Bilateral TKR New member - Bilateral TKR February 2021

[Ghostpipe]

My attitude has always been that if I am physically capable of doing it, no reason not to. Now I find myself evaluating risk for the first time in my life! Wise, or what! Cowardice, methinks, no way am I going through any revision surgery because I fell off something. You are having doubts about that ladder Merlin, that’s enough to tell you to leave that job to someone else.

 

[MerlinWizard]

I didn't listen yesterday, I had to go in the pool. I didn't have as much pain swimming which was very cool.

But, after about 30 minutes of sitting in the recliner when I got in - HELLO! Some odd pains but overall I felt pretty good all things considering. I slept very well too so maybe I need to go in that late every night!

I've conned a friend to help with some projects. That way I can be the supervisor for a change =).

 

[MerlinWizard]

My attitude has always been that if I am physically capable of doing it, no reason not to. Now I find myself evaluating risk for the first time in my life! Wise, or what! Cowardice, methinks, no way am I going through any revision surgery because I fell off something. You are having doubts about that ladder Merlin, that’s enough to tell you to leave that job to someone else.

I agree with that completely. But you know that part of your brain that tells you that you can still do it isn't easy to turn off!

I had a "moment" last year on a project when I realized there was no way I could safely finish it even with help as we are all getting "older". I didn't want to risk other people getting injured for that project. It had to do with heavy beams. posts and height and while I know I could have accomplished it with help and the right tools, I didn't want to risk injury to anyone because I would never have been able to live with myself had a friend or family gotten hurt or worse.

So, after sulking for about an hour, I bit the bullet and hired it out. It was kind of a "Come to Jesus" moment for me, realizing I am not as young as I used to be.

It was the first time in my life I needed let someone else do a project I had undertaken. It was very sobering.

 

[Jeaniesknees]

Naw you are not old, just getting smarter! "Work smarter not harder!"

 

[Ghostpipe]

How are you (over) doing, Merlin? You have gone silent. Your escapades have been an inspiration to me, being a bit further out.

 

[MerlinWizard]

LOL

Memorial Day weekend and preparing for a big party on Monday. I haven't been on the computer that much.

I have been doing all sorts of things, mainly on my feet, walking, etc. So much so that the swelling is affecting my ROM at the moment. I came to my office and saw you had replied so I thought I would give you a quick shout. I'll have more to share on Tuesday!

 

[Ghostpipe]

Can’t wait!

 

[MerlinWizard]

I had this bright idea that I was going to try and spend the long weekend as normal as possible.

The first thing I did was shed the compression socks and compression sleeves for my knees. I don't notice a lot of swelling anymore so I figure what the heck, let's give it a shot. I spent the first day doing a lot of yard work and heading off to Sam's Club and Menard's.

I spent about 8 hours I would guess, walking, bending, kneeling at times (although that lasted about 5 seconds each time!) throughout the yard and the stores. Saturday night I wasn't necessarily in "pain" but I was sore and stiff. Part of this included loading and unloading 7 cases of various waters for another party (more on that later).

Sunday I had to usher at Church, only my second time doing so since my surgery. The first time I sat, a lot. This time was more normal - again, sans compression socks and compression knee sleeves. It felt, "normal" although I couldn't kneel when required because I am simply not able to do so without my knee pads for very long. After going out for breakfast, it was time to smoke some ribs for Monday's party and get the chicken in the brine to smoke Monday before the party. While those were smoking I headed to the grocery store to pick up soda. The cheapest time around here to by soda is Memorial Day weekend, I don't know why, it's just always been that way. So I loaded up 24x 12 packs into the truck and headed home to unload. My wife was making pies and needed something from the store - the store I had just been to. So back to the store I went. Later on that evening after dealing with the ribs, I again wasn't necessarily in "pain", but was very sore, moreso than the day earlier.

Monday was "party day" and I had to smoke the chickens and reheat the ribs. Now, this wasn't a large party, about 10 people. But it was still a test (more on that next).

When we built our home, it was built around my wife's disability. She shattered her ankle at work 14 years ago. 7 surgeries later, including two failed fusions, several bouts of sepsis, she had it amputated in February 2020. She in turn had an infection 2 weeks later and was back in the hospital for two more surgeries for a total of 10 on just that part of her body. Anyway, she is doing amazingly well and although not "pain free", she is 1000% better than she was before having the leg removed.

Anyway, we built our home with the idea that she would eventually be in a wheel chair so we designed it around hosting all of the family gatherings, etc. This way she wouldn't ever have to worry about going to other people's homes and trying to get around, etc. Also, we tended to host a lot anyway so this is something that isn't new to us. She is in the wheel chair for 12 hours a day or more. Not normally during parties, but sometimes - if she over does it. Sensing a trend here?

