Bilateral TKR July 1 LHop - Bilateral TKR Recovery Thread

[iivesfam5]

Hey @LHop been thinking about you!! Time is ticking for me and I thought I would check on you...... Hope all is well......

 

[LHop]

Sunday was my first visits from both the visiting nurse and a PT, neither of which were my "regular" people since it was a holiday weekend. The PT gave me a list of exercises to start and when my PT, Sean, came Monday I think I showed off too much. I was hurting a lot Tuesday. Kevin helped me with another shower and it seemed a lot more painful than before. When Sean came Thursday he said that around the week mark is when it really starts to get hard for most patients because by then all the drugs from the hospital have worked through your system and now the pain you have is what you have. He also encouraged me by saying although I was in more pain I hadn't lost any of my range of motion I had from the other day and as long as I don't go backwards, it will continue to get better every day.

Two of the tools I am most thankful I have are the potty chair, which is high enough to keep me from having to do deep knee bends to use the facilities, and the other is the circulating ice machine. I keeps cold/ice water constantly circulating through wraps on my knees which help keep the swelling down. My incisions look good and are healing well.

Sleep isn't something I'm struggling with (knock on wood), although I don't like sleeping on my back. I have been experiencing something which is odd, when I am starting to drift off, my muscles spasm similar to when you're beginning to fall asleep and you jerk awake, it happens frequently.

I've read all the blogs that said there would be discouragement around this time and, of course, they are right. It feel like I'm slogging through molasses. I would like the recovery to be further along. I'd like to be able to get up and walk without using the walker, to shower standing up, to sleep on my side...but I'm not there yet. I've also developed a low grade fever which saps me of my energy. Wah, wah, feeling a little sorry for myself.

How are my fellow July friends fairing? @jbrooklyn and @iivesfam5 how goes the preparation? Any questions for me?

 

[iivesfam5]

Hi @LHop I am so glad you posted...... I have the toilet riser and the Polar ice machine with circulating water..... I am ready...... waiting for the insurance to tell me everything is all set...... I figure the doctor and hospital are certainly not going to do this until they know it is good because I sure can't pay for this!! Hang in there girlie - Let's all focus on the 1 month mark first and then the 3 month mark!!!! from now until then nothing matters except rest..... Us BTKR girls need to hang tight cause this is not an easy thing but we are tough and we can do it!!!

 

[Lovestoread]

@LHop, although I didn't have them, I have often read here of people that have those jerking spasms. So no, I'm sure nothing is wrong. Hopefully someone will come on give an explanation of them. The toilet riser and ice machine were my favorite recovery aids as well! Hang in there...it does get better!


Sent from my iPad using BoneSmart®

 

[ptmhcm]

@LHop Hang in there. I was also BTKR done May 28.

Had some knee jerks too in the hospital. OS said not unusual. The showering at first was a nightmare and that's because my legs were too short for the shower chair but I managed.

Yep. The raised toilet seat is a blessing. Stay strong. With each day comes progress. You will do great!

 

[LHop]

Hmmm some of my posts seem to have disappeared..curious.
My recovery is going well, my PT seems very pleased with my progress. The pain is manageable, with good days and bad days. I am still struggling with the muscle cramps and spasms. My PT suggested it could be an electrolyte imbalance so I am trying to drink a lot of Gatorade and get it back on track. My family has been wonderful during this recovery time.

Today was a big day for me! It started with a visit from the nurse for a blood test, which went well. She was able to draw my blood with no complications. However, I have acheived quite a reputation. The poor woman was so nervous to draw my blood, she was shaking. I'm pretty sure she said it was nice to meet me and that she hopes she doesn't have to see me again.

At 10:00 a.m. visit from Sean, my Physical Therapist, who gave me a run for my money. After a bagel and a short nap, I took a shower and got ready to see my doctor. This is the first time I've been out of the house since I came home from the hospital. It was quite surreal, in some ways feeling like it's been months, but also feeling like time has flown.

Waiting in the exam room was torture. There is no comfortable way to sit on that table. I was up on the table squirming around every five minutes trying to find a position that didn't hurt. I told Kevin the next time we come, he can go sit in the exam room and I'll stay in the waiting room until the doctor is ready. I feel this is a fair solution ;-)

The visit with Dr. Metros went well, I am still struggling with high blood pressure, which means I'll probably need to start medication for that when I see my GP again. They removed my stitches and Dr. Metros declared my range of motion "perfect"! I'm sure he is quite pleased with his work ;-) I'll see him in another month for a follow up.

While I was in with the doctor, the visiting nurses office called to say my Warfarin level was lower than the last time, so I am now taking 7 mg. Still three pills though.

