TKR TeeDee's Knee, see?

[TeeDee]

Here I am, at this hour almost six days out from RTKR on January 5th. Observations...

There is NO feeling to equal the moment the Poop Fairy arrives, in my case yesterday, five days and a half days after the last visit. Oh, but the hours before were miserable. I've not given birth, but surely there's some shared experience in having waves of peristalsis/contractions ripple through ones' body, waiting for it to pass and praying with every fiber of ones' being to Get This Out Of Me.

The most invaluable advice people have offered was to buy a leg lifter. I practiced with it before surgery and from right after, it was very empowering to be able to haul my log leg here and there. The people at the hospital and nursing home were puzzled and delighted at the notion of a patient figuring out a thing that would make their lives easier. I was happy because it gave me a sense of control over my body which meant there were fewer opportunities of pcking my leg up and hurting it.

I had pretty light anesthesia during the op, but it didn't matter up to the point when I started feeling the internal stitches being sewn (pinchy) and the staples being put in.

There were as people warn those feelings right after of "This isn't at all what I prepared for," but it is what it is.

On a CPM machine now which is soothing until the part when it straightens.

 

[Pumpkin]

to the other side!
I agree the arrival of the poop fairy is a milestone in recovery for a lot of us, oh what a relief.
Sounds like you are doing well, and are on your way to recovery.
Here is the post op reading for you, keep us posted on how you are doing.

First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM

 

[TexasTee]

Congrats!! Welcome to the other side, I'll be there ASAP Sounds like everything is going well...good to hear. Are you home or in rehab?

 

[metalheart]

Having just been visited by the Poop Fairy, I know what you mean. Prune juice and some bran cereal helped, but there was some serious painful gas that preceded the event. Constipation was one of my anxieties for after surgery and it was a figurative and literal relief to have that first bowel movement. Whewww!

I don't have a leg lifter, but I use a thin towel placed under my calf to lift the leg and it seems to work well.

 

[TeeDee]

Congrats!! Welcome to the other side, I'll be there ASAP Sounds like everything is going well...good to hear. Are you home or in rehab?

@TexasTee , I'm supposed to be in rehab, but in the real world it seems mostly to consist of bathroom visits in the wheelchair and a lot of leg elevating in bed. This is pretty cool and relaxing, I'll say that. I had a PT/OT evaluation the other day which was fun when standing me up made one of the staples bleed and there was a brief meeting about the need to get someone to clean the two drops of blood from the floor. Think that was Thursday, no, Wednesday. Thursday was just arm work in the therapy room, that machine like a bike pedaller but for arms, and the one like at gyms where one grabs handles and pulls forward against weights. Friday rehab finally got me using a walker for a little while. Walked a few steps, got tired, rested, walked a few more steps, done.

The remarkable aspect to all this is that to this moment not one person has hinted at ROM or extension. The only time they've been mentioned is in the setting for the CPM, where today I'm at 80 degrees. Otherwise this nursing home (it's very much that, with rehab as a feature but not its purpose) only sees rehab as "Are you gaining function? Can you do stuff for yourself? Here's a good way to be strong and capable."

 

[referee54]

Welcome to the "Other Side"!! I appreciate your humor and your candor!

We certainly appreciate your reports and look forward to continued reports about your improvement and recovery.

 

[TeeDee]

Observations...

If you have long hair to manage, bring plenty of whatever you use to manage it. I like to keep my hair in a ponytail and twice, with no rubber bands in the immediate vicinity, the nurses have had to improvise by tearing off the rubber cuff of their gloves and using that.

I've had no painkillers, specifically my new best friend Percocet, for two days and I don't mind at all. The knee throbs for a second or two every so often but nothing about it bothers me. Am I freaky? My family has always had a genetic lineage of pain tolerance.

Nursing homes sure do have a fair bit of drama. I'm loving the cast of characters we have here, especially when we can bond over episodes of HOARDING: BURIED ALIVE. I might be getting better treatment because of it!