My daughter is getting married in a few short weeks and we hosted the Bridal Shower a few months ago - around 7-8 weeks out for me. I told my wife I would be up for it and could do all the things I normally do for these events which usually means the main meal while she does appetizers and desert. I failed - miserably. I was 4 hours into prep and cooking the day of (half prepped the day before) and I couldn't stand up anymore, I could barely move. With no where to put my feet up because of the 40 people at this shower! If not for my sister-in-law, who did everything I was supposed to do, it would have been a disaster. My wife was running the shower part and nobody was the wiser and it went off without a hitch. I felt so bad for my sister in law, even though she was happy to do it.

Mother's day was the second test. I got through the prep and cooking and meal served. But when it came time to cleanup, I was done. I failed miserably AGAIN! Although my wife laughs today, she wasn't laughing when I told her I couldn't do the cleanup on Mother's Day, understandably so.

So, yesterday was the third test and I passed! BUT - the secret to it was, I put the darn compression socks and compression knee sleeves on.

I wasn't able to bend very well while I didn't wear them and almost not at all at night. I put them on yesterday morning and it was nearly the first "normal" day I have had since my surgery. I felt great when I got up this morning. Now, I need to recover from everything I did and get back to exercising. The weather is supposed to be really nice this week so I am going to hit it hard before we host the rehearsal dinner which I am 100% confident I will be up for! The day of the wedding is going to be a long one. Lot's of setup and tear down that has to be done all in the same day due to other events at the venue.

That will be the real test as to how "normal" things are getting. The really good news is that through all of that, I never had a Tramadol at night, not one. Been 3 weeks without any now? 800mg of Ibuprofen at bedtime seems to do the trick just fine for me.

 

[Celle]

@Merlin , Please will you tell us what date in February 2021 you had your bilateral TKRs. Than we'll be able to add it to your signature. Thank you.

I felt great when I got up this morning. Now, I need to recover from everything I did and get back to exercising.

I don't think you need to do any additional exercising. All those challenging things you've been doing count as exercise - some of them done much earlier in your recovery than was wise, probably.

 

[Ghostpipe]

Thank you for your post. You have boundless energy! I realise that you are younger than the average with new knees, but even so.... I would have been pushed to do all that even with good knees.
What is it about shopping that is such a challenge? I did gym, walking and static cycling yesterday and was ok in the evening, but a shortish shopping trip this morning has laid me up.

 

[MerlinWizard]

@Merlin , Please will you tell us what date in February 2021 you had your bilateral TKRs. Than we'll be able to add it to your signature. Thank you.

I felt great when I got up this morning. Now, I need to recover from everything I did and get back to exercising.

I don't think you need to do any additional exercising. All those challenging things you've been doing count as exercise - some of them done much earlier in your recovery than was wise, probably.

Hi Celle,

I didn't put the day in there for privacy reasons. Say I used that date in a password (I didn't but you never know what I will come up with next) not putting it the day would cause someone to have 28 chances to steal my password and normally after a few attempts "whatever" account would be locked out.

I can provide it but it would be reluctantly, never can be too safe!

You may be right about the exercise - I haven't felt the motivation yet because I started another project that has me on my feet for a few hours at a time.

Merlin

 

[MerlinWizard]

Thank you for your post. You have boundless energy! I realise that you are younger than the average with new knees, but even so.... I would have been pushed to do all that even with good knees.
What is it about shopping that is such a challenge? I did gym, walking and static cycling yesterday and was ok in the evening, but a shortish shopping trip this morning has laid me up.

I think the part with shopping is that you are doing a lot of stopping, turning, bending and pushing a cart around (as you can imagine mine get quite heavy). And because all of those things happen without thought you don't always take the time to make sure you do so properly.

When we walk, we know we are walking, when we cycle, we know we are cycling - because that's the main focus we have. When we shop, we are reading, calculating prices and thinking about everything but - our legs!

It may seem like I have a lot of energy but I don't have as much as I would like - I don't think we ever have as much as we'd like. ALTHOUGH - I will say I have more today than I had before surgery. I used to not do things or procrastinate because I knew what I was in for with the pain. Now, I do things stubbornly with the mindset that I can work through the pain because it's "good pain" or that I know at worst it will be a day or so until I feel normal again. It used to take weeks sometimes for my knees to stop being in so much pain.

And age is a mindset. Someone called me old the other day because I am 2 years away from the 55 Senior Discount marker. I was like - I'll pay full price! =)

 

[MerlinWizard]

Here's a question I haven't been able to form an opinion on:

Pre-Dental apt antibiotics.

