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Revision TKR Right Knee Take Two

KarriB

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@celynda I was insisting on meds on time and just so happened I could hold PT over their head! Convenient! I felt like a naughty spoiled child, but it worked and they all realized I wouldn't be putting up with anything. From that point on I had all my meds on time and was assigned fantastic nurses.
Perhaps do ankle pumps as you're in bed to keep the blood flowing and don't be shy asking for someone to accompany you on walks. In my rehab a patient had to be accompanied by a nurse or aide when walking the halls.
 

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Geez..you just confirmed why I drove 2 hours to find a surgeon who doesn't believe in sending patients to rehab after the hospital but has them go home. All the OS in my town require rehab, and as a nurse I don't care how you dress it up, it's still a nursing home. Kinda of like putting lipstick on a pig - it's still a pig! I kept my TED hose on for 2 weeks after my surgery, 24 hours a day. It doesn't hurt anything, and if it can prevent a DVT why wouldn 't you?
 
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celynda

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Good things to think about. I'm going to insist on meds going forward as we're still getting a set schedule. OT was just here and they're saying because I live alone, I could be here two
Weeks. Bummer. Since I'm moving around okay and can get To/from bathroom, I may see if I can go home sooner and have PT/ Ot come to me.
 

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Hope you get some rest and pain meds!
My OS says stockings for 6 weeks too - I'm being a bit naughty now as its a warm day and they are off.
 

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My discharge instructions said six weeks but at a four week follow up with the OS he said I could stop wearing them.
 

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I live alone but had my sister with me for a few days and one visit from a visiting nurse just to make sure everything was on track as far as the incision and my home was "safe." Luckily the only stairs I have to do are for the basement and I was able to get help with the laundry.
I mention this b/c maybe you won't have to stay in rehab very long if you can get some help at home.

The nurse also told me to take the teds off at night. My sense was to give the skin a rest--after a while the teds like to roll, which makes you feel like it's actually cutting off your circulation. Also presumably the swelling goes down while you're lying down overnight?
 

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My OS told me I could take the TEDs off at night after my 3 Week appt. he stopped my blood thinner at week 6. My experience was it stayed the same unless you sleep with a wedge to elicit your leg and knee. Problem I had, I'm a did sleeper, so the wedge was a nonstick for me.


Sent from my iPhone using BoneSmart Forum
 
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celynda

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Had my first post-op shower last night and boy did it feel good. Im only scheduled for a shower 2x a week. No sure if I can change or not.

OT/PT pretty good, mostly stretching and walking. No pain and just a minimal amount of pushing. I thinkI'll be getting pt 7 days a week which will be nice. The aircast/cryocuff is doing a nice job. Just wish I didn't need to explain to each new aide how to fill it up and attach it.

Soreness level is about a 4 now which is pretty good. Received 2 Percocet tbs (10mg) an hour ago which should hold me until the scheduled Oxy XR at 830.

Christa


RTKA 8 June 2015
 

PolarBear60

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I was surprised by how clueless hospital staff seemed to be with the cryocuff, too. Oh, well, they handled my pain meds well, and I guess that's the more important things. I knew what to do with the cryocuff once they got me some ice.
 
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celynda

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Day 5 update. RTKA was Monday the 8th. After 2 nights in hospital, went to rehab.

First to have say, I am glad I went to rehab instead of home. The things I don't like about the rehab are more around some of the staff and their procedures. For example, I'm scheduled for a shower 2x week. I spoke to the nursing supervisor and got a chair added to the bathroom so I can give myself I sponge bath. it's very noisy but I am managing 3 - 4 hours of sleep blocks. Today is the first day I actually feel good, tired but not exhausted; sore with low pain: 3 - 5.

Am doing therapy 6 - 7 days a week and twice a day during the week. The PT is good and paying attention to my expectations. The plan as I know it is approx two weeks in rehab and then home for a couple of weeks with in home PT

Keeping my fingers crossed..


RTKA 8 June 2015
 

KarriB

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I was happy with my rehab experience also. They got me through the first week of pain management, the stomach issues, and some good PT. I have 13 steps to get to the first floor of my home so the PT had me practicing on their stair model. When I told them I went down the stairs backward they let me do that. It was much less painful and I once saw a Piitsburgh Steeler doing that for after game pain. I only do that now when I'm lugging laundry baskets downstairs.
Sounds like you are right on track!
 

KarriB

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Do you have to stay till next week? Has PT had you work on stairs yet?
 
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celynda

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I can't figure out how to edit my day 10 post to increase the size of the font. I will keep trying...
 
