Bilateral TKR July 1 LHop - Bilateral TKR Recovery Thread

[jbrooklyn]

@Josephine, thank you for the information, perspective, experience, and wisdom you offer to this community. I am not alone in being deeply grateful for your words and attention to the many issues involved in joint replacement. Thank you.

 

[MidwestTKR]

Excellent post @jbrooklyn !!!! I am amazed at those of you that had a bilateral TKR done. I can't imagine having to have both legs weak and in pain. You all deserve medals!!!!!

@LHop , I hope you are doing OK. Please let us know how you are. We all care! I'm so glad that Josephine came to comment!

 

[MidwestTKR]

@MsBlue,

Hi and no, you should not start extending your meds yet. You are not even 2 weeks post-op yet sweetie. Please see Josephine's comments in this thread as well as others regarding medication management. I can understand how you feel about taking narcotics. I felt that way too. I wanted to be off of them as soon as possible, but this is a very traumatic and painful surgery. In order to heal and be able to function, you need the medication early on in the recovery process. It's important to keep the pain under control before it gets to a level that is hard to feel better.

 

[MsBlue]

@MsBlue,

Hi and no, you should not start extending your meds yet.

I'll be good! I promise! Drugs coming up at 12 PM

 

[iivesfam5]

@LHop I hope you feel better soon - I know the sadness is part of it and I know it will hit me too.... just waiting. Remember not to compare...... We are all so different - different genes, different fitness level prior to surgery, different needs taken care of during surgery - straightening, etc. I am somewhat of a special case. I worked with my daughter a personal fitness trainer for over 2 years prior to having my surgery. an example of things I was able to do (this is about 8 mos ago) was squats with 110 pounds on a bar - 3 sets of 8 to 12 reps. And upper body - I was doing 25 pound chest press..... and shoulder lifts and bicep curls - so much stuff for a couple of years. I was in the BEST shape of my life...... Then as the OA progressed - I had trouble keeping up the regimen and stopped working out - I gained about 20 pounds - in the 1 1/2 year I was struggling to continue exercising and in so much pain I finally gave in to surgery. So my point is - I am strong with lots of muscle so I am able to ambulate better than some but I will have my struggles - they just haven't hit yet....... I am sure they will come and I will get down. But you know what - we have only one choice now - we have had our surgery and it is time to brush off and keep positive and rest, ice, elevate and medicate as needed. IF you are not taking what you need for medicine it will also make you feel sad because you are feeling unnecessary pain and then you aren't able to move like you want and it is just a big circle. Did your doctor suggest some other type of meds? There was a huge article here on the CT news YESTERDAY regarding prescription medication addiction - not what we need to hear about so close to our surgeries....... I put the link below for your info and for all of you - outside the U.S. @Josephine this is what we deal with. constantly worrying by or doctors of addition. @LHop - just keep an open line of communication with your OS and if you need something it is best you talk and ask at the time of your appointment while you are face to face. I would think the statement he made - he would have followed up with some additional ideas?? I take Oxycodone, extra strength tylenol and Methocarbamol and I am still doing Oxy every 4 hours. I may not take the 10 mg of oxycodone every 4 hours but I do take at least 5 mg. and I do find that the more I ice the more comfortable I am....... You got this girlie..... Just a bump in the road. We are survivors.....

https://www.nbcconnecticut.com/trou...ription-Medication-Painkillers-318512611.html

I know you and me and @jbrooklyn we will all get through our BTKR - remember we are the 3 musketeers or was it 3 stooges?? I forgot what we decided....... hang in there!!! xxoo

 

[Josephine]

Josephine this is what we deal with. constantly worrying by or doctors of addition.

@iivesfam5 Why do you tell me this? You seriously think that after 8 years working on this forum that I am ignorant of how things are in the US?

(sorry, it's after midnight, I've just spent 7 hours working on this forum today and I'm tired and cranky. I'm off to bed! )

 

[iivesfam5]

No I am sure you know...... it was news to me so I figured I would share with others and it was showing how paranoid the US is about drugs....... I didn't want @LHop to think she was alone in this....... every state has issues....... I hope by the time you read this you have gotten some goid sleep

 

[LHop]

Thank you MidwestTKR iivesfam5 ptmhcm jbrooklyn MsBlue (I hope I didn't forget anyone) for your replies and encouragement. I so appreciate this forum for the for all the obvious reasons, but especially for friendships! I know I am not alone and that is so comforting. I am doing better today, I was just having a bad day, definitely seeing my glass half empty. It was one of those moments when you know you're being unreasonable, but can't seem to help it.

 

[LHop]

@Josephine

Please tell me you didn't expect to be all healed up and ready to go at 3 weeks!

Of course I didn't expect to be all healed. I know I was in an unreasonable state of mind, definitely feeling sorry for myself when I posted. I have read the other recovery threads and I know I'm actually doing quite well.

