Bilateral knee replacement scheduled for August 8

[Doggiemom]

My OS has scheduled me for bilateral knee replacement August 8 and I am definitely scared about the surgery but mostly about the recovery . I know it will be extremely painful and challenging. I guess I'm like a lot of people that want to get back to normal activity soon after the surgery but I know that's not realistic. And yes I am scared of the potential risks like blood clots and bone fragments which is potentially life threatening as the OS stated. But they would be giving me blood thinners to prevent blood clots. I do not have a problem with any blood clots right now so that makes me feel better. Also he said I may be in the rehabilitation hospital for a week or 2. As far as the pain I have been taking a pain medication called Talwin NX for quite a few years for my knee pain as well as fibromyalgia and I am worried that I might be immune to pain medication following the surgery and that I won't be able to have the relief I need during this time. My knees are equally bad so this is why he suggested bilateral. He also said there would be him and another surgeon at the same time each working on a knee and that the surgery would be around 1¼ hours. He is a very good surgeon as well as his colleague so I have to put my trust in them but I am still scared and worried. I am so glad I found Bonesmart. You have been a Godsend to me.

 

[Josephine]

Hi and welcome to BoneSmart! We've had plenty of other members had bilateral TKR so you will have plenty of company! In fact, we have two on staff @Roy Gardiner and @referee54. I'll get them to come and speak with you.

I know it will be extremely painful and challenging.

It doesn't have to be. Most of us on here have managed to bypass that particular description by not being too enthusiastic with the PT and exercises (like almost none at all!) and by being diligent with the pain meds. I'll leave you our recovery articles so you can study our approach.

I am scared of the potential risks like blood clots and bone fragments which is potentially life threatening as the OS stated.

Never heard about .bone fragments' as a risk before! Are you sure that's what he actually said? But as you so rightly mentioned, all joint replacement patients now have prophylactic anti-coagulants (blood thinners) so it greatly reduces the risk.

Talwin NX

I hadn't heard of this before so I did a search on it - interesting!

"What is Talwin NX (naloxone and pentazocine)?
Naloxone blocks certain effects of opioid medication, including feelings of well-being that can lead to opioid abuse. Pentazocine is an opioid pain medication. An opioid is sometimes called a narcotic. Naloxone and pentazocine is a combination medicine used to treat moderate to severe pain. Naloxone is included in this medication to prevent the misuse of the narcotic ingredient"

Here is the reading - everybody gets a free copy of the recovery reading!

Here are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Myth busting: no pain, no gain
Activity progression for TKRs
Heel slides and how to do them

Extension: how to estimate it and ways to improve it
Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
Myth busting: the "window of opportunity" in TKR

Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

 

[newlybionic]

I love your picture of your dog. Mine won't even let me put a ribbon in her hair! Read everything you can. You feel feel ready that way. Ask any questions or just anything you're feeling. We are here to support each other.

 

[Roy Gardiner]

I know it will be extremely painful and challenging.

|But controlled by medication, and whilst you're sitting doing nothing it's fine.

I guess I'm like a lot of people that want to get back to normal activity soon after the surgery but I know that's not realistic.

Excellent. Your knees will set the pace. Look out for boredom and apparent lack of progress in the early days.

And yes I am scared of the potential risks like blood clots

Sufficient unto the day...!

Preparation is key. You need to set things up so you can do as little as possible for some weeks.

 

[Doggiemom]

Thank you for your advice and information and for making me feel welcome. With Bonesmart you know you are not alone in this. And yes the OS did say bone fragments can chip off and get into the blood stream. I had not seen or read about that before either. And thank you newlybionic, I'm gonna miss my furbabies while in the hospital and rehab facility.

 

[Celle]

Your surgeon is duty-bound to warn you of all the possible risks associated with a knee replacement. That's so you can give what they term your "informed consent" to the surgery.
Just because these risks are possible, it doesn't mean they are probable. Some of them are extremely rare.