While I will always heed the advice from my Surgeon and do what he tells me to do, I couldn't help but be confused by the conflicting data out there.

In 2012, the recommendation was that for two years after joint replacement that antibiotics were required before visiting the Dentist. Shortly thereafter that changed to from two years to, life.

Then in 2016 the American Dental Association came out with guidelines that found there was little risk of infection for joint replacement patients from dental work. They only recommended that people who were at higher risk for infection that had joint replacement to take antibiotics prior to any dental work.

Today, it "depends" on your Surgeon and your Dentist. Both my Surgeon and Dentist subscribe to the hypothesis of mitigating ANY risk of infection and want you to take them for "life" before dental procedures. However, my mother and mother in law who have had both of their knees done at various times over the last 15 years have been told something else - except for my mother's last tkr which was done about 2 years ago by the same Surgeon I go to. And you can tell which knee was done 13 years prior and which one wasn't. The new one looks normal and the old one looks like a "one size fits most" implant. Anyway, my mother was told for "awhile" with the first one 13 years ago and after some time she didn't have to take them anymore. After her last one he said "for life" which makes sense because it was the same Surgeon. My mother in law wasn't told much at all. She had both of hers done at Mayo over the course of 10 months I think. In that time they have prescribed antibiotics but haven't been clear on how long she needs to keep that up.

I have heard other's yet who don't ever get antibiotics before dental procedures.

While I am not prone to infection, I know that infections can occur and that your mouth is a good way to introduce them directly into the bloodstream, that's Science 101. I also know that any implant can be susceptible to infection because bacteria like to hide there because there is no blood flow. Meaning that you can have the same infection reoccurring over your lifetime because of an implant. We (meaning the many Doctors and us) suspect that was the reason my wife kept going septic - she had a huge piece of metal in her ankle and since that was removed with the amputation, she's never been healthier and this is the longest she's ever gone without going septic (knock on wood).

My Surgeon also told me that the implants that he uses today are 1000% less likely to harbor infection than the ones my mother had 2 years ago. They are coated in a ceramic material that prevents metal allergy/poisoning as well as antimicrobial nanotechnology, including the bone cement they use. Also, the expected lifetime for the implants I have is 40 years and my mother's are only 20 years. If I get 20 years, I will be happy about it.

I picked up the prescription and I figured one pill an hour before my dental procedure. WRONG! 4 pills - 2000 mg of Amoxicillin! The prescription has 5 REFILLS! Seems to be overkill but I do know that antibiotic is broad spectrum with a focus on surface bacteria. And I have to do this for Life? While I err on the side of caution even though the risk is seemingly negligible, it won't cause me any harm to take this twice a year.

So knowing all of the information I know - what's your take on antibiotics before dental procedure?

 

[Celle]

I routinely took antibiotics prior to dental work when I had my first knee replacement, in 2000.

I don't any more, even though I now have two knee replacements and one shoulder replacement.
That is because of this:
Dental antibiotics: Evidence insufficient to recommend prophylactic antibiotics for dental procedures

The prophylactic use of antibiotics "just in case" is one of the reasons for the current proliferation of antibiotic-resistant bacteria.

In addition, the bacteria in your mouth (mostly Streptococcus Viridans) are rarely the ones responsible for joint infection. They can attack your heart, but usually not your joints.

In spite of the joint recommendations of the ADA and the AAOS, many orthopaedic surgeons are risk averse and so they continue to recommend antibiotics prior to dental work.

The choice is yours.

 

[Celle]

I didn't put the day in there for privacy reasons. Say I used that date in a password (I didn't but you never know what I will come up with next) not putting it the day would cause someone to have 28 chances to steal my password and normally after a few attempts "whatever" account would be locked out.

I understand your caution, but that sounds a bit far-fetched. You could use a neutral password, like "maryhadalittlelamb".

The reason we like to know your full surgery date is so we can offer more appropriate advice. There are over 4 weeks' difference in recovery between a surgery done at the beginning of the month and one done at the end of a month and, as you know, a lot of progress can be made in those 4+ weeks during early recovery.

 

[Jamie]

@Merlin, you mentioned that your antibiotic prescription for dental procedures has five refills on it and seemed quite shocked about that. I hope you realize that you only take the 4 pills just before your dental appointment and no more pills are required until the next appointment. It's not like a normal course of antibiotics where you are advised to finish the whole bottle by taking them every day.

The reason you'll see conflicting information and advice is because there is no science that directly can tie infections in a joint with dental or other invasive procedures. As Celle indicated, people must listen to their surgeons, listen to us, read on the internet and then make their own choice. There is no "right" answer to the question of taking antibiotics following a joint replacement.

