TKR VW's new joint venture

[Lilli215]

In the UK the NHS gets a dreadful panning but like everything else you never hear the good only the bad. Reading some of the posts from various members over the world I am so glad that I had my op here. The NHS runs a Rapid Recovery Program in most hospitals for joint replacement and it's very good. I was on waiting list for six weeks, was admitted at 7am, had op at 9.30 and was back on ward by 11.30am. There was a nurse for every four patients and physio twice a day (gentle stretches only plus teaching how to do stairs etc). In on Monday, home on Thursday. The onus was very definitely on becoming independant, there was excellent care but no molly coddling, by day 2 you were expected to wash and dress yourself and sit at side of bed most of the time, this of course was providing you had no complications, you were taught how to inject yourself with a heparin based anticoagulant as you were sent home with two weeks worth to ensure no clots.They put a huge emphasis on icing and there was never an issueat anytime of day or night getting the ice container refilled. Once home again if no issues then it was three physio sessions at outpatient clinic with none of the horrendous work that seems to happen insome cases in the USA, no problems with getting sufficient analgesics from GP and follow up appointments with consultant and nurse specialists for a year at various intervals. Reading some of the posts on the site I feel so sorry for some folks who can't get painkillers or physio and have to juggle their
needs against their insurance cover, it's a hard recovery without that extra pressure. No doubt there will be some UK members on the site who will argue and say that wasn't their experience, fair enough, but my experience is the common one in the Scotland and I am so grateful for it. VW54 sounds like you're having a similar experience in Austria , hang on in there, you have a long hard haul ahead of you but I and everyone else on the site who are a few months out promise you that it will get better

 

[VW54]

After trying second set of exercises my leg hurt so much! I called nurse. She in turn called doc and I got an extra dose of Novalgin. That helps! I'm to take another one before sleep. And I think I know how I can sleep on my side tonight. Got extra pillow and learned to arrange it.
I'll ask DH to lower blinds before he leaves so that room will be darker.
Spoke to another lady who had partial done here and she was mostly satisfied. She too noticed lack of staff, especially nights.

 

[Celle]

@VW54 , remember the guidelines we gave you - "if it hurts, don't do it."
Any exercises that hurt should be stopped. It is so early in your recovery and you have a whole year to increase your ROM (Range of Motion), because that's how long it can continue to improve.

At this early stage, your knee needs very little exercise. It's more important to let it heal.

 

[Pheebs52]

VW54, I find it all so interesting how different countries have such different approaches to the same exact recovery process. I overlooked your holiday circumstance, so can see how this creates a discharge problem. On the other hand, perhaps more time in the facility is better somehow in the long run! At least the food is very good and I consider that a real plus! My surgeon never spoke to me directly about ROM expectations at this point, it's the visiting PT that comes to my home 3x per week. I have a feeling my surgeon may have very different ideas; I certainly hope so! Many here no longer use motion machines either, yet some still do; puzzling. I'm glad my surgeon doesn't.

You are hopefully sound asleep right now, but if not, I hope you are relatively comfortable and able to get up without assistance.

 

[Pheebs52]

Just saw your post and Celle's and must agree with Celle as usual!

 

[VW54]

Day 3 post op. Just got big bandage removed and an impermeable one on with which I'm allowed to shower. But must first wait until a drip "docking point" gets taken out. Have bruises in 5 places now. Oh well.
On top of bandage I now have a tight anti- thrombosis stocking. I don't mind it. It actually feels good.
Managed really well to get to and from loo without assistance and do what was expected on day 3
The staff is now aware of my icepack "addiction"
and now have two straddling the upper thigh. They spoke to my OS and he told them it was Ok if they made me feel better. Yay!
Actually OS came by earlier just as I woke (before his scheduled ops. Said he had 3 today) and was pleased to see meds were working now. So I will be getting Novalgin in addition to Mexalen 3 x day. He said no or minimal elevation was standard protocol in this clinic because of extension issues and bending will come gradually anyway.
It's interesting how different views are all over the world regarding TKR recovery.

Physio guy will be coming by soon. Wonder how that will go.

 

[VW54]

As I wrote above Physiotherapist came by and made me walk the 4 point walk with crutches up and down hall. He said I did ok but need to practice rolling step. That a few times a day.
Also wanted me to do the sitting slides and heel toe pumps while sitting.
He measured ROM of slide in bed and it was 60 first and 65 the second try.
He won't be back till Tuesday so he left instructions as to what I should try on my own.

I noticed just now a very numb area below the knee. Was told by nurse sensation would come back.
Sure hope so! Now am worried about this

A pastor or priest? stopped by as well just now after physiotherapist left, (as this hospital belongs to a religious order). He said nice things and basically listened to my questioning as to why I opted for this operation.
I'm not religious but was good to have a talk like that with someone who doesn't know me.
After him a young lady came by to ask me if and where I'd like to go for rehab in September. Told me two places my insurance plan would cover and said I should ask around and let her know Tuesday.
I'd either be sent there stationary for 3 weeks or I could opt to go 3x week for 10 weeks.
Any ideas on this?

 

[Lilli215]

You'll have the numb area for quite a while, there's also a chance that it wont completely go away. My numb feeling isn't as bad as it was but still don't have full feeling in it. Be prepared once you go home for a lot of bruising to come out in your thigh area especially, it's due to the electronic tourniquet they use in theatre during your op, the bruising takes a while to come to the surface, I developed a bright purple thigh about a week after my surgery! Afraid I can't advise on rehab as we don't have that in the UK. I did gentle exercise in the hospital, heel slides, ankle pumps and leg lifts which got me started on the regime that I had to do at home. Will the hospital give you an ice cuff to go home with, I came home with two which were good, kept in fridge and nice and cold, however they didn't give me the ice reservoir home as that's deemed as expensive. I'm due to get other knee done next Feb and I'm going to buy one of the reservoirs (available on Amazon) so I can keep icing going through the night. You sound as if you're doing really well

 

[SusieShoes]

I too have large numb areas on my lower legs. My OS explained it's from cutting the skin: some nerves inevitably get severed. They will attempt to reconnect and he said I will get lots of the sensation back, but will probably end up with a numb patch on each leg. The numbness has gotten a little better already, but nerves are the slowest healing of all, so it will take a while until that process runs its course.

