Yes, I did. My connection wasn't good and tight. I suggest you try that. I never had a problem with condensation.
PKR ShedEnd's road to recovery<
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ShedEnd
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Even with the A/C on full blast, the humidity in our house is probably in the 70% range (Florida summers are brutally long and the temps don’t vary much between day and night). As a result I’ve been seeing a lot of condensation on the connection between the hose and the cuff. I think it may just be forming there and wicking onto the cuff around the connection. We’ve wrapped a sock around the connection to test this hypothesis.
I hope you narrow it down. You don't want to get your incision wet!
I'm glad you found the leak before it caused any damage!
ShedEnd
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@Josephine, I've seen your questions on other people's pages, so I went ahead and grabbed them to answer:
1. When sitting still, I'd put it at a 2-3, mostly in the form of aching, swelling, and burning. If I try to move my left leg at all that will spike up to a 7 or 8. I've been using my good leg to lift and maneuver the left leg to get out of bed and move around.
2. The post above was correct. 10mg hydrocodone/650mg acetaminophen every 4 hours (6am, 10am, 2pm, 6pm, and 10pm). 100mg Tramadol every 8 hours (6am, 2pm, 10pm). That's all for now, but I'm most likely going to go in to see the OS on Monday to get this changed to something different/stronger as it is completely inadequate in managing pain.
3. I have skinny legs, so my knee looks like a cantaloup on a straw. I'd put it in the "huge" category.
4. Flexion is only at about 60 right now - any farther is very painful (so I don't do it). Extension is pretty close to flat - I'd say 5-10. I've been letting gravity work on that by putting the pillows under the ankle and letting the knee extend out. I can do this without pain - it actually feels good to let it stretch out some.
5. Before my cryo cuff developed a leak, I had it on during the day for about 1.5 hours on, half hour off. Now I've moved to ice and I'm doing 45 minutes on, 15 off.
6. Yes. I'm spending most of the day in bed as the pain has been pretty severe if I move my leg around. I get up to go to the bathroom, and I get up to sit at the kitchen table to eat (and sit there for 30 minutes or so just to move around a bit). Otherwise, my leg is elevated.
7. Very low. I've gotten up to use the bathroom a couple times, and gotten up to move into the kitchen to eat. Otherwise I've been in bed.
8. Exercises done at home
heel slides (based on the links here) 3x per day, 5 reps each time
heel prop (knee sag) 5-6 times per day for 10 minutes or so. Helps straighten leg out and feels like a nice stretch.
ankle pumps 10 times per day, 5 reps each time. Do this to keep my leg moving. does cause some minor pain in knee.
quadriceps tightening (flexing muscles in leg without moving) 3 times per day, 5-10 reps each time. Does cause some pain.
Anything done at PT
PT came to visit me the day after surgery to show me the above exercises (plus some others that I cannot do). She hasn't come back and won't until the pain is under better control.
1. When sitting still, I'd put it at a 2-3, mostly in the form of aching, swelling, and burning. If I try to move my left leg at all that will spike up to a 7 or 8. I've been using my good leg to lift and maneuver the left leg to get out of bed and move around.
2. The post above was correct. 10mg hydrocodone/650mg acetaminophen every 4 hours (6am, 10am, 2pm, 6pm, and 10pm). 100mg Tramadol every 8 hours (6am, 2pm, 10pm). That's all for now, but I'm most likely going to go in to see the OS on Monday to get this changed to something different/stronger as it is completely inadequate in managing pain.
3. I have skinny legs, so my knee looks like a cantaloup on a straw. I'd put it in the "huge" category.
4. Flexion is only at about 60 right now - any farther is very painful (so I don't do it). Extension is pretty close to flat - I'd say 5-10. I've been letting gravity work on that by putting the pillows under the ankle and letting the knee extend out. I can do this without pain - it actually feels good to let it stretch out some.
5. Before my cryo cuff developed a leak, I had it on during the day for about 1.5 hours on, half hour off. Now I've moved to ice and I'm doing 45 minutes on, 15 off.
6. Yes. I'm spending most of the day in bed as the pain has been pretty severe if I move my leg around. I get up to go to the bathroom, and I get up to sit at the kitchen table to eat (and sit there for 30 minutes or so just to move around a bit). Otherwise, my leg is elevated.
7. Very low. I've gotten up to use the bathroom a couple times, and gotten up to move into the kitchen to eat. Otherwise I've been in bed.
