TKR Timetolive's Nov 9th TKR Post -OP<<

[kayak59]

Hope you feel better soon, @Timetolive. I am still in hospital but expect to go home today my drain came out first or 2nd day knee looks good and pain is much les every day

 

[Clipless]

Instead of compression hose consider one long (or maybe two) elastic bandages, available at any drug store. Start at your ankle and spiral up, controlling the pressure as you go. Wouldn't be fun to wear, but super easy to remove. It's just a thought!

 

[New England Librarian]

Good morning @Timetolive! You are doing amazingly well for just a few day out! I am sorry you are facing other health challenges as well.

How are the hiccups today? There are many remedies (mine was always slow steady breathing and small drinks of water), but I also have found that after I get them, I am more likely to get the again during the same day. I think the diaphragm must get irritated or tired from the first bout, and more easily upset. Usually this only lasts for one day, so probably sleep (elusive these days I know!) allows it to rest.

I also had trouble with the compression stockings, and due to a history of DVT/PE, I had to wear them for 6 weeks after surgery, night and day, on both legs . They were supposed to be thigh high, but my home PT angel took a look and determined that they were only knee high (based on the location of the heel). I called my OS and the word came back to use those, but wrap the TKR knee with a wide elastic bandage above the stocking and up over the knee. This apparently provided the additional compression I needed, on that leg at least. It worked out ok (still no DVT 9 weeks out hooray!), and was easy to remove for PT, scar massage, etc. This might work for you, but be sure to get a 6" bandage, as the smaller ones rolled and bent.

If you do decide to order thigh high stockings, be sure to check with your OS on the compression strength, as there are varying strengths which are measured in mmHg.

I am one of those apparently rare individuals who can take Dilaudid, and liked it, but I did find it caused my neck, face and chest to feel itchy, so it might indeed be your pain meds.

 

[Timetolive]

@New England Librarian , so far no hiccups!! That is a good feeling. Still have the feeling of my food not going down-that prompted the hiccups yesterday.

The compression is 20-30. I thought I would get PT's suggestion on a place here in my town or on sizing when she comes this afternoon. There is one medical supply place in town that had the next size larger. My ankles are small, so to fit the thigh, I get too large at the ankle. The thigh is very swollen now also. It is very sore and hard where the tourniquet was. I have been icing it.

I didn't want to be TMI, but the itching is mostly under my bra and below my waistband. Too embarrassing to scratch those places in front of people!

Thanks for taking the time to post! How are you doing?

 

[New England Librarian]

Hi @Timetolive - I am not a medical person, but have a family history of esophageal problems, and it sounds like you are sore in that area. The intubation tube goes into your throat for a ways, so it might be from that. @Josephine, any advice on this? Fingers crossed for you that those nasty hiccups are going to stay away for good.

Thanks for asking about me! I am doing pretty well, but disappointed to still be experiencing swelling and pain at 9 weeks. Some days it's a dull ache, but every now and then it's just outright 5 - 7 level pain, and I give up and take the meds! When I look back, I can see that I am continuing to improve all the time. have been approved to be out of work until 3 months post-op, and I think I am going to need all of that time. One of the most important things I have been given by this forum is that we all went into this with different stages of disability and pain, and we all progress at our own pace. I am definitely not at the "so glad I did this" stage, but I can tell now that I will be there eventually.

I found that the pain meds, which I took pretty religiously for the first 3 or 4 weeks, messed with my memory, and I feel that I lost a month somewhere. I went to the hospital just after Labor Day wearing sandals, and now it's almost time for snow boots here! Where did that time go?

Hope you have a great day!

 

[suemegane]

I have found icing very good for my movement of knee. Still can't do leg lifts though & i'm on day 9 should I be concerned? Can walk ok & lift my knee upwards when standing but laying down with rolled up towel under knee is a no no at present. Any advice on this please

 

[Timetolive]

I spoke with PA and we decided to ease off some of the quick acting morphine and try tylenol (verdict still out on the cause of the liver panel) to help relieve the throat closing feeling and itching. No hiccups yet! What a strange thing they were!

