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TKR Tabbycat's Recovery<

Hi everyone,
Well it's certainly been a roller coaster so far. I got through the actual surgery really well considering how anxious I was. The patient liaison nurse came into the anaesthetic room with me and said positive healing statements to me like 'you are going into a cosy and comfortable sleep', ' you are in good hands and your surgery will go really well', 'you are safe' and ' you will wake up feeling comfortable', you get the idea. I think it helped as I did wake up feeling ok, not nauseous or dizzy (that was to come later). I had the GA I wanted with a femoral nerve block, which was done after I was 'out' and was happy with this combination. I had little pain for quite a while, had no catheter, but did have feeling in my bladder so knew when I needed a bedpan which was often. One nurse said I was 'weeing for Wales'. I didn't mind the bedpan. Problems started when the nerve block wore off. Seems I cannot tolerate anything morphine based which is everything basically. I was nauseous and vomited a lot even with anti sickness meds. Nobody elevated my leg and the Cryo cuff was in the cupboard until I asked for ice. To be honest I was not that impressed with it, it didn't seem to stay cold for long. My other problem was complete lack of sleep, the room was stuffy even with the window open, I cannot sleep with any light on and the first night the oxygen thingy made a noise like Niagara Falls! By Sunday night they put me on a double dose of zoplicone and I did get some sleep. However any exertion at all, even just sitting up in bed caused vomiting which wore me out even more. My surgeon was great, popping in every day to check on me, and even took photos of my x-rays on my iPad. Nurses were excellent too. I was in hospital five days. I was discharged with paracetamol, codeine phosphate (which I have given up on due to the nausea) and metaclopramide (for sickness, but only for five days), so am basically trying to do this on paracetamol alone which does not give enough pain relief. After another poor nights sleep today has been one of the worst of my life, pain and vomiting and then dizziness as well. I am elevating and using ice packs for about two hours at a time throughout the day and night until I can't stand the weight or the ache in my joint from the cold. I could do with some words of encouragement at this point that this will get better :bored:
Love from a tired out Tabbycat xxxx:mcoffee:
 
Oh my-I am sooooo sorry you are having such a rough time of it. I don't really know what will help-but I do know I am in the same boat pain med-wise and am seriously stressing about how we will handle it this time. Morphine, codeine, etc, are on my very long list of meds that are not allowed, so I fully understand your frustration. I wish I could recommend something that worked with me, but the only thing that helps me is to go back to IV pain meds and get the medicines totally out of my digestive system. Even then the only thing that sort-of works is Dilaudid. My OS mentioned a new medicine he wants to try this time and I agreed as long as we try it in the safety of the hospital. I'm praying this one works. I will keep you in my thoughts and prayers, and really hope you can find a way to lower your pain while not vomiting, and that things get better for you. I do know that it will get better with time, but I am hoping you can find a way to get to that time without all this pain and sickness. Keep us posted, please.
 
Oh Tabbycat sorry that your feeling bad, the 1st 2 weeks are the worst. Hang in there it will get better, what about some sleeping pills will your doctor give you some just to get you through this tough bit. Your in my thoughts xx

LTKR 11 May 2016
 
Oh, @Tabbycat! My heart goes out to you! Your journey with the narcotics mimics mine first TKR. Truly, there is nothing more miserable. I'm so sad you are having to deal with so much pain. It was the main reason I totally dreaded my second TKR. Miraculously, we tried just one more narcotic and it was tolerated. It was narcotic #5, and no one expected it to be any different than the others, but it was.

You say you didn't like the ice machine. Did you come home with it, though, to give it another try? It was my ONLY saving grace with TKR #1 and this one, too. I wonder if you should give it another try. Perhaps your bandages at the first were too thick for the coolness to reach your knee? We don't use ice and water, but instead freeze water bottles and surround them with ice and cold water. It's VERY cold and we get 4-6 hours out of the bottles before they've defrosted. Then we just switch them out with an extra set of frozen bottles while the first set freezes again. We even have a third set for nighttime that we keep in a cooler by the bed so we don't even have to take a trip to the kitchen.

