TKR Two (almost) matching knees at last!

[Dulcimer Diva]

The guys were quite late picking me up, due to heavy traffic on Lake Shore Dr. after the Pride Parade was over. But we still made it to the restaurant in plenty of time. Had Malpeque oysters, lobster bisque and an "Alaskan duo" of sustainable wild salmon and halibut with a cherry tomato agrodolce over an heirloom tomato salad. I drank half a liter bottle of San Pellegrino sparkling water. Old habits die hard: because they served it in a wine glass, I automatically found myself swirling and sniffing. (It had a lovely mineral-y bouquet of seltzer with lime). I was so stuffed there was no room for dessert or even a single espresso. It was nice eating together as a family. And only my teetotaling and my nursing-home ID bracelet gave me away.

 

[Lovestoread]

You crack me up! Glad to hear you had the lobster bisque. I truly think they have the best I've ever had, and believe me, if its on the menu somewhere I order it! Love your description of your sparkling water. We love our wine and always end the week with a bottle on Friday with dinner. Ok, Saturday and Sunday, too. It was mighty strange having water or Gatorade all weekend. Our neighbors invited us to a cookout yesterday and I brought along my bottle of water. Oddly, the guy next door is four weeks out from his second knee replacement. He's been drinking since the first week and sat out there in the sun with his new scar exposed. Of course, he's been telling me how easy this knee was ( other knee was done last September). He didn't ice, elevate, wear the stockings, etc. He's paying the price now. Very swollen. Doctor wants him to do his pt at his office so he can keep an eye on him. I have pt coming over in a bit. I've tried to do my exercises over the weekend. Hope I didn't overdo. The bruising really came out yesterday. Looks awful, but I was expecting it. Bet you can't wait to get home!!

 

[Dulcimer Diva]

I miss good wine! Wine is one of my hobbies--in fact, my most recent getaway with Bob was to the Meritage Resort & Spa in the Napa Valley in late April. He had his cardiology course in the mornings; in the afternoons, they handed us sumptuous box lunches and herded us on to buses to visit boutique wineries from Napa to St. Helena. (Trinitas, Flora Springs, Artesa, Palmaz, Sullivan, etc.). Our last full day we toured on our own: up the Silverado Trail to Signorello, Mumm Napa, across to Silver Oak and then to 29 for Cosentino. We didn't do the Wine Train--it's just a rolling restaurant (albeit a very good one). Wish Napa Valley had something akin to the DC sightseeing tram where you buy a daily pass with unlimited on/off privileges--being able to go to as many wineries as your system (and budget) can handle without having to get behind the wheel and endanger anyone! BTW, for those who haven't been there in decades, the era of free tastings is just about over: nearly all wineries charge a fee for tasting and don't make their entire purchasable "menu" available to taste. Some of their better stuff commands a higher fee to taste. But some (such as Trinitas and Silver Oak) give you the glass as a souvenir--and they're really good crystal. (We bought a special padded rolling wine carrier at Cosentino that let us securely pack both bottles and the glasses and check it as luggage--SW didn't charge extra for checked bags). It was frustrating to sit there last night and suggest wines by the glass for Bob & Gordy without being able to taste them, just going by list descriptions and personal experience. (When you go off blood thinners & opioids, the Joel Gott unoaked chardonnay is worth a taste: Gordy confirms it's crisp like a Chablis but fruitier).

Have you tried Tin Fish in Tinley Park? We like it a lot--it and Cooper's Hawk are our go-to dinner spots in your neck of the woods. (I miss Texas do Brasil, though--bummer having to go to the Near North side and pay for parking).

I sure hope your neighbor put sunscreen on his scar--it's a different texture and can burn faster even as it seems to tan. I didn't wear compression stockings--this time out my OS didn't even suggest them. He says that they can cause circulation problems in those with varicose veins where the cuff hits--and on obese legs, the cuffs have an annoying way of rolling into tight rubber bands that hurt like the dickens. (Even my plain athletic socks leave "dents" just above my ankles, which proves I've got a ways to go to ameliorate my edema, no-salt-added diet notwithstanding). He says that icing, elevating (he advocates NINE inches above the heart!) and not overdoing is the best way to relieve swelling.

