Third Day- Tired but good

Interesting day.  Been on my multimodal pain regimen- ice, Tylenol, Alleve and the pain is at best 1 out of 10 and worst- 3 out of 10.  I focused on some bending exercises and easily got to 90°:

KneeFlexionPOD3

 

beagle puppy barking

Pain is interesting.  It is like the sound of a barking dog.  If there is a dog barking behind a door and you are scared of dogs then of course, you think it will be ferocious.  But if you know the dog is a cute puppy, like the one in the picture above, the bark really doesn’t scare you.  I knew I had a solid pain regimen and I trusted my surgeon’s advice to move and exercise the knee.  Didn’t turn out to be that much pain in the end.  So far, no need for opioids.

What I did find most interesting today was how quickly I got tired.  After some activity I was really worn out.  I think patients have to be aware of this and get protective as venturing to do too much can leave you in a bad position.

Here is my Day 3 video review:

Transcription:

Hi, I’m Dr. Kirschenbaum. This is post-operative day 3. I got called up by the New York Knicks today. Of course, based on their previous year’s performance, I obviously played better than they have played in the past on post-op day 3. On post-op day 4, I probably could play for the Cleveland Cavs.

This has been a good day so far. My pain ranges from the best of 1 to the worst of 3. I haven’t taken anything but Tylenol and Aleve all day. I’m able to get up pretty nicely. I’m a bit surprised actually. I always thought my patients would have done worse by this time, but we’re pretty aggressive with the multi-modal pain medicines with the ice, with the Tylenol, with the Aleve.

Last night at about 9:00 was the last time I took any narcotics, and I only took 10 mg of oxycodone about 9-9:30. Ended up waking up about 2:30 in the morning with a little bit of discomfort that was well-controlled with 2 Tylenol at that time. That’s the pain story.

The function is quite good. I’m walking a bit better. As I demonstrated on the post-op day 1 videos, I have this knee exercise which I’ll be using more today. One of the big things I do want to tell people about is you’re tired a lot sooner than you expect. For example, I was walking around a lot this morning. By 10:30, I found myself just very tired. I just think there’s a lot of energy in my body that’s being directed towards my knee to heal it. The rest of my body is getting tired sooner than I think.

I think you have to be careful. I’m not getting dizzy or having any imbalance while walking. I am aware when I’m starting to get a little tired to sit down, to lay down and rest. I took a nap this morning for about an hour and a half, something I don’t usually do. I just think the key is to be careful about your tiredness, keep the fluids going, keep the multi-modal pain going, and other than that it’s been a good day.

I’m going to get up now and show you how I could rise from a seating position.

I also improved in getting up independently to stand:

Transcription:

Hi, Dr. Kirschenbaum. I’m going to get up from a seated position. This is a very low couch, and I really don’t recommend it but it’s the only one we have here. It’s a nice and gracious host that I have a couch at all. It’s quite good. I’m going to sit up. I just plant the foot. I’m flexed at about 60 degrees, but I’m really able to get up really well and stand. I’m going to limp, I’m going to take the walker just for balance protection, and I could actually walk with no discomfort at all, a little bit of a limp right now.

You can see that knee is able to get to full straightening. I’m able to stand on it well. I’m going to put all my weight on the operative leg. I’m able to, of course, put it on the non-operative leg. If I was to lift this up, we can see the dressing. The incision is only from here to here. The dressing covers some navigation sites, but that’s part completely. I could walk fairly nice. That’s it.

Also I was able to walk outside:

 

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