TKR I really didn't know what I was getting into!
- Thread starter Knees4Me
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Knees4Me
member
@KarriB - My Dad was the same. He had both his knees replaced at once when he was about 78, then straight to a rehab facility. He seemed to be off meds and driving again in no time. He was very motivated to get back to recreational ballroom dancing with my Mom. Too bad he only got to enjoy his new knees for about four years before he passed, sadly. I apparently inherited the knee osteoarthritis gene from him, but not the speedy recovery one!
Have you looked into the cruise ship that stops at 4 islands? I normally do not like traveling with 4,000 of my closest friends 
however, if you did 7 days this way, you would only have to pack and move 1 time and then could stay for an extended time on one of the islands. I remember waking early as we arrived at Hilo and looking up at the sun rise on Mauna Kea from our balcony, starboard side.
however, if you did 7 days this way, you would only have to pack and move 1 time and then could stay for an extended time on one of the islands. I remember waking early as we arrived at Hilo and looking up at the sun rise on Mauna Kea from our balcony, starboard side.
jaschembra
post-grad
Judi, I too spend my day with my leg elevated and iced. The only things I do are the daily bathroom, dressing, those types of things. I added feeding the dog and I loaded the dishwasher- told hubby I would not be able to unload it - too much moving around. I was supposed to do PT 2 x per day and only did it 1x per day the first 3 weeks. I was supposed to do the CPM machine 3-6 hours per day, I only did it 1 hour per day. Now that I am at outpatient PT and hoping to get in some of these exercises 2 x per day, I've stopped the CPM completely.What I'm getting at is: If I were to have done everything they wanted, I would be really really swollen, in a huge amount of pain and depressed. Yes, you need to move it, but gently and only what you can tolerate. If it hurts, don't do it. If it increases your swelling or causes more pain, don't do it again. Live with the ice and elevation. I never sit with my feet down unless I have to. BoneSmart mantras!
Luckily, my OS has not required anything yet. He leaves therapy up to the therapist. In my opinion, asking for 135 ROM at 6 weeks is absolutely ridiculous.
I hope today gives you a lift in spirit. I did start my gratitude journal (opposite page of my medications lol) last week to make sure I stay positive. You will see a change soon. The recovery chart shows week 5 giving us a little bit more improvement- keep the end in site knee-twin!!! We can do this!
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jaschembra
post-grad
You also asked about my anti-inflammatory. Originally I was put on Meloxicam but I'm assuming since I had taken that daily for the last couple years he switched me on day 4 - I was also in a lot of pain. But, he switched me to: Indomethacin extended release, 2x per day 75 mg.
Aquafool
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@Knees4Me: you'll get to the point where you'll have no regrets. I had severe pain prior to both of my replacements. They were 80 days apart August 15 and November 3. At this point they seem about the same, recovery-wise. I would be able to fly anywhere at this point and enjoy a vacation. I can walk on sand and uneven ground, up and down over curbs etc. My complaints about my knees now consist of morning stiffness and sometimes they ache like a toothache! Annoying but not excruciating. No big deal!! I'd discuss your vacation plans with your surgeon and ask for an expedited 2nd replacement. (I don't know how it works in Canada, but my surgeon says 6 weeks apart minimum related to the blood thinner for a month.)
I was subjected to only one cruel therapist in the hospital. She was walking me down the hallway and she wasn't satisfied with my gait, I wasn't bending it enough. So she kneed me sharply behind my new knee and said "I wonder how many more times I'll have to do this before you get it right." She never had a chance to find out because I reported her and banned her from my room. I went on to have a few home PT visits but let him go too. He was useless. I had no PT really for both knees and I'm doing fine. Don't know my bend. Don't care. I can do anything I want to do so degrees don't matter.
I am a nurse since 1969 and am utterly disappointed with the state of nursing now. So many mistakes...delayed meds, no basic hygiene offered to patients, pain pump left unplugged. I could go on but will step down off my soapbox...because I can!
Sent from my iPad using broken link removed: https://r.tapatalk.com/byo?rid=75543
I was subjected to only one cruel therapist in the hospital. She was walking me down the hallway and she wasn't satisfied with my gait, I wasn't bending it enough. So she kneed me sharply behind my new knee and said "I wonder how many more times I'll have to do this before you get it right." She never had a chance to find out because I reported her and banned her from my room. I went on to have a few home PT visits but let him go too. He was useless. I had no PT really for both knees and I'm doing fine. Don't know my bend. Don't care. I can do anything I want to do so degrees don't matter.
