Wellness

[hckynut]

@judianne 

After any major surgery using common sense should prevail, especially when they are middle or lower joint or spine surgeries. Walking in an "unplowed anything" before fully regaining mobility and flexibility?  Don't make much sense to me.

Physical therapy for all joints and anything spinal, should always be for life. I see my own spinal issue exercises as what has, and will keep me as mobile and as flexible as possible, maybe for life. Every injury and health issue, I looked at Rehab and PT as a positive. I do know had I quit doing them after I "was healed?(?)", I would not be ice skating 3 times a week. 

Hope things continue to go well for you. Being positive about life's tougher issues bears fruit.

hckynut(john)

[chlema]

@KACEE1115 My surgeon used stitches for both of my knee surgeries.  The sewing was done by his assistant and what a great job he did - can hardly see where the incision was so I am happy.  The nurse said that she can always tell when Dr. Todd stitches someone up because he does such a good job lol.

[RedTop]

@KACEE1115,

When I had my first TKR in 2012, local ortho surgeons always closed the top layers of the incision with staples.  

By my second surgery in 2017, a glue adhesive was the preferred method.   A wide piece of surgical tape then covers the incision during the first two weeks of recovery.   

My ortho surgeon prefers to use the glue adhesive, and feels this is the best option for his patients.  I was the first of 6 TKRs done that particular day, and the ONLY one who experienced problems with the glue.   

[kismet]

My first surgery was 10 years ago and maybe staples were used more then.  Don't know about now.  I remember looking at my knee when I got home and honestly it reminded me of a football with the staples.  I did cancel the home PT with my second knee because I was running a temp of 103 and felt really bad.  This was the day after I saw the doctor for the staples to be out.  I asked him to check my urine since I didn't feel right.  He did.  When I called the number given to me if I needed help they said the results came in as infection.  The resident at the hospital called in a prescription and I was fine.  If you massage your scar area when your knee heals some it will flatten the scar so it won't stand out.  I did and can't even see it on my knees.  I was also told that the PT that comes to the house likes to come at least 5 times.  The woman that I called to cancel after 3 was really persistent and still wanted to come.  I told her no and she told me they like to come 5 times.  With what they charge I can see why.  I knew what I had to do from my first knee and honestly this woman wasn't much help anyway.  Could have done it all myself.  Make sure when you change your bandage that your hands are clean or wear rubber gloves.  I would make sure you have some bandages at home too since I ran out of mine. 

[pitdakota]

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@KACEE1115 wrote:

Another question, I noticed people mentioning Staples? Is that the only way they close up now? I was thinking it was some kind of special tape etc.

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@KACEE1115, surgeons can also elect to close the incision with glue.  But many surgeons have now moved to the Zip closure, which is what you might be thinking about.  Here is an article about it where you can see what it looks like, if you choose:

https://ryortho.com/2014/09/zippers-instead-of-sutures-this-is-cool/ 

It is now becoming very common for both knee and hip replacements as well as other types of surgeries.  It really does a very nice job.  There is no need to change dressings, clean the incision, etc.  When it is time, the entire piece is just removed as a whole like a piece of tape.  It just peels right off.

Best wishes for your knee replacement.  

[MILKI]

Hello! I am an RN, I work in Home Health, here in Sacramento. I, too, after delaying as long as I could, will be having TKR in June. In my practice, I take care of many patients postoperatively. Some, not all, patients will go to an in house rehab for a week or two. Depends on your insurance and your surgeon! Other patients, from the VA system, having their surgeries at the VA center in San Fran, have it done on an output basis, and if there are no complications, are sent home The same day. Personally, I would not want this. My surgeon will keep me in the hospital , one night, going home the day after the surgery, so no hospital stay. He states that insurance companies are really cracking down on in house( meaning hospital) stays for more than a day, or possibly two days at the most, then discharged home, as I will be ambulating on the day of surgery in the late afternoon. 
Request Home Home services from your surgeon. As the RN case manager, I help with pain relief

, removing staples and incision care .Also some patients are placed on anticoagulants, again a decision based on your surgeon, Home Health RNs can do the INRs that are needed for those patients placed on Coumadin, if not on Coumadin and on Plavix or Xarelto, no INR blood test is needed, but with all Anticoagulants we monitor for bleeding and bruising while you are home recovering. Home health also provides physical therapy , ususaly 2x per week , and Occupational therapy once or twice per week, depending on what is ordered thru their evaluation. 
Start looking for a community based PT while recovering, so you can continue when Home Health leaves your service, usually 4-8 weeks after your surgery. 
Please follow instructions to the T. Get your home ready NOW! Grab bars , raised toilet seat, shower chair, remove rugs that could cause tripping, 2 wheel or 4 wheel walker. Rest , Rest Rest! And Exercise will help you heal faster. Also, as the RN, most patients will be sent home on Hydrocodone, or Oxycodone! Take them sparingly, but MOST impaortantly, take a fiber supplement, start a week or two or three BEFORE your surgery date and take daily. The misery I see with patients in,  taking these pain meds that cause constipatation can all be relieved with taking Miralax or Metamucil regularly with drinking a lot of water throughout the day, will be one less miserable complication that you won't have to deal with. I am very serious about this! I have had to send several patients, post op, back to the ER after their knee, backs or hip surgery's because they haven't had a bowel movement in 5 days ! Hope this all helps! MJ