On the way home we stopped and picked up some pizza, something I've been craving. By the time I changed my clothes, had a few slices of pizza, and put my circulating ice machine back on my knees, I felt like I had climbed Mt. Everest. All my muscles were constricting and I was exhausted. I promptly fell asleep for almost three hours. But I feel better now.

 

[jbrooklyn]

Hi, @LHop! So sorry not to have responded a few days ago--somehow I did not get a notice when you tagged me in that earlier thread--now I have found your recovery thread and it's great to read up on how you are doing. Great idea to have someone else wait in the waiting room for you. It might be worth a mention to doc . . . he might be inspired to get a chair high enough for us knee-challenged folks to use comfortably. Even a GP is bound to have a number of people with bad knees.

Getting out of the house is amazing, isn't it? Changes your frame of mind. Glad to hear your ROM is coming along nicely. Hooray for pizza, ice machines, and sleep! Sending good wishes your way.

 

[MsBlue]

I don't like sleeping on my back. I have been experiencing something which is odd, when I am starting to drift off, my muscles spasm similar to when you're beginning to fall asleep and you jerk awake, it happens frequently.

I am having this too. I am side sleeper by preference, but am managing on my back. In the hospital, I slept in the recliner. I could not get comfortable in the hospital bed. Either this bed at rehab is shaped differently, or I've adjusted, because I am doing better with the bed (and there's no recliner here!). But I keep having those jerking motions. I was just trying to take a nap, and I can't drift off because I keep jerking awake. It may be because my muscle relaxer is due. I think that helps with those.

My feet also get crampy, and I have some "yoga toes" (Joy-a-Toes toe spacers that I bought at a yoga studio) which are helping with that. I put those on my feet for 20 or 30 minutes, and that does help.

 

[LHop]

I am having this too. I am side sleeper by preference, but am managing on my back. In the hospital, I slept in the recliner. I could not get comfortable in the hospital bed. Either this bed at rehab is shaped differently, or I've adjusted, because I am doing better with the bed (and there's no recliner here!). But I keep having those jerking motions. I was just trying to take a nap, and I can't drift off because I keep jerking awake. It may be because my muscle relaxer is due. I think that helps with those.

My feet also get crampy, and I have some "yoga toes" (Joy-a-Toes toe spacers that I bought at a yoga studio) which are helping with that. I put those on my feet for 20 or 30 minutes, and that does help.

I didn't get a muscle relaxer prescription, but I imagine that would help. I also get cramps in my legs and feet. I might have to check in to the "yoga toes"

 

[LHop]

It's been three weeks, I had to look at that twice on my calendar. I took a walk up and down our block today using my walker of course. I probably could have gone further, but my left knee was super tight so I didn't want to overdo it. It was nice to get outside in the sunshine. I even got to chat with one of the neighbors for a few minutes. It was good to get out.

Other than the obvious things, I really miss being able to take a bath. I love a good soak and usually take a bath every weekend. I think it would really help with some of the stiffness I'm feeling. Alas, there is no way I could get in and out of the tub, even if I could soak my knees in the hot water, which I'm not sure would be advisable since ice therapy is a huge part of my recovery. Oh well, something to look forward to in a few months.

 

[iivesfam5]

@LHop you sound real good. Just one week for me and I am doing alright....... wanted to visit everyone's threads to check on them..... this is not the easiest thing we have done for sure!!! Keep in touch.

 

[jbrooklyn]

@LHop, seconding that emotion, regarding soaking in the tub. That will be a reward in itself at some unknown point in the future.

It is so good for state of mind to get outside, right? Feeling the breeze, chatting with neighbors, etc. really feels great--agreeing with you on that, too!

 

[ptmhcm]

@LHop How are you feeling?

 

[LHop]

Well today I hit a wall. Having a little crying jag, and am feeling inadequate. I'm three weeks out and I thought I would be so much further along. I am still very unsteady in my balance and need to use my walker to feel comfortable. My knees still feel very stiff, I can't stand comfortably for more than a minute or two.

At my doctor's visit last week he started talking to me about the fact that I'm probably already addicted to my medication, so I have been trying to taper off the pain meds. I'm taking 20 mg Oxycodone. I take one before bed, one in the morning and I've been trying to not take one again during the day, but usually break down around 4 or 5:00 p.m. because I have a bone deep ache in my knees. It almost seems like the pain is worse in some ways.

I'm also feeling stir crazy, I haven't really been out of the house except for a short walk or two. I've had lots of visitors, and my family has been wonderful, but I feel like I'm stuck here. My home is usually a refuge, but when you feel like you can't leave, it starts to feel like a prison. I've been trying to do a little cleaning, but I don't have much stamina still. This also causes me angst, as my home is not at my cleanliness standard.

My youngest is leaving for camp for three weeks and normally I would drive her down and see her off, but it's about five hours round trip in the car and I know I would be paying a huge price.

