Bilateral TKR Bilateral TKR

[WFD]

...all y'all

“Y’all” is singular and “all y’all” is the plural form. My wife is from the South and is a Linguist by profession.

 

[Xsbank]

One fun part of this long recovery is a part that few talk about, all the nonsense around opiates. I'm having a lot of trouble renewing my Tramadol prescription because the surgeon is very busy. My supply will run out today and I am no where near controlling my pain, certainly not with Tylenol. So I asked the pharmacist for an emergency supply to take me through until Monday and you'd think I had desecrated the flag. I get that some abuse these meds but to add insult to injury, the irony is in BC we have "safer supply" so that every person who is an addict can get free hydromorphone. That has nothing to do with me but because I am a legitimate user, (and had stopped the Dilaudid a week or so ago) I can't get a day's worth without "special form this" or "special rule that." I am suddenly some nefarious abuser and all the Miss Grundys are telling me how I'm an awful person. Just what I need, another barrier to recovery.

 

[benne68]

Yes, @Xsbank, that's. an issue for us here in the U.S. too. Unfortunately, the opiod crisis has made the entire medical community wary and no one wants to prescribe any drug in that category for more than a week.

That's why we encourage taking a multi-modal approach to pain management. Are you icing and elevating often during the day? Be sure to ice for at least 30-45 minutes at a time; the longer the better.

Also, be sure you are taking enough Tylenol: 2 extra strength tables (500 mg each) every six hours (4 times a day) -- as long as none of your other medications contain acetaminophen. It's important not to exceed 4000 mgs/day.
Also, remember that it's important to stay ahead of the pain by taking them on a regular schedule. As a reminder, here is a link to the pain management chart https://bonesmart.org/forum/threads...ing-pain-after-a-tkr-and-the-pain-chart.7969/

 

[Jockette]

Another way to keep pain down is to not do too much that increases it, like too many of the exercises we’re told to do. Movement is good for your healing knee, but keep it simple and gentle. All you need in these first days and weeks are gentle bends and short walks. This way, you will need less of those prescription pain relievers.

 

[Layla]

One fun part of this long recovery is a part that few talk about, all the nonsense around opiates

You're not alone. It is actually discussed here fairly often. I hope you're able to obtain the pain relief you deserve at this point in time. Hopefully you're devoting some time to icing because it should help also.
Best Wishes for your recovery. Thanks for sharing it with us.

 

[Xsbank]

Slowly making progress, I think. I have about 108* flex on the right and about 100 on the left, still not close to being able to straighten either of them. Then again, I had been unable to straighten my left leg for 3 or 4 years...
I stopped taking the Dilaudid about 10 days ago and replaced each dose with 2 Tramadol. That is now down to 1 Tramadol every 5 hours so that is a huge plus (also Tylenol and Celebrex).
I still wake up far too often but that is getting a bit better and its not all my knee's fault as I am drinking lots of water...
Your brain produces dopamine to make you feel good and opiates attach to your dopamine receptors, making you think you are happy. It occurred to me that if you are anxious or stressed or unhappy, you will not make as much dopamine so I am experimenting with no news, no shoot-em-ups, no murder mysteries and I can imagine that meditation might be good too but try and lose the stress, the anxiety and I think that will help with recovery.
Still haven't ventured outside with my walker but I think this weekend is likely. We'll see. I want to start adding walks to my isometrics as my muscle tone is awful.
The one thing I have learned in this entire process is to endure, wait, no rushing, no pushing and definitely lose the anxiety. Stop the pain by not pushing into it or use the drugs as needed.
It doesn't all go as planned but if it's not, keep icing, waiting and being gentle with yourself as you just aren't there yet. But you will be.
And for any of you still on opiates, I have one word for you - prunes...

 

[mendogal]

You're doing great!

And attitude-wise you're right about pain and stress: both generalized anxiety and anticipatory anxiety about the return of pain create greater sensitivity to pain, and there we have a vicious cycle. Anything we can do to interfere with the cycle is a great help.

Having had issues with chronic pain, I've learned that distraction is one of my most potent tools.

Getting out of the house for fresh air and short walks was a wonderful tonic for me. And as I (very slowly) gained strength and stamina I discovered that as long as I respected their time and distance limits my knees really liked walking! I look forward to your update after you have ventured out.

 

[Xsbank]

Haven't been out yet, I am walking about the house a lot though. I am also weaning myself off the opiates but still not pain free. Sorta kinda boring life right now, interrupted with bouts of pain but I am definitely improving and having had a broken collar bone during Covid has helped prep me for this forced idleness.

Pee bottles, prunes and ice ice ice!

 

[Jockette]

had a broken collar bone during Covid has helped prep me for this forced idleness.

Sorry about the broken collar bone!

Remember, don’t look at this forced idleness as doing nothing, look at it as giving your knee its best opportunity in which to heal!

 

[Layla]

Hello and Happy Friday, Xsbank
How is the healing process going? Let us know if you are up to sharing an update.
Wishing you a wonderful weekend!
@Xsbank

 

[Xsbank]

Same back atcha!
I have hit a plateau; no improvement for a week or so and still not sleeping (last night was the worst for a while) but I sat out in the sunshine, had visits from Both my kids, a neighbour brought me a sandwich and I am comfortably ensconced in my Covid chair. Oh Sonia brought me some more grapes!
Icing a lot and sorta kinda doing my isometrics and reading a lot. When I walk about the house I get swelling after and I still have a one-Tramadol-every-5-hours-level pain. This week I go for my first PT out of the house.
This week will be better.

 

[mendogal]

Glad you got some sun therapy and visits!

