you listen to your knee and do only what it tells you it is up to doing for now. :fingersx:

celynda said:
I’m not sure why the OS prescribed PT when he thinks walking in best rehab. May be the department policy and he’s too new to buck the trend.
Click to expand...

My OS is of similar mind when it comes to exercise, believing walking is the best rehab. He even has walking goals I was supposed to achieve, and I did. But he, too, wanted me to "give [PT] a try." At my six week check-up when he discontinued the PT and said again that he thought the walking had done me the most good, I asked him why had he ordered PT, then. His answer: "If I don't order PT, some of my patients would never move."

He never sent specific instructions to my PT, not even what ROM goals I was to achieve. I picked a provider and they received some generic instructions about exercises for extension, flexion, strength, etc.. PT set up what they thought was a suitable rehab program according to their notions of such. It wasn't something the OS and the PT coordinated.

It might be different with your OS and PT. But it could just be he wants to have something in place to encourage his patients to move their poor, hurting knees.
 
I just re-read Josephine’s post where she commented on PT from the original TKA. I will follow her suggestions. So far, the only walking I’ve done is bed to chair and to/from chair to toilet.

I’m sitting in the chair with legs straight. It’s actually quite comfortable. When I get back from the catheter insertion, I’ll eat lunch in chair and then retire to bed.
 
my OS did not even know the physical therapy provider I picked. I was send a scrip with all my preop paper work that read “ eval and treat” . Amazing , when I was in the hospital, the PT just walked me down the hall twice, showed me how to do stairs, and call it a day! There is sure a difference!
 
My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good Range of Motion (ROM), as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.
 
The nerve catheter is working well and has enough medicine for 72 hours.

Question: My transport home tomorrow is a mid-size sedan (BMW 3 series), should I sit up front or in the back. With the back, I can stretch out and elevate. Of course, wearing a seatbelt will be a challenge.
 
Right off the bat, in the hospital, I told the PT "no!". I let her help me walk, but the rest of the stuff, only what I did on my own. Doing all those exercises will be bad on a brand new baby knee.
 
For a three hour ride you might be more comfortable in the back seat. If you do ride in the front, be sure to get a pillow or two to put under your leg and move the seat as far back as you can.
 
So the PT came by and I sent her away. I told her I’d do the exercises. She’ll be back in the am and we’ll see.

Got discharged scripts organized. OS prescribed Celebrex which requires pre-authorization from OS. A week’s supply is >$200. Ouch. In the hospital, he’s prescribed Toradol.

I don’t know what the difference is or if it’s covered by insurance. Or, maybe I’ll go back to Advil.

Any thoughts from the community is greatly appreciated.

Thanks for the suggestions. I think I’ll aim for front seat.

Partner of OS just left. He’ll sign the Oxy script. Still working on torodol v Celebrex decision. May just use Advil.

We’re targeting a noon discharge so I can see PT again. Goal is too make sure I’m safe when walking. I’ve already done a set of the “Josephine” approved exercises so am good to go.

OS only cares about PT in hospital for safety purposes. Goal for two week appointment is 0 extension and 120 flexion. Yeah, right. :rotfl:

The TEDs stockings will be staying at Hospital.

The incision looks good and is covered only with a mesh like glue. I’ll post a pic once I figure out how to.

I’ll keep it covered in gauze and ace wrap. I can get it wet once the block comes out.

Overall, I’m very pleased with things so far except for over aggressive PT and first night pain issues.
 
I love how you sent the PT away! What was her response?
 
She pushed back pretty aggressively. I said I’d do the exercises but no ones touching me. Today’s session will be demonstrating I can walk safely and that’s it.

Nurse gave me Oxy about an hour ago to make sure I was ready for PT.

I don’t know if she can prevent/delay discharge. I’m not letting her stop me.

In other news, lots of gas passing but no visits from poop fairy yet.
 
You must log in or register to reply here.
Active Antimicrobial Hydrogel

Staff online

Members online

Total: 683 (members: 1, guests: 682)

Latest posts

Back
Top Bottom