Sometimes it's hard to read my fellow BTKR friends posts because I compare myself and while I know everyone's recovery is different, it's hard not to think "Why am I not there yet?"

Sorry to be such a Debby Downer! Thanks for letting me vent. Tears are streaming down my face as I type this because I know I'm being totally unreasonable with myself and am way overreacting, but I feel like this is the only place where I might be understood.

 

[LHop]

@ptmhcm Aren't you sorry you asked?

 

[MidwestTKR]

Hi Lori,

I am 13 weeks post-op and I can tell you that everything you are feeling is normal. I also felt I should be much further along then I was and in fact still struggle with that feeling occasionally. It is a very difficult surgery to recover from and frankly I think the Dr's don't do a very good job of preparing us for how difficult it will be. This forum was and is a lifesaver for all of us that have been through it. I can't believe your Dr. even mentioned probably being addicted already. TKR patients need to be on regular pain meds for quite awhile still since you are only 3 weeks post-op, correct? I changed to Tramadol around week 2-3 due to severe constipation issues. I wasn't off of the meds until approx. 2 months post-op and I gradually weaned as I was able. I think Josephine would be a wonderful one to comment on your post above regarding the meds if you want to tag her.

Please don't feel like you are being a downer. We have all been there! I got quite depressed periodically. It is completely normal! You are doing great and you will get there!!!!

As for the house, I know how you feel because I like my home clean and organized but there is NO way you should be cleaning for quite awhile!!!! Your body needs to rest, ice, elevate and repeat........ to heal!!!

 

[ptmhcm]

@ptmhcm Aren't you sorry you asked?

@LHop no I am not sorry I asked. I can clearly understand your frustration and emotional status at 3 weeks out. Your pain is real and I can relate to you being a bit stir crazy at 3 weeks. I was taking oxycodone at 3 weeks but my OS said it was ok cause the pain was real. Just like you, I felt the pain was worse than when I was Suffering with OA. I got off of it at 4 weeks because it made me crazy.

Just like @MidwestTKR said you need to rest, esp at 3 weeks. With my BTKR I could not work for weeks (I work from my home) because each time I went to sit at my computer, it was agonizing.

I will be 9 weeks post op on Monday. I still get a sharp pain in the left knee only and my IT band in that leg gives me trouble but I focus on my PT.

Don't fret if you do not see your daughter off to camp. 5 hours is way too long to be in a car even with stops. Take care of yourself first. I am sure your family understands what you are going through.

For me, I found this forum to be another form of medicine. I never feel like I am bothering anyone and the feedback from others (esp BTKR patients who can relate to our double pain) is remarkable. Also remember everyone who has undergone a BTKR procedure recovers differently. It's 3:20 am and I am up due to the pain in my left knee. I have insomnia since undergoing this procedure. So what do I do? Pick up my IPhone and hit this forum. But also I am doing better. That's what's so weird. Hugs to you and smile please. :iagree:

 

[jbrooklyn]

@LHop,

So sorry you are feeling this way. Sending hugs and gentle encouragement to you. There are no shortcuts, but you WILL get to where you want to be, and you WILL feel the payoff . . . right now you are just feeling the price of it, but the benefits will start to show up gradually.

It's a long, slow road back to mobility, and there sure are some ruts in the road. Gotta tell you, I've cried more in the 3 1/2 weeks since getting this surgery than in the 5 years before, no joke--and we all steel ourselves before doing this--especially we BTKRs--but there's a difference between knowing it's going to be a gigantic challenge and then experiencing it. I am lucky enough to be able to walk short distances comfortably with a crutch (as long as I have taken my pain meds!) so people look at me and say, hey, you're all better! That makes me want to cry, because it's so far from true. I lie in bed and cannot get comfortable, my legs ache, I cannot sit at the dinner table with my daughter for more than 5-10 min, I cannot sit down without using my arms to lower/raise myself, I drop my crutch 100000 times a day . . . I basically spend a lot of time feeling like 100-year-old granny, and being basically grounded is also definitely affecting my mood daily. There is so, so much ground still to cover.

But we will cover it! We will! If we didn't have this community reminding us that it is inch by inch, and it is really hard, and really worth it, we would probably be crazy by now.

Your doc said you were probably addicted? That is not right, and probably really got to you. Sounds like you need more pain relief than you are getting--maybe MUCH more relief than you are getting. Something like 3 in 1000 people who take pain meds for pain end up with a dependency problem. But they treat us all like potential addicts.

Can I ask why are you taking meds only 2-3x a day? Being in chronic pain is horrible for you, both physically and mentally. That deep bone pain--I know it well, and am still taking meds every 4 hours to seek relief from it. You might want to check in with @Celle or @Josephine about where we should be with pain meds at 3-4 weeks . . . I've tapered the slighted bit, gone from 12 pills a day to 9, but giving myself permission to take whole original dose at tough moments. There is nothing wrong, morally or health-wise, with getting the pain relief you need. (You have to deal with the digestive tract issues that go with it--but there are ways to do that!)

