Bilateral TKR Finally On The Other Side. Bilateral TKR 1/9

[KC Kitty]

Hello, I just wanted to apologize for not writing sooner. I had bilateral TKR on January 9. It will be exactly 3 weeks tomorrow. I must say it has been a bit of a journey mostly because of my reaction to pain medication. I truly believe if I wasn't so sick with that, my recovery would have been much better. I am seeing my PT 3 times a week and he is telling me that I am doing as well as anyone he has seen. The PT is challenging but not to the point of painful. I am walking without a walker although my posture is better when I use it. I am sleeping thru the night and all and all handling things fairly well. My hope is to go back to work in a week. (I work from home so that makes it much easier.) I am just taking things one day at a time. I do owe all of you so much for your words of wisdom and support. It made it so much easier going into surgery and having a better idea of what to expect. My only hope is that I can return the favor to those facing bilateral TKR and helping them thru their journey. I know I am not out of the woods but I am off to a pretty good start! THANK YOU AGAIN!!!

 

[beachy]

That's a great update! Sorry it was so rough for awhile.
I hope you continue to improve every day!

 

[Layla]

Welcome to Recovery! I am sorry you had a rough start, but thankfully you're doing better now. I will leave the Recovery Guidelines with best wishes. Stop by often and share updates. We'd love to follow your progress!

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[EalingGran]

My hope is to go back to work in a week. (I work from home so that makes it much easier

That's quite ambitious- but it depends a lot on how much you can move during work.
I am semi-retired and just do 1 and 1/2 days / week from home. I did my first days work about 4 weeks. It involved 2 hour meetings morning and afternoon. I was able to ice at lunchtime and I would definitely recommend that. Also try to do ankle pumps/ gentle foot movement and see if there is some way you can elevate the leg a bit under your desk. If it's not meetings where you are in show- then get up regularly and walk about.

 

[LD of Michigan]

@KC Kitty
Wow! Grand to hear your coming along. Thank you for sharing your recovery status from a BTKR. The main advantage of the BTKR option is that your done - both knees! I wanted both my left and right TKR closer but COVID and life got in the way.

There's alot to consider returning to work. I'll return w/ restrictions (cane and reduced standing) which my employer allows. It's concrete mostly on-site - some sections covered with thin carpeting. I know I'll hurt first week - adapting. Wearing shoes inserts will help and I wear Clarks with thick soles - reducing impact.

 

[KC Kitty]

@KC Kitty
Wow! Grand to hear your coming along. Thank you for sharing your recovery status from a BTKR. The main advantage of the BTKR option is that your done - both knees! I wanted both my left and right TKR closer but COVID and life got in the way.

There's alot to consider returning to work. I'll return w/ restrictions (cane and reduced standing) which my employer allows. It's concrete mostly on-site - some sections covered with thin carpeting. I know I'll hurt first week - adapting. Wearing shoes inserts will help and I wear Clarks with thick soles - reducing impact.

Thanks for reaching out. Sorry for the delay. I am not on my computer as much these days. I hope you going back to work goes smoothly. Standing on concrete sounds painful!!! :( I office out of my home, but planning on going back to work next week! Hope I can do it!! Please take care of yourself!

 

[KC Kitty]

Welcome to Recovery! I am sorry you had a rough start, but thankfully you're doing better now. I will leave the Recovery Guidelines with best wishes. Stop by often and share updates. We'd love to follow your progress!

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

Hi Layla, I hope all is well with you! Thank you so much for the important information. I will be at Week 4 on Monday and planning on going back to work. (I office from home.) Things are improving but I never realized how tired I would be. It really does take a toll on your body! Still trying to be positive and appreciate the small "wins." Have a great day!

 

[Layla]

Things are improving but I never realized how tired I would be. It really does take a toll on your body!

YES it does, but thankfully its only temporary.
Our body's energy supply isn't limitless. So when we're in healing mode after major surgery our energy will be used for healing first, not leaving a great reserve for all the other activity of daily life. It is normal to feel tired for quite some time. How long....most likely relates to your body's rate of healing. Making our best effort to get adequate sleep and rest is beneficial. Our body does it's best healing while we're sleeping.

