Moving Forward On Two New (Conformis) Knees

You're almost there, just a little more than a month. Some things will pick up that should help you feel like something's getting done, like pre-op tests and/or interviews. You'll be setting up your nest and finalizing things at work ahead of your surgery. Have fun for Halloween, and next thing you know you'll have new knees.

You asked about the Lounge Doctor. The standard one I got easily accommodated both my legs.
 
Thanks @SusieShoes. I keep trying to be productive checking things off my list. I finished all of my pre-op responsibilities nearly a month ago. I am honestly just so ready to get on with my own busy life without this knee pain. I can deal with the recovery and welcome it in fact. I know it's not going to be easy but it will be moving forward at least.

I have been very diligent in my reading here and know that I am going to follow the recovery guidelines to the best of my abilities doing everything I can do to be ready to return to work at 12 weeks.

I think I am just exhausted from maintaining my day-today responsibilities when dealing with this pain.

Thank you for reaching out to me. I read every word of your recovery thread.
 
I hope the journal of my recovery can help others. :wave: There's no way of knowing ahead of time how our recovery is going to play out. All we can do is try to stack the deck in our favor through good preparation and good advice.

I know the pain you mean... that horrible, awful, grinding arthritic pain. The kind where when you stand up from a chair, it takes several seconds before you can manage a step. A step that lurches because the pain is so bad. The pain that won't let you walk half a block. The pain where any time you go somewhere, you look for a bench or a wall so you can sit down.

That pain will be gone the moment you wake up in the recovery room. You will notice it's gone the first time you stand on your new knees. A different pain, the pain of surgery, has replaced it, and you can get the better of that pain by following the mantras. It certainly worked for me. :happydance:

What you'll notice most, and be happiest about, is getting rid of that horrible pain that used to run your life.
 
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@SusieShoes. Yes, that is exactly this pain. Last week my boss told me that I am one tough cookie. Yesterday, while training a co-worker who is going to manage some of my responsibilities while I am on medical leave, said he had no idea of the amount of pain that I am in. He also said I hide it well. I suppose I do my best and shut down the minute I get home. So many here know that pain well.
 
Today is so much better. Standing up yesterday morning brought forth a searing pop in the front of my right knee which was followed by barely being able to put weight on it for the remainder of the day. Tough as I have two jobs to get through before I am able to go home to recover. At this point I manage to painfully make it through.

Yesterday, I ordered my Lounge Doctor, bath transfer bench and a small bag for my walker.

A couple of concerns:
My neighbor suggested I think of going into a rehab facility afterward as my surgeries will be two weeks before Thanksgiving which is the busiest time of the year where my boyfriend and I work. (He is also a chef). I will be home alone quite a bit with two new knees, two small Maltese pups and a cat who rarely leave my side. I have read of good and not so good reports on rehab facilities. Trying to decide what is in my best interest. In home PT connections have already been made. My mother is a nurse and I am sure she will visit often. I am thinking of what is also in the best interest of others.

My flexion going into this is not so good. My OS said my left leg is about 70 degrees (which was measured after a 3.5 hour car trip to see him). He stated upon my 4 week check up he may need to go in and "break up scar tissue" based on how I do in PT. I have had no prior knee surgeries. If this decreased ability to flex my knees is because of shortened muscles and ligaments, will they not stretch back out in time with physical activity and movement after surgery? Four weeks is such a short time and certainly in the angry soft tissue stage.
 
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I went to a rehab facility. Because of my family situation (caring for mobility-impaired 94 year old with dementia), my OS thought it best for me to go to rehab. As I look back, I'm not sure I needed to go there, but I'm not unhappy to have gone.

PT at the rehab facility was very practical. I was taught stair climbing, how to handle curbs and uneven surfaces with my walker, how to carry items in a kitchen (they had a mock kitchen, bathroom, living room, and bedroom), getting in and out of bed, and lots of other daily challenges. In addition, I had a hospital bed and a bathroom that was set up for someone like me.

On the less good side, the rehab facility was unreliable for my pain meds -- they kept trying to NOT give me my opioids -- and the food was terrible. They also insisted on tests I didn't need, like ultrasounds to check bladder emptying.

I think I could have done well at home, even with the 94 year old around. I could have controlled my pain meds better and the food would have been better too. In-home PT could have taught me the same useful things as rehab PT. Home is a safer option (less chance of infection) and you will like being in familiar surroundings. What does your OS think you should do?

Oh, and try not to think too much about the convenience of others. I get it; I did that too. I learned the best strategy for a good recovery is to think and do what's best for you and your new knees. A little tyranny goes a long way to a good recovery.

