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  • RAFH
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Re: Total Knee Replacement
Reply #25
Yay! I got the staples out today. What a relief. I was anxious about doing so, but it was only minor pain and almost instantly my knee and surrounding areas felt way better.

On the other hand, I started PT last week and that's been a mixed bag. Making good progress, at least as indicated by range of motion. Before the surgery I was like 10 to 15 degrees in extension (measured from 0 being straight out) and 85 to 95 in flexure (again from 0 being straight out). The surgeon said when they were done with the procedure they could get from 0 to 135, which is the goal.
First measurements starting PT I was at 20 and 90. Not good but not too bad for that soon after surgery and with still a lot of swelling. Last Friday it was 10 and 95. But I also apparently hurt myself last Friday when the toilet overflowed (it didn't have anything in it but water but two flushes before it did, I guess the line down a ways is jammed) and I sort of freaked a bit and may have done something I should not have. I don't remember any specific sharp pains and I didn't trip or fall or bang or twist my ankle but I must have done something. Fortunately the PT showed up right then and helped me clean up (actually did it all). I didn't have any pain or swelling right then but next morning my ankle was very sore, stiff and swollen. It's remained that way.
Meanwhile, Monday, the measurements were 5 and 105, which is good.
The surgeon checked out my ankle and said it looks like a sprain or strain and should with keeping it elevated and regularly icing clear up in a couple more days. I've had that foot raised up about 6" to 8" above my heart all day.
I see the PT tomorrow, it'll be interesting to see what progress I've made.

My daughter asked the surgeon how soon I could get the other knee done. The surgeon looked at her like she was crazy and then looked at me for confirmation. I repeated the question and she took a moment to reassess. Then proceeded to tell us most people want to wait a few months to often up to a year. I said I would rather get it over and done with as soon as possible. Her decision, of course, but as soon as possible. She just shook her head and sort of chuckled. I said I wasn't looking forward to doing the other knee, it's unquestionably a very unpleasant procedure, but that I was looking forward to being done with it.

So, we'll see.
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Re: Total Knee Replacement
Reply #26
I'm still not sure why getting both done at the same time wouldn't have been the better option?

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Re: Total Knee Replacement
Reply #27
I'm still not sure why getting both done at the same time wouldn't have been the better option?
Well, one thing is then you are relegated to a wheelchair or bed for a long time. With both legs out of action, recovery takes a lot longer, though in terms of overall time, might be a bit less. Much of the PT is not possible as soon and often has to wait way longer than is effective for the bones, ligaments, tendons, muscles and nerves. I don't know. The longer one waits the less one will get back.
Another is this really is a very painful surgery. doubling the pain all at once could well be detrimental. They split the knee open and then shove everything including some very large muscles to the side. then the cut & grind the bottom of the femur and the top of the Tibia to fit the titanium implants, that includes a deep hole straight both up & down. when the fit, all the parts get put in place with glue and then they put it back the was it was.
I talked with perhaps two dozen people who had had it done. All of them recommended doing it one at a time including the one that did the double. I also talked it over with both my daughter & son-in-law, who are both PTs and have a lot of experience with knee replacements. Both recommended against doing a double. So did my surgeon as well as several other doctors.

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Re: Total Knee Replacement
Reply #28
Ok, hard to go against all those recomendations

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Re: Total Knee Replacement
Reply #29
Ok, hard to go against all those recomendations
Yeah, and now having going through the one side, I'd have to agree. It was very painful the first week or so. While at the hospital I was on the morphine drip as often as I could push the button. I did manage to catch up a couple of times but it took very little to put me back behind the curve. I can not imagine trying to get around with both knees having been done. I simply can't see how one would do it. I mean, you can't weight bear on either leg. And much of the PT tends to rely on one leg being somewhat operational.

That said, my PT is of the opinion that a double would be preferable. She says she's treated several patients that have gone that route and she feels they recuperate better, her reasoning is they have to. They can't rely on the other leg to get them through. I'm skeptical. I've been through a lot of traumatic events and have experienced a lot of pain, pain most people can't even imagine - ie 12,000 volts that burned 9 cubic inches out of my chest leaving open wounds for 6 months and left an open wound on my dick about a third of the circumference and 2/3 the length for that same period. I was in a pain management program for 10 years based upon methadone, and then withdrew without medical intervention. The withdrawal was horrible. I can't really describe it accurately, other than it was horrible. There's been other stuff. In any case, I am very familiar with pain. And, yeah, everyone experiences it differently. Some folks can bear a lot more, some can't bear much at all. But there's a big difference between how much pain one can bear when it's inflicted regardless of what one does or chooses and the level of pain they will choose to inflict on themselves, when at nearly any time they can choose to not do so. Given my experience so far, had I know what it would actually be like prior to making the decision, I would not have opted for the double. The single was quite enough, more than enough. Way more.