 

[referee54]

The remarkable aspect to all this is that to this moment not one person has hinted at ROM or extension. The only time they've been mentioned is in the setting for the CPM, where today I'm at 80 degrees. Otherwise this nursing home (it's very much that, with rehab as a feature but not its purpose) only sees rehab as "Are you gaining function? Can you do stuff for yourself? Here's a good way to be strong and capable."

That is great!! It seems like you have found a tremendous facility with equally incredible PT's and support staff.

 

[TexasTee]

Interesting about the lack of PT - but the real problem is taking care of yourself so you might have picked the perfect spot to rest up. LOL on the improvised ponytail holders! I have pretty long hair - just about to my waist so my plan is to do a loosish french braid the morning of and just leave it in there until I'm home but that is 1-3 days so not the same as a week or so. When will you go home?

Great to hear that you're already off the heavy stuff and feeling fine, I super duper hope that's my reality also. I just hate the way they make me feel but if I need it, I'll take it, never fear.

 

[TeeDee]

Interesting about the lack of PT - but the real problem is taking care of yourself so you might have picked the perfect spot to rest up. LOL on the improvised ponytail holders! I have pretty long hair - just about to my waist so my plan is to do a loosish french braid the morning of and just leave it in there until I'm home but that is 1-3 days so not the same as a week or so. When will you go home?

Great to hear that you're already off the heavy stuff and feeling fine, I super duper hope that's my reality also. I just hate the way they make me feel but if I need it, I'll take it, never fear.

French braid, that sounds like a really good idea. I'm probably in here through next week but don't know. Initial expectation was I'd be here maybe three weeks, but the staff all seem to think I'm doing well enough that I should be out much sooner. I tend to figure that PT/OT will ramp up this week (if staff can get in by wrangling the nasty weather that brings NYC mass transit to a crawl or halt). If I get a bunch of advances in and can get to some semblance of walking, handle the toilet, put on my sleep shorts, train to step down and up the one short step from street level to building lobby at home, get the staples out, people will say, "Go on, get outta here, you don't need us."

So grateful percoset did nothing but make my pain disappear and dreams interesting. The PCA and whatever they had in it in the hospital, I don't even know what effect it had. I'd press the button but really feel no different afterwards.

 

[kneeper]

Good to hear you're having good pain control.

Yes, I'd bet you can get out earlier than 3 weeks if you can get around ok. Do you have any friends or relatives who can help out with fixing a meal here and there or help out with household chores when you get home?
I went straight home, but did have my sister with me for the first few days to fetch and carry and bring me pain meds etc.
I'm interested in what you said about the cpm setting. Do they let you control it or set it for you? I found it worked best to start fairly low for the first few minutes and then work my way up gradually seeing how much I could tolerate--maybe a little bit more each day or two.

 

[TeeDee]

Good to hear you're having good pain control.

Yes, I'd bet you can get out earlier than 3 weeks if you can get around ok. Do you have any friends or relatives who can help out with fixing a meal here and there or help out with household chores when you get home?
I went straight home, but did have my sister with me for the first few days to fetch and carry and bring me pain meds etc.
I'm interested in what you said about the cpm setting. Do they let you control it or set it for you? I found it worked best to start fairly low for the first few minutes and then work my way up gradually seeing how much I could tolerate--maybe a little bit more each day or two.

The meal situation is typical for two people (me and Significant Other) who never were taught culinary skills of any kind except what we invented for ourselves. I do cook burgers and grilled cheese and various turkey-chickeney stuff involving rice, but for the duration food is mostly going to be things that can be microwaved in 90 seconds or four minutes, lunchables, protein bars and drinks, and that eternal staple of Big Apple life, having Chinese/Pizza/omelettes/breakfast bagels delivered.

The SO has practiced and successfully completed three loads of laundry and we're optimistic he won't puke when the litter box needs to be cleaned for our sole cat, so that's a significant portion of chore coverage he'll deal with until I resume.

