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Blather, clicking knees and Hi Herbm!
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Peter_C Offline

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Post: #11
RE: Blather, clicking knees and Hi Herbm!
Nope, as this board focuses in other areas, I've never really written any posts about all my different surgeries to date. I am more than willing to talk or type about them, but (on other forums) I've been smacked for too much noise about surgery, meds, PT, etc... Of course I am not a Doctor of any type, but my first dislocation was at age 14, first surgery at age 17, and have been on and off pain meds and NSAIDS since 1979.

I have had to date:
Left patella realignment
Left patella realignment - done over after destroying it 4 months later, working with no PT
7 'scopes on the left knee
1 'scope on the right knee
Left knee replaced '09
Right shoulder rebuilt '10
Right hip replaced '11
Right knee replaced 33 days ago

Planned for this year:
Left shoulder rebuild in 2-3 months
Left hip replacement in 6-8 months

I've been in Pain MGNT 3 different times, currently for the last 3 years.

Due to a blood disorder, I can no longer take any form of NSAID. Which is very bad news, as NSAIDs actually enable you to do more with less pain, rather than just masking pain.

The stronger the joint is pre-op, the better the rehab will be post-op. Lots of folks don't think about this, and many times the joint is so bad they can't do much to work on it anyhow prior to surgery. PT and rehab is as important if not more important than the surgery~! Following your Doctor's instructions is critical, as different joints need different healing times, have different risks, etc. Not listening, doing rehab your own way, failing to do the PT **WELL**, is a recipe for turning yourself into a cripple. I know, because as a dumb kid, I destroyed my left knee by working (and falling) without ever doing any PT.

Typically, knee replacements can be worked as hard as possible from day one, limited only by swelling. Getting your RoM (Range of Motion) back is critical in this joint, and will determine the success or failure of the replacement. Only about 60% of people end up 100% pain-free. Most of the rest do fine with a low-grade daily NSAID. About 10% end up with chronic pain requiring pain meds - the Docs do not know why (in my case, too much prior muscle damage). The key to a successful knee replacement is hard PT/rehab work, getting the RoM back, and rebuilding knee strength, it is ALL up to the patient~!

Typically, hip replacements are pretty easy. Both in recovery of RoM on your own, walking, and PT/rehab - though it *IS* needed! The two biggest risks after a hip replacement is a fall (prior to RoM coming back 100%), or a dislocation - your Doc will give exact instructions about what movements you are NOT to do, and for how long~! Some 90% of hip replacements end up pain-free. The remaining 10% may have random weather issues, etc - and again, a low-end NSAID taken as needed usually will resolve any issues. Unlike a knee replacement, people are required to take it easy after a hip replacement, XX weeks of not much, XX weeks of PT, XX weeks of motion limitation - it's more of a time issue than a work hard and beat yourself up issue like with knee replacements. The key to a successful hip replacement is simply doing as your Doc tells you to, and mild PT rehab work when scheduled.

There is no 'typical' shoulder repairs. Everyone is different, you may have cuff tears, bone spurs, ligament damage, etc... The patient should expect and plan for roughly a full year to recover completely. Depending on what gets done will determine if you end up pain-free or not. I had two bone spurs, 2 cuff tears, one ligament almost torn in half. I was considered slightly worse than an average repair. I am about 98% pain-free, and it took 10+ months (with pain) to fully recover. Patient following Doctor instructions on use, motion, etc is critical - some 30% will re-damage the shoulder in the first four months. My arm was strapped to my side for eight weeks after surgery. PT/rehab is important, but done at a very slow and gentle pace. it is very easy to re-damage the repairs made, so time is a big deal.

In my book, the shoulder was my worst, and my hip was my easiest joint worked on. Free advice? Be very paranoid about falling~! Use a walker with wheels even after you can walk normally! I would not plan to get out of bed for bio breaks at night for at least two weeks (simply due to risk of a fall while sleepy). If you Doc wants a pillow between your legs and it bugs you - get over it Smile I would try to make sure you have plenty of available places to sit in every room - remember the Doc will mandate a MAX degree of bend for XX time - learn it, live it, don't fake it - if you need higher chairs, get em!

Oh - fugly scar! And if you are at all chunky (or fat like me) it'll be way worse looking than a knee ever will be. Herb, if you have a multi-floor home, you may strongly wish to consider living on one floor for a few weeks. Paranoia...one little oops is all it takes to require a do-over.

If anyone wants more info, whatever - am happy to tell all I have learned over the years - PM, email, phone - am happy to help.

Lastly, consider the hip good practice for the upcoming knee(s)...

