31 years old, bilateral TKR in August...how to do the bathroom?

[kneeper]

(((Jesse)))

 

[Jesse for the Fight]

Well, the relationship tension has simmered down and I have checked myself into a two week stay at a convalescent care facility ( thanks to a loving aunt!). I say convalescent care facility but what I mean is cruise ship on land! From the smell of chlorine and cedar chips to the watercolor painting classes, yoga, billiards room and eccentric chef ... the place is amazing… And perfectly climate controlled. looking at their menu makes me hope I am not as nauseous after my bilateral knees as I was after my hip replacement.... Nothing says loving like fresh-baked croissants in the morning and watermelon feta salad for lunch! I doubt I'll feel like taking a painting class two weeks postop but a girl can dream can't she.
Had my preop yesterday felt like déjà vu. It is definitely easier emotionally and psychologically the second time through a major joint replacement. I did enough research but did not overdue, did enough exercise but did not over do, abstained from some cholesterol laden food and wine but not totally.... The major shocker was learning that they have to give me an epidural plus a general anesthetic for my bilateral knees and that I will be hooked up to a machine that breathes for me. Trying not to project my fears but my cousin's oxygen levels were not monitored during a routine surgery and she suffered pretty bad brain damage. Pretty scared of general anesthetics in general. Bur general anesthetics for four or more hours is really freaky! I mean, my brain is my best feature! I'd rather lose my legs than even the smallest amount of brain function. knock on wood. My iron levels are still low so I'm going in for an intervenous iron treatment along with some kind of synthetic hormone that is supposed to help build up my hemoglobin. All that red meat, bloated tummy from taking ferrous gluconate on an empty stomach at bedtime and goose liver pate only help my blood count a smidgen.
10 days to go until new knees. Holy guacamole!

 

[bottomshollow]

Jesse, Happy for you that things have simmered and that you will be going to rehab for two weeks after your surgery. You will not regret it, and it sounds like a great place to get it all together and do some initial much needed healing without undue stress. Give your aunt a big hug from me for being so kind and generous.

Take care and keep us posted. We care.

 

[ditzy dinah]

Just brilliant Jesse! So glad your aunt came through for you, and you have found that family support when you so much needed it. Your rehab facility sounds blissful.....I have not been offered a GA for my forthcoming BPKR, just a spinal, nerve block and sedation, is this what you had for your LTHR? I am scared about the not being fully out of it bit, but am assured that the anaesthetist can give sufficient sedation to enable you to sleep through it, although like yours my op will be a long one 3 hours or so. The advantage of course is eliminating the risks of GA, nausea post op, a faster return to alertness, and a comfortable throat! but that is just for the day of and first day post op. After that whichever way you take your anaesthesia, the recovery will be just the same! I'm with you re our brain function! Precious precious. How terrible for your cousin, no wonder GA makes you feel nervous. Good luck with all your further preparations, and getting your HB up. I'll be following you a month later!

 

[Jesse for the Fight]

Hello Dinah! I had a spinal plus sedation for my LTHR. Don't worry about waking up from the sedation... I did and it was interesting... you can not feel pain, only mild sensations of pressure and I got to ask the surgeons sone questions before they promptly gassed me out again. In regards to thd nausea: I was not nauseous after a GA ( 4 impacted wisdom teeth) but was quite nauseous after my spinal! I guess it all depends on various factors. I'll keep you posted on the details of bilateral knees- glad to have other people also in the midst of this wild experience to share with ;)

 

[ditzy dinah]

Awesome Jesse ! Waking up during surgery and talking to the surgeons! I can't imagine it, your having the calmness and presence of mind to do that..respect! Also you remembered it! It was my understanding that the sedation made you so groggy that memory was lost...evidently not always. You were ok with it all, and so will not fear a spinal again....a pity then that you are having GA this time, which you do fear...too bad. Also how interesting that the nausea was switched around for you! bang goes my theory of being nausea free after a spinal...ain't necessarily so! Well I will just have to hope then that I am lucky, and that your experience of GA this time repeats itself in that regard. Absolutely agree with you about sharing...that is what this forum is all about, that and informing us...and I always did believe that forewarned is forearmed! It is great to feel that we are not alone in this trepidatious journey we are embarking on!