The main thing is that, if you trust your surgeon, you can trust him/her to do your TKRs to the best of his/her ability - after all, it's a job they do every working day. To us, it's a big deal (of course it is, and I'm not minimising that) but to them it's just another day at the office. They trained long and hard for it and (with very few exceptions) they are very good at it.

 

[dianehelen]

Welcome to the forum. And welcome to being another August Hotshot. If you add your name to the thread in the group of sticky posts here, we can go thru this together with others having surgery that month. Mine is August 17 and I am terrified of all the what ifs and the pain of recovering as well. Read up on all the great recoveries here that did so without the old mantra of "no pain no gain", others you talk to, will try to convince you to go with the old way, but the more you read here you will see that is NOT the best way. Bonesmart mantra seems to be the trick.

All the best to you, and we will get thru this together!

 

[Josephine]

And yes the OS did say bone fragments can chip off and get into the blood stream.

He may have misspoke. Fragments of bone fat (or marrow fat) can get into the blood stream and cause what's known as a fat embolus but they are extremely rare. I really don't know why he even mentioned it!

 

[lunula]

Hi @Doggiemom. You'll obviously get lots of great advice here, but I can tell you from personal experience with a LTKR that I was terrified going into it. I was honestly not scared of the procedure itself (i.g., "something" happening during surgery) as I've had surgeries before. For whatever reason, I was irrationally scared of a post-op infection. Other Bonesmarties were very helpful to alleviate my fears, especially those who had gone through the ordeal.

I had a rough recovery in terms of dealing with pain. For the first week, my pain was not controlled well, but having never gone through something like this, I just didn't know it wasn't controlled well. I experience extreme itching with narcotic pain meds, so I was having to take Benadryl w/ my pain meds and I was a groggy mess.

I've read about some amazing recoveries here, and going into surgery, I honestly felt like I'd be one of those people, too. I was young (43), in good health, no chronic issues or medications, worked out regularly, etc. However, I just didn't fall into that category. I'd read about others, who had surgery around the same time as me, who were up and out, taking walks, going to the gym, etc. and I was barely able to get up stairs - much less get outside for a walk. I admit, I had to take breaks from BoneSmart during that time because it made me depressed, angry, resentful and confused.

I just don't think there is ANY way to tell if you'll be one of those amazing/fast recoveries or one of the slow recoveries. I just had to resign myself to the slow healing group.

Good luck to you!

 

[dianehelen]

@lunula I totally get where you are coming from. I had a LTHR MARCH of 2014. I spent weeks reading all the great recovery stories. But I was not one of them. My surgical site got infected, I endured 2 additional surgeries to clean out. Then almost 8 VERY MISERABLE months using a wound vac, with daily tortuous dressing and packing changes and weekly visits to both an infections disease dr and a wound dr, along with in home iv antibiotics. I too felt so envious of all the great recoveries, I was not having. It caused me to be too scared to get my knee done, for the past 2 years. I'm finally at the point that I have to face it, because living with the pain of this knee, is just not living. And this knee is on the same side, to make me extra nervous. I hope you eventually got better and can live a better life.

 

[MarciHeff]

Dear Dogglemom, I am listed for my bilateral knee replacement tomorrow. I am thinking that the recovery pain is better than what I experience now.. which will never ever go away without surgery. With surgery Dogglemom my recovery pain will stop and one day I will be painfree. I will be posting as soon as I get home early next week, hopefully I can share good news, progress and tips and hints. I hope you will continue to find the inspiration and the courage to take the next steps onto a road or healing - from the wonderful support here on Bonesmart. xx

 

[lunula]

@dianehelen - Oh yes, I'm doing much better now! I was not posting to discourage or even scare @Doggiemom, only to say that none of us have any clue how hard or easy our recovery will be, but we all make it through. I've even read here of people who had a difficult time with one, and a much easier time on the second (or vice versa).