@New England Librarian , I am definitely not at that stage - I am still "what have I done?" stage. I am sorry you are still having pain and swelling beyond your expectations. I think if we think about how long our knees have hurt and how assaulting this surgery is on our soft tissues, we could better understand why the journey is long and hard. You are in my prayers. I can barely concentrate to read anything of any length and these postings may take place over 2 or 3 "focus" sessions! hahaha!

@suemegane , PT just left and put me through the paces of their plan. I had to do the short arc lifts and actually found them to be easier than the straight leg lifts. I am 3 days out, so behind you of course. I was able to do some leg lifts today, but it is the first day I could. She measured me at 15 and 80. I am still having a terrible problem with that sciatic nerve and hamstring. I am using the Zero Degree Foam block and it is torture for stretching those out. I think patience is not a virtue of mine and I need to learn it. Good luck with your knee. You continue to be prayed for.

A funny story now - NOT funny then. PT wanted me to sit in a sturdy chair for leg lifts. There was the office chair nearby so she suggested that. We moved it on the carpet and I asked her how high it should be. DH lowered it and then sat behind while I did my exercises. I told PT I thought it should be a little lower as my other leg was not parallel to the floor. Before she could get it out of her mouth for DH to wait, he hit that lever and BAM! down that chair went. OH MY GOODNESS! Tears immediately came to my eyes and I started to cry. DH felt terrible. PT said at least the leg was not bent or you could have gotten 120 degrees! What is up with this crying anyway?? Don't say "boo" to me right now! She did say I was doing excellent and had the right attitude. I did tell her I did not want PT stretching my knee where I could not function for the rest of the day. She said she had been watching my face and could not tell when I was in extreme pain. I told her if I said I was at my limit - that meant I WAS! Everyone doesn't grimace and make faces you know. Listening is a good thing and I am glad she did. I just hope the PT assigned to me will do the same. This was my assessment schedule.

Hope all are having a great day.

 

[Celle]

@Timetolive
You're correct. You certainly shouldn't be trying to get to a town 40 minutes' driving away just yet. You should only be resting at home. Is there anyone who would go for you?

Let's see what the PA says before you do anything. If he/she is adamant that you still need the hose, the PA might be able to suggest where to get a larger size. What you are using now is harmful and could contribute to swelling in your knee.

You could always just cut off the above-knee part and turn your current ones into knee-highs. You can't have teh upper part cutting off your circulation.

I don't think you'd be risking much if you ordered them on line, but only if they can be dispatched straight away. There's no point in having to wait for 2 weeks.
I wonder if there's a medical supplies web site that could send them faster - they do come in a variety of standard sizes and custom made should not be necessary.

 

[Timetolive]

@Celle , PA WANTS me in them. The nonsurgical leg is in a knee high. I have no problem ordering them and having them overnighted. I have one more place to check locally and my husband could go pick up. PT agreed with you about them doing harm. Thank you for following up on me. There is a steep learning curve to some of this for sure!

 

[Celle]

I'm glad to help!

It's odd how different protocols can be in different places. Here in New Zealand, the surgeons only use knee-highs. I've never seen thigh-high compression hose.

 

[Timetolive]

@Celle, I asked about the knee highs- I have one on the other leg. PA said it would not be good since it would be right over the incision. You are right- EVERYONE has encountered different protocols for the various stages. Just like the CPM and foam block.

Since you are here, do you think I should drop the long acting or the short acting morphine? I have to get some of it out of my system-the itching is terrible. I only took 1 MSIR at 8:30 this morning along with the MS CONTIN at 10:00 am and I am tolerating pain ok. It is not stopping me from doing anything.

 

[Celle]

Quite honestly, I think it's too early to be dropping any of your pain relief. Since you're having so much trouble with itching, you should probably discuss this with your doctors and ask if they can prescribe something different from Morphine, and which won't cause the itching.

