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Bilateral TKR Scheduled for bone scan of TKR and worried about timing

BusterBeans

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Hospital called to say I should report tomorrow at 11:45 which I thought couldn't be right because my OS said I would be the first surgery of the day. The nurse said the OS has office hours in the morning, I will be the second surgery and that he has several more that day after me. Wow! What a tough schedule my OS has tomorrow. But I would like to whine too because as a bilateral I've been told I can only stay 2 nights in the hospital and will be discharged at lunch on day 3, and I'll have already lost 1 day since I won't get to my room until about 7 pm. I guess I will have to go pack my big girl panties.


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Pumpkln

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BusterBeans,
An early Welcome to the recovery thread, Sounds like you are ready for your BKR tomorrow. Let us know how you are doing when you can.
This will be your post op thread, you can update and keep track of your recovery here.


Please add your surgery date to your signature, hover over your username top right, click on signature, and add your information there, Thanks!

Here is you copy of the post op reading, the articles are short and will not take long to read.

First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM
 

referee54

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Congratulations a bit early and welcome to the world-renowned BTKR Club!! I will soon be sending you a DVD of the Ultra-Secret Handshake!

My best to you on your big day!!! You have made the correct decision!
 

Jamie

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I don't know if you'll see this before you get home, but I'll post anyway. Please don't worry about your discharge from the hospital. You'll have to meet specific criteria before they let you go home. That means you'll need to have your pain under control, be able to walk to the bathroom and back to bed, use the toilet, be able to do stairs and show signs that your bowels are waking up. Insurance many times initially only approves a couple of days, but that an easily be extended if your doctor says you cannot be released. So....relax....make sure you are comfortable in the hospital and that you're getting proper pain management.
 

kneeper

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I hope all went well and you now have a matching set of shiny new knees. :flwrysmile:
 

Glamg1979

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Hi @BusterBeans !! Congrats on the shiny new knees!! I think having a bilateral done has already earned you your 'big girl panties' :heehee:
They won't discharge you too soon. Try to get some rest.
 
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BusterBeans

BusterBeans

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My OS stopped in this evening to discuss how the surgery went (remarkably well--with the ConforMIS iTotal implants he said each knee was done in about 45 minutes. Anesthesia and analgesics included a 48-hour epidural, a cocktail that was injected into each knee prior to closing, Propofol and Tylenol. Up until this point, I have not yet experienced any pain, but that will change tomorrow when the epidural is removed and I transition to pain meds. I started PT this morning (the day after surgery) with the a few light exercises, and they added a few more exercises this afternoon. They measured my range of movement and were very pleased but said this could change when the epidural is removed. My OS, the PT staff and the nurses will help me decide tomorrow if I should be discharged home or transfer to a skilled nursing facility. My OS says he thinks I could go straight home but he also believes I could benefit from several days at a skilled nursing acidity.



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BusterBeans

BusterBeans

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Now that the epidural is out, I am definitely experiencing pain! Much of it seems to be centered upon where the tourniquets must have been. Getting up out of the bed or recliner is agony, and now that the once despised, now missed, Foley catheter is gone, I dread having to go to the bathroom. So much for the policy that a bilateral had to be discharged the third day. My sodium level has been really low so I got 2 IV bags of that in about 90 minutes which meant more trips to the bathroom. And they seem to have gotten my BP under control now--had seen really weird readings like 85/75. My pain meds seem good -- just Oxy IR and Tylenol with some morphine before trips to the bathroom overnight. And last night I slept very well. I didn't do well at PT yesterday afternoon and they weren't pushing me at all. I had been their poster girl at the morning session. My OS stopped in about 8:30 last night to chat. He said since it was the weekend, there wasn't anyone at the health insurance office to approve my transfer to a sub acute In patient facility, so he would keep me in the hospital as long as I needed. I'm part of the test to determine the cost effectiveness of continuing to allow bilaterals that the insurance company is conducting and this continued hospital stay will hurt the numbers, but there's no way I could have gone home last night.


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Roy Gardiner

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The first days are the worst, of course. Just rest and relax and follow the posted advice. Remember, this pain will get better where your previous arthritis pain only worse. And -- I know this is tough -- once you're up and standing, the actual knee joint doesn't hurt at all now does it?
 