I had moments when I really really regretted my decision to have the surgery - even months later. I can honestly say it took me up until the last 6 months or so to even feel my new knee was better than the old one. But now... heck, I'm back at the gym - back to hiking (go on a 6-miler this Saturday) - went white water rafting for a week in the Grand Canyon (and even tackled some of the hiking there) and we are planning to hike the Inca Trail next year in celebration of our 20-year anniversary. I couldn't have done pretty much any of this without having had my surgery!

Totally natural to feel scared and anxious - before during and after!

 

[Doggiemom]

@MarciHeff I pray your surgery went well and you will soon be on the other side everyone talks about. I too look forward to that day. Like you the pain we live in every day in not living and we are far too young to think we have to live like this. God gave us a life to live not just exist. That's why I finally made the decision to go ahead and get this surgery scheduled and get it over with before winter sets in and hopefully I will be able to start bicycling and taking long walks again without pain. That does sound good, NO PAIN!!! @lunula I am so happy you made it through all the bad times and now you have the life back that you were looking for. Wow hiking the Inca Trail that would be so nice! I guess I'll be scared until it's all over with and then I can start on my rehab knowing this pain will soon pass. Just take it one day at a time...

 

[tjcteacher]

Everyday you will second guess yourself if you are like me-8 weeks after bilateral I am glad I did it-no regrets yet.

 

[Doggiemom]

@tjcteacher yes I went yesterday for finalizing the registration for surgery, lab work and ekg and clearance for the surgery. Everything is good and clear for surgery August 8, they said around 6 or 7am. I keep saying there's still time to back out but I know I don't want to do that because I don't want to continue to live with this bone on bone every day of my life. I have looked into renting a lift recliner from Aarons, it's only $99.99 a month or Overstock.com has some on sale for under $300. I'm sure the second guessing is because of the surgical pain afterwards and pray I am strong enough to get through it and be able to do my PT to avoid scar tissue and blood clots. I am so thankful for Bonesmarties out there who know exactly what I'm feeling and have been in the same place or will be. I'll keep everyone updated. Countdown starts now!

 

[uva55]

Everyone has doubts until last moment, it is normal to be scared, but there us no quality of life with arthritic knees so yo me the records worth it if it gives me my life back...I had a regular recliner and it was fine.

Good luck with your surgery!!!

 

[mamazipp]

Doggie mom, although the recovery paths are so different with everyone, you know it's bound to improve your life in the long run, instead of living with bone on bone pain, which doesn't get better. When I wasn't sure about having one TKR I realized that the alternative was pain and eventually disability and maybe wheelchair. THAT was not what I wanted for my future. You'll have so much support, information and encouragement here that you'll be able to do it. And, get that lift chair.

@Josephine when I was in nursing school in thr 1970's Talwin was commonly used for pain, like Tylenol, or aspirin. They used to have dishes of it sitting around the nursing station, for anyone to take. Of course this was pre-counting of narcotics and such. People said it made them "high". I took some once or twice for something, maybe a headache or so, and felt so weird that I never took it again. It did fall out of favor ( as did leaving meds on the Nursing station counter) and I've not seen it used since. But I've not worked in high pain areas.

 

[FlaGranny]

Re: bone fragments On one of the videos I watched, the OS was explaining how he carefully searched behind the knee to make sure there were no bone fragments. I imagine a bone fragment would be painful.

 

[tjcteacher]

I really didn't have terrible pain unless I didn't keep up with pain meds-that didn't happen too many times :rolleyes:
I bought a recliner that electric and don't regret it-is has come in very handy. The lift chair would be a good thing to have around. You are getting closer-icing and elevating are totally necessary. Nights seemed to be tougher to me. Had are hard time sleeping and getting comfortable. I think that is very common.

 

[Josephine]

Talwin was commonly used for pain, like Tylenol

@mamazipp, it's nothing like Tylenol! I knew it as Pentazocine, a synthetically-prepared narcotic drug of the benzomorphan* class. We kept it under lock and key and it had to be signed for like any other controlled drug.

*Benzomorphan does not actually possess analgesic properties itself!