TKR Surprised and a bit confuse...from looking around, that makes me normal - I guess!

[socman]

Another thing to note that I find rather interesting. The hospital reported that my surgery was an "out patient" procedure, and, as such, I did not qualify for Mom's Meals to be sent to me (28 meals paid for my United Health Care). It took them almost two weeks to discover why they (insurance folks) could not authorize my benefit. I told them, well, if that is the case, I guess I will not have to pay my portion of the payment for the room in which I "did not stay" for three days! Let's see how that plays out!

Roger

 

[mendogal]

Another thing to note that I find rather interesting. The hospital reported that my surgery was an "out patient" procedure, and, as such, I did not qualify for Mom's Meals to be sent to me (28 meals paid for my United Health Care). It took them almost two weeks to discover why they (insurance folks) could not authorize my benefit. I told them, well, if that is the case, I guess I will not have to pay my portion of the payment for the room in which I "did not stay" for three days! Let's see how that plays out!

Roger

(sigh) Technically nowadays a hospital can put you in a regular inpatient bed in a regular inpatient unit but tell Medicare you're on observation status, not inpatient acute status.

This protects them from getting "dinged" by Medicare if a person is readmitted within a certain number of days with a similar diagnosis.

As you see, it has bad consequences... the worst being when patients and families think they have met the criteria of "3 days of qualifying inpatient stay" for a transfer to a skilled nursing facility... but haven't. It's been a terrible thing going on for about ten years now.

 

[EalingGran]

One whacky thing was I was in the hospital for three days and never served one meal

That is appalling. Did the nurses not notice you weren't getting food or check on your food/ fluid intake?
It's not even so much the food but what about being offered regular cups of tea or coffee/ juice.

 

[Layla]

Happy One Month Anniversary!
I hope you had a good week. I see, Lefty, is coming up on ten months soon.
Two new knees going into a New Year soon.
Wishing you all the best!
@socman

 

[socman]

Hi Everyone,

Week six is about to begin. Had to get off the Tramadol after having been on it for too long. It started making me feel very weird and I wanted to sleep at all hours. Dreaming was nuts!!! I did not like waking up from such crazy dreams...almost in a panic at times. I know you are asked to wean off of opioids, but I could not take being on the drug another day. Yesterday, it was the first 24 hours without the drug...felt weird until later this morning. Now I think I feel rested and more at ease.

Update on Other Things:

1. Pain - Tylenol is not doing a lot, but one Celebrex and Tylenol is all that I am taking now. It's tolerable.

2. PT - working consistently at home and seeing therapist twice a week rather than three times a week. Advancing in ROM, but not as quickly as I would like to see. I have learned to not pressure myself too much about that....that it will come in good order.

3. Walking - started walking about a half-mile distance once a day. Somewhat challenging, but I am pausing every couple of minutes and stretching my back and hips. Have a can with me, but I am not using it. Making sure that I walk heel-to-toe so that I do not screw up my gait for the future. I hope this also helps with ROM.

4. Driving - Have driving myself since a week after surgery, but is easier now. Drove myself to therapy sessions (three blocks away) and to pick up groceries (five blocks away), and at times when traffic is almost non-existent. Now - no issues at all.

5. My Emotional State - Knowing what was awaiting me has helped this time around. I felt prepared and ready for the challenges. Not too active (yet), and that kind of bothers me. I can only take watching so much TV and reading with a bit of pain is not the greatest situation. I remain quite isolated and ever since my surgery, two people have come over for a visit. My sister was to offer me support, but she has been over here two times and that was for short durations of time. No one was really present with me...even from the very first night after returning home (which was not a good thing...I know). Bottom line: I made it so far in good shape, but the isolation is rather difficult to endure. I am OK.

That about summarizes my current, end of the fifth week, status. I think I am doing pretty good. This platform has really helped during both times...more so the first, but still important this second go-round.

Take care,

Roger

 

[sistersinhim]

the isolation is rather difficult to endure

I was also alone most of the time. I spent all kinds of hours on Bonesmart conversing with the staff and my surgical mates. Come on back here when you feel the loneliness creeping in. Someone is here 24/7 to converse with you. It helped to keep me sane!

 

[socman]

Almost at the end of week six. Just had a month more of pt scheduled for me by therapist. Not sure I will need all of them, but my progression this time around is not at good as it was last time. I think that is due to much more swelling. I have hated how it makes my lower leg look...edema, stretched skin, breaking of skin in a few small areas, etc. Started wearing compression socks. Then, developed an ingrown toenail which I had to have a partial nail removal yesterday - sore today, but not as sore as it was this past week!

