Bilateral TKR Recovery diary

[KateLynn]

Yes, I am in the proud beneficiary of two brand spanking new knees. I’m getting ready to be discharged this evening. Thank you to everyone who has prayed for me and sent their best wishes. I greatly appreciate you all.

 

[InkedMarie]

Glad you’re okay!

Marie

 

[KateLynn]

My PT says I am doing well. I am a bit concerned that I have gained so much weight. 21 lbs! I have been trying to eat, but it’s been all good food and very very small quantities. I don’t understand anybody have a clue or had this experience.

 

[Arjay]

Don't know about your weight, but you are fortunate you weren't scheduled with my ortho for your surgery. Apparently he is an absolute BEAR about any cut, nick, abrasion that could be perceived as an opening to infection. All patients are warned….can't tell you how I froze slicing an onion 2 days before my surgery! And as it happened, one of his surgeries right after me was cancelled that day.

Re the pounds, your surgery was only a week ago……might'n't it still be accumulated fluid? If you're lucky, the pain meds will kill almost completely kill your appetite. I'm thinking I came out of my recent recovery w a shrunken stomach - not a bad thing.

 

[Roy Gardiner]

@KateLynn I have taken the liberty of starting a recovery thread for you, I hope that's OK.

Knee Recovery: The Guidelines

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, but YOU are the final judge as to the recovery approach you choose.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

The Recovery articles:

The importance of managing pain after a TKR and the pain chart​

Swollen and stiff knee: what causes it?​

Energy drain for TKRs​

Elevation is the key​

Ice to control pain and swelling​

Heel slides and how to do them properly​

Chart representation of TKR recovery​

Healing: how long does it take?​

Post op blues is a reality - be prepared for it​

Sleep deprivation is pretty much inevitable - but what causes it?​

There are also some cautionary articles here

Myth busting: no pain, no gain​

Myth busting: the "window of opportunity" in TKR​

Myth busting: on getting addicted to pain meds​

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Roy Gardiner]

I am a bit concerned that I have gained so much weight. 21 lbs!

Over what period of time? The shorter the time, the more likely it is to be fluid retention, as has been mentioned. If it's been over just a couple of weeks or less, it's certainly fluid. The body can't put on fat that fast!

 

[KateLynn]

8 days

 

[Roy Gardiner]

That can't be anything other than fluid IMO, it'll go as quickly as it arrived.

 

[benne68]

I agree with Roy -- it's fluid retention, which is very common. I gained 12 pounds between the day before surgery and the next time I got on the scale about a week later. And is was barely eating because I was struggling with nausea from my pain medications. It disappeared as quickly as it came. I'm sure yours will too. Just give it time.

 

[KateLynn]

9 days post surgery and I am doing remarkably well for a bilateral simultaneous. My big problem right now is my insurance company refusing to pay for the pain meds because they think I shouldn’t be taking them. Also, my knees are still extremely swollen. PT is very good. She pushes me, but only in an encouraging way, but has not touched me at all, or asked me to do anything that was going to cause me significant pain.

 

[WFD]

No pain meds 9 days after a bilateral? That’s insane.

Maybe ask for a referral to a pain specialist? Their opinion might carry more weight with the insurance company.

 

[djklaugh]

@KateLynn Also call your surgeon ASAP and tell him or his assistant about the problems you are having with your insurance!! The surgeon and his office staff know how to deal with insurance companies and know what to say to get them to do the right thing. I agree with WFD - no pain meds 9 days after bilateral knee replacement is insane!! I had bilateral hip replacement done 11 years ago and took pain meds for close to 3 months following that ... and knees are more difficult to replace than hips!

 

[KateLynn]

I’ve got a call into the office to speak to them about this. Right now I’m being told I can take one oxycodone 5 mg every six hours and that’s it.

 

[KateLynn]

The doctors office had told me before surgery that I would be on a 10 mg every four hour round the clock schedule for the first 30 days but could take less if I felt I didn’t need that much. What I’m now getting is 40-5 mg tablets for 10 days.

 

[trinket]

That's crazy. Is it your insurance company or surgeon telling you that you can't get what is needed for your pain? If it's a problem with insurance company you can always go around them and pay for the oxycodone out of pocket. It's not ridiculously expensive. GoodRx (or something like that might be an option).

You're very brave to do bi-lateral TKR.

 

[KateLynn]

The doctors office is working on the language to put on the next script to see if we can get this resolved. This is a sad reflection on the state of our country and its street drug abuse.
Thank you all so much for the encouragement and kind words. I will let you know how this works out.

 

[beachy]

The PA at my surgeon's office added a muscle relaxer, upped the gabapentin and meloxicam in addition to pain med refill. The addition to and increase of other meds really helped me turn a corner in pain relief. Except meloxicam.... Made me really sick. And I was skeptical it would help, but it did.
Maybe your doc can offer you something similar if insurance gets stupid over refills.
That really is outrageous that they're drastically limiting pain meds for bilateral tkr do early on.

 

[KateLynn]

Day 17- Post surgery. Got a UTI, I was prescribed Keflex, which made me very very sick over the weekend. I stopped taking it. I’ve dropped 20 pounds of fluid in the last week that is good and bad. I’ve never been up and down and walked to the bathroom so much in my life but am walking well. I have not reached goals for the bending of my knees. I start outpatient PT tomorrow, and I will be really happy when I don’t have to take all these meds. I think a lot of them are upsetting my stomach. I hate a stomach ache but I’m sure there are worse things.

 

[beachy]

Wow! You're really getting hit with everything you don't need. Keflex is a major gut killer for me too. Unfortunately, we find out the hard way. It destroys all the good bacteria in your gut. There is another antibiotic that is gut friendly. Ask your doc.
Please be careful at PT. Only allow gentle movements. At 17 days bilateral post op don't worry.....that bend will happen.
I started PT at 3 weeks post op. My bend was 95. With no pt. Just ADLs.

 

[benne68]

Day 17- Post surgery. Got a UTI,

This happened to me as well, although mine was closer to a month post-op. I think it has something to do with all the medications during and post surgery. Like you, I found the treatment worse than UTI itself. Be patient, your body does stabilize as it works it's way through healing.

I have not reached goals for the bending of my knees.

Please don't let anyone -- including yourself -- set "goals" for flexion! We all recover at different rates and you are still very, very early in this year-long recovery. Your knees are still traumatized by the surgery. Your bend will improve gradually as the swelling goes down. So don't worry about the numbers.

If you are walking comfortably, you are doing really well for less than 3 weeks out!