Wednesday, April 13, 2011

KNEE REPLACEMENT DIARY: THINGS TO REMEMBER FOR “NEXT TIME”!

I mentioned earlier that Odel and I took a two and a half hour, pre-joint surgery class offered by Sutter General Hospital. It was great, and our first glimpse of what was to come. Now that we are just over a week post-op, here are a few things we didn’t know, some related to our special living situation and others more general. We’ll want to remember these things if Odel ever goes through this again, and they might be helpful to others in this situation.


MANAGING THE SIDE EFFECTS OF ANESTHESIA, IRON SUPPLEMENTS AND PAIN MEDICATIONS: To put it bluntly, constipation is a major, on-going problem. The health care professionals mention it – frequently – but don’t really prepare you for what that means: lots of discomfort for the patient and very little appetite at a time when they should be getting extra protein to promote healing. I ended up making several trips to the store for prunes (now called dried plums); prune juice, apricot nectar, and Karo syrup for the Senior Cocktail; Senakot and Senna tea; and laxative suppositories. Today we are experimenting with licorice. When things finally DO get moving, it is difficult to keep up any regularity. Have what you need on hand, start using it right away, and keep it up.


Although the medical folks advised that Odel should have plenty of protein and particularly red meat (to keep iron levels up) as he recovered, meat sitting in an immobile gut is an unappealing idea, even to a carnivore like Odel. We found a very tasty brand of Greek-style yogurt – with twice the protein as non-Greek yogurt – at Costco, Chobani. It has no fat and comes in 3 yummy flavors in each carton of 12 cups: peach, strawberry and blueberry. We mix tasteless, quick dissolving Benefiber into each cup, which Odel eats two or three times a day. Supports beneficial intestinal flora, too. :)


USING COLD TO REDUCE PAIN AND SWELLING: Ice packs are an important part of therapy. Because we have a smallish freezer (not particularly cold, either), we had exactly zero ice packs on hand. Our PT, Sandy, brought us her recipe for cheap ice packs, and it works very well: 1 part 70% rubbing alcohol (be sure you use 70% solution) to 3 parts water, double-bagged in gallon baggies. I ended up making four of these, which we rotate in pairs so each pair has more resting/chilling time in the freezer. Also, a tip for those of us with less efficient freezers: put one cup of alcohol in a 4 cup measuring cup. Add a couple cups of ice, then fill to the four cup line with water. Dump it into the baggie and repeat (a total of 8 cups per ice pack). The ice in the mixture will give you a head start on the freezing. I numbered our ice packs 1 through 4, so I knew which ones were used most recently, but decided to keep two in each part of the double-door freezer. A sticky note that we move from one door to the other reminds use which ice packs were used last.


The new elevatorUSING ELEVATION TO REDUCE SWELLING: Another key to reducing swelling is elevation. I posted a photo earlier of our pillow pyramid; though it elevated Odel’s leg sufficiently, it tended to collapse slowly to one side or the other. I wasn’t keen to fork out $100 for the specialized foam wedge available for this purpose, particularly when it would just be another thing to get rid of once Odel is healed. Costco had a “body pillow”, about 4 feet long, that offered a better alternative than our pile of pillows and cost just $11 – cheap enough to discard or give away when it is no longer needed. Here is a photo of our new elevator.


MANAGING INSIDE THE RV: Unless you have a quad slide rig (and perhaps even then), it is likely that the walker you come home with will not be practical in the bathroom or bedroom. As I mentioned, Odel uses our cane/seat in place of the walker, and of course we have plenty of sturdy, built-in furniture and countertops to help him mobilize. One thing no one mentioned to us that has been invaluable is the big plastic donut that raises the toilet seat by 4 1/2 inches, eliminating the need for help when arising from the throne. We were able to BORROW this from my good friend Becky – everyone should be so lucky. :)


Along those same lines… in the hospital, Odel had a plastic urinal to use to eliminate the need to get out of bed to visit the bathroom. Be sure you bring that home with you (as our nurse said, “You paid for it!”); it is a big help in the early days and at night. I don’t know what female patients do, and hope I don’t have to find out.


The physical therapists also recommend a sturdy chair with arms and a flat seat. The sofa didn’t have enough arm support; my Euro-lounger was too low; our built-in dinette was completely useless. We brought in Odel’s lawn chair that he uses outdoors, which worked pretty well. (The sturdy and comfortable passenger chair might have worked, too, but doesn’t face the TV comfortably, so was disqualified!) The lawn chair is stationed next to the couch, in the way but workable. I don’t think we’ll need if much longer, but it has been a necessity during this first week.


