TKR Susie-Q's 2nd TKR Recovery Thread

[Susie-Q]

Well, here I am on the other side of it. Finally got home around 7ish (pm). Doing fine so far after a couple of bumps in the road. The spinal took longer to wear off (they say 30 min to 2 hours, I was at least two hours) then the nerve catheter must have shifted after they put it in because it wasn’t giving me the pain control I needed and when the spinal wore off I was in agony. So they changed it out and things got much better. I’m home now, icing and elevating and everyone is waiting on me. I know this is the honeymoon period as my knee and leg are fairly numb. This will wear off in a day or two and then the real fun will begin. Alternating Tylenol and Advil every 3 hours and taking an oxy every 4.

Another thing that was different this time is when I walked around the recovery area with PT, went to the bathroom and tried their stairs, I ended up having shortness of breath and had to sit down. I literally could not take a deep breath. The same thing happened when I got home, got out of the car, did the 3 steps up from my garage and then back to the bedroom, which is the furthest room from the garage. Has anyone else experienced this?

I've already taken one stool softener, had a prune juice/Miralax cocktail and am eating oatmeal with fresh blackberries. Trying to get ahead of the inevitable constipation.

I'm icing and elevating in bed.

 

[Rain Dancer]

Glad your surgery is over! I occasionally had shortness of breath and attributed it to all of the drugs that they used during surgery and blood loss. It's no longer a concern. If you shower in the next several days, I recommend that you keep the water on the cooler side because hot water can aggravate the shortness of breath. Best wishes!

 

[Jaycey]

@Susie-Q Welcome to the other side. Please move around very carefully. This breathlessness is concerning. You don't want to risk a fall!

I'll leave your recovery guidelines here for you:
Knee Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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. At week 4 and after you should follow this Activity progression for TKRs

6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[Susie-Q]

Shortness of breath is gone. It helps that I have a rambler house and don't have to do stairs. I'm walking every 1-2 hours to the bathroom. Spending some time on the reclining couch right now icing and elevating.

The night went well. I slept in short burst in between doses of medication. Right now I'm only taking 1 oxy every 4 hours and alternating Tylenol and Advil every 3 hours. I got a call from anesthesia to ask how I was doing and she mentioned that one of the blocks will wear off tonight so I might be upping that oxy to 2 at a time. I'm really not in much pain at all, other than the normal pain when walking, lifting my leg and doing my stretching. This is mostly discomfort, not actual pain, and I remember it from the last time. Hubby is very helpful, he even did a med chart for for me on Exel to keep track of my meds. I know this is probably the honeymoon period and that things will most likely change tonight but hopefully not too much. I've got pudding and apple sauce squeezes to use when I take my meds during the night.

My daughter is doing all the animal duty (we have one dog and two cats) and she will be taking our dog to work all this week (she works at a vet clinic) Her cat is exercising her nursing skills by trying to climb on me but I'm not letting her. She will sit by me and let me pet her, which is nice and comforting. If she gets too bad we will kick her out of our bedroom.

 

[CricketHip]

You are sounding good! You are right to keep an eye out for that nerve block wearing off.. it's a bear to play catch up with pain.
But you sound like you've got a good grip on your recovery, It's great when you can start out feeling minimal pain and or upsets..

 

[Susie-Q]

Well, either something is wearing off or my body really knows when I'm a little late on my oxy (15 min). Hubby was trying to make it easier for me by saying I should slide my oxy an hour earlier to line up with my 9am and 9pm pills of the day but I realized that made extra pill times during the wee hours of the morning so I said I should switch back. Who cares if I need to take pills at 9am/pm and then the oxy at 10am/pm, I'm awake. I don't need an extra pill time at 5am and then 6am. Boy that lag of 15-30 minutes to try and get back to a 2pm oxy and I could feel it!

Back in the bedroom icing and elevating. Maybe I'll even take a nap

 

[CricketHip]

napping is good! especially topped with ice and pain meds.

 

[Susie-Q]

Yes! My ice machine is humming away and I took my oxy about an hour and 20 min ago, Tylenol 10 min ago.

 

[Susie-Q]

Ok, massive quad pain has started, I'm sure due to the tourniquet. I can't lift my leg much at all without severe pain. How long does this last? I did one set of exercises this morning, there ain't no way I'm going to be able to do any more today. My PT was changing underwear and pj bottoms with a little help from hubby a few min ago.

Also, has anyone else had numbness in their index fingers? I've had it off and on all day. They said to be concerned if I have numbness in my lips due to the nerve catheter but I haven't had any of that. Pain meds are due in 14 minutes.

 

[Jockette]

It’s very common to have trouble lifting your leg for a while. Mine lasted a couple of weeks. Don't worry, it will come back.

Don’t worry about doing all the exercises this early in recovery, changing into your PJs was PT enough. It’s considered an ADL (Activity of daily living) Gentle movements and short walks are all you need right now.

 

[Susie-Q]

Thanks, Jockette. Yep, I agree. No more exercises for me until this quad feels better.

I'm also wondering if I should take my oxy every 3 hours like it says in my discharge paperwork? My prescription said every 4 hours. I will run out quicker but supposedly I'm able to get refills.

 

[Susie-Q]

Well, the honeymoon period is definitely over. I'm in a LOT of pain. I upped my oxy to 2 at a time. It's funny, the post-op instructions say to take 1-2 oxy every 3 hours but the prescription said 1 oxy every 4 hours. That is definitely not enough and 2 barely is as well. I'm having pain of at least a 7 walking to the bathroom and 5, 6 or 7 just moving my leg. I'm going to call my doc today and ask about it. The other funny thing is the doc said he was going to text my husband on Monday night so then we would have his personal cell phone number in case we needed anything. Well, he never did.

