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Bilateral TKR Two New Knees- My journey back to life with BTKR

CarrieBTW

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I had both knees replaced (bilateral total knee replacement) on Dec 13. I was a younger candidate (44yrs) but was told my knees were that of an 80yr old. As of this post, I am 2 days away from my 6 week milestone. Finding this forum late, so will make this first post a “catch-up” on some of my recovery.
Day 0: Surgery Day- drains in both legs, retransfused with own blood, very difficult to move legs at all, moved with assistance from bed to bedside chair.
Day 1: 2 Times PT, one time OT. Surprisingly (to me) didn’t hurt to stand with a walker. Just hurt to bend at all.
Day 2: More PT (was able to get 72° bend in both knees) and was released to home. Was able to climb stairs at home while holding railing and using cane.
Day 4: Home PT. Got left knee to 83° and right knee to 90°
Day 8: up to 93° in left knee, 100° in right. Spending days 85% in bed. No attention span still, dozing most of day- always exhausted.
Day 16: no longer dependent at all on walker, just a cane. Doing PT twice a week. Short outings out of house- such as grocery store (using their power scooter). ROM up to 107° in left and 115° in right. This was also my turning point of 100% exhaustion all day to feeling like I could be awake for a couple hours and feel energized.
Week 3.5: with doctor’s permission, flew with my son for a college audition. I wore compression stockings and iced on the plane. I made sure to get up often, even to stand. I did use a wheelchair in the airport, as I was afraid of overdoing it by walking too much in the terminals. ROM now up to 115° in left and 120° in right. This is where it remains today (at almost 6 weeks).
Week 4.5: no cane needed. Still 2 PT visits per week. Doing land and water physical therapy. Also added in recumbent bike. On off days, I do home exercises and have been doing bike at the gym.
Today (Week 5.5): Exhaustion is my main enemy. I need at least two naps a day, and cannot sleep through the night. I’m only taking Tylenol except for after PT sessions- then I take a Hydrocodone/Tylenol pill. Pain is less, but I know there is a lot of internal healing to do.

Welcoming support and advice from my fellow TKR’s!
 

amymj

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Wow, Carrie! you are doing amazing! I cannot imagine two at once, although I just had my second done a week ago! You have done so well, keep the faith, it truly is a journey. Keep us informed!
 

Pumpkln

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@CarrieBTW ,
Welcome to BoneSmart, glad you joined us!

Sounds like you are doing very well, your ROM is great.
Your sleeping pattern is normal after joint replacement and will improve with time.
Sleep deprivation is pretty much inevitable - but what causes it?

Here are the recovery guidelines, the articles are short and will not take long to read.

Knee Recovery: The Guidelines

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
5. At week 4 and after you should follow this

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.
 

SusieShoes

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You’re having a stellar recovery. You’re a braver woman than I am to have traveled so soon, but you handled it like a champ. Right now you’re in the “dog days” of recovery: lots of improvement, but the days drag because of energy drain and sleep disruption. Both of those should resolve soon.

Best surprise of TKR... standing up and realizing your arthritis pain is gone! Like totally. Gone. :roseshwr:
 
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CarrieBTW

CarrieBTW

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You’re having a stellar recovery. You’re a braver woman than I am to have traveled so soon, but you handled it like a champ. Right now you’re in the “dog days” of recovery: lots of improvement, but the days drag because of energy drain and sleep disruption. Both of those should resolve soon.

Best surprise of TKR... standing up and realizing your arthritis pain is gone! Like totally. Gone. :roseshwr:
Oh my gosh, yes- standing with no pain was a huge win! I’ve noticed I have to re-train myself to walk standing straight up and not hunched. I got so used to walking that way for pain. When I used to go to the grocery store- I wound hold on to the cart for dear life!
 

Roy Gardiner

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Hi, CarrieBTW, welcome to BoneSmart.

Cause...
Doing land and water physical therapy. Also added in recumbent bike. On off days, I do home exercises and have been doing bike at the gym.
...and effect
Exhaustion is my main enemy.
Remember, your body needs ALL your energy for healing.

There is no need to do any exercise that raises your heart rate or causes you to breathe even slightly heavily.