The insomnia is beginning to take a toll on me. I get anxious at night going to bed because I know what is going to happen....uncomfortable, nervous stomach kicks in, total sleeplessness....up for a few hours then, if I am lucky, asleep in my recliner until the sun has risen. I have stated to not look forward to going to bed...for some reason I am getting a bit of anxiety this time around, but it clears up once I am up and active during the night. Do not like how it makes me feel.

Went off Tramadol cold turkey - would not recommend that! It's been a harsh week follow my stoppage of that drug. Four weeks was long enough on that opioid...I do not like them. However, I would be lying if I did not say that I have been tempted a couple of times to start things up again...but have not.

Going to go out and a short walk in today. The sun and cool temps may do me some good...at least emotionally.

It's Thanksgiving, so happy holiday wishes to everyone!

Roger

 

[mendogal]

(waving hello)
I'm sorry the swelling and pain continue to pose problems. Totally agree that getting out for some fresh air and sun is a worthwhile tonic.
Three thoughts...
re swelling: many of our Bonesmarties have had excellent luck with getting very gentle lymphatic drainage massage from a certified practitioner. Your PT or ortho team might refer you to a local one.

re sleep: at our age lots of docs prefer not to prescribe sleeping pills. I was also having a lot of insomnia to the point of being anxious at bedtime. It's a terrible feeling! You can find herbal tea blends for sleep that include valerian. In the USA, Traditional Medicinals and Celestial Seasonings both offer a sleep tea sold in a box of tea bags(you definitely want the variety with valerian).
I took a mug an hour before planning to try to sleep (whether in bed with legs extremely elevated or just in the recliner), along with a tablet of sustained release melatonin. The first night I tried it was amazing; I slept five hours straight, woke up with no drug hangover. I used it nightly for a week or two then started cutting back.

re toenail: is there any open wound at the toenail? Generally it's fine and podiatrists don't feel that even topical antibiotics are needed. With your new knee, you might consider calling your ortho team to see if they'd want you to take a precautionary oral antibiotic as some of them will prescribe before dental procedures.

Hang in there!!!! you're not alone. Happy Thanksgiving to you.

 

[Layla]

Hi socman,
Looking back, it seems you struggled with some of the same symptoms with your first TKR. The inability to fall asleep easily, the strange stomach sensation, the anxiety. You received some great suggestions from, mendogal, above. I suggest you give them a try. Inexpensive options that hopefully bring relief. Also, as mentioned earlier in your thread, don't forget Magnesium as an option. I do agree with the call to your OS to fill them in on the ingrown toenail procedure. Better safe than sorry. I hope you have a peaceful weekend.
@socman

 

[socman]

Advice needed. I seem to be stuck at around 104-107 (knee bend) and 4-8 on flex. This has been the case for three weeks now. Should I expect things to get better? I am walking now without issues. Try my best to heel-to-toe when walking. Knee seems to swollen just a bit all the time...first knee was better. This knee...a little more problematic, but I want to use common sense when it comes to expectations and working out. I fear that pushing myself for advancement may, in fact, set me back!!!! Roger

 

[sistersinhim]

I fear that pushing myself for advancement may, in fact, set me back!!!! Roger

That is very possible. Pushing past where your knee is healed enough can increase inflammation, which increases pain and swelling. It's best to not have to recover from that and to just get on with your surgical healing.

It is not unusual to have plateaus during this recovery. I lot of it depends on the amount of swelling you have. A swollen knee is harder to bend cause the fluid is in the way and has nowhere to go. That's why we suggest lots of icing and elevating. The ice helps to cut back on the pain and inflammation and the elevation helps to flush out the fluid.

This second knee was probably more damaged than the first knee since it carried the load for a while. This is not unusual. I know my old knee raised Cain when I had the TKR and then broke the same ankle within a year. I was so afraid I was going to have to have lefty replaced, but it got better so I'm holding off as long as possible!

 

[mendogal]

Hi!
My second knee is also giving me more swelling than my first, plus some muscle issues I skipped on number 1....
For getting off a ROM plateau without forcing things.I have some thoughts...
I wonder if you've tried the trick of slowly, gently rocking on an exercise bike, set to no resistance, and if that's ok, doing some slow easy revolutions?
For trying to help my extension, without forcing things: I would sit on a firm flat surface with the leg extended to a comfortable degree and as relaxed possible... then simply hold above and below the knee with my hands, and gently shake my knee up and down. Not engaging the muscles, just letting gentle shaking help them to relax. No pain but the movement and relaxation definitely helped to increase the extention.
Just a couple of ideas! Gentle stretching isn't bad either!

