My recovery timeline

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richfriz

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My recovery timeline - Bilateral TKR

Bilateral knee replacement recovery timeline (My story so far)

On the 18th of December 2008 I underwent a bilateral total knee
replacement.

I am a 52 year old male

Before the operation I read a few comments from people whom had undergone a similar procedure but to be honest I did not find it all that useful when it came to trying to understand what the operation would mean for me. What was the pain like and when could I expect certain milestones

A week after the operation I did find an article that I found very useful in trying to gauge my progress and what to expect in the future. Here is the URL http://www.velocitypress.com/knee_replacement_surgery.shtml

Anyway here is my account. I hope it proves useful to anyone undergoing a similar procedure. I will endeavor to keep it current

Day1 the operation
Before I left home I showered and washed myself toughly with the special antiseptic wash the hospital provided. Arriving at the hospital I was put into pre op and my knees were shaved. After some pre op medication I was wheeled into the theater where an epidural was put in (painless) and a drip attached. Then it was lights out!
I woke up in recovery feeling quite good. No pain at all. The only discomfort was all the tubes coming out of me. I had a drain in each leg, an epidural in the back, a drip and a catheter. After an hour or so I was taken to the ward where I met my wife and talked for an hour or so before going to sleep. During the night a nurse came and took my blood pressure and temperature every couple of hours

Day2
I awoke in a cold sweat but feeling quite good. I did have some pain in my legs so the epidural was increased. My blood pressure was low and I had an oxygen mask on. Sometime during the day the physiotherapist arrived and told me I should get out of bed and stand. I thought they were absolutely crazy but with a little help I stood up holding onto a special walker that you put your arms in.

Day 3
More cold sweats overnight. My epidural was decreased because my BP was low. This resulted in a bit more pain (not bad) so I had a jab or Morphine that helped. Once again I got to stand up for about 30 seconds on the walking frame. I was put on an automatic knee bending machine for an hour and managed about 55 degrees of movement

Day 4
The Epidural was removed along with the drains in my knees. I got to stand and walk a few paces on a frame. Once again the automatic knee bending machine. This time I was up to about 60 degrees of movement

Day 5
Last tube, the catheter was removed and I got to take a shower sitting on a chair. Having a shower was the highlight of the day! Once again more automatic knee bending for an hour

Day 6
Things are improving. I can make it to the loo and the shower unassisted but I did suffer a bit of a mental breakdown. The enormity of the operation hit home and I found myself very down. The physiotherapy is hard. I can now sleep on my side with a pillow between my legs

Day 7
Things are improving. I can shower, go to the loo all unassisted. The physiotherapist got me up on crutches and I managed to walk 20 or 30 meters. The physiotherapy is still painful but by taking some painkillers before it was much better

Day 8
Slow but steady improvement. Walked a bit more today and went to Hydrotherapy. Hydrotherapy was wonderful! In the pool I could walk. The exercises were easier and as a reward I could “float” in the deep end for the last 10 mins

Day 9
The physiotherapist told me we will do stairs today. Once again I thought he was stark raving mad but he was right and I was wrong. The stairs weren’t all that difficult. The surgeon came to visit and told me I could go home in 2 days even though I could only manage 80 degrees of bend. More Hydrotherapy

Day 10
More practice on the stairs followed by hydrotherapy

Day 11
More hydrotherapy in the morning before I was discharged. If I did not have a caring wife it would have been a lot harder but she took good care of me. I managed to get up the stairs at home on crutches and settle into my own bed. What a relief!

Day 14
Still doing the exercises at home. I can get up and down the stairs and walk in the garden on crutches

Day 16
My wife loaded me in the car and we went out to a local café for breakfast. It took a bit of time getting in and out of the car and walking on crutches but a very good day. My right knee is improving rapidly and I can bend it well but the left is still not bending that well. I continue to do the exercises

Day 18 (The day I started to write this down)
We went out to visit my wife’s sister. Things improving slowly

Day 19
I find I can walk a few paces without crutches. I still have my crutches in my hand but don’t put any weight on them. I am defiantly still wobbly. I did manage to get into my pool at home and do some exercise. It was unnerving getting in but once in it was wonderful! My right knee is still doing better than the left but both are a lot better than a week ago

Day 21
Not much improvement in the past few days (Well not that I have noticed) I can walk a fair distance on the crutches and can navigate the stairs well but I stiffen up as soon as I sit down. All the muscles in both legs ache I am not sure if I am under or overdoing the exercises but have an appointment to see the physiotherapist tomorrow.
I think I am getting about 100 degree movement in my right knee and about 90 in my left but I have to push it hard

Day 22
I went to PT and did an hour in the hydrotherapy pool. I feel tired but good. I have 105 degrees in my right leg and 95 in my left

Day 28
I did a lot yesterday. I went and did the grocery shopping with my Son and then spent an hour in the hydro pool. Ended up a sore last night so I am taking it easy today. I am doing a fair bit more walking without the crutches. I guess the frustration is beginning to set in and I am getting a bit depressed. I just want my legs back!
 
Hi, Even though I went through THR, your journal is very interesting and I identified with some of your experiences when I spent a few days in our subacute center (like when I took my first shower at about day 5). I take it you had surgery in November, not December?

Here is to your recovery continuing on an up hill path. (I hear that knees are more complicated than hips---so sounds like you are doing great!!!)
Laurie
 
I think this is great because although it is one persons healing, it does sort of point to how it happens.

One thing which I noticed (although I may have missed it) was you made no mention
of anticoagulants and TEDS and the associated issues thereof.

Did you not get any of those.
 