I am a nurse since 1969 and am utterly disappointed with the state of nursing now. So many mistakes...delayed meds, no basic hygiene offered to patients, pain pump left unplugged. I could go on but will step down off my soapbox...because I can!
Sent from my iPad using broken link removed: https://r.tapatalk.com/byo?rid=75543
OP
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Knees4Me
member
@Arttie - I am intrigued by the cruise and have heard it's the closest we'd get to an all-inclusive vacation in Hawaii. But I don't like the idea of being a captive audience at close quarters with hoards of people. And my husband hates the idea of cruises! We're very independent travelers and can't imagine being herded around the the sites at each port of call! But your description of the sunrise is sublime!
OP
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Knees4Me
member
@Aquafool - That physical therapist you had the bad experience with sounded incompetent! The nerve! I was at physio today and the PT said I need to have flexion of 120 degrees when I see my surgeon for my six week follow up on Feb. 15. I'm very nervous! This doctor is very strict about certain things and I'm not going ask her to expedite the replacement surgery on my right knee. She does them 5½-6 months apart and I don't know why yet. Maybe to have enough strength in the "baby" knee? My husband and I are in no rush to go to Hawaii. I want to make absolutely sure that both of my new knees are completely recovered and functioning well before I take such a long flight each way. If that means January 2019 rather than January 2018, so be it!
OP
OP
Knees4Me
member
@jaschembra - I've never heard of those drugs. My PT told me when I went for rehab physio today that Celebrex is only given for two weeks, so even if I'd been taking those tablets, I'd be off them by now. However, I need at least 120 degrees flexion before the surgeon will schedule my second knee surgery! There is no way to get around it: they're obsesseed with ROM. Today I got to 102 degrees - with a lot of pushing and pain! But I have to be in that range in order to get back to driving our car, riding a stationary bike, sitting on an airplane for a long flight, going to a movie, the theatre or a restaurant, etc. And I want those things to happen very soon! I'll need a few months of "normal" before what I now know will be an equally long q- or longer! - process for the next knee. I just hope and pray that I won't need a hip replacement or two!! How are your hips?
jaschembra
post-grad
You ask how my hips are... hmmm there is one that gives me trouble but I try to think it's muscular and not joint related. The chiropractor usually helps me with stretching. I sure hope you don't have to go in that direction too. I'll bet there will be a time when we have no doubt that we're ready to do the next knee!! 
The cruise was my 1st intro to Hawaii. My wife had worked there with a Navy contractor. It was a way to see 4 islands easily. Pearl harbor is a must. I much preferred the other 3 islands to Oahu/Honolulu, speaking of crowded. As to the flights, a suggestion would be to fly to the west coast and change planes. This makes for a longer time traveling but has the advantage of giving you a chance to get up and move around a little bit. Also, the mimosas in 1st class are delightful when leaving for the Islands in the morning. 
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Knees4Me
member
@Arttie - Yes, we definitely want to see Pearl Harbor! My husband is a history/WWII buff, so we must go to Oahu for a couple of days. I want to have two strong new knees by the time we go that don't ache and tire quickly - so we're not in a rush to go. And we definitely want to go to Maui to relax on a beach. I hear Hawaii is expensive, and our Canadian dollar doesn't go as far as the USD. So we will probably limit our trip to 15 days total. Did you mean to fly to the west coast, as in L.A.? We plan to stop there to visit friends on the way to Honoulu. Then we'll fly back from Maui via Vancouver, where we'll stay over for a night or two. Let the planning begin and let the knees heal!!
OP
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Knees4Me
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OP
OP
Knees4Me
member
@Josephine - I'm asking you this question, Josephine, because it 's a medical one and you've seen and been involved with lots of knee surgeries over your career. (Bear with me, the question is coming...)
I haven't had a whole lot of time or conversation with my surgeon, so I got few details about my LTKR, except that I did need one because my arthritis was bone-on-bone. (Actually, I need two ops, but my RTKR is to happen later this year.) When the surgeon came to the foot of my hospital bed during her rounds after my operation, she said that she "did some realignment while I was in there."