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.

Thank you for your insight. I thought it sounded extreme and there's a chance I misunderstood what he was saying, but it frightened me. I have to call for a refill on Monday so I will see what happens and let you know.

1. My pain levels vary between 5-7 before I take my meds. When they are in effect, my levels are closer to 3.

2. 20 mg of Oxycodone, prescribed every four hours as needed. I have been trying to stretch it out when I am not being active and take it closer to every 6 hours. I also take Acetaminophen 1000 mg every 6 hours.

3. I have a Polar ice machine and I use it most of the day when I am inactive (not walking around or doing PT) with breaks every few hours. I also leave it on all night.

4. are you elevating your leg, how often and for how long?
Yes, again, when I am not active I elevate for a minimum of an hour then lay flat. I try to vary my position every hour or so. I am lucky, I have a bed that elevates my feet and head.

5. What is your ROM - that's flexion (bend) and extension (straightness)
My flex is 95 on my left and 100 on my right, and my extension is 100.

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
My activity level is minimal right now. I do a little light cleaning, rinsing dishes, wiping counter, etc. I don't do any of the cooking or shopping right now.

7. what kind of PT exercises and exercises at home are you doing? How much and how often?
My PT has all been done at home so far. I am supposed to start outpatient PT this week.

At home
Chair Heel Slides - 10 reps x 5 seconds - 3 session a day
Hip abduction - 10 reps each side x 2 sessions a day
Straight Leg Raises - 10 x 2 sessions a day
Ankle Pumps - 20 reps every hour
Quadriceps - 10 x 2-3 sessions a day
Ankle Foot raise bilateral - 10 x 2 sessions a day
Side Kicks- 10 x 2 sessions a day
Back Kicks- 10 x 2 sessions a day
Knee Flex- 10 x 2 sessions a day
Chair Squats- 10 x 2 sessions a day
Calf Stretch- 3 for 15 seconds each x 2 sessions a day

 

[MidwestTKR]

Lhop,

If your pain levels are at a 5-7 before you take your meds, your pain is not adequately being managed and can actually work against your optimal healing. In my opinion, if the pain level is getting that high, it is going to be more difficult to get it under control. I think your meds need to be tweaked. I hate to see you in that much pain. I know my Dr. ordered 3 different type of pain meds post-op so that there was 1 that could be given in between if needed. I am very fortunate that the hospital I was cared at, takes pain seriously and makes sure they make their patients comfortable. I will let @Josephine comment on this issue though, as she is more qualified.

Also, I tried to keep my foot elevated the majority of the time. I got the impression from my Dr., nurses and PT's that is what I should be doing when I was not doing PT exercises or getting up to briefly walk around the house.

 

[Josephine]

Thank you so much for answering my questions and being so clear in the answers! A rare treat for me!
I hope you don't misunderstand my somewhat cryptic comments before - it's just part of my Britishness!

1. My pain levels vary between 5-7 before I take my meds. When they are in effect, my levels are closer to 3.

Jolly good!

2. 20 mg of Oxycodone, prescribed every four hours as needed. I have been trying to stretch it out when I am not being active and take it closer to every 6 hours. I also take Acetaminophen 1000 mg every 6 hours.

fine

3. I have a Polar ice machine and I use it most of the day when I am inactive (not walking around or doing PT) with breaks every few hours. I also leave it on all night.

good

4. are you elevating your leg, how often and for how long?
Yes, again, when I am not active I elevate for a minimum of an hour then lay flat. I try to vary my position every hour or so. I am lucky, I have a bed that elevates my feet and head.

good

5. What is your ROM - that's flexion (bend) and extension (straightness)
My flex is 95 on my left and 100 on my right, and my extension is 100.

Your extension must be 0 which is great. You whole ROM is very good for 3½ weeks out!

My activity level is minimal right now. I do a little light cleaning, rinsing dishes, wiping counter, etc. I don't do any of the cooking or shopping right now.

Good

My PT has all been done at home so far. I am supposed to start outpatient PT this week.

At home - my comments in bold
Chair Heel Slides - 10 reps x 5 seconds - 3 session a day - do 5 every now and then throughout the day. Doing 10 at a time 3 times a day is punishing and unnecessary. Read this Heel slides and how to do them.