I'm doing ankle pumps, icing and elevating all the time. I can't really do any other exercises at the moment, which is fine by me.

I managed (barely and with a ton of effort) to pass one tiny poop last night but I think today I'm going to try and brown cow drink that was recommended on here. It was like trying to pass cement. Yesterday I had miralax with prune juice, 3 fresh prunes off our tree and 3-4 Sunsweet prunes plus a stool softener. Not sleeping much, just a couple of hours here and there before my pain wakes me up.

 

[Susie-Q]

Another question...... I've been using those apple sauce squeeze packs when taking my pills in the middle of the night to have something in my stomach. I'm remembering when my kids were little the BRAT diet, Bananas, Rice Apple sauce and Toast. Wasn't this given to help firm things up when a person has diarrhea? If that's the case, I need to switch to something else as this isn't helping me "get things moving". Opinions?

Just talked to the PA. He'd like me to up my Advil to 3 at a time (12 per day) first to see if that helps but he also said I can take 2 oxy every 3 hours or 3 every 4 hours.

Hubby agrees to quit the exercises for now until the med schedule gets worked out. I'm doing ankle pumps and walking to the bathroom every 1-2 hours, that's enough. The PA thinks I'm just supposed to do them and work through the pain.

 

[Gingerbread]

Yes, the BRAT diet is for an upset stomach. It really won't help you evacuate your bowels efficiently. If anything, it helps regulate them when they are too loose.
The first 2 weeks I had to incorporate Miralax into my routine for a few days (along with Colace, which was prescribed right out of the hospital). That, coupled with prunes, got things rolling
Good luck, and hope you stay on top of the pain with your pain med schedule!

 

[MerlinWizard]

Sounds like you are doing pretty good!

The pain sucks but it's relative as I am sure you know. That quad pain was a shock to me, I didn't even think about it going into surgery.

Fortunately for me, I don't have some of the digestive issues with medications many others do. I know when I was in the hospital for 3 days that I made sure I ate a lot of fruit and salads. Not too much meat or anything like that. I didn't empty at all until the 3rd day and it was very little but another few days everything was fine. They never gave me a stool softener and said if I needed it to call. I know with my wife, she has a horrible time getting going after surgery. We have a 55 gallon drum of Miralax somewhere. She hates prune juice but she did it. Grapes seem to work well for her side of the family.

I was not allowed to be on ibuprofen for the first 20 days as I was on a blood thinner. I really wish I could have been because I have found of all of the pain relievers, 800 MG of that did the trick for me. I still pop a tramadol now and then, maybe once or less a month when I do something stupid. It would seem you have the regimen down and now it's just a matter of time, patience and PT!

 

[Jockette]

I would have a couple of those prunes when you take your medication, instead of the applesauce.

 

[Susie-Q]

Thanks, Jockette! Duh..... I will do that next time. I took a second stool softener around noon after having another, very small, BM. My friend stopped by today with some Russell Stover sugar free candy with Malitol. I had a few gummy bears (a little over a serving) but I'm certainly not going to do anything crazy like eat the whole package. I haven't tried the Brown Cow yet but I've got that tucked away in the back of my mind if I need it. I want to move things along but not have to deal with explosive results. I also have Milk of Magnesia and Magnesium Citrate if things get desperate.

The daily routine, intestine-wise is: Miralax with a small can of prune juice once a day, 1-2 stool softener, and prunes, both fresh and Sunsweet. I will take a break from the apple sauce.

Pain seems to be much better too. Coming up on my oxy dose and alternating 3 Advil and 2 Tylenol every 3 hours. Oxy is every 3 hours now so that will make everything easier to remember. My hubby has changed my chart several times already, it's sweet of him to help me keep track.

Anyone else notice their lack of interest in watching shows on tv? I've got this long list to keep me busy but don't seem to have the brain power and attention span to watch anything yet.

 

[Susie-Q]

Day 4 (or is it 3?)

My nerve catheter is supposed to come out tomorrow, to those that have had one, did your nerve pain go way up after that was removed or will most of it have subsided by now? Thanks in advance. Worried my pain will go up again after I remove it.

 

[Susie-Q]

Feeling pretty good today. I did some extra walking around the house with the walker, I think it will help with the #2 issue. I took some Milk of Magnesia about 2.5 hrs ago, hoping it will get things moving. I even did a few exercises and gentle stretches. Someone on here mentioned dangling their leg from a bar stool and just letting gravity give it a gentle stretch. That felt good.

 

[patriciad]

@Susie-Q ”I managed (barely and with a ton of effort) to pass one tiny poop last night but I think today I'm going to try and brown cow drink that was recommended on here. It was like trying to pass cement. Yesterday I had miralax with prune juice, 3 fresh prunes off our tree and 3-4 Sunsweet prunes plus a stool softener. Not sleeping much, just a couple of hours here and there before my pain wakes me up.”

So this time around my constipation was the worst and I totally relate to that cement quote. So painful. I didn’t have a lot of luck except with Milk of Magnesia plus Miralax together! A friend recommended a herbal tea which I rolled my eyes at but purchased. You would not believe how brilliant it is. It works wonderfully without cramping or urgency and stops those rocks from forming. Its actually pleasant tasting and I did 2 cups a day in the morning and at night when still taking the stronger pain killers. I am still drinking it every other day as my diet is not back to normal. There are a couple of flavors but I like the mild mint taste of this one. Its in the tea section of most supermarkets so easy to find. Give it a go