Having BTKR surgery July 11, 2012 "Looking for support"

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Brave4life

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Good Word of Encouragement to Kathy and Me!

Tim I am new to Bonesmart and trying to figure out how to post information to the site. I am having my BTKR next Wednesday July 11, 2012. I did my research and self educated my self in the procedure, watched several BTKR surgeries on Youtube. But what I lack now and desperately need is support from those who have been through this. I work at Naval Station Guantanamo Bay, Cuba. I am a civilian. I need to return to work with optimum functionality because there is no BTKR "rehabilitation" available there. I think because I am visiting a relative here in VA and there is no one home during the day that I need an intensive rehabiltation center to handle my recovery. I would like to be discharged from the hospital to a rehab facility. What is your thinking on this?

Anyone else that would like to comment on this please do :)

Also, how do I post my operation date in July?

Thank you all,

Brave4life
 
Thank you first of all "Bottomshollow."

Your help in how to post was perfect. I feel relieved already. Something about me: I'm 64 and only in the states for this operation. I currently work in Naval Station Guantanamo Bay, Cuba.

They cannot perform a TKR at GTMO and our physical therapy is not equipped for TKR physical therapy. So, I would like to be discharged from the hospital after the initial 2 or 3 days and go to a Rehabilitation Center. Because I don't live here and currently staying at my daughters, (sleeping in my grandsons bed) her home is not equipped for my recovery. She also works during the day and no one is home from 5 am to 6pm.

What is the best way to get my need across to the case manager and the insurance company pay for short term rehabilitation in a facility?

Did anyone run into problems with this?

I have self educated myself about BTKR. I've also watched about 3 BTKR surgeries on Youtube. What I need now is encouragement from those who have gone to the other side!

My fear is not the operation, but rehab that is not aggressive enough to get me on my feet in a moderate amount of time. I'm also collecting STD (short term disability benefits from my job) and need to be functional in 12 weeks after the surgery. Any tips on accomplishing this?



Thank you all,
Brave4life
 
Good luck on the 11th. I am having one knee done on the 12th. Based on my pre-op classes, if you specifically tell them you have no one to care for you at home (especially with a BTKR) they will automatically discharge you to a care facility. Call the doctor's office and express your concerns and maybe they can help.
 
Thank you first of all "Bottomshollow."

Your help in how to post was perfect. I feel relieved already. Something about me: I'm 64 and only in the states for this operation. I currently work in Naval Station Guantanamo Bay, Cuba.

They cannot perform a TKR at GTMO and our physical therapy is not equipped for TKR physical therapy. So, I would like to be discharged from the hospital after the initial 2 or 3 days and go to a Rehabilitation Center. Because I don't live here and currently staying at my daughters, (sleeping in my grandsons bed) her home is not equipped for my recovery. She also works during the day and no one is home from 5 am to 6pm.

What is the best way to get my need across to the case manager and the insurance company pay for short term rehabilitation in a facility?

Did anyone run into problems with this?

I have self educated myself about BTKR. I've also watched about 3 BTKR surgeries on Youtube. What I need now is encouragement from those who have gone to the other side!

My fear is not the operation, but rehab that is not aggressive enough to get me on my feet in a moderate amount of time. I'm also collecting STD (short term disability benefits from my job) and need to be functional in 12 weeks after the surgery. Any tips on accomplishing this?



Thank you all,
Brave4life

Brave4life I am 4 months post op with my RTKR and must say I have had a pretty good recovery. You are having a BTKR and to be back to work in 12 weeks is pushing it. Its not your decision it will be your knees. They make all the calls. Agressive PT will do no good if your knees are swollen and trust me they will be swollen. I was back in the gym at 34 days but my knee was still swelling and I ice everyday still. I think in your situation a rehab facility will be your best option since you are having a BTKR and really no help at home. I went home but I had help for a few days. Then I was home alone while my husband was at work. I was able to manage on my own but I had only one knee done. My best tip would be don't push it, your knees will need rest, elevating, ice and pain meds. Best of luck to you on your surgery.

Margie
 
Thank you, Scarey,

I will do that! Thank you so much!

Brave4life


Good luck on the 11th. I am having one knee done on the 12th. Based on my pre-op classes, if you specifically tell them you have no one to care for you at home (especially with a BTKR) they will automatically discharge you to a care facility. Call the doctor's office and express your concerns and maybe they can help.
 
welcome-group.gif
Glad to see you could follow my directions and made it here. And yes, let your OS's office and the hospital know what your situation is and that you will have no one to care for you. That should get you into a rehab facility.

