Bilateral Total Knee Replacement (both knees)

BILATERAL TOTAL KNEE REPLACEMENT

Sections

Susan

1. Introduction – My History
2. My Intention
3. The Hospital
4. Monday – Friday in the hospital
5. Weeks 1 – 16 after the surgery and beyond
6. Bilateral specifics
7. General Info
8. I wish
9. Tips
10. Thoughts to get me through this
11. Chart showing my transition from Vicodin to Tylenol & then Ibuprofen

1. INTRODUCTION – MY HISTORY

Hello and welcome to the story of my bilateral knee replacement surgery and recovery.

I am 61 years old and I was and am in moderately good physical shape – except for my knees. We renovate houses so that has kept me physically active but bum knees do not do well in this kind of work. Here is my story.

July 2007
My left knee buckled for the first time. I went to see Dr. Bond who was the orthopedic doctor who had treated my broken wrist three years earlier. He x-rayed my left knee and it did show signs of wear on the inside.

September 2008
I went back to Dr. Bond because now my right knee was rubbing and hurting. He x-rayed both knees and they were both worn down on the inside edges – bone on bone rubbing. Since I was 60 years old, I would not have Medicare for 5 more years and he said that I wouldn’t make it that long. I had several more appointments with him and we began talking about the possibility of having both knees done at the same time. He played the devils advocate and told me all of the reasons for not doing it this way (longer surgery, increased possibility of infection and blood loss). I got permission from him to speak to a woman (Nancy) who had both knees done by him several years ago. Nancy encouraged me to go for it. She was doing really well and was very glad that she did both knees at the same time. She forewarned me that she got depressed during the second week – I had read this somewhere online also.

In mid November, my right knee buckled. At my visit with Dr. Bond in early December, I told him that I wanted to proceed and have the surgery. Since I am one of the many uninsured in our great nation, I filled out financial aid paperwork at our local hospital. Three years earlier, they had covered the cost of my broken wrist 100% so I was hoping for the same. Unfortunately, they couldn’t tell me exactly how much they would cover until they had a dollar amount to work with but the term 100% was mentioned. I decided to proceed with the surgery on the faith that I would get this 100% coverage. The surgery date was set for January 26, 2009.

(April 17, 2009 – I received a letter from the hospital today saying that they are covering 100% of my hospital bills, which are around $42,000. The surgery ended up costing me personally around $750 for the CPM machine rental, the x-rays, the radiologist and my prescriptions. I feel very thankful.)

One day I had a good cry about the fact that I was going to be loosing my birth knees since they have supported me for my entire life. I felt better after the cry.

About a month before the surgery, I ordered a book online called Total Knee Replacement Surgery and Rehabilitation by Brugioni and Falkel ($19.95 new). I wish I had ordered this book sooner but I was thrilled to have it. I HIGHLY RECOMMEND getting this book at least one or two months BEFORE your surgery. My doctor now plans to order this book for his patients.

I began doing the pre surgery exercises suggested in the book to build up my muscle tone, which had really begun to atrophy. Doing the knee and leg exercises before the surgery would help my body know and remember what was expected of it after the surgery. I also strengthened my arms and they got strong enough to raise my sitting body about a half-inch up off of the seat of a chair. I am glad that I developed these muscles because I have definitely used them.

I chose to have this surgery done sooner rather than later. I was getting much more sedentary and I was aware that my legs were loosing more and more muscle tone. I was hobbling around and hurting so I didn’t see any reason to wait. Especially after my doctor said that many artificial knees were now lasting for 30 years – I was 61 and that seemed good enough for me.

I feel like I want to address the fact that according to EVERYONE who worked with me, my recovery went amazingly well. I asked my doctor why he thought I have done so well. He said that he thought it was because I was the most psychologically and physically prepared patient that he had ever done surgery on. I was physically prepared because I did all those exercises before the surgery, I am only 61, I am not overweight and I was in decent shape except for my knees.
I was psychologically prepared because I really wanted this surgery and I wanted both knees done at the same time. For me this was a fantastic decision. I wrote my intentions (see below) and that set the stage for a positive recovery. I also asked many friends to send me good energy and prayers as I recovered. (If you ever have surgery, I hope that it goes every bit as well for you.)

I am not religious but I am very spiritual. I believe that what I think assists in shaping my reality. (If this doesn’t seem possible to you, go to http://www.masaru-emoto.net/english/e_ome_home.html and look at the photographs of water droplets that change from being very beautiful to very distorted as people focus either positive or negative thoughts on the water. If our thoughts can affect the beauty of a water droplet and my body is about 60 percent water and my brain is 75% water, then I think I will play it safe and do my best to think positive thoughts. What can it hurt? My intentions reflect this positive way of envisioning my future.

It got hard waiting for the surgery to happen – I was ready to get it done. As I waited, I worked on what my intentions were for this surgery. I am very glad that I spent time doing this. I share it with you below – please feel free to use any part of this if you feel that it speaks to you.

2. MY INTENTION:

My intention for my surgery is that it goes completely smoothly. My body will have a healthy blood supply flowing freely, healthy lungs with breath that comes easily supplying oxygen for red pulsing tissues, and a strong, nausea free stomach. I will have perfect Susan-like knee implants with the cement forming a strong, long lasting “Bond” thus allowing these new knees to support my active body until I pass over. My intention is for fast healing knees, free of infection; supported by a strong immune system and other needed supports. My new knees will have maximum range of motion and flexibility and amazing strength to carry me in health. I intend the doctors’ hands to be guided by the angels to maximize my body, mind, emotions and spirit. I wish for my doctors and staff that everything go smoothly with the highest grace possible and I hope that when they are done with the surgery that they can say, “Wow – two at once – that was a great surgery – and it all went really well!” Or something better!
(Please note that my intention is stated in positive terms. My spiritual belief is that God/Goddess/Great Spirit hears only positive intentions. So, if I had said that “I wanted to have no nausea” – that could be interpreted as “I wanted to have nausea”. It was also a VERY good experience to write down what I wanted rather than what I didn’t want.)

I talked to my doctor before the surgery about having FUN during my operation. Dr. Bond and another doctor (Dr. Roberts) were to be my surgeons. My doctor told me that he and Dr. Roberts were talking the week before about how much they loved to do the surgeries but also how boring it would get when they finished one surgery and had to just sit and wait while the operating room was prepped for the next patient. They were excited about my surgery because they got to do two in a row. I asked my doctor to tell Dr. Roberts that I wanted him to have a good time as well. When Dr. Bond came out after the surgery to tell my partner, Kathy, that everything had gone very well; he also told her that they had FUN!

My 2008 December Birthday Horoscope
You’ll be disengaging yourself from unproductive activities in favor of taking new paths of promise.

x-ray before surgery

MY BILATERAL KNEE REPLACEMENT SURGERY!

3. THE HOSPITAL

I asked that friends NOT come to visit me while I was in the hospital and this turned out to be a good decision for me. My room felt like a constant bustle of traffic – nurses, aides, the doctor, Physical Therapists, dietitian, finance office personnel, glucose testers, etc. A visit in this situation would not have been very pleasant and I didn’t need to expend any more energy than I was. I also asked that people not expect me to return emails for about 3 weeks after the surgery and that was a good decision.

I was glad that I brought my eye mask to the hospital with me. At night there were many small lights all over the room and I am used to sleeping in the dark. If you like a dark room, bring a mask or use a folded bandana or rag to cover your eyes. It is hard enough to get enough sleep in the hospital so do whatever you need to do to make it as easy as possible.

4. MONDAY – FRIDAY IN THE HOSPITAL

January 26, 2009 Monday – Surgery
I was in surgery for about 3 hours. I don’t remember being in the recovery room – my first memory was being in bed in my hospital room. I had an epidural, which was supposedly better for diabetics and it did not cause me to be nauseous afterwards. I was on a morphine pump and I hit that button whenever I felt that I needed it. It turns out that they used identical knee implants for both of my knees and that seemed to please my doctor. I didn’t care as long as it was the best implant for me.

January 27, Tuesday
I stood in the morning and walked a few steps – it wasn’t too bad. This had been my biggest fear – the first time that I was supposed to stand on both legs. Of course I was on morphine, percocet and one other pain drug – thank goodness! I had some physical therapy (PT) that afternoon and was told that I did very well. Everyone was very pleased with how good I was feeling and how well I was doing.

January 28, Wednesday
They put me on a CPM (continuous passive motion) machine, which moved my leg up and down so that the knee would bend. I could control the degree of the bending. I was on this machine for 2 two-hour sessions on each knee every day or 8 hours a day. This sounds uncomfortable but it actually felt pretty good – boring but good. When Dr. Bond came by to see me, he told me that I was his poster child for bilateral knee surgery!

January 29, Thursday
I had been on an IV since the surgery and it was removed today. This IV was delivering morphine, antibiotics and other needed stuff. I had donated my own blood before the surgery (good idea to do so). They didn’t use it during the surgery but they ended up giving it back to me because my iron count was low. It was so freeing to be IV free!
I was able to bend over to get something off of the floor before the surgery and I was also able to do this today. The surgery did not affect my ability to bend over. (I had been curious about this.)

January 30. Friday
I came home. I rode sideways in the back seat. I wore my nylon pants because I had read that nylon pants would allow me to slide across the seat easier than other fabrics and that was correct. I leaned on two pillows behind my back against the rear side door and I had one pillow under my legs. The 25-minute ride went very well. Later that day the CPM machine arrived. I was so blitzed on the percocet that I was happy to lay for 8 hours a day with my eyes closed. I got to where I could occasionally fall asleep while on the machine. Kathy of course helped me get my leg into and out of the machine.

NAUSEA
The best solution that I found for nausea that was caused from the Percocet or Vicodin, was to eat 2 saltine crackers (I prefer whole wheat) before the pill, take the pill, and then eat two more saltines. I drank water with each cracker. (More Nausea info in the TIPS section.)

5. WEEK 1 – after the surgery week

February 1, Monday
The home health nurse came and took blood for the coumadin check. I was walking to the bathroom to use a potty seat that was over the toilet. I ate meals in bed.

February 3, Wednesday
The home health physical therapist (PT) came and I got a series of exercises to do in bed. I did them with her for this first time.

The home health nurse came for the next two Mondays to draw blood to check my coumadin levels. The PT came about once a week and her last visit was on Feb 18, which was the middle of week 3. She could have come more often but I was trying to save the hospital (and possibly me) money. I was also doing well and was able to do the exercises without her being present so it seemed to me to be a waste of her time for her to come more than once a week.

Knees with staples - it looks worse than it felt!

Knees with staples – it looks worse than it felt!

WEEK 2

February 12, Thursday
I went to Dr. Bond’s office and had the 49 staples removed. Each knee has about a 6-inch incision. I didn’t know how much better it would feel with the staples gone. Steri-strips were put across the incisions. These were to stay on until they fell off – usually about 2 weeks. The ride into town made me a little nauseous – I rode in the back seat and I was sitting sideways so I think that is why it caused me to feel queasy.

February 14 Saturday
I didn’t mind the CPM machine. The percocet had me so blitzed that I was happy to just lie there and let the machine do its work. This was good because I was not able to be doing much else anyway so it was a win-win.
I was now able to get myself into and out of the CPM machine. This means that I could be at home alone for a longer time during the day. Kathy usually fixed my lunch so that I could just go and get it myself.
I carried our portable phone with me WHEREVER I WENT! Better safe than sorry!

February 15 Sunday
When I woke up today something seemed wrong and then I realized that I was depressed. I was tired of all of this knee stuff – like the TKR book said – recovering from TKR occupies you 60/60/7/24/4 or 60 seconds every minute, 60 minutes every hour, 24 hours every day and 7 days a week for at least 4 weeks. I cried and felt sorry for myself – that made me feel better. I did remember that Nancy and someone online had mentioned getting depressed at around week two so I was right on schedule. (I never had any other bouts with depression during my recovery.)

I still had no interest in reading (I am an avid reader) or watching TV – I guess because of the Percocet.

WEEK 3

February 17, Tuesday
They came to pick up the CPM. I had canceled it on the 13th but it took them a while to pick it up so I continued using it for free for those few days. (I had it for 2 weeks at $150 per week – my cost)

February 18 Wednesday
Today was my last PT at home. I had 94 degrees on my left knee and 99 degrees on my right. I was at 4 degrees with my legs straight out.