 

[LemonCheesecake]

KC Kitty, I am super-impressed that you are sleeping through the night with bilateral replacement! You are entirely right that you got it done! Take it easy on yourself.

 

[LD of Michigan]

Thanks for reaching out. Sorry for the delay. I am not on my computer as much these days. I hope you going back to work goes smoothly. Standing on concrete sounds painful!!! :( I office out of my home, but planning on going back to work next week! Hope I can do it!! Please take care of yourself!

I am perhaps on my laptop in bed too doggone much - interfering with my sleep !

Yeah from previous TKR the concrete made big diff when I went back at six weeks, restricted activities. Then it got better, but I'd still prefer not to be on concrete. Glad I have giving wood floors at home.

 

[KC Kitty]

Hello there- Sorry for the delay. I have to be honest. I have had some set backs and I hate posting depressing things. :( (There have have been good days as well, but I have run into some difficulties.) I have had some very painful lower back pain and have had issues getting relief. (When I went back 10 days after surgery the Dr. prescribed Flexirill but only about 5 days worth. I have been on a heating pad as much as I can and I bought a back brace. It provides some comfort but not a lot. I feel like it is hindering my rehab. In all my wisdom, I thought since tomorrow I will be at 4 weeks it would be a good idea to go back to work. (I work from home) I am worried sitting at my desk is going to prove a challenge. I am afraid to call and ask for additional medication as I know surgeon's are reluctant to offer more. My PT tells me that back pain is common for those with bilateral TKR since there is no good leg to stand on and your posture is off. Just wanted to post for any other bilateral's out there to beware of a potential back issue.

 

[benne68]

Sorry to read that you are struggling with back problems on top of the post-surgical pain, @KC Kitty.

I struggled with my back after both my hip and my knee surgery. Like you, I used heat and a back brace, but what really helped me was massage. My PT taught me some simple techniques I could do on myself, but I also started seeing a massage therapist. It took about a month, but it did eventually clear up.

Sending hugs.

 

[EalingGran]

I have had some very painful lower back pain and have had issues getting relief.

I have back problems in additionto my knee and hip arthritis. Lumbar arthritis at L4/5 and L5/S1 and spinal stenosis at L4/5. I have had sciatica in the past but thankfully straightening my knock knee has hopefully cured that. I still have more general lower back pain.
What works for me is;
- heat pad and heat gels
- a padded sciatica cushion so I don't have to sit on hard surfaces
- a back support for the car seat
- naproxen ( a non- steroidal). I was able to stop it for a while post my pkr but back on it again due to back pain. I find with NSAIDS the painkiller effect only comes after a week or so when the anti inflammatory action kicks in.
- back exercises. But this is tricky post knee surgery. I can now lie on my tummy if my knees are lightly padded. So I am starting to do back extensions etc
In the past I have wondered about a special chair but some of those put pressure on the knees....
This is the problem when you have multiple joint issues- it is really tough. You have my sympathy.

 

[KC Kitty]

Sorry to read that you are struggling with back problems on top of the post-surgical pain, @KC Kitty.

I struggled with my back after both my hip and my knee surgery. Like you, I used heat and a back brace, but what really helped me was massage. My PT taught me some simple techniques I could do on myself, but I also started seeing a massage therapist. It took about a month, but it did eventually clear up.

Sending hugs.

Thanks for the suggestion. I didn't even think of a massage therapist! I so appreciate the suggestion

 

[beachy]

Don't be sorry. You are going thru a huge recovery with tremendous changes every day.
If the Flexirill helped ask for more. All they can say is no. Hope your knee pain is controlled..

And we all have those depressing days. Talking about them here usually helps.