As for aggressive PT
others-231.gif
, that's an absolute NO-NO. I am going to give you links to articles in our Library that are essential reading for anyone undergoing a BTKR. Please read and reread them. Knowing about the surgery itself is fine, but that's the easy part. Recovery is a whole other animal.


The importance of managing pain after a TKR and the pain chart
How Long Does Healing Take ......

Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice
Swollen and stiff knee: what causes it?
Constipation and stool softeners

Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee RecoveryWork “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it


Along with the articles in the Library, I highly recommend Brugioni and Falkel’s Total Knee Replacement & Rehabilitation. The authors are an orthopaedic surgeon and a physical therapist who had bilateral total knee replacement himself. It is available on Amazon in paperback and e-book for $15 and $10 respectively. It covers every aspect of recovery on a week to week basis for the first 4 weeks and then on a monthly basis by 3 month segments for a full year. It is a great resource, answers questions you didn’t even know you had, and has lots of rehab exercises with pictures.

Total recovery from BTKR takes at least 12 months. You will begin to feel almost "normal" between 4 to 6 months if everything goes well. Some folks just take longer to heal and rehab than others. You MUST understand that it is your knees that are in charge of the recovery--not YOU, not your OS, and not your PT. If you embrace the BoneSmart philosophy (our mantra) of taking pain meds on a schedule; getting lots of rest; elevating those legs (toes above nose), and icing, icing, icing; keeping exercise and PT to easy, gentle stretches and bends for the first 3 to 4 weeks, you will find that your knees will be pretty kind to you. However, if you insist on pushing them---they are going to push back---they will swell, ache and just plain hurt---and you'll be back to square 1 again. You should not even be considering getting back to work for at least 12 weeks. Please remember that we are here to answer your questions and concerns, to give you a place to vent if you need to, and to support and encourage you from pre-op to post-op through recovery. Keep us posted.
icare.gif
 
Welcome Brave4life! Best of luck next week! We'll be thinking about you and sending prayers and positive vibes your way for a smooth and successful surgery! The support and advice here are phenomenal; please take advantage of that after the surgery as well. And let us know how you're doing won't you? For those of us still in the wings, seeing others cross the bridge to the other side is helpful and also allows us be the encouragers. :thumb:
 
Welcome to the forum---we are glad that you have found us! I took your post from the one thread and started a thread of your own so that others could chime in and help you out and advise you. I see that you have done a great deal of research on your own---we have an excellent forum library here chock-full of articles with excellent information for you: I will give you a list of them so that you can help yourself in reading them.

The importance of managing pain after a TKR and the pain chart
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

We will be here to help you throughout all of this---from the pre-op, the surgery itself, and the ensuing recovery. Ask all of the questions that you want---pose any concerns that you have---ar stop by simply to vent or to rant--we will be here for you.

I believe that you are wise, making the decision to go to a rehab facility after having your BTKR. Speaking from experience---I had a BTKR going on five years ago---a BTKR recovery can certainly be challenging and the fact that down at Gitmo there is no rehab facility for a BTKR----you definitely need to get a "leg up" (sorry for the pun) on moving forward correctly and gently through your recovery.

Rehab for a TKR or a BTKR is not like an athletic injury---it is not "No pain, no gain", but rather, "No pain, MORE GAIN", as you do not want to overwork your knees which have been surgically traumatized.

I returned to the classroom at eight weeks---which seemed like a long time, but, in reality, was only halfway through a standard TKR or BTKR recovery. We recommend that you try to return to work at around the 12-week mark---and then on a phased-in basis, if possible. I returned to early, and that slowed my recovery down quite a bit.

I am glad tht I had a BTKR: I knew that both knees were shot and needed to be replaced. I asked my OS about getting a "BOGO", so to speak, and he agreed! I had one wait for the surgery, one surgery, on rehab, and I didn't have to have one done, go through rehab, and then go through another.

That being said, recovery from a BTKR can be challenging as you don't have a non-surgical leg to help "carry the weight." Patience is the key virtue that many TKR or BTKR patients need to find---we think that recovery should be over, but, in reality, the knee or the knees are in charge and you cannot set a timetable in terms of recovery. Now, in retrospect, I am very, very glad that I had the BTKR and my life is great---I can do basically anything that I want to do, and without pain.

