PKR Snooz is a "Snoozin" Susan

[tiredwife]

@Snooz Prune juice, nothing else worked for my husband, bran cereal might help too.

 

[skigirl]

I was also so worried about infection, but the whole infection process for our metal joints is not completely clear---I would not worry about small cuts--even fissures. It is hard to control this process---i myself had to visit the letting go issue a few times myself. Your body is slowed down due to pain meds, but don't worry, it is not completely stopped!! I found the eating Metamucil crackers had a fairly immediate response---but I would caution you about taking laxatives---with your knee, you don't want to be running to the bathroom every five minutes---a more natural process is necessary. I will tag @Poppet as she is the expert on natural healing.

Most of all, let yourself relax--this, like other things that will come up in the next few months, will pass away and you will heal.

 

[Snooz]

Thank you, again, @skigirl . I have had a very difficult morning, and I truly feel I am doing all that I should and need to be doing. At the risk of too much information, it is very impacted right at the surface, and I am not able to release it other than the first little bit that I had to remove with tissue. Now there is a bit of watery seepage leaking, and I have had to send my daughter for Depends. Talk about a humiliating situation on top of a already very dependent recovery! I am still wearing the compression hose, and I am very afraid of something getting on them because they are the only ones I have. My nerves are at the breaking point now.

I have not been able to follow through as thoroughly as I would like with the exercises from my PT, due to dealing with this and an issue with my pharmacy yesterday where they did not have my pain meds, did not fill them, and did not let us know so we ran out, and I was very uncomfortable overnight into yesterday morning. By the time I received them, my knee was stiff and sore, and the exercises became quite painful so I quit. Today, I have not been able to do them at all dealing with this.

I called my OS, and the nurse is trying to get to him right now to see what else I can do. She said I have done all that she normally reccomends. Everything else has gone so well with my surgery and now this! Ugh.....

 

[Jamie]

Snooz.....so sorry you are experiencing constipation problems. If you can feel a hard feces at the rectum, try to see if you can work it loose with a tissue like you were doing. Suppositories may help, but if the hard stool is at that point, what you eat and drink may not help to get the job done.

Why not give a call to your GP and see if they can help you.

 

[Poppet]

Thanks @skigirl for tagging me

Snooz, your pain meds will no doubt be producing a slow transit time (with food) and too much fibre can worsen the symptoms and of course a high fibre diet requires an adequate fluid intake. You are doing very well nutritionally and fluid wise you are having just a little over 2 liters which is very good.

However, as the impacted mass can be very painful it sounds like you may have to have it broken up by hand, as you are attempting to do. If you are unable to have a success soon and you are in extreme discomfort, the next step will be for the following:

• A health care provider will need to insert one or two fingers into the rectum and slowly break up the mass into smaller pieces so that it can come out. It will be done very gently.
• This process must be done in small steps to avoid causing injury to the rectum.

Here is the anatomy..

I am hoping by the time you get to read this, you have had a successful BM

 

[Snooz]

Thanks @Jamie, @skigirl, and @Poppet as well as the others! Finally found some relief late Thursday, and though it has continued, I am dealing with it slowly but surely. I figure it did not happen in a day so it will take more than a day to get rid of it, yuck! I am drinking Miralax twice a day, taking Senecot S twice a day, and have used a suppository once each day since Thursday to help. The GP suggested an enema, but I already felt traumatized enough once I got a little relief, so I did not think I could handle that. If there is not significant improvement by Monday, I will try the enema. The pain and misery I was in on Thursday is gone, so I am hoping this will deal with the problem that continues to exist. I am also cutting way back not the prescription pain meds as much as possible. @Poppet, do you think I am handling this correctly? It is still hard and somewhat difficult to pass, but it is working slowly. Again, thank you all! Who knew the knee would be the least of the problems?!?!?!

 

[Snooz]

Here is a question that may be very dumb! The PT insists I have not been elevating my legs properly. He wants me to lie flat on my back for 30 to 45 minutes out of every two hours during the day and have my legs propped on the back of the sofa (Talk about uncomfortable!!!) Here is my question: Do I have to elevate and ice at the same time? It is much more comfortable to ice the knee when my feet are not propped quite so high.

