Re: Re: Bi-lateral TKR -- biggest challenges?

[Guest guest]

Hello Anne: I had BTKR on Sept. 8. My brother just had one knee replaced two weeks ago, and he will go back in two months to have the other done. So I have seen both sides. I needed to have both of mine done at once because of my job. I couldn't take the time for two hospital stays and two recoveries. I can certainly see that my brother is having an easier recovery having only one knee done that I did with two. Yet, two months from now he will be going through it all again. It's a trade-off. There are some concerns with having two knees done at one time. You lose more blood and must be able to tolerate twice the pain. Does your husband tolerate pain well? Of course, you are more incapacitated, yet you must get up after surgery and walk as much as possible because there is a greater chance for blood clots. Also, does your husband have a healthy heart? The surgery for double knee replacement is more demanding on the body. My recovery was tough the first three month. Few people get through it without

taking some heavy duty pain meds. When the time came, I weaned myself off them slowly but I am delighted that there is no second surgery for me; also, that I will not have to be put under an anesthetic a second time. You say your husband has good upper body and leg strength, and that's a real benefit in recovery. If he has a healthy heart, it sounds like he would be a good candidate for double-knee surgery. Whatever his decision, I believe like Alan and me, he will love having new strong knees. The cold weather is making mine a bit stiff and sore. Yet there is a sturdiness and stamina that allows me to do and accomplish things I haven't done

in two years. And it has renewed my self-esteem and self-confidence. Few people get through recovery for this type of surgery without heavy-duty meds, which are necessary for physical and mental recovery. A weaning-off period is necessary to avoid painful and emotional withdrawal. This turned out to be the easiest part. I did it slowly over an entire month without one symptom. I can't stress enough that no one should be a hero and suffer through post-op pain. Effective management of pain will prevent depression and allow you to give your all in physical therapy, which will lead to a speedier recovery. I wish you the both the best. If I can help you with all the things I have learned

about preparing for the surgery as well as recovery, please feel free to write. Warm regards, Donna mbwebman <mbwebman@...> wrote: Hi Anne,I did my BTKR last Sept-18. The biggest challenges are the pain andthe length of recovery. It will take approximately 3 to 4 months tobe

fully able to resume a somewhat normal life after a BTKR. The tripis hard and slow, but I am greatful that I did both at once. This wayI don't have to deal with the pain or issues again for another 15 - 30years. If your husband does decide to do BTKR, he will be in thehospital for 3 to 4 days and then go to a rehab center forapproximately 10 days before he is allowed to return home. He willthen undergo 3-months of PT, 3 times a week for about 2-hours eachvisit. He will need a lot of love and support because it is not easyor fun.Best of luck to you both,Alan B.>> Hello. I joined this group to gain information for my husband who will > soon be having TKR surgery. At first they were going to do bi-lateral; > then decided one at a

time. Now they are discussing the possibility of > the bi-lateral again. What are the biggest challenges when > rehabilitating from bi-lateral versus single? He has very good upper > body strength, and good leg muscles, although he is 70 years old. He > has been an active person until this past year he has slowed a bit > because of the pain in his knees. Thanks for any of your comments about > this. -- Anne>

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[Guest guest]

Hi Anne,

I think most places teach you how to do stairs before you go home.

I had no stairs anywhere at my house, but they said it was a safety issue,

and important that you could negotiate stairs before you went home.

Aussie Margaret

RTHR 1990 revised 2004

Re: Bi-lateral TKR -- biggest challenges?

| Thank you Don, Donna, Alan, and others who have replied to this

| question. Your letters have been informative and comforting. His

| regular doctor is the one who will decide and he is doing checks on

| Carl's heart health. Yesterday he did a treadmill stress test with good

| results. Today he will be a sonogram (?) of his heart to check the

| valves. If that appears ok then they will do the bilateral. I had

| concerns about the added blood loss/pain/clotting risks, and I guess

| they are there with any surgery. Hopefully the hospital staff will

| supervise carefully. The doctor has said that he would probably need

| blood transfusions to prevent blood-loss anemia. Carl has been in great

| pain with his arthritic knees, but knew they would not get better

| without surgery. I think knowing that the post surgery pain will

| diminish over time will make it at least tolerable for him. He deals

| with pain much better than I do.

|

| One more question: Are stairs do-able in the first weeks after surgery?

| We do have stairs, even to get into our house.

|

| Thanks again. This is a great group!

| Anne

[Guest guest]

Anne, I did not work on steps day 7 post-op, at the inpatient physical therapy. But if Carl has both knees done at one time and has several steps to negotiate then he may need help getting into the house. I was not allowed to negotiate steps for about the first three weeks, I believe. (I wish I would have kept a diary to remember all the milestones of recovery.) Since my bedroom, kitchen and living room are on the first floor, the I didn't have to make any special arrangements. People who have double knee replacements are required to to live on one floor for a time that is designated by the surgeon or physical therapy doctor.