Please keep posting and let us know what other questions or concerns that you have---we will be here throughout the entire process!
 
Welcome to BoneSmart! I agree with all that Tim has said - the very LAST thing you need is "intensive" rehab. Contrary to what you might suppose, the first 2-3 weeks you need nothing but REST, ELEVATION, ICE and PAIN MEDS! You should read Roy Gardiner's recovery thread here BILATERAL TKR Recovery Diary and one page diary summary. He got a really good result but not by intensive anything! Plus you need not to rush back to work. So many people think that 6 weeks will do it and it doesn't. You will probably need more like 10-12 weeks if you can't have a phased return to work
 
HELLO EVERYONE! Kathy, Scarey, Margie, Tim C, Josephine A, Lori-M,

I feel like a powerful team has been commissioned on my behalf!
Thank you for the wonderful heads-up on so many important topics. I will be reading through your responses tonight. Most importantly, I needed the mind-set adjustment concerning my previous "sports injury" mentality. I embrace "No pain, More Gain."
I will be taking my IPAD with me to the hospital and will touch base with you all day by day.
Thank you so much for your generosity in sharing your TKR wisdom!
Brave4life
 
Here is an idea about rehab. First call your insurance company (if you haven't already done so) and see if rehab is a covered benefit. Good to know that before. Also, when you talk to the case manager, remember she. Or he is the one that you have to "impress". Do not even tell them that you have family in the area. and get support from your doctor beforehand.

Look at rehab as a great place to recuperate. I would not suggest that you look at it for intensive therapy so that you can work. And always remember that you own your body..and don't allow anyone hurt you

I had the time to check out rehab facilities that you may not be able to do. You need to see which ones your insurance plan are contracted with..and you cannot sign up beforehand as they, of course, will only admit you if they have a bed.

Most insurance companies go by Medicare rules which is you must be in the hospital for at least 3 days before Medicare will pay for rehab. I realize that you do not have Medicare coverage but this is something eanother check on with your insurance company.

I could not imagine doing any work at 12 weeks. Not even a plan trip would have felt very good.

Be kind to yourself and good luck.
 
Hi Brave4life, this nick name already tells me that you are a very brave person so thats good. I must say I did not expect you to be 64 years looking at your picture. You look 20 years younger. Your target of 12 weeks to be functional is quite realistic if you mean going back to work and just doing normal stuff. But if it requires a lot of physical demands, then it may be tough.

I went back to work at 2.5 months but I could actually go back slightly earlier. I managed to climb 2 floors up to my office. But my job is mostly desk work so it was manageable. Even then getting up and down the chair numerous times to move about in the office was really tiring due to the stiffness. At the end of the day, I go home exhausted but I could sleep really well unlike the downtime during recovery when sleep was a problem due to all the inactivity.

Over here, outpatient rehab is not very popular. I only had a PT who came to my hospital room to teach me some exercise and gave me some advice. As I was still relatively young (at 49+), disciplined and physically active person, my doctor felt that I could just do the PT on my own. I continued doing the PT at my own pace at home and I had quite a quick recovery. I could climb stairs, walk without aids and drive car in quite a short amount of time. I did not experience much swelling except the stiffness was quite bad. Now, after 14 mths + out, life is great. My ROM is average but I will not sweat over it. If it improves over time, it will be a bonus for me. My stiffness is still there but I have lived with stiffness for so many years due to arthritis, I will not let it bother me anymore. If it improves over time, then it will be a bonus for me. I have a normal walk and posture now and am back to doing more intensive exercise. I am most grateful that BTKR has given me pain free knees.

Good luck to your surgery. I am sure you will pass with flying colors!
 
Good Word of Encouragement to Kathy and Me!

Tim I am new to Bonesmart and trying to figure out how to post information to the site. I am having my BTKR next Wednesday July 11, 2012. I did my research and self educated my self in the procedure, watched several BTKR surgeries on Youtube. But what I lack now and desperately need is support from those who have been through this. I work at Naval Station Guantanamo Bay, Cuba. I am a civilian. I need to return to work with optimum functionality because there is no BTKR "rehabilitation" available there. I think because I am visiting a relative here in VA and there is no one home during the day that I need an intensive rehabiltation center to handle my recovery. I would like to be discharged from the hospital to a rehab facility. What is your thinking on this?

Anyone else that would like to comment on this please do :)

Also, how do I post my operation date in July?