8. Exercises done at home
heel slides (based on the links here) 3x per day, 5 reps each time
heel prop (knee sag) 5-6 times per day for 10 minutes or so. Helps straighten leg out and feels like a nice stretch.
ankle pumps 10 times per day, 5 reps each time. Do this to keep my leg moving. does cause some minor pain in knee.
quadriceps tightening (flexing muscles in leg without moving) 3 times per day, 5-10 reps each time. Does cause some pain.
Anything done at PT
PT came to visit me the day after surgery to show me the above exercises (plus some others that I cannot do). She hasn't come back and won't until the pain is under better control.
ShedEnd
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The doubling of the pain meds has seemed to work - it has gotten the worst of the pain under control and it has allowed me to get up and move around a good bit more. I'm aiming to split time evenly between lounging in the bed and sitting up on the sofa, but lounging on the bed wins out in the end. I'd say right now my split is about 1/3 on the sofa sitting and 2/3 in the bed lounging. Have the leg elevated while in the bed, and I'm icing for 20 minutes every hour. Still waiting for my replacement cryo/cuff to arrive.
I'm trying to do my exercises, but the knee just doesn't want to bend right now. Not so much pain, but overall pressure - it feels like a balloon that is on the verge of bursting when I try to bend it. Still swollen up a good bit.
I'm trying to do my exercises, but the knee just doesn't want to bend right now. Not so much pain, but overall pressure - it feels like a balloon that is on the verge of bursting when I try to bend it. Still swollen up a good bit.
SusieShoes
Former BoneSmart staff member
What a shame about your cryo/cuff. Ice packs can do the job, though! 
Just bend your knee as it is able. When swollen, it won't bend very much and there's nothing to be gained by forcing it. Just bend to the point of discomfort and stop if you reach actual sharp pain. Your knee will thank you. Sounds like you're doing a first-rate just of icing and elevating. Those will help the swelling go down.
Just bend your knee as it is able. When swollen, it won't bend very much and there's nothing to be gained by forcing it. Just bend to the point of discomfort and stop if you reach actual sharp pain. Your knee will thank you. Sounds like you're doing a first-rate just of icing and elevating. Those will help the swelling go down.
Icing for only 20 minutes does very little to help that swelling. I iced the whole time I was sitting or laying down. I'd get up to go to the bathroom or get a snack and put the ice baffle right back on. I even slept with it all night, changing out the ice once during the night. Be sure you are elevating toes above nose as you're icing. That helps to get the fluid moving in the right direction to the kidneys.
Josephine
NURSE DIRECTOR EMERITA
Very innovative!
Since you are not even one week out yet, I am not at all surprised! In my opinion, exercises - if done at all but more on that later! - shouldn't be done until at least the third week.
This is also not surprising as you are still in the early days when your knee has not yet reacted fully to the full impact of the surgery. But it's a temporary situation.
Quite so!
I'd suggest you go on a Tramadol and Tylenol routine like one of these. Note the 4am dose. It is very important to have a steady intake of meds otherwise your pain spikes and then you're playing catch up. Did you read your Recovery Guidelines? Specially this one Pain management: importance of managing pain after a TKR and the pain chart? This is THE most important issue and one quite a lot of people get wrong from the very start!
LOL! Imagination is good!
Remember when you were rejoicing that your ROM was 115/0? Then the surgery impact hit! Yes?
I would advise even more than that. Try using ice packs for as long as you can, even as long as 1-1½ hours.
You've not said anything about HOW you elevate. And spending the day in bed is NOT necessarily elevating! You need to have "toes above nose" for effective elevating, like one of these
Then you're not mobile enough. You need to follow the suggestions in this article Activity progression for TKRs. Mobility is essential for getting the fluids (blood and lymphatic system) moving around your limb and your body.
8. Exercises done at home
heel slides (based on the links here) 3x per day, 5 reps each time - base on the links here? 5 reps x3 a day? That's not what I recommend. It's "do 5 every couple of hours" and never stress into pain. Heel slides and how to do them properly.
heel prop (knee sag) 5-6 times per day for 10 minutes or so. Helps straighten leg out and feels like a nice stretch - I disagree it's a 'nice stretch. What you are doing is increasing the swelling and thus the pain. Walking is the best way to improve extension. Walking and time.
ankle pumps 10 times per day, 5 reps each time. Do this to keep my leg moving. does cause some minor pain in knee - given you are resting in bed a lot, then yes, you do need to do these but not so frequently. Do 5 every couple of hours. More will indeed cause pain.
quadriceps tightening (flexing muscles in leg without moving) 3 times per day, 5-10 reps each time. Does cause some pain - these sound like jolly good exercises to do, don't they? WRONG! They pull on your quads tendon and patellar tendon (all one structure) and this will cause an upsurge in pain and swelling. So don't do them. Read this BoneSmart philosophy for sensible post op therapy.