I believe I forgot to mention one benefit I realized by having two knees done at one time was that my insurance company approved a stay in an inpatient physical therapy rehab facility for one week. My surgeon has never released a double-replacement patient to go directly home from the hospital. He insists they spend appx. a week in inpatient physical therapy. And I certainly needed it. I received great care and observation and much more intense physical and occupational therapy that I would have at home. The doctor stopped in daily to discuss pain management. The nurses changed my dressings daily. I was taught how to get in and out of the shower and other things and was watched closely until they were sure I was safe. But even those who get one knee done may be approved for a stay in an inpatient PT facility if there are other circumstances, including age or the inability of your caretaker to care for you early on in your recovery. I was very surprised but delighted that my brother, who only had one knee done, was approved by Medicare for a ten-day stay in an inpatient PT facility. The reason was that he is a very big guy, and my sister-in-law is a very tiny gal. No way could she physically support him. I talked to him last night. Even though he is having an easier recovery than I did, he is extremely glad that he opted for the inpatient PT. He agreed that he is getting much more PT and will be fully prepared when he gets home. And by the way, you are most welcome. I have received so much support and good advice at this site, I am glad to have the chance to give back by sharing my own experience. I hope the cardio tests are all positive. Let us know when Carl goes for surgery so we can keep you both in our thoughts and prayers. Warm regards, Donna aehege <hecorp@...> wrote: Thank you Don, Donna, Alan, and others who have replied to this question. Your letters have been informative and comforting. His regular doctor is the one who will decide and he is doing checks on Carl's heart health. Yesterday he did a treadmill stress test with good results. Today he will be a sonogram (?) of his heart to check the valves. If that appears ok then they will do the bilateral. I had concerns about the added blood loss/pain/clotting risks, and I guess they are there with any surgery. Hopefully the hospital staff will supervise carefully. The doctor has said that he would probably need blood transfusions to prevent blood-loss anemia. Carl has been in great pain with his arthritic knees, but knew they would not

get better without surgery. I think knowing that the post surgery pain will diminish over time will make it at least tolerable for him. He deals with pain much better than I do.One more question: Are stairs do-able in the first weeks after surgery? We do have stairs, even to get into our house.Thanks again. This is a great group!Anne

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[Guest guest]

On Feb 2, 2007, at 9:44 AM, aehege wrote:

> Again, thanks so much for your replies. Reading your experiences gives

> me hope that whether Carl gets the bi-lateral or single replacement,

> he

> will not be sent home before he is ready and there are many ways to

> make accommodations. We are waiting for results of the last test to

> see

> if they will do a bi-lateral, but he feels confident it will have a

> good result.

>

> Blessings to all of you who take the time to answer the questions of

> the inexperienced. We get the information we need from you, but

> also,we

> feel the care and support you offer. May you all be pain-free today!

>

> -- Anne

>

>

" If you are all wrapped up in yourself, you are overdressed. "

[Guest guest]

Don, Anne got me chuckling, but you got me laughing out loud. Your friends do deserve some points for coming up with that contraption -- even if it didn't get you up the steps. :-) DonnaDon <donavp@...> wrote: Anne:As others mentioned they went to an rehab center and then home. Thiswas mainly because of stairs and other obstacles that we have to dealwith. I have stairs also and we talked about having a bed down stairswhen I first came home. You also need to get to the bathroom. Wedecided that it would be to much of a hassle seeing that mosteverything I would need was upstairs except for food. So we madearrangements to have a couple of strong-backs and weak minded fellows8^) lift me up the stairs. I would stay up there until I could usethem on my own.Well when I came home two friends came over with the funniestcontraption you ever saw. They had taken a plastic lawn chair withduct tape, plywood and two studs on either side. I was to sit in thechair and they would carry me up. It looked kind of like somethingthat a king or Pharaoh would use only much more

crude. I don't knowhow I would have gotten into it and it was too long to make the turnin the stairs (we have a landing half way up). My doctor had saidsomething about getting up stairs by sitting on my butt and lifting upone step and a time. I try this but it did not work so I stood upbackwards and stepped up as well as pulled myself up with my arms onestep at a time. One of the fellows stood in-front of me and help liftand support me as I went up. It took time but I got there. I wouldsuggest doing it frontwards instead of backward if you try this.He will have a walker and should be able to get around. Just bringhis food to him and if you don't get a TV in the bedroom. That is howI did it. Oh, if he can't walk up the stairs when he first gets homehave him sit in a chair and have two friends one in-back the otherin-front lift him and the chair up the stairs .Don>> One more question: Are stairs do-able in the first weeks after surgery? > We do have stairs, even to get into our house.> > Thanks again. This is a great group!> Anne>

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[Guest guest]

Of course I did not have any hospital PT after my release from the hospital. It was so bad when I got home for them to get me up the stairs.