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celynda

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Post-Op Day 10 Update:

Therapy
PT 2 30 - 45 minute sessions per day M - F and 1 session on Sat and Sun.
OT 1 45 minute session M - F.

ROM: 90; Flex: 15 - wouldn't let therapist push on me. The PT has been very good in respecting my wishes for gentle, non-aggressive therapy. Current exercise regime includes:
- 10 mins on recumbent elliptical
- Heel Slides: 2 sets of 10
- Quad Sets: 1 set of 10
- Straight Leg Raises: 1 set of 10
- Straight Leg slides to right: 1 set of 10
- Sidestep walking: 10 feet = 1 set; 4 sets
- Regular walking: 15 feet = 1 set; 4 sets
Expect to start using the cane tomorrow.

Icing: CryoCuff broke last week and since then I've been using two of the instant cold packs after each PT session and after dinner. The knee is not that swollen, considering.
Medications
Once Daily: Venlafaxine: 150 mg; Loratadine: 10 Mg;
Twice Daily: Aspirin: 325 mg; Celecoxib: 200 mg; Docusate Sodium 100 Mg; Oxycodone: 20 Mg
Every 4 hours as needed: Oxycodone Hcl 5 Mg

Pain
For the most part, it averages 2 - 4 with spikes to 6. Definitely managable.

The 37 staples were removed today. Expecting to be discharged from rehab on 25 Jun. Next post-op appt: 29 Jun

I am getting around on the walker very well and sleeping okay. I'm really ready to go home!

Any thoughts or opinions on the exercise regime?
 

Celle

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I don't think all those exercises are necessary, but I'm going to tag @Josephine for her comments.
 
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celynda

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That's what I was thinking. During today's sessions, we worked on walking with the cane. It's not as difficult as I thought it might be. The end is near: Wednesday is the last day of PT/OT and then I go home on Thursday.

Christa
 

Josephine

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Post-Op Day 10 Update:
Therapy
PT 2 30-45 minute sessions per day M-F and 1 session on Sat and Sun.
OT 1 45 minute session M-F.
When you get home, do only 1 sessions per day and none at the weekend.
ROM: 90; Flex: 15- wouldn't let therapist push on me. The PT has been very good in respecting my wishes for gentle, non-aggressive therapy. Current exercise regime includes:
- 10mins on recumbent elliptical
- Heel Slides: 2 sets of 10 - 1 set of 5 is sufficient
- Quad Sets: 1 set of 10 - 1 Set of 5 is enough
- Straight Leg Raises: 1 set of 10 - 5 in the morning is quite enough
- Straight Leg slides to right: 1 set of 10 - 5 enough
- Sidestep walking: 10 feet = 1 set; 4 sets - unnecessary for knees
- Regular walking: 15 feet = 1 set; 4 sets - don't understand this - just walk as and when you need to, nothing more
Expect to start using the cane tomorrow.
My comments in bold

Icing: CryoCuff broke last week and since then I've been using two of the instant cold packs after each PT session and after dinner. The knee is not that swollen, considering.
Buy a gel pack from a convenience storeb- they're cheaper and last longer
Medications
Once Daily: Venlafaxine: 150 mg; Loratadine: 10 Mg;
Twice Daily: Aspirin: 325 mg; Celecoxib: 200 mg; Docusate Sodium 100 Mg; Oxycodone: 20 Mg
Every 4 hours as needed: Oxycodone Hcl 5 Mg
That's okay
 
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celynda

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Thanks @Josephine for confiming the exercises are too aggressive. Turns out I didn't get a PT session today. Not sure why so I just did the exercises you mentioned.

Today has not been a good day. The knee is very sore and feels swollen. I've not any energy to get out of bed. Hopefully Sunday will be better. It's been confirmed I'm leaving on Thursday, the 26th. Once at home, I'll have two to three weeks of home therapy. The PT doesn't think I'll need outpatient PT as I'm making really good progress... Considering I don't like going to PT and paying them to watch me do exercises, this is a very good thing to hear.
 
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Jamie

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This is a time to listen to your body. You need lots of rest! So don't feel bad that you're getting it. All you really require in the way of exercise in these early days are some gentle bends and stretches during the day and now and then at night. I'm sure they will have you up walking to go to the bathroom and learning how to use the stairs. That will likely wear you out and you'll need a 2-hour nap!!

Be sure that you're icing and elevating that knee for the swelling. That's very important and not all hospitals do it routinely.
 
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celynda

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I guess I may be overdoing things after all. I'm using the walker to get around the rehab facility. When I'm in my room, I generally use the walker. There, however, have been times when I've taken as many as 5 - 6 steps without any assistance.

I was trying to keep the PT happy and at the same time follow the mantras as explained here. Thanks for your support!
 

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