The ice machine made me so cold to the core that I kept a heating pad on my torso, under my shirt. Just on low, but I found it very soothing. I like to be warm - I'm very cold blooded, so even if not chilled this might bring you some comfort.

Not to hammer the point home, but are you elevating enough? "Toes above nose' is so much more effective than 'just' elevating. I know you are smart and have read here -just trying to see if there's a missing piece that will provide you more relief.

I'll be thinking of you over the coming days. It's just not right to have to suffer.
 
It has to be so much harder with basically no pain control. Did they try everything? I didn't think everything was morphine based? The only one that ever bothered me was Percocet which I was given after c-section so I took nothing. But at least it does get better, every day is one closer to much less pain. First couple weeks are the worst. But getting sick and not eating must make you weak and dizzy so hope that resolves.

I can't handle too long with ice either but I use two cold packs from the freezer in a holder that straps on (hospital gave it to me) and let them thaw just a bit first - much better!


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I am so sorry. My TKR is nicknamed Ralph because my daughter said that was all I did in the hospital was "ralph"! I had forgotten the kids called vomiting ralphing. I took MS Contin and Zofran. I still was so nauseous. My pharmacist gave me the hint of always having some protein when I took the pain meds. Protein stays in the stomach longer and you never want to take your pain meds on an empty stomach. Sometimes all I could manage was 8 almonds (and yes, I counted them out and made myself eat them) or 1/4 of a peanut butter sandwich. I had hot tea and dry toast. It is miserable and I am so sorry you are unable to find something to help with the pain. Could you try a smaller dose? And yes, it will get better. Sleep all you can, elevate, and ice. You are just going to have to "gut" your way through these first days and realize that every day you have gotten through is one less you have to live through.
 
I'm sim sorry hat you are going through so much pain. That was me the first time around. Any type of anaesthesia caused me to have nausea for days afterwards. Did the try any other anti nausea meds like Zofran or scopolamine patches. The aesthesthetist used the patch for me while in the hospital. I also use it for motion sickness. It might work for you too since you say any movement makes you feel worse. It's worth the try.
 
It breaks my heart to read your post, Tabbycat! I don't have much to contribute as far as pain meds, but I wanted to let you know that I'm currently checking into an icing machine that's called "Game Ready". It provides icing and compression both. My insurance company won't pay for it, but I'm starting to think it would be worth paying the rental fee myself, if necessary. Even if this brand isn't available in Wales, I don't think it's the only brand that combines icing and compression. My niece has had multiple joint surgeries, and swears by this.

Actually your biggest battle is probably what's going on in your head. When you're miserable and scared and tired and painful, it really takes a lot to have that talk with yourself about getting through this. Regardless of how you feel, try to focus as much as you can on the final outcome. It's time like this that people find out they are stronger than they ever imagined. Know that you can and will get through this! And try to feel yourself surrounded by love.

Sending a gentle virtual hug!
Sara
 
Thank you to everyone for the kind thoughts and helpful suggestions. Yesterday was a very 'dark day' for me but thankfully today I feel a bit better. I was on lots of meds in the hospital at different times, including paracetamol, codeine phosphate, Tramadol, Oramorph, Buccastem, Cyclizine, Ondansetron (Zofran), Piriton, omeprazole and Fragmin injections, ( as well as the general anasthetic and whatever antibotics I got) I think the opioids have been the main problem, and I read that morphine can result in severe hypotension especially after depleted blood volume or with certain anaesthetics, and although my other obs were always ok my blood pressure stayed very low. I'm now getting all these drugs out of my system and am just on Cocodamol, it doesn't give good pain relief but has a lot less codeine, and I feel less sick.

@charmed-life
I am using ice packs as you suggested, frequently but not for so long, and it is working well so far - thank you.

@GimpyGal
The Cryo Cuff only went on after the initial big bandage came off, but at home I am using ice packs wrapped in a tea towel to take the edge off the extreme cold. I think I am very much like you with pain meds and liking warmth! Also, thanks for the advice about elevation, I was not doing it as well as I could have, but I've now put a pillow on top of my wedge cushion and with the recliner right back am able to get my toes up above my nose.
This is all such a learning curve!