Reading your update, I have to wonder if shorter walks will be the key to less swelling, thereby getting you off this plateau?

Mind you, plateaus do happen during this process... and quietly there is healing happening on a cellular level... yet if you swell after walking that tells us something.

 

[Layla]

Thanks for the update!
Plateaus are no fun, but they happen. I hope you slept better last night.
But...YAY for sunshine, visiting kids, neighbors and grapes! Sounds like you're loved and well cared for.
I like your optimism...The coming week WILL be better!
Happy Weekend!
@Xsbank

 

[AlyCat]

Well hello Xsbank from a Vancouver Islander who also gave up on the BC system. They would not touch my knees due to my age and their perception that it wasn’t bad enough via radiographs to justify. After 2+ years fighting with my surgeon and several useless injections I also bailed and went private. Off to Montreal (Duval) and had both knees done on January 25 so I’m just coming up on 3 months. The surgeon graded all but 1 site as 4/4 with several bone on bone locations. I am so glad that you believed in your own health assessment and was unwilling to continue suffering. The BC system really is failing so many people.

As I’m sure others have mentioned, it’s a slow improvement game. I’m not so good at taking it easy and bounce around between good and bad days a lot more than I should due to being a chartered member in the ODIC (overdoing it club). Suspect that won’t be changing any time soon as that’s how I roll, lol, but not recommended.

Day to day it often seems like nothing is improving but when I look back over a week or two I definitely see it. Keep you chin (and knee) up and stay positive, it does get better. I’m not at the point where I’m on par with my presurgical levels yet but I’m getting close. Going down stairs first thing in the morning, or rising from a chair is a bit better than before, but I’m not able to engage in my usual physically activities. It will come and I know that. I know that will happen for you as well.

As for sleeping, I’m have never been a back sleeper so this was tough! It took me a full two months to be able to sleep on my side for 1-2 hour stints before desperately needing to shift (which involves fully waking up). At 3 months I’m up maybe 50-60% of pre surgical levels…but that’s way better than even a month ago. With one knee, I hope you find a comfy position sooner than I did. My advice is stay ahead of the pain and try to ice just before sleeping.

Happy to stay connected with you and be here for support or questions as my journey is just ahead of yours so everything is fresh in my mind…whether I like it or not! Go Canucks!

 

[Xsbank]

I had both done in Montreal at a different clinic and I'm pleased with the result so far but I'm still in some pain. Fortunately I have no stairs to negotiate so that's a plus.
Yes, keep in touch. At this stage I'm finding it difficult to stay positive but I'm working at it.
It was one month yesterday.

 

[Jockette]

At this stage I'm finding it difficult to stay positive but I'm working at it.
It was one month yesterday.

Still very early days in this recovery that takes an average of a year. Healing both knees at the same time takes double the energy drain.

Maybe take a look at this article from the Recovery Guidelines:

Post op blues is a reality - be prepared for it

Post op blues is feeling depressed, weepy, nervy, shaky, fearful of the future, anxious, overwhelmed by what is happening to you, convinced it's never going to get any better and finally, uttering that most intense of all cries "I wish I never had this done!" It arises out of a variety of...

bonesmart.org

I sat out in the sunshine, had visits from Both my kids, a neighbour brought me a sandwich and I am comfortably ensconced in my Covid chair. Oh Sonia brought me some more grapes!

Definitely good rehab activities!

 

[Layla]

A belated Happy One Month Annuversary!
You get two cupcakes because we missed that special milestone, one for each new knee.
I hope your week is a good one!
@Xsbank

 

[Xsbank]

I'm off to check my mailbox...Mmmmm cupcakes....

 

[Xsbank]

A physio I saw suggested that I put vitamin E on my scars - is that a reasonable recommendation or is there anything else I should do with them?

Also, icing. I have used gel packs and an ice machine on my knees regularly but always of the front. It occurred to me today that maybe I should surround the knee with ice? Does it matter?

Slow progress, I'll have one good day and then a couple of bad ones, rinse repeat. I haven't lost the plot yet except my lovely wife is getting close. I shoo her out of the house as often as I can and make her do her regular, usual activities and she's getting used to the fact that I can load my own dishes in the dish washer and can sit for a short while at the dining table.

We're still married.

 

[Layla]

When Can I Safely Put Lotions And Creams On My Incision?

Sometimes the skin around your incision becomes dry and itchy while healing. Although it is okay to put lotion or cream on the surrounding skin if it is uncomfortable, you should not apply anything close to or on the stitches or incision without the approval of your surgeon. It normally takes four to six weeks for the incision to fully heal and close. You don't want to risk infection by applying a product near an open area before that time. Some of the more common creams and lotions used on a healed incision are Bio-Oil, Vitamin E Oil, E45 Cream, Palmer's Cocoa Butter Lotion with Vitamin E, and Coconut Oil.

The one exception to the guidance in regard to applying products topically over your incision is a product called ACTIVE AntiMicrobial Hydrogel Spray. This product contains hypochlorous (HOCL), a compound made naturally by your body to promote healing. It can be applied to your incision at any point during recovery - it's a germ fighter as well as a healing and moisturizing agent. Discuss its use with your surgeon before using it. You will find a link at the top right of the page in a sidebar ad you can click on.

You can certainly use ice liberally anywhere there is swelling or pain, always placing fabric between bare skin and the ice source.

Great you're cutting your wife loose now and again, hopefully it will keep her sanity while caring for you because you seem like a handful, lol Just kidding....well, only kinda / sorta kidding.

Wishing you a wonderful week!
@Xsbank