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Old 01-25-2010, 01:17 AM   #1
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TKR - what it would have helped to know beforehand.

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Old 01-26-2010, 06:26 PM   #2
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Re: TKR - what it would have helped to know beforehand.

Hi Cricut - Like you I started reading the boards right before surgery, but there was so much to read and a lot of it scary. But I had trouble finding the little things so I am trying to write as I remember or use something useful.
A friend of mine in Virginia had TKR surgery the same day that I had it in FL. When they remodeled they had the comfort height comodes put in and she says that they are great during recovery. So much easier than the 3 in ones and the top riser that I have and other people can use them. I am jealous.

Showers ... My doc let me have one before I left the hospital and I am having them at home as long as there is no drainage. I have a bench in my walk in shower but also chose to get a shower chair when my wheelchair bound mother-in-law was here. I am using that and have the adjustable shower head on a hose. A hint they taught me in the hosp was to put a towel or mat on the seat (no cold shock to your butt and not slippery) Also get anti bacterial liquid soap and a couple of wash cloths. I had a couple of sticky optisheets that kept the incision dry which they gave me in the hospital, but starting tomorrow I will just let the water run on it some. The nurse said not to towel dry it but to use a blow dryer so you don't rub it. Dry everything else first, by then it is already air dried or use the dryer. Have Hubby help you in and out the first couple of times. If you have room and your bed is a ways from the shower bring a chair into the bathroom to sit on while you dry. ( I sit on the edge of my soaking tub) My friend, DJ's, doctor does not allow showers until after the staples come out, so check with your Doc. It feels great, but like everything else, it will tire you out.

Other things that help: organize the kitchen so that you can reach or don't have to bend to get things you want easily. My hubby doesn't really cook, but he is trying. (often painful to watch - you just want to do it yourself) but I am finding that while I walker around the house, I stop in the kitchen for drinks and snacks. Also I have about a 1/4 of the appetite I had before (pain and meds I guess), but to take my meds I need something in my stomach, so I try to get him to get things that I can do myself in the middle of the night - like bananas, apples, applesauce, yogurt, high fiber granola bars and prunes (the tkr patient's bon bon) that I can eat a few minutes before the pills. High fiber will be your friend....

Ok sleeping, I have been going through 2 night shirts a night, due to night sweats (thought I was done with those) so now I leave an extra one out to swap during the night.

Get a tote bag out to hang on your walker so you can carry little things from one room to another. Also something I use a lot is a large (4 cup) insulated mug with a handle and lid and bendy straw. I fill it with ice and water a couple of times a day and can hook it in a couple of fingers to go room to room. I am pretty much using that and smaller mugs with lids for my drinks cause they are portable and the handles are really helpful if you don't want to constantly ask hubby to carry stuff ( I save him for moving the laptop and toting the cooler for the ice cuff). I am finding that I can do 1 step things, like getting a bowl of sauce, or frying an egg, but multi-step just wears me out.

Pain - you're going to have it - it will probably be worse than before, but different, but the pills really do help - do not try to be macho, take them and remember that you have to ask for them at the hospital, I made the mistake of thinking that they would bring them automatically - nope - ouch. There is a window when the pills taper off and before they kick in. Hard to avoid. Try arrange for PT to be there about an hour after you take your meds. Spend lots of time in the CPM and use the ice cuff.

Oh - and your leg is going to turn lots of pretty colors. Bruises everywhere. Ted Hose - watch when the nurse puts them on you so you can explain it to your husband. They are a necessary evil and a pain to get on. I can do my good leg, but need help on the surgical leg. My daughter, got frustrated and decided to start over and started to yank, but I saw the motions and said NO YANK in time! Try to keep them stretched out, if you let go bunched up on your leg it is a pain (PAIN) to get them pulled up.

Naps - take them whenever. I think of the CPM as my snooze machine. Some nights, have been sleepless, so you have a potential of 6 or 7 hours while in the CPM - not much else to do in there anyway. I have been keeping one of my light fuzzy throws near me to cover my non CPM leg while in it.