Once your damaged knee joint is repaired, your muscles and tendons will stretch and elongate with even ordinary exercise. My left knee was deformed by arthritis and didn't bend well; after surgery, I could already bend it better. The tendons at the back of that knee, however, took longer to stretch back to normal ROM. That's because those big tendons stretch slowly. But they got there.

Lots of surgeons and PT try to motivate their patients with the threat of manipulation under anesthesia (MUA) to "break up scar tissue." Some people might in fact need that, but most don't. Whether quickly or slowly, TKR patients get back their ROM with Time. Time spent getting rid of swelling. Time spent letting the knee heal and get better. Four weeks? That's unrealistic. Many people get more ROM months into their recovery, and even a year or more.

No need to worry about that yet, though. There'll be time for that after your surgery. :friends:
 
Thank you @SusieShoes. My gut tells me to go home. I think my own support system will support me. You are certainly an asset here. Thank you for your continued good care and information.

The PA for my OS says I'll need to "work hard" in PT .

I am so thankful for this forum.
 
My insurance only covered nursing homes and not orthopedic rehab centers. My doc only agreed to do my bilateral if I went home from the hospital. I was released from the hospital about 72 hours after surgery. My mom came and stayed with me so somebody was home with me the first week (so husband could go to work, take kids to school and activities, run errands, etc). After 5 days at home, I was fine on my own for most of the day while everyone took care of their own business.
 
I just did the math and am 35 days from my RTKR, a day of rest and then my LTKR. I have a few things to do still but I am so ready to move past preparing for surgery. Isn't this all so mind consuming? The mental side of preparing for this type if surgery.
 
I know. It all seems so overwhelming prior to surgery. I knew I needed it. There was no question of that, but it is such a big thing and produces anxiety. Just hang on. It will get better. I'm 3 months out on my new conformis knee and I have my life back. I haven't been this active in years. In spite of early pain and a long recovery, it was so worth it for me. I hope things go as well for you as they did for me. People here will tell you it doesn't matter what brand of knee you have, and who knows? I've certainly haven't had anything else to compare but I'm totally happy with the conformis custom knee and seem to have recovered faster than a lot of people.
 
If you're going straight home after a bilateral, do make sure that you are shown how to mobilise and get around. You'll need to be able to get into adn out of bed, walk inside the house, get to the bathroom and manage there, take a shower (if allowed), how to manage steps and stairs.

Also, do have an effective system for pain relief in place, and make sure that you will be able to get repeats of your prescriptions. Check before the weekend, so that you don't run out of medications over the weekend.
 
@Jajakio, thank you for your kind reply and words of encouragement. I am driving 3.5 hours to get the Conformis implants and have an excellent surgeon and support system. So happy yo hear that your life has returned.
 
@Celle, I have decided to not go straight home opting instead to stay with my parents in an indirect way.

My parents own a medical supply business which is in a house next door to where they live. There is an empty room available to me. I have ordered a hospital bed and lift recliner for the first month. My mother was a cardiac care nurse at Duke before she and my father decided to open their own business. In addition to my chef work, I am also employed by the family business and it feels like home to me.

There are only a couple of steps into the house and once inside every room is on the same level. At my own home there are two sets of steps to get inside and another to get to my bedroom. The two weeks post surgery are the busiest weeks of the year where my boyfriend (also a chef) and I work. After a bit of soul searching I felt it would be best for all involved if I were close to my mother and not put stress on my other half who will be incresibly busy at work. I would be alone at night but only a phone call away from my parents at any time.

I will have home PT visit me there.

My parents are both traveling to Columbia South Carolina with me and will be there for both of my surgeries. There is a Marriott within walking distance and my parents have reserved a suite there for the week.

I am beginning to feel an increased anxiety as my first surgery is four weeks from today. I am beginning to wrap up work responsibilities informing coworkers and customers of my extended absence. I am a cooking coach and work directly with customers in a high profile position.

28 days and counting.
 
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Your arrangements sound sensible and loving. Yes, taking care of you would put some burden on your better half; it's just the nature of the recovery. He will want to help you and do a lot for that reason alone. Also, the first couple weeks after a TKR will disrupt both your sleep and his unless you have totally separate sleeping quarters. :alarm:

Your steps in either location would not present a serious problem. Yes, you will find them a little awkward and uncomfortable (for a while) but you will totally be able to do steps, curbs, or complete sets of stairs. You just won't want to. All on one floor really is easiest, but if you have to do stairs you can.

After a month, you will be quite self-sufficient. You will be using either a walker or cane, but will be able to do quite a bit to look after yourself.

