Coming aboard for two new knees

[ticket]

Thought I would hop on. I've been reading through a lot of the posts, both the Pre-Op and Recovery threads. There is a lot of information to take in. The Pre-Op threads are asking a lot of the same questions I have, while the Recovery threads are giving a lot of insight that just reading the run of the mill knee replacement pamphlets don't really provide. A thumbs up to BoneSmart and all the forum members.

I'm heading for two new knees. First one will be a ltkr, then the rtkr in approximately 6-8 weeks, as long as my recovery is on track from the left one.

I've been approved for the surgeries and currently I'm waiting for the call from the os office for setting up the process, beginning with cat scans for measurements. I'll get my surgery date for the ltkr once they hear back on when they can expect to receive the customized surgical guides made from a 3D model of my knees.

I'm not looking forward to the surgeries, but so very much looking forward to getting past the every day pain and limitations.

 

[Roy Gardiner]

Hi, Ticket, welcome to BoneSmart.

Have you considered BTKR? Just one surgery and one recovery.

 

[ticket]

I thought about it and discussed it with my os. He prefers to do one at a time, with at least 6 weeks in-between. In thinking though it, I think that is also the best option for me. This way I can do my recovery from hospital to home with DH's help and stay with my os, who I trust completely.

 

[Roy Gardiner]

Fair enough, it is 100% your decision.

 

[bottomshollow]

@ticket, so pleased that you have joined us here on the forum. I have some reading for you! The first set is essential reading, the second and third are useful and the fourth is just good information, but you will need it all.

Group A
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice

Group C
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

Group D
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Constipation and stool softeners
Sleep deprivation is pretty much inevitable - but what causes it?
Recovery Aids: A comprehensive list for hospital and home

Please don't be overwhelmed by the list. The articles are not lengthy and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish; giving you a place to vent, whine, complain if you need to; sharing experiences with one another; and having fun and some laughs along the way.

Take care and keep us posted. We care.

 

[PuppyLove]

Welcome and congrats on your decision. I had BTKR a three weeks ago and cannot believe the difference so far. I was like you and read everything I could before surgery ( started off on the hippy side, then moved over here). It is amazing what they DON'T tell you at the OS office or in the preop class. I have not found another website as helpful as Bonesmart. Plus, you'll find great buddies to share your ups and downs with! Ask as many questions as you have - someone will always be around to offer advice or support.

 

[ticket]

Thanks for the reading material! One question I missed asking my os is when does he like to start outpatient PT.

I have a PT that I like, so I'm hoping she will have open appointment times. As soon as I know the approx. dates when I will need her, I'll give her a call to see if she will be available. My need to do list is growing.

Hmmm- he also didn't mention a pre-op class. I wonder if they even have them here? yep, the list is growing...

 

[jeano]

There's probably as many variations in pre op education and times to start outpatient PT.

For example, for a variety of reasons I ended up getting two knees done by two different docs in the same two doc practice. Doc one does not do bilateral, but would've done my second knee as soon as two months after the first. However, Mr Jeano preferred that I wait some months longer than that, preferably a year if I could manage it. My right knee pretended to be all better after the left was done, so I was cool with that.

As it turned out, I was desperate to do the second knee way earlier, but as you can see in my signature line, surgery w's postponed. In any event, though I would have LOVED to have done both at once, I have not minded giving each baby knee my undivided attention. (They have both been very good babies.)

Back to pre op education--my first OS showed me the implant, we shook hands, that was it except for the pre op meeting at the hospital with the same day surgery nurse. I am a RN, so I'm already reasonably fluent in the language of surgery. I educated myself via the Internet and even watched the op on Youtube (not advisable for the faint of heart or weak of stomach. First OS was horrified that I'd done this.)

As to PT, I already had a relationship with a group and let my OS know I was sticking with them. The original plan was to have home health come in 5days a week for two weeks. However, it looked to me like insurance was not going to cover this, and anyway I felt it would be overkill to send a visiting nurse to a house occupied by a RN and a former paramedic. So I ended up starting outpatient PT the day after surgery for the first knee, with an order for five times a week for several weeks. (I went home from the hospital 13 hours after the first surgery, and 11 hours after the second.)

Now I know that starting any formal PT on the first post op day was too much, too soon, but I didn't know that then. I had a wonderful recovery despite, rather than because of being very gung ho and diligent at doing exercises twice very blessed day.

