Bilateral TKR La's new knees (recovery diary)

[karmigirl]

La,

Might I impart an insurance company story on you. I was seeking insurance, they asked what I had been seeing a Dr. for in the last 6 mos. I was honest and told them. They FINALLY got back to me with WE Cannot insure you, I asked why. They said the rheumatologist had told them I was being treated for benign hypermobility syndrome, and beacuse of that I could not be insured. I then asked if they knew what that was, ans. No but if it was benign it might turn maglinent. I then proceeded to ask them if they have ever run into a case of malignent double jointedness????? Very shocked.

This is might be the answer to what an uninformed pencil pusher( pardon me) does. It is very frustrating.

 

[Josephine]

Re: La's new knees (recovery diary) Insurance is a pain!

Well, it's day 15 post surgery for me

tomorrow, McQ and I are going to find some place to walk a bit.

Umm, I think at 15 days that might be a bit of an ask. You shouldn't be 'going for walks' yet. In this article Some suggestions for home physio (PT) and activity progress it says - and this is for one knee/hip replacement - you've had two!

Walking
Hip or knee, walking is about the best exercise you can do but again, you need to moderate your time and distance.
Always use your walker, crutches or canes as appropriate, only moving from one to the other as you gain confidence or until as advised by your PT or physio.
I would suggest the following regime

Week 1
Walking around the house. Trips to the bathroom and kitchen are included!
Being up on your feet several times a day as you need to but don't get obsessive about it.
A 5 minute walk every one to two hours is plenty.

Week 2
Start on a plan of walks around the house lasting longer than 5 minutes but don't a) get into too much pain and b) get too tired. Stop before you get to that point.

Week 3
Take short walks outside the house in the garden, driveway or road for about 5-10 minutes maximum, once a day.

Weeks 4 and 5
Lengthen the walks to about 10-15 minutes once a day, maybe twice a day if it doesn't cause your knee/hip to swell or be painful.

Weeks 6 and onward
Start taking car trips to the shops but keep them short and sweet at the start, no longer than 15-20 minutes
Take at least one 5 minute rest while you are out.

 

[Larosser]

Re: La's new knees (recovery diary) My first outing!

Hi, All!

Well, it's day sixteen, and I just got back from my first "outing". My physical therapist has been walking me around the block at my house for about a week, with no ill effects, so I asked him if I could have a short outing today with McQ.

He said that was fine, with the following precautions:

- Avoid stairs, uneven surfaces and crowds
- Plan to go only half as far as you think you can. Make sure you have somewhere to rest and an "escape route" in case you can't complete your planned route.
- Take your cane or walker (I took the cane).
- Take anti inflammatories before, and ice after.
- Take it easy and don't get cute.

So, what we chose was a trip to the local farmer's market and grocery shop. McQ drove, and I was able to wander about selecting yummy things to eat until I got tired, without ever getting too far from the car. It was a good outing, I think. At the end, I felt tired, and the muscles in my back and legs were a tad sore, but my knees weren't particularly swollen or painful. I'm sitting with them iced and elevated now, and am feeling pretty comfortable. Of course, tomorrow will really tell the tale. We'll see how I feel at tomorrow's PT session.

Josephine, I didn't see your message until after I got back. It's interesting that my surgeon and therapist seem to expect a bit more in the way of early activity than your sources do. They aren't pushing, or bullying me to do more than I want to, but they do seem to think that some more exercise and movement is okay. So far, it seems to be working. I'm not having too much pain or swelling, and I do seem to be regaining function pretty quickly - although, after ANY kind of activity, I want to go take a nap.

I wonder, is the expectation of time to regain function different between the US and the UK? Both my doctor and my insurance company's first guess is that I will be able to return to work full time 8 to 10 weeks after surgery. What are other people being told about that?

Best
La

 

[daisycats]

Full time work at 8 to 10 weeks might be a bit much depending on what you do. You will be very tired and sore. I went back to work teaching at 7 weeks part time 3 days a week 3 hours a day and I was done by the time I got home and slept and rested made dinner and back to the couch. This takes a long time to really recover particularly in the strength department and thinking department.:th_heehee: I don't think my memory or thinking recovered until last month. At 6 months I feel good and am feeling as though my life is in order. In fact it is so much better than before btkr because I can think without pain and finally do things again
Keep up the good work and enjoy relaxing. Pretty soon yo will be too busy to relax.

 

[Jamie]

So sorry to hear about your insurance fiasco! What idiots!!!! It's a good thing you pushed....I'm proud of you.

 

[Roy Gardiner]

Re: La's new knees (recovery diary) My first outing!

