Fire wolf
graduate
United StatesHope you are doing well! Miss seeing you!
Bilateral TKR SusieShoes' New Knees
- Thread starter SusieShoes
- Start date
Luanne
new member
Susie, I have enjoyed reading your story....I had my BTKR exactly two months after you and followed a very similar course as you....except I was in rehab 14 days! I have a 2 story house with 15 stairs to get upstairs and I guess wasn't ready to go home until I could master 15 stairs safely......I loved the rehab place so I was happy to stay. (well, I was getting itchy to leave near the end there) I am 5 weeks out now and doing fairly well. Just trying to figure out when I will be ready to go back to work. Supposed to in 2 weeks.....but I am a little nervous about that.
OP
OP
SusieShoes
Former BoneSmart staff member
Hi @Luanne! I really appreciated my time in rehab, but... 14 days! I would have gone stir crazy. 
But yes, they really focused on my doing stairs and on walking. I was fortunate to not have difficulty with either. Stairs were painful and awkward at first, but I was used to painful and awkward because of my old arthritic knees, so felt walking and stairs already better than I started!
I just caught up on your thread. You don't say what you do for work. The kind of work you want to go back to makes a difference as to when you should do it. A desk job that lets you ice and elevate throughout the day is more doable than a job that keeps you on your feet, like an elementary school teacher or a mechanic.
Six weeks is quite ambitious for any job, though it's been done. A lot of people recommend doing part time before going up to full time... can you do that? Lots of people recommend that. Just speaking for myself, three months is where I would consider going back to a full time job. Also consider that pain and swelling from doing too much too soon might set back your recovery a little. Not derail it or anything, but slow it down.
Bilateral knees recover as quickly and well as single TKR, but you do have two of them going and so have twice the disability early on. Two stiff and maybe painful knees. Two joints that can swell. If one knee acts up, your "good" leg is one that itself has just had surgery. It may or may not be a solid backup for doing steps and things. So listen to your body and heed what it tells you. Don't forget to include any commute into your calculations.
What kind of work do you do? Is your workplace adaptable to elevating and icing while you're there?
But yes, they really focused on my doing stairs and on walking. I was fortunate to not have difficulty with either. Stairs were painful and awkward at first, but I was used to painful and awkward because of my old arthritic knees, so felt walking and stairs already better than I started!I just caught up on your thread. You don't say what you do for work. The kind of work you want to go back to makes a difference as to when you should do it. A desk job that lets you ice and elevate throughout the day is more doable than a job that keeps you on your feet, like an elementary school teacher or a mechanic.
Six weeks is quite ambitious for any job, though it's been done. A lot of people recommend doing part time before going up to full time... can you do that? Lots of people recommend that. Just speaking for myself, three months is where I would consider going back to a full time job. Also consider that pain and swelling from doing too much too soon might set back your recovery a little. Not derail it or anything, but slow it down.
Bilateral knees recover as quickly and well as single TKR, but you do have two of them going and so have twice the disability early on. Two stiff and maybe painful knees. Two joints that can swell. If one knee acts up, your "good" leg is one that itself has just had surgery. It may or may not be a solid backup for doing steps and things. So listen to your body and heed what it tells you. Don't forget to include any commute into your calculations.
What kind of work do you do? Is your workplace adaptable to elevating and icing while you're there?
OP
OP
SusieShoes
Former BoneSmart staff member
Three Months: Weekends and Weight Loss
Another weekend with the Big Italian Family (abbreviated version). We played lots of games and cooked out, and all was good. I spent a lot of time on my feet, preparing food, setting the table out on the screen porch, running things out to Mr. Shoes at the grill, and avoiding dogs. Yep, the family travels with its dogs, so every weekend my sweet Cate gets to host a pack. And where there is food, there are dogs underfoot. Mostly I chased them out of the kitchen (I do not allow dogs in the kitchen while I cook, and visiting dogs need to be reminded of this).
Sunday was quieter. Our weekly trip to the grocery store (always good for a half mile of walking). A little cleaning about the place. Laundry. A trip to the pharmacy. Watched a movie and some TV shows.
So knee-wise, it was a usual weekend. I'm forgetting to elevate and ice most of the time now. I do so in the morning after my walk. I do so at night while watching TV. But in-between is now free of elevating and icing. It's been this way for about a week. Oh, and I have slept on my side every night since I first managed to do so last Tuesday night! I have achieved every intermediate TKR goal! Long range goals remain on the table.
