BTKR - the Bee's Knees for Maggie

[referee54]

I have a handicap full size toilet in the bath room, will I still need the throne? Those toilets are not only bigger but taller

If you have that type of toilet, I would not think that you need a throne---but do you have some hand rails---you may want the walker with you, as you will be hoisting yourself up and around in the early days of the BTKR---including while in the bathroom.

 

[Maggie94]

Ok - today is 6 weeks to K-Day!! I have been planning, sorting and throwing out, and gathering bits and pieces for my at home recovery. List so far... recliner tick; easy on shoes 1/2 size bigger than normal (for swollen feet)- tick; blocks of wood to prop up my bed by about 4 inches / 10 cm - tick (had a giggle getting these - people are renovating a few streets away and on top of their garbage skip was the base of a kitchen cupboard, or similar, with the exact size blocks on it - used for guess what... propping it up. I had to (1) laugh, (2) snaffle this from the dumpster and (3) accost my neighbor with said junk and request to separate blocks from base - he did this willingly in a bout 15 minutes and presto I have the perfect chocks)

I'm also thinking of other things like backing up my computer a couple of days before going into hospital & rehab (it is a laptop and will come with me) - what other practical things did others do / are doing leading up K-Day?

@wberry gives me a warm feeling to thinking that I have helped you in some small way - that is the magic of this site. We are not alone, others have taken the path before us, some walk with us and others may look back and take something from our posts. You mention that you are up for the "double" in spring 2015... do you have a date yet?

@Threads you are home. I bet that is a magic feeling. Just take on board what others have written on your thread and rest, rest, rest with the ice, ice, ice, between knitting and reading sessions. Please throw these words back at me if I go astray in my own recovery.

@jude2014 thought about you on and off throughout the day.... hope all went well and you are comfortable.

@Drachenschwanz thanks for bring up the question of icing with @vinny - it is one of the things I have been wondering about. Are people using gel bags, continuous flow icing machines, loose ice in a towel or just standing close to the freezer in the supermarket??? It is one of the mysteries I have yet to investigate.

@vinny you inspired me with you diet advice.... I was right on it until I went to visit a friend to see her new puppy... she is an Italian grandmother and plied my with great coffee and really nice cakes. What can I say... I fell off the wagon again BUT I only had soup for dinner

Ok all 10pm here - time for the beauty rest - wish you all a good night - Maggie x

 

[vinny]

It's the holidays Maggie and I have fallen off the sugar wagon every day...comfort food after BTKR you know....thankfully I have not fallen off the booze wagon for 15 years and 53 days but who is counting......you are going to do great........

 

[Maggie94]

thanks @vinny - I have posted on your thread re your Donjoy & I have also emailed the supplier in the US... thanks for the heads up on this one

on the weight scene - breaking the sugar craving is really hard - but once done it is easy to walk past the cakes n cookies.... For me this whole thing is complicated by the silly season .... too many pals and too many parties and the old saying a minute on the lips forever on the hips just gets truer and truer with each passing year - ho hum!!! I will try to be good till after Christmas then hit is hard - hopefull i can drop a few pounds (kilos over here) before K-day - Maggiexx

 

[vinny]

Right back at you Maggie as I just sent you my Dura Kold info..... I lost all of my weight by getting off sugar so for me a cookie is like a heroin injection and is probably why I was so paranoid about taking opiate pain meds as I was afraid of getting hooked....

 

[TexasTee]

Hi Maggie - you're just two days after me so we'll be rehabing together - but just one for me, please and thank you!

I have the same reasons as you - yoga, golf, hiking, traveling and anything else I've had to self monitor for. I'm completely over the question "I wonder the knee will let me..." actually I call it Jack for jack - umm - donkey

Totally endorse the recliner, I got an electric one after going to the showroom and watching the guy have to hurl himself backwards to make the normal ones fully recline...yikes. Mine gets me to about level maybe a hair below but to get to toes over nose I'll have to use pillows and I'm ok with that. Even sitting in it pre-surgery is like heaven. All the weight is off the knee and I elevate all the time so it's not just that, something is different. I'm a giantess so I pretty much had to go to the store to find one that my legs would be supported by. I have 2 dogs, an Austrailian Shepard mix rescue and a ginormous English Mastiff. I hope/think/am counting on them being careful with me but having my legs hang over the end for them to run into is NOT in the cards!.

I also have the Donjoy Iceman - I've had it since my first knee surgery and it has been loaned out to two knee replacements and an ankle replacement and still works a charm! I have a rolling cooler that's ready to go with ice back ups, anywhere I need! My husband will be home the first week but will be working 30 minutes away during the day so I figure I'll be able to refill during the day if needed too.

What else - perhaps this will help you with the sugar demon - sugar in all forms is highly inflammatory, the last thing you need! I'll be spending some time next week making mini meals using lots of protein and bone building nutrient veggies. The surgeon can do only the best he can do, then WE take over, good nutrition, sleep to heal, keep a positive attiude and do the PT in a sensible fashion.

Geez, sorry I wrote a book on your thread!

