40 dealing with life prior to TKR. Next stop PKR May 27th, 2010.

[bombero1969]

Yes I have the CPM also 2 hours on 2 off, I actually like it alot. It helps to keep the knee from getting to stiff. The other is a yes also, Ice Ice Baby. 

I came out of surgery with a cryo cuff on, but the insurance was playing games with it, and the equipment company didn't know about it. When I called to tell the supervisor that the guy never showed up with the CPM like he said he would 8 hours earlier I told him about the cryo. He came straight out with both, left me with the CPM going and also the donjoy ice box. I told him that I already have a donjoy at home but did not think about bringing it. The wife will bring it with her this morning, so he said that I wont be charged for the one night usage and he would pick it up today. Sweet. I also have a ice pack on behind the knee on top of the CPM. I am absolutely in love with ICE.

At this moment I would take any sleep even 30 minutes.

Worse than childbirth, heck I have had to change my pain scale. When asked I would rate a 10 with the kidney stones I have had in the past. Thought that nothing would hurt worse than the stones. Well I was wrong, giving birth of bone from around the knee is 10 thousand times worse.

[suntan toes]

Bombero:
Congratulations on the deed being done!  Sorry to hear of the pain.  The pump didn't work for me so I was on pain meds every 2 hours. Stay ahead of the pain.  Shots aren't so bad are they?  Isn't  it nice not to have the other bone on bone pain?  The surgery pain will be better than the daily knee pain.  With me it turned into an ache  and then just a gentle reminder that usually is cured with a dose of advil when I overdue it.  Also, KEEP A POSITIVE ATTITUDE.  To a bright and active future, I wish you 120+/0 for your future.  Only us knee geeks understand that reference.
Take care and try to rest.
Eileen aka Suntan Toes

[bombero1969]

Ok so last night I tried to go to sleep with the cocktail that they prepared for me. Should have worked and was trying to work. Then my right kne and upper leg started to scream. I formed a superficial thrombosis. Even with the puff puff shoes. The shoes were sctuall forcing blood into the knee and also putting pressure on the clot.

The nurse did not believe me when I told here that I have a clot, finally a doctor on call came by felt it and ordered a doppler. They don't have that capability during the weekend so they almost tried to transfer me to another hospital. Thankfully my doc got here in shorts and a ball cap. He confirmed what I know about the ST, they are harmless with the exception of a lot of pain.

Got some sleep finally and the meds are starting to help with the pain, Demerol and percocet.

[Redwing]

I'm amazed at how quickly you came back on line to begin your tale!!!  But sorry to hear of the setback with the clot and the associated pain.  I too had the puff up booties for the first few days, counting them at one point I was hooked up to 5 different lines and tubes! Yuk!

Wishing you the best Bom, may you be well.   

[bombero1969]

This morning is so much better, even if the knee is stiff and yells with pain. I was finally able to sleep all night long waking only once to pain requesting meds. Still trying to stay on top of the pain and ahead of it by taking the perc's every 4 hours, do not want to get behind. It really does take a lot out of you to catch up to the pain instead of staying ahead of it. Got a bit cocky and decided I didn't want all of the narcotics and there side effects of constipation and space head. That was the wrong thing to do. So now it is Percs every 4 hours and a shot of M.O.M. for breakfast.

I am surprised on how much of my ROM I lost from my PT the day of the op. I quess the swelling and pain just finally caught up. Plus since I could not do any pt while they tried to figure out what to do about a superficial clot (about 12 hours of just sitting ) That the knee just stiffened up with lack of movement and inflammation. So last night the PTer came by and helped my do the exercises, basically she held my foot and moved it in the directions it was supposed to.

That was kinda disappointing. So this morning I woke up, shaved walked to the nurses desk to get my own coffee then ate breakfast. Haven't seen any PTer today yet, but decided to do the rehab routine on my own. Then the CPM and cranked it up to 80 (WOW too much) so went down to 75 and slowly returned it to 80 over the next 2 hours. For some reason the knee almost feels more stiff after the CPM, do not know if that is supposed to happen. To ease the stiffness I struck out to walk around for 2 laps instead of my 1 lap. 

All that before noon. I think that this will not be easy but with this attitude I can do it.

[bombero1969]

Doc just came in and asked me of I want to go home now or tomorrow, that all they are doing for me tonight is giving me a place to sleep. SO.......... My wife has already packed my truck and we are waiting for the discharge papers.

Wow, I get to sleep in my bed tonight.

[teachmath912]

Glad you got to go home.  I only stayed 3 nights too- though I know some people stay longer.
I had a cpm for my tkr that I enjoyed for about 5 days and then got tired of being stuck in it. 
Good luck with your at home recovery! 
~ Kit

[Plumb]

Congrats on the moving to the at home stage of your recovery.   Plus you get to practice sitting in a car/truck post op.   How many weeks until your vacation ?

[bombero1969]

So the drive was not that bad, the left over drugged feelings really made for an interesting trip. The railroad crossings were fun also.

The doc had me do a self flexion, to which I was able to get a bit more than 90 with pain but no assistance. He told me that I did not need use the CPM but I still need the outpatient PT. I have opted to use the CPM for a while longer since I have it for 3 weeks anyways.

Feels good to be home, almost feel like going straight to bed and sleep.

My vacation starts in 4 weeks, maybe I will be able to get around pretty self sufficiently.

[bombero1969]

Yeah felt like going straight to bed and sleep, well I tried that.  This is the 1st morning home and I feel like I should have stayed at the hospital one more night. The doc was unable to send me home with the percoset which worked great for the pain. His triplicate script book was locked up in his coordinators office and he could not get to it. Today is Memorial Day so he can't get to it today. I will not be able to get the script till tomorrow. Had to resort to the old vicodin that does not work that great. So it was a pretty restless night in bed. I could not get the pillows just right, could not get my body in the same position as the bed at the hospital.   