One of my long range goals: Lose Weight
When first meeting my OS, I mentioned this as one of the things I hoped a BTKR would accomplish. He looked at me soulfully. "Knee replacements don't cause weight loss."
A true statement. They don't. In fact, studies have shown that most TKR patients don't lose weight, and often gain it. But as I pointed out, "No, but if I can finally move again like a normal human, that might help me lose weight." To which my wise OS nodded.
And so it has played out this way:
* I lost 10 pounds before surgery because I tried really hard and dieted
* I lost 15 pounds in the first four weeks after surgery because I was NAUSEATED
and didn't eat (works every time)
* I have lost 6 more pounds since then because I am maintaining my low-carb diet (type II diabetes) and walking
Those last 6 pounds happened because of TKR. I am eating more than pre-surgery, though keeping a healthy diet. But I am walking so MUCH MORE. Before my surgery, I walked maybe 500 steps a day.
That number was so sad, so depressing, that I stopped wearing my Fitbit. I mean, who wants to be reminded all day long that they are walking that little? Heck, 700 steps was a good day, probably spent grocery shopping. It was bad.
Now I walk 3000 steps a day even if I don't take a long walk. If I take a long walk, up that to 5000. And occasionally I do more. Mostly, though, between 3000-5000. Consider that number: between 7 and 10 times MORE activity than before surgery.
It's hardly the healthy 10,000 steps recommended by fitness studies, but it's a big step up from where I started.
I'm not really trying to lose weight right now. It's a goal, but the real motivation for all that walking is to rehab my knees and my life. I want my legs to become strong again. I want my knees to loosen up and regain full ROM. I want to become again that active person I was 10 years ago. Those are the primary goals. Do I hope weight loss will follow? You betcha. That's not the reason I got my knees replaced, but it's sure a wanted side effect.
Another weekend with the Big Italian Family (abbreviated version). We played lots of games and cooked out, and all was good. I spent a lot of time on my feet, preparing food, setting the table out on the screen porch, running things out to Mr. Shoes at the grill, and avoiding dogs. Yep, the family travels with its dogs, so every weekend my sweet Cate gets to host a pack. And where there is food, there are dogs underfoot. Mostly I chased them out of the kitchen (I do not allow dogs in the kitchen while I cook, and visiting dogs need to be reminded of this).
Sunday was quieter. Our weekly trip to the grocery store (always good for a half mile of walking). A little cleaning about the place. Laundry. A trip to the pharmacy. Watched a movie and some TV shows.
So knee-wise, it was a usual weekend. I'm forgetting to elevate and ice most of the time now. I do so in the morning after my walk. I do so at night while watching TV. But in-between is now free of elevating and icing. It's been this way for about a week. Oh, and I have slept on my side every night since I first managed to do so last Tuesday night! I have achieved every intermediate TKR goal! Long range goals remain on the table.
One of my long range goals: Lose Weight
When first meeting my OS, I mentioned this as one of the things I hoped a BTKR would accomplish. He looked at me soulfully. "Knee replacements don't cause weight loss."
A true statement. They don't. In fact, studies have shown that most TKR patients don't lose weight, and often gain it. But as I pointed out, "No, but if I can finally move again like a normal human, that might help me lose weight." To which my wise OS nodded.
And so it has played out this way:
* I lost 10 pounds before surgery because I tried really hard and dieted
* I lost 15 pounds in the first four weeks after surgery because I was NAUSEATED
and didn't eat (works every time)* I have lost 6 more pounds since then because I am maintaining my low-carb diet (type II diabetes) and walking
Those last 6 pounds happened because of TKR. I am eating more than pre-surgery, though keeping a healthy diet. But I am walking so MUCH MORE. Before my surgery, I walked maybe 500 steps a day.
That number was so sad, so depressing, that I stopped wearing my Fitbit. I mean, who wants to be reminded all day long that they are walking that little? Heck, 700 steps was a good day, probably spent grocery shopping. It was bad.Now I walk 3000 steps a day even if I don't take a long walk. If I take a long walk, up that to 5000. And occasionally I do more. Mostly, though, between 3000-5000. Consider that number: between 7 and 10 times MORE activity than before surgery.