One week post-opt and it's tough, but it will get better. I'm a little worried that it is going so well now that I am going to hit a wall somehow. See there is always something to worry about... Gotta get in the CPM and take a little nap. Write if you have any other questions, and we can get through recovery together. It is funny but my girlfriend in VA and I are at totally different places in recovery, eventhough her surgery was only 2 hours after mine. Everyone moves at their own pace and experiances things differently. Talk to you soon - G@home

 
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Old 02-04-2010, 06:53 AM   #3
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Re: TKR - what it would have helped to know beforehand.

CPM - Continuous Passive Motion machine. It is a sling type machine where you lay flat, or almost flat and strap you leg in and it moves your leg slowly from flat to bent. Sort of like a slow motion recumbent bicycle. It keeps your joint moving and helps prevent scar tissue from forming and also increased your extention and flexion, increasing your range of motion. Extention is how flat your leg can go and flexion is the degree your knee will bend. My Doc aims for O extention and over 120 degrees of flexion. At a little more that 2 weeks post-op I am at 0 and 111 degrees, so I am progressing really well. But the pain is tough.

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Old 02-19-2010, 08:00 AM   #4
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Re: TKR - what it would have helped to know beforehand.

[edit]
If you are having a bilateral, then they may or may not work for you.

The list is intended for folks who are going home with caregivers who are not used to being caregivers. My list is in no particular order and will be added to as things pop up and my mind clears up - remember I am drugged up and in pain as I type this.... Also it is easier to set up or at least know where these things are or can be found or what brand you might want to send someone out to get you ahead of time.

You will receive information about your stay in the hospital, but then they send you home and a lot of you recovery is trial and error. There seems to be a lot here, some of it will help you, some may not apply to your case. I am not a doctor, but I have had a TKR and know that it would have been nice to know more of what to expect. Everyone recovers differently from this surgery. I have a friend who had the same surgery 2 hours after I had mine. Two different doctors, two very different recoveries. Hopefully, when all is said and done, we will have similar results. Good Luck and don’t let the following scare you. In the end you should have a functional knee with little pain, if you don’t have the surgery, your knee will only get worse and your quality of life will continue to go downhill. But, not to sugar coat it, it is a long haul to recovery. You should anticipate that everything takes longer, cause your body and mind are moving at half speed. Also, whether in hospital, or at home, nurses/aides/caregivers will not anticipate your needs, or respond to your calls for assistance immediately. Don’t wait till you are peeing your pants or screaming in agony to call for assistance.)

1. You will need a caregiver! 24/7 for the first couple of days (weeks). Yes, they will be able to leave some for groceries and stuff, but pretty much you don't want to be in a house by yourself. The first couple of days, you will want a back up caregiver when your primary goes out.

2. Bedroom - if your spouse is your caregiver and you love them, ask them to move into another room, or if your bedroom is up a staircase, you may want to set up downstairs for awhile. Although you may be able to walk up stairs when you get home, why risk it.

A - We have a king-sized bed. On one side I have my CPM machine, the other side is for sleep and exercise. If your spouse is in the bed, neither of you will sleep and they will need their rest to put up with you. You on the other hand, should be gracious even if the toast is burnt - they are trying and without them you would be in rehab.

B - The CPM is heavy so you don't want to have to move it much. Put a bath towel under it so you don't ruin your sheets. The tech guy who delivered it set it up.

C - Linens - Time to use those old towels and sheets you couldn't get rid of, why ruin good ones. I am finding that a bottom sheet, a top sheet and some light single bed size or throw blankets work better than a big blanket and bedspreads or quilts (you will not want the weight or confinement on your surgical leg). Fold them up until you are back to normal. Your body temp may change and the light blankets are easier to maneuver when you are in the CPM or on the sleeping side. Some different size towels are also helpful for rolling up for exercises or to keep your leg up straight.

