PKR The Knee Replacement Train Rehab Station

[glazed151]

Sorry I haven't been posting any updates. Seems like it's just one thing after another.
Day 10 and I am still in the hospital. I have been moved into the rehab unit. I have been doing PT/OT and CPM 2 x a day. My pain has been pretty decent since the adjustments to my meds...except for my quads, which have been spasming quite badly. I am still unable to do any straight leg lifts ,which to their credit all of my therapists say is not a major issue - they will wake up when ready...but the spasms have been quite bad and once again today I felt the need to say "Valium is obviously not working, so let's try something else." Tonight they gave me Flexril, which I have taken in the past when I was injured at work. I seemed to have no problem then turning into the proverbial puddle of jello, but tonight I feel nothing. The Flexril was given 3 hours ago so the Dr just gave me my normal dose of valium. Of course, I am taking my normal "cocktail" of Lyrica and Delsymn as well.
You'd think I'd be a zombie for crying out loud....but yup I'm the one who's 2 nerve blocks wore off in under 15 hours lol!
Every Dr I speak to says my body is just metabolizing meds at an incredible speed.
Right now I've got a hot blanket on my leg and that seems to help but for what ever stupid rules they don't allow the use of heating pads. Hook me up to electric ice packs but god forbid it's soothing heat! Grrrr.
I'm so ready to go home.
Every one of my nurses has been excellent and perhaps the major reason I've not gone insane yet.
Saturday I will go home with a walker and my crutches. They are mainly concerned that the quads are not firing fully and I've got nearly 30 stairs between my getting out of my car and into my bedroom! I'm great on stairs so I'm not to concerned but I'll humor them and take the walker. The staples (all 17 of them) came out yesterday, with only one or 2 pinching a bit. Incision looks great no pain at all. I will begin PT a day or 2 after I get home and will be striving towards the 3 week mark when I can hit my local Y for time in their therapy pool and hot tub. This excites me very much!
Anyway....I'm still alive and kicking but I honestly was hesitate to post my ongoing battle as it might scare those waiting for surgery. I'm apparently one of the 3% of the population that nerve blocks do not work on...so everyone else...you're in the clear lol!
If nothing else this whole situation has opened up a good dialog up between myself, my dr & nurses about how my left knee surgery needs to be thought out before hand.
Ok...enough for now....

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[Pumpkin]

Good to hear from you! My femoral n block did not work either. Hope the leg spasms are under control soon.

 

[Jamie]

Don't ever worry about posting. One thing we want to do here on BoneSmart is present a variety of recoveries.....both the good and the more challenging. It's this honest dialogue that makes BoneSmart what it is! So, post away.....we're always here to chat with you and answer any questions you may have.

 

[kneeper]

Getting those staples out is one of those early exciting milestones. Hope those pesky spasms settle down soon.

 

[jeano]

Yes, please do keep posting. It's helpful as well for folks to understand that a PKR can mean 10+ days in the hospital OR it can mean less than a day--folks really have no grasp of how unique each surgery and each recovery is.

Every post made here can help somebody. I just want to tear my hair out when I read stuff like my discharge instructions that said something ridiculous like keep your knee elevated (without specifying how) and use ice for 10 minutes twice a day for 2 days...If hadnt known better from reading BoneSmart and FOLLOWED those instructions I might have been wondering why I had a knee as big as a basketball.

 

[Celle]

When I was discharged from hospital, I was given a small pamphlet of easy exercises to do - just the ones I had been shown. My discharge nurse told me "Keep your leg up and you can ice it from time to time." That was it! Thanks to BoneSmart, I knew exactly what to do.

 

[Josephine]

That was about all I had too! Not the most intensive of instructional sessions!
But thanks to BoneSmart, I was also ahead of the game!

 

[Celle]

That, and a little inside knowledge, I believe!

 

[glazed151]

Holy cow! Yippee yahoo, I am home!! 12 days in the hospital was more than I bargained for but was obviously needed. So...where am I at physically? Pain is quite tolerable, and I am getting around well with my crutches.

My ROM is 90% or so. My biggest hurdle is the lack of sensation and control of my quads. I am able to lift my leg when standing, but completely unable to do any straight leg lifts when laying down. I can do heel slides well. Side slides and such also. It's just that upwards thing I can't do. I concentrate and will it but nothing. My Dr is unconcerned, he said that the quads may wake up tomorrow or in 2 weeks....but not to worry. My PT thinks 2 of my quad muscles are firing, but the other 2 are not. They seem to think I'm scared of the pain I will feel when I raise my leg, so I am not doing it. I told her she's wrong lol. Pain doesn't scare me. I'm going with my Dr. and not going to worry.

PT starts Tuesday. I will be doing 3 x a week. I am going to be doing PT in a therapy pool as soon as the incision heals enough to allow it. Dr said that will be roughly a month or so. I think the pool will be awesome.

I had the best nights sleep last night too! Just being home was amazing. Slept from 11 till 4, woke to replenish the ice in the polar pack, then slept till after 8! So much better than being woken every 2 hours for pain meds or vital checks!

I love the polar pack, but right now I've got one of the home made ice packs I made with water & alcohol in the gallon zip lock bags. I can not recommend these highly enough. Everyone should make at least 2 before surgery and have them waiting for you when you get home. They are so much more pliable and molding to your leg than the polar pack.
Hope everyone else is doing well...and managing the whole process.

