Hi Folks,
I’m a 54 year old female school teacher from the US, and I had bilateral knee replacement on July 6th 2020! I’m either crazy or brave or a little of both.
Background - In my 30s and 40s I used to run regularly for exercise and weight control. 11 years ago I tore the medial meniscus in my right knee (a running overuse injury). I got it scoped and 3 years later tore the medial meniscus in the left knee! After it was repaired, arthritis set in and did a number on both knees. Fast forward 8 years - I gained a good bit of weight due to inactivity, and the medial meniscus in both knees was 100% gone. I was bone on bone and in a constant state of inflammation and pain. Cortisone shots lasted all of 6 weeks and were expensive with my high deductible insurance. I was becoming more and more crippled every year. So it was time! Seven months before surgery, I started working on weight loss and fitness. I bought a bike and rode it 4 days a week to improve strength, endurance and range of motion and to burn calories. I can’t wait to get back on my bike!!! I also had to take a joint replacement class, complete pre op testing (including CT scans of each leg for the robotic arm assisted surgery), swab my nose with antibiotic ointment and use a special antibiotic body wash for 5 days before surgery.
Surgery - Surgery went well. The worst part was that the surgeon had the catheter taken out after the operation that morning despite the fact that I had 4 large iv bags of fluids and 3 small iv bags of antibiotics flowing through my body for the next 24 hours. I had to get up to pee 6 times that first night. It was brutal! I was also very surprised that my knees didn’t hurt in the hospital due to the nerve block during surgery, but my thighs screamed with pain due to the tourniquets used during the procedure. My thighs! Who knew! Like everyone else, I walked the first day using a walker (the second day the PT switched me to arm canes), learned to do some basic exercises, and even went up and down a whole flight of stairs on day 3 before I left the hospital. The hospital PT scared me a little about not working hard enough over the next 2.5 months and “wasting” my surgery.
So when I got home, I really pushed myself. Bad idea! I ended up with a Charlie horse cramp behind my right knee on day 6 post op that would not go away. It lasted for hours and hours! I had to have the doctor on call phone in an RX muscle relaxer and use a heating bad all night to get it to go away. That was probably the worst day I’ve had. I took it easier after that. I developed a routine of icing/elevating, then sitting in a chair, then doing some exercises, then walking with my arm canes for 10-15 minutes, then back to icing/elevating. Repeat, repeat, repeat.
PT - I started out patient PT one week post op. At first I was scared, but after watching some of the 80-90 year old patients struggle with the same exercises I was supposed to be doing, I realized I COULD do them too! PT has not been hard. I’ve been working on balance, strength and endurance, and ROM. I didn’t realize balance would be an issue until I tried to put my hair up in a ponytail while standing up that first week. I almost fell down flat! Last week at 17 days post op, I was at 95-100 flexion (I’ve got some work to do here) and only needed 5 more degrees for full extension. I’m also getting ready to move to one arm cane when walking. My PT is pretty happy with my progress so far.
Pain meds - my doctor/insurance is super stingy about pain meds, which does not make me happy. I was on 2 Tramadol, 2 Tylenol every 6 hours and oxy every 4 hours only as needed for break through pain in the hospital and the rest of the first week. I needed the oxy pretty much the whole time but I had to ask for it. At my 8 day follow up, he cut it down to 1 Tramadol, 2 Tylenol every 6 hours and 1-2 hydrocodone every 8 hours, but he did not give me enough pills to actually take this dosage regularly for more than a week. I had to start rationing pain meds before I was ready. I still take the hydrocodone at night to sleep and for PT appointments. I called and got more Tramadol at the beginning of this week because during the day sometimes Tylenol just isn’t enough. Rationing stinks!!! I may run out of hydrocodone before I’m ready, and I’m dreading it.
Sleep - sometimes I sleep great for a couple of nights and then I’ll have a couple of nights where I can’t sleep much at all. I cut out daytime naps after the first 1.5 weeks in an attempt to sleep better at night. Doesn’t seem to make a difference though. I either sleep on my back with my legs elevated on a wedge of 2 or 3 pillows, or I sleep on my sides with a pillow between my legs in a nest of pillows. I’ve been trying to side sleep for the last 1.5 weeks and it’s going ok. The funny thing about sleep though - the better I sleep, the worse my legs feel in the morning due to lack of movement.
Hot Spots - my left leg feels pretty good most of the time. It gets super stiff but there’s not a lot of pain. My right leg gets really sore behind/in back of the knee. I think the tendons or ligaments back there are really aggravated by something, and I’m not sure what to do about it. I think ibuprofen would help but I can’t take it until I’m done with the blood thinner medication (Xarelto for 8 more days).
Work - As a teacher I don’t have a desk job. I walk 8000 to 10,000 steps a day, have various duties throughout the day that require 30 minutes of standing, and work on the 3rd floor of a 100 year old 3 story building with no elevators. I plan to take a full 12 weeks to recover (6 weeks of my own time this summer and 6 weeks of medical leave once school starts). I’m hoping by the time I go back at the end of September, my school will have the whole Covid face to face vs distance learning dilemma solved. I’m rooting for distance learning.
Fears -
At 54, I’m worried that I did my knee replacements too early. I’m actively working on losing more weight in order to make my new knees last! I lost 24 pounds before surgery and I’ve lost another 5 lbs post op. I need to get a good bit more off long term.
I will also breath a huge sigh of relief when the blood clot and infection windows both close. I’ve done and continue to do everything in my power to avoid both of these complications.
That’s where I am right now. Good luck and happy healing to the rest of the July Sparklers!
