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[TKR] Time for #2

Discussion in 'Knee Replacement Recovery Area' started by ebungalow, Dec 9, 2018.

  1. ebungalow

    ebungalow member
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    Thought I’d set up a thread tonight - surgery is scheduled for 10:30 tomorrow morning.

    I relied on everyone here for my earlier hip and knee replacements.

    Just knowing I’ll be spending lots of sleepless nights with y’all is very comforting :)

    Thanks for being here.
     
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  2. kmak81230

    kmak81230 post-grad

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    Good luck tomorrow! We'll be here for you.
     
  3. Breadman

    Breadman junior member

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    Good luck
     
  4. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    We're here for you! Good luck! I will leave you our recovery articles. Following these will help you to have a less painful recovery.

    Knee Recovery: The Guidelines


    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
    5. Here is a week-by-week guide for Activity progression for TKRs


    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.
     
  5. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Best wishes!
     
  6. Larryhg3

    Larryhg3 senior

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    Good luck!
     
  7. Spex10

    Spex10 post-grad

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    Are you back in the room yet?
     
  8. ebungalow

    ebungalow member
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    All done- I’m so relieved to have it done!!

    Surgery, anesthesia, etc. went well and I was in a room by around 3.

    Pain is well-controlled and I’ve had a couple of visitors.

    Planning on going home tomorrow morning. Thanks for asking!!
     
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  9. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    Yay, you have a brand new knee! Now, remember to be very, very gentle with that newborn baby of yours.
     
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  10. ebungalow

    ebungalow member
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    I sure will remember that. The PT at the hospital gave me all sorts of direction about how to handle rehab.

    I just smiled and nodded and came home determined to follow the BoneSmart mantras - they worked so well last time.
     
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  11. Spex10

    Spex10 post-grad

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    Excellent @ebungalow . Start as you mean to go on!
     
  12. ebungalow

    ebungalow member
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    Things are going ok. I’d read many posts on BoneSmart about not comparing two knee recoveries on the same person and wow, am experiencing that now.

    This time around I had so little pain in the hospital (yes I know, good pain control) and was super alert (not so much last time). Friends and nurses were surprised at how alert I was.

    I said to my daughter, “what if this is one of those kind of miraculous recoveries where I never really feel pain?” Hahahaha I was on drugs.

    She’s a nurse too and just kind of humored me as she prepared the ice packs and made sure I h

    Welp, the pain has arrived. It’s still managed but the alertness is blunted.

    Just here keeping a record. I’ll be sitting elevated and iced for quite some time.
     
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  13. ebungalow

    ebungalow member
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    *made sure I had meds

    Hope every one is doing well
     
  14. ebungalow

    ebungalow member
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    Things are going as well as expected here at day 5 post-surgery.

    This right leg is MUCH more swollen than the left leg was when its knee was replaced one year ago.

    I had a fairly massive blood clot in my right thigh about 18 years ago after an emergency appendectomy. It’s been treated all these years by blood thinners and, although my right leg has been a bit larger than my left since then, it really hasn’t caused any other problems.

    After I had the blood clot, a few other family members had some clots. Turns out we have Leiden Factor V, a blood clotting disorder that’s quite common.

    So I’ve bridged blood clotting meds before the hip replacement, knee replacements, colonoscopy, etc. No problems. And I’m back on my regular blood thinner regime.

    Anyway, my surgeon said that the weakened circulation in the right leg might mean more swelling and might mean I’d have to wear compression stockings longer.

    I know LOTS of people don’t like the compression stockings, but I don’t mind at all. I’ve had open-toed, thigh-high compression stockings for years, worn them very occasionally, and they feel comforting and help so much.

    Went to first PT yesterday. I really like her, and have gone to her for each of the replacements.

    She was content with my 4-day progress. The leg had 89 degrees of flex and can nearly lie flat.

    I’m not sure it’s 89 today - even the super gentle massage and super gentle passive exercises upset the tissues and the knee seems more swollen today.

    But I’m sitting elevated, iced, and medication and know that’s all there really is to do.

    I’m wondering about other people’s experiences re general anesthetic. I do choose general because of the Leiden Factor V - I’m know the spinal is often considered best practice but am afraid of getting a clot (probably needless worry).

    Anyway, with the other replacements I was wiped out after surgery and came home in a fugue state.

