TKR ROUND 2: MotownGirl made it to the other side

[Jozilla]

Morning @MotownGirl66 you are sounding really good. It is so good to be home - I think it was the first good deep sleep I had for a long time. I am taking percosets or oxicodone which I am used to but the oxicontin twice a day knocks me for a loop. My money would be on that affecting me. I think that is the drug of choice all these addicts steal from the pharmacies. Actually way too strong for me!

Hope each day brings you less pain and more improvement. I have to say my knees are nine months apart and I forgot so much! I had my "why did I do this" moment but it has passed as I get into my routine and am keeping my pain controlled. I ice all night long and as much as I can stand it during the day.

I lost 17 lbs with my first tkr but think I gained at least ten with my second surgery. My first tkr I had absolutely no appetite for three weeks. This one I have pretty much have had a good appetite.

The woman in the hospital room next to me with a tkr revision thought she was in labor for two days. She screamed and moaned day and night. And we were supposed to keep our doors open. I was constantly being told to not get up by myself and was according to them very noncompliant. Too bad - the entire stay was subpar. I had no choice but to be noncompliant.

Anyway I hope our journeys both are positive ones and we continue to improve! I can't believe how much better I feel on six days out!

Xoxoxo
Joanne

 

[PuppyLove]

@MotownGirl66 you are not being a brat- you are being honest with your needs for recovery. I felt the same way after THR- didn't want to "entertain" visitors. I had my recliner in the living room, so when people dropped things off I was right there. This time, my recliner is in my bedroom and my family has instructions not to allow anyone back here. After a few weeks, there were a few friends I felt like visiting with and they knew not to stay long. I've also told everyone I communicate by email- that way no one calls or drops by and wakes me up when I need a nap. Sounds harsh, but we have to take care of ourselves!

 

[Jozilla]

Hi Robyn -I think you will find once you get your swelling down you should be able to control your pain. My pain the first night home was an 8 and the low a 5. Since then it is at its worse a 6 and best a 3. I added the celebrex yesterday which is starting to reduce my swelling and my pain.

I know you asked Josephine about adding a water pill. For my first tkr I was on one and had no issues. I think as long as you can monitor your blood pressure it would be ok as it reduces blood pressure. You can also call your pharmacist or GP to make sure there are no interactions with any of your other medications.

I also have neuropathy and have been treated for years with Neurotnin/gabapentine which is for nerve pain and a muscle relaxer Amrix. They may be one of the reasons for my reduced pain. A good part of my pain right now is from swelling in my incision, the staples in my knee and in my stomach from the blood thinner injections which I have to two for almost 3 weeks.

I do not wear any type of brace and was surprised to read that people do. When i had my first tkr I was told to trust this knee as it could take almost anything. I never had an issue with not feeling safe. I do however have to wear an immobilizer brace while sleeping for two weeks. It keeps my leg straight and keeps me from moving it. My very bowlegs are now both very straight. My OS had a lot of ligament work to do on this knee especially on the left side and that is where my pain is at the moment. And so far my hip pain that I had in the same leg seems to be gone!

If you are taking the maximum dose of your pain meds and are still in pain call and talk to your OS. Your pain should be controlled by the medication, icing and elevating. Sometimes your medication just needs to be adjusted. I think each OS starts with a certain level of meds and increases or decreases the dosage according to the patient until he gets it right. I think that is very normal for this surgery.

Please take care and feel better!

(((Hugs)))

 

[MotownGirl66]

Muscle twitches and jerking: has anyone been experiencing these since surgery? Never had them before now: Now, they are so frequent -10-15 times a day. I should give them a name. I've also had the sensation that I'm falling. Say I'm just resting on the couch with my eyes closed. I have this weird sensation that I'm falling, which causes me to jerk and jump up. Inadvertently, I end up hurting my leg.

 

[MotownGirl66]

@Jozilla- I have some Celebrex here. I'm going to try it. I have pain on a level of 6+ in spite of religiously taking my pain meds every 3 hours. I know it's the swelling. Tried to do the PT exercises but had to stop due to the severe pain from swelling.

Thanks!

Robyn

 

[MotownGirl66]

Lol! They called you non-compliant? What a joke. Glad you are feeling better. Does your pain ever get tolerable? Say, down to a 2 or 2.5? Mine is always right on the crest of being out of control.

 

[MotownGirl66]

@supjam, in reference to you commenting on proper form, when I walk a distance like 20' or stand for longer than 45 seconds, my lower back starts to spasm. I know that I immediately need to sit down. Doe that happen to you?

The meal train sounds like a great idea except the 1 friend who decided to cook it at your house. Then there's the dishes and clean-up.....ah, no. I'll pass.

 

[supjam]

I think what I experience is similar just different muscles.
The other thing you mentioned is the restlessness. When I feel pain I feel agitated and don't want to stay still even if I also feel tired,as if I could nap.
The cpm moving my knee actually helps. Maybe it's just a feeling of not finding any comfortable position that seems agitating.

As for the meal train, it is a gift to not need to obtain & cook food. How are you handling that?

 

[Phil75070]

@MotownGirl66 If your knee was fully cemented it will support your full weight practically immediately. I had surgery at 7:30 AM and was up on my feet at noon. Most TKR patients are either on their feet same day or the next. Getting over the fear that the knee won't support you is one of the purposes of PT early on. From what I understand there is an alternative to fully cemented which is a prosthesis that has a more porous backing that promotes the growth of bone into the prosthesis itself. I believe that methodology is one used in younger patients which at 48 I would put you into that category. If that method is used then full weight bearing is delayed for several weeks. I don't think that method is used very much, though.

