TKR Second time lucky for LTKR

[Nick-UK]

A-ha! I was waiting for my thread to move to post op but suspect I need to do it myself so the first item of wisdom I need from you guys is how to move it.

So.......

Day 1 - Day of the op!

Arrived at the Horton and put into a 2 person room with 84yo George who was having the same op as me. The first thing they said was George was moving nearer to the nurses station post op as he had had heart problems within the last 2 years.

George and I went through the check in processes and had some bloods taken. Next the anaesthatist came to see us and the first item was cancelling the op for George. Apparently issues over warfarin and levels in blood. Luckily I was given the all clear.

Final visit who was the surgeon who came down with another doctor, went through a few basics and I was wheeled up to theatre with them.

Into pre-op and had a canula fitted in my hand and the spinal block applied. I was asked about the level of sedation and said i wasn't bothered about having it although everything was prepared ready in case I did.

The op went well, I was able to converse with the anaesthetist and surgeon during the op which made it far more interesting. The only real issue was the choice of music during to op; Shania Twain? Really? The surgeon and I both asked to switch to AC/DC but were outvoted by the nurses..

I dod ask if I could watch the op but they said they couldn't due to spatter and to be fair those up close did have a fair amount on the clear face masks they used. I could see some due to a reflection in a light arm but not as much as I would have wanted.

All done and off to recovery where they kept me 15 minutes as I wasn't sedated and sent me back to the ward.

I was very tired once back so Jackie and Pippa (OH and youngest daughter) left me to it.

Woke about 7 in agony and called for the nurse. I don't know what was wrong but I had managed to do something to my wound and the bed was a bloodbath. Also had severe stomach pains.

2 nurses cleaned and redressed my leg and it was decided that my bladder was probably causing the pain and the spinal block had left certain parts of my anatomy numb.

Installation of a catheter and some really good meds and I was back to sleep.

 

[Roy Gardiner]

hope to be sedentary at work after a couple of weeks

Very optimistic, good luck. You may still be mentally affected that close to the day, the body takes all the resources it can to heal, including brainpower.

Obv I dunno what you do that requires you to pay for your own replacement, which makes things tricky, but the longer you can take off work the better

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

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

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

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.

 

[Nick-UK]

Day 2 - First post op

Woke several times during the night for obs but when I finally came awake I felt a lot better. Some pain in my knee but the stomach pain was gone.

Ate some breakfast and several people came to see how I was.

Final person to see me was the physio and this one individual was probably the low point of me being in. She seemed quite flustered when she came in. She was annoyed with everything it seemed, she was throwing seat raisers on the floor and kicking them about. She asked me to stand with the frame and said I had an issue with my quads, not sure what but said I wasn't ready.

She put me back on the bed and gave me a booklet with some exercises and left.

I was a bit frustrated with this and thought she hadn't given me or my knee a fair chance so got up on the frame and managed to walk all the way round the horseshoe and back which was the top floor. Also took the opportunity to move to the chair bay the window to read.

Watched the Grands Prix and went to sleep, felt I had a good day.

 

[Nick-UK]

Day 3 - Released back into the community!

BEST NIGHTS SLEEP IN MONTHS! Woke refreshed and feeling good. Knee felt great and although still swollen wasn't hurting so turned down the pain meds.

Was expecting to be kept in another night but wanted to be at my best so continued regular voyages around and about.

Eventually saw the physio (different one) who said she had left me til last as I was given a poor write up the previous day. Went for a trip round the building on crutches and up and down a flight of the fire escape steps and was given the all clear for departure!

Still some bleeding but think its the movement which causes it. The staff didn't seem concerned so I'm not.

 

[Jaycey]

@Nick-UK Your thread is now in recovery. Welcome to the other side!

 

[Nick-UK]

Day 4 - At home

First night sleep in my bed and it was a dream!

Still taken no meds and all feeling good. Ditched one crutch while moving about the house. Had dropped to a stick but felt more secure with the crutch so went back to that.

Knee is swollen but going down slowly, lots of bruising, especially on the back of the knee.

Took for walks during the day, three of about 400yds and the fourth (which was the third time wise) was half a mile. Used the crutches and unlikely to win any races but feeling pretty good.

I do still tire easily and am icing and elevating between exercises.

Overjoyed with my new knee. Pain free and no tearing and clicking when it moves.

 

[SusieShoes]

So I take it you're home now? Home is the best place to recover... peaceful, your own schedule, your own stuff, your own food and bed. You are now in charge of a most important project too!

Your recovery.

