TKR BeachKnees11 - Both Knees Replaced January 2020

[BeachKnees11]

Hello everyone. I recently found this website and it has been so helpful and encouraging. Thank you to all the posters who have shared their experiences - you are all lifesavers.

After walking (or more like hobbling) in pain for more than 12 years due to severe arthritis, I have had both my knees replaced earlier this month. My RTKR was completed on 1/3/2020 and the LTKR a week later on 1/10/2020. My surgeries went well and my range of motion is currently at 120/0 and 115/0. I am thankful for that.

I am still experiencing a great deal of pain in my soft tissue and throughout my legs in general as well as sleepless nights. The pains move from different parts of my legs to my knees, etc. Sometimes the pain subsides a little and I have some relief. There are 14 steps from my bedroom to my first floor that I go up and down once to twice per day. I have some pain doing that, but not in one specific location. I do feel my legs getting stronger in some ways like when I lift them up and down off the bed. I am able to shower on my own and I walk using my walker on my own.

My PT wants me to start using the cane at our next visit which is tomorrow. I am looking forward to that.

One thing I struggle with is elevating my legs. I keep reading that it is so important, but it hurts me a lot when I elevate. I was wondering if anyone uses those triangular pillows for elevation? I use regular pillows, but they do not work for me for some reason.

I take percocet every 5 hours or so and sometimes take an extra 325 mg of tylenol depending on my pain level. I was wondering how long it takes before I can expect to take less pain meds? I found a helpful chart on this site about the time it takes to recover and it seems as though I have a ways to go before things really start to feel better.

Thanks again for all the info on this site and if anyone with BTKR recovery experience around the 3 week mark would like to share their experiences please let me know what worked for you.

 

[Jockette]

Hi and Welcome!

You sound like you are coming along well, and as to be expected, for so early in this Recovery. This recovery takes a long time, usually a year, on average.

Here is a list of members’ threads who have had both knees done very close together.
https://bonesmart.org/forum/view/knee-surgery-recovery-area.9/?prefix_id=129


I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
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​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Celle]

Welcome to recovery, @BeachKnees11

My RTKR was completed on 1/3/2020 and the LTKR a week later on 1/10/2020.

Technically, we call that sequential knee replacements. We reserve the term "Bilateral" for knees replaced on the same day. That sounds a bit "picky", I know, especially when your knees were replaced so close together,
Your recovery is going to be very similar to a bilateral recovery anyway.

I am still experiencing a great deal of pain in my soft tissue and throughout my legs in general as well as sleepless nights. The pains move from different parts of my legs to my knees, etc. Sometimes the pain subsides a little and I have some relief. There are 14 steps from my bedroom to my first floor that I go up and down once to twice per day. I have some pain doing that, but not in one specific location.

Yes, it's normal to experience pains all over your legs, moving from one place to another. It should settle down before long.

Don't overdo the PT. Those steps you go up and down daily are also moderate exercise for your new knees.

My PT wants me to start using the cane at our next visit which is tomorrow. I am looking forward to that.

It's OK to try using the cane at PT Let your therapist show you the correct way to use it, but I think its much too soon to be giving up the walker, especially as you've had both knees replaced.

Only give up the walker when you feel ready to do so. It's only a tool and there are no prizes for giving it up early. In fact, some people continue to use the walker until their gait is correct.

You can try using the cane indoors until you feel confident with it, but use the walker out of doors.
It's much better to keep using the walker than it is to risk having a fall.

One thing I struggle with is elevating my legs. I keep reading that it is so important, but it hurts me a lot when I elevate. I was wondering if anyone uses those triangular pillows for elevation? I use regular pillows, but they do not work for me for some reason.

Are you trying to elevate with your knees completely straight? It is painful to do that. It doesn't matter if your legs are slightly bent - that won't affect your eventual extension at all.

Or you could try elevating using just two pillows. While "toes above the nose" is ideal, any degree of elevation is better than none. As long as you keep your knees above your hips, you'll be doing OK.

I take percocet every 5 hours or so and sometimes take an extra 325 mg of tylenol depending on my pain level. I was wondering how long it takes before I can expect to take less pain meds?

