Bilateral TKR The "tweens" Thelma and Louise were born 11 Jan, 2016

MerciQ, it's good to hear you are doing so well. I good night's sleep is a gift from God! I pray that I do as well as you have been doing when I have mine done. I'm 'interviewing' a new OS Friday. I pray I can hear God's will about him. If I don't feel he's right, I'm on to another one! With reading your threads and other bilaterals, if I find a doctor to agree to it, that's what I'll do. I don't know if the lack of kneecaps with be a deterrent or not. I'd like to think that without them, there would be less work to do!! Got to think positive. I, too, have been reading the depression thread. I am pretty much facing this alone. But, with BSmarties here I am not alone except physically.
 
I was going to mention the depression thread, but you're doing so well, you've already been there. Good for you. Taking good care of yourself. Keep up the great recovery.
 
Timetolive, PegGar16, New England Librarian and PolarBear60 - thanks for your words of encouragement, all true and welcomed. I'm certainly taking the time to gauge the down time and I don't want to risk rushing my return. I've been working on my "To - Do" list and that has helped, some tasks are more fun than others, but still gives me something to do. I do welcome when a drowsy spell comes over me and I take the cue just in case the night sleep is not as good. I alternate rest periods (elevating and icing) with recumbent bike and short walks in the house to stay active, I also do minor shores around the house in sections, like meal preparation and doggy duties. The short periods of activity and the mild tightness around my knees, lets me know I still need more time and helps me to rethink my return to regular activity. I may start the outline on the book I've been meaning to write for years.

Last night I had another better night sleep, waking up and while first standing I did notice that this morning, weight bearing ability on my right leg had improved from yesterday, the difference was minor but noticeable. I have approximately 25 to 30 steps from my bed to my on suite bathroom, until yesterday, it took the full distance for my leg to "warm up", today, I was at my "normal" post op gait at halfway the distance. It brought a smile to my face. While up and walking my gait is guarded but steady. I don't feel my knee joints any differently from before surgery and I hear no clonks or clicks when I walk.

I had asked my OS prior to surgery regarding the prosthesis he uses. I found out that the prosthesis an OS uses is determined by the hospital where the surgery is performed, at least that is the case in my area. The name of my prosthesis is Biomet XP Cruciate Sparing. I also found out that while cruciate sparing is an option, my OS does cut the ACL and does preserve the PCL. My OS also told me that there was minimal to no clonks-clicks associated with Biomet, which was welcomed news. Surprisingly, it is also a very low profile prosthesis.

[Bonesmart.org] The "tweens" Thelma and Louise were born 11 Jan, 2016


I do notice occasionally that I experience a mild instability while walking/standing on either one or the other knee, I usually catch it quickly and steady myself. I suppose this is part of what some say is "learning to walk" again.

I'm extremely pleased with my OS, his surgical technique, aftercare and his office staff, they are not perfect, but I attribute a large part of my recovery to his expertise.

I'm pleased with my recovery process, but cant help wishing for faster process, then I think, "wow, it's only been 4 weeks, this is major, major surgery and I'm walking without any pain". I'm very fortunate.

@sistersinhim, hang in there and keep doing your research. I researched my OS and he came up as the number 1 in my area, he has not disappointed, best of all, he agreed to perform a bilateral procedure which was number one on my wish list. I don't know the implications of no knee caps, but I tend to agree with your assessment, less work, my knee caps did have to be refaced and fitted with a "button", so definitely took more time. Surgical time is one of the main criteria taken into consideration when deciding to move forward with a bilateral replacement. One other criteria is age or candidate is ideally under 65 yrs. old. Finally, state of health with minimal co-morbidities that could put the patient's health at risk. The advantage in my opinion is that the bilateral procedure can be performed under a spinal anesthetic instead of General anesthesia, this was a huge win for me. Fell asleep and woke up after surgery without ANY recuperation or complications, I was able to have a regular meal the evening of surgery. I'm so happy that I was able to get both my knees done at once. I hope you get what you want. I did have help, but I know that if I didn't, I would have probably been able to handle it.

Thank you all for your comments.
 
When my knee began clunking, I eventually figured out I needed to pick my foot up more when I walked. Not in an exaggerated way, but just a little. I attributed it to having a proper gait, and it makes me smile, because it's my knee reminding me what I need to do. What a smart knee, eh?

Keep up the good work, MerciQ!
 