I was too groggy to ask for details, so I asked my physiotherapist later. She said my knee had been straightened, and pointed to my intact knee and said "see how that curves?" Well, I'd never noticed that in my life! I'm almost four weeks post-op and I'm still having a lot of pain, as well as IT band and sciatica discomfort/pain on my left side that make it impossible to sleep. These issues also make it hard to elevate my legs for more than a few minutes at a time.
When I came out of surgery, I had a lot of blisters on the outside of my left leg and a lot of bruising and swelling came in the following day. I still have constant swelling and have really stepped up the icing. I'm attached to my Cryo Cuff for much of the day. The swelling makes doing my exercises (and going to rehab-physio) very painful. I skipped my exercises today - guiltily!)
My questions (actually, there are three) are:
How likely is it that the fact I had realignment done, in addition to the actual knee replacement, has resulted in a slower, more painful recovery for me than for people who don't have any realignment done?
Is realignment common with TKR surgery? What is the benefit?
I would like to know, so I'm more informed going into my RTKR. Thanks for any info you can provide!
I haven't had a whole lot of time or conversation with my surgeon, so I got few details about my LTKR, except that I did need one because my arthritis was bone-on-bone. (Actually, I need two ops, but my RTKR is to happen later this year.) When the surgeon came to the foot of my hospital bed during her rounds after my operation, she said that she "did some realignment while I was in there."
I was too groggy to ask for details, so I asked my physiotherapist later. She said my knee had been straightened, and pointed to my intact knee and said "see how that curves?" Well, I'd never noticed that in my life! I'm almost four weeks post-op and I'm still having a lot of pain, as well as IT band and sciatica discomfort/pain on my left side that make it impossible to sleep. These issues also make it hard to elevate my legs for more than a few minutes at a time.
When I came out of surgery, I had a lot of blisters on the outside of my left leg and a lot of bruising and swelling came in the following day. I still have constant swelling and have really stepped up the icing. I'm attached to my Cryo Cuff for much of the day. The swelling makes doing my exercises (and going to rehab-physio) very painful. I skipped my exercises today - guiltily!)
My questions (actually, there are three) are:
How likely is it that the fact I had realignment done, in addition to the actual knee replacement, has resulted in a slower, more painful recovery for me than for people who don't have any realignment done?
Is realignment common with TKR surgery? What is the benefit?
I would like to know, so I'm more informed going into my RTKR. Thanks for any info you can provide!
Jo is away from the forum for a week or so. I'll try to answer your questions for you.
All TKRs require some measure of alignment work. This is one of the reasons you want a very skilled surgeon because it is the alignment of all your soft tissues that makes the knee work properly or not. In cases where a patient's knees are bowed inward or outward, the new implant straightens the leg. Sometimes if the bow is significant enough it can make a difference in gait until the second knee can be done. But it shouldn't be a real problem as a person waits for the second TKR. So if you had a bow to your knee, it was straightened and your surgeon then made whatever adjustments were necessary to get your knee to articulate properly. It is the goal of surgery to put your knees in the best alignment possible so that stress on your other joints is minimized when you are mobile.
Generally, the worse a knee is going into surgery and the more work a surgeon has to do to get things properly aligned, the more chance there is for a lengthier recovery. This is a factor of the soft tissues and bone being moved, adjusted, tested, and in general just "worked with" and as you can imagine the extra manipulation leaves the tissues more irritated.
All this is why we tell people not to compare surgeries. There can be differences among people, between surgeons or even in two knees done at the same time by the same surgeon. Every recovery is unique. There are no "standards." A recovery may be a bit slower for one reason or another, but it should not be more painful. Proper pain management and taking medications on a set schedule is a must for a good recovery. If you're experiencing pain, then a person should take a look at medications and scheduling and make whatever adjustments are needed to reduce pain to a manageable level. (This is not to say you should expect no pain....it should just be manageable and not tremendously uncomfortable)
All TKRs require some measure of alignment work. This is one of the reasons you want a very skilled surgeon because it is the alignment of all your soft tissues that makes the knee work properly or not. In cases where a patient's knees are bowed inward or outward, the new implant straightens the leg. Sometimes if the bow is significant enough it can make a difference in gait until the second knee can be done. But it shouldn't be a real problem as a person waits for the second TKR. So if you had a bow to your knee, it was straightened and your surgeon then made whatever adjustments were necessary to get your knee to articulate properly. It is the goal of surgery to put your knees in the best alignment possible so that stress on your other joints is minimized when you are mobile.