As a matter of comparison, my surgeons for both knees and my shoulder plus my dentist all say take the meds for 2 years and that's what I did.

 

[MerlinWizard]

I didn't put the day in there for privacy reasons. Say I used that date in a password (I didn't but you never know what I will come up with next) not putting it the day would cause someone to have 28 chances to steal my password and normally after a few attempts "whatever" account would be locked out.

I understand your caution, but that sounds a bit far-fetched. You could use a neutral password, like "maryhadalittlelamb".

The reason we like to know your full surgery date is so we can offer more appropriate advice. There are over 4 weeks' difference in recovery between a surgery done at the beginning of the month and one done at the end of a month and, as you know, a lot of progress can be made in those 4+ weeks during early recovery.

I disagree with your thought process that it is "far-fetched". Every piece of information you put online is stored indefinitely and subject to various security measures, most of which are inadequate. It doesn't matter what the "source" is, whether it be this website or Microsoft, Google, Amazon, Facebook, etc.

SnapChat data is supposed to be deleted based upon whether it was opened or not or sent to a group from anywhere to 24 hours to 30 days. Guess what? That's not true. It's "removed" from public view but it's store on the servers and in backups - forever.

Anything you put on the internet is an accident waiting to happen. Personal profiles are one of the biggest things people hack. They do this by information trolling and Social Media is the biggest security threat to your personal privacy.

Data that you put into any "Cloud" is stored, forever - even if you delete it. Also, you don't "own" that data once you place it in the "Cloud", it's in the fine print.

If any of you have Passwords that are "English-like", oh say like, "maryhadalittlelamb", a Hacker can figure that out easily. You might as well use "123456" or "Password". In fact, if you ever forget a password there are programs out there that can try to figure it out for you. Anything in plain "English" literally takes less than a second with the computing speeds available today.

This has given rise to "Password Vaults" so you can store your passwords on your local device, which is encrypted, which allows you to use more cryptic passwords that you won't remember.

While I may sound like some kind of "alarmist" or "conspiracy" nut, I do know just a little bit about what I am talking about.

I am an expert in Data and Technology, it's what I do for a living. I have been engaged in this type of science and work since I was 14, before the first PC's even showed up. I am someone who you would call who needs their data to be reverse engineered, decrypted, extracted, translated, loaded, moved or removed. All within the law of course. I have never engaged my work for use nefariously and I never will.

I also don't want to "alarm" anyone, this is just the nature of the world we live in and my family and I go to great lengths to ensure our privacy. Everyone is different and everyone can make their own choice about how much or how little to reveal. The reality is, if you have a bank account, your information is already out there and there isn't a whole lot you can do about it. Personally, I saw the world we live in today coming. I was fortunate enough to have gained the expertise to help guide me as to what information I would and would not share in public forums, Cloud Platforms, etc. But as I said, once you have a bank account (or a credit card), you are pretty much "out there" lol.

Sorry for the long response - I really enjoy what I do for a living =).

That being said, my surgery date was February 17, 2021 @ 8:00 AM CST.

As far as the antibiotics go, I appreciate the advice. I have a very extensive understanding of the types of bacteria that can be spread through the mouth (unfortunately) due to a family member having issues with infections that come after dental surgery. I also know someone who had an infection 10 years after their joint replacement and that bacteria came from the mouth after a routine cleaning. In fact, the family member who has the infection issue - it's a very dangerous problem. You can go septic very easily due to the quick access to the bloodstream in your mouth. This person has to see the dentist every 3 months and their GP every few months to make sure nothing is brewing. I should ask them if they have any surgical implants?!?

But that doesn't mean I believe I am at risk or think it's necessary. I was just taken aback at the dosage and the advice from my surgeon. It would seem there is no right or wrong answer.

I am 100% sure by now that you all can tell I love to learn and I really enjoy it the sharing and it is well appreciated!

 

[Celle]

Thank you for your surgery date. I had added it to your signature and I will also add your username to the February Valentines 2021 surgery team thread.

 

[MerlinWizard]

I spent the weekend putzing in the yard and attending a couple of graduation parties. In the extreme heat, I also spent time in the pool. While it did cool me off, I couldn't help but work on my ROM in the pool.

I have no idea if it's working or not, my wife says it is but she could just be telling me what I want to hear. My legs get so stiff after spending time in the pool it's hard to imagine I am doing them any good!

 

[FCBayern]

My legs get so stiff after spending time in the pool it's hard to imagine I am doing them any good!

Sounds like your doing more than your new knees are happy with if you are very stiff afterwards. Try dialing back a little and seeing if that helps.