I'm glad to hear you are planning for an extended absence. Everyone recovers differently, but bilateral replacements require a lot of the body's energy and resources to heal. You are going to be exhausted and physically compromised for a while. Three months is a reasonable projection for being able to go back to work. Some people do it sooner because, well, they have to... but they almost always report they find it difficult and wish they could have waited. The way I look at it, plan for the three months, and if you feel ready to take on the world sooner, you can always do that... especially with your job situation, which sounds like it could be flexible that way. :flwrysmile:
 
I think that is a good idea. Less steps for the first few weeks will help a lot. Will you have a handy freezer for ice? Even if you use an ice machine you will need to refill with frozen water bottles or ice. It is so much handier to have the freezer close by. Even a half one right next to your recliner would be great. You will ice a LOT the first few weeks. If you don't get an ice machine be sure you have plenty of decent sized ice packs. I would say 6 minimum(more is better) so you can keep rotating and always have a cold one in the freezer or an extra one for aching back or thighs.

If you are going to do physical therapy, most American doctors want you to start right away. I had my surgery on a Friday, went home on Saturday and started PT first thing Monday morning. If you choose PT, you may need to find a place reasonably close to parents and be sure someone can bring you to PT. It's usually 2 or 3 times a week for an hour to an hour and a half. Some people chose not to go, but some of us found it very beneficial.

Good luck. You've got this and a few months from now you'll be so glad you had this done. My sister had TKR two years before me and she told me I'd be sorry I had it done for the first two weeks but it gets better from there.

Oops I missed the part about home PT. That sounds like a good idea.
 
@Jajakio, I had considered a small cooler for the ice bottles (I am already making them in the kitchen freezer). Do you think they should stay cold enough there to last me through the evening when I am alone?

I spoke with the physical therapist who had been working with me on my knee pain. After 31 pt sessions I decided to ago to an orthopedic and found out that I have advanced arthritis. When asking the PT if he would push on my knee he said that it was necessary to do so. I consider him a friend. He often shops my store with his family and takes a look to make sure I am standing on a stress mat. :) I, of course, am not going to let anyone push me to pain after my surgeries and will baby those knees like nobody's (but my own) business. What is reasonable going into this as far as PT? I understand NO strength training and stretching is a must for some time. What is an appropriate conversation to have at the onset of PT? I will have home PT by a woman who is a very good friend of my neighbor. I have spoken with her and she gave me excellent recommendations regarding equipment to have in advance. At the hospital I should be walking a bit, learning safety, a few steps, how to dress and bathe I think???

@Josephine, I read that squats and standing on toes are a no-no. What else should not be done that first month? I want to go into this armed with knowledge. Thank you in advance.

@SusieShoes, it is always such a pleasure to hear from you (from @Jajakio as well). In addition to the steps, I have two Maltese pups who adore me and would need to be taken care of. They are a bit excitable and would be more than I could do when alone I think. They will come to visit and Carlos (my other half) will certainly cook for me as needed. I am sure he will be here visiting on most nights but he cooks breakfast at our sister store and is up every day at 3:30 then runs for a solid 8 hours. When I told him my plans to not return home I literally saw the stress melt off him. In good conscience (and forethought of my own recovery) I decided to let my parents do what they do which is taking very good care of sick people. When my knees permit I will go home ready to begin taking a bit more on myself. An aside, Carlos is from Fleetwood PA by way of Santa Cruz, Bolivia.

Yesterday I was unable to connect to the Bonesmart site and didn't quite panic (smiling here) but the very first thought was how will I ever get through this without you all.

I have future professional goals which may in fact come into fruition. Before taking that on I was first admonished to get healthy. I am going to need a good set of knees to pull this all off.

my continued best to all,
Sherry
 
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One other thing if I may. I ordered the Lounge Doctor and it arrived along with my bath transfer bench. My father is concerned with the Lounge doctor as it allows the leg to bend. He makes positioning products for hospitals using the recommendations of nurses to meet their needs with patients. He made a leg elevator as specified by a local hospital but it does not allow any flexion keeping the leg fully extended. I believe I read a post by @Josephine which stated it is not natural for us to keep our legs fully extended and that it may cause additional pain.

I have a friend who went to South Carolina for her two year knee replacement checkup with the surgeon I am using (on her recommendation). I had her ask if I should bring the Lounge Doctor with me and they suggested I not use one. Why would that be if elevation is so incredibly important? My father is very concerned about the knee bending aspect of the Lounge Doctor. I am very concerned about my knees and do not want to add additional strain to them post surgery. My extension is limited now because of pain. (The doctor stated 70 degrees but I had just made a three and a half hour car trip to see him and know I was quite possibly not allowing him to push too far on examination). I cannot imagine lying straight legged for a month. My doctor has already suggested that he may need to make a return visit to my knees at my 4 week checkup to break up "scar tissue." I know my muscles and ligaments have shortened. I have had no prior knee surgeries for scar tissue to develop.
 