If your leg is stiff and swollen then using an exercise bike for training is not a good idea; but you can still use one for mobility exercises.
  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Here is a bit more chat and some pix http://bonesmart.org/forum/threads/rom-and-extension-stretches.13159/page-3#post-423701
 

jboles

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It seems like you are doing really well. I’m so looking forward to walking straight up again, not hanging onto the shopping cart, and not leaning over watching every step. I’m not feeling nearly as much energy drain as last time, but I got my anemia under control before surgery, how is your blood count?
 

SherrieT

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You are doing wonderful!. I was wondering today if I will regain the height I've lost once I can straighten my knees all the way. Can't wait to hear about all the wonderful things you are now able to do.
 
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CarrieBTW

CarrieBTW

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Six weeks post surgery, as of yesterday.
I decided to cut back on formal Physical Therapy, and concentrate on home exercises to keep flexion. I also cut back on the bike at the gym- as I think (I know) I was overdoing it. I’m loosening up on the bike only, and then moving to the pool for light exercises. I’ve noticed I only need one nap a day now (could be correlation with less aggressive activity, or could be healing related)- which is good because I feel more “normal”.
My knees are still both bruised up from surgery. They look better, but still not going to win any beauty contests :)
Any suggestions from anyone on treatments to minimize scars or promote better internal healing?
 

sistersinhim

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You can not speed up your healing inside or outside. And don't worry about the scar. It will become a thin line.

Great on needed just one nap a day. That means your energy drain is getting some better. Are you sleeping at night better?
 
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CarrieBTW

CarrieBTW

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You can not speed up your healing inside or outside. And don't worry about the scar. It will become a thin line.

Great on needed just one nap a day. That means your energy drain is getting some better. Are you sleeping at night better?
@sistersinhim I still don’t have a good nighttime rhythm yet- some nights I sleep great, but many nights I wake every hour or two.
 

sistersinhim

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That has been a problem for most of us who has had a tkr. Just sleep whenever and wherever you can. While you're sleeping, you're healing even better!
 
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CarrieBTW

CarrieBTW

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7.5 weeks post surgery, and it’s been a rough week. I decided to stop taking my hydrocodone (Norco) entirely, as I felt like my pain was better managed by just Tylenol at this point. Unfortunately, I didn’t read the BoneSmart article about tapering off opioids first. This led to a horrible few days of dependence withdrawals. My ortho surgeon and my PCP both recommended Benadryl to ease some of the symptoms. It took 4 full days to feel like myself again.
 

mlwreader

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It took 4 full days to feel like myself again.
@CarrieBTW Me too - stomach cramps, anxious, restless, all of it. I had a milder bit of withdrawal when coming off the Tramadol as well. Now, at almost five months, I rarely take anything at all. I did take two tylenol the other day, for some reason the lefty decided to talk to me a bit. I didn't know about the benadryl, that would have been a good idea.
 

GingerP

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@CarrieBTW , you are an inspiration to those of us doing one knee at a time. I couldn't in my wildest imagination think of doing both knees at once. Well, that and the docs wouldn't allow it since I have bmi issues for surgery too - oh, and most don't do bilateral knees around my area.
I saw my surgeon one week after I left the hospital, and I was on the hospital 4 days so I guess in 10 days and he suggested that I start weaning off my Norco and just take tramadol and Tylenol. Not once do I know of anyone telling me to 'wean' myself off. Perhaps those 10 days were not too much. Then a week later I stopped taking Tramadol and since then I have been on Tylenol only for the last 4 days. I am one that has been on tramadol for many years having had both his replaced and now both knees replaced. It is freeing to think I don't have to use potent pills to deal with pain. I am doing well with pain control now and greatly appreciate that. Getting up from a chair and taking a step right a way is fun too - no thoughts if my knee is coming with me or not!
Keep up the good work! Continted healing!!
 
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CarrieBTW

CarrieBTW

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@GingerP That is great that you haven’t had to rely on the potent pills! Wow- both hips and both knees...you have really been through it all! I had same issue with getting up from chairs in the early days.
Happy healing to you!
 

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