February 19 Thursday
I saw Dr. Bond today and this time I rode in the front passenger seat. This was much better for my stomach. I have a PT Cruiser so the seats are up fairly high. I would not have liked trying to get in or out of a small car. I got a prescription to go to outpatient physical therapy and I got permission to remove the steri-strips. Kathy and I went out to lunch – my first outing!
I chose a restaurant with a booth so that I could sit down sideways and then slide into place. I could also use the table and the back of the booth to help me stand up – it all worked very well and I was very happy to be eating out! I am still using the walker. I got a prescription from Dr. Bond for Vicodin.

February 20 Friday
I did make the switch to Vicodin and I am much happier. I don’t have as much stomach upset and my mind is much clearer – YEAH!

Boredom has definitely set in. I am not a daytime TV watcher but I can now tell you the latest from Dr. Phil, Ellen and Oprah!

WEEK 4 – ONE MONTH

Feb 23, Monday
A friend of ours died last Friday. She had a very nice walker and her partner offered to lend it to me so Kathy brought it home today. I felt like I had gone to walker heaven – it had 4 wheels and a basket and a seat and it was hunter green. It made life much better since I could transport items so much easier plus I could sit down anytime I needed to do so.

Feb 25, Wednesday
Kathy drove me to my first outpatient PT with Melissa who was very nice and seemed to be an excellent PT. Today we did mostly assessment. She did say that since I was doing so well that I might not need to use the pool, which really bummed me out. I told her how much I was looking forward to it. She had me attempt to balance on one leg and I could only do it for 3 seconds on each leg. I tried it again the next day at home and got to 20 + 30 seconds – much better. Regaining my balance will help me walk without the walker. Kathy and I went out to lunch again – this time I just sat in my new walker seat at the end of the table and it worked great.

Feb 26, Thursday
Went to PT again – climbed stairs – did stair lunges, used a step machine, walked unaided for a good distance, talked with her again about using the pool and she said that she thought we could do it. I now had many more exercises to do and I did them all twice a day. When I did the stair lunges at home, I had a handrail on the right side only and I felt unsteady. So, I used my cane on the left side and put the tip of the cane in the corner of a step above and then I felt more balanced.

This was the first day that I tried using Tylenol rather than Vicodin. It was OK at first but by the 4pm time I was hurting so I went back to the Vicodin.

WEEK 5

March 4, Wednesday
I got to go into the hot (90 degrees) pool today. It was fantastic! I had read that the warm water would feel really good and it did! I was able to stretch my knees further due to the buoyancy and the warm temperature. The therapist forewarned me that it is easy to over do it. I did over do it just a little on my left knee because it hurt more than usual that afternoon – but it was worth it! I drove a little today – just from the restaurant to the grocery store and it was OK.

March 5, Thursday
I tried Tylenol again this morning – same experience as before. I will just keep trying this weekly until the Tylenol takes care of the pain! Today Kathy was gone and I actually spent more of the day up rather than in bed – this was the first day that I had done this. When I say in bed, I am sitting upright in the hospital bed with my legs extended. The TKR book suggested retrofitting a recliner by building it up several inches higher so that the patients can get up and out of it by themselves. This would have allowed me to sit in the recliner in much the same way as I sit in the hospital bed. We did not do this to and I WISH WE HAD DONE I T. This would have allowed me to sit comfortably in the living room as well as in my bedroom.

March 6, Friday
Today in PT, Melissa really pushed down on my left knee during a stretch and it hurt – I had to finally tell her to stop. She did this several more times (this is her job) and each time she went until I just begged her to stop. I was almost ready to cry and I’m not willing to put up with that kind of pain. However, my left knee went from 94 degrees before the extreme stretching to 107 degrees after which made it the same as my right knee. That was pretty amazing. She had me walk quite a bit with only the cane. I had wondered about how I would use a cane since I had both knees done. Someone had said that I might use two canes but this seemed like an accident waiting to happen to me. Melissa had me try using just my one cane and I automatically put it in my right hand since I am right handed and that then gave more support to my more troublesome left knee. It felt safe and good to use the cane this way. I drove some more today and I think that next week I will be able to drive myself to and from my PT. It seems that every time I go to PT, I get new exercises to add to my regimen.

March 6, Saturday
At home today, I used the cane and did not use the walker at all. YEAH! Another big step!

WEEK 6

March 9, Monday
I drove myself to PT and everything was fine. I had a different Physical Therapist today. She had me walk on a board way with handrails on each side and I had to step over plastic orange cones. As I was doing this, I realized that I could not tell where my feet and legs were in relation to the cones. I mentioned this to her and she explained that I had lost the proprioceptors that had been in my kneecaps. These proprioceptors help the body maintain balance and provide relationship between the body and the rest of the world. She said that my body would learn to adjust to this. This information was so interesting and it certainly made sense! Many of the balancing exercises are designed to realign these proprioceptors and this is a big part of relearning to walk after the surgery.

March 12, Thursday
After PT today the bend of my left leg is 102 degrees and my right leg is 117 degrees. My left knee extension (straight out) is 6 degrees and the right is 2 degrees. It is important to get this extension number as close to zero as possible so that the artificial implant parts ride on each other properly.

I stopped by to visit a friend on my way home today and she noticed that I didn’t have any wrinkles. I looked in the mirror and she was correct – no crows feet, no mouth lines, nothing. (I later asked Dr. Bond about this and he said that my face must have still be a little swollen. A friend of mine had surgery a few weeks after I did and she had the same experience – she lost her wrinkles! So, if you have ever wanted to do a Glamour Shot – this might be the time to do it!)

WEEK 7 – boredom is still very present

March 16, Monday
Today for some unknown reason, I was nauseous most of the day – from 9 am to 4pm. Kathy was in town and so I asked her to buy some Pepto Bismol for me. I had never taken this but it did work and I finally felt better.

March 20, Friday
My left knee is 109 and my right is 116 degrees. The boredom of the last 6 weeks is definitely lessening since I am able to be up and about more. I continue to do exercises twice a day for about 1½ hours each time.

March 22, Sunday
I went to my first “away from our house” social event tonight. It was somewhat difficult. I was not comfortable standing around the potluck table so I missed some socializing. This was not unusual – apparently sitting and standing comfortably take longer than just walking. I had been to this home before so I knew that their toilets were not handicapped height so I took my donut style toilet raiser with me – luckily, I didn’t need to use it. After 2 ½ hours, I was ready to stay but my knees were saying, “take us to bed!!!” So, we left a little early.

WEEK 8 – TWO MONTHS
March 24, Tuesday
My last prescribed PT session was today but Melissa had contacted Dr. Bond and talked with him and they are extending my PT for two more weeks. I am glad because I want to make more progress. Today she had me go outside and I walked a lot without my cane – she carried it in case I got tired. This rehab facility is housed in what used to be our old Lowe’s store so when we were walking outside, I was walking on the cement where we used to buy 2×4’s and other lumber – sort of a strange déjà vu.
I am barely using the cane at home and I am using the stationary bike several times a day for 5 – 10 minutes each time.
I saw Dr. Bond today and he says I am doing great. I will see him again in a month and then not for a year. I asked what happened to the bone dust when they cut my bones. He said that they flushed the area with water and that probably a little bone dust stayed in my knees. As a woodworker, these things intrigue me.

I am currently taking ½ Vicodin every 6 hours. At 10am, I took 2 extra-strength Tylenol and it worked pretty well. I will try doing the Tylenol during the day if I am not out and about.

March 25, Wednesday
Today I drove over an hour each way to take Kathy and her mother to the airport to fly to Texas for 4 days – I will be home alone and I feel that I can handle it. We stopped at three thrift stores and I went into each one. All in all I was gone for 5 ½ hours, which is my longest outing so far. I came home, grabbed a quick dinner and gladly crawled into bed.

WEEK 9

March 30, Monday
I over did it today. Suddenly it was 4:30 and I had been up all day and I should have taken my Vicodin a half hour earlier. I was hurting. I went to bed and took the Vicodin and rested. We were going to a meeting tonight at 6:30 and I wasn’t sure I would feel like going. It was amazing – a half an hour of rest, some pain meds and I was good enough to go. Luckily, we were home by 9PM so that was good for me.

March 31, Tuesday
I could tell today that I over did it yesterday. I’ve felt sort of sluggish today. That was a good lesson for me to learn.

SIDE NOTE:
I am becoming more aware of what a long, slow recovery this is going to be. Looking back now I see that at first, I made huge strides in a relatively short amount of time. Now, I am making teeny, tiny strides and so the process seems to be taking a longer time. I’ve read that it will be a year before I feel free of issues from the surgery. I can see now that this is probably accurate. It happens to be spring now and I have a several blooming trees outside my window. I identify with them as I watch them make their teeny, tiny steps from bud to flower to full green leaf. I look forward to my own upcoming changes.

I am not using the cane at all at home but I still take it if I go anywhere else. I ride the stationary bike whenever my knees feel stiff and uncomfortable. Sometimes in the middle of the night I will hop on it for a few minutes and then I sleep more comfortably. I continue to do all of my exercises twice a day. I do some in bed and others in various parts of the house.

The stiffness from the scar tissue is such a strange feeling and it is very pervasive within my knee so I am glad to have the bike to help with this. This stiffness feels like my knees are filled with styrofoam that doesn’t want to move. I still need to use a handicapped height toilet in public and at home (thank goodness for potty seats!).

April 2, Thursday
I tried two Tylenol this morning and it just didn’t do as well as the Vicodin. My knees ached more and felt a lot stiffer so I took my ½ Vicodin before I went to my afternoon PT session. On my way home I stopped to visit a friend. Eventually, I needed to use the bathroom and she does not have a handicapped toilet. I decided to risk it and I was successful. Now, I did need to use both of my hands to get down onto the seat and up off of it but I did it! This felt like a real milestone – YEAH!

April 4, Saturday
Today was the first day that I did not do any exercises – well, I did ride the bike and I did a few stair lunges to limber up. I usually do the exercises right after breakfast but today we went to yard sales and I decided that after 9 weeks, I could take one day off and I enjoyed it.

WEEK 10

April 7 – Tuesday
Today when I went to PT, I found that I have lost range on my knee flexion. I lost 8 degrees on my right knee and 4 on the left. My extension was about the same. I had switched from doing my exercises (usually) twice a day to only once a day. I guess I have learned that twice a day is needed now – plus I took Saturday off. I was disappointed. I wish I liked exercising more but I can’t say that I do but I like me and so this is what I need to do for me for now. I asked how long I would need to exercise and she said about a year. Oh well, this too shall pass.

April 8 – Wednesday
Today I really exercised – so much that my left knee was a little sore. I hoped this would help!

April 9 – Thursday
Today was my last day of therapy. It was a sad/happy mixture. I felt sad because I am now on my own and happy because this was another milestone. I had better numbers today. My left knee was 110 degrees flexion and 3 degrees extension. My right knee was 116 and 0. I had achieved all of the goals that the PT had for me. She said that they wanted me to be at least at 110 flexion and less than 4 extension before releasing me so I was there. They did their goodbye ceremony for me – they blew bubbles on me and gave me a t-shirt since I didn’t miss or cancel any appointments.
I took 2 Tylenol at 4pm and it worked pretty well so I decided to try it for my 10pm night med. I have heard that nighttime can be more painful but I was ready to try it. Well, bad decision. At 2am I was still awake and hurting so I took ½ Vicodin and finally fell asleep around 3am.
I will keep trying to wean off the Vicodin.

April 10 – Friday
Just as I set my Intention for my surgery, today I realized that I could also set my intension to assist my exercise routine. So, here is my intention:

“My intension is that for any exercise or movement that I do today; that it greatly increases the flexion/extension/ balance and/or strengthening of my knees and legs – or something better!”

(I have continued to say this intention every morning for the day ahead.)

WEEK 11

April 20 Monday
Today I choose to not take my 10am Ibuprofen because my knees seemed to be feeling much better. It worked pretty well but I was ready to take one again at 4pm. I still took a half a Vicodin at 10pm.

I lowered the seat on my stationary bike about an inch because it wasn’t stretching my knees anymore. This seemed to be a confirmation that I was gaining range of flexion. I missed having a PT to measure that range.

April 22 Wednesday EARTH DAY!
Today I removed the raised potty seat from over the handicapped height toilet in the bathroom. I could get up and down fine – I used my arms and the furniture on each side of the toilet to help raise and lower my body.

