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Bilateral TKR Oregon Mom's recovery journey

Mrs. Ciz

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@Oregon mom
Yep, he massages my knee caps and my lower legs. And he spends time stretching my legs out in various ways. It is the best, most relaxing part of PT. It loosens up my knees and makes the exercises easier.
 

Jockette

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By 4 weeks post op I was convinced that the PT I was getting was counterproductive. It led me to search google and that’s how I found Bonesmart. At that point I wanted to stop going to PT but that was unheard of, in my circle of acquaintances. My husband, being an athlete, was not in favor of me stopping, even though he did admit it was counterproductive for me. We also both feared making my surgeon mad, and feared if a problem came up later that he wouldn’t help me, and chalk it up to my lack of PT. (He was a big fan of PT)

We compromised and I cancelled most of my appointments and only did what I wanted when I did go, which was actually only 2 times in the next month. I got an ”honorable” discharge from PT several days before my 8 week anniversary.

If I ever do this surgery again, and chances of that are good since I have a partial that has never felt right, it will be a whole different situation. I now know enough to know I can disagree with my surgeon’s protocol and and do what is best for me. I will also do my own rehab at home. Once I leave the hospital I won’t be seeing another PT.
 

SpaceGirl

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I think you did the right thing. If you really want to try some pt, is there other offices you could try? I would ask what their protocol is and what it entails.
 

leejaa

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Great decision to put yourself first and what your knees want. Keep listening to your knees and body.

I had in home PT with both of my knees for 4wks 2x/wk but it was super gentle with no pushing or pulling. For the first knee I then went to OP PT and the first thing I did was have a discussion as to my expectations of no pain = more gain. They agreed and I did do the exercises and recovered.

With the 2nd knee I decided not to do OP PT as I did not think it really helped that much. I did exercises at home and had purchased a recumbent exercise bike and used that in the amounts that felt good without pushing. Again, I had a good recovery.

I never overdid exercises and made sure I had healing time and lots of ice and elevation to keep the swelling going down and it really worked for me. In fact there were many days I did no exercises except for ankle pumps which are not exactly strenuous and some heel slides without pushing. The funny part is my PT people kept saying I must have really been doing a lot of exercising because I was progressing so well. I just said hmmm and did not tell them till the end that I elevated and iced more than exercised to get to my result.

There is a place for PT when needed but it has to be tailored to the patient and their issues. The idea of standard knee replacement PT is just silly. We are not all the same and had different abilities before the surgery due to our knees or other issues.
 
OP
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Oregon mom

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The idea of standard knee replacement PT is just silly. We are not all the same and had different abilities before the surgery due to our knees or other issues.
Yes! What's crazy to me is that what they are calling standard seems so aggressive and time consuming. I consider myself to be in good shape and I'm relatively young (47) and the "standard" program is just unacceptable to me.
I am so grateful for the words of support.
 
OP
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@Jockette @leejaa - I loved reading your stories. It is so helpful to hear from people who have been there and faced the same challenges. Not being someone who normally says no to an established system, it is so fortifying to hear from people who have. It takes some bravery and faith in self to say no to "professionals,."
 

KnitChica

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@Oregon mom I know you wrote this a couple of weeks ago, but your words so perfectly express my thoughts on the whole asking for pain meds game!

“and then having to call the ortho nurse to beg like an irresponsible child for more pain medication that I don't even want to be taking in the first place.
I do so resent having to call the ortho nurse... Yes, I've been icing and elevating... Yes, I know that narcotic medication is only one way we manage our pain... Yes, I tried out the guided imagery podcast on the provider website... Yes, I'm trying to get up and move throughout the day... Yes, it still hurts like hell, which is why I called you, ortho nurse. I wouldn't call to go over all the basics with someone on the phone. I would call because the pain is so bad I have to do something proactive.”
 

Mrs. Ciz

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@KnitChica and @Oregon mom
It is truly stupid that we have to beg. My doctor cut me off pain meds at 6 weeks. I stretched what I had left out a week more and then saved about 5 Tramadol for when I had a really bad day. Those are all gone now. And guess what??? At 11 weeks post op, I still have some bad days. Yesterday was one of them. A Tramadol would have really helped, but instead I suffered all day and most of the night with just ice, elevation, a heating pad, Voltaten gel, Tylenol and Advil. None of those helped much. It STINKS!!!!
 
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Oregon mom

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@KnitChica @Mrs. Ciz
Oh, it doesn't feel so long ago! It's the rhetoric dujour in the wake of the opiate crisis, a crisis unfortunately created by the pharmaceutical manufacturers.
Every professional along the way had the same spiel:
Opioids have terrible side effects.
They cause constipation.
They make you groggy.
And they are addictive!
The sooner you stop taking opioids the better!

I was given 50 x 5mg oxycodone with the caveat that "most people don't need a refill," implying that if I did need a refill I was not in the normal group.
There were a couple understanding souls: my surgeon, an anesthesiologist, a PA. In fact, the PA was so adroit in stating that having a BTKR isn't always simply pain doubled, it can be pain squared. My BTKR doesn't necessarily make me extra special, because a TKR can be just as excruciating if the pain isn't under control.
All of the front line people, the people you deal with the most, had the same things to say. One nurse grilled me on how exactly I was elevating my legs. I was told repeatedly that I needed to expect some pain, as if I were trying to mask it completely.
It's just an unfortunate residual effect of cultural mismanagement of very useful medications.
If there's anything I would tell someone going in, especially a BTKR, it is this:
Don't hesitate to speak up for yourself.
Don't let anyone minimize your pain for you. It's your pain.
Don't fall prey to the generalized paranoia around opioids.
Don't be afraid to contact your surgeon directly after surgery to discuss pain.