About the Lounge Doctor, keeping the legs straight, and PT...

The "legs must be kept straight" thing is an obstacle we all encounter because the wisdom of nurses -- bent legs (like sitting in an airplane) for long periods impedes blood flow and makes them prone to developing blot clots -- is not the same as the wisdom of TKR recovery. TKR knees, through years of arthritis or other issues, have developed shortened tendons. In most cases, those tendons will eventually stretch back to normal after TKR. But until they do that... the darn things hurt! It's painful to lay with our new knees perfectly straight.

It's also not necessary. You don't have to have perfectly straight legs to prevent blot clots. Just not hours of deeply bent legs. A small bend does not impede blood flow and is perfectly safe. But most hospitals have the "legs must be straight" thing as gospel.

That's why my first week, starting in the hospital and then in rehab, were part torture. It wasn't the PT (more on that later) but my battle with staff to elevate (they thought that meant putting thickly rolled towels under my ankles) AND have a little bend... like the one of my Lounge Doctor waiting at home. It was a battle I fought by getting rid of those towel rolls and bending my knees just a little, very little, only to the point of comfort, at every opportunity. Because I was progressing so well, the nurses just let me do what I wanted. I was SO HAPPY to go home at last and use my foam wedge with a bend. It was so comfy, and I could sleep with it, and I elevated all the time (seriously, about 20 hours a day) for the next several weeks. Ice and elevate, that's what I did.

I also did PT. Many people here did none at all, but I did some. My OS wanted it (with restrictions such as no weights, machines, etc.) and I figured as long as it was useful to me, and the therapist didn't force my knee EVER, I would give it a go. The PT at rehab was gentle, focused on function, and consisted of stretches over which I had full control (except for one therapist who was aggressive and who taught me what NOT to allow). At rehab I did lots of walking practice, stairs, and other practical things.

You will definitely leave the hospital knowing how to get in and out of bed, chairs, cars, walk, go up and down stairs using a cane, and bathe yourself. I was two days in the hospital, and they taught me those things before I headed to rehab (where I learned even more tips, such as how to transport things safely in a kitchen). :ok:

My outpatient PT (also a concession to my OS, whose work was performing so excellently I gave him the benefit of the doubt) was a constant battle with my therapist, who wanted me to do leg presses so insistently I wondered if he was on commission. But I stuck to my guns, did only the exercises my OS stipulated in his virtual guides (again with a couple exceptions that taught me why those exercises were bad for my new knees) and my progress was BETTER than his other BTKR patients, who were there at the same time I was.

So my advice would be to work with your PT(s) but keep to the wisdom that if what you're doing is causing pain (not just discomfort, even lots of discomfort, but pain), that's your knee telling you to stop doing it. You can always try the exercise again a little later, after a week or two, and then it might be just fine. The PT's job is to advise; yours is to be the decision-maker. It's your knee. You decided whether or not to have the surgery. You decide whether or not to do the exercise. :) It need not be adversarial. Your PT just needs to respect your judgement.

How cool about Carlos! I have a Bolivia connection myself. My first husband was from La Paz, and our oldest son's wife is from Sucre. I have lots of family (through these marriages) in Santa Cruz also. Bolivia is a beautiful country with amazing people. I spent a portion of my twenties living in La Paz and Irupana where I was, for a time, the tallest person around and in great demand for playing basketball.:yes!:
 
@SusieShoes, I just might just go to Bolivia to be the tallest person for once in my life.:rotfl:

Regarding the Lounge Doctor, makes perfect sense to me regarding the bend. My tendons are about a quarter inch long at this point.

I just received a reply from my surgeon's office regarding post-op meds. I will have a long-acting and short-acting narcotic and am expected to be off those in a "few weeks" using Tylenol as a bridge. He does not prescribe any step-down meds nor sleep aid. They suggest Tylenol PM. If need for more than that they suggest I contact my primary. Are these expectations reasonable? Tylenol 325 taking 1 or 2 (was not informed of the frequency) and Eliquis twice a day for two weeks.

Time is starting to progress rapidly just as you suggested it would.
 
“You need to have faith in yourself. Be brave and take risks. You don't have to have it all figured out to move forward.” Roy T. Bennett

Many things have been left to faith, a faith much bigger than myself. Today I have faith that all i's will be dotted and all t's crossed in 27 days.

Tonight I am shopping for comfortable-post surgery clothing to snuggle in with. Today's faith is for the knees to hold out for these last days. I know I am so blessed in life and expect good things going forward. Wishing you all blessings in your own journey. This year, no struggling through Thanksgiving and Christmas holidays cooking for many people only to be too tired to enjoy them for myself. I am looking forward to long naps in winter. Certainly a rarity in my world.
 

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