I'm a little concerned about your Tylenol intake. Each 10 mg tablet of Percocet also contains 325 mg of Tylenol. The recommended safe daily total intake for Tylenol is 4,000 mg in 24 hours.
Taking 5 doses of Percocet in 24 hours (approximately 5-hourly, you said) would give you a total of 1,626 mg in 24 hours, so you should be safe adding an extra 325 mg occasionally, but try to keep track of the daily total.

Is the 325 mg you're adding the Tylenol Arthritis format? If so, it's slow release, so you won't be getting the benefit of the full dose straight away. Tylenol arthritis keeps acting for 8 hours or so.

 

[BeachKnees11]

Hi Celle, thanks for all the information. I have never heard of the term "sequential knee replacements" so that's good to know.

It is reassuring to hear all the pain I am experiencing seems normal at this point. It's just tiring. I will keep using my walker until I am totally sure about the cane. I can't say I feel totally ready to use the cane yet anyway.

When I elevate I do keep my knees straight so maybe that is why it keeps hurting. I will try your suggestion about keeping a little bend. Hopefully that is my missing link!

I write down when I am taking all of my pain meds and was told not to exceed 3000 mg of tylenol each day. My percocet is oxycodone-acetaminophen 5-325. When I take one I consider it the same as taking a 325 mg tylenol and account for it in the 3000 mg daily total of tylenol.

I feel like I am making good progress, but am still in considerable pain. I am hoping more elevating will help so I can start spacing out pain meds even further. I have read some people are off pain meds and are just taking tylenol after a few weeks, but it seems I'm not there yet. I wonder if my pre-surgery condition has something to do with it. I waited to have my TKRs until my knees were totally worn out and until I could barely walk. Maybe because of this it is making my recovery a bit more painful? I'm 64 and am in good health other than my knees and maybe an extra 25 pounds. Thanks again for your reply.

 

[Jockette]

Here’s a little more detail about elevating:
These are examples of elevating correctly, with the knee slightly bent:

Here’s an article with more detail:
https://bonesmart.org/forum/threads/elevation-the-dos-and-donts.7602/

 

[eaglemom]

A couple of things. Yea, the surgeries are behind you. Now to patiently wait to heal and recover.

I'm concerned about your using a cane so soon. Make certain you feel ready, not the PT. On that note - it might sound silly, but use two canes. I've done that and I know others that do it. Goodness there is an entire wave of 'walking sticks' sweeping the nation, so why not two canes. Just a thought.

On my last revision I too had a very difficult time with the elevation. It had never happened before. What I finally figured out was that I didn't have the wedge close enough to me. So it was causing the knee not to be totally supported. Once I figured that out I can elevate without pain.

Don't let PT determine what you can and can not do - your in charge. Well, really your knee's are!!!

 

[Helizabug]

Leaving a slight bend when I was elevating made all the difference, and I iced almost all the time for the first month. I don’t remember if you mentioned how much icing you’re doing.

 

[Lindylee]

I'm amazed you can do stairs this early on after 2 new knees. I can't imagine bending my new knee to go up or down yet. You seem to be doing great.

 

[BeachKnees11]

Hello again everyone, thanks for all the responses.

Thanks Jockette for all the visuals and that article about elevating. I was able to purchase an elevation pillow that works better than stacking pillowcases (at least for me). I will use it for about 20-30 minutes at a time a few times per day. I still don't love elevating, but it is definitely easier with the wedge. I am elevating with more ease and @eaglemom I used your advice of placing the wedge close to me and @Helizabug I have the slight bend which makes all the difference. Thanks! I bought the Millard Double Foam Wedge.

My right knee was replaced a week before the left one so I am just about at 5 weeks out for the right and 4 weeks for the left.

I am still struggling with sleep at night, but it is getting better. I alternate between my bed and a recliner that is in my room. I actually went downstairs last night and fell asleep on my couch next to my fireplace.

I was wondering if anyone had started applying heat around this time to ease the pain? I feel like I am always cold and the heat helps sometimes.