I see my OS this morning. This afternoon I have what may well be my last inpatient PT session--after that, I meet with the social services team to choose my home care provider, get my discharge meds, and book the visiting PT and nurse (for INR and vitals). I'll keep you posted!

 

[Lovestoread]

Five years ago we flew to LA and drove up the coast. Of course we spent time in both Napa and Sonoma. We joined several wine clubs while we were there, so we are always well stocked. Thanks for the suggestions, though. I'll write them down. We are in the Coopers Hawk wine club as well. We had dinner there about 3 weeks ago. I haven't been to Tin Fish in ages. For some reason, my husband doesn't care for the place.

Sounds like all systems are go for you! I'm sure you're counting the minutes!

 

[Ready]

Of course, he's been telling me how easy this knee was

Usually, those who "brag" about TKR being easy aren't telling the whole story...

Wishing you a good trip home, Sandy. It has been a long road and you deserve your own home. I am anxiously awaiting my first glass of wine, too. When I do, I will raise a toast to all of us June TKRs.

 

[Dulcimer Diva]

It's official: I go home Wednesday! (That's all my insurance will cover anyway). My OS was impressed with my extension and the way my incision looks, though not wowed by my flexion. He says I probably have better flexion during & after PT, when I've been warmed up. He isn't worried--he says I had the same flexion (but not as good extension!) at this point after my RTKR. (He measured the R knee at 140). Says as long as I see improvement, however small, I'll be fine. If I hit the wall for more than a couple of weeks, then I might have scars or adhesions--which he says have nothing to do with how hard I did or didn't work; some people just are scar-formers. Says MUA isn't something a PT should ever threaten.

Discussed my meds with him. He wants me on the Opana for a couple more weeks, then quit--at which point I should take Norco as needed in order to control pain and avoid withdrawal symptoms from quitting Opana cold turkey (because it's 12-hr time-release, extending the interval between doses wouldn't work and there's no lower dose available). Meanwhile, he discontinued the Tramadol and substituted extra strength acetaminophen for breakthrough pain, up to a max of 3 or 4 grams of acetaminophen per day. Then once I'm off the Opana, discontinue the acetaminophen because I'll be taking more Norco (up to 12 pills a day); and when I feel ready, start weaning off the Norco too.

One wonderful benefit of going to my OS' office was getting a cappuccino and pain au chocolat at the cafe in the lobby. Yum! Got back to rehab, had lunch, iced & elevated (sorely needed!), changed into workout clothes, took my Norco, and dreaded PT because I had sat so long in my wheelchair in the doctor's waiting room and in the medi-car and my knee was stiff. But to my surprise, I found myself raising my L knee higher than before while marching in place, squatting deeper than even in pre-op PT, and when I bent my leg backwards and the PT bent it further, it didn't hurt at all! (I had a substitute PT because my regular one's on vacation). And in OT, I bicep-curled 7 lbs by mistake, because they were the same color as the 5 lb weights!

I am paying particular attention to proper heel-toe gait, neither limping nor waddling. And I've gained a quarter-inch....not on my waist or hips but in height!

 

[Lovestoread]

Yeah! Finally a date to go home! A light at the end of the tunnel.... I want to go to your doctor. Cappuccino and pain au chocolat? You're killing me! He must be a very busy doctor if this is part of the appointment! Maybe I'll make you a little bit jealous when I tell you there is a Subway sandwich shop on the first floor of my doc's building;)

 

[Dulcimer Diva]

Yup--there's Cafe Descartes in the lobby of the building on Lake Shore on the edge of Streeterville. Comes with the territory!

Last night I brought back the remainder of my bottle of San Pellegrino from my dinner out. Took it to the table tonight for dinner here at the facility. I popped the cork, and the supervisor ran over, horrified. "We can't do that here!" she exclaimed. I replied, "You can't do SELTZER?" She looked at the bottle and did a double-take; she said she thought it was a bottle of champagne!

 

[Titianlady]

Dulcimer Diva Sandy, between the Norco, and the extra strength Tylenol, you may be getting too much acetaminophen. Please calculate the amount daily. What milligram Norco are you taking?

