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[TKR] Rockgirl4's Recovery---already full of surprises.

Discussion in 'Knee Replacement Recovery Area' started by Rockgirl4, May 23, 2019.

  1. Rockgirl4

    Rockgirl4 senior
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    It's finally over!!! I'm pretty out of it, so forgive me for any typos and weird sentences.

    Surgery Tuesday morning went well and my hospital stay was mostly pain-free except in the night, as the dressing was way too tight. Once the nurse loosened it, I could sleep. Everyone was shocked how well I was doing moving with the walker and lifting my leg on/off the bed. We were home by 1:00 yesterday. All of the good stuff ended last night though.

    Most of yesterday was spent trying to use the restroom. After 11 other joint surgeries, I've never has this big of a problem. The stool softeners and Miralax aren't cutting it. Horrible gas pains have been a common occurrence. We're trying something new tonight.

    The knee is awful----very swollen and blistering. Home health wasn't too concerned, but the Home Health PT wants us to be super cautious,especially if the blisters open. They both can already tell I'm going to bruise horribly.:sad:Elevating it is brutal right now too. They both told me to alternate times elevating if it's too painful. Just be sure to DO it though.

    The best part is my surgeon wants me to do super light PT, limited standing/walking. He is well aware of my past history with scar tissue/adhesions following aggressive PT. He insisted I have to be treated with the gentler approach. He cut out huge chunks of scar tissue thanks to my brutal ACI (cartilage implant) PT regimen in 2015/16:headbang:, and he agrees we need to find a balance He gave me free reign to keep the PTs in line--he even said when they want 2 sets of exercises, just do 1. There was a PT at the hospital Tuesday evening who said the only way to get the bend was to let them crank on it. I politely told her no, and Dr. Martin agreed. Luckily my husband was with me too, so he told her the whole discussion Dr. Martin had with us about this NOT being a standard TKR recovery. She was still a little put out, but I told her this is just the way it's going to be.

    Lastly, 1 Percocet-5 just wasn't enough. I've tried twice and just lay here and cried. We already called the surgeon's office, and they're mailing out a new script. Good old Memorial Day Weekend in the US just HAS to be this weekend.:tantrum: Thankfully I have spare pills left over from 3 yrs ago if we start running out. I seriously don't know how anyone can do this without Narcotics. I had the ropivicaine/torodol injection into the knee post-op, but those wore off by last night. My surgeon doesn't do spinals or nerve blocks, so here I am, hoping these next few days fly by.

    My heart goes out to all the others who had their TKRs this week. I look forward to following the other recovery threads once I can think straight again.
     
  2. Jolease

    Jolease senior

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    It is a awful surgery pain wise. Wishing you a speedy recovery and know the surgery pain will lessen soon. I thought I was going to pass out from the pain/ swelling and massive bruising the first week. Hugs and happy healing.
     
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  3. Woodpusher

    Woodpusher junior member

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    No spinal or nerve block? I got both of those and still need Oxy to get thru these early days. Good luck to my fellow 5/21 patient, wishing you well.

    Ken
     
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  4. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Welcome to recovery @Rockgirl4

    Are you trying to elevate your leg with the knee completely straight? That is painful, I know. However, it's perfectly OK to have a slight bend in your knee . Have a look at the article on elevating that is in the recovery reading, below. The other thing you can do at first, is to elevate your leg slightly less high, until your knee gets used to it.
    Well done for insisting on doing things your way - and your surgeon's way. It's good to know thta you have your surgeon's support for this.

    As promised, here is your recovery 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. At week 4 and after you should follow this
    6. Access to these pages on the website

    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 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.
     
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  5. Rockgirl4

    Rockgirl4 senior
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    @Woodpusher Yes, I too was hoping for something more than just meds and local analgesia in the knee. As wonderful as my Dr is, he still insists on General Anesthesia and prefers no blocks of any kind. For him, it's all about ambulating sooner and having an awake quadriceps muscle. Personally, I was hoping for the OnQ pump or SOMETHING....ANYTHING else!!! I'll survive though.:shrug:

    @Celle I WAS trying to elevate with the leg perfectly straight, only because I can keep it straight the rest of the time without pain (which was another surprising thing I could do right after surgery). I think you're right though that I need to start lower, and not worry about keeping it straight 24/7.

    @Jolease It was very interesting when the home health nurse took the gauze/bandages off. Considering the level and coloring of the bruises already, she said to expect it to look REALLY bad and not panic--especially when it starts settling in to the back of the leg. She's been visiting knee replacement and hip replacement patients for 12 yrs, and she's seen enough of "this" early on to know what's likely going to happen later.

    Thanks to everyone for all their support and advice. I've had my 2 pity parties of the day already, crying from the pain, but I DO KNOW this will get better. All in time, right???!! :thumb:
     
  6. Rockgirl4

    Rockgirl4 senior
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    Did anyone else have the nasty blisters form just a day or two out from surgery? I know I read about someone else here having them, but I couldn't remember how common it is....
     
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  7. BCSAnna

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    @Rockgirl4

    So glad to see your post-op thread and hear that your surgery went well. Good for you for advocating for what is best for you with the PT. Cranking on the knee? I don't think so and not on my knee either!:no-fin:

    Again, I am happy to hear that you have now made it over to the recovery side. I will be following your recovery thread. In the meantime, take care.

