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Blather, clicking knees and Hi Herbm!
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Post: #21
RE: Blather, clicking knees and Hi Herbm!
So I went to my Combatives & Self-Defense group (Have a friend teaching it) last night, 1 day post op, and 'worked out' for 10 minutes: slow flow drills, knife attacks and disarms. (Guy with knife attacks the other guys without knives, who disarm and then attack someone else.)

Stood and chatted another 10 minutes then came home to eat dinner.

This morning, I just completed a 5/8 mile walk (took 30 minutes so it was only about 1 mile per hour) at less than 46 hours post-op. Really I wasn't pushing it folks, but I did want to get the walk in before it gets really hot. Austin was at about 90 degrees and 83% humidity already, and will get close or to 100 later today.

My knees continued to be more the limitation than the new hip so I used two canes and have ice on the KNEES now. Although I remained mobile & ambulatory throughout my hip problem, this is the first 'walk' I have taken in 2.5 years.

Looking forward to replacing the knees in 2 months. My surgeon is (pretty obviously) one of the best and he said that he would do the bilateral knees and if I am healthy we would only need to wait 2 months.

It pretty much takes 6 weeks for bone to fully heal so that will give the hip enough time.

My only regret is that I didn't do both hips this time. Even the one that doesn't hurt needs replacement and with this type of result I could easily be rehabbing two hips.

Knees are harder so not 100% sure yet about that plan, and likely I will go straight to the rehab facility in the same hospital rather than walk out that day. Smile

Needless to say (to those of you who know me), I am having a ball. Probably the only guy in the world who can ACTIVELY ENJOY a total hip replacement.

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."
(This post was last modified: 08-21-2014 09:29 AM by herbm.)
08-21-2014 09:28 AM
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herbm Offline

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Post: #22
RE: Blather, clicking knees and Hi Herbm!
For Webbie73 if he looks here:

My ANTERIOR Hip Replacement was done as an OUTPATIENT -- went home the SAME day with practically 0 pain. (Total actual pain was literally 1/2 second on the 3 night post-op when I sneezed.) Going back for bilateral knee replacement, BTKR, and likely will just take the machine as is typically recommended -- though I MIGHT make that as an OUTPATIENT as well.

I also might just skip my treatment for a couple of nights as this really isn't a big deal for me (although I never have skipped it at home or traveling.)

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."
09-20-2014 07:29 PM
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Peter_C Offline

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Post: #23
RE: Blather, clicking knees and Hi Herbm!
Getting both knees done at the same time, (no offense) but I bet least three days in hospital. Not only are hips much easier to recover from, but you also had the really cool procedure done on you. My hip was an overnight stay, my shoulder was out-patient, and my recent knee was 2.5 days (of course, overall health plays a big roll here as well) - my Doc would not consider doing both of my knees at the same time - due to my lousy health, and 300+ pound weight.

For those that are counting, I am just over eight weeks post-op, and it was only yesterday at PT that I got down to two degrees (RoM), am 130+ degrees without any work, but hitting zero is the bane of my life it seems. I've been going to PT 3X weekly since one week post-op.

Again, everyone IS different. For instance, can you get to zero right now with the current knees? If so, won't be any big deal for you. But even though my right knee has not had much trauma over the years, I could not get zero pre-op if my life depended on it, so that is why it is such a struggle for me now. The hamstring is simply too tight and we are having to (slowly) stretch it.

I do hope that your knees go as easy for you as your hip Herb, but I would make a plan B just in case?

*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."
09-20-2014 07:39 PM
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herbm Offline

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Post: #24
RE: Blather, clicking knees and Hi Herbm!
Pretty much everything Peter wrote is correct.

Surgeon estimated I would be in the hospital/rehab 3-4 days but he says, "When I can go then I can go." (Take care of myself, get up/down on chair/bed/toilet, walk at bit (with walker), good on pain meds, and normal recovery (e.g., no fever.) He will NOT hold me articificially.

He also said he wants to see what happens when I apply myself to the knees like I did to the hip.

To be clear, I have a plan B, C, and really infinite flexibility on dealing with the BTKR recovery.