I suggest you decline the in home PT sessions and any other sessions.
There are many of us on here who did their recovery yet did NO exercising or PT whatsoever. I was one of them. We all got excellent outcomes. I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)
ShedEnd
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I am absolutely rubbish with quoting on sites like this, so I will just go in order:
1. Yes, the early flex of 115 was wholly a product of the nerve block still being in place and the swelling not to have hit fully yet. The 60-70 is much more indicative of what it is now. I can bend it to that point with little pain - its the swelling that is preventing it from going farther. It feels like I'm trying to bend a fully pressurized fire hose.
2. My OS doubled my hydrocodone and tramadol, and that seems to have done the trick for the pain I was feeling. They will have to reassess what they want to do for pain tomorrow, and I will be able to discuss the options with him then. I'm leaning towards upping the acetaminophen to help with the swelling as well, so what you propose would be beneficial in that area as well.
3. Swelling is not going down any. I've been icing (got a replacement for my cryo/cuff) and elevating. But it's still a cantaloupe in a straw. I know it will take time for it to return to normal.
4. Flex and extension are still about 60-70 and 0-10 right now. So no real improvement there.
5. Got a replacement for the cryo/cuff, so I have that on for as long as it keeps water cold (about 2 hours), then off for 30 minutes or so. Wash, rinse, repeat.
6. My elevating is using pillow piles, and it is definitely is toes above nose. When I am in bed, my legs are elevated.
7. Activity level has been a bit more than what I wrote. I just feel like I haven't been doing much. I do get up and move around every 3-4 hours. Probably more than that. I get up to eat every meal at the kitchen table, so that is generally around 08:00, 13:00, and 18:00. Before sitting down for dinner, I do a few laps around the house, for about 5 minutes of hobbling around. In between meals, I get up at least once to wander around the house, more if I need to use the bathroom.
8. Heel slides - I do these at each meal and at any other times I am sitting in the chair rather than lounging. I do 5 reps each time, and I hold them for about 10 seconds. I do not take it to the point of pain, but rather to the point of pressure - where my knee doesn't feel like it can bend any more. Like I said above, it is like a pressurized fire hose...
9. PT - I did make it clear that I won't be doing anything that will cause pain. I'm planning to discuss it with my OS tomorrow.
1. Yes, the early flex of 115 was wholly a product of the nerve block still being in place and the swelling not to have hit fully yet. The 60-70 is much more indicative of what it is now. I can bend it to that point with little pain - its the swelling that is preventing it from going farther. It feels like I'm trying to bend a fully pressurized fire hose.
2. My OS doubled my hydrocodone and tramadol, and that seems to have done the trick for the pain I was feeling. They will have to reassess what they want to do for pain tomorrow, and I will be able to discuss the options with him then. I'm leaning towards upping the acetaminophen to help with the swelling as well, so what you propose would be beneficial in that area as well.
3. Swelling is not going down any. I've been icing (got a replacement for my cryo/cuff) and elevating. But it's still a cantaloupe in a straw. I know it will take time for it to return to normal.
4. Flex and extension are still about 60-70 and 0-10 right now. So no real improvement there.
5. Got a replacement for the cryo/cuff, so I have that on for as long as it keeps water cold (about 2 hours), then off for 30 minutes or so. Wash, rinse, repeat.
6. My elevating is using pillow piles, and it is definitely is toes above nose. When I am in bed, my legs are elevated.
7. Activity level has been a bit more than what I wrote. I just feel like I haven't been doing much. I do get up and move around every 3-4 hours. Probably more than that. I get up to eat every meal at the kitchen table, so that is generally around 08:00, 13:00, and 18:00. Before sitting down for dinner, I do a few laps around the house, for about 5 minutes of hobbling around. In between meals, I get up at least once to wander around the house, more if I need to use the bathroom.
8. Heel slides - I do these at each meal and at any other times I am sitting in the chair rather than lounging. I do 5 reps each time, and I hold them for about 10 seconds. I do not take it to the point of pain, but rather to the point of pressure - where my knee doesn't feel like it can bend any more. Like I said above, it is like a pressurized fire hose...
9. PT - I did make it clear that I won't be doing anything that will cause pain. I'm planning to discuss it with my OS tomorrow.
NavyGunns
Former BoneSmart staff member
@ShedEnd, something to keep in mind: acetaminophen (Tylenol) does NOTHING for swelling or inflammation! Pain? Yes. Otherwise, no. I’m sure @Josephine will confirm this.