April 23 Thursday
Today I saw Dr. Bond for my third and last visit (for a year). I asked him how much the implants weigh and he said about a pound each. I gave him a copy of My Intentions and told him that I thought the reason that I had done so exceptionally well was due to my believing in my intentions. I suggested that he read it later and he said that he would. He reminded me that I couldn’t do things like jog or play high impact sports. Good – I have no interest in those things anyway. I can walk, hike and swim which I love. He added, that if a bear chased me, I could RUN! We have bears in this area so I was actually glad to hear that. So, I will see him in a year!

I also stopped by the PT place to get measured. I had asked if they would do this for me. My right knee is now 117 and my left is 112 so I have gained a little more flexion.

Knees at 3 months

This is a photo of my knees at about 3 months – lookin’ good!

WEEK 12 – THREE MONTHS

At three months, I feel like I’ve rounded a bend.

Up until this week, I still had to consciously put my right foot directly in front as I walked – it wanted to swing out to the right – it seemed to have a mind of its own! Now, my right leg is walking much better. I’ve tried to be aware of how my legs have been moving. I’ve also encouraged friends to give me feedback if they see me walking oddly. Several did and I appreciated it!

In the hospital, when I first stood on my new knees and walked, I remembered that I had read that, “I would need to learn how to walk again”. However, right then I thought, “I am walking so I won’t need to relearn that”. Well, I was wrong – the relearning is subtle but it is definitely there. I thought the relearning to walk part of my recovery was an interesting experience. In my PT sessions when I had to step over and around orange cones, I enjoyed feeling like a kid as I was learning something new.

It’s amazing how these fake knees feel pretty normal. I get a sense of the metal aspect when I cross my legs or when I am laying on my side with my knees touching. In both of these positions my new knees feel more metal like than my old bones! But, all in all, I have found it amazing that the implants feel so natural.

May 1 Friday
Last night I slept totally flat for the entire night – this was another first! I had been sleeping with the hospital bed slightly raised at the head and just a tiny bit at the knees so this was a welcome transition.
Today was also the first time that I skipped my 4am and 10am dose of Ibuprofen. By 3:30 pm I was pretty achy so I took the Ibuprofen.

May 2 Saturday
Last night was the first time that I did not take any meds at 10pm before I went to sleep. I also slept again with the bed flat and everything was great!
If I sleep on my side, I tuck some of the bedding between my knees to soften the pressure.

WEEK 13

May 3 Sunday
This was my first day to not take any meds. YEAH!
I can get up from some seats without using my arms but I still need to use my arms to get myself up from a standard dining room chair.

May 8 Friday
It had been cool and rainy for several days and I felt achy so I took one Ibuprofen around 11am. Last night was the first night that I slept back in my own bed and I did great – it sure felt good to be back in my bed!
I continue to do from 1 – 2 hours of daily exercises. My knees feel better after I exercise so I am motivated.
I saw an acquaintance in town the other day who had knee surgery before I did. She felt that she still wasn’t doing very well. I asked her if she still exercised and she said, “No, I know that I should exercise, but I just can’t make myself do it”. Now, she could CHOOSE to make herself do it – I believe that we always have choices. I still don’t like doing all of those boring exercise but I am motivated to come out of this experience stronger and healthier so I will do these exercises as long as they are benefiting me.

WEEK 14

May 11 Monday
I have been taking an occasional Ibuprofen when I have felt achy. The cool temperature and rain have made my knees feel achier than when it is sunny and warm.

May 15 Friday
The hospital bed was removed from my bedroom today and it felt great to have my room back. Of course I still have an exercise bike, a balance board and a raised cinder block (stair step exercises) in the room but getting that huge bed out was wonderful.

WEEK 15

May 20 Wednesday
I stayed up today until 9:30 pm and I was still not really tired. This is the latest that I have stayed up rather than getting into bed for the evening. I am feeling more energized.

I still have a hard time standing still (this is still normal) – I shift and raise one leg and then the other and somehow that makes it better.

WEEK 16 – 4 MONTHS

Standing is still not comfortable, I still do exercises once a day for about an hour, my weight has remained steady with only a gain of 2 pounds, I still rest mid-afternoon for 10 – 20 minutes, I now stay up until bedtime, my energy is almost back to normal, I can cross my legs at my ankles and at my knees, I continue to apply the cocoa butter several times a day and I am still using the original tube, I still walk very carefully, my right knee occasionally wants to swing out so I am always aware of it as I walk, I feel that my range of flexion is slowly increasing, I still don’t like to exercise but I do – I now take one day a week off, my balance has definitely improved but there is still room for more skill there, when I sleep on my side, I stuff some of the covers between my knees to cushion them,
I don’t take my cane with me in public any more, and I use the electric chairs at big stores if I have a lot of shopping to do – the cement feels to hard to walk on for long periods.

WEEK 24 – 6 MONTHS
Almost everything has continued to improve. Standing continues to be uncomfortable but I’ve read that this can take up to a year to improve.
I still exercise 6 days a week for about 45 minutes, my weight has remained the same, I no longer rest mid- afternoon although I do sit down periodically if I have been walking about for a while, my endurance is still somewhat compromised but I continue to see improvement, I apply the cocoa butter to my scars several times a day (still using the original tube), I can now sleep comfortably on my side with my knees together, I no longer use the electric chairs when I go shopping (unless I am really tired after a long day) and my right leg still wants to swing out when I am tired so I continue to be aware of that. My flexion has had no increase from what it was at 3 months even though I exercise daily. This is disappointing but I still believe that I can gain more range (112 degrees – left knee and 117 degrees – right knee).
I can finally walk up and down stairs bending both knees although my right knee still pops sometimes when I use the stairs.
Walking finally feels more normal – I don’t need to think about every step any more – YEAH!

ALMOST TWO YEARS

I am extremely happy with my new knees. At 14 months I actually gained more range in my left knee. I knew this because I was able to get out of our truck without having to scoot my body toward the middle of the bench seat. I was measured and I had gone from 112 to 115 degrees! I accomplished this by just being physically active.

Here is a photo of my new titanium knees!

TWO YEARS AND THREE MONTHS – just a few more bits of info

I am 63 now and I hiked 3 miles (half of it uphill) the other day and felt fine afterwards. (The waterfall was well worth the hike!)

I live in the country and when I used to walk along our driveway, I would kick away sticks away that had landed in the driveway. After the surgery, I was uncomfortable doing this kind of kicking. Now, it is fine – I can kick a stick off the road just like I used to do.

I saw my doctor recently for my 2 year check up and everything is great. I chose to not have him do any x-rays. My knees feel great, so why should I expose myself to the x-ray radiation. Luckily he is a great doctor who allows me to participate in the decisions about my body.

Both knees have maintained their fairly equal range of motion and I can do everything that I want to do.

I hope that this information has been useful for you. Feel free to email me with questions and I will do my best to answer them!

ALMOST 6 YEARS

It has been almost 6 years now and I am still doing great. Having both knees replaced was a great decision. Standing is still not very comfortable but since that is my only complaint, I feel very lucky.!

6. BILATERAL SPECIFICS

I didn’t find very much to read online about bilateral TKR so here is a hodge-podge of my thoughts about it.

It was interesting that my two knees responded differently to the surgery. My right knee was generally less troublesome and further along in therapy than the left. My left knee generally felt much stiffer and achier, but when I got to stair exercises, my right knee was more resistant – it sort of popped when I did the work. As I build up my muscles, this will lessen.

Another aspect of bilateral is that I had to do the exercises with each leg so that doubled my time spent doing exercises. It was still is a lot less time than the amount that would be spent in physical therapy with two separate surgeries. I was glad to be strengthening BOTH legs.

I have never regretted doing both knees at the same time. I was lucky that my weight of 149 pounds (5’5 tall) was pretty good. Supposedly one pound of body weight puts four pounds of pressure on the knees. I am consciously eating less since my surgery to maintain my lower weight of 138 pounds and so far, I have gained only 2 pounds!

7. GENERAL INFO

By week 9, I started being up most of the day but even now (week 13), I take a rest in bed around 4 or 5 pm. I stay for a half an hour or so and then I am ready to stay up until early evening. I am usually in bed by 8pm and we watch TV or I read until bedtime. I’ve never experienced a culture that has siestas but a late afternoon siesta sure feels good to me. If I had a recliner rocker in the living room, I might choose to rest there – the important thing is that my legs are able to stretch out and my body can relax. It will be a big milestone to reach when I am able to stay up all day – but I am not going to hurry this healing.

I learned that 145 degrees is the bend for a normal, healthy knee. Just FYI.

As I have been recuperating, spring has blossomed outside my window that looks out onto woods. Since the view is up about 20 feet, I see a lot of tops of trees that are blooming. I have closely watched a Sarvis berry tree and then a Dogwood bud out into beautiful white flowers. They remained open and gorgeous for weeks and now they have lost the blossoms as green leaves have begun to sprout out. I feel like the process has mirrored my own renewal as I have changed and adapted to my new bionic knees.

8. I WISH!

I wish that I had measured how far back each of my knees would bend before the surgery – just out of curiosity to see how it compares to where I am now. I would have sat in a chair with my back against the back of it. I would have tucked my feet as far under as possible and then measured from the tips of my toes to the front legs of the chair on each side.

9. TIPS – not in any particular order

* Have the knee surgery done SOONER rather than later.

* Go into this surgery with a POSITIVE ATTITUDE and do your best to maintain a positive attitude through out your recovery. Anytime I had a negative thought, I tried to notice it, cancel it and then restate it in a positive way. This is not an easy task but it has gotten easier the more that I have done it.

* EXERCISE BEFORE YOUR SURGERY so that your body will be in the best physical shape possible. You will be very glad after the surgery that you have done this. As a woman (who had frozen shoulders 15 years ago) my upper body strength was not as good as I wanted. I built up my arms by sitting in a sturdy wooden desk chair with arms. I would then use my arms to pick up my body from the seat. I got to where I could raise up about ¼ inch for several seconds. I am very glad that I did this and feel that I have used those muscles a lot since my surgery.

* EXERCISE AFTER SURGERY – if you don’t do the exercises, the only person you are affecting is yourself and your chance for a better future.

* HOSPITAL BED – HIGHLY RECOMMENDED!!!
I strongly suggest that you have a hospital bed in your home for when you come home from the hospital. Buy it, rent it or borrow it and if you don’t need it, then just return it. If you need it – you will be SO glad to have it. I am still using mine and it has been 3 months since my surgery. I can sit in it comfortably and I can raise the leg area just a tiny bit for when I sleep. Now, the PTs do not recommend this practice since the goal is to get the leg as straight at possible. However, so far, I have not able to sleep with my legs flat – I try to do this every so often because it is a goal. I lay flat and wait about a half hour and then I raise the leg part of the hospital bed and I am asleep shortly thereafter. To compensate for “cheating” about this, I do extra exercises during the day that help straighten my legs. Finally on May 1, I was able to lay flat in bed all night long.

I recently talked with my cousin who had both knees replaced 4 years ago and she did not use a hospital bed but she did use pillows under her knees. I prefer the hospital bed because I did not have to keep adjusting pillows and it provided a wide variety of ways for me to sit and lay.

As I got stronger, I lowered the height of the hospital bed a little bit at a time and built up my strength to get out of the bed at that new lower height without using my hands

Using the hospital bed meant that I needed a bedside table that could be about 4 feet out from the wall. I used a wooden TV tray and it worked very well. It was lightweight and I could move it in any direction to accommodate where I had the head of the bed. I also happened to have a chaise that I could reach – it was right next to the side of the bed where I kept the side rail up. I put pillows there when not needed, Kleenex, a trash container, my rolled up towels for exercising, books, my hair dryer, and weights for exercise – all sorts of things that I could use and reach while in bed. So, I would suggest having a card table or something on that side of the bed if at all possible.

A side story:
I planned on renting a hospital bed for $150 a month.
Kathy and I are very good at conjuring up things that we need. About 2 weeks before my surgery, we went to the Habitat Restore where I purchased an electrical hospital bed for $10.00! It cost more than that to hire two people to move it into my room. I have been very glad to have a hospital bed. I have spent a lot of time there sitting up with my legs extended which is very similar to how one would sit in a recliner. Luckily we had a twin mattress that we were able to put on the bed. When I tried raising the head of the bed, the mattress just stayed straight and did not conform to the bed. I got a ratchet strap and put it across the mattress and bed at the point that the mattress needed to bend and it has worked very well. I also added a foam egg crate on top of the mattress, which has made it very comfortable. I had all of this ready before I went to the hospital.
I put up the bedrail on one side of the bed and it has come in very handy. I can grab it when I want to move around plus it gives a place to hang the remote for moving the bed up and down.
If you do use a hospital bed, get a nail apron (available at most hardware stores for less than $2) and tie it to the bed rail. Mine has two pockets in which I keep the portable phone, the TV remote, a pen, my glasses, a small tablet and the paper on which I record when I took my last medication.