I am icing my knee with the ice machine through the night and about 85% of the day. Is this too much or too little? How have others been most successful with managing the pain while also cutting back on the prescription pain meds?

 

[tiredwife]

@Snooz I don't know if your elevation needs to be that high, but it does need to be toes above the nose. The higher you elevate the easier it is for the swelling to drain from the leg. I don't know if icing while elevating is manditory, but ice is great for the pain, so why not. Ice as long as you can without getting frost bite. My husband still ices and elevates a lot. If you are in pain you need meds. perhaps a milder form. My husband switched to extrastrength tylenol, when he felt the pain meds wasn't needed, keeping some percocet on hand if he had a flair. Everyone's need for meds varies.

 

[Poppet]

Hi @Snooz - thanks for tagging me. How are your pain levels 1 - 10 with 10 being the worse? The reason I ask is that I understand that you are about a month post your surgery and if you are cutting back on your meds due to the constipation and still getting high levels of pain, I would be concerned for you honey. It would be better to deal with the constipation rather than be in pain. I note you mentioned you have had some relief BM wise, which must feel like a great a relief for you. Are you naturally a constipated person? Some folk have a long transit time to start with. If so, we might look at your diet pattern a bit closer

Regards the elevation, here is an article that may help. https://bonesmart.org/forum/threads/pain-and-swelling-control-elevation-is-the-key.7602/ also, yes ice whilst elevating is good practice.

 

[skigirl]

Here is also an article from the library:

Elevating your leg to control swelling and pain
Using ice

 

[Snooz]

@Poppet , I am actually on day 9 post-op for a partial knee replacement. It is so hard for me to answer the question about pain. I do not have much in the way of actual shooting pain, but a very dull deep ache that keeps me from getting in any position that is comfortable. It is so different from the pain before the surgery, that I have a hard time rating it. Does this make sense? When it is the worst, I would say it is about a five, but I can manage it with ice and ibuprofen. For PT and bedtime, I do take the Oxycodon. Iwill be ending the Oxycotin this weekend and using Ibuprofen and Tylenol regularly for the baseline and the Oxycodon as needed (hopefully just bedtime and PT). In PT yesterday, I was able to get a 93 degree bend but extension was not as good. I am working on that at home with six fairly simple but challenging exercises. They are not pushing me, and encourage me to be very vocal when something is hurting.

As for the constipation, there has been some relief, but not where it normally would be. I still feel "full" but able to move small amounts at a time. I guess this early, I am expecting too much. I will keep working at it. If I were able to just walk in my pool or ride my recumbent bike, I think I could take care of this problem, LOL!

Thanks everyone for you replies! I am reading articles from the library, but with the meds, they are not sinking in too well! Hopefully that will improve in a few days.

 

[Poppet]

Hi @Snooz - ok, now I get the picture. Nine days post surgery for any joint replacement is still very early in the timeframe of recovery.

I understand that it is hard to read and absorb the information, so take your time, when you are ready this article will give you the timeframes related to the healing process - it is an important article for you to understand what is happening under your incision and within your body xx

The following is a link to an article which provides the current science regarding the healing beneath and around the implant and approximate timeframes for the healing phases and processes and the relevant nutritional information for each phase.

Healing Phases & Nutrition

This second link is to other nutritional articles which you may find interesting, including one relating to bone health.

Nutritional advice for pre op and recovery

 

[Snooz]

Okay, another strange question before I call it a night! Have any of you experienced the leg jumping/jerking (I guess more of a tremor)? It typically occurs when I doze off. Very odd feeling, but it does not hurt.