Fast forward to my second knee, by which time I was well versed in the Ways Of Bonesmart. I had surgery on Tuesday, went home, rested, iced, elevated and puttered around the house until the following Monday, when I strolled into PT sporting my cane, having used a walker at home for only a few days. PT cleared me to quit pretending to use the cane the next week. When I saw the PA 2 weeks post op to get staples removed the PA asked if I even felt like I needed PT. I told him I'd gotten a script from the OS for 3x week for 4weeks (evidently all he felt necessary.)all 2nd OS felt necessary.) Except for some heel slides and bending my knee while sitting in a rocking chair, I've done no, zero, zip, de nada exercises on this second knee except at PT.

 

[tiredwife]

@ticket Welcome to bonesmart! It really varies from doc to doc when they want you to start PT, Hubby had PT while in the hospital and was given a list of exercises to do on his own and then his home PT started about a week after he was home from the hospital. With the list of exercises and concentrating on getting the swelling down, we didn't even really need home PT. After a few week of that we switched to outpatient PT.

 

[Josephine]

One question I missed asking my os is when does he like to start outpatient PT.

My surgeon has a very simple protocol: NO exercising for the first three weeks, just lots of rest, elevating and icing and taking pain meds by the clock (yes, that'e where the mantra comes from!) Also just a few gentle heel slides during the day, a few straight leg raises before you get up of a morning and what walking is necessary for bathroom and kitchen. I complied 100%! Even after that he just requires a physio assessment of one's ROM and nothing else. Amazingly, most of his patients progress really well with little else. And he does very few MUAs and his good outcomes are superb! You might like to read the potted version of my recovery to see how little exercising I did and how good was my outcome! Knee recovery - UK style

 

[gazelle7777]

Josephine I am starting to believe that the American Doctor Mantra of starting PT days after surgery are out dated and causing set backs in healing. I remember doing the PT after my BTKR when my knees were like balloons ready to explode! Hot, inflamed yet I was told to bend those knees! I truly believe it only leads to an extended healing from just over doing it early in recovery. Just like the over push on antibiotics my American Doctors for a tooth cleaning. We are just behind the times here in the USA.

 

[jeano]

And as Mr Jeano says, 'keep doing what you're doing and you'll keep getting what you got.'

 

[kneeper]

Welcome aboard, ticket!

 

[ticket]

@kneeper, Thanks!

I called the os office today as I still haven't heard from them. The person that makes the appointments was out yesterday, but I was told they are working on it and she gave me a direct number to reach them so I don't have to go through the reception desk. I don't want to be a pain, but I'm in pain and want to get this moving.

Finally decided to give myself permission to take Hydrocodone tonight. With both knees being bad, the pain just seems to gnaw away at me. I just don't like taking any medication since I occasionally have had bad reactions. I usually get by on Tylenol ex strength, but today it was an exceptionally bad day.

 

[midwest girl]

Hello @ticket if you are not wanting to take hydrocodone and Tylenol isn't enough for pain control, talk to your doctor about getting a prescription for tramadol. It is a step down from hydrocodone and I find that it doesn't really have any side affects - for me anyway. While I was still in the hospital following my RTKA the Percocet I was taking was not agreeing with me at all. On day 3 post op I was switched to Tylenol and tramadol. I am 5 months post op and I still will take Tylenol + tramadol together, just once or twice a day if needed. Taking them together gives the best pain relieve without making me sick. It's an option. Wishing you a speedy surgery date! Good luck!!

 

[ticket]

@midwest girl, Thanks. I'll check on it. I see you are looking at a date for your LTKR?

 

[midwest girl]

Yes @ticket - I meet with my surgeon in February for a 9 month follow-up visit on my RTKA. At that time I'll schedule my left TKA which I'm looking at end of May first part of June of next year. My left knee feels like it is failing fast. I'm going in Monday to get a cortisone injection. My knees usually feel pretty good after that and the effects last awhile. On my right knee it had gotten to where the cortisone only had an affect on my knee for less than a week - part of the reason I knew I was done waiting. I'm hoping this injection does the trick!

 

[kneeper]

Everyone reacts to pain meds differently. I never tried tramadol but find hydrocodone fairly mild actually. I'm with you in that I only took it pre-op on particularly bad days.
I'm glad your doc's office was responsive and gave you a direct number.

 

[ticket]

Do you find that the longer you are in pain, the less patience you have with just about everything?
I'm finding it a lot and I hate it. I'm normally one of the most patient person I know.

Thankfully the days are counting down...

I go for my scans tomorrow (both knees) and then they will be calling me within the week to let me know when my surgery date for the LTKR is. (once they hear back from the company making the 'parts' and have a timeline)

I am so hoping it is set up quickly. But just knowing the surgery date will help a lot.

 

[Jane B.]

Being patient is critical for the healing process, Ticket. I can't think of a single thing more important and more difficult for those of us who are not at all patient!