* NAIL APRON FOR WALKER
Again the same nail apron mentioned above can be stretched across the front of a walker thus giving 2 pockets for storage. Cheap and helpful!

* CARE OF THE SCAR – after the staples were removed I started putting vitamin E on the scars. A friend suggested using cocoa butter ($1.39 for a yellow tube of it from Cococare – only cocoa butter with no other ingredients) and I feel that it has worked very well. The cocoa butter is not as greasy at the vitamin E. At week 16 I am still applying the cocoa butter – still using the same tube.
My PT says that I need to put sun block on my scars whenever I am going out into the sunlight. The scar tissue will burn if it is not protected.

* STATIONARY BIKE – ANOTHER HIGHLY RECOMMENDED ITEM
I got my used bike for $15 at a Habitat thrift store. Also, many sporting goods stores sell new as well as used equipment. The bike loosens my knees faster and easier than anything else and it is almost fun. I didn’t use it for the first few weeks but I am very glad that I had it ready to go before I went to the hospital. It was particularly good to stretch both of my knees, which were always at different degrees of range. I could put my ball of my right foot on the pedal to give maximum stretch to that knee. Then, I could put my left foot more forward on the pedal so that it was not as flexed but still gave that knee the stretch it needed.

EXERCISE ITEMS
I bought a 6-inch diameter ball in the pet section for $3 and have used it for exercising (after about week 7).
Before surgery, I took a sheet and rolled it up along the long axis. I taped it in 7 places to hold it together. I have used this a lot to increase the bending of each knee. I place the center of the sheet under one foot and raise my knee (keeping the foot on the bed) and then use the sheet to pull my knee closer to my body thus extending the stretch.

* SHOWER SEAT
It was a good while before I could stand for long enough to take a shower so a shower seat (with adjustable legs) is ESSENTIAL.

* A GRABBER – another necessary item to have.

* BABY MONITORS
We had three monitors – one in my bedroom, one in Kathy’s room and one in the kitchen. Our house sort of rambles so this way we could talk to each other. When I first came home I would put my monitor on LOCK when I got up in the night to use the bathroom. This way Kathy would be able to hear sound from my area in case anything happened. It sure made me feel safer. Once I got back in bed, I would turn the lock feature off. As I got more stable, I quit doing this but we still are using the monitors.

* DON’T BECOME A COUCH OR CHAIR POTATO!
Don’t spend all day in front of the TV or at your computer – it may feel good to stay seated but it is not good for long periods. Sitting made my knees stiffen up even more. Get out and walk and try to go farther every day. Your knees will feel better and better if you do this. Use your walker at first and then your cane but get out and walk! Notice how stiff you are after you have sat for a while and then notice how much looser your knee/s feel after walking or exercising.

* NAUSEA
The best solution that I found for nausea that is caused from the Percocet or Vicodin, was to eat 2 saltine crackers (I prefer whole wheat) before the pill, take the pill, and then eat two more saltines. I drank water with each cracker.
In addition, if I still felt nauseous, I drank Clover Valley sparkling water beverage – no calories, no nutra sweet and no caffeine. This is available at Dollar General for 50 cents for 32 ounces. I also would chew Papaya Enzyme tablets. I did find that if I waited too long to take the next pain pill, I would get nauseous. Pepto Bismol also helped with the nausea.
Several times I got very nauseous and dizzy about 2 hours after lunch when I had taken the Vicodin with my meal (and with the four soda crackers). I began timing my meds so that I did NOT take them with food – this seems odd but it worked for me. I have been taking my meds and crackers at 10am, 4pm, 10 pm and 4 am and it has worked very well. My appetite did not return for about 3 weeks and at week 6 I am still eating less than I used to eat but I am satisfied. I lost 11 pounds and have not regained them so I am happy with that! I found out that each knee weighs about a pound so maybe I lost more weight than I realized.

DIABETES – I AM A TYPE 1 DIABETIC – info for other diabetics
My sugar definitely got out of control after the surgery for about 2 weeks – this is normal. I just kept taking Humalin/regular insulin as needed (in addition to my normal insulin) to attempt to bring my high blood sugars down. At one point in the hospital, they wanted to give me 16 units of Humalin and I told them that was WAY TO MUCH! I agreed to take 8 units and sure enough that was enough. You know your body best, so take control of your insulin when you are in the hospital.
I was also concerned about infection in my knees. With sugar in my bloodstream, it can be difficult to heal wounds. Luckily I have had no problems with infection. My doctor told me that the cement that was used to attach the parts actually contained antibiotics.

10. THOUGHTS TO HELP ME GET THROUGH THIS: (I wrote this during the several weeks prior to my surgery and printed it out to have available.)

Getting through this experience will make me a stronger, more physically active person and I will rejoice in this newfound strength.
I’ve heard that the pain level is like that of having a baby – so suck it up and take it – many, many women have many, many babies every second of each day. Some even go out and work in the fields afterwards. I have the “luxury” of having several months to recoup. (HA! HA!)
(Luckily for me my pain level was never really terrible and the drugs worked very well to cover it up.)

I can do this!!!
I can do this!!!
I can do this!!!

When in Physical Therapy, I will do what they ask me to do. (Whew – that’s a hard one but I know that this is in my best interest.)

If I feel like I can’t take it – BREATHE!!!

Keep the pain meds constant – do not let the pain level increase too much just because I don’t want those drugs to be in by body. Drink lots of water to flush out my system.

From a friend who just had rotator cuff surgery – don’t go off the pain meds too soon or the pain can come back with a vengeance. If pain meds are too strong, I may get a headache.

Stay in my adult – don’t become the whiny, crying inner child. A whiney child is not pleasant for me or for those around me. I can have a private cry if I need to.

Allow others to help me in their own way. I do not need to be the sole director of this experience.

Replace negative thoughts immediately with positive ones – there is always a positive choice.

I choose to walk in this lifetime using and appreciating both of my legs.

I’ve always said that CHANGE and DEATH are the only “for sure” things. I am choosing CHANGE. I am letting go of my birth knees and I am becoming a bionic woman. Pretty cool – who would of thunk it!

I choose life at this time and eventually “When the roll is called up yonder, I’ll be there” – but not a minute sooner.

Do NOT get angry with those who are caring for me – this is not in anyone’s best interests and it is especially not in my best interests.
(I used this thought the most and it helped me to just let go of some anger that I felt a few times toward Kathy.)

Others who have had bilateral surgery say that having both knees done at the same time is best because otherwise I would be relying on my bad left knee and that knee would only get worse.

Pain is inevitable – suffering if optional.
Greta Randolph

11. TYLENOL – attempting to change from Vicodin to Tylenol
This switch took longer than I expected.
(I eventually found out that Tylenol is very bad for the liver so I switched to Ibuprofen, which can be hard on the stomach. You might want to research these drugs for yourself before your surgery.)

Dr. Bond said that I would probably take Percocet for a month and then Vicodin for a month and then Tylenol.
I switched to Vicodin at 3 weeks after my surgery and I took my last Vicodin at the end of 3 months.

When I first came home from the hospital on January 30, I took one Percocet 4 times a day. On February 20th, I switched to one Vicodin four times a day and eventually I changed to ½ Vicodin. As the chart below shows, I eventually added two Tylenol and then switched that to one Ibuprofen. My first day without any meds was right at 3 months – May 3 although at week 16, I still take one Ibuprofen a day if needed (especially on rainy days).

Transitioning from Vicodin to Tylenol to Ibuprofen to Nothing!

DATE 10 AM 4 PM 10 PM 4 AM 1(bad) – 5 (good)

(sorry – I lost the formatting on this)

2/20 V V V V 4
2/26 T V V V 2
3/5 T V V V 2
3/24 T V V V 2
4/1 T V V V 3
4/7 T V V V 3
4/9 V T V V 4
4/13 V T T V 4
4/19 T T V V 3
4/20 N I V I 3
4/30 N I V N 4
5/1 N I I N 4
5/2 N I N N 4
5/3 N N N N 4
5/8 I N N N 4

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129 Responses to “Bilateral Total Knee Replacement (both knees)”

  1. Sally Says:

    I am having TKR on June 24th on right knee only, although I have pain in the left knee now also. This particular blog is the most helpful, positive thing about TKR that I have read to date. So glad you included photos also.

    • mtnwoman Says:

      HI Sally – thanks for the feedback. If your x-rays show that you will need to have the left knee replaced at any time in the near future, I would suggest talking with your doctor about doing them both at the same time. Just my opinion.
      Susan

  2. Sally Says:

    Thanks Susan,
    I’ve been thinking about that all day since reading your blog this morning. I think I’m going to call my doctor tomorrow and ask about getting an x-ray.
    Thanks for writing this blog. I’m sure I’ll be referring to it often over the next several weeks and months!
    Sally

  3. penny mackenzie Says:

    Thanks for writing this- I had bilateral total knees done on 4/22/10 at age 67. Your blog has really helped me “know where I’m at”- more info than the Dr’s able to provide.
    What kind of flexion/ extension do you have now? How long did you see increases before it got as far as it would go?
    Are you doing all the activities you’d like? Are you pain free?
    Penny

    • Susan Says:

      Hello Penny – thanks for writing. At week 10 I was released from physical therapy and my left knee was 110 degrees flexion and 3 degrees extension – my right knee was 116 and 0. I had achieved all of the goals that the PT had for me. She said that they wanted me to be at least at 110 flexion and less than 4 extension before releasing me so I was there. I am now at about 117 for both knees and I assume my flexion is the same or better. I did ask my physical therapist if I could come back for another measurement so that is how I got the more recent and higher numbers. I quite doing my exercises in November (9 months after surgery) because I was not gaining any more range but I found that I actually gained more range (just by doing my daily activities of renovating a house and going up and down the stairs) during my 13th and 14th month after surgery. My left knee gained more range and now is very similar to my right knee. I check this by laying on my back and bending my knees up in the air – then I look at both heels to see how close they are to the same flexing. Both of mine are the same now so I assume that I both are at about 116. My doctor told me that I would need 115 to be able to climb up the ladder at the side of a swimming pool and I can do that. I am able to do what I want – I went on my first short hike the other day and it was fine. If I had a little more range it would be easier to get pants on and it would be easier to get out of small cars but those are minor limitations! I am pain free but standing still for more than several minutes remains somewhat uncomfortable. I find myself flexing each leg as I stand and that helps. Some mornings I feel a little stiff so I ride the stationary bike for a few minutes and that limbers me up. You are over the worst (the surgery) but you still have a “long road to hoe” so hang in there and exercise, exercise, exercise! Feel free to write anytime with any other questions that come up. Best of luck to you – Susan

  4. Fire Surround · Says:

    when using desk chairs, i would always prefer to use wood instead of plastic desk chairs ‘-“

  5. barbara larmonie Says:

    hi, im barb, im going 6/30/11 to make date for bilat surgery. scared to death im 68 and very overweight cant seem to lose it tried all my life to but not good at it.am italian so theres your answer lol.i,ve read your blog a lot and am grateful for it .i ordered the book and am awaiting its arrival.getting a stationary also.this surgery has consumed my whole existance my peace of mind is gone and i dont like it 1 bit.wish i could overcome this fear.pain has comsumed me also.so i guess its time to get my big girl pants on and just do it. thanks for listening to me whine barb

    • Susan Says:

      Hello Barb – I am glad that you have found my blog to be of help and it is great that you have ordered the book and are getting a stationary bicycle. I would strongly recommend that you begin doing the exercises in the book as soon as you get it – this will get you in better shape for after the surgery. I have a friend who is also overweight and she had bilateral knee surgery and is doing great. I know that it is hard to not be afraid but that fear can add negative energy to the process. Time spent worrying about the future is lost in the present. If you feel like it, if your write out your own “intention” for this surgery, perhaps that will make your feel more secure about the entire thing. I would also suggest that you speak to your surgeon about your fears. My surgeon played the “devil’s advocate” and gave me all of the reasons to not do both knees at the same time but I was insistent on having both done so then he became totally supportive. I would also suggest scheduling the surgery far enough in the future so that you have some time to strengthen your muscles as explained in the book (unless your pain level is so extreme that sooner is necessary). Please let me know when you will be having the surgery and keep me posted on your progress. Best of luck to you.