For instance, I will not even ask to go if I can't take care of myself and I will go to rehab from the hospital if not ready after a few days -- my wife can't really be expected to help me much PHYSICALLY. (She'll feed me and run some errands but can't get me up and down if I can't.)

Been trying to get my friends on Facebook to start a pool (3 days is only duration taken). Range is about 6 hours to 2 weeks (including rehab) to get me home.

Same day is unlikely (but I haven't dismissed it as impossible), and either 1 or 2 days are not too unlikely if I get really lucky.

As Peter indicated: Knees are HARDER to recover than (Anterior) Hips and two knees are harder still.

My ROM is about Left 14 to 110 degrees, and Right about 11 to 120+ degrees.

I am a bit heavier than would be ideal, but have very strong legs and good strength overall, plus my training and experience includes a LOT of hypnosis and NLP, plus while the Hip was incredibly easy, it gave me a chance to practice most of the recovery steps and issues.



FYI: My surgeon and I were discussing quick recoveries and he told me about a 400+ lb man for whom he performed a BTKR.

3-4 other surgeons had also turned the man down due to the weight.

The fellow told my surgeon, (words to the effect), 'I don't plan on living to be old, and knowing myself, I am NOT going to change and lose the weight but right now I cannot walk and am in pain all the time.'

My surgeon got it, and agreed. Turns out this really big guy was up and around pretty effectively at only 4 weeks post op -- surprising even the surgeon.


My philosophy: Prepare to the worst and shoot for the moon.

So far, I have been pretty lucky with this but it will be what it will be.

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."
09-20-2014 08:43 PM
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Peter_C Offline

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Post: #25
RE: Blather, clicking knees and Hi Herbm!
Sounds like you're in the right frame for this.

I would politely suggest that on the new knees you accept nothing other than 'ZERO" on both knees. It IS possible, though rather painful to get to zero. If you do not do so during your rehab, you never will. Most Orthos call anything below a '10' a success. And yes, if you can get down into the single digits you can walk without a limp and do most stuff reasonably well.

But I am here to tell you that I got my left knee to zero (am still at zero four years later), and if me with all my issues can do it, anyone else ought to be able to do so if they care enough. Frankly speaking, this is your *one* window to make the new knees as good as possible - but it takes real work and time - besides being right in the head- I would also politely suggest regardless that you take your pain meds one hour prior to each PT session. Pain does not help in any way during PT.

I plan to continue to work on my right knee til I can get zero without any effort. The PT Doc is thinking another 2-3 weeks and (hopefully) I will be there.

Lastly, whether it's this thread, or a new one, I really do hope you will give us progress reports at least 2-3 times weekly? I for one am very interested, mainly because people are so different, I enjoy reading other people's take on what I have gone through myself.

One lady about my age, tall and 200+ had both done, got to zero within 4 weeks, and was back at work (standing/walking all day) eight weeks post-op. Hurting by the end of the day for a few weeks, but missed no work. Minor point, she had no prior injuries to either knee, complained of knee pain, was found to be bone-on-bone and got them replaced some six weeks later - so she went from 'sore' knees, to replacements - no real pain, no NSAIDs or pain meds prior. My thinking is the less damage prior to replacement, the easier it is to recover (opinion only).

*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."
09-20-2014 09:12 PM
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herbm Offline

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Post: #26
RE: Blather, clicking knees and Hi Herbm!
Again, Peter pretty much has it all correct (for those who aren't informed about joint replacement).

However, I can walk without a limp with less than 0 extension, probably with 10-15 degrees since I did it for decades. In the last five years or so, I went bone on bone and bowlegged (vagus) from the knee joints losing all space medially (inside) and bowing outwards.

For me, I am much more concerned about getting to 120 degrees flexion COMFORTABLY on both knees for doing steps and and one leg squats (half squats are enough for me.)

My knees are VERY STRONG from protecting themselves for decades -- once he gets me decent space, tracking, and removes the severe osteophytes (bone spurs etc.) I expect things to improve RAPIDLY.

Right now, I am working out for both my legs to get them ready, and for my upper body to allow easier movement when my arms and shoulders have to get me up and down while the knees are recovering.