Slainte

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I liked having a catheter too. Much easier. Sounds like your OS has your best interests at heart. It takes a while for our bodies to get back on an even keel after such extensive surgery. Glad you are able to be closely watched as you regain your equilibrium. It gets better.
 

Josephine

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The nurse said the OS has office hours in the morning, I will be the second surgery and that he has several more that day after me. Wow! What a tough schedule my OS has tomorrow.
Oh that's quite usual! Besides, the other cases might not all be TKRs. Some surgeons I've worked with would do between 3 and 5 cases before lunch and another 3-5 after!
And this was me after the session!

nurse exhausted s.JPG

I could benefit from several days at a skilled nursing acidity.
"skilled nursing acidity"? Don't much like the sound of them!

she sergeant major s.jpg

I didn't do well at PT yesterday afternoon and they weren't pushing me at all.
Make sure they continue that way!
so he would keep me in the hospital as long as I needed.
Jolly good, I thought he might.
 

Glamg1979

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Relieved to hear they are keeping you longer in the hospital but sorry you are in so much discomfort. Very brave to have bilateral knees. I need both done but tackling them one at a time. One this month and then one in December. Good to hear PT is not pushing too hard. Sending you healing thoughts.
 
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BusterBeans

BusterBeans

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Thank you everyone for sharing both your wit and your concern. My nurses said today would probably be my worst day and they were right. My knees were red, swollen and painful and getting up from the bed to go to the toilet was a major challenge, but physical therapy really helped to loosen them up

One of my OS's partners stopped in with 2 residents this morning, said hello and that with a 160 in PT the day before, I was going home today. Word must have gotten around quickly because by the time I finished physical therapy, a patient care coordator came in to talk with me. She said that since I had not tried steps yet, have a consistently low sodium count and need to use Lovenox they were recommending that I stay at the hospital until Sunday evening or Monday morning and then transfer to a subacute PT facility. Exactly what I wanted!
 

Celle

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One of my OS's partners stopped in with 2 residents this morning, said hello and that with a 160 in PT the day before, I was going home today.
A 160? I'm sorry, but I don't understand that.
 
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BusterBeans

BusterBeans

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Celle, I don't understand range of movement measurements (frankly I thought he said 360 which didn't make any sense) but his comment led me to believe that he thought my ROM was already high enough that I didn't require hospital support.

Glamg, Cindy, my pre-op nurse, came up to visit me Friday to learn how I was doing. I felt like Johnny Appleseed as I handed out my gourmet chocolate chip cookies to people on my pre-op, surgical and recovery teams, but you should have seen the smiles. Several said it was the first time they had ever been given a thank you note, much less a gift, from a patient. Several said they hadn't had time to eat yet. And everyone smiled. I hope your knees give our Fiesty baker a chance to bake something.
 

Celle

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Celle, I don't understand range of movement measurements (frankly I thought he said 360 which didn't make any sense) but his comment led me to believe that he thought my ROM was already high enough that I didn't require hospital support.
I think your interpretation was correct.

This article will help you to understand about ROM (range of motion/movement):
ROM (range of motion) information
For a quick glance, here's an illustration from the article.
ROM.JPG


I hope this helps!
 

tigz

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I'm wondering if he meant a 180 degree turn around in his decision from the other day to keep you in the hospital as long as possible....nothing at all to do with ROM?

(360 degrees would put you right back where you started from! )

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Glamg1979

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@BusterBeans that is so great, I know it was very much appreciated by the staff. I miss making/baking cookies but think I might do the same thing! :flwrysmile:
 

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@BusterBeans , Congratulations on your new knees!!! I am so glad your hospital is being careful with you, and not giving you the "Bum's Rush" out the door. It sounds like an excellent facility. On catheters, yes the first time around I totally wanted to keep mine longer for the same reasons. With this knee, however, I was getting antsy in bed therefore it was nice to get that catheter removed so I could move around. That said, since it is difficult getting up & down from the commode after just one knee I don't know how you bilaterals manage. Do you have The Hulk's upper body strength? Respect!
 
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