 

[ladymax]

That happens to me sometmes. When it happened in the first couple weeks it was painful, but now not so much. I think it is due to sore or tired muscles, but not sure. I don't think it's anything to worry about. BTW, you might want to consider the enema. Sounds horrible, but it's actually just a little oil in a squeeqy thing that has a tiny tube thing on the end that is painless. Basically the bm slides out within minutes of the oil being inserted. You could also do a gut massage a couple times a day. Gentle pressure on your belly (counterclockwise in a wide circle aroudn the belly button area) little circles, then go around the circle. Helps get things moving. I have a daugher with consitpation issues and these two things have been a painless gentle way to move things along. Hope you get a good nights sleep tonight!

 

[Poppet]

Hi @Snooz - second link I provided will take you to my nutritional library. I have an article about restless leg syndrome and magnesium - for when you are not so tired - get some rest now xx

 

[Josephine]

but keeping it straight with no support is almost unbearable at this time. I do not want to hinder regaining the knee extension, but keeping it straight with no support is almost unbearable at this time. Do you think I am okay to prop it on the king pillow as I have described?

You don't need to keep it dead straight. That will cause pain. The human knee is not constructed to be rested that way. You can keep it comfortably bent, just not very bent - these are the right and wrong ways to do it

I have always heard the third day after surgery is the worst

Third day, third week - it differs for everybody! Mine was at six weeks!

I am most concerned about the bend and extension of my knee. With the bandages and ice wrap, it is hard to get much extension or bend that knee.

You really don't need to worry about that. You're only 10 days out yet. I suggest you don't worry about it for at least three weeks.

I am able to tighten the quads and feel my knee straighten somewhat, so I am doing that and holding it for 20 seconds at a time multiple times an hour.
I can sit at our table for dinner with my knee bent, but it does make the incision area sore. I am trying to bend it as much as possible frequently throughout the day.
Do you think I am doing enough? What are your recommendations?

I think you are doing too much! And you are not following the guidelines (as per BoneSmart!) which are here Activity progression for TKRs.
So in these early days don't
- sit at the table
- do any bending stuff
- do anything except rest, ice and elevate and take you pain meds!
And while you are doing that, you can go back and read ALL the articles Kelly left for you.

I am not able to release it other than the first little bit that I had to remove with tissue. Now there is a bit of watery seepage leaking, and I have had to send my daughter for Depends. The GP suggested an enema, but I already felt traumatized enough once I got a little relief, so I did not think I could handle that.

Water leakage is a sign of impacted faeces for which the solution is an enema. Don't think about it - do it!

The PT insists I have not been elevating my legs properly. He wants me to lie flat on my back for 30 to 45 minutes out of every two hours during the day and have my legs propped on the back of the sofa (Talk about uncomfortable!!!)

No way! Obviously a PT who knows just enough to be dangerous! I have never ever known that to be advised and would strongly advise against it.

Do I have to elevate and ice at the same time? It is much more comfortable to ice the knee when my feet are not propped quite so high.

'Have to' is beside the point. It's just more convenient and comfortable to do so.

It is so hard for me to answer the question about pain. It is so different from the pain before the surgery. I do not have much in the way of actual shooting pain, but a very dull deep ache that keeps me from getting in any position that is comfortable.

Of course it's different! That which was responsibly for the pre-op arthritic pain is now gone and what you are left with is definitely different. It includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness. And all of this is not 'just' - it's real pain and needs to be medicated.

 

[tiredwife]

@Snooz about the leg jerks, my husband did it all the time just starting to dose off. I think it is fairly common. It stopped when he came off the percocet.

 

[Jozilla]

My neurologist told me its a form of pain when I saw him after my tkr. It is weird having those jerky leg movements when you try to go to sleep. Feel better!

 

[ladymax]

How are things going with you? Any progress with the constipation? Last night I had a leg jerk that made me bite my cheek so I wouldn't yell! Typically it doens't hurt anymore, but that one was a doosey. I guess that will come and go as we heal...

 

[kneeper]

Most of my early pain was in the form of stiffness and achyness. Medication helped.

I'm not sure of the things you are taking BMwise, but I hope you are taking a stool softener. You can get various brands--i have found dulcolax (just the stool softener, not laxative) used steadily helpful to help keep things moving more normally once they are moving.