D - Bedside tables - you will need them, for the Ice pack machine (I will get to that) Supplies, Books, Clock, Lamp, Water bottle, etc...This will be your hospital room at home and you will have clutter everywhere.
You will also want extension cords or better yet a power strip to plug in things like the CPM, Ice Cuff, phone recharger etc…

E - My Doc sent me home with a continuous Ice pack machine, Cryo/Cuff - wonderful. If you don't know if you will get one automatically, call your doc's office and check. Check with your insurance to see if it will be paid for. If not - start saving. As an alternative - find a knee wrap that has a frozen flexi pack. Get at least two if you can afford it (mine was $15) and get extra frozen packs. So there is always a cold one. I already had these and use them when I'm not set up in the machine. The ice cuff is a little movement confining, so the frozen packs are good when you are not set up near the ice cuff machine.

F - Pillows - lots a shapes and sizes... A king size or body pillow works well between your legs when you sleep on your side. For awhile, in the CPM or on your side are your only alternatives. The others are to wedge behind you to sit up etc...

G - A shoe box size box - clear plastic is good so you can see into it. This is to hold all the stuff that keeps getting lost in the sheets as you move from side to side. (Remote, breathing thingie they send home with you that you should continue to use, tissues, glasses case, thermometer, cell phone, chap stick etc..)
Also a second one to keep you dressing supplies etc... The little basin they sent home with me from the hospital worked well for this.

H - This may be one of the most important. A small notebook and pen. Mine is 4X 6, big enough to be used when drugged. In this I keep the times that I took my pain meds, because you need to know and you (trust me) will not remember accurately. I also keep track of the times in and out of the CPM, PT info, and for me what quadrant I had my last blood thinner shot (you may not have shots, but I did) Also questions that come up for PT or Doc. Your memory will stink - you need this.

I - A sectioned pill box. This is in addition to the notebook. I take out a day’s worth of pain meds and put them in the box with approx times to be taken written on a post it on the lid (which I can change, if I miss the correct time, the future times will need to change too). Or if you are really loopy, put your caregiver in charge of your meds, but unless they want to get up during the night, you will need you night meds near you. But having the full bottle near you is a mistake; nights can be a little loopy.

3. A reacher - you aren't going to want to bend over and reach socks you drop or paper etc. They cost about $22 at the drugstore, check them out before the TKR, you can always send someone to pick one up for you. I was pretty mobile fairly quickly, and didn’t really need this. But the times I did use it, it was very handy, and also fun to annoy the cat with….

4. Your Walker - they should set you up with one at the hospital. But you want to make sure that you have maneuvering room for one. Make sure to make your home walker friendly. Mine will only fit sideways into my closet, so I set up things that I use all the time near the door of the closet. (My therapist switched the wheeled legs on the front of my walker, so that the wheels are on the inside. This facilitated getting through my narrowest door, and also, kept me from scratching furniture & woodwork. I did not affect the balance or functionality of the walker.) I can still get in if I need something else, but I don't have to. Besides believe me, you will be dressing casual. Put the Baggy T shirts and exercise shorts somewhere easy to reach.

5. Potty seat: there are choices... In the hospital they used the 3 in one freestanding models. If you get one of these you need to take some measurements because they come in different widths as do our butts.... Go to the healthcare supply store and sit in some. You Will want wiggle room, but you also need to look at the area around your toilet to see what will fit.
I did not get a 3-in-1, I prefer the one that sits on top of the toilet and has arms and a little thing in front to wedge it to your toilet. Means you will need to walk farther at first to get to the bathroom, but then someone has to dump and clean the other... Do some research.

If you are by some chance remodeling your bathroom, consider using a comfort height commode. They are great. (the friend with the comfort height toilet says that she never needed a seat, as she was able to get up and down without assistance from the day she got home from the hospital.)

6. CELL PHONE - have your caregiver have one too. That gives them a little freedom to get away from you. You can also call your friends and quietly complain about the burnt toast... Keep it with you, so you don't have to get up to get to a house phone before it stops ringing...