During my first two weeks I had a self-contained cryo unit for my knee. I wore it whenever I was in my recliner or in bed elevating my knee. When I had to send it back, I switched to freezer gel packs (large ones). I kept them on until they were no longer cold and then got another. I think I bought 4 or 5 of them so I always had frozen packs available.
Your activity around the house sounds like what mine was the first couple of weeks.
During my first two weeks I had a self-contained cryo unit for my knee. I wore it whenever I was in my recliner or in bed elevating my knee. When I had to send it back, I switched to freezer gel packs (large ones). I kept them on until they were no longer cold and then got another. I think I bought 4 or 5 of them so I always had frozen packs available.
Your activity around the house sounds like what mine was the first couple of weeks.
ShedEnd
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You are correct - I always forget which ones are anti-inflammatory. And I always get them wrong.
I wouldn’t be surprised if they move me over to toradal for the pain and to help reduce the inflammation.
I wouldn’t be surprised if they move me over to toradal for the pain and to help reduce the inflammation.
bowhunter8
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@ShedEnd
It does get better, I promise. The first week was pretty rough, 2nd week was hard, 3rd week better, and now in my 4th week, I am feeling pretty good. So good in fact that I am spending time in a hunting blind. I distinctly remember and still do tell my wife how with each passing day I notice an improvement.
My biggest takeaways from the first 2 weeks were:
1. Ice, elevate and medicate constantly! 20 minutes is nothing, leave that cuff on all the time unless you are going to the bathroom or filling it back up. I didn’t spring for one so I am using gel packs and they do the trick. I used different degrees of elevation tactics. I used a pillow stack that was “Bonesmart approved” and it bothered my knee. The higher it got, the worse it felt. So I did what my knee liked. Second week, that same stack felt better. I still at 4 weeks ice and elevate for hours in a day.
2. Don’t sweat the ROM. IT maks sense, you are swollen and you don’t have good ROM. Do your best at addressing the pain/swelling before trying to get better ROM. First week for me was calf pumps, flexing my quads gently, and at hospital and OS advice leg straightening stretch. But as Josephine said, that stretch can cause discomfort and pain so I did not stress it. I am sitting at 130/0 now. One thing that helped before I left the hospital was occupational therapy said try and do something on your feet every hour. Thismcouldmbenjustcstanding up, bathroom, short walk, snack, etc... This may sound silly but I made my self drink a lot of water to “force” myself to get up and move. Pain was raw during the first week and I was on a walker.
3. Rest and relax. This was the absolute hardest one for me and my biggest fear going into this operation but I have settled in nicely now.
this is your time to sit on the couch or bed and be lazy. Rest is awesome medication. Don’t give yourself timelines or compare your recovery (I’m reminding myself of that as I say that too). Everyone recovers differently so dont feel you are behind or something is wrong. I haven3 children who are homeschooled so being at home is a lot more mentally active than work but I have found that it has distracted me nicely and I haven’t had time to stress the small stuff.
Hang in there buddy!! It gets better, I promise!
It does get better, I promise. The first week was pretty rough, 2nd week was hard, 3rd week better, and now in my 4th week, I am feeling pretty good. So good in fact that I am spending time in a hunting blind. I distinctly remember and still do tell my wife how with each passing day I notice an improvement.
My biggest takeaways from the first 2 weeks were:
1. Ice, elevate and medicate constantly! 20 minutes is nothing, leave that cuff on all the time unless you are going to the bathroom or filling it back up. I didn’t spring for one so I am using gel packs and they do the trick. I used different degrees of elevation tactics. I used a pillow stack that was “Bonesmart approved” and it bothered my knee. The higher it got, the worse it felt. So I did what my knee liked. Second week, that same stack felt better. I still at 4 weeks ice and elevate for hours in a day.
2. Don’t sweat the ROM. IT maks sense, you are swollen and you don’t have good ROM. Do your best at addressing the pain/swelling before trying to get better ROM. First week for me was calf pumps, flexing my quads gently, and at hospital and OS advice leg straightening stretch. But as Josephine said, that stretch can cause discomfort and pain so I did not stress it. I am sitting at 130/0 now. One thing that helped before I left the hospital was occupational therapy said try and do something on your feet every hour. Thismcouldmbenjustcstanding up, bathroom, short walk, snack, etc... This may sound silly but I made my self drink a lot of water to “force” myself to get up and move. Pain was raw during the first week and I was on a walker.
3. Rest and relax. This was the absolute hardest one for me and my biggest fear going into this operation but I have settled in nicely now.
this is your time to sit on the couch or bed and be lazy. Rest is awesome medication. Don’t give yourself timelines or compare your recovery (I’m reminding myself of that as I say that too). Everyone recovers differently so dont feel you are behind or something is wrong. I haven3 children who are homeschooled so being at home is a lot more mentally active than work but I have found that it has distracted me nicely and I haven’t had time to stress the small stuff.Hang in there buddy!! It gets better, I promise!