Hi EDK

I sort of forgot about the blood thinning meds. For the first 10 days or so I would get a jab in the stomach every morning. I know it sounds bad but it was really nothing. Just a little prick and it was all over. Now I am on an aspirin a day

I am now at day 31. I went to my Doc yesterday and he was pleased with my progress. He told me I can start driving again next week :)

The crazy thing is my right leg is coming along great but the left is lagging behind quite a bit but the doc told me this often happens and not to worry
 
Hi EDK. Wish I had done a journal but reading yours I can remember pretty accurately what I did when. I had BTKR in May, was in hospital six days then home. Had to use a walker to get around the first ten days then I used a cane for a couple of days then nothing. Went to PT three times. By week three I had regained full ROM and extention so OS was pleased with my progress and told me I didn't need further PT just to do what I had been doing on my own. Went home on 6th day and on 8th day resumed cooking thanks to my husbands desire for food. I seem to remember his first question to the OS was how long before she can cook? By the time I was at two weeks post op I was pretty much back taking care of my house and the six dogs. The only thing I didn't do was run the sweeper but my son lives with us and he does that job anyway as I have a bad back. As we all seem to recoup at different rates of speed it is hard to compare yourself to others as you will find your body responding on it's own time frame. Sounds like you are doing wonderfully though and that is what is important. I think we all have a couple of emotional melt downs during our recoup as this is a very big surgery and takes a lot out of us, especially when we have both knees done at the same time, which, I am sure you will agree, was the only way to go. I just keep thinking isn't it wonderful we live in a time when such surgeries are pretty much common place. I know in the weeks leading up to my surgery I never seemed to talk to anyone who wasn't having either a TKR or their mother/wife/husband/brother or best friend was having it done or just had it done. Good luck on you progress, be sure to keep us posted. Rowdy
 
Rowdy and EdK,
Thank you so much for these histories of your knee surgery experiences. I am now scheduled for BKR 2/2/09 and although I am scared to death, I also am sick of the constant pain and want my active life back. It takes a lot of courage to go through knee replacement surgery and your accounts are comfort and encouragement to me.
The details are so important too, because you really don't know what to expect. My OS has said he thinks I may be able to have partial replacements but won't know for sure until he in in there. I think recovery is a little less extensive when you have partials.
 
A little less but not a lot! And the PT can be almost as bad.
 
cheryl50, Glad you took encouragement from my experience. That is what we are here for as others were here for us and continue to be here for us. This site played a big part in my recovery and I do not think you will go anyplace and find better people or a better moderator. Jo is a wealth of information and always has time to listen and advise us. I will keep you in my prayers. Just remember we all recover at our own speed and it so very important to get enough rest and to have proper pain relief while you are recouperating. Then there is the mantra, ice, elevate, rest and stool softeners. For heavens sake do not forget the stool softeners. Good luck, we will look forward to your posts. Rowdy
 
Thanks and sorry for not giving richfriz proper credit. Now I have a few dumb questions.
1. How do they measure rom or what you guys report in degrees? I am thinking I would like to know my pre-surgery rom for reference.
2. What kind of pain pills do they give you? The ones I have now don't really help that much and I'm scared of the pain factor.
 
Thanks and sorry for not giving richfriz proper credit. Now I have a few dumb questions.
1. How do they measure rom or what you guys report in degrees? I am thinking I would like to know my pre-surgery rom for reference.
2. What kind of pain pills do they give you? The ones I have now don't really help that much and I'm scared of the pain factor.

Hi Cheryl

In my case they get this protactor thingie to measure ROM. They just hold it against your leg while you bend it.

I was also worried about the pain but honestly it was ok. I did have the epidural and full anethesia. In hindsite the operation and first few days were virtualy pain free. Once I came off the epidural the pain was fine but I did take all the pain meds they gave me. In my case they offered me two types of pain medication and I chose Endone ( A stong morphine type painkiller) that worked fine. Now at 5 weeks I only take one at night to get me off to sleep

I can say that 31 days post op on a BTKR I did the right thing

Good Luck!
 
Here's a few pointers about pain and pain meds for you ...

1. There are lots of different pain meds on the market. If one doesn't work for you, get you doctor to try you on another.

2. Sometimes a cocktail of them will work where just one won't, for instance, for my migraines I use ibuprofen, codeine phosphate and paracetomol (or Tylenol). It works every time! I started using this because it was a cocktail we gave patients in recovery only then it was Diclofenac instead of ibu. It was extremely effective.

3. The pain you are getting now is going to be quite different to the pain you get after the op.

 
I was wondering also about the importance of rom....what is the usual or normal before the tkr. I had the left tkr done Jan 16 2009 2weeks plus 2days. the last rom was 95 and my pt said it was good. I know she said something about 120. Does that mean that's what it needs to absolutely be? And one more thing...I've continued to be on Warfarin since surgery and apparently will be for at least 2 plus ? weeks. I see dr. on Feb. 12. Is it because of my age 63 perhaps that I'm still on Warfarin?
 
The ROM is important, but the number is just that....a number. What is most important is getting to a place where you are comfortable with the bend and it is adequate to do whatever things in life that are your own "normal." I think it can be different for each person. But I agree with your therapist that 95 at 2 1/2 weeks is great. I'm sure the therapist will continue to work with you to gain more flex and extension.

As for the Warfarin, my guess would be that you're on it because your doctor wants to be sure you don't develop a blood clot. It is an effective blood thinner. I've been on it for a couple of years for heart problems. They are giving you frequent blood tests to make sure you stay within the range, aren't they???
 
re my warfarin....yes the nurse comes in twice a week to take blood and check. Apparently it was low because the dr. has upped it. Thanks for the info re rom.
 
Great, Lindy....sounds like everything is going as it should then.
 
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