7. Showers ... My doc let me have one before I left the hospital and I am having them at home as long as there is no drainage. I have a bench in my walk in shower but also chose to get a shower chair when my wheelchair bound mother-in-law was here. I am using that and have the adjustable shower head on a hose. A hint they taught me in the hospital was to put a towel or mat on the seat (no cold shock to your butt and not slippery) Also get anti- bacterial liquid soap and a couple of wash cloths. The nurse said not to towel dry it but to use a blow dryer so you don't rub it. Dry everything else first, by then it is already air dried or use the dryer. Have your caregiver help you in and out the first couple of times. If you have room and your bed is a ways from the shower bring a chair into the bathroom to sit on while you dry. (I sit on the edge of my soaking tub
8. Get a tote bag out to hang on your walker so you can carry little things from one room to another. (If you have a sewing machine, or sew by hand, you can attach strips of Velcro to the side seams of the tote bag and strap them around the side/front of the walker, so that it stays semi-open.)
9. Something I use a lot is a large (4 cup) insulated mug with a handle and lid and bendy straw. Drink a lot! I fill it with ice and water a couple of times a day and can hook it in a couple of fingers to go room to room. I am pretty much using that and smaller mugs with lids for my drinks because they are portable and the handles are really helpful if you don't want to constantly ask hubby to carry stuff (I save him for moving the laptop and toting the cooler for the ice cuff). I am finding that I can do 1 step things, like getting a bowl of sauce, or frying an egg, but multi-step just wears me out. (Anticipate a very dry mouth. Take on lots of water. Pretty sure it is the pain meds.)
10. Constipation: One of the evils of the pain pills, but better this than pain. Fiber and possibly stool softeners, check with the Doc.
11. Goals and PT : You will hear a lot about extension and flexion and range of motion. Extension is how flat you can make your leg go – the goal is O. Flexion is the degree of bend in your knee – the goal is 120 or higher. Range of motion is basically these two measurements. The exercises to attain these measurements hurt, but you need to do them. This is why you had your knee replaced. TKR is to improve your mobility. It will not give you the knee of a teenager, there will still be things you can’t do, but if all goes well, it won’t hurt to walk anymore. Anything beyond that is gravy. Take advantage of the guidance your Physical Therapist gives you. ( The doctor may give you exercises to do prior to surgery. My extension was very bad prior to surgery. I had not straightened my leg for at least a couple of years. I would recommend not getting to that point—have the surgery before you lose too much range of motion; but definitely faithfully do the exercises before surgery, as it will help afterwards.)
12. A support network: It helps if you can talk to someone who is going through this or who has had a TKR. They will understand the stages you are going through. There are good on-line support groups or find a real person who you can talk to.
13. Mood Swings: You will have them, another possible evil from the pain meds. Tears, crabbiness, they may happen – as you are boohooing into a pillow, just explain that it’s the pills…enough said. Another reason to be nice to your caregiver.
14. Appetite: You may not have much of one, eat as healthy as you can.
Other things that help:
15. Organize the kitchen so that you can reach or don't have to bend to get things you want easily. My hubby doesn't really cook, but he is trying. (Often painful to watch - you just want to do it yourself) but I am finding that while I walker around the house, I stop in the kitchen for drinks and snacks. Also I have about a 1/4 of the appetite I had before (pain and meds I guess), but to take my meds I need something in my stomach, so I try to get him to get things that I can do myself in the middle of the night - like bananas, apples, applesauce, yogurt, high fiber granola bars and prunes (the tkr patient's bon bon) that I can eat a few minutes before the pills. High fiber will be your friend....
16. Sleeping: I have been going through 2 night shirts a night, due to night sweats (thought I was done with those). Your body thermostat may be off for a while. So now I leave an extra one out to swap during the night.
17. Pain: You're going to have it - it will probably be worse than before, but different, but the pills really do help - do not try to be macho, take them and remember that you have to ask for them at the hospital, I made the mistake of thinking that they would bring them automatically - nope - ouch. There is a window of time when the pills taper off and before they kick in. There will be some pain. Hard to avoid. Try arranging for PT to be there about an hour after you take your meds. Spend lots of time in the CPM and use the ice cuff.
Keep track on when you will be out of pills, because you will need to call the Doctor’s office to request refills and then your caregiver will need to pick up the new prescription. They cannot call in the narcotics. You generally will have 5 days worth; do not wait until the 5th day to call.
18. Oh - your leg is going to turn lots of pretty colors. Bruises everywhere. And swelling. Do not be alarmed. They will tell you what to look for and when you should be alarmed.
19. Ted Hose: Watch when the nurse puts them on you so you can explain it to your husband. They are a necessary evil and a pain to get on. I can do my good leg, but need help on the surgical leg. My daughter, got frustrated and decided to start over and started to yank, but I saw the motions and said NO YANK in time! Try to keep them stretched out and bunched together in your hand, if you let go and they bunch up on your leg it is a pain (PAIN) to get them pulled up.
20. Naps: Take them whenever. I think of the CPM as my snooze machine. Some nights, have been sleepless, so you have a potential of 6 or 7 hours while in the CPM - not much else to do in there anyway. I have been keeping one of my light fuzzy throws near me to cover my non CPM leg while in it. Have your ice cuff on while in the machine. You will probably need help getting in and out of the machine until you are fairly mobile lifting your leg.
21. TV and/or Laptop computer: a TV is nice to have in your room – you won’t feel much like reading, and during CPM time and sleepless nights it can be good company. Being able to use a computer is a definite plus.
22. Cleanliness: Wash frequently, and have anyone who messes with your leg, wash and use anti-bacterial gel. You do not want to have to deal with infections.
23. Scars: After your staples come out, you may want to put some sort of Vitamin E oil on your scar.



