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TKR The Journey on the Other Side Begins

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@Lusknewknees Just remember that each knee is different so don't compare, and be patient. TKR takes a long time to recover from. Elevate and Ice.
 
Hello, everyone! Post op day 1, captain's log 22 October 2014 Starship Arthroplast.
Had my first day of occupational then physical therapy. First round my BP was super low, PA attributed to probable dehydration from surgery. Took my walk ~ 70 feet round trip. BP a little better after that. Funny I normally take BP meds, but they withheld today. Got bend to ~60. Not very hungry. Weaning off IV meds and to 100% oral. Today was a little more challenging as rest of anesthesia wore off. But hope tomorrow is a better day. Trying to get some sleep. Last night was noisy around here and didn't sleep well. Probably will go home tmrw after climbing a few stairs. Appetite is "meh". But eating as much healthy food as I can. Pain is controlled.

Signed, Captain Kneemo. :)
 
Hi Lu @Lusknewknees

Great report and hopefully, the appetite will return and that you'll be home tomorrow.

Rest, elevate and ice are the 3 things to remember.

Take care,
Cathie :flwrysmile:
 
@Lusknewknees For some reason a lot of people experience lower BP after TKR. Hubby wasn't allowed his BP meds either. Eating is important, you need protein to heal. It seems to take a day or so to get the pain meds worked out. Sounds like you are doing good though!
 
@Lusknewknees, Hi Lu! I'm glad you're doing well! My LTKR was just four days before yours, and I'm home now. After surgery my normally low BP dropped even lower and stayed there for > 24 hrs. I guess it's pretty common but on rare occasion dangerous. In my case faster IV fluids, tip me upside down and time for the anesthesia to wear off. Taking extra deep breaths (or using Incentive Spirometer) seems to speed up the process.

I discovered I prefer frozen gels packs over the drippy ice machine. However you do your ice at home, like everyone says it really helps!

I'm in SoCal also. Simi Valley to be exact. When we're both recovered enough let's get together for lunch or an easy walk.

Diana
 
Good to hear you are heading home shortly. My BP was also low for 3 or 4 days and I normaally take a low dose BP med.
Look forward to your next post when you are home and comfortable!
 
Home from hospital, discharged after eventful day. Blood work showed need for new IV which they installed early morning. Also ended up having ultrasound to confirm no blood clots after pain felt on rear of operated calf. Very stiff and sensitive back there. Ultrasound resulted in bakers cyst but not confirmed, so ok to discharge. Hospitalist sent me home with only 2 days worth of Norco (could be a few more days if I don't take full recommended dose). She changed original OS Rx for Percocet to Norco because it made me sick . When I figured this out, I emailed OS office to get this worked out. Hope I can have this resolved tomorrow- his office is 25 miles away. I can't drive so my hubs who is also my nurse will have to go down there.
 
@Josephine @Jamie @jeano @referee54 @ConnieJOS @tiredwife
Its 12:52 a.m.here in California. Awoken by a grumpy left knee-definitely surgical pain around incision site. Because of aforementioned issue with insufficient size of non refillable RX for Norco 5/325, I took my last dose at one pill instead of 2, hoping that would do the trick. When the upset knee awoke me, I took 1x650 extra strength tylenol. Seems to have taken off the edge. I had iced with cryocuff most of the evening until about time of Norco dose at 10:30. Turned off the ice man. Pain seems to be subsiding, but that was a literaland figurative wake up call. Any suggestions on what I can do differently? afraid to run out of narcotics altogether and relying solely on higher dosage tylenol if dr doesn't supplement my script over the weekend. I have 47 pills left. I also turned on the cryocuff just now and this plus tylenol seem to have taken the edge off. Any other suggestions? That was an "ouch" moment. I've only had a couple do those in 3 days time. Want to avoid. Still have pain on back of calf and cryocuff doesn't reach there. Should I ice or hear ther? Home health care/PT provider coming tomorrow afternoon. Will ask him as well
 
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@Lusknewknees i would definitely contact the dr to ask for a new prescription for the Norco. One 5/325 pill wouldn't do it for me. With 47 left, I hope you can get a new one before it runs much lower. It's very, very early on after your surgery, and the dr will surely understand the need for more medication. The OTC meds just don't help much this early on. The pain can get pretty intense! And keep the ice on it! It really does help. I've never had a machine, but I like to fill my ice packs with a water and rubbing alcohol solution. I wish I could remember the ratio but I'm thinking one part alcohol to three parts water. It stay firm but malleable so you can shape it to your knee easily. And you re freeze and reuse the same bag over and over.
 
