Total Knee Replacement
Prior to Surgery Preparation
For the 8 weeks prior to surgery I did the recommended strengthen exercises (2x day) recommended by the hospital where my surgery was to be preformed. Suburban Hospital in Maryland. My surgeon used the Conformis customized knee implants.
Day of surgery (December 2, 2015):
Dressed for operation with gown. Wheeled into operating room (9am) and slid myself on the operating table. I must have been put out immediately since I do not remember anything else.
Woke up in recovery room. Feeling nausea. They went through three different types of treatments to make the nausea go away. I only know that it was about 1-2pm when the nausea feeling stopped. But then a general malaise came over me probably from not eating. I think they put me into my single room at about 3pm. They didn’t say anything about eating so I had to initiate getting food on my own (calling for room service). Ordered a fruit salad with cottage cheese (really tasted good). About one hour after that I felt just fine. Around 3pm they got me up and I took a walk with the walker down the hallway. No pain at all since the surgeon injected a pain block during surgery that I was told would wear off on day two. Physical therapist came in at around 4pm and had me do a couple of exercises. I ordered dinner at about 5:30 because the kitchen was closing. I was given a 12 hour slow release pain killer at about 10pm. If my block wore off quickly my pain would increase quicker than the Percocet they provided would kick in.
Stayed at the hospital the first night since the block would not wear off until the next day and the hospital wanted to make sure I was managing my pain OK on the Percocet. I slept ok since the drugs make me drowsy. The nurses came in at 1am and 5am to check vitals.
Was woken up at 6am to begin the day. They brought me coffee and then I ordered breakfast. My first PT was at 10am (Second at 1:15pm). Went very well .. actually less aggressive than I expected. I was walking all around the floor (to the amazement of the staff). They would not let me walk anywhere without a staff nurse being with me (very restrictive since I had to call the nurse to just go to the bathroom). They actually have a bed and chair monitor that alerts the nurse if you get up. After my afternoon PT I was cleared to go home. They gave me a prescription for more Percocet with the instructions to take every 4 hours as required for pain management. That night and for the next several days I took it every four hours (actually setting an alarm so I woke up to take the drug). I slept like a baby and because of the preventive use of the pain killer I never experienced any great pain. Later on I describe the pain I did have as a badly sprained knee. I brought a walker and cane home with me since I did not know how long I would need them.
My knee and leg was swollen quite a bit (which I was told would happen). I did notice a bruise on the inside of my thigh. The surgeon told me that was where the tourniquet was applied. That area hurt the most while doing a couple of the exercises. BTW I did the recommended exercises 2X per day, religiously. I used my walker initially to get around the house carrying it up and down stairs (easily).
This was my first in-home PT. Blood pressure, pulse, circumference of my knee and flex were recorded. I could only flex my knee 85% at this point. I was given a number of additional exercises to do in between PT sessions by the therapist (which I did 2X per day). Still taking the prescription medication every four hours. (I was also taking a stool softener and big doses of aspirin each day as prescribed by the hospital).
I could notice each day an improvement in how I felt and moved. I ditched the walker and went to the cane because it was easier. Apparently I walked and stayed upright more than I should have because that night and the next morning notice my leg was swollen even more than before. As part of my exercise routine I started walking outside ¼ mile 2X per day.
I called my surgeon office about the swelling and they said it was normal and that I should be frequently applying ice and positioning my leg above my heart. After I did that the swelling went down.
I kept up my exercises and walking. I also noticed that I could sleep in practically any position I wanted. At the end of Day 8 I ditched the cane because it seemed to be more trouble that it was worth. Although for the next few days kept it for my outside walks (just in case).
Started backing off on the prescription meds during the day and only taking Tylenol as I was feeling less potential pain each day. My PT measured my knee flexion and I was now at 90 degrees. Started walking at least ½ mile once a day.
I continued to back off my prescription meds but still taking a ½ dose at night to sleep. I was concerned that I would wake up in pain and not be able to go back to sleep (that never happened). Now walking ½ mile 2x per day and doing exercises 2X as well.. About every other time my walking felt normal without any limp. Over these last two weeks the only pain I really felt was self induced through the exercises. In particular the knee flex exercise was the hardest. Now only taking a lower dose of the pain meds at night.
First follow up visit to the surgeon. They took out the staples and took an xray. The surgeon examined my leg and said everything looked just fine. BTW you should schedule your initial out patient PT appointment before seeing your surgeon at two weeks if they tend to be backed up in your area. My first out patient PT is on Day 21 then 2X per week after that.
Stopped taking prescription pain meds all together. I plan to take one before PT on Day 21 because everyone says you should. Now walking ¾ mile 2x per day without any problem. Continuing exercising at home 2x per day. I can go up stairs alternating each foot but not down the stairs yet. My knee is much improved and feel I can drive and walk anywhere.