I'm only in my third week of having both my knees blown inside out and I'm taking half the original dose of oxycodone now. And I'll tell you, there is another side effect to this medication:
It Helps With the Pain.
:yes:
 
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OP
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Oregon mom

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My doctor cut me off pain meds at 6 weeks. I
Have you discussed with your primary physician?
I was told that protocol for my system is that Ortho will wash their hands of my pain management at 6 weeks and from there if I needed further support in that area my primary physician would be assisting.
It doesn't seem right that you would have to suffer through a whole day with breakthrough pain at this point.
 
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Murphy2013

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Hi Oregon mom, my small exercise “set” are (in no particular order)
Knee wall slide (does me most good, but easy to overdo, I could bunk myself with a rubber polo mallet if I get sore afterward because I know better)
Self mobilization knee flexion/extension (I use this to hold the quad a little bit now at week 14)
Quad set slight flexion
Sitting knee flexion with bathrobe assist ( I go very easy for the assist part)
Mind you I have had an MUA and I am gradually learning the skills to get the stretch just right and not be so darn crazy. I continue to read your story with great interest and hoping the best.
I can’t wait to get back to the bike and the pool, but I’m not driving the bus here; my knee is the boss.
 
OP
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I could bunk myself with a rubber polo mallet if I get sore afterward because I know better
LOL! Ha ha I feel the same almost every other day. How did I overdo it just going downstairs to make a snack?
Thanks for sharing your exercises. It's so interesting to hear about what others are doing on this adventure!
 
OP
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Totally off topic, but I love these dancing baby penguins and would like a line of them dancing on my thread.


:happyfeet::happyfeet::happyfeet::happyfeet::happyfeet::happyfeet::happyfeet:
 
OP
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Oregon mom

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I let my surgeon know that I canceled PT and he wasn't concerned. The left knee has a steel band feeling on the inside when I try to flex. The right knee just feels tight but is slowly starting to relax and bend. The left knee feels like there's something stuck. It's difficult not to worry about this. The left knee was worse before surgery also.
I'm in the middle of week 3 post op.
I go for x rays Monday, then speak to my surgeon the following week for a check in.
I looked at the parts of my incisions that were exposed now with the steri strips peeling back. I used a magnifier. That was kind of gross. There's a lot of lint. Nothing that indicates infection though. My knees look really gross and I don't want to show them in public just yet. I'm wondering how I'll go to get x rays... It's mainly the flappy gross steri strips and the linty glue residue... And the 8 inch slices.
I've decided that I'd like to move to Idaho and I'm looking closely at Pocatello. Hubby is on board, but we've got at least one more year here. I'm starting to feel a little cooped up. I might ask hubby to take me on a walk outside and see how far I can go. I try to walk in the house, but I have to turn around every few steps and I'd like to just walk in a straight line unencumbered for a bit.
 

leejaa

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I hope you enjoyed your outside walk. A little fresh air and nature is great for the spirit.

As my steristrips started flapping around, I would cut off the flappy ends so nothing was loose.

I would not worry about the x-ray tech seeing your knee. They see it in the OR and they have seen worse things than a recovering knee replacement knee as they also deal with accident cases.
 

Mrs. Ciz

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At 11.5 weeks post op, my left knee is healing up so much better and faster that my right knee. The left is stronger, rarely ever hurts and has waaaay more bend that the right knee. The right knee is stuck at around 100, and I cannot even get it to scoot back any further when I do my heel slides. It’s just stuck. I still get lots of pain behind the right knee that goes down to my calf, shin and foot. In addition sometimes the right glut hurts as well. My therapist says it’s all due to a tight hamstring. I stretch that thing religiously, but it still acts up and when it does, all the other muscles in my right leg are bothered as well. I’m hoping it will improve with time. But if I’m still having issues with the right leg in November, I’m going to have my surgeon look into it more deeply.
 

Jockette

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One of our members @maryo52 wrote this:

”I watched a bilateral knee replacement when I was a nursing student. The patient happened to be a neighbor. It was quite a comfort to him that I was there. I was not that physically close to the surgical area because that's a super-sterile area. They wear space suits so they're not even breathing near the wound. I was by the patient's head. They did the left knee first and then the right, which went easier because they'd figured out the correct components on the left which means there was more tourniquet time, more putting on and taking off of components, and generally tweaking of the artificial joint on the left. So it was no surprise that the patient's right knee recovered more easily and with less swelling. Who knows how much each of our knees get tweaked and manipulated during the surgery, resulting in more tissue trauma?”
 
OP
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Oregon mom

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@Mrs. Ciz I'm not going to say I'm glad your knees are on different schedules. But it is good to know I'm not alone.
@Jockette Wow I hadn't even thought about the surgery order being a factor. I asked my surgeon which one he'd be doing first - the left since it was worse off. So with the fact that it was already worse off plus the possible factor of surgical order... That would make sense.
 

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