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I weighed myself in hospital and also when I returned home. I was also weighed in the pre op preparation area before I was steeled into the OR. Scale in room and at home show I gained 16 lbs in 3 days and 2 nights! That makes me crazy! I diligently record all I eat , and reduced appetite due to meds, never got over ~ 1300 calories per day. What is causing this? I need to reduce weight, not gain! :what:
 
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@Lusknewknees - don't be concerned about that weight gain, you are definitely retaining fluids at this point as your body tries to heal, and you're in such an abnormal state with the myriad of drugs you've been subjected to. Also, constipation can add weight - coupled with bloating/swelling and it's a terrible mix.

I don't think it's physiologically possible to gain 16 lbs in 3 days! I guarantee once you get back to normal your weight will balance out.

I used to be crazy about tracking every bite, every bit of exercise and weighing in every day and I was amazed at the fluctuations I'd see. Even weighing in weekly, I'd get so angry when I had a killer week and would gain 3 lbs - but I always saw it come off (and then some) within a week or two if I just stayed the course.

I had a myomectomy a few years back to remove a huge fibroid, was in the hospital for 3 days and pumped full of drugs - ate almost nothing. Got home and stepped on the scale - bam! 10 lbs gained - I almost fainted!!
 
Hi @Lusknewknees - just popped on to say hello. Hope you have your medication sorted out for the weekend. I'm sure that your weight gain is fluid retention. It must be impossible to have put on so much in fat!!!! Remember - 'A pint of water weighs a pound and a quarter' :old:
 
@Lusknewknees that is awesome I have only had two episode of high pain on in the hospital and one today Keep up the good work you will be up and around before you know it
 
@Lusknewknees , to reiterate what others have said, no worries about weight gain. I lost 20# leading up to surgery. Now post-op my leg feels like it weighs a ton, therefore I refuse to weigh myself until it feels more normal.

If you want to ice the back of your knee/calf, just turn that cryo-cuff around, or put it sideways or whatever it takes. I use large frozen gel packs. I rotate them and place them wherever I want, including the back of my knee.

As for pain meds, my pharmacist had no problem accepting a telephone order from my surgeon. But my local pharmacy has known me very well for years. Indeed CA has some strict new rules on narcotic pain med refills because of all the abuse. I hope nobody has to make that long drive.

I was released from the hospital too late to reach my pharmacy (where percocet awaited) before it closed. So I, too, had to rely on extra-strength Tylenol until a.m. I wasn't thrilled but Tylenol got me through the night.

The first few days at home are rough, then everything starts getting better.
 
@Clipless @Lusknewknees Taking a prescription by phone for a Schedule 2 narcotic is a Federal offense. I'd be surprised if any pharmacy would do it no matter how well you know them. Hydrocodone (Norco) was a Schedule 3 up until October 6, so they could write scripts to include refills, but I don't think they could be called in even then. I missed getting two refills of 60 of them each because I let that date slip by, knowing I had another surgery coming. Made me sick! My husband told me, though, that Walgreens has a sign in their pharmacy that they can receive prescriptions electronically in such a form that is accepted as an original. I'm going to look into that further.
 
@ConnieJOS , thanks for that info. Still waiting to hear back from OS office. My guess is my husband will have to go pick up a written script. I think I have enough to last me until Monday, and I am seeing my primary care doctor to write me the proper prescription. I have some good news! I just got back from a 15 minute walk around my cul-de-sac, that was about 400 steps or approximately 1/10 of a mile. No pain, and I stepped up and down to walk over the entry-level in my house. Also stepped down onto the porch and from the porch onto the walkway. I'm a little tired now I'm going to take a nap with the CPM machine and ice taking care of business for me.
 
@Clipless @Lusknewknees -- @ConnieJOS is right on, any pharmacy that would accept it via phone would be in major trouble.

Also, I was at my OS's office the other day, and someone was trying to pick up a script for someone else in order to go to the pharmacy, and the front desk wouldn't give it to them because the patient hadn't "signed off" on anyone picking up their scripts. Apparently, they required written consent - which I fully intend to sign off to my husband before my surgery. Definitely call them and ask!!
 
@Lusknewknees :wowspring:That's wonderful! I'd be afraid to attempt that walk right now! I walked up and down the hall at the hospital, but haven't actually attempted to go outside for a walk this soon. Congratulations! And I'm a bit jealous of your CPM machine. I really enjoyed using it at the hospital, it was so soothing. But no one suggested or offered to help me get one for home.
 
@Lusknewknees after reading about you gaining wait I thought wow I probably have lost a lot as have not eaten much well to my surprise I gain 13 lbs from what????? Can not figure that out
 
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