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[BILATERAL TKR] Double or Nothing! ; )

Discussion in 'Knee Replacement Recovery Area' started by ulrich2000, Apr 25, 2019.

  1. ulrich2000

    ulrich2000 junior member
    Thread Starter

    Member Since:
    Apr 21, 2019
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    In summary:

    BTKR - Computer Guided Journey II BCS (S&N)
    Anesthesia - Combined Spinal / Epidural, Adductor Canal and IPACK blocks
    In hospital for 6 days
    Anticoagulation - Xarelto
    Pain meds - Tylenol Extended release, Celebrex, Tramadol, Dilaudid (minimal)
    Sleep meds - Melatonin, extra pain meds, Benadryl if all else fails
    Vitamins - C,D, folate, iron, multi

    Best post-op friends:

    Wife and Son!
    A home PT with a gentle approach
    Pain meds
    Relatively inexpensive recliner which goes completely flat - home base for 2 weeks (a sheepskin seat pad highly recommended for the lower back) I use a wedge for elevation frequently
    Game Ready Ice+Compression unit
    Pain meds
    Swing arm Computer / iPad stands
    Kindle
    Netflix / Amazon Prime
    Pets

    At 22 days post op ROM is pretty decent. Pain is improving. The right side is still more swollen and stiffer. No surprise. It was way more damaged and bow legged so took lots of manipulation. I’ve walked for 10-15 minutes with crutches and let night made the first ascent to the second floor of the house and slept in my own bed. Sleep is improving.

    Now I’m preparing for the transitions. Home PT will end. Thinking about outpatient PT but in no rush. I’m doing some work at home (email, conference calls etc.) but will eventually need to get back to work. I’m not rushing it.

    There’s a lot of great advice on this forum and a lot of stories to learn from. Thanks everyone. Experience is the best teacher.
     
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  2. Liebchen

    Liebchen new member

    Member Since:
    Apr 13, 2019
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    Thanks for sharing your recovery story. I am having double TKRs on 5/22 and have been searching for that kind of of detail. It helps to have something of a timeframe. Sounds like the first 3 weeks are rough.

    Wish you a continued and speedy recovery!
     
  3. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

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    @ulrich2000
    Welcome to the other side!
    Thanks for sharing the early days of your recovery.

    Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

    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
    5. At week 4 and after you should follow this
    6. Access these pages on the website

    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.
     
  4. ulrich2000

    ulrich2000 junior member
    Thread Starter

    Member Since:
    Apr 21, 2019
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    Thanks Chris,

    I’ve been through the guidelines and take them to heart. Thanks for all the time and effort you moderators put in making this forum a quality resource.
     
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    • Agree Agree x 1
  5. possum65

    possum65 junior member

    Member Since:
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    @Liebchen All the very best for your May BTKR. I had both mine done in March, and yes, the first 2-3 weeks are tough, but for me, things progressed well after that. Lack of sleep was a problem for me for those early weeks, and there is no need to try and do much at that stage other than rest, elevate, ice, and gentle range of motion exercises. It just takes time and patience.
     
  6. ulrich2000

    ulrich2000 junior member
    Thread Starter

    Member Since:
    Apr 21, 2019
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    My Recovery Setup

    Preop I figured I wouldn't need any special furniture or silly toilet seat risers or handles. Tough guy, right? After a couple of days in the hospital reality hit I realized there was no way I was going to be able to sit and get up from any of my low slung Euro furniture and there was no way I was going to be able to use the bathroom facilities without a commode type seat. The commode fits over the regular bowl, folds, could be used as a shower seat, and has strong arm rests to help stand. I looked into chair rentals and immediate purchases. I was able to get a decent recliner with a lift mechanism that goes completely flat for 800 bucks. It was delivered the day I was discharged. It is not heirloom quality and does not do Trendelenberg like some of the fancier medically focused chairs, but was half the price and available for immediate delivery. The lift mechanism made it easy to get up and down with the bilateral repair. I lived and slept in the chair for 17 days. Now I'm sleeping and showering upstairs but spending most of the day in the chair.

    members pic.jpg

    The setup - little wooden tables, double swing arm computer mount, wireless headset for tunes and calls, cheap remote LED bulb for the lamp. Note the red handle of the Game Ready Cold/Compression unit in the background behind the lamp. Lazy terrier is optional. Also in close reach is a thermos of tea and a large insulated water cup. And in the pocket of the chair are all necessary remotes and my Kindle. And close by is a wedge to get toes over nose as the day goes on.