@MerciQ, thank you for all your suggestions. How did you find out who the number one is in your area? When I google it, just a bunch of OSs come up in my area. I would love to not have GA like you did. Do you remember anything at all about the actual surgery? That would be scary. Every time I have GA, I end up sick for days, even with anti-nauseous medicine. Many times the after effects are worse than the wounds from surgery! That is one of the questions I'll ask this new doctor. Also, if he believes in 'no pain, no gain' therapy. If so, forget him unless he agrees to the BS way! Your xrays look great! A question about your left one...what is the 'plate-like' thing between the implant? How nice it is to see xrays with gaps between the bones! I haven't seen that in ages.
 
@PolarBear60, very smart knee indeed, LOL! Glad you figured out what caused it.
@sistersinhim, I googled several questions about best OS including my general area, zip code, town, etc. I'm not sure which combination brought up his name, I also compared results with the healthgrades.com website and also searched for reviews in several sites.
In addition to the spinal, which only lasts approximately 4 hours, I was given sedation, along with femoral blocks for pain, which remained in for almost 3 days, couldn't walk while they were in; I don't remember anything during the actual surgery. my surgery took just under 4 hours, but they didn't want to risk it, so towards the end I was also given a sciatic nerve block to my right and second knee. This was a discussion with the anesthesiologist but they follow the doctors lead/preference, I'm sure this is something you can discuss with your OS. This approach is less risky, but the candidate must be in good respiratory health otherwise they prefer to intubate and GA. If I ever need another surgery (God forbid), I do hope I can go the Spinal/Sedation route, it was awesome.
If the OS prefers "No Pain - No Gain", I would not make that a deal breaker, my OS believes in that mantra, however, I've managed to side track it and follow my own preference. After surgery, he insisted that I have the aggressive PT, I recited my numbers and how they had gone backwards due to the aggressive rehab and he did not rebuff my statement. I have surpassed all his goals and expectation without the aggression. As far as PT, same story, I told them I was willing to work to the point of discomfort but not pain right up front, it has not been an issue since.
Good catch about the plate, I asked the same question. He said that both knees have the same plate, it was just the angle of the X-ray. I'm still amazed that I have two metal knees.
 
I've been to healthgrades.com, the Surgeon Scorecard and many more sites and have contacted a few OS via email. Today, when I got home I had an email from a doctor's PA that said that he has done replacements on patients without kneecaps and would see me! And he is within about 20 of me! What an answer to prayers! I can't get in to see him until 3/17, but I'm willing to wait. Before I see him I'm seeing an OS about 50 miles away that has done over 6000 joint replacements. I don't know if he has done any knees without caps, but with that huge number, I bet he has. I have prayed that God would help me in this search, and He is! Now, I just have to be able to hear His Will! Great that you were able to do your PT the way you wanted to do it. With all I've read here I will also do it my way, too. How are you doing today? Does the cold hurt you? It's amazing that we ice and it helps but go outside in the cold and it hurts. Wonder why!
 
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@sistersinhim, too bad you have to wait, but glad you have prospective OSs. It's not too cold here in Florida, and it should not be a factor when I travel up north. What has affected me (tightness in the knee) has been humid and rainy days, last week and this week we've had both, which is not the norm and my knees have "complained". I know there is a correlation between bones and humidity, don't know the "science" behind it, but it is definitely there. Icing has been extremely helpful, I expect that when I travel up north, cold temperatures will help.

I had my PT and 4 week visit with my OS today. I continue to notice small progress, I'm now able to do leg raises, both legs without any effort. The OS was amazed at my measurements in the 120's, not too concerned about my Extension. His goal for his patient's at 6 weeks is 90 degrees, I'm way ahead of that goal.

He did release me to fly and drive, I'm so excited! He does not feel that I'm ready to go back to work (neither do I), wants me to complete another 6 weeks of PT. I'll see about the 6 weeks of PT, I've completed all the routines without any problem. I'm wondering at what point PT stops being helpful, especially when the exercises are no longer challenging. Not sure.
 
@MerciQ you are doing absolutely amazing! How encouraging you are to me! And I bet to your OS, too. Maybe he'll realize that the BoneSmart way is the smart way and not inflict painful and harmful PT on future TKR recipients. How silly of me to not realize that it's a whole lot warmer in Florida than it is here in Virginia. I think maybe you hit it on the head about the cold weather up here hurting our knees. It's the moisture in the air along with the cold that hurts. When we ice, it's dry, not moist. Are you finding that PT is doing things for you that you can't do at home? Maybe you can do it all at home yourself. It sounds like starting with rocking motions on a recumbent bike is a normal starting place for a lot of you and I'm looking for a used one, but haven't been able to find a suitable one yet. I did get the shower seat and portable potty at a local 2nd. hand store!! Save lots of $$$$!
 