That's not to say there's not some folks that would opt for it and get along quite well. Just that I'm certainly not one of those folks.

At the same time, I'm already chomping at the bit to do the other knee. It's not that I like pain or am looking forward to it. It's that knee is eventually, and sooner than later, going to have to have it done. I'd rather it got done sooner. Until it does, I'm going to be in severe pain anyway, so the sooner I do get it done, the less pain I will have to endure and the sooner I can resume a normal sort of life. Like walking in the beach with my girlfriend.
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Re: Total Knee Replacement
Reply #30
Saw my surgeon on the 20th. X-rays and examination says things are going well. Except it still hurts a lot at times. PT says that's a sign it's healing. And, of course, the right knee continues to deteriorate.
However, I'm scheduled for the right knee on February 27. Was hoping for sooner but the surgeon's schedule was full up. I am #1 on the waiting list should somebody back out or die.
I am down to 0 on extension and up to about 110, maybe 115 on flexion. But I need to work on strength.
Actually I am not in as much pain. I am taking less and less pain meds, primarily aspirin. Occasionally some oxycodone. And doing more.
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Re: Total Knee Replacement
Reply #31
It sounds like your recovery is going great!

Strength will come with activity and exercise, but some judicious weight-bearing exercises speed it up.  I expect your PTs are working with you on it.

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Re: Total Knee Replacement
Reply #32
It sounds like your recovery is going great!

Strength will come with activity and exercise, but some judicious weight-bearing exercises speed it up.  I expect your PTs are working with you on it.
I continue to believe my loving daughter would not intentionally torture me, but there are times when my conviction in that belief is not as strong as other times.

I can bear weight reasonably well, I get up the stairs stepping normally. On the other hand, I'm damned glad there's not another flight. 
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Re: Total Knee Replacement
Reply #33
Tomorrow, it's my hope to take our new kitty for a walk. Or let her take me for one. Nicky is a 1.5 year old Maine Coon mix. Came to us quite circuitously. Supposed to be a friend for the Girl's mom. But that's not actually happening, for a variety of reasons nobody seems to be willing to vocalize.

OK by me. I like the cat. She's quiet, sweet, affectionate, smart, respectful, gentle, playful, etc. She learns stuff quickly. Not so big for her age, but apparently she's got another 2 to 3 years before reaching maturity.

She's been restricted to our room, mostly because the queen of the house, Tora, is a very large and very territorial cat with serious street skills. As a kitten, she had to push past a pit bull to eat. The rest of her family were euthanized. I like her, but I also respect her. She's mellowed a lot since I've been around, maybe because I am nice to her and pay attention and demand she be civil, at least to me. But she's also been known to take people's feet off.

Anyway, Nicky was original obtained to be a pet for a very young girl. Girl turns out to have serious allergies to cat dander. So, we became her new people. Just tried a harness on her today. So far she's not having a problem with it. I don't like the idea but she's got no street skills whatsoever and leaving her out around here would be not be a good idea.

So, tomorrow, we try out the beach. Well, the beach park. Big lawn. Creek. Away from traffic and noise. But if she likes it and my knees don't freak, maybe we'll see what she thinks of the beach itself that is right adjacent. It will be interesting. Fortunately, she is good with being in my Odyssey. Not overly happy about it at first but quickly gets interested in all that's going on. Sits on my shoulder and helps me drive.

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Re: Total Knee Replacement
Reply #34
pic of Nicky?  :)

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Re: Total Knee Replacement
Reply #35
Here's some pictures of Tinker (name change):
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Re: Total Knee Replacement
Reply #36
She weighs about 11# and is about 30" long. She has another 1.5 to 3.5 years before she reaches maturity.


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Re: Total Knee Replacement
Reply #37
Meanwhile, I've been back to the hospital to have the right knee done. Went in early (5:30am) last Monday and got out about 5pm on Wednesday. Back to my daughter's place and I'm pretty much settled in. In a lot of pain but have good drugs for that. Very little blood bruising and almost no swelling. Which is good. Still, lots and lots of pain. The criteria for getting out was getting off the morphine drip on demand for at least 6 hours, piss on my own after they remove the catheter and be able to walk (with the walker) at least 50 yards.