 

[Jockette]

At only a month and a half post op you still have a lot of healing to do. My ROM continued to improve all through my second year, so don’t worry about it this early in recovery.

 

[MSuki]

The insomnia is beginning to take a toll on me. I get anxious at night going to bed because I know what is going to happen....uncomfortable, nervous stomach kicks in, total sleeplessness....up for a few hours then, if I am lucky, asleep in my recliner until the sun has risen. I have stated to not look forward to going to bed...for some reason I am getting a bit of anxiety this time around, but it clears up once I am up and active during the night. Do not like how it makes me feel.

I feel the same way. I tried to take a nap today but just stared at the ceiling awake. I hate to go to sleep because I know I will wake up in 3-4 hours in more pain from lying still. I am getting 5 1/2 hours sleep on a good day.

 

[socman]

I wish to thank all of you for the advise and encouragement. I have decided to keep working out with my home PT and seeing my therapist twice weekly. My workouts will be more stretching than for increasing strength. I think I am pretty good in that category. Again, thanks for the advice. By the way, I tried taking Tylenol PM and I think it had the reverse action on me....not again! Just have to tough it out for a few more weeks.

 

[socman]

Quick questions:

I have a narrow area from the top of the kneecap extending for about three inches...below the surgical scar. I noticed I have the same condition, albeit somewhat less pronounced, with my other knee (surgery was in January 2023). Is this normal knee/thigh muscle physiology, or could this be excessive scar tissue? ROM remains elusive with bent knee at 107 unassisted, and straight flex stuck around 4-6...depending upon the day. I am now in my second month of therapy.

Have a feeling that things are going to be stuck here and will just get better over time. Both knees remain painful during sitting squat exercises. Walking is pain-free with normal heel to toe full gait. Doing about 1/2 mile with no assistance from device at the beginning of week eight. Sleeping still limited to 1-3 hours per night. Knee can experience slight swelling.

Still have pain around outside of kneecap on the left knee that was repaired in January. I think its recovery was impacted by the right knee's painful situation which I had for nine months before it was repaired in October. I am thinking that it may be arthritis since my kneecap is still part of the original knee's structure, i.e., it was not replaced...just had the back "cleaned up".

Thanks for any insights and suggestions. Hope all are doing well, Roger

 

[sistersinhim]

I have a narrow area from the top of the kneecap extending for about three inches...below the surgical scar.

What is happening in this area? I wasn't understanding what you were trying to say.

Still have pain around outside of kneecap on the left knee that was repaired in January. I think its recovery was impacted by the right knee's painful situation which I had for nine months before it was repaired in October. I am thinking that it may be arthritis since my kneecap is still part of the original knee's structure, i.e., it was not replaced...just had the back "cleaned up".

Wasn't a kneecap button placed on your kneecap? It would be very unusual to replace the whole kneecap. I can't remember ever reading where one was during a TKR. As far as arthritis is concerned on the kneecap, that is a question for your doctor since we have no way of knowing that.

 

[Jamie]

With a knee replacement, you either get a patellar button or you don’t. As sistersinhim noted, kneecaps are not “replaced.” If there was no button placed, it’s possible that you could have arthritis under the patella. But, if it was observed and “cleaned up” during your surgery. that would be a bit unusual. Usually if arthritis is found in the patellar compartment, the button is placed. You need to ask your surgeon which was done in your case.

 

[mendogal]

May I respectfully ask why you're doing sit squats if they hurt your knee?
If it's just a little soreness in the quads or glutes that evening or the next day, that's one thing - an expected exercise response!
If it's actually hurting the knee while doing them, that's a clue to your stuck ROM: each time you (over)do it you're creating fresh swelling within the joint, restricting ROM.

 

[socman]

Doing sit squats because my therapists ask me to do them during our sessions. Getting up or lowering myself from a chair hurts while sitting or rising. Then, I am ok once up...or down. I am confused by all of this. My last knee had a much better time recovering...this knee has been stiff and swollen a bit every day. I have been faithful with my home therapy...the usual 12 exercises. Therapist ask me to continue therapy for another month...November-December which I was a bit surprised at. My ROM on Tuesday as 107 (bending) and 4 for flexing straight. Just a bit bummed by it all. Roger