It's hardly the healthy 10,000 steps recommended by fitness studies, but it's a big step up from where I started.I'm not really trying to lose weight right now. It's a goal, but the real motivation for all that walking is to rehab my knees and my life. I want my legs to become strong again. I want my knees to loosen up and regain full ROM. I want to become again that active person I was 10 years ago. Those are the primary goals. Do I hope weight loss will follow? You betcha. That's not the reason I got my knees replaced, but it's sure a wanted side effect.
Last edited by a moderator:
sandi4213
graduate
Great report Susie! The best part, I think, is that you are establishing new, healthy habits. As the rehabbing evolves into healthy living, you will have all these goid habits in place. Congratulations on such a great job. 
OP
OP
SusieShoes
Former BoneSmart staff member
I could use some good habits. I sure have enough bad ones! 
Polkadot
graduate
I have had a similar experience with losing weight with TKR. I'm not obsessing over it, but I am trying to keep up the good habits that have been established of necessity due to the TKR--eating three meals a day so narcotics could be taken, eating small meals so the narcotics didn't nauseate me, and eating low-carb meals because when meals are small, we have to get protein and nutrients, and that means there's very little room for empty carbs. My weight loss has progressed beyond the expected surgery weight loss, so if I can keep away from some favorite "triggers," I may be able to continue losing. That would be a blessing!
Pheebs52
big-cheese
My cardiologist has been rightfully on my back for the last year about losing 20 pounds. I never did it. Now, post TKR, I've somehow shed 10! I know it's due to more protein, less carbs and more exercise, 'cuz nothing else makes sense. When I mentioned this to my dahling brother he said "Wow, congratulations! Your old, natural knee must've been very heavy!" 
kmak81230
post-grad
About 7 or 8 years ago I lost about 50 lbs. I was hoping it would help my knees last a little longer (it did), hoping to have better lipid numbers (mixed results), sick of my "fat" clothes(got rid of garbage bags full - YEAH), and tired of being so slow riding up mountain passes on my road bike. I promised myself a new road bike if I met my goal - so was able to get a sweet new road bike. I kept most of it off - every now and then some creeping back upward so have done a bit of yo-yoing over the past 8-10 years. When I decided to get the first TKR I got my weight back down and then lost another 5 lbs post-surgery. I've put some of that back on in the past few weeks but am hoping that with increased walking and other activities I can keep it in check. I'd like to lose about 15 more lbs but am going to just focus on keeping active, getting stronger and eating healthy instead of daily scale monitoring.
Polkadot
graduate
I've lost 26 so far from the measurements taken just before surgery. Would like to double that. @Pheebs52 , I did toy with the idea of asking the OS whether or not my "old" knee plus inflammation could be THAT heavy! If that's so, all I'd need to do would be to get the other knee done. 
(It's SO not happening, hopefully never, but at least not for quite a while!). 
(It's SO not happening, hopefully never, but at least not for quite a while!).
Pheebs52
big-cheese
gertie
post-grad
Oh, yes! A wonderful--and realistic--goal. Not striving for the knees we had at age 25 but 10 years ago? Sure thing.
gertie
post-grad
Ha! If only!
OP
OP
SusieShoes
Former BoneSmart staff member
@gertie, if only I could have the body I had at 25! That body could have ruled the world, had I but known how to use it. Alas, I did not. But it was a really nice body and I wouldn't mind having it back, except it seriously can never happen. Among other things, I lost some non-vital parts along the way. Not much missed, especially those knees. These new ones are better than I had expected and I'm dead set on keeping them.
@Pheebs52 and @Polkadot, ever curious as I am, I made a few calls and did some research to find out the weight difference between an original issue knee and one implant. And that difference is... about a half pound, with the implant weighing more than original issue. My OS told me my DePuy Attune implant weighs .94 pounds. He didn't weigh the bone or other stuff he removed, so that part's an estimate. Anyway, it appears if anything I gained a pound from my bilateral replacements.
I have noticed these new knees *feel* heavier when I put them one atop the other while lying on my side. They also feel harder and bumpier. They are also rock solid and stable, so a pretty good trade off!
@Pheebs52 and @Polkadot, ever curious as I am, I made a few calls and did some research to find out the weight difference between an original issue knee and one implant. And that difference is... about a half pound, with the implant weighing more than original issue. My OS told me my DePuy Attune implant weighs .94 pounds. He didn't weigh the bone or other stuff he removed, so that part's an estimate. Anyway, it appears if anything I gained a pound from my bilateral replacements.