So far, I think this one is going better than the other one. For one thing, I have a fully functional knee on the other leg whereas before I had a fully dysfunctional knee on the other leg. And I know what to expect and what to do.

My big worry now is I'm constipated from all the opiates. I'm working on that issue. Various stool softeners, lots of laxatives  (primarily dried prunes, but so far no results.

Hopefully I'll be back home by April and pretty much recovered by May.
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Re: Total Knee Replacement
Reply #38
Whew.  You're doing the right things for constipation.  Your alimentary canal will right itself in a bit.

In talking to other patients who had 2 knee replacements back-to-back when I was recovering from my one measly surgery, the second replacement recovery did go better.

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Re: Total Knee Replacement
Reply #39
More lap time for Tinker.

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Re: Total Knee Replacement
Reply #40
More lap time for Tinker.
We attempted a visit by Tinker, last Sunday before the surgery. It'd be nice to have her company plus my daughter's cat is seriously lonely because her playmate, an old scrappy male, passed away. So she, Sparkle, wanders the house crying out for him. Anyway, it did not work out well. Tinker wasn't real happy about the ride down but she tolerates it. Trying to get her used to traveling in the car. She complains for the first five minutes or so then just sits on my shoulder and watches the world go by. The big issue is my daughter's pups, not sure what they are, fairly big but slender, long silky hair. Very high energy and very enthusiastic in displaying it. When let in it's pandemonium. The male can easily clear 6' from a standing position, it's like he's on springs. His mom is only slightly less active. Anyway, some miscommunication regarding the status of the pups and we entered while they were still in the house. Which meant they absolutely had to meet this new person. With them jumping up and all over me, she naturally freaked and escaped my hold and found a place to hide while the pups were being escorted out the back door. No damage done except to me, lots of serious scratches on my back and shoulder and the shirt I was wearing was destroyed. $1 shirt from Value Village, no loss.

Sparkle was finally encouraged to come down and meet Tinker but Sparkle was having none of it. I think Tinker was probably the third other cat she'd ever met and she is high strung. Sparkle was the second other cat Tinker's ever met and I doubt she's been exposed to any dogs, certainly not any such high strung, highly enthusiastic and energetic dogs like these. They're good dogs, just a bit too much. So some growling and hissing and the two cats went their separate ways. We were there about 2 hours and Tinker was glad to leave. She complained for about 1 minute and then was on my shoulder her face right next to mine.

So I don't think we'll go for a retry. Better I ride with my daughter up to the Girl's house, get dropped off and then a few hours later picked up and brought back. I'll get some time in with both Tinker and the Girl. Best of all, Tinker bore me no ill will. We played and cuddled the rest of the day and through the night as though nothing had happened.

Got through my PT Eval this morning, and I'm going to get the PTA I like, lives close by and is good friends with my daughter.
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Re: Total Knee Replacement
Reply #41
glad you came out ok both times.

my MIL had her hip replaced last year.  I was shocked to learn they had her taking a few steps the same day, and walking around the block by the end of the week.  but apparently it is better for healing and rehabilitation if you get to walking right away.  that way, all the various tissues don't "heal wrong"....or something?

if the same principle applies to knee replacements, maybe one reason doing one at a time is better is that you can then use the "good" one to assist in walking on the one that just got operated on.  if you do both at the same time, walking might not be possible.

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Re: Total Knee Replacement
Reply #42
glad you came out ok both times.

my MIL had her hip replaced last year.  I was shocked to learn they had her taking a few steps the same day, and walking around the block by the end of the week.  but apparently it is better for healing and rehabilitation if you get to walking right away.  that way, all the various tissues don't "heal wrong"....or something?

if the same principle applies to knee replacements, maybe one reason doing one at a time is better is that you can then use the "good" one to assist in walking on the one that just got operated on.  if you do both at the same time, walking might not be possible.

Apparently that's the trend nowadays. Get the victim up and moving as soon as possible.

Personally, I don't see how someone could do both knees simultaneously. But there are cases of such and apparently most of those that chose it were satisfied. 
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Re: Total Knee Replacement
Reply #43
How are you doing, RAFH?