 

[Plexiburg]

Hip replacement is nothing like a tkr much less a btkr, I'm surprised nobody has mentioned that, brace yourself. It took me a week before I could muster my first stool and that was a harrowing agonizing battle with constipation. I could only get from my bed to the toilet with a wheel chair, standing up with a walker much less walking itself was impossible without brutal pain. My body hated this surgery and in the end required 6 units of blood just to stabilize my heart. In order for the drugs to be affective against the pain, I had to dose pretty heavily which left me in a zombie state. Sorry, I really need to stop this rant, after a year of struggling to heal and move on, I now am battling a staph infection in my left knee, so I'm pretty bitter about this whole thing.

To be fare, did I mention that my right knee healed beautifully and shows very little scaring. Did mention that before the infection I was able to easily walk four miles a day up into the mountains and back. I was also able to walk around with my 5 year old daughter on my shoulders with my new knees. Your experience will very likely be completely different than mine, but still again, brace yourself for a wild ride. Oh, see if the med team has used Duramorph before. They used that in my spinal instead of your typical morphine and I had absolutely no pain for 24 hours after my explant last week. Once it's effects faded though, in came the crushing pain like a steam roller, so transitioning to opioids needs to be timed carefully. If I had had Duramorph during my btkr last year, my experience might have been completely different. Does not seem to work for everybody though, so ask the docs.

 

[Jesse for the Fight]

Plexiburg, thanks for your candour. I like to be well prepared for any surgical outcome be it good or bad. People sugarcoated the immense pain of hip replacment, so it was a bit of a shocker. I am fully prepared ( gulp) for the intestinal discomfort. There were tears, shaking, sweating, grunting and pain involved in a regular BM after my hip... So only time will tell.

Great to hear the knees served you well for a period of time and I hope they continue to do so after the infection clears out. I know how disheartening a set back can be.

I am going to convalescent care for 2 weeks folowing BTKR and I only hope they are prepared for the nauseated, weeping zombie I know I will become. It is a top knotch facility but They don't see many bilaterals. I am comforted at the fact that the staff were very kind and maleable. Fingers crossed. However, They seem to think I may be well enough to do flower making and watercolour painting sessions....they are used to patients ambulating well after 3 days. I smiled when they said this and gently let them know the reality and complications of bilateral knees plus Rheumatoid arthritis.

Thanks for the advice on thd opioids too, they always give me trouble! Also, I love your picture- I am a painter and enjoy creepy portraits!

 

[Plexiburg]

"I love your picture- I am a painter and enjoy creepy portraits!"

Ha ha, you just made my day! Thank you!
p.s. the image is from one of the original early 1970's promotional posters for the play 'One Flew Over The Cuckoos Nest.'

 

[Kavan]

However, They seem to think I may be well enough to do flower making and watercolour painting sessions....they are used to patients ambulating well after 3 days. I smiled when they said this and gently let them know the reality and complications of bilateral knees plus Rheumatoid arthritis.

That just seems like an energy drain. The first 13 days after TBKR I was so wiped after PT and OT I'd just either read or watch TV. I cannot imagine trying to paint or arrange flowers.

 

[MissJ]

Hi Jesse
I've been absent on your thread for awhile and have been caught up in all that has happened with you. It's absolutely wonderful that an aunt stepped up and you will be cared for. Even if the staff isn't used to BTKR patients - it sounds like they can shower you with amateur watercolored get-well cards made by the other, more ambulatory patients.

As for the terror - I think many of us felt that way beforehand - and it's like jumping under a wave in the ocean: you just go under and then come out the other side to go from there. I'm sorry you have to have GA which you dread - since an epidural didn't work for me (anesthesiologist, after a couple of tries, got air in the needle which gave me a killer headache, so I got wheeled out of the operating room before anything else even happened & surgery had to be rescheduled), I had to go GA. The only problem I had was nausea that night, but once an anti-nausea drug was administered, I was OK.

You certainly have a lot on your plate. Though I agree with all that your BF was not "the right guy," I'm sure it's stressful to have him around since you have to share a place. The fact that he'd discuss this with co-workers and take their guidance about what his responsibilities are is disrespectful and immature (OK I finally came up with those two words after throwing out some more expletive-ridden expressions). He needs to grow....well. Bonesmarties can complete that sentence as they will.