Sorry I have written so much--just trying to share some experiences and "where it's at" from a fellow traveler. We are and I am here for you--we have to take it one day at a time, and gradually this or that will be easier, and it will be wonderful. xxooxxoo

 

[MsBlue]

I was just wondering about meds today - I'm not quite two weeks yet. I was wondering if I could start extending the time between doses or taking a half dose at the give hour. However, after reading this, I am going to stay with my current full dose schedule through Wednesday - that will be two weeks - and see how I'm doing.

By the way, my medication is 10 mg Percocet (oxycodone and acetominophen) and I take that SIX times a day (every 4 hours). I also take a muscle relaxer (Robaxin / Methocarbamol) every 6 hours and Celebrex (prescription anti-inflammatory) once daily. So I keep my alarms set on my iPhone and I am taking medication all day long.

My house was an upside down mess before I left. Now that I have just come home, it's even worse! Medications, ice bags, ice machine, canes, walker, suitcases, dirty laundry bag ... stuff everywhere to add to the usual array of unsorted mail, newspapers, dog toys, books, shoe boxes (I love buying shoes, but I never have anywhere to put them so I have boxes of shoes stashed everywhere - my doctor SWORE I'd be able to wear heels again when all this is over). It's a mess! But, I've cleared out my little area where I'm going to spend most of my time, and I'll get to the rest of this mess later.

I think you are having a "glass half empty day" - completely understandable! Compared to how we are used to being in control of our own lives to where we find ourselves post-surgery, we are a long, long way from "normal." I scared myself so much before surgery that most of my days are "glass half full" because I was really convinced I wouldn't be able to do anything. My expectations were incredibly low. Additionally, being in the rehab hospital for a week provided an excellent transition from hospital to home for me. And I was in the company of a lot of people who had such serious issues or who were having such bad recoveries, that it made me seem so functional by comparison. We'll see how that holds up now that I'm back in "the real world."

I'm betting you are going to have a much better day today.

 

[Josephine]

I'm three weeks out and I thought I would be so much further along. I am still very unsteady in my balance and need to use my walker to feel comfortable. My knees still feel very stiff, I can't stand comfortably for more than a minute or two.

Please tell me you didn't expect to be all healed up and ready to go at 3 weeks! It takes a LOT longer than that. And I think that when you read other recovery threads, you maybe forgot to check where they were in their recovery, because I know of nobody who didn't feel like you are feeling at this stage - including me!

At my doctor's visit last week he started talking to me about the fact that I'm probably already addicted to my medication

Quite simply that is RUBBISH! There is no way you can be 'addicted' after only three weeks. Forget what he said and stick with the full amount prescribed as you need it right now. If he gets difficult about giving you more, try your Primary Care doctor and she if he will help you out with future prescriptions because you are going to need them for at least another 6-7 weeks.
Myth busting: on getting addicted to pain meds

I have been trying to taper off the pain meds. I'm taking 20 mg Oxycodone. I take one before bed, one in the morning and I've been trying to not take one again during the day, but usually break down around 4 or 5:00 p.m. because I have a bone deep ache in my knees. It almost seems like the pain is worse in some ways.

Of course it's worse, take your pain meds properly.

I'm also feeling stir crazy, I haven't really been out of the house except for a short walk or two. but I feel like I'm stuck here.

Well you know, it goes with the territory, especially when you have a bilateral replacement. There's nothing you can do about it right now so try and focus on something you can do without being active - knitting perhaps? Playing on the computer (that's what I did only it wasn't playing! LOL!) What I'm trying to say is - to use an old aphorism - it's a case of mind over matter: meaning if you can manage not to mind then it won't matter quite so much! On another tack, it's not forever. Just a few more weeks and you'll be out and about again with pain free knees! Not pain free from the surgery of course but none of the pre-op pain.

I've been trying to do a little cleaning, but I don't have much stamina still. This also causes me angst, as my home is not at my cleanliness standard.

Did you read the recovery articles earlier in this thread? Post #9 actually. In the mantra is one line that goes "if you won't die if it's not done, don't do it" which means NO HOUSEWORK! Further, dust bunnies are a sign that you are doing your recovery correctly! When you're better you can have a spring clean or get a woman in to do some jobs now but don't do it yourself yet. It's not worth the after effects.

So despite all that, I would like to ask you some questions and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT exercises and exercises at home are you doing? How much and how often?

Can you detail it like this
At physio or PT
First description - 5 reps x 2 sets
Second description - 10 reps x 2 sets

At home
First description - 5 reps x 2 sets 3 session a day
Second description - 10 reps x 2 sets 3 sessions a day

In there was one titled Activity progression for TKRs.