TKR Three days post op

[bunchesofun]

Hi, My husband had RTKR on Monday August 1. He is doing great. I am here because he is not comfortable online with a forum. Physical Therapy came yesterday, and his ROM is 106. He's on Tylenol, Celebrex, and Oxycodone and has 0-1 for pain. However, re-reading some of the (many) pieces of paper they gave us, I saw that the Vena Go compression machine is supposed to be on the surgical leg even with the Iceman machine. Both PT and the RN were here yesterday and neither mentioned anything that it was not on his surgical leg. (it wasn't on the surgical leg in the hospital) How do you fit them both on there? I'm calling in the morning, but my frustration led me to ask about it here. By the way, the PT we saw yesterday was adamant about not doing too much or not having pain while doing things, so we feel comfortable. But he will not be our regular PT person and we are hoping his replacement has the same attitude. He'll be awake in an hour for his pain pill and I am going to try again to get them both on his leg.

 

[Roy Gardiner]

to BoneSmart


My personal view is that I would not sweat the details. Recovery is healing, which the body does by itself.


Knee Recovery: The Guidelines

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, but YOU are the final judge as to the recovery approach you choose.

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 Care In Hospital​

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.

 

[sistersinhim]

I looked up the Vena Go compression machine. It looks to me like it would go on the lower part of your husband's leg while the ice machine wrap goes around his knee. If you have to choose one or the other, I'd always go with the ice machine. Compression is to help with not forming DVTs. As long as your hubby is doing ankle pumps and walking a bit every few hours he should be OK. If you have any doubts, call his doctor.

 

[bunchesofun]

Thanks everyone. It had just come to me that he hadn't been wearing it since Monday and since he was (supposedly) higher risk for blood clots at 300 lbs, I just panicked. I did finagle a way to put both on his leg and it's working fine now. My first attempt had not worked, hence the panic. PT was here and she too is not a "no pain no gain" kind of therapist. In fact, she said scale down the CPM from 8 hours a day to 6 hours with the addition of her exercises she wants him to do with periodic walking around the house. Next challenge will be changing the dressing later tonight. Wound looked great yesterday. Thanks again for the support!

 

[Jockette]

In fact, she said scale down the CPM from 8 hours a day to 6 hours with the addition of her exercises she wants him to do with periodic walking around the house.

All total, that is still a lot for only days out of surgery! At this very early stage, the exercises are the least important, since the CPM is giving his knee plenty of movement. Short walks inside the house, like to the bathroom or kitchen, are good.

Does he break up those 6 hours? He only needs gentle movement, so if the CPM bend is too much, ask about adjusting it to a more comfortable level.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

 

[bunchesofun]

In fact, she said scale down the CPM from 8 hours a day to 6 hours with the addition of her exercises she wants him to do with periodic walking around the house.

All total, that is still a lot for only days out of surgery! At this very early stage, the exercises are the least important, since the CPM is giving his knee plenty of movement. Short walks inside the house, like to the bathroom or kitchen, are good.

Does he break up those 6 hours? He only needs gentle movement, so if the CPM bend is too much, ask about adjusting it to a more comfortable level.

Regaining our ROM is more about Time than repetitions of a list of exercises.
<snip>

Yes the 6 hours are separated by a few hours. He does the exercises as a warm up for the CPM. She only has him doing three exercises., 5 times each one. They had the CPM adjusted too low as he was feeling nothing while using it so she adjusted it up. He's at 80. He's been fine after using it, not hurting or fatigued, or anything.

 

[bunchesofun]

One week from his surgery. Doing well. Keeping up with his exercises well. Reducing the amount of Oxy slowly. A lot of bruising, but the wound looks good, and no longer any blood on the bandage. Progress being made!

 

[bunchesofun]

Two weeks post op. Staples came out yesterday. His ROM is now 111. We are so pleased. He uses the CPM 6 hours a day and the exercises that the PT gave him. He's planning on asking the Dr to schedule his second knee for November.