Well, it's day sixteen ... I was able to wander about selecting yummy things to eat until I got tired, without ever getting too far from the car. It was a good outing, I think. At the end, I felt tired, and the muscles in my back and legs were a tad sore, but my knees weren't particularly swollen or painful.

I think that's absolutely fantastic; you are at least a week ahead of me and in fact I have only just started (on day 50) planned walks, of 1/2 - 3/4 mile only.

...It's interesting that my surgeon and therapist seem to expect a bit more in the way of early activity than your sources do.

Errrrrrr, what? You seem to be doing OK, to say the least

Both my doctor and my insurance company's first guess is that I will be able to return to work full time 8 to 10 weeks after surgery. What are other people being told about that?

I had a desk job, reckon I'm about ready now (8 1/2 weeks) were I still working ; not sure about the travel to and from work though.

 

[Josephine]

No real difference between US and UK. People are people the world over. I think it's a cultural thing - you guys over the pond tend to be more aggressive and more driven than others. Not that that's a bad thing in itself, but your tissues and bodies take the same time to heal as anyone else's and your bodies take the same time to recover from a major trauma.

What I suggest on here is what seems to be the norm in most places - according to my research. However, it's not a given and there are always people who will recover more quickly - or more slowly - than the rest.

I just don't like to hear of surgeons/PTs applying set targets that appear to be carved in stone regardless of the individual. It's the same with achieving targets of ROM, activity, transitioning from walker to crutches/cane, and that behemoth of all, pain meds!

To be honest, I get really incensed when I hear of people being told (as they are all too frequently)
- you should be at * flexion by now
- you shouldn't still be needing that much pain meds now (this at two weeks post-op was the last one!)
and the best one, often issued at the primary interview
- you will be back at work in X weeks!

It's all ridiculous and sets people up with a stressful post-op experience as they worry about whether they will be able to, the inference being that they don't achieve them, the failure will be theirs not the issuer of such unrealistic targets.

[here endeth the first lesson!!]

 

[bottomshollow]

A BIG, BIG AMEN to that, Josephine! :amen1: Judy

 

[Larosser]

Re: La's new knees (recovery diary) Do what you can, not what somone says you should

Hey, everyone!

Well, apparently my outing didn't kill me - I wasn't horrid sore today and took a nice walk down the street with my PT and a friend. I have noticed a new symptom the last day or two....it's occassion little pops or sprinkles of feeling in and around my knees - some are itchy, some are pains, some are tickles. They don't last but a minute and don't occur at the same spot - just randomly around the area. TJ says they are probably nerve fibers waking up

Roy, I'm with you in that I'm more concerned about getting to work than being at work. I have a long commute that involves a car, two trains and a bus plus a short walk. Pretty sure I'm not going to be up for THAT at eight weeks, especially along with a full work day. My boss has already offered that I can work from home as much as needed, and I'm going to take her up on that.

Josephine, thanks for explaining your position more. I COMPLETELY agree with your perspective on hard dates and numbers. I call that kind of thinking "statistical medicine" and think it is of no use to an individual. People heal and progress as their bodies allow, and the important point is to be heading in the right direction. Recovery is not a contest and it helps no one to treat it as such.

Anyway, it's been a pretty good day. I had a walk, a nice visit from a friend, and several naps. (See, I'm learning). Now McQ is grilling some salmon to give me my protien fix, and then we'll do something strenuous like perhaps watch some telly...



Best to everyone,
La

 

[Campervan]

Hi La,

Isn't it great to be able to work from home. Wonderful bosses that allow us to to that. Take care

 

[Josephine]

Grrrreat!

"statistical medicine" - LOVE it! :th_heehee:

 

[skigirl]

Re: Cutting back on painkillers?

La, I had the same issues with narcotics. I took a 5mg percoset every four hours for the first two weeks, then I started taking Hydracodene one 5mg every six hours. After four weeks, I would sometimes take a hydracodene at night and did have some tramadol 50 mg which I used during the day---maybe two a day. I just could not stand the sweaty, yuckey feeling---used an anti inflammatory and two tramadol--actually that took care of the pain. 'but, I was pretty active by then too and that helped. Kelly

 

[Jamie]

Re: Cutting back on painkillers?

As Kelly suggests, there are a lot of options for pain medications. If the hydrocodone bothers you, call your doctor and ask to try something else.

 

[FrogFeathers]

Re: Cutting back on painkillers?

There is only ONE reason to reduce or stop taking pain meds and that is no pain!
Any other reason is not sensible. It's what they are for.