 

[Thesoutherncook]

Thinkng about you! Have you gotten the itching taken care of? Can you take Benedryl? That helps me.
Don't feel obligated to join the Over Did It Club, it is not required for recovery! Take it easy and REST!
Hugs!

BTW, I didn't have a CPM, compression hose or a foam block and am walking around just fine!

 

[Josephine]

personal question: my itching is mostly confined to my chest area. Has anyone had that problem or do you think it is just a side effect from the morphine?

Yes, it's the morphine without a doubt. I wouldn't expect it makes any difference between the two types - if you're sensitive to it, it doesn't really matter. But your doctor can prescribe something for the itching though it might make you drowsy. In the meantime, try using cold wet cloths on the itchy places. We did that in recovery (where we used to get the odd patient with morphine reactions) and it was very effective.

Anyone have experience with the compression thigh highs when you have a "cone" shaped leg? (small ankle, medium calf, and very large thigh) I cannot keep it from rolling down and acting like a tourniquet where it stops.

I'm with Celle. Both times I took my TEDS off after a couple of days because they were ill fitting and causing dark blue depressions at the top. I considered that to be far more of a hazard than not having them at all! Interestingly, my surgeon saw I'd taken them off and never batted an eyelid!

I have researched and know they have larger sizes for the thighs.

They do but they need to be properly measured so I wouldn't think an online pruchase would be a good idea.

I am using the Zero Degree Foam block and it is torture for stretching those out.

Is that a block like this?

I wouldn't ever encourage a TKR patient to use those as it's agony! Your knee is not ready to do this yet and does not like to be straight out as it over stresses the hamstrings. Obviously you should have it very bent but it can be just a little without the ceiling falling in! Here's the good and the bad of elevating

 

[KarriB]

I used oxycodone for pain. I don't know if it's in the morphine family or not, but it relieved my pain and made me fuzzy. I don't know how much good Tylenol will do your pain levels at this point. Can you call the OS and ask for something else?

 

[newlybionic]

@Timetolive I had thigh hi stockings on both legs but I wound up taking them off sooner than tthe 2 weeks I was told to leave them on. I had the same problem as you with the fit. You might encounter the same type of problems with knee highs on that leg too. I'm surprised the therapist can't measure you for the exact size and help you get them. I worked for a visiting nurse company that had PTs and we all could measure and get them for our patients. After I took mine off I just made sure I got up and walked ( seemed like it was to the ladies room every 10 mins) and did ankle pumps. I had considered using Ace elastic wrap in the 6 in size to take the stockings place. I've used them in the past and they're easily put on and off and can be adjusted as the swelling goes down.

 

[Thesoutherncook]

And I used Demerol because I can't take codeine or oxycotin or any of the " normal" pain meds! Not only do I itch, I throw up my toe nails!

 

[newlybionic]

A new pain med I was able to use for a while was Nucynta. I was told to take 1tylenol ES with it. Worked well for pain.

 

[Timetolive]

@Josephine, i have attached a file showing the Zero Degree Knee Bone Foam. It helps wth the extension. I also have an outward rotation of my foot/leg that was from a broken leg when I was two. They straightened my leg, so I am learning to rotate that foot straight and not let it rotate back out. (I hope I explained that well.) Thank you for the suggestion about the cool wet compresses! What a lifesaver! I am taking Benadryl to help with the itching. I am extrememly sensitive to medications, so it was either vomiting with codeine or itching with morphine - although the Dilaudid REALLY made me sick. Thank you for your help! I really do appreciate it.

Thanks everyone else for your experience and insight. I was just telling my dear friend, who brought over dinner, how nice it is to have a site you can go to and ask ANY question and get help from dear people that have lived what you are going through!

 

[newlybionic]

@Timetolive I saw your picture and my PT had told me about doing this because it was causing my IT band to be shortened but my leg was not straight before surgery either. I used regular pillows and accomplished the same thing. One thing I did learn was that I still let my leg turn out when driving (my left was replaced). After a 3 hour car drive down to see my 90 year old dad and back I could hardly walk because of it. My leg is now straight and I don't need to have something to hold it that way.