Take it easy. Rest a lot, ice all you can, elevate your leg(s), and rest some more. Keep the physio to gentle stretches, walking (as your knee says is good), and daily activities. I thought it was great you got up to walk around at the hospital after that therapist blew you off. Sounds like your knee is doing great!

 

[Nick-UK]

Day 5 - Still at home. Today.

Slept well again and all seems good. Swelling reduced further and still no meds. Delighted.

Went out for lunch, walked about 400yds and all great. No beer which would have improved it

Went out again this afternoon with no crutches or stick, again about 400yds but felt great. Not breaking speed records but @SherrieT and I are a long way from the Boston Marathon still.

Worked half of yesterday with my MacBook on a lap table and worked most of today.

Plan was to spend 2 weeks at home and then start back to work slowly and am delighted at my progress so far.

Any questions, please feel free to ask away

 

[Nick-UK]

Forgot to mention I have a couple of 4 inch steps at the front of the house. Can step up those bad leg first too

(Showing off)

 

[Nick-UK]

Thanks @SusieShoes I think my knee is going incredibly well. I have it in my mind that pride comes before a fall but am home figuratively rather than literally if it does.

I am trying to take it easy but will admit i am impatient

 

[Roy Gardiner]

I have it in my mind that pride comes before a fall

Maybe...

I am trying to take it easy but will admit i am impatient

Patience is one of the big challenges

Your knee will tell you, indeed will dictate to you, if you listen. If you do 10 x something one day, don't try 50 x that thing the next day -- go for 11 or 12. Gradually do more and more, then you won't slip back.

Having said that, sounds like you're doing great!

 

[SherrieT]

Congratulations!! It sounds like you are doing AMAZING!!! And no meds?? Guess you weren't lying when you said you were Superman. I still don't believe the part where you said you can fly.

Do just a little bit more than when what your knee says and you will be running all around Orlando before you know it. No meds means no brain fog, right? So no excuses for what you might say . And also no reason to try the incredible "Brown Cow" cocktail.....

 

[Nick-UK]

Im really chuffed @SherrieT, its exceeded my wildest dreams

I can fly, just don't like to do it in front of others

Will send the dancing on the table vid when it happens

 

[SherrieT]

Im really chuffed @SherrieT, its exceeded my wildest dreams

I'm so happy for you. And that is no joke

 

[Nick-UK]

I know and appreciate it

"We all experience personal challenges in life but what makes it easier is good people around you".

Nick 2018

 

[Eeek]

Huh. I could not find your thread!

But I am soooooo happy for you. Excellent progress. I am impressed that you conversed with folks during surgery.

Sounds like you’re making a good recovery, good progress. Such good news!

 

[Nick-UK]

Hi @Eeek, think i messed something up so was lost in translation between pre and post forums.

All is going really well, so pleased with progress

How are you doing?

 

[Nick-UK]

Day 6 - The other end of ROM

Everyone seems happy to attain high numbers in the ROM, I can currently manage about 100 degrees and that movement seems more limited by my scar and dressing than by my new knee.

My issue has always been the other end on the scale, I couldn't straighten my leg. I think for about 9 months prior to the op I was at about 10 degrees and my body got used to this and adjusted. The muscles in my leg strengthened when necessary to allow me to walk using the muscle for as much of the support as the joint itself.

I am now reaching the issue (is it an issue?) where my replacement knee can manage 0 so it is stretching muscles and sinews that haven't stretched for almost a year.

Continuing stretches, it may be 10 degrees but don't need to get to 0 over night. Think I will probably notice the change most as my gait adapts to full extension.

Also my dressing has gone from spotting to saturated over night so, quick visit to the nurse booked for a couple of hours just to check all is in order.

 

[SusieShoes]

You're doing right to get that bleeding checked out. Spotting is one thing, and that much blood is quite another. Hope it's easily remedied!

You're being very smart about your extension! It does take time to stretch those muscles and tendons, so patience will pay off. People get impatient and try to push (literally) to get more extension, and that's how some get hurt.

I noticed it most when I could stand for longer periods after my knees reached full extension! My PT told me it was because my knees could "lock" into straight and that meant they tired less. It also helped my gait. I gained a second "gear."

 

[Eeek]

Hope the bleeding has settled down. Glad you‘re well otherwise, released into the community!

I had this waterproof big, thick heavy bandage on mine. They told me I could shower. So I did....after about 12 days it became totally gross...the bandage interior turned to some gross looking gel. Like an alien sea creature. This time, I want spares.

It took me nearly 3 months to get to 100! And 0. But I notice that i’m very comfortable with my new knee. Sure, it’s still a bit stiff, but so stable! Just hoping that the right is as happy. Six weeks to go!