NavyGunns
Former BoneSmart staff member
@bowhunter8, fantastic feedback! Couldn’t have said any better myself! Us guys like to push through pain and force rehab when we are injured, but this is different, WAY different!
Josephine
NURSE DIRECTOR EMERITA
No matter, you are still only ONE week out!
Wrong! You are most definitely NOT doing 'nothing'! Right now your entire body is in a high mode of healing. That takes prodigious amounts of calories and energy which will create a significant Energy drain. This is not a choice on your part, not something you can control or overcome. Anymore than you can control or overcome the effects of a general anaesthetic! So behave yourself!
I did advise you not to do them at all. They don't enhance ROM. They only 'enhance' swelling and pain, even if you don't do them to the point of pain.
I would say that was somewhat excessive. Once every TWO hours is more than enough.
ShedEnd
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@Josephine It takes a couple of tries to get things through my thick head, but I am paying attention to what you are saying. I'm limiting my "exercises" to just moving my knee through its ROM that is comfortable right now - I'm not pushing it to the point of tightness or pain. So basically I'm just making sure it doesn't sit completely still while I'm elevating/icing. I'm also getting up to move around every couple of hours, and I'm trying to find the right length of time to be up on my feet to get the benefits of motion without exhausting myself.
I am keeping the cryo/cuff on constantly now, and it does feel a lot better.
Finally, I have to keep reminding myself that I am very early in the process. When I start getting frustrated with the lack of progress, I just focus on the fact that I'm only 6 days out from a major operation, and I still have weeks of recovery ahead of me.
I am keeping the cryo/cuff on constantly now, and it does feel a lot better.
Finally, I have to keep reminding myself that I am very early in the process. When I start getting frustrated with the lack of progress, I just focus on the fact that I'm only 6 days out from a major operation, and I still have weeks of recovery ahead of me.
Josephine
NURSE DIRECTOR EMERITA
No, don't even do that!
As I think I said before, your activities should be limited to your ADLs (activities of daily living) which include
eating
bathing
dressing
toileting (being able to get on and off the toilet and perform personal hygiene functions)
transferring (being able to get in and out of bed or a chair without assistance)
maintaining continence (being able to control bladder and bowel functions)
bathing
dressing
toileting (being able to get on and off the toilet and perform personal hygiene functions)
transferring (being able to get in and out of bed or a chair without assistance)
maintaining continence (being able to control bladder and bowel functions)
ShedEnd
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I’m beginning to wonder about my OS. Had a call into his office about the pain meds as I was going to run out of the hydrocodone today and the Tramadol tomorrow morning taking them at the rate they had me on. Response I got back was that they wanted me to get off the narcotics and just use acetaminophen (650mg every 6 hours). And this guy wants me doing PT 3x a week already? (Edit to add - I refused to do the PT just yet).
So basically, this guy doubled the amount of narcotics I was taking 3 days after surgery because the original dosage was completely inadequate to handle the pain. 3 days after doubling it he is cutting it off completely.
More than a bit frustrated, and seriously questioning whether I went with the right doc...
So basically, this guy doubled the amount of narcotics I was taking 3 days after surgery because the original dosage was completely inadequate to handle the pain. 3 days after doubling it he is cutting it off completely.
More than a bit frustrated, and seriously questioning whether I went with the right doc...
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I think most doctors are doing this these days. Not that I agree with them doing it, but I think they are under a lot of pressure to keep narcotics to minimum. Those who are causing this pressure don’t consider those of us fresh out of a major, traumatic to the body, surgery.
It gives you an excellent reason not to do PT.
My surgery was March 13, 2017 and I was told, at least in Delaware, rules were changing on April 1, 2017, and some kind of contract would be drawn up for narcotics.
I was not involved in that because possibly unwisely, I ditched my narcotics on day 11. (my eyesight had changed drastically overnight with the surgery and I feared it was the pain medication, so I stopped taking it.) It was tough but I managed with over the counter ones.
It gives you an excellent reason not to do PT.
My surgery was March 13, 2017 and I was told, at least in Delaware, rules were changing on April 1, 2017, and some kind of contract would be drawn up for narcotics.
I was not involved in that because possibly unwisely, I ditched my narcotics on day 11. (my eyesight had changed drastically overnight with the surgery and I feared it was the pain medication, so I stopped taking it.) It was tough but I managed with over the counter ones.
