Bilateral TKR Superior and Inferior Patellar Enthesophytes

[Celle]

My PT was surprised that I could walk reasonably well with a cane. Both knees were at 100/0 at 3-1/2 weeks. I told him that my main complaint was a ""tiredness" in my hamstrings at the knees that makes it uncomfortable sleeping. My legs feel very restless. He told me to try to sleep with my legs straight, and he gave me some gentle stretches to do along with a couple of gentle strengthening exercises for the quads. He said my main goal right now is to heal and get the swelling out of the knees. The PT told me that I am lucky to have great genes. He said he has only had one or two other patients in his career that have healed as quickly.

I'm glad to hear you're doing well, after such a rough start. Well done!

I like the sound of your therapist. He's giving sensible advice. I like that he advises not to do too much, too soon.

The only thing I would query is his advice to sleep with your legs straight. Do that if it feels comfortable, but it's not really necessary, so sleep any way you find comfortable.

 

[freeriderNC]

I pray you are feeling better. hope they have they have your pain meds regulated.

 

[New England Librarian]

So glad to hear you are doing well! You deserve an extra easy recovery after the trauma of your hospital stay. Still makes me angry when I re-read your posts - it was almost in humane

 

[GratefulNana]

Thanks for the prayers and positive comments. The first week was a challenge for me and my family. Now, it seems like just another faded event that gets filed away in the recesses of my mind as I move forward on my recovery journey. I did get a survey from the hospital, and I gave it low marks where appropriate. There was a space for comments, so I outlined my grievances, highlighting the fact that this was considered an "elective" surgery, the hospital surgical office chose the date for my procedure, and they should have been appropriately trained and staffed to handle the needs of my case, including knowledge of the CPM and icing machines. My recovery has been pretty amazing to me. They took me off of pain medication at the end of the first week because of respiratory side affects. I can tolerate Tylenol with Codeine, but my OS is adamant that it is not a proper surgical recovery drug for whatever reason and refuses to prescribe it. Luckily, another doctor, through the Advice Nurse, the first week after surgery, did prescribe 40 Tylenol with Codeine for me, so I do have something if needed. Amazingly, I have been okay with 500mg of Tylenol three times daily and one Meloxicam 15mg tablet (anti-inflammatory) daily. I have always had a strong pain tolerance, so I don't feel that I have suffered undue pain at this point.


BTKR -12/28/2015

 

[kneeper]

Good grief. I would say tylenol with codeine is pretty weak for post tkr, but since it was the only one you could tolerate it makes sense to me.

 

[GratefulNana]

Just checking in. I had my second outpatient PT today. I had to hold the line with the PT. He is actually overwhelmed dealing with five of us at a time in the gym. I am the newest patient, the only BTKR, and am fortunate at having a quick ROM recovery. I feel so guilty watching the others struggle. I do ice, elevate, take short walks around the house/yard, and do simple, gentle exercises routinely. I still have moderate swelling, and at four and one-half weeks, lots of healing still ahead. Both knees were at 112 degrees flexion and 0 degrees extension. I see the OS tomorrow, and the PT said he will be very pleased at my progress. I also spoke with a young woman who had a different surgeon, but whose surgery and hospital stay was at the same hospital where mine was. She had her LTKR on December 7, 2015. She had a very similar hospital nursing experience as I did. I asked her if she had gotten a survey. When she said she did, I encouraged her to complete it and send it in documenting her grievances. She said she would. Even though this is a large hospital, they only choose to staff a few regular nursing rooms. The hospital opened about seven years ago, but they specialize in come and go surgeries. Their staffing levels fluctuate, so they have limited regular floor nurses and rely on "traveling" nurses....no vested interest in outcomes.



BTKR -12/28/2015

 

[kneeper]

and limited training in ortho

 

[GratefulNana]

Had my four week check up with OS last Friday. He was extremely pleased with my progress and told me that I could forego PT after this week. He told me to listen to my body and that some days may be more difficult than others. He added not to be discouraged if I get a setback once in awhile. I definitely was not expecting to hear all of this so early on, but I don't feel that PT can do much for me at this point. The only thing that seems to be holding me back is the swelling and the healing process, and that will resolve with time. I have been very fortunate in my recovery. The hospital called me this afternoon regarding my comments pertaining to the poor care that I received from hospital nursing and PT while in their care. It was a conference call with a doctor-in-charge and the nursing supervisor of the floor that I was assigned to. They were extremely apologetic and said that the issues that I brought up were very disturbing to them and would be addressed with staff through training. I told them that I realize that bilateral knee replacement isn't that common , and staff may not realize how much assistance may be required in the beginning few days, especially with the ice machines, CPM machine, chair that they expected me to sit in too low, as was the toilet, and with no trapeze to use to move myself in bed. We also went over the ten pages of "discharge notes" that said absolutely nothing of how to care for myself, no number to call if I had problems and/or questions, and the fact that there were no pain medications, or any other medications ordered. I was on baby aspirin twice daily to prevent blood clots, but there was no mention for me to purchase any, how to take it, and for how long. I just don't want what happened to me to happen to someone else. They asked me if they could call again if they had more questions. Of course, I said yes. Frankly, I was surprised that anyone actually called me to address my grievances.


BTKR 12/28/2015

Sent from my iPad using BoneSmart Forum

 

[Celle]

I'm very pleased to hear that the hospital called you. It shows a willingness to listen and to try to address your problems, so that no one else has to go through what you did.

 

[kneeper]

It's good to know that they are following through!