This should be cross-stitched on a pillow. ♥

 

[mcotrel]

Thank you so much for sharing your experiences. I will be having a BTKR ( no date yet) and I am very nervous. I already have a lot of pain and the sitting/standing up issues are already pretty serious at this point BEFORE surgery. Your blog is very helpful to me!

 

[Larosser]

Thank you so much for sharing your experiences. I will be having a BTKR ( no date yet) and I am very nervous. I already have a lot of pain and the sitting/standing up issues are already pretty serious at this point BEFORE surgery. Your blog is very helpful to me!

Hi and welcome, Mcotrel. I am not sure that I am typical, but here's my experience. Prior to surgery, I'd gotten to the point that I had to stand up like a baby - put both of my hands on a solid surface, push my butt up, and then straighten up. It hurt heinously, and sometimes my knee would lock and I'd be stuck, unable to finish rising. I'd have to thump back down in the chair and work my knee until it loosened, then try again.

The first time I got up after surgery, my quadraceps (thigh muscles) hurt like the very dickens. For the first few days, every time I stood up, I'd have to promise myself that the next time my thighs would hurt less. But...from the very start, my knees did not hurt.That stabbing, searing pain that I had come to associate with standing, walking, and climbing stairs was gone. It hasn't been back since. And the pain in my thighs is less every day. Now when I stand or sit, what I mostly feel is a dull ache and some tightness. So...I'm two and a half weeks out of surgery. I'm not cleared to drive. I'm not off the painkillers. I am still getting PT at home. But I can already tell: this was the right choice, and things are gonna be better.

Chin up,
La

 

[referee54]

Re: La's new knees (recovery diary) My first outing!

I wonder, is the expectation of time to regain function different between the US and the UK? Both my doctor and my insurance company's first guess is that I will be able to return to work full time 8 to 10 weeks after surgery. What are other people being told about that?

I am honestly in awe of your progress---I am very happy for you. My progress was much more frustrating and slow---I did return to teaching at eight weeks---my OS said that that would be the earliest that I could return.

I had a limp (albeit slight towards the end) for the next four months. My OS, when asked about returning at eight weeks, thought and said that "I think you should be able to do it" In retrospect, I honestly believe that I returned to the classroom about two-three weeks too early. From my experience, I believe that many insurance companies and OS's are a little to aggressive---or unrealistic---in advocating a return to full-time work at that time.

You are doing great, and I applaud you. Others though, may not have the same outstanding recovery.

 

[Larosser]

Re: La's new knees (recovery diary) My first outing!

Tim,

I am actually a bit in awe of my own progress - I think I have been very, very lucky. I had an excellent surgeon, I've had tons of good advice (much of it from here) and I've tried very hard to be compliant - do the right things, and don't do the wrong ones - but I know many other people have had the same advantages and good attitudes and still had much more challenging recoveries. Sometimes I feel like I should add a disclaimer to my posts: "This is the story of a very lucky lady who was dealt an outstanding hand in her recovery. This is NOT due to her own efforts, intelligence or condition, but is purely the luck of the draw."

Best
La

 

[Roy Gardiner]

The first time I got up after surgery, my quadraceps (thigh muscles) hurt like the very dickens. For the first few days, every time I stood up, I'd have to promise myself that the next time my thighs would hurt less. But...from the very start, my knees did not hurt.That stabbing, searing pain that I had come to associate with standing, walking, and climbing stairs was gone.

That the interior of the knee doesn't hurt I think we can all agree. The pain for me was in the quads just above the knee and the surrounding tissue in front and to the sides of the knee only. The back of the knee was OK, as was the upper part of the quads.

... I think I have been very, very lucky. I had an excellent surgeon, ... I've tried very hard to be compliant - do the right things, and don't do the wrong ones

Hmm, I'm not so sure it's luck. The choice of surgeon surely isn't. And doing the right things afterwards, well, perhaps it is -- but that's the point of diaries like this, so that those of us who feel lucky (I do too) can maybe offer up what we do as examples. Let us hope that there are common features to be able to help others that follow.

 

[shutterbug]

Re: Cutting back on painkillers?

Well...... I am cutting back on my pain meds. I had my LTKR 12-5-12.
My journey has been a tough one. I started taking hydrocodone in 2008, and have been taking 3-4 a day since. I did need to function through the pain. Now the doc has told me this is my last script. I am ready. To weanw myself off I am cutting back 1/2 pill every 3-4 days, so at the end of the script withdrawl should not be too bad. I intend on getting support / counciling also when done. This is what happens when doctors wait to do tkrs because of age . Please if so inclined keep me in your prayers.