@sistersinhim, I'm so glad to return the favor, this site has been a great help to my journey, It's good to know that my experience can help someone else in return. This surgery is challenging and we need all the encouragement we can get. I'm extremely pleased with my progress, but I don't want to give anyone the wrong impression. I had a very successful surgery and first few days overall and I'm way ahead of most, if not all expectations. I was hoping that I would continue doubling up on the progress as days have passed, but that has not been the case, don't get me wrong, each day I see a little more improvement. However, I still have discomfort, minor swelling and tightness after standing/walking for more than 10 minutes, sleeping at night is sometimes challenging. What I'm trying to say is that just because I'm doing better than expected, it doesn't mean that I'm fully recovered, far from it. I will need to continue rehabbing my hamstrings, muscles and soft tissue that were affected during surgery. I know that eventually I'll get back to almost normal and the best part is that the horrible pain I had before is already gone.
Check Craig's list for the recumbent bike, I found one for $50. and it has been a great help. I also found all the pieces you mention (Amazon) to make your home comfortable at very reasonable prices. I have not used the bedside commode. I would recommend a toilet raiser with side handles or you can place the commode over the toilet without the bucket. The toilet raiser has been one of the best investments I made.
 
I have the toilet riser that I bought for my shoulder surgery, but I use that in the den bath, where my recliner is. When I finally am able to get into my bed, I'll need one for the master bathroom, the den bathroom is too far. The portable potty is perfect height!

I pray you continue on your road to recovery. Hopefully, I'll soon be getting my two new knees!
 
Sounds like a plan. I know you will do OK, I will continue to report from time to time.
 
Today marks the 5th week since surgery. I can't want for anything better. I was cleared to drive on my last Tuesday's appointment with my OS! I had no trouble getting into and out of my sedan. I'm OK getting in and out for our (very high) SUV. Went and had my nails done, got some of my independence back. Did stairs, up and down, last Friday with my PT, did all the other routines really well. Although my OS prescribed PT through the end of March, she explained that as long as I can reach/master all the bench marks, I can be discharged from PT sooner, judging from her list, I've meet most of them. My Flexion and Extension are getting better each week. Side affects from the opioids have been very difficult, especially with constipation; totally wore me out over the weekend and managed to get through it. I stopped my heavy duty pain meds since Saturday, still taking NSAIDs and muscle relaxants and this approach has worked. I have felt no pain to speak of. Still icing. I'm keeping the option to take Percocet over night just in case, but I have not had to the last two nights. I weighted my self today and I'm down 17.5 lbs. one of the positive side affects of the opioids, I hope I can lose another 10 lbs, that would be awesome!

I'm planning to re-assess but as of now, I plan to return to work March 1st. I've been testing sitting with my legs down, trying to mimic sitting in a plane for 2+ hours and that has been working well. My OS also cleared me to fly. I will likely need to continue icing, which should be doable if I can return to my prior client, if not, I may have to extend my return to work by a couple of more weeks. I can walk with no assistance, although I still keep the walker near my bed at night and I do take my cane on outings "just in case". My knees do get heavy if I'm on my feet for more than 10 minutes or so. Luckily, I sit for most of my work day with intermittent short walks to meetings within the building. I'm waiting to get confirmation on my return.
 
Wow! How blessed you have been! I can't believe you are doing so well after only 5 weeks and I know driving and being able to do 'girl' things has been liberating! Being able to sit down with the legs bent is a milestone. I look forward to that day! I pray you keep up with the good recovery.
 
MerciQ you are doing great! Are you back at work now? How is it going?

I am in my 9th week btkr. I still have the very tight feeling around the knees. I don't know what my ROM is now, last time it was checked it was around 100. I don't see my OS since it was at Mayo Clinic, will check in with them at the 3 month period. I stopped all PT and was thinking about swimming in the near future. I can drive but I can't see myself walking into the facility from the car alone. Maybe I will have to make many stops to rest, tho I doubt the chairs will be high enough to get out of alone. My walking is not very good for any duration. I should do more walking in my house. When I overdo it I collapse the next day and do nothing.
 
Maybe in a few weeks you can hit the pool.
 

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