  6. penny mackenzie Says:

    Amen to the above comments. This is hard but wonderful surgery, I havy a very overweight friend who encouraged me!
    I’m VERY glad I had both knees done at the same time. Dr wanted me to wait 3 months between surgeries, but if you are healthy, there are no greater risks… so then he was supportive. His concern was pain.
    I had surgery on a Thursday and went for 3 days of in hospital [not nursing home] rehab. The Dr didn’t want me to go, but I asked to see a social worker and told her what I wanted- also had spoken to people who had been pleased with rehab. This gave me PT twice a day, and a chance to be more independant when I got home.I also investigated who offered rehab and spoke with them preop. I told my Dr and the preop nurse this is what I preferred. [My husband was nervous about helping me.] Altough I had little appetite, meals were already prepared at rehab.[Be sure if you have little appetite you get adequate protein- whey shakes with fresh fruit and ground flax for fiber is good- your body NEEDS this for post op healing.] If you have both knees replaced, or live alone, you meet criteria for Rehab. At 67, I was medicare and had a supplement, so it cost nothing extra.
    I was indepentant with a cane in 2 weeks, but used a walker for 2 more weeks when my huband took me out.[couldn’t drive.] I asked the dr for a handicapeed sticker- In FL you have to buy them, and I used it for a month after I got home. I also found out what a wondeful thing big ice packs are, and went through a small cooler a day for a month.
    I found the local hospital provided free transportation to their outpatient rehab when I asked if that was available. I had rehab at home for 5 wks and OP for 4 wks- the last 2 weeks I drove myself using an automatic shift.
    I took after finding I needed it and getting thr DR’s OK, a double dose of pain Rx 1 hr before therapy, which was rough. I live in FL, so got in the pool as soon as the insisions were healed to do more threrapy.
    In July I was scubadiving, taking my stuff off in the water [someone else would bring them in the boat] and going up the boat ladder- also down house stairs– it still hurt from the surgery, but things were doable, Mid Sept I went with an art group to Italy where we did alot of standing/ walking. This march I went to CO for 7 days of skiing- mostly blue, no more bumps, but NO problems- spaced the days .
    Now it has been 1 yr and the pain has finally[ slowly] gone! I still have stiffness and exercise [ try to keep bending] but you can see I was able to resume activities fairly soon.
    I did use pain meds for 2 months, longer than the Dr wanted, but as the pain decreased, I stopped without problem.
    I think I’m bending at about 120 degrees. [didn’t go for the high flex knee since the doc felt the regular one was sturdier.] I had normal full flexion before.
    penny- from comment of 6/2/10

    • Susan Says:

      Hello Penny – thanks for sharing your experiences. It is good for others to know how varied our responses can be. You seem to be doing extremely well for the one year point. We are both lucky to have done so well.

  7. Kathleen Says:

    Hello My name is Kathleen and I’m only 45 years old and both my knees are bone to bone. my right knee was first to go then my left knee is now bone to bone. I have been to several doctors and tell me because of age I’m to young…..it’s frustruating because I’m in consent pain every day. Now that I have read your story. I’m more than encourgage to find the right doctor that can do my surgery.
    Thank you,

    • Susan Says:

      Hello Kathleen – I highly encourage you to keep looking for a doctor who will do your surgery. My doctor told me that the new knees are capable of lasting up to 30 years and in 30 years they will have even better options so when you are 75 you could do what ever is needed then. In the meantime you will have your life back. If someone is in an accident and both knees are crushed, do they tell them, “No, you have to remain a cripple for 20 more years until we think that you are old enough”? By waiting you will also continue to lose muscle tone which could make your recovery even more difficult. Best of luck and please keep us posted about you future surgery (optimistic thinking is always best!).

  8. Penny MacKenzie Says:

    Hello,
    My neighbor had a Dr who insisted she wait until she could not walk, and she was 71 at the time! This caused severe muscle wasting and an accidental fall when her knee completely gave out. He insisted on the same for the other knee which they knew was also bone on bone at the time of the first surgery. Again she had her knee give out in the shower and fell- no way to call for help as she lives alone. It took her an hour of agony to crawl to the phone. Then she had to wait weeks more til she could fit in his schedule!
    I feel this is old thinking and barbaric.
    I completely agree with Susan.
    The plastic piece between my new knees will probably have to be replaced in 20-30 years; not to worry- this is not a major thing. In the meantime I have been able to resume my life. Most Drs feel the same way.My Dr said I will probably nee th

  9. Susan Says:

    Wow – this poor woman. I agree that this is barbaric. I hope she has found a better orthopedic surgeon. Thanks for your post Penny.

  10. Susan M. Says:

    Hi Susan,

    I apologize for leaving this in a comment but I couldn’t find another way to contact you. I’m working to pull together a virtual insight group (conference call + online meeting) for patients and caregivers who have dealt with Knee Replacement and I wanted to invite you to attend (or at least give you more information!).

    If you’re interested in finding out more, drop me an email. =)

    Susan Mees
    Susanm@wegohealth.com
    Director, Community Relations of WEGO Health

  11. Barbara Czapla Says:

    Hi, I’m Barb, 67 years old and had bilateral knee surgery 6 months ago. I love my new knees and I totally agree that if you need to have both knees done have them done at the same time. Having a positive attitude is absolutely essential for a successful surgery and recovery. I had so much pain before the surgery that rehabing was not difficult for me. I was off pain meds at three weeks, driving and walking a mile. I rode a recumbent bike for an hour each day before my surgery to build up my thigh muscles and continue to do that now. I walk 2-3 miles a day, snowshoe, and keep active. My life has changed so much for the better with my new knees and I’m thankful every day for this type of surgery. Please, if you are reading this blog and considering knee surgery, JUST DO IT. Thanks for sharing your info as I’m sure it has encouraged many people who might be considering this surgery and are worried about having it.

  12. barbara Says:

    I had bilateral knee replacement surgery seven months ago and I feel terrific. The surgery was very successful and I’m able to do so much more than I could before it, i.e. walk 3-4 miles a day, snowshoe, hike, walk up and down stairs, etc. The pain right after was very well managed and I was able to transition to ibuprophen after 4 weeks and now I only need it if I’ve been exceptionally busy. Most days when I wake up I don;t even think about them, they are part of me and feel like my own knees only better. If you’ve been told you need knee replacement surgery, please just do it! Do exercises to strengthen your thighs and ankles beforehand, have a good attitude, and follow your physical therapists suggestions for exercises after the surgery. Good luck. Barb.

    • Susan Says:

      This is great news – glad that it all is going so well and I agree with everything that you wrote. Yesterday was the three year anniversary of my new knees! Thanks for sharing your experience.

    • Susan Says:

      Good advice – thanks for sharing your experience! We are all so lucky to have our new knees.

  13. jan Says:

    i had total knee replacement on my right knee in december of 2011. i knew both knees were bad about 3 years ago but i kept putting the surgery off. i had bursitis in my left hip in september of 2011 and met a new orthopedic surgeon. he gave me a shot of cortisone and that helped. a month later i went for a follow up appt for my hip and my pt had called my surgeon and told him how bad my knees were. both were bone on bone but the right one hurt the most. since i work in retail that made it even worse. dr xrayed them and we had the knee replacement discussion and i opted to have the right one done the following month. he ordered an mri to measure what size joint parts i would need. on dec 12 0f 2011 i had the surgery folowed by home therapy for four weeks then o/p therapy for four weeks. i worked really hard on my own before during and after. i had gone to a joint class at the hospital before surgery which was very informational. i am now at 11 weeks post op and still on medical leave from work/ i see my surgeon again on march 14th and hope i will be released for work with no restrictions. i took nucynta for pain for about 4 weeks then tylenol.

    • Susan Says:

      Hello Jan – thanks for sharing your experiences. Sound like you are doing really well. I am at 3 years now and am doing great. I dug 3 holes yesterday for new plants! Keep us posted on your progress.

      • jan Says:

        i had another post op appt with my surgeon on 3-14-12. he said he would lift my restrictions and allow me to return to work if i use a kneeling pad and a knee brace whenever i kneel at work. i work in retail stocking shelves. so i return to work on monday 3-19-12. i know it will hurt some and i will be sore for a while but i need to get back to some normalcy. i will be very careful but feel that i am ready.

  14. penny Says:

    Good news!
    At almost 2 yrs,I am skiing for a month in CO. [on my bucket list]
    I’m at about 120 degrees of active flexion, and can push both knees a little more.
    I do use a foam pad when kneeling- couldn’t tolerate even that til 10 mo. post op. I never had to use any knee brace.
    I am so greatful for this technology.
    At 1 yr I was also able to climb the ladder of our motor home to wash the roof.

    • Susan Says:

      Well congratulations and it is so nice to hear from you. My doctor told me not to ski, jog, play tennis – none of the hard on your knees sports which was fine with me since I prefer swimming. I enjoyed reading of your milestones. I used to ski a little when I was young so I am envious. I was surprised by how uncomfortable it is to kneel on the metal knees – even bumping a table edge is rather uncomfortable. This is a small price to pay for getting my life back with my new knees. AT 3 years post op and 64 years young, I am back to renovating a log house in the mountains of western NC. Life is good! Thanks again for writing.

      • jan Says:

        i went back to work this week. i work in retail and kneeling is a big part of my job. i am 14 weeks post op from my right tka. yes you are right. kneeling even on a soft kneeling pad really hurts. and getting back up wasnt very easy either. ouch. my surgeon told me it would be painful so i wasnt shocked but it did hurt. still like everyone says its so worth being able to walk without severe pain constantly

      • Susan Says:

        Wow Jan – that is impressive. I don’t think that I would have been able to kneel at 14 weeks so good for you. Kneeling is still not very comfortable for me. Titanium definitely feels different than bone. Today while gardening, I lightly hit my knee with a shovel and it sure did hurt. I am not complaining because I love my new knees but I am stating a fact for me. I can say that it gets better and better!

      • jan Says:

        susan…i wish i had a sit down job or at least one where i didnt have to kneel or squat etc. but finding a job like that at age 60 just doesnt seem possible. i worked at the phone co for 32 years and did various jobs there. if i knew then what i know now i would have never taken early retirement. lol it is what it is and at least i have a job

      • Susan Says:

        I wish you did too. It is amazing what we can manifest so I would like to suggest that you envision the perfect (no kneeling, etc.) job. It can’t hurt – who knows what might happen. It is great that you have such a positive attitude.

      • penny Says:

        I am so glad to hear of your contiuing active life.
        I had discussed with the Dr my desire to continue to ski- there are many of us out there. There also was a recent study that showed easy to moderate skiing [blue and green runs] don’t stress the new knees more then walking- for green, and only a little more for blues.
        I too was surprised at painful kneeling.

  15. barbara czapla Says:

    I like to believe that we are truly like vintage wine and with our new knees, we just keep getting better with age. I’m now at 9 mos. postop and went cross country skiing two weeks ago. I hadn’t done that in 12 years and it felt so gooooooood.I was also on the ladder last week washing windows and helping to put up new blinds. Life is good and the reason I post here is to hopefully inspire others who are “waiting” to decide to have knee replacement to just do it!

    • Penny MacKenzie Says:

      Congratulations!
      Thank you ALL for this site and Susan for doing such a great job of her experiences. When I go back to my Dr, I will take the site to him- I believe though everyone is different, this will give people facing TKRs an idea of what to expect and how to manage.

  16. Susan Says:

    Penny – that is good news that so many of us are out there skiing. Thanks for letting us all know!

  17. Melinda Says:

    Dear Susan,

    Thank you so much for your incredible blog. I am 33 years old and had a bilateral replacement 3/2/12 (rheumatoid arthritis). The hardest part of this whole thing is the depression! It started right when you said it would. So I guess I’m on week 4. The PT is going well but my right leg is more painful.

    I have been taking some notes and some pictures to go with them to keep track like you. Do you remember how you slept at night? For 2 weeks I managed to sleep with my legs straight but I’m a side sleeper! So now I bend my knees.

    I look forward to moving again. I’m trying to heed your couch potato advice but the depression does get in the way. I think I should be walking more but I’m afraid of over doing it. I do go up and down the stairs multiple times a day. My raised toilet is upstairs! PT also drains me. I get very tired but I feel great after I move. I think I will start walking like you said and see if I can go further each day.