WHAT TO TAKE TO THE HOSPITAL:

Not much, but have a case packed for you caregiver to bring you after surgery. You will be in the hospital gown until your IV is out, and you won’t be able to wear panties or pants until after they remove the femoral block (if you have one) and they should give you footies with rubber tread for walking. But after that:
A couple of knee length Night Shirts or gowns and/or Big T-shirts.
A knee length robe
2 pair Baggy Gym shorts - . A size bigger than you need, with pockets and preferably a slippery nylon material. They make getting out of bed easier.
If you are a woman, forget fashion, forget the bras and panties, forget modesty... Your hair is going to get mushed up in the pillows, and it will be dirty... believe me you won't care.
A pen and pad. You will have questions, and if you don't write them down you will forget.
Deodorant, toothbrush, toothpaste, comb and brush, nail file in some sort of tote bag so it is all together. Not much else.

Last edited by HBMod07; 08-05-2010 at 01:34 PM.

 
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Old 03-08-2010, 04:54 PM   #5
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Re: TKR - what it would have helped to know beforehand.

Just an addition to the things that are helpful to have:
I have since ordered an Elasto-Gel hot/cold wrap that is great. It is very soft and flexible and the one I have is 9" X 24" with 2 velcro straps. It wraps completely around my knee and covers the entire incision site. It stays cold for about an half an hour . They use them at my physical therapy and I liked it so much I ordered one on-line for about $43. It's a little pricey, but you will ice so much that it is worth it to be comfortable. There is more info on Matter's TKR thread.

 
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Old 03-25-2010, 01:28 PM   #6
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Re: TKR - what it would have helped to know beforehand.

Get things in your house in shelves no lower than waist high so that you don't have to bend. Get all the dressing aids. Lay in food for freezer and pantry. Have higher toilet seat with arms. Have firm chair with arms. Short rail on my bed at the head has been a blessing for me. Leg lifter is wonderful for the first days. Be as independent as possible. This will help your relationship with your family and be a big boost for your spirit.

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Old 03-31-2010, 01:47 PM   #7
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Re: TKR - what it would have helped to know beforehand.

Move your bed down stairs. It doesn't seem far now, but those stairs will look a mile long after. My PT is in my bed in the living room.