The wife had to get up and go to work this morning, even after she tried to sleep beside me as I kept her and myself awake every time I moved. I think the only one in the room that got enough sleep was my dog. He was so happy to see me when I got home and layed right beside me all night. He even tried to snuggle as if he knew I was hurting. What a good dog. 

Wife got up and made me waffles to eat so I would have some kind of breakfast before she left. Also brought me a big cup of home brewed coffee, oh it was so good. My timer went off signaling me that it was time to get into the CPM. The only way I could figure out how to use it at home was to go to it, meaning I am now on the floor strapped into the machine. 

I feel like if the swelling would just go down by half that I would feel so much better. So I have tried to elevate the leg as much as possible. Hopefully the swelling will go down significantly in the next couple of days. It just seems that there is not anymore room for the knee to swell.

Ok enough of me whining this morning. Things will get better and I know that, just trying to rush what can't be rushed.

[Plumb]

Ice ice ice ..  Shame on your doctor for not having right tools he needs to send you home AKA - prescription blank.    I am not sure if you have pharmacy's that deliver around your area.  but maybe they could pick it up for you..  or at the very worst the doctor can fed ex the script to your home overnight priority.


Just remember the first 14 days bite.     Things start to less up after 7 days .. but it still hurts and your still gonna be stiff. 

The CPM machine is kind of relaxing .. even pain wise.. 

But you know outpatient PT is where all the fun is at.

[bombero1969]

Last night was the second night home for me. I decided to sleep in the recliner as it is in a similar position as the bed at the surgery center was. Sleep is something that I wish I could get more of, I have heard there is lots of healing during sleep. 

Ice feels great and so does the PT routine and the CPM that I brought home, well it feels good by working the stiffness out at least. Then it is back to the ice, which helps the stiffness to return. It is like a viscous cycle between all of the ice, soreness and the stiffness.

Wish that the doc could have sent me home with something that actually helps more with the pain, but then again I am getting used to the pain a bit. It is totally different feeling than the pain before the surgery. No bone grinding, teeth gnashing pain of the OA. Just the surgical pain that seems to be getting a bit better daily, not by much but by little strides.

Felt a bit cocky last night and got off the walker to get to the fridge in the garage to get a soda. Wife's car would not allow the walker to get past. Got the soda, was making my way back then the wife stuck her head out and caught me red handed, well bare handed. It kinda startled me, so I unwillingly tripped on a pair of shoes that one of the kids use for yard work. Stumbled a few feet caught myself with the walker after the few feet. But the full weight and slamming of my right foot to the floor was all it took. My knee yelled at me about as much as the wife did for not using the dang walker or asking for help. The pain did eventually go away but the wife didn't, I am blessed with a wife that wants to help so much. But am cursed by not wanting to totally let go of my independence.

Tomorrow starts the out patient PT, will see how mu ROM I have gotten back. Was not given formal instructions for the CPM so I start at 90-95 first time in the morning and by bed time I am up to 110. The only thing I was told was a total of 8 hours at 2 hours on and 2 hours off routine. Maybe the PTer can give me a full routine. Kinda winging it.

Thanks for all of the encouragement. I helps to know that the pain and the swelling will eventually subside.

[suntan toes]

Bombero:
It does get better!  2 days without the right pain meds is insane.  Do what plumb says, ice ice ice.  I kept mine on all the time the first week.  I had the same thing , even now that the knee gets stiffer after a workout.  Do you have staples?  When you get them taken out it's like the bear trap has been taken off : )  You're a tough one and the first couple weeks are going to make you test that toughness.  How has PT gone?  When I layed in bed watching TV, I elevated my legs way up with 3 floor pillows.  I was fighting the ankle swelling as well from that surgery.  Take care and remember one day at a time!
Suntan

[bombero1969]

My wife is so awesome, she went by the docs office, adding an hour to her trip home, just to get me the script for the right pain meds and the ambien. Now I can do more than take the edge off of the pain and might be able to get some restful sleep tonight.

I keep the iceman on almost 24-7, though it seems that icing the knee helps to make it stiffer, which adds discomfort. I do love the ice though, it feels so good.

Tomorrow is the first out patient PT kinda wondering how much I will enjoy the visit. What kind of sadistic routine is he going to put me through? Give me more.

Found a funny thing out today while trying not to scratch my incision. There is one spot that when I scratch it I swear I actually feel it on the other side of the knee. No feeling where my finger is at all, every sensation is like I am actually scratching an inch away. Kinda wired, I know it has something to do with the nerve being cut and growing back together. Plays with the mind a bit.

[teachmath912]

If the ice makes your knee stiffer, do not use it as much.  My orthopedic does not believe that icing a knee truly works (something about the arteries and veins being too far below the surface of the knee that by the time they are reached the skin can be damaged??)  and does not prescribe ice for his knee patients.  I use it anyway- the coach in me, I guess- but will use it for only 20 minutes at a time, which is the amount of time you are supposed to ice something.  I just use the ice gel packs that you can refreeze and they stay cold for about 2-30 minutes so are just about perfect.
I am sure that a pkr has similar incisions as a tkr and there is a nerve that does get cut which will cause the numbness feeling.  Some people's nerves will regenerate, some do not.  Mine has not and I have about a 3 inch long x 1 inch wide numb patch on my knee/leg.  It is kind of cool feeling, but be careful you don't bump or cut it without knowing!
Be careful walking too much too soon or you could damage some of the knee as it is healing. 
Sounds like you are doing okay, though!  Keep up the good work!
~ Kit