 

[Maggie94]

@TexasTee I don't mind books on my thread - especially informative ones Yes we will be in rehab together and I am soooo pleased that you have tagged up with me - nothing like some one at the same place at the same time. I had a chat with me OS office today re costings... if I go on 28 Jan it will cost me about $A5,000 but he said I could wait and go for $A0.... I think I will take the financial hit as I have a trip planned and paid for to Vermont, Maine and New York in October / November 2015. We are flying premium economy directly from Sydney to New York and then straight up to Boston. I think the extra month (at least) of recovery + the "certainty factor" are well worth the $$$.

I don't know how your system works in the US but I have had a very quick and steep learning curve for ours here - never having to use it for anything major. We have universal health care + the option of additional private cover (which I have). My hospital (1 week) and rehab hospital (3 weeks) + all meds (including anesthetic) while in both + knee prostheses + part of OS fee will be covered by these 2 insurances - so I guess this is a great deal.

Have to run now... just looked at time... have to blow dry hair and get into the city to meet girls at 6pm for dinner and Dirty Dancing (stage show) - all good. Will post / chat more later - Maggie x

 

[TexasTee]

Morning Maggie - I agree, not fun to pay extra but the peace of mind knowing you'll have a LONG flight a month might make a significant difference. I'm hoping to go to Italy about the same time you are coming here!

I have private insurance and I know it's really great as I'm in HR and we have to monitor these things to make sure we are competitive but I have zero idea what I'll have to pay...I meet with my OS and his business manager on Tuesday so I'm sure she'll have all of the numbers crunched.

Hope you have a great night with the girls!

 

[referee54]

I am very lucky---my darling bride works for a major health care provider here in Northern Ohio, so, as long as I use a doctor in their system, it is all covered. If I go outside of this healthcare system, it reverts to the 80%/20%---so I had my knees done at the system's orthopedic hospital, and I rehabbed there, too. The prescription coverage is really good, too.

If I remember correctly, my co-pay for the outpatient PT sessions were $10 a visit.

 

[wberry]

Tomorrow is the big day at the doctor, I have my list of questions, and hopefully will get a planned date for my Bilateral TKR

 

[Maggie94]

Hi @wberry please share your Q and As.....always interested to hear more info. Maggie x

 

[wberry]

Lets see, here is my list @Maggie94, @referee54 :

Am I a good candidate for a bilateral TKR?
How many Knee replacements do you do a year?
What are your feelings about doing TKN, when and why?
Have you done bilateral total knee replacements before?
Will you be the only surgeon or will there be another and what is his experience?
I know there are other surgeons in this group are there any more experienced than you at TKR?
Who will do the closure?
Will closure be with staples or sutures?
How long will you keep me on coumadin to prevent blood clots?
Have you had any revisions needed following a replacement and why?
Which implant hardware do you prefer and why?
Do you think I should get fixed or non fixed and why?
What do I need to do now to prepare for my TKR?
What do you think my recovery will be like based on what you know about my case?
How long should I plan to be in recovery before I go back to work?

 

[Maggie94]

wow @wberry that's quite a list and right on the money form a more technical side.... my only observation is that you have not had any comments / questions about YOU... I checked that the OS I saw did BTKRs + one of my friends had a LTKR done with him about 5 months ago, so my discussion with him was around My life and MY outcomes. I have known for years that both would need doing as some point round age 60 ( I have 9 month to go to that mark but who's counting).

Yes when I am cold and clinical my right really could go a few more years BUT in the mean time how much will that hold back what I want to do... yoga, pilates, gym, hiking golf (we walk the courses most of the time here in Australia so that is up to 4-5 miles in your speak over a period of 4 hours and swinging a club in between) and travel. My point yo him was that doing 1 knee (my left) would still leave me unable to really do theses things - I told him that I thought doing 1 would be like being half pregnant!! I think that the decision the OS makes is part clinical and part the individual - motivation, focus etc cause the "double" is a hard row to hoe.

Bottom line for my input is think about what you want out of the procedure - for me it was going back to being active, eveyone is different. My view is that this is an important part of the overall discussion. Sorry to blab on but I hope you see where I am coming from. Maggie x

 

[Maggie94]

Hi All - I want to talk pain..... well more getting my head around the 0 - 10 scale. I know everyone has a different tolerance so I have been thing about how to get some kind of measure.

The general consensus on the forum seems to be to hold pain at 4 or below. But what is 4??? My reference that I think you all can relate to is the pain that wakes you from a good sleep and you need to take a tylenol or similar. Where is this on peoples scale? I thought it would be interesting...

I know I am mega curious and analytical - moderators any comments or other reference points? - thanks Maggie

 

[Maggie94]

@TexasTee loved your comment re stacking the freezer with "for one" meals... its on my list too. You might also want to think about getting one of the protein powder meal relacements - I have some (chocolate flavour) and intend to just mix with milk and shake for a nice easy snack or just to sip & get some nutrition at the same time - these shakes come in lots of flavours

Great night out.... wedding this afternoon for a frien's daughter. Its being held on one of the beaches here in Sydney. Spectacular day here with a magic clear blue sky & sunny. Should be fab. Maggie x

 

[TexasTee]

Hi Maggie - yes, I love the Jay Robb egg white protein powder and it meets all my weirdo diet requirements AND it's somethint my husband can prepare, score!