    Thank you again or your site. I hope you are doing great!

    Take care,

    Melinda

    • Susan Says:

      Hello Melinda – thanks for writing. I was so amazed that the depression showed up right when someone mentioned that it would. I am not normally depressed so I was surprised. It did pass before too long so hang in there and don’t let it get you off course. I remember that I woke up one morning and couldn’t figure out what was different – I finally realized that I was depressed. DUH!
      My right leg was more painful too but now they are both great!
      I used a hospital bed and slept on my back (like I normally do) with my legs raised just a little – the doctor said to not have the bend very high. I just couldn’t sleep all night with them flat out. I am not much of a side sleeper but when I got back into my regular bed and I laid on my side, I would put some of the bedding between my knees because it hurt to have them directly touching. Is your doctor or PT concerned about your knees being bent most of the night? It seemed to me that my doctor didn’t want that – the goal is to have the legs get to a zero degree bend when straight out so maybe check with your PT to see how you are doing.
      I don’t think that you would over do it walking too much so walk, walk, walk! Your idea of going further each day is great because then you can feel like you have achieved another small milestone – good for depression. PT would drain me too but that is just part of the program here. That will improve too. Be patient – you are not yet a month out and it sounds to me like you are doing really well.
      I am doing great – I have my life back and my new knees are now just part of me.
      Please keep us posted on your progress.

    • jan Says:

      melinda i had knee replacement in december of 2011. i did as much christmas shopping as i could before my surgery. my husband had to finish it though. i was in the hospital 2 nights and three days. i did well walking with my rolling walker after surgery etc. with it being around the holidays i got reall depressed but my home therapy therapist took me outside to walk one morning when it had warmed up. i was using my cane by then. walking is the best thing and working on straightening exercises. i love walking and am sure i do it every day. i either go to a store like walmart or traget and push the cart for support or i walk in our neighborhood. i work third shift at walmart and i was released to return to work on march 19th but surgeon insisted i use a kneeling pad for kneeling. but i have lost 13 pounds the last 2 weeks from walking. hang in there. it will get better

  18. Elsie Yan Says:

    Hi Susan,

    My name is Elsie Yan and I live in Kuala Lumpur, Malaysia. I had bilateral TKR 14 months ago at age 50. I read your blog and was impressed that you took the trouble to share in detail your experience with bilateral TKR. I wish I had more info before my surgery so I did not have to learn it the hard way.

    So far, I think its quite rare to see such detailed sharing of TKR experience which is certainly a big benefit for people with similar problems. That’s why I have also started a blog recently with detailed account of my bilateral TKR experience.

    I have also joined the Delphi Forum which is very interactive. Perhaps, you are also a member already.

    Its great to see that you have received so many responses to your blog and its like a small community has been formed. I am hoping that this will happen with my blog but I know I still have a long way to go. Keep up with the good work.

    … Elsie

    • Susan Says:

      Hello Elsie – your write up about your TKR was very interesting. I am surprised by how different we each heal and progress with this. I like your idea of approaching others to hopefully encourage them to seek help with their failing joints. I will start paying more attention and will speak up if it seems appropriate. Thanks for commenting on my blog and for writing your blog. Keep up the good work. I tried to post this comment on your blog but I kept getting that the URL contained an error – oh well. Susan

  19. elsie yan Says:

    Hi Susan – Thanks for your encouragement.

    There is one issue I raised at the Delphi Forum which we haven’t found an answer yet. You know before TKR, we all suffer from morning stiffness, stiffness after we get up from sitting, standing and walking for a period of time. Medically, they say that this is due to OA. However, after TKR, OA should be gone but we seemed to be having the same stiffness which could be at the same or lesser extent than before TKR. This led me to think that could it be caused by the previous scarring of OA considering all the bony spurs? Maybe you or any of your readers have an answer to this.

    Despite being very physically active and a relatively good range of motion, I still feel the stiffness syndrome. Of course, considering my condition before TKR, I really cannot complain about it as I am pain free from my knees now. I can certainly live with it as I already have done so for many years before TKR. Its just that I still wonder about the cause of it or whether it will go away eventually after many years. What’s your experience?

    By the way, here’s my blog and email address in case any of your readers are interested. I am puzzled why you cannot leave a comment in my blog. Would appreciate if you or any of your reader can try to leave a comment and let me know if there’s any problem.

    Email: elsieyan@unifi.my

    Blog: totalkneereplacement-elsie.blogspot.com

    • jan Says:

      i also have stiffness in my operated knee after tkr if i sit for a long time without my knee propped up. i usually eat my lunch at work then i get up and walk around which helps eliminate the stiffness. if i go anywhere and sit with my legs down and cant prop them up i get up and walk around some. that really helps me and certainly i can walk further distances without knee pain so much better than before tkr

      • penny mackenzie Says:

        I still have stiffness- somewhat uncomfortable-2 years after bilateral knees. It is slowly decreasing. I believe we have to keep aware of maintaining the flexibility of our knees the rest of our lives, or we will lose some flexion. However I feel much better 2 yrs out than at 1 yr. That surprised me since I thought healing would be complete at 1 yr.
        Until my 2nd anniversary, I was more comefortable sleeping with a pillow under my knees, and when on my side, between my knees. I’m still sensitive on my side lying with knees touching each other, but now can sleep that way. [I didn’t worry about keeping my knees straight when sleeping as I could straighten them fully a few weeks post op. My low back bothered me, and felt better with slight flexion.
        Thanks to all for sharing.

      • barbara czapla Says:

        Thanks, Penny, I’m just coming up to my first anniversary this June and I can’t believe they actually get better so I’m looking forward to that. I’m wondering if anyone has experienced one knee being better than the other. I can do many things on both of them for which I’m very grateful, but I don’t even have to think about stiffness at all in my right knee, but I do in my left. Wondering if anyone else is experiencing the same thing. My doctor rated my right knee as an “A” and my left as an “A-.”
        -

      • Susan Says:

        I want to thank everyone for posting. Our sharing is important.
        I don’t have much stiffness. I do get a little stiff if I sit too long but once I move it goes away. My two knees are fairly equal now in both flexion and feeling. I still get uncomfortable if I have to stand for extended periods. I had read about this so I stand and flex my knees as needed. As we all comment – we are all much better off than before our surgeries. I think it is interesting that only women have commented on this site. Do we have more TKR surgeries or what????

  20. Elsie Yan Says:

    I can see from the feedbacks that stiffness is quite common after TKR. I keep coming back to the issue of stiffness and have just written a topic on this in my blog. I have been on a quest to find out the cause of stiffness after TKR. Recently, I have been reading a lot of write ups from medical websites about stiffness after TKR. There seems to be quite a number of causes indicated. However, there are two very interesting causes which I find to be quite relevant and realistic for me.

    1. Some people seem to make more scar tissues than others after
    surgery which causes stiffness.

    2. A patient’s motion before surgery can be used to predict the
    patient’s motion after surgery. Patients with stiffness before
    surgery are more likely to have stiffness after surgery.

    Item 1 may be possible for me. Item 2 is really spot on for me. This explains why I have the same experience with range of motion and stiffness before and after TKR. In my opinion, the damage from OA cannot be corrected even after TKR. It is the same as my friend whose bow legged legs were corrected after TKR but her inability to squat cannot be corrected as her body structure has already been affected. Well, I am more at peace now with the stiffness and it is something that I can and have been living with for years. But if it improves over time, then it will be a bonus for me. I am still grateful that I did my TKR as I am pain free from the knees and have a better qualify of life.

    • Susan Says:

      Elsie – thanks for sharing your research! It is a huge help for others to understand what may be happening in their situation.

  21. Elsie Yan Says:

    Susan – I have recently written a post about bow legs which is quite typical for prolonged OA. I have also just written a post on my experience with addiction due to OA. This is something that is close to my heart but by sharing with others, it gives me a sense of freedom. So please check out my blog.

    totalkneereplacement-elsie.blogspot.com

    • penny mackenzie Says:

      Great Blog Elsie!!!!
      You have overcome many things.
      I am surprised your regular Dr did not slowly wean you from the sleeping medication, as the medical professionals know quite well what happens when some meds are stopped abruptly.
      I too notice when I see people suffering with their knees, and try to be brave to approach them and tell them of my experience, and not to delay too long, if possible.
      One thing concerns me, the jumping jacks in your program of exercise. The Drs here advise no jumping or running, as this puts pounding pressure on the “plastic like” material between the other total knee components and causes it to wear more quickly. It is this part that will need replacement in 20- 30 years, not the entire TKR- unless it loosens in the bone, which is fortunately seldom. So they say the second surgery for that isn’t quite as bad as the first- we hope! Maybe you can make a substitue for the jumping jacks, like squats [bottom even with your knees, not letting your knees project over your toes. Or low impact aerobics, or fast walking.]
      Thank you for sharing your site and experiences with us!

      • Elsie Yan Says:

        Penny & Barbara – Thanks for your feedbacks. Being an addict, I will resort to all means of getting the pills without any drs involved. You will be surprised at how many pills I can take at one time. My son said that its amazing how I didnt OD on it. This is how crazy one gets when you become addicted to something. Your mind isnt working anymore. I was fortunate that my addiction did not cause any relationship problem with myhusband and family members nor did I have to steal money but I was really concerned about my health after swallowing tons of the pills. So the first thing I did in recovery was a full medical check and I was so lucky that everything was ok.

        I am so glad you raised your concern about the jumping jacks. You have just confirmed my fears and I will seriously take your advice and replace with lower impact exercise. The DVD workout that I follow has great exercises with lots of squats, lunges, strength training but the only thing is those jumping exercises in between which I myself was nervous about even while doing it.

        Once again, thanks for your feedbacks.

    • Susan Says:

      Elsie – thanks for sharing your experience. Great blog also! My doctor also said no jumping – only low impact.

  22. barbara czapla Says:

    Penny, I totally agree with what you wrote. Low impact exercise is the key to longer lasting knee replacements – biking, hiking, walking, swimming all are great. My doctor says, “walk, walk, walk and to strengthen my back, do pilates exercises. Love all of you on this blog. I look forward to opening my “inbox” just to see if there is anyone has anything new to add. And a big thanks to Susan for beginning this.

  23. Susie Blust Says:

    Don’t get discouraged! Pt helps but sometimes they want too much too fast! Your body will heal when it is ready. It took me 2and a half mos. to give up the cane or walker, but when I was ready it happened over night. Drugs definitely help but get off as quick as you can comfortably. Depression can be a problem if you don;t progress as quickly as someone else. Give yourself a break and time will take care of most problems. Best wishes to you all!

  24. Elsie Yan Says:

    Please check out my latest post on “Addiction Rehab”

    http://www.totalknereplacement-elsie.blogspot.com

  25. Elsie Yan Says:

    Hi Susan, I have written a post on Water Therapy which I have personally benefitted from. You will also discover that our cartilage actually contain water and dehydration can cause joint damage. Hope you will find the post useful.

    totalkneereplacement-elsie.blogspot.com

  26. Susan Says:

    Excellent information – thanks for sharing this.

  27. Elsie Yan Says:

    I have written a post on Massage After TKR in my blog and there is a link to a video on scar and adhesion massage to loosen tissue and help improve range of motion which may be of interest to TKRers. And it is something that we can do ourselves.

    totalkneereplacement-elsie.blogspot.com

    • Jibi Says:

      Dear Susan,

      Thank you so very much for sharing your humble and compassionate journey of bilateral TKR.
      There is very little info available and I truly appreciate your candor.

      Since Oct 2011, I have been on Chemotherapy treatment for HCV. I am in remission and complete my course of treatment in late September 2012.
      I was recently Diagnosed with bilateral degenerative knee disease and am discussing doing both knees w my surgeon in ten days.
      I believe in positive intention and mindset. I have been in recovery for drugs and alcohol for over 4 1/2 years. I have faith this will not be an issue.

      My concern is the atrophy from lack of exercise for the past year due to chemo… I am anemic, and even w rescue drugs; I get wiped out. The sporadic knee pain unfortunately does not help the situation. I just began stationary seated 5 lb weight for my upper torso strength.
      I have bookmarked your page, and have discussed many of your suggestions with my RN…. she agreed with all as she had a bilateral a few years ago. Runs around like a loon, works in hospital plus her farm, hence zero kneeling. Nope nada. Squats are ok for her, but kneeling is out.
      Anyhoo I will check back with an update… Thank you again, Susan; so very much for being here…. Hugs…. Janet

      • Jibi Says:

        Just to clarify, I meet with the surgeon in 10 days, poss November?