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Re: Total Knee Replacement
Reply #44
glad you came out ok both times.

my MIL had her hip replaced last year.  I was shocked to learn they had her taking a few steps the same day, and walking around the block by the end of the week.  but apparently it is better for healing and rehabilitation if you get to walking right away.  that way, all the various tissues don't "heal wrong"....or something?

if the same principle applies to knee replacements, maybe one reason doing one at a time is better is that you can then use the "good" one to assist in walking on the one that just got operated on.  if you do both at the same time, walking might not be possible.

Apparently that's the trend nowadays. Get the victim up and moving as soon as possible.

Personally, I don't see how someone could do both knees simultaneously. But there are cases of such and apparently most of those that chose it were satisfied. 
I used to be in favor of it. I have seen many bilateral knee replacements work out great. But If something goes wrong, it REALLY goes wrong. Maybe I'm being paranoid but I don't feel that comfortable with it anymore.

But yeah, early movement is extremely important. Life is movement, movement is life, my chief consultant would say.
Who even made the rule that we cannot group ducks and fish together for the simple reason that they are both aquatic? If I want to group them that way and it serves my purpose then I can jolly well do it however I want to and it is still a nested hierarchy and you can't tell me that it's not.

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Re: Total Knee Replacement
Reply #45
How are you doing, RAFH?
Doing.
Getting better all the time.
Though at times it's difficult to tell.
Left knee, the first one they did, is doing good. A little pain or weakness from time to time but generally good. Which is a huge improvement over having the "other knee" being in as much pain and as little use as the one being fixed.
The one being fixed now, the right knee, is hurting. 2 x 5mg Oxy @ 4" hours just breaks the edge.
The Girl and I played a bit of a trick on my daughter. Daughter works up near where we live, so I'd have a ride up that way in the morning and back again in the afternoon. Little to no extra driving gets me and the Girl a visit. But I planned it so I'd end up staying overnight and ride back with my daughter the next day. A much longer visit. Didn't do much, just hung out and played with Tinker, slept some, talked. It was great. Probably a bit early for such tricks, but ... ...
So I think we're going to do it again Tuesday. Ride up with my daughter, she drops me off, the Girl takes me to my 2 week checkup and then we have the whole day and night and part of the next day till I get a ride back with my daughter on Wednesday.
Hopefully I get my staples out on Tuesday morning. They look gruesome and the image of them coming out is nasty but it turns out there's little to no pain and within minutes the whole knee relaxes and feels much better. Much, much better.
I did use the TSO or ESO cannabis oils while at the Girl's. Very helpful. Good pain relief (not all by any means) and excellent distraction from just about anything. Long lasting too.
Had a bunch of guff from the local pharmacy about refilling my prescription. Well, not refilling the one from the hospital, it was, as it should be, non-refillable. But the doctor had sent the pharmacy a new prescription and the pharmacist had a serious of ever weaker stories as to why he couldn't fill it. Started out it was too soon. I couldn't have that much Oxy in that short of time. I told him that was the doctor's decision, not his. He's not empowered to interpret the doctor's prescriptions. Then it changed to the insurance company wouldn't authorize the medications. Reasons. Finally, he relented but I had to pay cash. I'm taking it up with the Insurance. I have other issues with them and the various doctors, nurses, hospitals and pharmacies. And they seem interested in dealing with them. They are getting me set up with a new Primary Care consisting of an office with 4 doctors and staff, been there for years, not looking to change but are looking for new clients. As opposed to the one I have now with which I've had 8 or 9 difference PCGs (or whatever they are called) in about 32 months. Two of which I've never met. Three of which I've met once only. The other three have been good for the most part and one, the first one, was really good. Still, three decent doctors in less than three years is really not appropriate. So if I'm going to clean house, might as well do it all.

Otherwise, this one is going better than the first. For one thing I know what's coming, so a lot less anxiety. And it's just going better. Virtually no weeping from the incision, no really bad swelling. And I know better how to deal with hospital employees. Give them a chance to do what they are supposed to do, like hook me up to the CPM machine every 4 hours and increase the angle by 5 degrees. This is a machine they strap your leg into and it moves continuously in an elliptical arc, supposed to loosen up the knee. But they couldn't get it to work on a reliable basis, wouldn't go get another, didn't come when I called, etc. Or bringing me my pain meds on time. They get a chance to get it right on their own, they get a second chance once I remind them and then I call for the charge nurse and if she's not effective, call for the chief nurse or the administrator in charge of client relations. Plus I know the various exercises so I do those as I can. Actually made it up the stairs Tuesday night. And back down again, in full control.

Getting old quickly. But that's to be expected. Just glad I only have two knees.
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