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
08-15-2014 07:43 PM
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herbm Offline

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Post: #12
RE: Blather, clicking knees and Hi Herbm!
Well, this is it. Tomorrow early is my hip replacement.

Anterior approach so there is very little chance of dislocation (Peter is correct, the more common posterior approach has a 2-4% dislocation post-op).

Generally, there are no post-op precautions with this type of hip replacement -- the posterior approach comes with a serious "Do NOT..." list.

Hoping to do it outpatient -- home tomorrow night, but otherwise a few nights in the hospital should do it.

I am ready, and hoping to try out for "hip replacement post boy" to add to my OSA success.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
08-18-2014 05:16 PM
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retired_guy Offline

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Post: #13
RE: Blather, clicking knees and Hi Herbm!
I'd wish you good luck Herb, but I know I don't need to...... You're going to do absolutely great! I'm sure of it. Congrats in advance on your new framework.
08-18-2014 05:25 PM
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Peter_C Offline

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Post: #14
RE: Blather, clicking knees and Hi Herbm!
Can't wait for the after action report Herb. I am not clear why my Ortho chose one method over the other. He's the specialist, and I like the results...

PT today was one of my worst sessions. Doc climbs up on the table to push down on my leg for 30 seconds at a time - felt like he was trying to break it, but also got me to 3 degrees. On my own am only (currently) straightening to 15 degrees - long way to go, rather poor day for me, and PT took me two hours to complete today...oh boy!

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
08-19-2014 12:51 AM
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herbm Offline

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Post: #15
RE: Blather, clicking knees and Hi Herbm!
Today I had a Total Hip Replacement, Anterior approach, by Dr. David Dodgins.

Outpatient, so I am home making a little video.

Done. Home. Comfortable. Happy.

Not using a walker; cane is optional.

They let me walk OUT OF THE HOSPITAL unassisted (had my HurryCane.)


More details to follow if you want them.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
08-19-2014 08:00 PM
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retired_guy Offline

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Post: #16
RE: Blather, clicking knees and Hi Herbm!
Amazing. Absolutely amazing.... Congrats on your new parts Herb.
08-19-2014 08:23 PM
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herbm Offline

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Post: #17
RE: Blather, clicking knees and Hi Herbm!
It is amazing -- I planned for the best but exceeded even my own expectations. Only regret now is that I didn't have him do BOTH SIDE even though the left is not PAINFUL yet.

You wil really want to see the video Carol and I made when we returned home about 6:30pm. I will get it in a good spot and post a link tomorrow.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
08-19-2014 10:59 PM
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Peter_C Offline

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Post: #18
RE: Blather, clicking knees and Hi Herbm!
Sweet~!

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
08-20-2014 12:20 AM
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herbm Offline

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Post: #19
RE: Blather, clicking knees and Hi Herbm!
For about five years, I have been teaching a self-defense group, and one of my greatest concerns was that our group would dissipate if we could not keep it going regularly. Most of the guys who have practiced with me all this time don't have regular schedules and can't promise to be there to lead but my good friend Ryan offered to try it and has been running the show since the day before my surgery.

So day one post-op, my wife helped me sneak by practice tonight where Ryan and Shane were working on slow flow knife disarms.

[FYI: I invented a really slick method to teach and learn knife (or other weapons) disarms: Principle Based Disarm Chains. It is highly effective and a big part of our self-defense practice. ]

Everyone immediately realized that I am walking better already than even before the hip started hurting. Apparently it was restricting my movement prior to the serious symptoms.

So I got 10 minutes of attacking and taking away knives slowly to satisfy my inner training junky.

All was fine -- at this slow speed.

Before you say "take it easy", I am and I am staying well within the envelope, that is why 10 minutes was all that was prudent.

Carol and I stopped to pick up dinner at Chipotle and picked up a couple of dinners and I am now home icing proactively with my feet up and resting comfortably.

My energy remains good (took a two hour nap this afternoon. AHI 1.0) A little activity doesn't deplete me but I am keeping all activities short.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
08-20-2014 09:28 PM
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Peter_C Offline

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Post: #20
RE: Blather, clicking knees and Hi Herbm!
I finally rode 4.34 miles yesterday on my trike - felt more like a first ride of the season than a post-op ride. My inner thighs complained more than the knee did. Today at PT Jeff (the PT Doc) tried something new on me that was really painful but also worked really well - got me to 5 degrees with no real effort on his part. Feeling pretty beat-up tonight but am hoping to feel better after a good night's sleep.

My plan is to ride every day I don't have PT, even if only for a couple of miles. Glad to read you are doing so well Herb, at this rate you oughta be able to do the knees soon.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
08-20-2014 11:55 PM
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