      • Susan Says:

        Hello Jibi – thanks for responding to my blog.I was thrilled to hear that your RN agreed with what I had written. It is VERY wise of you to build up your upper body strength so that you can more easily use the walker and get up from a seated position. If you are at all able to also build up your leg muscles, that would be helpful.I understand that exercise is hard to do when your energy if low. Keep us posted on your progress. Best of luck.

    • Susan Says:

      Elsie – thanks for the excellent video on scar adhesions.You blog is also very good.

  28. LawandOrderfan Says:

    Wow, what an amazing story, thank you for sharing your journey. I personally haven’t had any type of knee surgery but I watched my grandfather go through two total knee replacement surgeries… Although it was painful, his PT encouraged the same thing, always get up and keep going, but just don’t over do it. He had a bad heart on top of everything, a quadruple bi-pass just 10 years prior to the surgery… our only problem was the bill afterwards… Unfortunately the insurances looking at all his pre-exisiting problems weren’t so kind in taking care of much of his bill… when it arrived we were all in quite a bit of shock…. We even thought we were being thrown for a loop until I stumbled upon this great cost estimator, although we were still in shock, it was nice to have peace of mind, wish we would have found it sooner… we would have been better prepared for it.

    http://www.healthline.com/surgery/total-knee-replacement/costs

    It lets you customize it to your age, location, insurance and even pre-exisiting conditions and then produces a bill that includes physical therapy on it. I’ll pass it on to you as well or for anyone you might know that may need it, great site, answered a lot of medical questions and gave me and my family peace of mind, I hope it helps you as well, good luck with everything you’re going through!

  29. Elsie Yan Says:

    Thanks Susan, I have also just written a post on Numbness which is what all of us have following TKR. Please check it out.

    totalkneereplacement-elsie.blogspot.com

  30. blondeunicorns Says:

    Hi there, my name is Theresa and I will be 51 just before my surgery. I am hoping the dr does bilateral surgery as both my knees are bone on bone and I also have bone spurs on both knees. I go in Dec 19th to see him and ask more questions. My name will get put on the list for surgery in February.

    • Susan Says:

      Hello Teresa – you have lucked out because you are seeing your doctor on my birthday so I am betting that it will all go really well. If the doctor doesn’t give you a good reason for not doing both knees I would get a second opinion. Keep us posted.

  31. barbara czapla Says:

    hi Teresa – I checked with my regular ortho doc and two others who would not do bilateral knee surgery. Found one on my insurance who also happened to do Tiger Woods knee and he said I was the perfect candidate for bilateral knee surgery. It is definitely worth checking around. I’ve had my “new” knees for 1.5 years and love them. Every day I get out of bed and feel so fortunate this technology is available. I used a recumbent bike for two months before my surgery to strengthen my thigh muscles and did exercises for my ankles. I can’t stress how important that was to my recovery. Bilateral is definitely the way to do if you are mentally and physically prepared for it. Best wishes and let us know how you do.

  32. Elsie Yan Says:

    Just to share with you about the power of Green Smoothies and arthritis and for that matter, our general health. Please check out my latest post on Green Smoothies & Arthritis.

    http://www.totalkneereplacement-elsie.blotspot.com

  33. Fred Says:

    Thanks for sharing your information. I fell a moth ago because of not walking squarely. I took your advice gettinto the best shape that I can for my age of 63. I have good upper body strength just bad knees. I plan on having surgey in June. Hope to lose about 20 pounds and built muscle. Thanks for shasring. I started a diary to track my progress and goasls. Happy New Year!!!!

    • Susan Says:

      Fred – glad to hear that you are taking the time to build muscle and lose weight and the diary is a great idea. Best of luck – please keep us posted on your progress.

  34. Maureen Croteau Says:

    Thanks very helpful Surgery March 26. Will drop a line after asap

  35. project management forms Says:

    After I originally left a comment I appear to have clicked the -Notify me
    when new comments are added- checkbox and from now on whenever
    a comment is added I recieve 4 emails with the exact same comment.
    There has to be a means you can remove me from that service?

    Appreciate it!

    • Susan Says:

      I am sorry to say that I do not know how to remove you from that service. Can you un-check the “notify me” box?

  36. Manie Says:

    Hello everybody

    I found this blog in the weeks leading up to my bilateral TKR which was performed by Dr Ockie van Zyl at the Panorama Medi Clinic in Cape Town, South Africa. I had my bilateral TKR on 26 March 2013.

    This blog meant so much to me that I felt compelled to also share my experience with those of u who have had TKR and especially those who are contemplating to undergo it.

    I am a 62 years old male and have had severe knee problems for at least the past 15 years, due to repeated sport injuries from playing rugby and competitive field and track activities during my younger years.

    The cartilage on both knees was completely worn out and my knee joints were actually bone grinding on bone. I could not bear any weight at all with my knees bent. Imagine the spectacle I presented when being forced to negotiate stairs! A Giraffe trying to eat off the ground provides a reasonably accurate mental picture lol.

    My experience was so much less difficult from some accounts I have read about, that I almost feel hesitant about sharing it here.

    Day one – I spent the first day and night in Intensive Care. The surgery was performed under epidural and light anaesthesia and I experienced discomfort, but relatively little pain during the first day and night. I was able to rotate my ankles a few hours after the operation, but my quads did not work due to my legs being numb from the epidural. The Physiotherapist visited me during the day and bent both my knees to about 90 degrees. This was not painful at all, as my legs were still numb due to the epidural and possibly pain meds administered.

    Day two – I was moved to a general ward and received injections for pain every six hours (for pain management) irrespective of whether I experienced pain or not. The PT visited me in the morning and showed me how to get out of bed ( I was able to lift both legs) and stand beside the bed holding on to a walker for balance, but taking my full weight of 105 kg (230 pounds) on my legs. To me that felt like a huge achievement! That same afternoon the PT made me walk with the walker, to the door of the ward and back to my bed. I had very little pain, but felt awkward and unsure of myself. I tried to walk “normal” with heels first and toes last from the start. The usual in bed exercise routine to regain mobility and strength was started.

    Days 3 to discharge on day six – The pain meds were gradually reduced and the exercises and walking distance were increased. On day 3 the walker was replaced by crutches. On day four I had to go up and down two portable steps. I have to admit that this scared me beforehand, but it turned out ok, and gave me a much needed confidence boost.

    I was discharged on day six, and was able to get into the front passenger seat for the drive home.
    I live alone but was fortunate to have my girlfriend and future wife stay with me for the first two weeks at home. She lives and works in a different city at present. This was a blessing as I would have battled to cope alone during that period. She is an angel and I will never be able to thank her enough for her love and care. I have been coping by myself for the last 8 days without any problems.

    I have fortunately not required any pain medication for the last two weeks. Ice packs and regular exercises gave me major relief.

    My first appointment with the surgeon was two weeks post op. He was very happy about my progress in terms of strength and mobility and gave me permission to drive my car from that point. I have a medium sized car with a gear shift and clutch and have been driving short distances from week three.

    I was able to walk short distances without crutches from day eleven post op and have been increasing the distances to the point where I can now (28 days post op) walk without crutches around the block before the muscles supporting my knees get tired and sore.

    I drove to Sportsman’s Warehouse today to buy ankle weights so I can increase the intensity and quality of my leg extension and other exercises.

    I fully realise that the rate of my recovery may be faster than that of many people, but I do hope that my account may encourage fellow TKR patients and especially those who contemplate having the procedure done.

    Yes, it is a major procedure, and yes it is painful and uncomfortable at first. BUT, it can be done and it is a turning point in one’s life. It is a transition from ever increasing pain, immobility, frustration and even embarrassment, to a life without the pain, increasing strength, mobility and normality that can and should not be denied.

    I have not been able to play golf for 3 years. Now, 28 days post op, I am looking forward to slowly start practising my long lost golf swing again within a month, and join a group of old golf friends on a golf trip at the end of July this year! My surgeon says it’s doable, and I will be on that plane!

    I thank God for the miracle of my fast recovery and I also know that this thing should be approached with a positive and attacking mind set.

    Be strong, be positive, set challenging goals and start living again.

    Regards

    Manie

    • Susan Says:

      Wow Manie – you are doing really well. Thanks so much for sharing your experience. We are all different so it is great to hear each others perspectives.
      I hope your golf trip in July goes exceptionally well – sounds like you are really looking forward to it!

    • Penny MacKenzie Says:

      Hello Manie,

      Thank you for offering your experience. it is very helpful since each of us is different, and the way our health care systems operate & what they provide is different.
      What we all seem to agee on, it how wonderful it is to get your life back!

      I am 3 years post op this month and just spent 28 0f 30 days skiing in Colorado (USA). I do use CADS to alleviate pressure on my knees and hopefully the “plastic” between the tibea and fibula prothetics last longer. For you skiers, look on CADS.com.

      Happy golfing!

      • Susan Says:

        Penny – thanks for writing and I agree with all that you wrote. It is wonderful that you are back to skiing!

      • Penny MacKenzie Says:

        Thanks- would love to hear what you are up to-

      • Susan Says:

        Penny (and others) – we just got back from a month on the Mediterranean. We did 2 back-to-back cruises out of Rome and then went to Venice for 5 days. I was so grateful for my new knees as we walked around Venice and climbed the many, many steps that take you across the bridges that are every where to cross over all of the canals. We also continue to renovate a log house that we bought several years ago. The end of this renovation is finally in sight and we hope to move there soon. So, I am as active as I want to be for a 65 year old woman! Thanks for asking.

      • Penny MacKenzie Says:

        That sounds wonderful!

  37. Barbara Czapla Says:

    Dear Mannie,

    Everyone who tells of their experience here enhances all of our experiences for those who are contemplating this type of surgery. I will be two years post op in June and it has been a fabulous two years. I have been able to do so much more with my “new” knees than I was able to do before. I truly have a much better life back. I am not saying it is easy…..you have to put in the time, do the exercises both before and after knee replacement; have a good attitude and know that there will be a good outcome. You will be golfing before you know it, Mannie. Have fun and enjoy those knees. We are so fortunate to be born in a time when this type of surgery is becoming so successful and helping to change peoples’ lives. Best wishes.

    • Susan Says:

      Thanks Barbara and yes, we are lucky to ave this kind of medical help available. We are all clearly extremely happy to have our lives back – lucky us!

  38. Lynn Says:

    I have had the privilege of serving with Susan on a local environmental committee in our county. She indeed is very active and you can’t even tell she’s had surgery on both knees. I shared with her that my mother recently had TKP and she referred me to this blog. I have enjoyed reading her story and everyone else’s comments. Your experiences give me much insight and hope for my mother, age 78, as she recovers.
    Thanks.

    • Susan Says:

      Hello Lynn – it was a nice surprise to see your comment here. Thanks. If you or your mother have any questions, please don’t hesitate to call or email me.
      Please tell her that I wish her the best recovery possible!

  39. Elsie Yan Says:

    Hi Susan, I thought it might interest you or your followers to read about the root cause of arthritis and other diseases. Check out part 1 and 2 of the posts in my blog.

  40. Nike Free Run Says:

    Good day I am so happy I found your blog, I really found you by accident, while I was browsing on Askjeeve for something
    else, Anyhow I am here now and would just like to
    say thank you for a fantastic post and a all round interesting blog (I also love the theme/design), I don’t have time to look
    over it all at the moment but I have saved it and also added in your RSS feeds, so when I have time I will be
    back to read more, Please do keep up the great work.

  41. Tammy Bolton Says:

    Oh wow, I’m so glad I found your blog…just searching the web about bilateral TKR. I’m having both knees done on 9/11/13. Very useful and helpful information here. I’m very scared and nervous. I also have a blood clotting condition which I will need to have an IVC filter placed prior to surgery to prevent any clots (if there are any) from making their way to my lungs/brain. This probably scares me more than TKR! I am overweight so this also has it’s risks. I get cortisone shots about every 3-6 months and they help for a while but this last time around, they only lasted a short time and I had to be wheeled in to see ortho! Scared, excited, overwhelmed!

    • Susan Says:

      I felt much more confident after I wrote out my “Intentions” – perhaps thus would help you ass well. I would also suggest beginning to do some strengthening exercises for your arms and legs. Glad you have found this blog to be helpful. Best of luck and please let us know how it all goes.