Thank you all,

Brave4life
I am due for a 2 day stay at hospital and then home for rehab, most insurance policies should cover this.
 
Welcome to BoneSmart! I agree with all that Tim has said - the very LAST thing you need is "intensive" rehab. Contrary to what you might suppose, the first 2-3 weeks you need nothing but REST, ELEVATION, ICE and PAIN MEDS! You should read Roy Gardiner's recovery thread here BILATERAL TKR Recovery Diary and one page diary summary. He got a really good result but not by intensive anything! Plus you need not to rush back to work. So many people think that 6 weeks will do it and it doesn't. You will probably need more like 10-12 weeks if you can't have a phased return to work
Hi, Brave4life,

Josephine is the expert, I did what she and everyone said and which matched my nature (I am bone idle lazy) and got the result.

It looks as if you (like many others) are dead keen to speed up recovery. It can't be done, it's a healing process, not a training process - as others have already pointed out. Trying too hard can only slow you down.

You have embraced 'no pain, no gain' :thumb:. This plus lots (again, as Jo says) of rest, ice, elevation (watch lots of telly, OK?) will do the job.

Best of luck, you will LOVE it as I now do. Freedom!!!!! No Pain!!!!

Because I don't live here and currently staying at my daughters, (sleeping in my grandsons bed) her home is not equipped for my recovery. She also works during the day and no one is home from 5 am to 6pm.
If you can make it from couch to bathroom and back, you'll be OK. Pre-prepared food, lots of telly and DVDs, books maybe.
My fear is not the operation, but rehab that is not aggressive enough to get me on my feet in a moderate amount of time.
As we've all said, you cannot speed up recovery. Please, don't try. You can only make things worse by being too aggressive - but I think reading your posts above you have already realised this.

12 weeks to return to work, if it's a desk job not involving standing or walking or kneeling, is just about possible. But look out, at about 8 weeks you may be starting to panic thinking nothing's happening. But don't, that 4 weeks extra is a long time.
 
Best wishes for the 11th. It does sound like if you can wrangle even a short stay in rehab it would be helpful.
As others have said, recovery is on the knee's schedule. Now certainly you shouldn't sit like a lump ;) but more activity isn't always better. Plenty of ice, elevation, rest and gentle exercises is the way to go. I think it's all about balance.
 
It looks as if you (like many others) are dead keen to speed up recovery. It can't be done, it's a healing process, not a training process - as others have already pointed out. Trying too hard can only slow you down.

You have embraced 'no pain, no gain' :thumb:. This plus lots (again, as Jo says) of rest, ice, elevation (watch lots of telly, OK?) will do the job.
'---

This is very, very true---if you prepare yourself to set a record for the speediest recovery---if you try to work hard and beat everybody---you will only set yourself up for a very, very frustrating time. The knee or knees are in charge---and often time, it is not "work harder"; it is, rather, "work smarter"---which means that there are times that you absolutely should be doing little or nothing and let your knees heal.

If you work too hard, you will only aggravate your knees and the surrounding tissue and slow your recovery down. Remember---your knees are in charge!
 
Hi Brave4life!
You have my support! I'll surely be thinking of you on Wednesday. Post when you get to the healing side. Wishing you a safe and uneventful surgery!
 
Hi Brave4Life,
Just letting you know someone else is also thinking of you and wishing you well. :console2:
 
Good Word of Encouragement to Kathy and Me!

Tim I am new to Bonesmart and trying to figure out how to post information to the site. I am having my BTKR next Wednesday July 11, 2012. I did my research and self educated my self in the procedure, watched several BTKR surgeries on Youtube. But what I lack now and desperately need is support from those who have been through this. I work at Naval Station Guantanamo Bay, Cuba. I am a civilian. I need to return to work with optimum functionality because there is no BTKR "rehabilitation" available there. I think because I am visiting a relative here in VA and there is no one home during the day that I need an intensive rehabiltation center to handle my recovery. I would like to be discharged from the hospital to a rehab facility. What is your thinking on this?

Anyone else that would like to comment on this please do :)

Also, how do I post my operation date in July?

Thank you all,

Brave4life
You have come to the right place. I found this group only last week and have read so much helpful information. Best wishes for a successful surgery. I look forward to watching for your posts 'on the other side'.
 
You/we certainly do have a wonderful support team on here. They will give you courage all the way through, from pre-op, post-op right the way through your recovery. Not long now for you, Brave. Keep on with the positive thoughts.

Kathy
xx
 
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