I’m a 54 year old female school teacher from the US, and I had bilateral knee replacement on July 6th 2020! I’m either crazy or brave or a little of both.
Background - In my 30s and 40s I used to run regularly for exercise and weight control. 11 years ago I tore the medial meniscus in my right knee (a running overuse injury). I got it scoped and 3 years later tore the medial meniscus in the left knee! After it was repaired, arthritis set in and did a number on both knees. Fast forward 8 years - I gained a good bit of weight due to inactivity, and the medial meniscus in both knees was 100% gone. I was bone on bone and in a constant state of inflammation and pain. Cortisone shots lasted all of 6 weeks and were expensive with my high deductible insurance. I was becoming more and more crippled every year. So it was time! Seven months before surgery, I started working on weight loss and fitness. I bought a bike and rode it 4 days a week to improve strength, endurance and range of motion and to burn calories. I can’t wait to get back on my bike!!! I also had to take a joint replacement class, complete pre op testing (including CT scans of each leg for the robotic arm assisted surgery), swab my nose with antibiotic ointment and use a special antibiotic body wash for 5 days before surgery.
Surgery - Surgery went well. The worst part was that the surgeon had the catheter taken out after the operation that morning despite the fact that I had 4 large iv bags of fluids and 3 small iv bags of antibiotics flowing through my body for the next 24 hours. I had to get up to pee 6 times that first night. It was brutal! I was also very surprised that my knees didn’t hurt in the hospital due to the nerve block during surgery, but my thighs screamed with pain due to the tourniquets used during the procedure. My thighs! Who knew! Like everyone else, I walked the first day using a walker (the second day the PT switched me to arm canes), learned to do some basic exercises, and even went up and down a whole flight of stairs on day 3 before I left the hospital. The hospital PT scared me a little about not working hard enough over the next 2.5 months and “wasting” my surgery.
So when I got home, I really pushed myself. Bad idea! I ended up with a Charlie horse cramp behind my right knee on day 6 post op that would not go away. It lasted for hours and hours! I had to have the doctor on call phone in an RX muscle relaxer and use a heating bad all night to get it to go away. That was probably the worst day I’ve had. I took it easier after that. I developed a routine of icing/elevating, then sitting in a chair, then doing some exercises, then walking with my arm canes for 10-15 minutes, then back to icing/elevating. Repeat, repeat, repeat.
PT - I started out patient PT one week post op. At first I was scared, but after watching some of the 80-90 year old patients struggle with the same exercises I was supposed to be doing, I realized I COULD do them too! PT has not been hard. I’ve been working on balance, strength and endurance, and ROM. I didn’t realize balance would be an issue until I tried to put my hair up in a ponytail while standing up that first week. I almost fell down flat! Last week at 17 days post op, I was at 95-100 flexion (I’ve got some work to do here) and only needed 5 more degrees for full extension. I’m also getting ready to move to one arm cane when walking. My PT is pretty happy with my progress so far.
Pain meds - my doctor/insurance is super stingy about pain meds, which does not make me happy. I was on 2 Tramadol, 2 Tylenol every 6 hours and oxy every 4 hours only as needed for break through pain in the hospital and the rest of the first week. I needed the oxy pretty much the whole time but I had to ask for it. At my 8 day follow up, he cut it down to 1 Tramadol, 2 Tylenol every 6 hours and 1-2 hydrocodone every 8 hours, but he did not give me enough pills to actually take this dosage regularly for more than a week. I had to start rationing pain meds before I was ready. I still take the hydrocodone at night to sleep and for PT appointments. I called and got more Tramadol at the beginning of this week because during the day sometimes Tylenol just isn’t enough. Rationing stinks!!! I may run out of hydrocodone before I’m ready, and I’m dreading it.
Sleep - sometimes I sleep great for a couple of nights and then I’ll have a couple of nights where I can’t sleep much at all. I cut out daytime naps after the first 1.5 weeks in an attempt to sleep better at night. Doesn’t seem to make a difference though. I either sleep on my back with my legs elevated on a wedge of 2 or 3 pillows, or I sleep on my sides with a pillow between my legs in a nest of pillows. I’ve been trying to side sleep for the last 1.5 weeks and it’s going ok. The funny thing about sleep though - the better I sleep, the worse my legs feel in the morning due to lack of movement.
Hot Spots - my left leg feels pretty good most of the time. It gets super stiff but there’s not a lot of pain. My right leg gets really sore behind/in back of the knee. I think the tendons or ligaments back there are really aggravated by something, and I’m not sure what to do about it. I think ibuprofen would help but I can’t take it until I’m done with the blood thinner medication (Xarelto for 8 more days).
Work - As a teacher I don’t have a desk job. I walk 8000 to 10,000 steps a day, have various duties throughout the day that require 30 minutes of standing, and work on the 3rd floor of a 100 year old 3 story building with no elevators. I plan to take a full 12 weeks to recover (6 weeks of my own time this summer and 6 weeks of medical leave once school starts). I’m hoping by the time I go back at the end of September, my school will have the whole Covid face to face vs distance learning dilemma solved. I’m rooting for distance learning.
Fears -
At 54, I’m worried that I did my knee replacements too early. I’m actively working on losing more weight in order to make my new knees last! I lost 24 pounds before surgery and I’ve lost another 5 lbs post op. I need to get a good bit more off long term.
I will also breath a huge sigh of relief when the blood clot and infection windows both close. I’ve done and continue to do everything in my power to avoid both of these complications.
That’s where I am right now. Good luck and happy healing to the rest of the July Sparklers!
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