 

[VW54]

Thanks Lilli for the heads up re bruise on thigh. I do bruise easily so I even wondered why there was nothing on my thigh. Now I know to expect that. I do have bruising around scar and strangely enough on my ankle! Extensive too.

Good news is I took a shower. New nightgown. Ahhhh.... Feel refreshed but exhausted! Nurse helped me dry my lower legs and feet and thrombo stockings went on again.
OS doc was here before going home for long weekend. He took my number and said he would call in directly every morning to see how it's going. He asked me to sit at edge of bed to measure ROM and said 65-70 was excellent for day 3.
We spoke about rehab. He said I should apply and come end of August and I feel ok, I can cancel and just go to local physio chappy near my home.
DH just stopped by for 5 minutes. But tomorrow he has more time. Now at the end of school year and his last one at that, he has so many events and things to do. Plus he said he'd be there more for me once I'm home. It's logical this way.
Have had many phone calls and emails to cheer me up. That's good too.
Everyone who wrote about all those naps is so right! Catch them when you can!

 

[Pheebs52]

VW54, it sounds as though you are progressing very well! I'm pleased to hear they have decided to cater to your *ice-addiction*; brava! The bruising and numb area are normal for now and it does take quite awhile for all the bruising to fade. I am colorful from the top of my thigh to my foot. I have a numb area about the size of my palm to the left of my incision. I'm not worried about it because I've experienced the same with other surgeries and eventually, most sensation returned for me. Try not worry about anything right now and just concentrate on rest, and better days to come in the future. I can't speak to the concept of Rehab so many months down the road because we don't do that here, but perhaps someone else will be able to shed some light on that process. Wishing you a relatively, pain-free night and continued good progress!

 

[IowaNana]

@VW54, as others have said - the bruising and numbness is normal. I had significant bruising on my right knee, but very little on my left. And the bruising on my right was on the back of the leg - from thigh to ankle. Most of it has gone away, but I still have a nice large bruise on my calf that is hanging around.

I hope you have a restful weekend ad that your progress continues


Sent from my iPad using BoneSmart Forum

 

[sistersinhim]

As all have said, the bruising and numbness is completely normal. I still have a numb area right and under my knee. It feels so strange to shave there! It'll itch and I'll scratch it, but not feel it! All in my head? Who knows, but the itch goes away!

 

[Celle]

I noticed just now a very numb area below the knee. Was told by nurse sensation would come back.
Sure hope so! Now am worried about this

Don't worry about that area of numbness. It's normal and we all get it. It happens because a large branch of a nerve has to be cut during surgery, as well as some little nerves. This article explains it:
Numb area after TKR: how long will it last?

Some people find the numbness fades, but it can linger for a long time.

 

[VW54]

It's 3 am and things are not good at all.
An hour ago I got up to go to the loo. When I went to put operated leg back in bed from half sitting on edge position I heard and felt big thunk in thigh. Once lying prone it hurt sooooo much under my knee. I thought I'd move my ankles a bit to gwt circulation going as physio taught me but my leg just knackt and knacked with every move. It didn't do that at all yesterday.
I am so afraid I must have dislodged something.
Nurse has given me something for pain now and just said I should mention this during rounds.
How am I going to sleep now worrying I made some wrong move.
Nurse said swelling and intense pain in ankle is normal after activity. But this has me worried also.
My foot keeps falling asleep. Quite annoying. So I try to wiggle it awake but leg knacks with every move.
have had a setback i guess
Cursing at everything right now. Very upset.

 

[Celle]

Make sure that you tell all the day staff what happened, as soon as they come in this morning. And of course you need to tell your surgeon.

Do let us know how you get on.

 

[Jennszoo]

Ooh. That sounds scary. I hope it's nothing serious.

 

[Pheebs52]

I hope this is nothing serious and it will just disappear as mysteriously as it arrived. As Celle said, alert all staff tomorrow and keep us updated if you can.

 

[Lilli215]

@VW54 how is your leg now, have you seen your doctor today yet?

 

[VW54]

Rounds were only at 10 due to skeleton crew. Xray was ordered. That was done promptly an hour later. (Normally no non- emergency Xrays done on Saturdays...but since radiologist was at hand, they had him see me) Only now 3 hours later has a station doctor stopped by for measured 40 seconds to tell me everything is as is supposed to be.
Painful ankle: no idea why: BUT compression stockings stay on.
Nurse had said earlier maybe they fixed the ankle during op and bad pain is only now 2 to 3 days later. I would like to know though. Maybe docs are puzzled too why some patients have some symptoms but don't dare say they don't know why.
So I still also don't know why my operated leg knacks clic-clic-clic when I bend my ankle.

Had bfast and lunch sitting at table ever so careful to bend it no more than to no pain point.

On a humerous note: an hour ago: I looked down at floor and saw something brown and furry crawling in the distance. On my way to loo, I note it's a centipede! Of all critters to encounter in an orthopedic clinic!
Cleaning lady just came by, laughed and gathered it up with brush saying: "before they operate on you"
(A friend told me on phone after I told her what just happened that the elm trees here have a centipede plague)