    I've been doing administrative work and conference calls and keeping busy otherwise. Productive and amused. Could be worse...

    Happy healing all.
     
  7. Jamie

    Jamie ADMINISTRATOR Administrator

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    Nice setup! You've made a great recovery nest for yourself.
     
  8. possum65

    possum65 junior member

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    I think the dog is essential equipment for recovery.
     
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  9. ulrich2000

    ulrich2000 junior member
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    Rainy day progress report-
    It's been a busy week. I've been doing work from home several hours a day in my nest. Reading and binging shows on Netflix and Amazon Prime. Today I was up before everyone so I prepped all the veggies in the refrigerator, sauteed all the mushrooms, and made a pot of coffee. I'm not sure what I'm going to make with them but once sauteed they can last a good while.

    I'm feeling reasonably well. Swelling was way down. Milestones yesterday included my first car trip since I came home from the hospital which was fine. I think if it was longer I'd need to gt up and stretch at frequent intervals. I remember the trip home from the hospital was the most physically painful 90 minute period I ever had. I was literally in tears. Lesson for others - consider medicating before they roll you out of the hospital. The car ride can be brutal! I also sat in church for my nephew's communion (I stood up sometimes when instructed). I went home to rest then attended a party at my next door neighbor's for about an hour. Sitting on regular chairs becomes uncomfortable in about 20-30 minutes. I'm definitely more swollen around the feet and ankles this morning and a little more tender around the knees. More ice and elevation today. That being said it was awesome to get out. I used a single cane which was very helpful for balance, for getting up from pews / seats and frankly to let others know to give you some space.

    My home PT told me on Friday that I "graduated". He said it was time to start outpatient PT. I said I was in no rush, planning to keep doing the stretching, walking, stuff around the house etc. I'm researching the local PTs to see what their approaches are. There's more PT places than pizza joints in my neighborhood. I may wait till after my follow up exam with my OS on May 20. I have full extension on both sides. ROM on the right hit 126 degrees and on the left 116! No complaints there. It is clear to me that getting the swelling and inflamation down has a huge impact on ROM.

    I keep extending the rental on the Game Ready. I figure as long as the knee feels several degrees warmer than the surrounding tissues at rest more ice can only help. If anyone has other ideas for conveniently icing both knees simultaneously with 360 degree coverage and some compression I'm all ears.

    Medication-wise I'm still anticoagulated (only a couple of pills left). I'm taking Tylenol and celebrex around the clock. Tramadol is down to 50mg 2 or 3 times per day from 100mg 4 times a day. I plan to start breaking them in half this week. I have not taken a Dilaudid for breakthrough in almost 2 weeks. Melatonin and gabapentin at night definitely help me with sleep.

    I plan to go into the office a bit this week - maybe 3 or 4 hours for 2 days. I need to get an ottoman or something to put my legs up on intermittently. Any ideas? Perhaps some mild compression socks and black sneakers for a bit. We'll see how it goes.

    A buddy who wrecked his ankle in the fall asked if I'd like to go bicycling with him this summer. This gives me something to work towards and look forward to. Time to tune the bikes up. I have not been on them for a few years. I'm also thinking about getting a training stand to be able to pedal inside when the time comes.

    Happy Healing All!!!
     
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  10. FCBayern

    FCBayern member

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    @ulrich2000 I re-purposed the shower stool I had bought and tied a small pillow on top of it, its been working great for me.
     
  11. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I have often thought the same thing!
    You really don’t need to go to PT. Your ROM is excellent (and enviable!) for so early. It’s too early to do any strengthening exercises, you need to heal more first. PTs have a tendency to give us more to do than our knee is ready for which causes unnecessary set backs. That would be a shame to happen to you at this point.

    It’s not exercising that gets our range of motion back, it’s Time:

    Time to recover.
    Time for pain and swelling to settle.
    Time to heal.

    Our range of motion is right there all
    along just waiting for that to happen so it can show itself.

    In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

    This information is talking about ROM, but your leg will also strengthen with time, as you heal and are able to do more activity. Something as simple as walking will do very nicely for you, rather than specific “exercises.”
     
    Last edited: May 6, 2019

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