One thing I was amazed at is just how tiring it is to move afterwards. Just walking from one room to the next is an effort! I guess I just didn't expect that. The Drs never talked about that at all before the surgery. Just an interesting thought that I realized after.
Anyhow I feel I'm rambling lol....

Enough for now!
Hugs everyone. ..


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[Pumpkin]

Glad to hear you are home, no more interuptions just as you are falling asleep . Give it time to heal and you will get there.

 

[JackiFL]

I'm so amazed at what you've been through, Glazed!

SO glad that you spoke up - I'm one of those for whom the CPM made recovery worse so I refused it after two sessions. It wasn't helping, out it went.

Those homemade slushy ice bags are wonderful, I concur! They stay so very cold and pliable.

Thank you for sharing your story and keep posting - you're in my thoughts! (I had BTKR on January 14.)

Hugs,
Jacki

 

[jeano]

Yes, the slush bags saved my bacon more than once when I had to be away from the umbilical cord excuse me Polar Care Cube. I also used them as sort of emergency cold when the knee hurt badly and I for whatever reason couldnt get the Ice Sherpa or myself off the dime to feed the Cube. Like in the middle of the night--sometimes just the slush bag on the knee for 15 minutes at 4AM would settle the knee down enough for me to get back to sleep.

 

[Josephine]

My biggest hurdle is the lack of sensation and control of my quads. I am able to lift my leg when standing, but completely unable to do any straight leg lifts when laying down. I'm going with my Dr. and not going to worry.

Oh it took me about a month before I could do a decent straight leg raise. I contended myself by helping the leg up with my other foot or with the leg lifter which is a good inbetween thing to do. Either that or you could do half lifts - with out without assistance! - putting a pillow or something under your knee and just lifting the lower leg. See here Home physio (PT) and activity progress: suggestions.

One thing I was amazed at is just how tiring it is to move afterwards. The Drs never talked about that at all before the surgery.

But we do! We talk about it ad nauseum! Energy drain for TKRs

You should also read the rest of our recovery articles .....
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!

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
Elevation is the key
Ice to control pain and swelling

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 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

 

[hbacres]

Welcome home!! I am sure you feel awesome just being in your own bed and surroundings!! Be careful and keep resting. I am getting ready for water therapy too....actually it is a water aerobics class I have been in for several years and I am going back the beginning of Feb. I will just get in the water and do gentle stuff, not try to do the class.
Take care of yourself!
Robin

 

[glazed151]

Okay, looking for some feedback on a couple questions.
I've searched the library and read everything I can find pertaining to my situation.
My quads...my thigh...the weird numbness that isn't fully numb...I can feel it but it's not quite right. Heavy feeling. I'm icing and keeping up with meds. It doesn't seem to be super swollen. I am bending quite well, pain is minimal and easily controlled.
I know the Dr said my quads will wake up when they want and the straight lifts will come but when?

I'm trying my best not to be a whine butt but am frustrated and slightly worried.
Who else has had this weird not all there feeling? Everyone? A few? Is it forever nerve damage?? I'm way over thinking this right?



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[hbacres]

Hi Caryn,
I did not have this problem after my surgery... but I was thinking. Does the PT you are going to on Tues do ESTIM? I wondered if that might help to get your quads to wake up. My PT does Ice and ESTIM for 15 minutes at the end of my appointment... it feels just wonderful and wonder if the little electrical buzz would help wake up the quads. I don't know.. just a thought.
Robin

 

[DogLoverx3]

I'm way over thinking this right?

Yes, you're overthinking this. I know, because I do the same thing. It took almost 3 weeks for me to do a straight leg raise and when I finally could, it was a whopping 1". Whoopee. I'm now at almost 6 weeks and it gets better all the time. Try not to worry about it too much. As Josephine says, it will wake up when it wants to. Yours is just sleepy. ;-)

 

[NuNe4Me]

One day, my quads were asleep, and then suddenly one day...ta da!...they were awake. I think that was approx one week after I got home. I think the PT was what woke them up. Plus I was also doing my PT exercises at home.

The medical peoples will push you...hard. Remember: Your body has just been traumatized, big time. It really needs REST. Patience. Patience.

I have completely numb spots around my incision on my knee. On a 1-10 scale, I feel zero (0). I am not panicking because this is not my first surgery in my body. I had BAD bunions. My foot doctor broke my feet, shaved off the bunions, straightened my feet, put rods and screws in my feet. I think my feet surgeries were more painful than my knee replacement. My feet were NUMB after those surgeries. I mean NUMB. It took five years for the numbness to wear off - this happened gradually. Today I can say my foot surgeries were worth it. And the numbness from the surgeries is gone. My neurologist says it just took that long for the nerves to reconnect, regrow, etc.......

Read, and reread the articles Josephine sent you previously. The advice contained in those articles is worth its weight in gold.

 

[Josephine]

I know the Dr said my quads will wake up when they want and the straight lifts will come but when?

Ever heard the term "how long is a piece of string"? You are asking unanswerable questions, my dear. It will come back when it's good and ready and before. That might be next week, it might be next month, it might be later than that. Who knows? I certainly don't and neither does your surgeon. But the chances are very good that it will come back, so please just chill out and bide your time. No point in getting frustrated and stressed over something you cannot change.

 

[glazed151]

@ Josephine
Yes! I understand...and you're right I know.
I think I over did it a bit yesterday. I think I was so full of happy endorphins from just finally being home I didn't realize how much I was doing.
Another example of why I love this group. Tell it like it is. I need that.
I know and trust everything will be fine.
I need to remember that this is a whole new ballgame, and I am still learning the rules.

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