Total Knee Replacement Surgery Issues - Left Arm Lymphedema

Thanks everyone for your replies!

After reading sbelizabeth's post, I was thinking maybe I misunderstood and they need a 2nd IV site to be selected ahead of time as a precaution, but jazziD did have 2 IV's in, so will need to check on that. I've read that sometimes a machine is used to filter drainage blood and then give back to the patient, so maybe that's why the additional IV?

With prophylactic right mastectomy and no axillary nodes on that side, risk is probably low for lymphedema, but already dealing with it in my left arm, I know I definitely don't want it bilaterally and do everything I can to protect my right arm. Automatic BP machines seem to me to inflate quite high and measurements would need to be repeated frequently during surgery so BP on arm is not acceptable. While an IV and arterial line in the same hand/arm is a concern, always thought that restricting fluid flow with BP cuffs, tourniquets, etc was more of a risk factor than infection or trauma from a vein stick. I have blood drawn from my right hand without a tourniquet.

Another thing in the back of my mind.....I've been by told there is no-way lymphedema can happen in the leg after TKR as there are no nodes in the knee and that any swelling is just from the trauma of the surgery and not actually lymphedema. But I have read that lymphedema can and has indeed happened after knee surgery.

When day to day living and getting around is this difficult, not to mention extremely painful (knee alignment also affecting my back), guess it's time to move forward......be as informed as possible about the surgery, take necessary precautions, have a good and caring surgical team and most of all, trust in God that I'm in His hands.

Thanks octogirl! The surgeon wants 2 IV's in - with the 2nd just in case of trouble or failure with the 1st during surgery and this is standard procedure for their orthopedics department. Normally one would be in each arm, but in my case only one arm can be used (and that reluctantly on my part) so the other "in case" IV will go in the jugular vein. One will be removed immediately after surgery - I'm assuming it will be the jugular IV. The arterial line is to monitor blood pressure since I do not want the automatic thing on my right arm during surgery. Thoughts of the arterial line I must admit does scare me, but having lympedema already in one arm, I'll do everything in my power to prevent it in the other.

Epidural does definitely sound like the way to go. They sometimes also use a peripheral nerve block, but pretty sure I'll pass on that.

Looking forward to a fully functional and pain free knee! Wouldn't you know it, that a couple days ago my left knee,usually much less troublesome, has greatly increased pain now.

Surgery is done and recovery in progress, although not progressing as quickly as I'd like. I did opt for spinal and nerve block for knee. The anesthesiologist decided to use blood pressure monitor on my left calf and BP was also monitored on calf for the 2 day hospital stay. Even though the calf BP measures higher than my normal, he was more concerned with it being consistent. They never inserted a second IV, so guess they just wanted to have a location ready in case the hand IV failed. I was not permitted to wear compression on my left arm during surgery, but have 2 Solaris extended gloves that I wore the rest of time in hospital and LE was controlled very well. Right hand IV also was fine with no issues.

Because of calf pain few days after being discharged, I was sent for ultrasound - negative for clots. At 4 1/2 weeks out, pain continues not just in my knee, but also in foot, thigh, hip and especially right rear area (sit bone?) which is much worse than the knee pain. Have an upcoming appointment with chiropractor soon, so hopefully he can help with the lower back/rear/hip pain. Ortho said some of this pain is muscles learning to work with new knee.

I wore compression TED knee high stockings everyday for 4 weeks (3 on non-operated leg). Without stockings, swelling has increased in my ankle and calf, but the knee and thigh area has lessened. Question: What advice or suggestions would you have to help with this swelling. I do try to elevate whenever I sit and I think this helps some, but is annoying. Thinking to try compression socks of some sort or maybe bandage wrapping. I'm pretty sure the swelling around knee is normal at this point, but in the ankle and even top of foot is more of a concern for me.

Thanks cowgal! I have felt exactly the same - when a friend asked if I was glad I had the surgery, my reply to her was "not yet". It's been tough and I'm sure my back issues have been responsible for a large part of this, but am now beginning to see the "light at the end of the tunnel". Feeling a lot more confident about my recovery and my decision to have the knee replacement.

I had dropped off on the icing, but going to pick that up again today along with elevating. It's hard when beginning to feel better and wanting to be up and around and doing stuff, to then make yourself sit, ice and elevate!