Knee Flex- 10 x 2 sessions a day - you're already doing heel slides. Two very similar exercises are unnecessary


Straight Leg Raises - 10 x 2 sessions a day - once you can do these there is no longer any need to do them more
Ankle Pumps - 20 reps every hour - these are merely anti-clot exercises and unnecessary after two weeks out

Hip abduction - 10 reps each side x 2 sessions a day - these are unnecessary for a knee
Side Kicks- 10 x 2 sessions a day & Back Kicks- 10 x 2 sessions a day - these are also unnecessary for a knee

Chair Squats- 10 x 2 sessions a day - these can be very punishing on your knees so I recommend you don't do them
Calf Stretch- 3 for 15 seconds each x 2 sessions a day - okay

Quadriceps - 10 x 2-3 sessions a day - quadriceps what?
Ankle Foot raise bilateral - 10 x 2 sessions a day - I'm unfamiliar with this

These are my suggestions which should make life more comfortable for you. It's long been my belief that all this PT is grossly over rated and overdone. I've proved it twice now by getting good results with virtually no exercising at all, just moderate walking. Read my recovery threads - links in my signatures.

But whatever - you're doing splendidly. I really admire you r results thus far.

 

[jbrooklyn]

@LHop, Hello and sending good wishes your way. I hope you and your family have had some good time together, and that you and your knees are feeling relatively content.

 

[Jamie]

One thing for anyone reading along here to note is the article @iivesfam5 linked is about people who are taking narcotic pain meds for a chronic condition (meaning they are on them for extended periods of time). It's a whole different issue than when the pain medications are used for relatively short term pain relief need with joint replacement surgery. And by "short term" I'm talking about people who may need them for up to 3 or 4 months.

Sadly, for some reason some doctors here in the US seem to panic and paint all use of these meds with a broad brush. If your surgeon really meant to say what you posted about possibly being addicted to your pain meds at this point in your recovery, well.....please take that comment with a huge grain of salt. You are not addicted. Your body might (and I really mean it is not a given) become *dependent" on the meds, but this is a situation that can be handled well by tapering off the drug and/or using a step down medication such as Tramadol. It's much worse for you not to properly manage any pain you might have. I'm glad you realize this and, if your surgeon really insists that you cannot have the refills you need right now, do talk to your GP. They seem to understand the need for this pain management better than the surgeons sometimes!

Personally, I think you're doing really well with your recovery! Those "blues" days will happen and it usually means you need a bit more rest or to get that pain managed a little better. They pass and the small milestones we all celebrate along with you will come. So, hang in there and keep the focus on you. This is your time to pamper yourself a bit and allow all those normal life "responsibilities" to fade to the background. Your future is going to be great with those two new knees.

 

[LHop]

@Josephine Thank you so much for taking the time to respond to my specific recovery! I value your opinion and experience and will modify my PT as you suggested. It's a blessing to me, and I'm sure many more, that you are willing to commit so much of your time to share knowledge.

 

[iivesfam5]

@LHop I must say I haven't been doing a ton....... the bulk is during. PT and I am moving along...... I am sore from PT not horribly but Def sore so I didn't do much at all since PT.

 

[LHop]

Yesterday I went out for the first time since the doctor visit two weeks ago. My husband took me to our favorite pub and we socialized, ate dinner and I had a cider. I was sitting in a wooden barrel shaped chair with arms. I started out quite comfortable and happy to be among the land of the living. But after an hour or so I began to get very uncomfortable, I don't know if it was the chair or because I was sitting up, but I was ready to go home. I got home, put on my pajamas and promptly fell asleep. I guess it will take a while for my stamina to build up ;-)

 

[referee54]

I guess it will take a while for my stamina to build up ;-)

Indeed---it will take quite some time for you to regain your stamina---it can take months and months and months.

You had a BTKR less than a month ago, and your body is still sending large amounts of energy toward the healing of both knees.

I know how great it feels to finally get out---after my BTKR I did a little trip with my wife---I went to the school where I taught and then to a store to pick out a snowblower---and that was it for the day.

But after an hour or so I began to get very uncomfortable, I don't know if it was the chair or because I was sitting up,

It is also quite normal to get this feeling of discomfort it is still very, very early yet, and your leg muscles have atrophied somewhat, and your knees are still a bit stiff at times, so you will be feeling this feeling for, most likely, some time to come.

 

[iivesfam5]

GLAD you got out. I know that window.....when I am ready to go upstairs to get ready for bed now we go up and I settle in and ice and then sleep.hits and out I go........ I Have always been A super light sleeper. It is a bit worse now......

 

[LHop]

@iivesfam5 I'm sorry that sleep is an issue. I'm lucky, I don't seem to have trouble sleeping which I know is rare with our TKRs. I was sharing in MSBlue's feed that my husband calls me "One and Done". I can do one errand, or go for one meal and I'm done.

 

[referee54]

Going on these little outings bring us a sense of normalcy that we all crave so much---in actuality, the normalcy that may have been missing due to arthritis, as well. It is something that we look forward to and something that we crave.

We also have to understand,though, how long a TKR or a BTKR recovery can take and also understand that, in the early days of recovery, our knee or knees will tell us when they have had enough and sometimes, the stiffness and the energy drain attacks rather quickly.