I have noticed these new knees *feel* heavier when I put them one atop the other while lying on my side. They also feel harder and bumpier. They are also rock solid and stable, so a pretty good trade off!
OP
OP
SusieShoes
Former BoneSmart staff member
@kmak81230, what a stunning weight loss! Shedding weight is not an easy thing to do. About five years ago, upon learning I had diabetes (big surprise, because I'd gone into surgery without it) I shed 70 pounds. Doing so did help my knees last a little longer, though my needing TKR eventually was never in doubt. Still, I bought some time. And new clothes. A whole new wardrobe, and I tossed all the "fat" clothes. I'm still overweight, indeed clinically obese, as my pictures show, and so would like to lose more. From past experience, I know it will happen best if I can exercise and, like you said, aim to be as fit and strong and active as possible, rather than obsessing over numbers on a scale.
Way to go Susie! Great weight loss and healthy eating. I lost about 15 lbs post surgery due I am sure to the nausea from the drugs and the lack of regularity which caused lack of appetite. However since I have been feeling better I have been baking as a pick me up. Unfortunately I have picked me up about 4 of those lost pounds Booo! Guess I need to find a new activity!
Pheebs52
big-cheese
@Canada35, and that is exactly why I stopped baking about 10 years ago, lol! Mistah doesn't have a "sweet-tooth" but I sure do!
@SusieShoes, I second your style of weight-loss. I only stand on the scale about once every two weeks, just to make sure things aren't creeping up. So far, so good!
Thanks for doing the research on knee weight, lol! I did the same when I had my hip replaced and found the implant was actually quite a bit heavier....perhaps by roughly a pound. I know what you mean about the bionic feeling heavier. It definitely does, but also feels as you said, much sturdier. When I lay on my side and both knees touch, it's clear to me that something metallic is in there. I think that's when I most notice the *heavier* aspect.
@kmak81230, huge congratulations on shedding so many pounds, but best of all, keeping them off!
I was actually fairly thin (5'5", 138 lbs.) and active when my hip and right knee began to ache from arthritis. While I fully understand that less weight=less pressure on the knees, it certainly didn't prevent OA's development for me, nor reduce the pain. Some might say the pain would have been worse if I'd been heavier at that time, but honestly, I fail to see how it could've been. Now, five years after THR, I wonder if the additional pounds I've gained (25) contributed somehow to the torn meniscus that led to TKR? I've no idea, and no way to test this theory, but I suspect it's not a factor.
@SusieShoes, I second your style of weight-loss. I only stand on the scale about once every two weeks, just to make sure things aren't creeping up. So far, so good!
Thanks for doing the research on knee weight, lol! I did the same when I had my hip replaced and found the implant was actually quite a bit heavier....perhaps by roughly a pound. I know what you mean about the bionic feeling heavier. It definitely does, but also feels as you said, much sturdier. When I lay on my side and both knees touch, it's clear to me that something metallic is in there. I think that's when I most notice the *heavier* aspect.
@kmak81230, huge congratulations on shedding so many pounds, but best of all, keeping them off!
I was actually fairly thin (5'5", 138 lbs.) and active when my hip and right knee began to ache from arthritis. While I fully understand that less weight=less pressure on the knees, it certainly didn't prevent OA's development for me, nor reduce the pain. Some might say the pain would have been worse if I'd been heavier at that time, but honestly, I fail to see how it could've been. Now, five years after THR, I wonder if the additional pounds I've gained (25) contributed somehow to the torn meniscus that led to TKR? I've no idea, and no way to test this theory, but I suspect it's not a factor.
liam2015
post-grad
congrats @SusieShoes and @kmak81230 for the weight loss you accomplished. funny story (hubby is a tease): when we got our now 1-3/4 y.o. pup (liam) i lost around 10 lbs. in the first couple weeks we had him as we couldn't eat when he was out of his crate as he would constantly try to grab, not to mention taking him for lots of walks, even in the middle of the night for potty training. (that aspect of training went very well with no problems). we put him in his crate whenever we sat down at the dining room table to eat, but we could never sit and watch t.v. with a snack which is what we did before liam. guess what hubby said when i told him i lost 10 lbs.? he said maybe we should get another puppy...hmmmm!!!
Polkadot
graduate
@SusieShoes - Well, golly geez, then every time I weigh myself, I'm taking off that half pound!