I sat on the stairs and one of my sons lifted me under my arms and my hubby helped my legs go up. Every step was agony. Once up there I did not come down for a couple weeks. Terry

Re: Bi-lateral TKR -- biggest challenges?

For me, with both knees, and after two weeks in hospital and recovery

facility - I could barely manage the 6 or 7 rather shallow steps to

get in the house. I would definitely not have been able to go up and

down a whole flight of stairs - fortunately, I did not have to because

our living area is on one floor. Even now after 3 months I do not

like going up and down the steep flight of stairs to our laundry room.

Judy

>

> Thank you Don, Donna, Alan, and others who have replied to this

> question. Your letters have been informative and comforting. His

> regular doctor is the one who will decide and he is doing checks on

> Carl's heart health. Yesterday he did a treadmill stress test with good

> results. Today he will be a sonogram (?) of his heart to check the

> valves. If that appears ok then they will do the bilateral. I had

> concerns about the added blood loss/pain/clotting risks, and I guess

> they are there with any surgery. Hopefully the hospital staff will

> supervise carefully. The doctor has said that he would probably need

> blood transfusions to prevent blood-loss anemia. Carl has been in great

> pain with his arthritic knees, but knew they would not get better

> without surgery. I think knowing that the post surgery pain will

> diminish over time will make it at least tolerable for him. He deals

> with pain much better than I do.

>

> One more question: Are stairs do-able in the first weeks after surgery?

> We do have stairs, even to get into our house.

>

> Thanks again. This is a great group!

> Anne

>

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[Guest guest]

Yes, I'm 7 and 4months,Shirley Re: Bi-lateral TKR -- biggest challenges?

Hey Judy,

My Fellow BTKR. Do you find that you still wake up in the middle of

the night when you straighten a bent knee and all of a sudden it

screams at you? Also do you find that the first few steps in the

morning are like a squeeky and uncoperative painful door? I'm 4

months post.

Alan

> >

> > Hello. I joined this group to gain information for my husband who

will

> > soon be having TKR surgery. At first they were going to do

bi-lateral;

> > then decided one at a time. Now they are discussing the

possibility of

> > the bi-lateral again. What are the biggest challenges when

> > rehabilitating from bi-lateral versus single? He has very good upper

> > body strength, and good leg muscles, although he is 70 years old. He

> > has been an active person until this past year he has slowed a bit

> > because of the pain in his knees. Thanks for any of your comments

about

> > this. -- Anne

> >

>

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[Guest guest]

i was taught stairs before i was discharged and since insurance would only pay for one walking aid, the walker, we bought a pair of crutches for me to get up and down the stairs and they work perfectly. i got that down pat. ;-)

Hugs,Lindy LouRight THR 1/22/2007

Hi Anne,I think most places teach you how to do stairs before you go home.I had no stairs anywhere at my house, but they said it was a safety issue, and important that you could negotiate stairs before you went home.Aussie MargaretRTHR 1990 revised 2004 Re: Bi-lateral TKR -- biggest challenges?| Thank you Don, Donna, Alan, and others who have replied to this| question. Your letters have been informative and comforting. His| regular doctor is the one who will decide and he is doing checks on| Carl's heart health. Yesterday he did a treadmill stress test with good| results. Today he will be a sonogram (?) of his heart to check the| valves. If that appears ok then they will do the bilateral. I had| concerns about the added blood loss/pain/clotting risks, and I guess| they are there with any surgery. Hopefully the hospital staff will| supervise carefully. The doctor has said that he would probably need| blood transfusions to prevent blood-loss anemia. Carl has been in great| pain with his arthritic knees, but knew they would not get better| without surgery. I think knowing that the post surgery pain will| diminish over time will make it at least tolerable for him. He deals| with pain much better than I do.|| One more question: Are stairs do-able in the first weeks after surgery?| We do have stairs, even to get into our house.|| Thanks again. This is a great group!| Anne