    Anna:flwrysmile:
     
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  8. Jolease

    Jolease senior

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    @Rockgirl4 I had the blisters I took benedryl. They didn’t last to long:)
     
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  9. Rockgirl4

    Rockgirl4 senior
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    @Jolease Thanks for the idea. The nurse did mention it could be an allergic reaction to the scrub, so I think it's worth a try. I take an antihistamine every day for severe seasonal allergies, so I'll take the benedryl (instead of my zyrtec) and see what happens.
     
  10. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I would call the pharmacy just to be sure you can take Benedryl with your current prescriptions.
     
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  11. Rockgirl4

    Rockgirl4 senior
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    Thanks, @Jockette . Wonderful idea.

    I did find it interesting that they were giving me Visteril (a different antihistamine) in the hospital, as it makes the oxycodone more effective. I hadn't heard of that before, but apparently it's a thing:) It definitely helped. It's truly amazing what these Drs are coming up with now that they're trying to rely on less narcotics.
     
    Last edited: May 23, 2019
  12. Rockgirl4

    Rockgirl4 senior
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    Today is Day 3 post-op, and the pain is already better than yesterday. I was still very stiff when getting out of bed, but I slept well with the Percocet and ice machine most of the night.

    I still can't go to the bathroom,so we're doubling the stool softeners, added a prune/apple juice cocktail, and now I'm waiting, not so patiently. I think I'm sending my husband to the pharmacy to buy a suppository or fleet enema. I do NOT want this getting as bad as last time in 2015 when I literally felt like dying.

    I also managed a shower this morning, which felt wonderful.

    My "specialized, surgeon-ordered PT" is getting a little easier too.:dancy: All I have to do is sit in a chair for 30 minutes twice a day, letting my foot rest on the floor at first, then slowly moving my foot back toward my other foot, increasing the bend a little at a time until it's back as far as I can get it with just a bit of discomfort. The idea is to remind my leg what a partial bend feels like, knowing that all the swelling will only let it move so far. I won't get into the numbers, but we could definitely tell it went further today. I do have a list of other exercises to do that are fairly easy. I'm only doing 1 set instead of 2 (per my surgeon's instructions), and not necessarily a full set either. I'm letting my body be my guide at this stage. :)

    Lastly--the fracture blisters are getting bigger. I called the OS's office because it's a 3-day Holiday weekend here in the US. The nurse said they received the pictures from Home Health yesterday and are NOT concerned. She said they likely won't pop for a few days, but as soon as they do, I need to keep them covered to ward off infection.

    All in all, not bad for Day 3 post-op. Now, if I could just go the bathroom like a normal person....:whistle:
     
  13. Rockgirl4

    Rockgirl4 senior
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    I forgot to mention an interesting piece of information from my TKR surgery on Tuesday---especially for anyone thinking of "trying anything and everything" before undergoing TKR.....

    Some of you knew I put off TKR for a few years due to my age. At age 43, I had something called ACI (Autologous Chondrocyte Implantation) on my medial femur. It was supposed to buy me 7-10 yrs before finally getting a TKR. The cells seemed to take and grow in over the next 18 months, but by last summer (2.5 yrs), I was miserable again throughout every compartment in that knee. My TKR surgeon was VERY curious to see it this week during the TKR, and he knew I wanted to know if there was any cartilage left. He said these articular cartilage techniques have a 10% chance of success on people >30-35 yrs of age.

    Sure enough, there was no evidence of the ACI graft. The area was completely pulverized. There was no cartilage left in either the lateral or medial compartments. I can't remember what he said about the back of the patella.

    1) It's nice to know I wasn't crazy, and 2) I could shoot my old sports surgeon for lying to me about ACI working on someone >35 yrs of age. It's all in the past now though, and time to keep moving forward. I hope everyone else is having a good day.
     
    Last edited: May 24, 2019
  14. Benay

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    Fleet is fabulous. Honestly saved my life.
     
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  15. Celle

    Celle FORUM ADVISOR Forum Advisor

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    From what I've learned, ACI only works if you have absolutely minimum damage - too small an amount to have any symptoms, so very hard to diagnose at that stage.
     
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  16. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I had to send my husband on a run to the urgent pharmacy, to buy a do-it-myself enema. It worked like a charm!
     
  17. Rockgirl4

    Rockgirl4 senior
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    @Celle Now that I'm informed, I could kick the old me for not getting more opinions---but we live and learn, right??!! :) As for the enema, hubby is leaving here shortly. He remembers last time ALLLLL too well, too.:bignono:
     
  18. Rockgirl4

    Rockgirl4 senior
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    Woo Hoo!!! All we had to do was talk about the Poop Fairy, and he showed up by surprise. :ok::spin::dancy::giggle:
     
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  19. Irish471

    Irish471 senior

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    @Rockgirl4 , YAY for the poop fairy arriving! Wishing you a speedy recovery from the 40-something club :egypdance:
     
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  20. Woodpusher

    Woodpusher junior member

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    Mine wants me to sit in a chair and do 3 exercises, leg extensions, leg raises, and heel slides on the floor. Nothing objectionable but they are tough. She wants to see an increase from 66 to 71 degrees flexion by Sunday.

    Was the ACI procedure covered by insurance? And was it non surgical? I know bonesmart gives this and procedures like PRP and stem cell a platform. Those later ones aren't covered and I have no idea what chance they have for a bone on bone situation.

    Ken
     

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