 

[Josephine]

I've also come to realize something so obvious; the pain I am feeling is nothing more than swelling and stiffness. It is not joint pain, it isn't incision pain, it's merely swelling pain.

That's not "nothing more" that's real post-op pain! Pain also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness. All of these need to be medicated. Especially at only one week out!

@Josephine - I have a diuretic here...should I take it to help the swelling move along faster?

No, not this kind of swelling. it's from trauma and should be managed by icing and elevating.

when I walk a distance like 20' or stand for longer than 45 seconds, my lower back starts to spasm. I know that I immediately need to sit down.

It's more like you need medication!

One last thing, while @ the hospital, the PT guy Doug gave me this stiff blue knee brace. It has a flat steel bar on each side. Doug said I was to wear it any time I was walking more than a few steps.

I quickly remembered Doug's words that my knee couldn't support my body weight yet and that's what the brace was for.

That's absolute bunkum! Unless there is something in your case that makes your TKR not a normal one, there is no need for a brace. I strongly suggest you contact your surgeon and ask if he knows and ordered this brace as I've never heard of such a thing.

 

[Josephine]

I've got a few questions for you. It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.

 

[Josephine]

He said there were free-floating fragments, the area under my patella was chew up, and there was severe degeneration, or something like that.

Sounds like almost every other TKR I ever scrubbed for!

my surgical leg is ENORMOUS....severely swollen

However, something I have discovered over the years is that the amount of swelling is often proportional to the degree the tissues are handled and roughly handled during surgery. In general, those will minimal swelling generally have more careful surgeons in this regard.

My complaint lies in the quantity of the reps for the 1st day.

It's a strange fact but my surgeon absolutely forbids any exercising except a few gentle heel slides, straight leg raises and some walking on an 'as needed' basis for the first three weeks. He is also one of the 'very gentle' types! You might like to read the potted version of my recovery to see how little exercising I did! Knee recovery - UK style

 

[supjam]

That's not "nothing more" that's real post-op pain! Pain also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness. All of these need to be medicated. Especially at only one week out!

I was just figuring some of this out for myself & your reinforcement is really helpful. Also, when I am hurting, extra sleep during the day has been hugely helpful. Yet it eludes me at times because I feel restless.

 

[Lovestoread]

So sorry to hear you've had such a rough start. You do need to stay on top of your meds and ice as much as possible. Your pain is real...there has been much trauma done to your knee and medication and ice is what you need now. I was walking with a cane a few hours after my surgery and was told my knee was rock solid. I'm surprised to hear your PT thinks you need a brace in order for your knee to withstand your normal body weight.


Sent from my iPad using BoneSmart®

 

[MotownGirl66]

@Phil75070, I saw on the board in my hospital room that I was to be "Full Weight Bearing" - I think it's just me. I haven't really ever had my pain under control so I think that's what is impeding me.

 

[MotownGirl66]

@Lovestoread, yep, the PT at the hospital who gave me the brace so my knee doesn't go sideways (is what I think I heard Doug say) and the PT here at home asked me where it was. I showed it to him and he said to make sure I was wearing it when I walked or was on my feet for longer than just a few steps (say, going to the bathroom or something).

 

[kneeper]

One of the first things I noticed with knee #1 was how strong and stable it felt when I stood for the first time on the first day. I had cementless but my doc also put in a couple of screws which apparently holds it while the bone grows in.

Posted before I saw your latest. Maybe you have some weakness around the knee?

 

[MotownGirl66]

I decided to do something different these last two pain pill times. I added two Tylenol to see if it would take the "edge" off. At the 3:20p (EST), I took 2 Tylenols with my 2 Dilaudids...From 3:20 to 6:20, I noticed my knee was not as tender and the pain didn't seem so noticeable. Subsequently, at the 6:20p pill time, I took 2 Ibuprofen with 2 Dialudids...I have noticed that simply moving my knee across the bed doesn't incite pain, moving my leg off the bed to the floor doesn't cause me to yelp out in pain (like when you step on a dog's tail)...so maybe I need to get this pain issue under control. I would like to get to the point where it isn't constantly on my mind, either through causing myself pain by merely changing positions or by trying to do my PT exercises.

Any thoughts?

Robyn

 

[MotownGirl66]

@Josephine, thank you so much for getting back with me. I will definitely ask my surgeon about the brace. I have a call into their office anyways and I hoping they call me back tomorrow (Monday) morning. It could be something the hospital sent me home with. The Hospitalist physician also messed up one of my pain med RX's so it is quite possible my OS has no idea about the brace.

Thank you for reminding me that this swelling is from trauma. I do ice more than frequently and I do elevate. It doesn't seem to be making a difference but I do it anyways. Since the get- go, my pain was never managed. I think that's a major problem here.

Just a while ago, I was seated on a chair in my bedroom trying to coax my knee into a 90 degree bend. At about 45 degrees, the pain was burning, achy, and stiff...I tried and tried and finally pushed it to about 80 degrees myself and held it for 15 seconds. BRUTAL!

 

[MotownGirl66]

@kneeper, I wish! When I even touch my knee, I have instant medial pain as well as very tender skin around the knee, calf, and upper thigh. I feels stable, but it hurts.