Best of luck to you Jesse! Your strength and optimism are impressive and will help guide you to a good outcome.

 

[new knee in June]

Good morning Jesse,
I see you are having surgery this Monday. I am popping over from the recovery side..
I wanted to wish you all the best for Monday, I will be thinking of you & waiting for your arrival on the
" other side" please post when you feel up to it....we care about you
Have a relaxing weekend,
Diana

 

[katie830]

You are one strong, positive woman! Good luck with your surgery.

 

[Jesse for the Fight]

Friday was my last per op PT session. I pulled my neck in my sleep ( slept on the remote control again) and my RA was flaring, so I wheeled in on my chariot ( wheelchair) and the session consisted mostly of pulling my chin towards my back - the double chin stretch. I had to increase my prednisone from 8 to 15 mg just to stop my arthritic flare. Since I was at the hospital I popped by the orthopedic clinic to tell the nurse to add the change to my file as prednisone increases the risk of infection. Earlier that day, stuck in bed, arthritis flaring and unable to get out of bed to urinate or get my medication which needs to be taken with food, I called my partner to whom I've been in break up/together limbo land to help me. I was crying because I could barely move. I asked him to get me a glass of water and he just stared at me and said "I'm tired I'm going to bed " .... He has done this before, so no surprises there, but I really needed help. He had made grand promises to get counseling and be a better partner but it didn't happen so I asked him to leave our home for the remainder of my recovery as his lying in the next room while I was Writhing in pain caused me great distress and anxiety. He agreed and left. I was still tired and still in pain and my eyes were a little puffy and red from crying when I arrived at the orthopedic clinic to tell them about the prednisone.

They had me see the orthopedic surgeon on-call. And before I saw him I saw some kind of resident. The resident looked at me with my puppy eyes in my wheelchair and asked me if I thought I was emotionally and psychologically ready to have the surgery and did I want to postpone it? For a brief second I wondered," am I emotionally strong enough to go through this? If I am sad about a break-up will it hinder my recovery? am I going to die on the operating table because I have fear? ".... Keep in mind I was very, very, very tired. So it took a minute for me to say "wait a minute! I'm just here to tell you I made a small, incremental increase in my prednisone which was okayed by my doctor. Postponing my surgery with knees as bad as mine and arthritis as bad as mine isn't going to change anything except maybe my muscles will waste further and I will get fatter."
Note to self: It is really easy to doubt oneself when one is tired.

Tomorrow is the night-before. And today, on the eve of the night-before I have made and frozen all my food, bought a comfortable slip on bra, bleached all of my sheets and doorknobs and readied ice packs and orthopaedic cushions.
Tomorrow I will hold my knees gently in my palms and tell them I love them. I'll say Thank You! Dear body part, I love you and am grateful for the good times - gardening, running, biking, falling down, getting up .... Love-making... and I will cry- good-cry, like, but not quite like loosing a pet - loosing a thing to gain memories. I personally believe losing one's knees is the only time a person will ever be truly grateful for them. And that is not such a bad insight.

 

[Roy Gardiner]

Is he still gone? I hope so, he doesn't seem much use to me.

All the best for tomorrow. I was in fear, yet I have a loving wife and perfect support structure -- even to the hospital being 200 yards from my house. Your courage is both humbling and an inspiration.

 

[kneeper]

All the best for tomorrow. We'll be here for you when you get back.

 

[My way]

I'll be watching for you when you join us on the other side.
Your new Canadian pal
Wanda

 

[Jesse for the Fight]

Well, 18 hours before surgery and my calf muscles ache as if I've already had the surgery. Since I can't straighten my legs, I can't really stretch them and they feel pretty cranky. Also, losing some blood in the regular monthly way ladies tend to do. Seriously, I need all of my blood for the surgery. :-(.

 

[NightQuilter]

Good luck Jesse!! In a few hours you will be feeling so much more relief and hope - in so many realms of your life. I cannot wait to see you on the other side!

 

[Diesellily]

Hang in there Sweetie we're all here for you xxx