Generally, the worse a knee is going into surgery and the more work a surgeon has to do to get things properly aligned, the more chance there is for a lengthier recovery. This is a factor of the soft tissues and bone being moved, adjusted, tested, and in general just "worked with" and as you can imagine the extra manipulation leaves the tissues more irritated.
All this is why we tell people not to compare surgeries. There can be differences among people, between surgeons or even in two knees done at the same time by the same surgeon. Every recovery is unique. There are no "standards." A recovery may be a bit slower for one reason or another, but it should not be more painful. Proper pain management and taking medications on a set schedule is a must for a good recovery. If you're experiencing pain, then a person should take a look at medications and scheduling and make whatever adjustments are needed to reduce pain to a manageable level. (This is not to say you should expect no pain....it should just be manageable and not tremendously uncomfortable)
OP
OP
Knees4Me
member
@Jamie - Thanks very much, Jamie. You're very knowledgable. I think this explains a lot about my particular surgery. I keep to a strict pain control schedule (excuse me while I take my midnight meds!) I even set the alarm on my cellphone for 3 a.m. and 6 a.m. My pain is pretty much controlled, if not eliminated. I try to ice my knee if I hurt a lot, but it isn't quite time for my pain pills. It's mostly the lower back pain on the left side, down through my hip and outer left thigh to my knee that keeps me awake at night. I just can't find a comfy position! As for the realignment, I guess I'm a chip off the old block because my Dad was very bow-legged just before his BTKR surgery. My Mom used to say that when he walked, he looked as if he just got off a horse! Maybe that's a reason why he had both legs done at one time. And he probably suffered too long with bone-on-bone arthritis before he had the replacements. I'm at least 10 years younger than he was at the time of his operation...and I've never noticed that I was bow-legged! Neither did my husband!! I guess maybe I'll be out of alignment for a while until I have my RTKR and it heals. I look forward to two corrected knees, but it's a long, hard road, as you know!
Yes. If you can, treat yourselves to 1st class from the west coast to Hawaii. You will appreciate the extra leg room and the pampering is a fun way to start your vacation. We just returned from Chile and had a window exit row seat in something euphemistically called Comfort+. They were anything but, padded like a mid-evil torture bench, for 9 hours.
But the leg room was fantastic in that row. ( I missed your second reply scrolling down. my bad 
) (second edit: my avatar is from the beach in Papeete where Brando filmed "Mutiny on the Bounty")
RMasano
senior
I had knock-knees, which is the opposite of what you had. I absolutely think it makes a difference in recovery. Mine was severe. I couldn't put my feet together by multiple inches. I feel like I am also relearning to walk, as I've been struggling with the alignment problems for decades. I also had blisters on outside of knee. Good luck in your recovery!!!
Josephine
NURSE DIRECTOR EMERITA
And they could more likely be stiff because they did too much PT!!
I'd sooner say 'a year or even longer'.
I know a few surgeons who prefer to use that time scale. I think the only reason is to not let the patient feel pressured.However, I know just as many who will do the second one a month or even a week after the first.
Oh Knees4Me, did I waste my time advising you here ....
OP
OP
Knees4Me
member
@Josephine - Those two ladies I mentioned didn't want to do any exercise post-op, I'm told. And their new knees supposedly "seized up" on them.
Pre-op, I was repeatedly told by well- meaning people that recovery would take about six weeks. I won't even be close! My surgeon says I'll be on prescription pain meds "for at least six weeks!" Since she saw the whole surgical process, she should know!!
I'm okay with having knee #2 done in June or thereabouts.