    • Susan Says:

      Tammy – how are yo doing now?

  42. Stella McDonald Says:

    I enjoyed reading your blog prior to my TKR on Aug 5. The pain pre op had become almost unbearable due to severe arthritis and absolutely no cartilage in that knee. The first day post op I experienced less pain than I had Pre op! I found I only needed the walker for 3-4 days and then back to my cane for a few days and then walking independently in no time. The PT sessions were very helpful and I was able to return to my full time position as an RN in 6 weeks. (I am a case manager so I am not on my feet all day with patients!) I established a goal pre operatively that I would climb Mt LeConte in the Great Smokey Mtn National Park next year. That remains my goal, and I WILL do it. Thank you for sharing your experience with us. I trust that you continue to do well.

    • Susan Says:

      Stella – you made amazing progress after your surgery. I am sure that you will climb the mountain – just get in shape to do it. I enjoy hiking now too!
      Keep us posted!

    • penny Says:

      Bravo, people!!!
      I just had my 3.5 yr check up- all holding out well- no nix on a month of skiing in March. Next check up in 5 years.
      There is no hilly, beautiful hiking here- FL where I am is super flat with little variation in the natural plants, unless looking at the very tiny stuff. I do miss real hiking.

      • barbara czapla Says:

        Hi, Stella. I can so relate to what you said about the pain preop. People wanted to know how I was able to manage the pain of having two knees done. Unless you’ve had the unbearable pain before the surgery in your knees, It’s hard to convey to someone how easy it is to deal with the pain after surgery. It’s been 2.5 years now for me and I’m grateful every day for my knees. I’m going to be 69 next month and feel and act much younger. I’m able to walk/hike 3-4 miles a day and exercise at our community gym every day. I’m sure you will continue to get stronger and stronger as long as you take advantage of being able to walk and exercise every day. No one has commented on the “type” of knee replacements they have received. My doc told me mine was a woman’s athletic knee which means it can move like a natural knee. It’s important for anyone undergoing bilateral knee surgery to have a good connection with their doctor….tell him what kind of activities you like to do so he has a clear understanding of what you would like your life to be like after surgery and rehab. This blog is a Godsend for people who are about to undergo surgery and don’t know what to expect. Thank you, Susan for your vision.

  43. Susan Says:

    Thanks to all of you for sharing your experiences here so that others may benefit!

  44. Alice Says:

    Wow…thank you for taking the time to record your experience. I’m 36 years old and I am a month in on the same bilateral total knee replacement. This experience is not for the faint of heart. I’m doing well but it is discouraging thus I was searching the web for other peoples experiences and found you. The worst is not having balance and pain getting up from the sitting position, but I know it will get better with time. Thanks again.

    • Susan Says:

      Hang in there Alice – things definitely get better. I didn’t have any issues with balance. I hope you have mentioned this to both your doctor and your PT’s.
      I am 65 now and I go hiking – actually just walking but I am thrilled with my new knees. You are still in the very challenging stage. Soon you will begin to have little milestones that will give you even more encouragement. Keep us posted.

  45. penny Says:

    Alice,
    Some people do have balance problems.Ask for the balence board as part of your PT- this will help alot. Did you previously have these problems? Ask the therapist to measure your leg length to be sure they are both= length.[fixed with heel lift in shoe, if not.]

  46. Susan Says:

    Thanks Penny – good advice that I was unaware about! It is so wonderful that we can be so supportive of each other in this “online” age!

  47. Lissa Says:

    Contemplating bilateral knee replacement…have been suffering for over 3 yrs w both knees… Can’t walk
    Properly and take pain meds (Vicodin and tramadol) just to get through the
    Day.
    I care for my 2yr old adopted grandson..he has been an angel and a blessing…. Obviously I can’t do the things I WANT to do with him… My dream is to RUN with him. He is starting preschool on Sept.. And I was going to
    Use that time to have my surgery
    I have just turned 65 and am in fair health. Most issues due to to being overweight (200lbs 5’3 1/2)
    I did a lot of research …. Finding no
    Real answers…. After reading your story
    I think I have found the inspiration and motivation to do what I need to do.
    ( remain positive, lose weight, and exercise, get ready! To be a better me)
    THANK YOU for putting your story out there

    • Susan Says:

      Hello Lissa – your post brought tears to my eyes. I am so glad that you found my blog. I hope that you can buy the book – Total Knee Replacement Surgery and Rehabilitation by Brugioni and Falkel ($19.95 new) so that you can begin to do the exercises which will make you stronger to make your rehab faster. BTW – I am 66 and I can run so go for it! Please keep us posted on your progress and good luck!

      • penny Says:

        I bet you will lose weight after surgery when you can move without the arthritic pain.
        3 years is the time I struggled to not have knee replacement- arthroscopic on both knees, shots in the knees, even paid for stem cell injections; none of these were successful.
        Susan- you can run!!!! I can’t, but I just went back to Zumba classes- feels good. [still can’t kneel or get in and out of a bathtub without a struggle, but that’s not unusual.]
        I look forward to hearing of your progress as you go through this journey to feeling better.

      • Susan Says:

        Thanks Penny – I can’t kneel either and have the same bathtub issues. It helps if I can get some kind of padding under one knee as I get up. Metal, bone and skin seems to hurt more than just bone and skin – makes sense! Your Zumba class sounds like a fun way to be active and that is great!
        Nice to hear from you.

      • penny Says:

        Good to hear from you!
        You have made a wonderful venue for people dealing with arthritic knees. I believe it is more informative and encouraging than any other source I have read- and I feel I have another friend!
        I do wish more people who drop in would continue to post on how they are doing.

  48. Susan Says:

    Yes, I agree with you – I would like to hear from others too. Perhaps some don’t know (or choose) to click on the link to get emails about these posts. Anyway, it is always nice to hear from you.

    • jan Says:

      susan I always appreciate your posts and helpful information. I went to my orthopedic surgeon for my 2 yr check up and he released me. he did tell me if I have any pain or problems whatsoever with that knee or with my other knee or my hips to call him he is an excellent surgeon and very good at communicating so if I decide to have total knee replacement on my left knee in the future he wull be who I call

  49. jan Says:

    penny I still cant kneel on my right knee without pain but it was a small price to pay to be able to walk a lot further without having to stop with severe debilating knee pain

  50. Susan Says:

    Thanks Jan and Penny – always appreciate your comments.

  51. Cynthia Says:

    Thank you so much for your detailed experience with tkr. I had both knees replaced on January 27, 2014. My friend, who had her knees replaced, recovered in a couple of months with relatively little discomfort or pain, so that was what I expected. It is now going on week 9 after surgery and I am experiencing pain and stiffness in my knees. I saw the surgeon yesterday and he was very pleased with my progress. The flexion in my knees are 120 right and 127 left. I weaned myself from the heavy dosage of oxycodone I was taking 4 to 5 times a day to one 5mgm a day. Yesterday the doc gave me a prescription for Norco with Tylenol which I can take once a day, preferably at night, for pain if necessary. I am reducing physical therapy from 3 to 2 times a week and as suggested by the doctor, I will get a stationary bike to use at home. It was reassuring to read your post (and others) to see that what I going through is more the norm. It is my hope that I will increase my stamina and reduce the pain. Your very positive comments are inspiring and I will continue to do what is necessary to make a complete recovery.

    • Susan Says:

      Cynthia – It sounds to me like you are making wonderful progress and your flexion is much more that I got – yea for you! It is a good idea to get the stationary bike. I rode mine whenever I felt extra stiff (sometimes even in the middle of the night) and it really helped. Tylenol can be hard on the liver so drink lots of water! My knees felt like they were filled with styrofoam but that eventually lessened until it was finally gone. I assume you are doing exercises at home ???? Keep up the great work and keep us posted on your progress and milestones!

  52. Kim Says:

    Thank you so much for all of this wonderful first hand information. I just had bilateral tkr 10 days ago. While I was preparing to do one knee, my wonderful surgeon suggested doing both. SO glad I did. I am so early in this journey but I already know it was right for me. I thought I knew what I was in for, that I had done all the research I could and yet I was not fully prepared for the challenges this has brought to my life. I just wanted to say thank you for sharing. It shows me that yes, I can do this.

    • Susan Says:

      Yes – you can do it and it is SO worth it. Best of luck. Keep us posted on your progress!

      • Kim Says:

        Well, got all those pesky staples out today. Sort of funny, usually I have a strong stomach but I had not seen my knees since surgery. What a shock! Started to feel dizzy lol….nurse had me lay down for the rest of the staple removal. :). All seems to be healing well according to my doctor. Was curious though, did anyone else have massive muscle spasms or Charlie horses in their knees and thighs?? Wondering if this is something else I’ve just had to learn on my own. Either way, feeling blessed..getting stronger everyday, painful therapy and all!

    • barbara czapla Says:

      I did have Charlie horses in the area behind my knees….especially if I was extra active that day with physical therapy, walking or shopping more than usual or I also noticed if I was on the couch watching TV for a length of time and my legs were stretched straight out, when I bent my knee to get off the couch I could feel a Charlie horse once in a while. If you are getting them often you might want to check with your doctor and get his opinion. My bilateral knee surgery was three years ago and it gets better and better all the time. Hang in there and have a positive attitude and you will do well.

  53. Kim Says:

    Thanks for the input! Will be asking him just to be sure. Seems like it’s only after the p.t. has beat me up pretty good. :)

    • Susan Says:

      I occasionally get legs cramps (not in relation to my surgery) and I find that taking a dose of Ultima Replenisher (balanced electrolyte powder) relieves them. In fact I take a dose of this about 3 times a week just for health and prevention. It is not expensive and the raspberry flavor is yummy.

  54. Kim Says:

    Thank you for the response Susan! Learning a lot here already! Glad I found this blog, :)

  55. Kim Says:

    Have another question…what was the most comfortable sleep positions you all found? How about how to not wake up so stiff in the morning either? Having a hack of a time with this. Was sent home with a constant motion machine and odd as it sounds, I would sleep while it ran then wake up and switch legs. But they picked it up a few days ago and now I’m having a hard time figuring this out. Thanks in advance for any input!

    • penelope mackenzie Says:

      I know they told me to not put a pillow under my knees when sleeping, but It was too painful to sleep in full extension. I used a small [flat] pillow to give me about 2 inches of flex. I put a regular pillow between my knees when sleeping on my side- it took 2 years before it didn’t hurt to have 1 knee lying on the other. I had no problem with straightening my knees other than the normal post op pain- lots due to swelling and disruption of all the muscles. Time-lots- takes care of this. After 4.5 years I still feel stiff but I think I always will. I have great extension and very good flexion. I will have to work on this the rest of my life- I can snow ski, bike, climb a ladder, etc. I don’t have pain. Yea for this surgery!

  56. barbara czapla Says:

    I also slept with the machine running and I used an ice machine on both knees while I slept as well. My husband was great…..he got block ice and cut it to fit the machine and it lasted all night….greatly cut down on my use of pain meds.

    After the machine I found my most comfortable position was on my back with a pillow under my knees. Sometimes I would switch and put the pillow between my knees and lie on my side. I will admit sleeping was not the best for the first 3-4 weeks. If you are tired during the day, take a nap…it really helps to maintain your energy level during the day. I would nap after my exercises. Just hang in there, it really does get better with time.

    • penelope mackenzie Says:

      I agree- ice is so important to comfort. My Dr didn’t order the ice machine – I worked in a hospital where we used it all the time. The hospital where I was used the small disposable ice bags which are what I came home with. I sure could have used your husband’s idea!

  57. Susan Says:

    I bought an electric hospital bed for $10 from a thrift store so I was able to raise my knees just a little bit which made it much more comfortable. If I woke up and I was stiff in the night I would get up and ride my stationary bike for a few minutes and that would limber me up. The stiffness does eventually go away so hang in there. it took at least a year before I could sleep on my side with my knees touching each other. Thanks to everyone who is using this blog to share information. I really appreciate your thoughts and comments.

  58. Kim Says:

    Thank you all SO much for the advice/information! This has been so helpful for me in this journey. And each day is a little better in some way…just can’t wait until I get a full good night sleep lol. I tell you what, this surgery was the BEST thing I have ever done for myself! And again, I feel so lucky to have found all of you and your wonderful insight!

    • Susan Says:

      I agree, Kim, that this was the best thing I have ever done for myself as well. Rolfing was probably the second best thing. it is a lengthy process but well worth it.

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