The CPM setting was intriguing
Pretty much they evaluated my bend, waffled at starting at 70 or 75. I told them let's try 75, they did for a couple of days, moved me to 80 today, will probably stay there another day or two. It is some kind of tri-level process the CPM is set for, it bends to something less than the target, rests for a second or two at that degree, lowers down to a low degree that isn't zero, comes back up to max it's set for, lowers to zero, starts over. I don't control any actual mechanics, just through force of cheeriness let them know what I'm up for. There's a handset the technician uses to set it up.

 

[Legin]

I chortled thru your post me thinks SO is going to need to help you just a tad more. So the.sole cat I'm sure is.getting looked after so should you be. Good for you on the bends omg sounds.like an.old deep sea diving movie

Legin THR Sep 14

 

[TeeDee]

Observations...

A brief aside and hat tip to goon friend @Legin , who makes me feel like the forum has Neddy Seagoon among us. Ying tong iddle i po.

Knee feels pretty good all things considered. I think I felt some of those small zappy sensations as I was waking up a little bit ago, right in the area of the kneecap or near it. It wasn't bad. Thinking of them as nerves firing up make them tolerable and it was for just a few seconds.

Quad may be waking up! That's what's happening when you can lift your leg straight up off the bed? It's really hard to do and when I do it I can feel the clunkiness of the knee hardware in there, but it also makes my leg feel more under my control.

Trying to do heel slides but the knee feels so constrained due to that tight band feeling, which I don't know is because of the staples or because of general lack of bend.

Hey, I'm going to be able to sleep on my side! I experimented a little bit with the position last night and it felt GREAT. Not a big fan of sleeping on my back, although this bed with the customized head and foot positioning makes that less of a problem.

 

[Legin]

Glad to see you know the goons. Tho a tad before my time but still.loved them.but Tommy Cooper was the genius now there was a funny man. Toodles

Legin THR Sep 14

 

[kneeper]

Trying to do heel slides but the knee feels so constrained due to that tight band feeling, which I don't know is because of the staples or because of general lack of bend.

Probably some of each, but mostly post surgical swelling. Are you getting cold packs or an ice machine to use?

 

[TeeDee]

Probably some of each, but mostly post surgical swelling. Are you getting cold packs or an ice machine to use?

Cold packs. This facility loves its CPM but mechanical cold water circulators are beyond its imagination.

 

[treypops]

@kneeper @TeeDee

that was my MO on my cpm machine.....increase the rom every 30 mins or so as long as I could tolerate it. It's amazing how fast things loosen up and your rom increases when you do it that way. Ive been in my cpm at 120 but unfortunately, that's as high as it goes.

 

[TeeDee]

@kneeper @TeeDee

that was my MO on my cpm machine.....increase the rom every 30 mins or so as long as I could tolerate it. It's amazing how fast things loosen up and your rom increases when you do it that way. Ive been in my cpm at 120 but unfortunately, that's as high as it goes.

That's the funny thing. I've got a fat belly and fat thighs so even if they want to up the CPM much more, my knee isn't going to be what prevents it, my lovely lady lumps will.

 

[TeeDee]

Update dear friends...

Thirteen days after the operation. I no longer use the leg lifter. All leg muscles are fully awake and just need strength and flexibility. I no longer use the toilet riser. I can sit on an ordinary chair, in fact so long as I can put my foot flat on the floor everything feels really good. I've probably taken only ten percoset pills since I came to the nursing home eleven days ago.

I can walk unassisted for a few steps here and there, but I think my mind is carrying the old ways of arthritic hunching over and hobbling when it's no longer physically necessary. I'm sure if I can convince my instincts to stand up straight and balance my whole body evenly over my legs, I'd be able to walk further, so gotta work on that. As it is, today I walked around the therapy room with a cane for the first time, and got up and down the four-stair-step thing quite comfortably. I feel ready to go home if only someone would find it suitable to take these staples out and set a discharge date!