 

[Joyfull61]

I'm just now reading through your thread and am truly shocked at your hospital experience. Wow!

 

[GratefulNana]

Today is the beginning of week 12 of my healing journey. Sleep is still elusive...I awaken every 1-1/2 to 2 hours to pee. My regular doctor wants me to take a urine test, checking for an infection. She said I should not be getting up so often. I figured the fluid retention in my knees and legs that accumulated during the day was being eliminated at night. I usually try to sleep with my legs elevated. Today was Grandparents/Special Friends Day at the Catholic School where are granddaughter is in Pre-Kindergarten. It was a lot of fun; however, unfortunately for those of us struggling a bit with our mobility, poorly planned logistically. Because of necessary security for the children, gates that would normally be open, had to be kept locked because the activities were held during school hours. I ended up walking over a mile altogether, according to my pedometer, and had to navigate several stairs, and try to maneuver through a large crowd and lots of children and strollers. It was challenging, but I feel a great deal of accomplishment that I was able to be there for my granddaughter. Five hours later, I was really not too much worse for the wear. My knees and lower legs are swollen, but not painful. Icing and elevation have eliminated a great deal of the fluid rather quickly...yes, several trips to the bathroom. I am feeling very blessed today!

 

[Celle]

My regular doctor wants me to take a urine test, checking for an infection. She said I should not be getting up so often. I figured the fluid retention in my knees and legs that accumulated during the day was being eliminated at night. I usually try to sleep with my legs elevated.

I think you're probably right, but your doctor is wise to make the checks.

It was challenging, but I feel a great deal of accomplishment that I was able to be there for my granddaughter. Five hours later, I was really not too much worse for the wear. My knees and lower legs are swollen, but not painful. Icing and elevation have eliminated a great deal of the fluid rather quickly..

Well done! I'm sure your granddaughter was pleased.

 

[GratefulNana]

We have been so busy with our garden, since the first of April. I have been experimenting with canning pasta sauce this year along with the salsas. We tried out my new knees in June on a week-long trip to a couple of National Parks. I had the usual swelling, but no problems overall, the short hikes were mild. We got back last Thursday from a two week trip to National Parks in Utah, Colorado, New Mexico, and Arizona.

The first day at Bryce Canyon, Utah, on a relatively flat trail, I began having problems with the knee cap area of my left knee. The pain was a 10. My husband had to hike to Inspiration Point without me. I rested the knees as much as possible the rest of the day, and took an anti-inflammatory drug that night. The next day, everything seemed okay. We did another couple of short hikes, I used my cane and my husband helped me with climbing in some areas. I noticed that on any steep decline in the paths, which there were many, I had this sane sharp pain around the knee cap.

I have had this issue with my left knee since the surgery on and off. It could happen walking through the grocery store, or walking down the steep steps of my home. Funny, that the surgery was done primarily for kneecap problems, and my right knee was the most problematic. The doctor told me months ago that the scars would turn white when the tissue was healed. My scars are primarily still purplish, with the left knee's scar wider than the right knee.

I was wondering how everyone else was healing. I have developed anemia with the blood loss from surgery. My blood test values are just now at the low end of the "normal" scale.
I am thinking about making an appointment with the OS.

 

[mamazipp]

Wow, gratefulnana, I just read your recovery story with your hospital fiasco. What a horrible experience. I. Glad you are otherwise healing well, (except for that kneecap pain) and that you were able to go to the national parks. Do try to see your OS to evaluate your knee pain.

I had a very similar experience and mine was in Seattle in an orthopedic institute! The nurses were traveling nurses with obviously no ortho experience, did not answer bells in a timely fashion, none of the staff gave me any personal care and did not offer ice unless I thought to ask for it. I won't go on and on, but I did not file a complaint, but hearing your story and how you did pursue it, I think I will now, even if it's 6 months later. It was appalling. Especially since most people on Bonesmart have had such good hospital care.

Best wishes on continuing improvement.

 

[GratefulNana]

Today Is my BTKR one-year anniversary. WOW! What a journey. I finally made an appointment a few weeks ago with the OS regarding the pain in my kneecaps when hiking downhill. He said it was extreme inflammation. I was to go back to elevation and icing several times daily.

We haven't visited any National Parks recently, so I haven't had the opportunity to see if anything has changed. I ordered a pair of hiking shoes, and intend to try to walk the hills in my neighborhood. I having hiking poles, so I will use them


BTKR - December 28, 2015

 

[kneeper]

Happy Knee birthday!

 

[Want2hike]

Happy AnKNEEversary!

 

[Celle]

Hello @GratefulNana
That's a really good one-year anniversary report.
Thank you for coming back and updating us.

I hope the kneecap tenderness decreases. I know that my OS told me once that going downhill does put quite a strain on the knees, so it may be something that takes a little more time than the rest of recovery.

Best wishes.

 

[FlaGranny]

That's really unfortunate. My hospital put me into the orthopedic section of the hospital and the nurses were all well versed in the care of knee replacements. Care at hospitals I believe really relies on hospital policies: how many staff they hire, how the staff is trained, etc. I know there are still the kind of hospitals where you were, but some are really upping the quality of care. I was really fortunate to be in one of those hospitals. Both times I was there, there was a full complement of nurses, assistants, and aides. There was no waiting at all for medications or help when I had to use the bathroom. Everyone was pleasant and the one time they were more than 5 minutes coming to me, they apologized for the delay. Its a shame that some hospitals err on the side of saving money rather than providing adequate care. Good care is probably more cost effective in the long run.