No, don't worry, Josephine, you didn't waste your time advising me!! I naturally gravitate towards your philosophy/mantra. I had major swelling immediately post-op which continues almost four weeks later. Simply put, if I hurt, I don't exercise. If I don't, I do a few knee slides. However, please understand that I'm having my two surgeries at, reputedly, the top place in Canada for arthritic joint replacement. I asked for - and got - the surgeon I wanted, based on the experiences of pleased people I know. I definitely want her to replace knee #2. And this facility includes with surgery their physical therapy/rehab program. So I was put into a knee "class" twice a week for a month. There is a note on my chart that says I am not to have therapists physically "help" with my ROM unless I ask. I admit that last Thurs., I did let one kind and very professional PT (there are others who seem to have a sadistic streak!) "assist" me, gently, in getting to 100 degrees flexion. (My extension is "perfect" at 0.) There was some pain, but I didn't dissolve into tears and I reached 102 degrees. My motivation is so I can drive again soon, use my opera tickets, sit in restaurants and cafes - or even our dining room table - comfortably, and get on the recumbent bike in our condo building's gym for exercise. I can't even reach one full rotation right now! I really enjoyed the bike pre-op - and I'm not athletic at all, so it'll be perfect for getting me moving, when I'm ready. I also want to breeze through my six-week post-op with no scolding, threats of MUA or warnings that my second TKR won't go ahead if I'm not a good little girl. I don't like the condescending, one-size-fits-all approach, but I'm also not willing to risk a stiff and frozen - and useless - new knee...or further surgery on It. There must be a happy medium for every person! Do you think you'd have been as happy to recommend no exercise post-op if you hadn't been lucky with your ROM flexion reaching 135 and 123 with no exercise?
So...please be assured that I listen to and appreciate your advice, I'm glad I found this informative and supportive site/forum and I plan to be here, learning every day, meeting new "bone smarties," and reading about our shared trials, tribulations and successes as we take this journey together! Before I found BoneSmart, I felt completely adrift in a sea short of information on total knee replacement surgery.
Thanks for helping people like me. I've already made a small contribution and will send a bigger one soon. I actually tried to send more when I joined, but there was a technical glitch and it didn't go through. But Jamie came to my rescue!
Pre-op, I was repeatedly told by well- meaning people that recovery would take about six weeks. I won't even be close! My surgeon says I'll be on prescription pain meds "for at least six weeks!" Since she saw the whole surgical process, she should know!!
I'm okay with having knee #2 done in June or thereabouts.
No, don't worry, Josephine, you didn't waste your time advising me!! I naturally gravitate towards your philosophy/mantra. I had major swelling immediately post-op which continues almost four weeks later. Simply put, if I hurt, I don't exercise. If I don't, I do a few knee slides. However, please understand that I'm having my two surgeries at, reputedly, the top place in Canada for arthritic joint replacement. I asked for - and got - the surgeon I wanted, based on the experiences of pleased people I know. I definitely want her to replace knee #2. And this facility includes with surgery their physical therapy/rehab program. So I was put into a knee "class" twice a week for a month. There is a note on my chart that says I am not to have therapists physically "help" with my ROM unless I ask. I admit that last Thurs., I did let one kind and very professional PT (there are others who seem to have a sadistic streak!) "assist" me, gently, in getting to 100 degrees flexion. (My extension is "perfect" at 0.) There was some pain, but I didn't dissolve into tears and I reached 102 degrees. My motivation is so I can drive again soon, use my opera tickets, sit in restaurants and cafes - or even our dining room table - comfortably, and get on the recumbent bike in our condo building's gym for exercise. I can't even reach one full rotation right now! I really enjoyed the bike pre-op - and I'm not athletic at all, so it'll be perfect for getting me moving, when I'm ready. I also want to breeze through my six-week post-op with no scolding, threats of MUA or warnings that my second TKR won't go ahead if I'm not a good little girl. I don't like the condescending, one-size-fits-all approach, but I'm also not willing to risk a stiff and frozen - and useless - new knee...or further surgery on It. There must be a happy medium for every person! Do you think you'd have been as happy to recommend no exercise post-op if you hadn't been lucky with your ROM flexion reaching 135 and 123 with no exercise?
So...please be assured that I listen to and appreciate your advice, I'm glad I found this informative and supportive site/forum and I plan to be here, learning every day, meeting new "bone smarties," and reading about our shared trials, tribulations and successes as we take this journey together! Before I found BoneSmart, I felt completely adrift in a sea short of information on total knee replacement surgery.
Thanks for helping people like me. I've already made a small contribution and will send a bigger one soon. I actually tried to send more when I joined, but there was a technical glitch and it didn't go through. But Jamie came to my rescue!
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