WHAT TO WEAR: At the pre-surgery class, it was suggested that patients come to the hospital dressed in loose clothing with a drawstring waist, making it easier to dress to leave the hospital. Odel bought an inexpensive pair of lightweight cotton pants (I think they are pajama bottoms, but they are suitable for public viewing) with a drawstring, which have turned out to be the only pants he has that are comfortable and practical enough for post-surgical use. Though he has a pair of heavier sweatpants, the elastic at the end of the leg makes it too difficult to maneuver over his foot, and jeans would be impossible. I went back to Target to get him another pair yesterday, along with a similar pair of shorts. The man is stylin’ now!


Here’s hoping YOU never need to have any of this information!

20 comments:

  1. All very good info! Some of us might even use some of this if we suffer a twisted ankle or knee that need elevation and ice!

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  2. All good suggestions. Thanks for the updates Laurie. Keep up the good work.

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  3. Isn't it amazing how much you learn during a process like this? The body pillow looks like just the ticket for keeping that leg elevated!

    I hope that Odel's pain level is staying in (or close to) the "smiley face" end of the scale most of the time, and that his recovery continues on this good path.

    How lucky he is to have such a pretty, caring nurse to take care of him 24/7! What an amazing bond you share...

    Thank you for the update. It is very kind of you to take the time to let your readers know how you are doing. Don't forget to take care of you, too. Being a caregiver is exhausting!

    Tell Odel that when I use AOL spell-check on my comment, it wants to change his name to "model" - don't you think that is appropriate for the Pretty Man?? ;-)

    Kerri in AL :-)

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  4. Odel = Model! That made us laugh!

    About the only time Odel's pain rises significantly above the smiley face level is when the physical therapists visit. He is really good about pushing himself during his exercises... but they add an extra little "something". :) The pain is manageable though. Thank goodness for drugs!

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  5. That whole post should be put into a book for people living in RV's having knee surgery...Great read with lots of info!!!! Keep downing the prunes, Odel...Once he gets active that will help too...

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  6. Great info...thanks for taking the time to share it!

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  7. Try magnesium supplements for the constipation. We use a product called Natural Calm found in our local natural food store.

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  8. Glad to hear Odel is progressing--at least with the knee and once he can do without the pain meds the "other" will resolve itself. That's not much encouragement now, is it??

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  9. information overload!..what a great post, Laurie!..we just have to hope we never need it!..hope Odel gets moving regularly soon!..

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  10. Laurie & Odel, I'm delighted to hear of the progress. I'm bookmarking/copying this information for my own adventure sometime in the future. This is worth it's weight in vicodine!

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  11. Egad! Hope everything works out! :)

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  12. I was fortunate to already own two pairs of elastic waist culottes when I had my knee surgery. I wore them to follow-up doctor appointments which meant I didn't have to change clothes for my exams. Tell Odel to wear shorts to those follow-up appointments if the weather will let him.

    I can't believe how much your posts are reminding me of various coping mechanisms. I just wish I could remember more of them before you need them. :)

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  13. Thanks for the great information. I'm sure we'll be going through the same thing before too much longer and I'd rather be prepared before hand.

    Hang in there, it's bound to get a little easier before too long.

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  14. Great information. We are heading home to Vancouver Island and an appointment on the 18th of May for my husband to have a total knee replacement so I have been following your posts with great interest. We have been wondering how hard it would be to deal with the recovery while living in our coach. We do have 4 slides but you are right Laurie, a walker is not going to fit anywhere beyond the living area!

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  15. Great post Laurie, Your solution for elevation was a good one and cheap too. I liked your idea of the picnic organizer in your last post to keep everything together, what a great idea! I found that a good tummy massage several times a day along with everything else helped to get things moving. Good Luck Odel.

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  16. Check out the following blog for a view of the knee replacement surgery 4 months down the line.

    dasusmusings.blogspot.com

    Susie is 4 1/2 months past her knee replacement surgery.

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  17. Al, thanks for that link. Took me awhile to put it together with Susie of "Dave and Susie"! I plan to go back and read her earlier posts on the subject, too. Very interesting to us, of course. Happy birthday to Joan, too.

    Cheers,
    Laurie

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  18. Hope Odel feels better soon. But I am sure it will all be worth it!

    Take care you two!

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  19. Ok, now that you know who I am go back to my blog in Dec of 2009 and read about the first knee surgery. Also as soon as Odel gets rid of the steri-strips after they take the staples out start masagging the heck out of the scar. If he get a thick build up of tissue get some ScarGard or ScarCare and follow the instructions. The problem that I had was that I needed to almost wear it 24-7 so I had to wrap in with big bandages to hold the gard in place. But it works. I had no build up of tissue afterwards. Feel free to contact me sucie49@gmail.com Take care and get well Odel.

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  20. Hello friend,
    Your blog is nice for medical relative services.I like this site. It is one of the best Post from other. I have some information about medical relative services.

    Dr. Pasquale Longordo, Kee Replacement Surgery

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