I didn't have to look long before I found the journal I had written after my
TKR in 2000.  I left out all the background history and am typing just the
journal of recuperation by itself.  There will be places where I skip days
because of lack of any reportable change in my condition.  Hope this helps
you!  You're free to use this document on your website and/or as it will
help someone else.  Nanny

"On the 4th and last day of my hospital stay following my TKR, the doctor
wouldn't release me until I'd been given a unit of blood.  My hemoglobin was
11.1 before surgery, and dropped to 7.5 post-surgery.  It is not unusual to
have a blood transfusion after surgery, and in my case having been in
treatment for anemia before, it was not surprising.

FIRST NIGHT HOME:  I slept fairly well in my hospital bed, although would
awaken every few hours to take my pain medications (Lortab, Ultram and
Ecotrin).  The Ecotrin, which is an OTC aspirin, is primarily to help
prevent blood clots from forming in my knee/leg.  I can only sleep on my
back, although I elevate my head/shoulders and legs.  I rented a hospital
bed for downstairs, as climbing stairs is not possible yet.

DAY 2:  My Home Health nurse, who would be with me throughout my recovery,
made her first visit to check on me.  My knee and surrounding area is
painful and stiff, but I still started my physical therapy exercises.
Fatigue is minimal; took pain meds every 4 hours.

DAY 3:  I was prescribed an antibiotic, Cephalaxin, as the area around my
knee had become red.  Constipated.  Home Health nurse said to take a
laxative each morning and night until bowels are regular.  She said the pain
medication and inactivity from surgery contribute to constipation.  Also,
the iron supplements I am required to take for the anemia.

DAY 9:  The Home Health nurse said that the *average* healing from a TKR is
at LEAST 6 months.  However, my surgeon said it can take up to 2 years for
everything to heal (bones, muscles, tendons, ligaments, nerves).  My leg
aches and swells more in early evening.  I find that the leg brace they sent
home with me relieves that discomfort somewhat.  Still needing pain
medication every 4 hours.

DAY 10:  I got curious and counted my knee staples.  There are 73!  The
infection has cleared up, thank God!  The surgery site is still very painful
and tender to touch.  I cannot as yet bend my leg enough to use the rocking
chair, which is one of the therapies recommended.

Each night my husband helps me do 10 leg lifts, with my leg brace on.  On my
own efforts, I can only move the leg up a couple inches at a time while
sitting in my lounge chair.

DAY 11:  I found that by lying on the couch, I was able to do 10 leg raises
on my own!  The Home Health nurse said I need to work more on bending my
leg, doing the heel-slide exercise.  This one seemed the most difficult
exercise for me, as well as being tedious.  Little mobility of my surgical
leg as yet.  (I will add here that the particular surgeon I had did not
require his patients to go to out-of-home PT sessions, but he had 6-7
exercises he required them to do at home.)

DAY 12:  Went to the hospital for the routine leg doppler test to check for
blood clots.  It was a long, uncomfortable ordeal (nearly 3 hours), but the
technicians said they didn't spot any clots.  Another reason to be thankful!

DAY 16:  Although my bowels are moving, I still have some constipation.
I've been taking 2 Fiber-Com caplets a day, plus a laxative in the A.M. and
P.M.  The nurse suggested adding prune juice daily.  I am going 5 hours now
between pain medications.  I continue to do my home therapy exercises twice
a day and am now using the rocking chair minimally.

DAY 18:  I am going 5-8 hours between the stronger pain medication.  Bowel
stools are finally beginning to soften.

DAY 20:  Home Health nurse drew some blood to check my hemoglobin.  Result:
10.5, and seems to be going up nicely again.  Had lots of gas today,
probably a release from my days of constipation and trapped gas.  Am weaning
myself off Lortab to 1/day and supplementing with Ultram, Excedrin and Soma
at night.

DAY 21:  The HH nurse removed my 73 staples today!  She made the remark that
I am doing exceptionally well.  That is nice to know.

DAY 24:  Went upstairs for the first time and took a shower, sitting on a
special tub stool.  This was so much nicer than sponge bathing at the
kitchen sink!  Stopped wearing leg brace at night.

DAY 26:  My husband took me on my first outing since surgery - to the local
library.  I used my walker.  Slept upstairs in our own bed for the first
time.

DAY 28:  The HH nurse released me from their care, and I called to have my
hospital bed picked up.

DAY 30:  Cooked my first full meal for my granddaughter's birthday.  Took
first tub bath by myself.

DAY 32:  Started using a cane instead of my walker.  Went to the Mall to eat
and see a movie with my husband.  Great to be out and around!

At 7 WEEKS following TKR, I am able to do the following:  tub baths,
laundry, ironing, cooking, but slower than usual and with the aid of my
cane.  The knee "bend" is coming, but very slowly.  I still have numbness
around my knee, particularly on the outer side, but some feeling is
beginning to return.  I am told this is normal.

I'm beginning to find that when I'm working around the kitchen and other
areas of the house that without thinking, I take some steps on my own,
leaving my cane behind.  The next big step will be using no walking device
at all.

JANUARY 17, 2001:  After 7 weeks from my surgery, I had my follow-up X-rays
and consultation with my Orthopedic surgeon.  He said my knee bend was at
90% and he is anticipating even more as time goes on.  Said I could discard
my cane.  His nurse said the heat, numbness, swelling and "hardness" around
the knee is normal, and that it could take up to 2 years before the healing
is complete.  He is well pleased with my progress, and so am I!

ONE YEAR after my TKR, my Fibromyalgia pain around the knee more than the
Arthritis pain condition.  My surgeon said the joint is doing great, and
that the pain now is FM related.  Would I recommend TKR to others?
Definitely!  I have no pain when standing on my TKR leg, and I can walk
unassisted.  I have started using a small pillow at night between my knees
to relieve pressure on the hips and legs.

I sincerely hope that by my sharing my own experience, that someone else
will be encouraged when facing a decision to have a total knee replacement.
Peace and less pain to all of you!  Gloria (aka Nanny)

EPILOGUE:  Since I have written this journal, I have recently had my 5-year
examination by the orthopedic surgeon.  His comment was that "the joint
looks as good as the day he put it in!"