And @Lindylee, thankfully I have been able to do steps. My bedroom and shower are on the second floor so I think that was a nice carrot to dangle to make me want to walk up them lol. There were a total of three or four days throughout my recovery process where I did not go downstairs so as to give my knees a break. I was in a lot of pain and decided to rest them after finding BoneSmart and reading about the importance of rest. My kids have been staying with me to help me get through this recovery and so they would bring me whatever I needed upstairs during those days.

I also drove my car for the first time two days ago and, ironically, it was to my first outpatient PT appointment. The PT office is less than 10 minutes from my home so it was a good start. It felt great to be behind the wheel again! At PT, they measured my ROM at 113 and 117 so it seems it is a little less than when I had in-home PT, but hopefully that improves over time. I go again later today for my second outpatient PT appointment.

Another change is I am switching between the cane, the walker and nothing at all. I usually lean against something if I am not using the cane or the walker. I am icing a few times throughout the day and still have pain, especially at night. Sometimes walking around helps my pain or stretching my legs using my leg lifter will ease a little pain. When I experience a lot of pain in the evening and can't sleep I will go in my recliner and ice and that helps more so than staying in the bed.

I am taking percocet 5mg-325mg three to four times per day with some tylenol spaced throughout the day. I am going longer now between when I need percocet so that is an improvement. I also take aspirin in the morning and the evening instead of the blood thinner.

So this is me at 5 weeks out from the RTKR and 4 weeks out from the LTKR. Thank you again everyone for taking the time to share your experiences with me.

 

[Celle]

@BeachKnees11 - I've edited your post a bit, to remove the image of the wedge you bought. It's not one that BoneSmart recommends, as it gives too much of a bend at the knees.
If you read this article - Elevation: the do's and dont's - you'll see the type we do recommend: the Lounge Doctor.

Not this -

- it keeps your knees too bent.
But this

You can achieve the same, correct angle with pillows:

 

[Helizabug]

I haven’t applied heat yet, except for lovely long showers. When I’m cold, and I still need to ice, I pile on wool blankets, and that seems to get ahead of the chill.

 

[Jockette]

I was wondering if anyone had started applying heat around this time to ease the pain? I feel like I am always cold and the heat helps sometimes.

You can use heat, but not anywhere near your knee. Heat can increase the swelling and that’s not what you want.

I forget how far post op I was then I tried heat, it was a big mistake. I used a rice bag, heated it too long, so it was too hot, and the weight was too heavy. My knee was quite upset and I only had it on for a couple of minutes. (My knee was such a drama queen!)

 

[Jenn3319]

I truly cannot imagine recovering from two knees done close together! And going up stairs!!!!! You are my hero. My doctor also gave me percocet 10 although I’m now taking hydracodone - but still at a 10.

Elevating was painful for me as well until I tried the pillow stack shown above. It really helped.

 

[BeachKnees11]

@Celle - I can clearly see the difference with the pillows now. I looked online and it says it could take 3-30 days for the lounge doctor pillow. I ordered one and hope it gets here sooner than later. Will report back after it arrives. @Jenn3319, maybe I will try stacking those pillows again in the meantime and thank you for the positivity.
I went to PT yesterday and they said the same thing as @Jockette - use heat anywhere but the knees. It will help my soft tissue pain. They did some massaging of my scar and some stretching exercises/manipulation. I also did ten minutes of recumbent bike. It was a good visit.
Another thing I have been using that helps with my soft tissue pain is biofreeze and extra strength bengay. I do not put it on my scar, but use it behind my knees and all around the knees where my muscles hurt. It works pretty well.

 

[sistersinhim]

It sounds like you're coming along quite well for taking care of two infant knees.

 

[eaglemom]

I've really benefited from the Lounge Doctor pillow. Just wondering, where did you order it from? Amazon prime and I think I had mine in just a couple of days.

Take recovery as slowly as possible, your knees will thank you!!!

 

[pamsknees]

Glad to see about the elevating pillow - I also realize I bought the wrong one. I was trying to save some $$, but it’s like yours. Will return it & pay the extra for lounge dr.