    Not this time! For some reason I was slightly euphoric and slightly manic. The euphoria felt VERY physiological, and not just the relief of having the surgery over with.

    My hospital nurse and my nurse daughter were watching me bounce around the hospital room and having a discussion about the euphoria. They kept having to tell me to lie down, quit hopping up, etc.

    Everyone at the hospital was telling me to slow down.

    Well - it didn’t last. I’m at home and am much calmer but think that the euphoria set up some pretty high expectations - like why aren’t I still feeling that good and why is my leg so swollen, etc.

    Believe me, I know it’s ridiculous. Haha

    Whoa. I’m chatty today :)
     
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  15. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I'm glad you're at home.

    I think that most people find their leg swells a bit more once they get home - probably because you tend to be a little bit more active than you were in hospital.

    Rest, ice, elevate, and medicate on time is the routine to follow now. I know you'll be on the lookout for blood clots, so remember to keep doing those ankle pumps.

    I always have to have a general anaesthetic, too, but for the opposite reason to you. I have a mild bleeding disorder and I can't risk having a spinal, because of the (admittedly slight) danger of having a bleed around my spinal nerves. I don't need a paralysis.
    I don't have any problem with a GA, as long as I ask the anaesthetist for medication to prevent nausea and vomiting.

    Yes, I'm probably sleepy for much of the surgery day, but that doesn't seem like a problem for me.
     
  16. ebungalow

    ebungalow member
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    Thanks for the response, Celle, and for sharing your experience with general anesthetic and blood disorders.

    Always comforting to hear other’s experiences!

    Hope everyone is recovering well.
     
  17. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I requested general , I have lower back issues that are at a manageable level and I didn’t want any needles in my back. They agreed without argument. I came out of it fine. (at least I dont remember any issues)
     
  18. ebungalow

    ebungalow member
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    Another great reason for choosing general anesthetic. Thanks

    This knee is painful today - pain starts around my ankle, goes through the whole knee, and then goes up my inner thigh.

    The oxy helps but doesn’t knock it out. I know it’s normal, but it’s still a drag so I’ve come to whine

    I’m still very happy it’s been done and the surgery is over and that this kind of pain will get better (knock on wood) and not worse like an un-replaced knee.

    Any Louise Penny fans here? A friend sent me her new mystery so I think I’ll try to stop knee obsessing and go find out what’s happening in Three Pines.

    She writes my favorite kinds of mysteries - smart and literate cozies with smart and literate characters in a great location.
     
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  19. ebungalow

    ebungalow member
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    I need to cry a little bit here.

    So I just got home from my second PT appt. The PT is a friend of sorts - we know each other from community stuff.
    She’s a former collegiate athlete and is about 6 years younger than I - she’s very used to working through pain in her own life (athletic injuries, etc)

    She rehabbed my first knee replacement a year ago and that knee was very cooperative and responded to gentle PT.

    She measured the healed knee today and it’s at 130 and she commented that I’d gotten another 15-20 degrees after leaving PT. I’ve been reading BoneSmart for a long time so I thought to myself “yeah, because it healed.”

    I remember being super emotional during week 2 last year and I’m crying today in week 2.

    Today the PT told me that this is the week where “we want to get flex to 90 and want to have 0 degrees flatness [can’t remember the word right now] by day 10”

    In week 2. What in the world.

    So I muttered under my great “that seems a bit early” and she muttered under her “no it isn’t”

    And this new right knee replacement is in the leg that had a blood clot years ago and it’s more swollen, etc.

    Anyway. I’ve been around here enough to know what to do - told her not to push on anything.

    I know going to PT is my choice.

    What I’m thinking about today is this social contract that seems to exist and I’m so grateful to have this forum as a place to come and be honest.

    For example, the PT brightly asks me how I feel this morning and looks truly disappointed when I say I’m feeling rough.

    Seems I broke the social contract of not keeping a stiff upper lip and pretending that everything is just fine.

    What I really want to tell at everyone is this: “well, I had a total knee replacement one week ago so I’m in a fair amount of pain but am working on managing it. I know everything will be ok, given time, but yeah, right now it’s pretty rough.”

    I’d say it a lot meaner though.

    Oh gosh. Feel better just having written this into the forum.

    Things feel rough. I’m crying and emotional. The leg hurts. I know it’ll get better with time.
     
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  20. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    :console2:This social contact is now your employee, and you are her boss. This is now a business arrangement.
     
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