This was posted on another thread by TiredWife - no idea where she found it but it makes good sense to me so it's what I plan to use, perhaps I'll run it by my doc to make sure we're speaking the same number language!

Comparative Pain Scale
0 No pain. Feeling perfectly normal.
Minor
Does not
interfere with
most activities.
Able to adapt to
pain
psychologically
and with
medication or
devices such as
cushions.
1
Very Mild
Very light barely noticeable pain, like a mosquito bite or a
poison ivy itch. Most of the time you never think about the
pain.
2
Discomforting
Minor pain, like lightly pinching the fold of skin between the
thumb and first finger with the other hand, using the
fingernails. Note that people react differently to this selftest.
3
Tolerable
Very noticeable pain, like an accidental cut, a blow to the
nose causing a bloody nose, or a doctor giving you an
injection. The pain is not so strong that you cannot get used
to it. Eventually, most of the time you don't notice the pain.
You have adapted to it.
Moderate
Interferes with
many activities.
Requires
lifestyle
changes but
patient remains
independent.
Unable to adapt
to pain.
4
Distressing
Strong, deep pain, like an average toothache, the initial pain
from a bee sting, or minor trauma to part of the body, such
as stubbing your toe real hard. So strong you notice the pain
all the time and cannot completely adapt. This pain level can
be simulated by pinching the fold of skin between the thumb
and first finger with the other hand, using the fingernails,
and squeezing real hard. Note how the simulated pain is
initially piercing but becomes dull after that.
5
Very
Distressing
Strong, deep, piercing pain, such as a sprained ankle when
you stand on it wrong or mild back pain. Not only do you
notice the pain all the time, you are now so preoccupied with
managing it that you normal lifestyle is curtailed. Temporary
personality disorders are frequent.
6
Intense
Strong, deep, piercing pain so strong it seems to partially
dominate your senses, causing you to think somewhat
unclearly. At this point you begin to have trouble holding a
job or maintaining normal social relationships. Comparable
to a bad non-migraine headache combined with several bee
stings, or a bad back pain.
Severe
Unable to
engage in
normal
activities.
Patient is
disabled and
unable to
function
independently.
7
Very
Intense
Same as 6 except the pain completely dominates your
senses, causing you to think unclearly about half the time.
At this point you are effectively disabled and frequently
cannot live alone. Comparable to an average migraine
headache.
8
Utterly
Horrible
Pain so intense you can no longer think clearly at all, and
have often undergone severe personality change if the pain
has been present for a long time. Suicide is frequently
contemplated and sometimes tried. Comparable to childbirth
or a real bad migraine headache.
9
Excruciating
Unbearable
Pain so intense you cannot tolerate it and demand pain
killers or surgery, no matter what the side effects or risk. If
this doesn't work, suicide is frequent since there is no more
joy in life whatsoever. Comparable to throat cancer.
10
Unimaginable
Unspeakable
Pain so intense you will go unconscious shortly. Most people
have never experienced this level of pain. Those who have
suffered a severe accident, such as a crushed hand, and lost
consciousness as a result of the pain and not blood loss,
have experienced level 10.

 

[Jamie]

How you rate things on the pain scale is very personal. There are no guidelines that everone observes. When your nursing staff asks you about your pain, they will get an idea of how YOU rate it by referencing all your responses. They can see when you're in pain. They have tons of experience with this. So you'll find them asking you many times about your pain level so they get a feel for your interpretation of that scale and how you feel.

That said....never try to endure pain in the hospital. You should be comfortable. So if you're not, give a number high enough that you are provided pain medication on a regular schedule. If the meds don't work, speak up and tell them it's not working. The main thing is to not let pain and discomfort build up because it takes a lot more medication and time to get it back under control than if you just take the meds on schedule.

Know that your nurses will not give you meds on a schedule automatically. You must tell them you want/need pain meds. So watch the clock yourself and take them at around the 4-hour mark. You will be sleepy. That's good. You're supposed to be resting these first few critical days with maybe a couple of times up and around each day.

 

[Maggie94]

another question to the forum - does anyone have suggestions for quad exercises pre op? I can't do squats or leg presses at the gym but I can to the exercises on the machines for inner and outer thigh muscles - these are strong on both legs. I have seen lots of comment re getting quads strong particularly with extension post op. Any suggestions appreciated. Maggie

 

[Jamie]

Water exercises are easy on your joints. You might give that a try.

 

[sandbar525]

@Maggie94 My OS had me riding my stationary bike to strengthen my quads. It tweaked my knee a bit but actually not as much as walking on it. I rode 60 minutes a day/4-5 days a week for 3 months leading up to my surgery. My recovery has been uneventful and both my OS and PT tell me I've ahead of the curve in terms of my recovery. Best wishes to you for a smooth surgery and an uneventful recovery!