@newlybionic
I did have Ondansetron (Zofran) in hospital, but it was not successful enough for me to keep on with the codeine. At home I use Stugeron for travel sickness and think this is probably as good as anything if I feel queasy. I also fished out a bottle of smelling salts, old fashioned I know, but quite helpful if you feel sick :sick:

@Timetolive
It's funny you call your TKR Ralph, my husband bought me a gorgeous soft toy rabbit for Easter and his name's Ralph. He will be a reminder of what I went through (and achieved)!

@Happydale
Encouragement from caring people like you makes all the difference, I do feel and appreciate the loving wishes from across the pond and send hugs back:console2:!

Feeling tired now, time for a nap :sleep:
Love, Tabbs xxxx
 
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I'm glad you are feeling better today. You certainly were on a lot of meds while you were in the hospital! Take your naps whenever they come. Feel better.
 
@Tabbycat, I was awake a good portion of the night - just couldn't get comfortable, nothing serious - and you were certainly on my mind. As much as you needed to try all those meds, I can't help but think you'll feel better (except for the pain levels) with them out of your system. I have such a love/hate relationship with narcotics.

I'm glad you've found an icing solution that works for you. I have the same exact set up - a wedge pillow topped with a bed pillow lengthwise and then I hunker down low. I long for the day when I can sleep in a different position!

Hang in there. It's a long recovery, but each day should be just a little easier.
 
@Tabbycat so sorry to hear you're having such trouble with nausea and pain control, though it seems you're feeling a bit better as the other meds leave your system.

I remember you found some affirmation things to help keep you calm pre op, I wonder if you can find something similar for healing and/or pain control. I know there are hypnosis techniques for pain control (I even saw a video once which was a C-section with hypnosis as sole anesthesia), so maybe someone has created something for pain control for self-hypnosis.
 
You might also try downloading Vibrational Sound Healing by Dr. Andrew Weil. It's very soothing, and makes you feel like you're in a relaxing spa. Take yourself on a little vacation in your mind.
 
Thanks Sara, I'll have a look at that too, I've come across Dr Andrew Weil's work before.
 
I'm so glad you're feeling some better Tabbycat. You really had a rough go of it for a while. I think all these suggestions have been helpful and you're bound to find a couple that help ease these trying days for you. You are in my prayers for a speedy and pain-controlled recovery! God bless you!
 
Tabbycat said:
I have some exercises to do at home: ankle pumps when lying or sitting, heel slides and straight leg raises. Heel slides are hard because of the pain and swelling, and I can't do a straight leg raise for the life of me, it just won't move. I can go up and down a flight of 11 stairs no problem using my crutch and taking my time. I go back to the hospital Thursday to have the staples removed then physio, goodness knows what they will say. But my knee was quite swollen for seven and a half months before the op and the surgeon said there was even more damage than on the x rays, also a lot of chronic inflammation. This knee has been through a lot, it will need time to heal.
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@Tabbycat
I've copied your post above from the pre-op April rainbows thread, so I can talk to you about it.

It's very early days since your surgery, so don't worry if you can't do much yet. It's quite normal to not be able to do straight leg raises for a couple of weeks, so don't worry about that. I think it took me about 12 days before i could do them.

Heel slides done in bed are hard to do, as well. I found it was easier to do them sitting in a chair. As the pain decreases and the swelling goes down, they will come easier. Heel slides and just walking around the house a little are really all the PT you will need to do. Heel slides and how to do them

At the moment, your most important job is to rest, elevate, ice and take your pain meds by the clock.

It doesn't matter what the physio says. She/he works for you and has to please you, not the other way round.
Your knee is your own and you are the only one who can decide what will happen to it. Just remind the therapist that your knee was in bad shape before your surgery and to make allowances for that and treat it gently. Above all, don't let them try to force the bend.
 
@Tabbycat you and I have problems with the rules of the forum.:capn::capn: But I appreciate BoneSmart. I have a recovery thread now. I am taking Just Loratab and tylenol since day 2 and it works good with me. I had some Dilaudid in the hospital and it was just too much for my body to handle. My blood pressure went way down and my blood sugar went up! Loved the epidural -had it for 48 hours :yahoo:
 
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