 

[JusticeRider]

I agree with all the suggestions above. I know my massage therapist has been an absolute godsend to me. I swear this recovery finds all your weak spots and brings them to the fore. I’m favoring a sore hip and sore foot at the moment, and I know it can be frustrating when you’re trying to heal your knee and other problems are interfering. So much more for you, being that you’re recovering from a bilateral! I know you’ve probably heard it many times by now, but you really are brave to do them both at once. Do you feel like you made the right choice? Would you do it again if you had it to do over? Only asking because I have multiple joint issues and I could see it being a choice I could be faced with at some point (hopefully far) in the future. The recoveries for these things are so long, it makes sense to get it over with all at once. But the idea of it is scary. Would love to hear your take on it.

 

[Layla]

The recoveries for these things are so long, it makes sense to get it over with all at once

While KC Kitty can share whether she is happy with her decision to undergo bilateral joint replacement, bilateral surgery is obviously not for everyone. While it's only one surgery with one recovery period and likely less time off work, there is criteria.

You need to be physically healthy, at a healthy weight, without heart disease or diabetes, well controlled diabetes may be considered. Surgery time is longer, meaning prolonged anesthesia. There is also the risk of complications that accompany any major surgery such as blood loss, blood clots, infection, all of which the risk may be increased. Age will likely factor in also, making the elderly less likely candidates.

You need a strong support system for recovery. Recovery can be more of a challenge because you're unable to depend on a stable limb for support. Lots of considerations, likely more than what I mentioned here. Oh...and BRAVERY, you have to be brave! Counts me out.

 

[EalingGran]

@Layla That all makes a lot of sense about the anaesthetic/ surgical criteria.
Also not having a support leg for especially stairs.

 

[KC Kitty]

I have had some very painful lower back pain and have had issues getting relief.

I have back problems in additionto my knee and hip arthritis. Lumbar arthritis at L4/5 and L5/S1 and spinal stenosis at L4/5. I have had sciatica in the past but thankfully straightening my knock knee has hopefully cured that. I still have more general lower back pain.
What works for me is;
- heat pad and heat gels
- a padded sciatica cushion so I don't have to sit on hard surfaces
- a back support for the car seat
- naproxen ( a non- steroidal). I was able to stop it for a while post my pkr but back on it again due to back pain. I find with NSAIDS the painkiller effect only comes after a week or so when the anti inflammatory action kicks in.
- back exercises. But this is tricky post knee surgery. I can now lie on my tummy if my knees are lightly padded. So I am starting to do back extensions etc
In the past I have wondered about a special chair but some of those put pressure on the knees....
This is the problem when you have multiple joint issues- it is really tough. You have my sympathy.

Wow! Those are great suggestions. I too have had surgery on my L5/S1 so I wonder if I am more predisposed to it. Thank you. I will certainly try them.

I agree with all the suggestions above. I know my massage therapist has been an absolute godsend to me. I swear this recovery finds all your weak spots and brings them to the fore. I’m favoring a sore hip and sore foot at the moment, and I know it can be frustrating when you’re trying to heal your knee and other problems are interfering. So much more for you, being that you’re recovering from a bilateral! I know you’ve probably heard it many times by now, but you really are brave to do them both at once. Do you feel like you made the right choice? Would you do it again if you had it to do over? Only asking because I have multiple joint issues and I could see it being a choice I could be faced with at some point (hopefully far) in the future. The recoveries for these things are so long, it makes sense to get it over with all at once. But the idea of it is scary. Would love to hear your take on it.

Good Morning JusticeRider, I appreciate the advice about the massage therapist. Dealing with my both my knees and now my back is a lot! My PT told me at around 4 weeks that I would feel grateful that I had both my knees done. He is probably right. I truly believe if I had only one knee done, I would not go back for the second. The recovery might be longer, but for me, I just know I wouldn't want to go thru this again. I am so sorry about your joint issues and I do hope you don't have to worry about it in the near future. My only additional advice is, I am glad that I did it now verses 10 years from now. I fear I would be weaker and the recovery would be tougher for me. Those are just my thoughts. I hope you have a great day!

 

[EalingGran]

I know my massage therapist has been an absolute godsend to me. I swear this recovery finds all your weak spots

@JusticeRider Agree about the weak spots!
I have been thinking about massage but have been a bit nervous about finding the right therapist.Also only recently been able to lie on my tummy for a back massage.
Any tips about type of massage and finding the right therapist?