 
Old 04-09-2010, 01:49 PM   #8
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Re: TKR - what it would have helped to know beforehand.

I agree - part of getting through the first few weeks was being able to cruise the house with the walker, getting drinks and snacks from the kitchen on my own and feeling independent. I did exercise by doing the stairs once a day, but I think that I would have stayed upstairs in my room too much, 'cause that is where the CPM was and I did nap a lot. I would have been bugging my husband more to bring things to me. I could do stairs, but would have been wary early on of going up and down as often as I would have liked

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Old 05-20-2010, 12:22 PM   #9
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Re: TKR - what it would have helped to know beforehand.

Some more things that have helped. I'm at 4 1/2 months now.
Elasto-gel freezer wraps - I love my 9" X 24" wrap with velcro straps. I use it every night. You can find them on line for about $40.

Now that it's warm, I'm in the pool a lot.

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Old 08-06-2010, 10:00 AM   #10
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Re: TKR - what it would have helped to know beforehand.

Talking about ice. I have found an ice machine (basically a small cooler with an electric pump) to be a life saver, especially at night. The one I have has an adjustable temperature setting and a full cooler lasts all night long. Allows your care giver to get a good nights rest.
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Old 01-11-2012, 04:47 PM   #11
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Re: TKR - what it would have helped to know beforehand.

Just had TKR. You don't feel the pain while in the hospital since that have you on the good drugs. I felt the most pain after going home. My main problem was that I ended up having muscle spasms for about two weeks after discharged. There was two occasions where the spams got so bad that I had to call 911. First instance was two days after discharge and the second was the day after the staples were removed. They eventually went away. Now 4 weeks postop, main issue is that I get sore on the hip joint at the top of the leg, from doing a lot of walking with the crane. Went back to using crutches/walker doing better with soreness. I take advil 3x daily.

 
Old 01-28-2012, 03:34 PM   #12
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Re: TKR - what it would have helped to know beforehand.

Hi, Ive had 3 tkr's and the first thing I would tell you is get a test to test for nickel allergies. My first TKR was 8 yrs ago, and was in constant pain from it. Then I had my other knee replaced with a Smith and Nephew replacement,(nickel free), and it is wonderful. Eventually had the right one revised with the nickel free, and was going around on the bike in PT 2 weeks after. The pain after surgery isnt really too bad. They give you good drugs, morphine I think, with the push button. I think the drains hurt more coming out than the actual knee pain. I was up the same day and using a walker. Hope this helps.

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Old 04-11-2012, 07:49 AM   #13
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Re: TKR - what it would have helped to know beforehand.

Hi Grumpy, thank you for posting this. I like to be prepared and you gave me a lot of things to think about.
Jenn

I appreciate this thread a lot and have already made up my lists.

I added a strapless boob tube to the hospital list, since I have bigguns and hate to have them sitting on my lap looking at my feet. Or hanging around in my armpits.

Since I am making my bedroom my new home, I am bringing a wing-back chair in and taking the little swivel rocker out, its too low to the ground and tries to escape when I get out of it now.... And I taught my 12 year old to enjoy the art of laundry, so I don't have to worry about that!

Last edited by Administrator; 04-22-2014 at 11:29 AM.

 
Old 06-18-2012, 09:30 PM   #14
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Location: Kelowna, BC, Canada
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collsknees HB User
Re: TKR - what it would have helped to know beforehand.

If you are a young patient having a TKR, dont assume you will heal quicker. The people 25 years older than me, are up and out of physio by now. I just had a manipulation done at 11 weeks that has set me back. I healed too fast and scar tissue stopped the knee from bending. I also had well-developed muscles that wanted to kick in and protect the joint. I use muscle relaxants prior to physio. It has been a tough go, with some tough days ahead yet. Still not able to drive at 11 weeks post op.

 
Old 09-07-2012, 11:13 AM   #15
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planetarium HB User
Re: TKR - what it would have helped to know beforehand.

ice ice and more ice

 
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