 

[Dulcimer Diva]

I'm taking the 10/325 (10 mg hydrocodone, 325 mg. acetaminophen). I calculated the amount in 6 daily pills (3 pair, 650mg. per pair, at 1950 mg. of acetaminophen per day. So taking a 500 mg. Tylenol for breakthrough pain twice a day would put me at 2950 mg., just below the 3 gm. threshold. And it's not a given that I will have breakthrough pain once I'm home and better able to space out the Norcos (doubling up only at bedtime and before PT--and I would only have PT once every other day, to a max of 3X a week). Once I am off the Opana and taking Norco around the clock as needed (and not waking during the night to take it if I'm sleeping soundly), I will of course NOT be taking Tylenol. The goal is to wean off Norco entirely, ultimately using two Arthritis Formula Tylenols twice a day as my only pain relief.

 

[tori645]

Malpeque Bay is just 1 mile from my cottage on PEI.. alas, due to surgery, no PEI this year...

 

[Titianlady]

Dulcimer Diva. Sandy, why is your OS disappointed with your flex? It sounded like your flex was coming along just great. If its over 90, then I don't think there's anything to be disappointed about.

 

[Dulcimer Diva]

Dulcimer Diva. Sandy, why is your OS disappointed with your flex? It sounded like your flex was coming along just great. If its over 90, then I don't think there's anything to be disappointed about.

Because I was much further along by 3 weeks out last year. But it's all moot now--we got to 100 this afternoon when the PT trotted out the Dial of Doom. My OS reassured me that progress is what he's looking for, whatever the starting point.

 

[Lovestoread]

Yeah! I think it should always be about progress being made instead of simply a number. That was your last session?? Home Sweet Home tomorrow, right?

 

[Dulcimer Diva]

They might make me squeeze in one more PT and one more OT session in the morning before I leave. I want one more E-Stim session (I like the buzz, and it seems to lessen the pain) at OT--I can do the weight and Thera-Band work at home because I have the equipment. For PT, I want one more round on the NuStep recumbent trainer, but no flexion exercises, as I will be having them at home. (My therapist mentioned that I might be able to go to Athletico and skip the home PT, but I'd like to do both as I did last year--it made quite a difference and enabled me to handle the walks on the cruise last fall).

 

[Lovestoread]

I'm looking forward to my out-patient therapy starting next Monday. I've always loved the stim part of the sessions. Feels great, doesn't it? Just don't overdo when you get home! I'm sure it will feel great to sleep in your own bed!

 

[Brithael]

I just read all your posts and am glad that I'm not going to a rehab and will be able to give myself meds when required. That being said, I love your writing - quite humorous in spite of the pain you've been through. I hope I can be as interesting when I do mine (in 7 more days!)

 

[new knee in June]

Good morning diva,
Are you going home today....if so...I hope you have a smooth transition, it's great to be home
Are you having p.t.at home....I wish you all the best...happy 4th of july
Thinking of you,
Diana

 

[Lovestoread]

There's no place like home!

 

[Dulcimer Diva]

Yup, going home today (they need the bed!!!). Will have a PT come over every other day Mon-Sat. for 4 wks, then 4 wks semi-weekly at Athletico (by then I should be driving). All in all, being at this particular rehab was a positive experience: I was as independent as I wanted to be but help was immediately at hand when I felt I needed it (whereas at home I'll be fending for myself most of the time, including during the night). The food was mostly very good, and the amenities excellent. The array of equipment in PT and OT was much wider than one could have at home. The staff was wonderful and solicitous (even the night nurse softened up). I'm not sure how universal those computerized locked drug carts are among nursing homes and rehab facilities (they're getting common in hospitals), but that was the root of my medication problems. The facility I was in last year had PT only half as often, unskilled patient care techs, wasn't geared as well toward joint replacement patients, and had awful food. Here, I also made friends--we got to eat our meals in the dining room, hang out in the ice cream parlor, see current movies (with popcorn!) twice a week. Even PT and OT provided opportunities to socialize. In a way, going home feels like leaving summer camp or a retreat.

If you are self-sufficient and have friends & family on whom to depend once you're home, and are not still in major pain upon leaving hospital (here in the US discharge on the second or third post-op day is the norm, whereas in the UK 7-8 days in hospital seems to be common) then going home makes sense. I knew in advance I couldn't depend on having someone there for me the first couple of weeks, and I was still in such pain upon discharge from hospital that I couldn't lift my leg on & off the bed and needed a bedpan for toileting; so rehab was the right choice for me.