I am not moving a LOT of weight, about 90 lbs for both legs together on the leg extension and about 80 on the femoral biceps (hamstring) curl -- 2 rounds x 2 sets x 10 reps.

Probably going to start taking the weight up in the next week or so (and reducing the reps as needed) as long as the inflammation doesn't get bad. (High weight for lower reps produces STRENGTH as opposed to muscle building or stamina.)

If the knee joints complain, then the current weights and reps will need to suffice.

Similarly for dips and pull-ups to prepare the upper body.


If you want reports, then I would be delighted (I was banned* from BoneSmart.org so nowhere else useful to post my progress except for Facebook.)

* Basically, they banned me on phony charges of "giving medical advice" due to having an inate opposition by the forum admins to telling people how easy a joint replacement CAN be. (Really.)

It bugged the crap out of them.

BTW: For anyone having a joint replacement (especially a hip or knee, total or partial, single or bilateral) I still HIGHLY RECOMMEND BoneSmart.org (no matter what issue they may have with me). There is a LOT of good advice and support over there -- is the closest thing to THIS forum you will find for joint replacement and mostly a bunch of really nice and helpful people.

The admins aren't crazy or bad people, but they have invested so much effort in explaining HOW HARD IT CAN BE to people having trouble (e.g., like people who come here months or years without getting good therapy) that it's hard for them to accept and admit that the other end of the spectrum is possible too.

Always, I explained that MY results were exceptional (but possible) and not the norm. The members regularly expressed interest and enjoyment in my results and methods that worked for *ME*.

My real 'offense' was having a PERFECT HIP REPLACEMENT experience in which I actively enjoyed the ENTIRE experience.

This is literally true -- I had FUN throughout, and have the videos to prove it. Smile

All the videos are short, less than a minute each.

Outpatient Total Hip Replacement (THR) home on same day as surgery -- video was made on my back deck the day of the surgery (I am still wearing the compression stockings and have the hospital tape on my right hand)
https://www.youtube.com/watch?v=fBnOTMkMMh8

The following three videos were made on the evening of Day 1 Post-Op of the Total Hip Replacement when I did 20 minutes of my Combatives & Self-Defense class (one of my friends is running it during my recovery).
https://www.youtube.com/watch?v=SGzUGKD6kn0
http://Outpatient Total Hip Replacement ...as surgery
https://www.youtube.com/watch?v=Sy_Hz5PhniQ

I am the old, bald guy wearing the DARK SHIRT -- (still with hospital tape on my right hand and actually have the stockings under my long pants too.)

Any problems with movement are mostly the knees -- and not the brand new baby hip -- but the hip flexion was still bit low at this time and now is up around 110-120 degrees easily.

My weight is down a little since this video and I am working on reducing it further (as well as strength & ROM) over the next month (exactly from Sunday) getting ready for Oct 21st, 2014.


Bottom line: My primary goal is to have the BEST possible Bilateral Total Knee Replacement (BTKR) that *I* can have, based on the actual results of the surgery whatever that may be.

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."
09-20-2014 11:58 PM
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Peter_C Offline

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Post: #27
RE: Blather, clicking knees and Hi Herbm!
I cannot stress enough, that everyone is different. Different pain tolerances, different degrees of damage prior to the joint replacement, different levels of overall health and strength prior to surgery. All this will change how each person deals with the event of replacement.

For me getting big RoM numbers just happened with no work whatsoever - I think it was like week five or so that I went over 120 degrees with no pain (internal joint swelling must come down first, which takes time).

The neat (??) thing about knees is, you can work them as hard as you like - pain and swelling are your only limits. After replacement (both times) it felt like I was going to tear my quads off (I didn't), but it still *felt* like that to me.

I know we've spoken about pain Herb, but at least get the script filled - just in case?

*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."
09-21-2014 12:11 AM
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herbm Offline

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Post: #28
RE: Blather, clicking knees and Hi Herbm!
To allay your worries Peter: With the hip, I did take the pain meds for a few days "by the clock"*


* BoneSmart has a number of "mantras" for joint replacement and this includes "take your meds by the clock" with the intention of STAYING AHEAD of the pain, ice often and really almost continuously (none of that 20 minutes and stop stuff), elevate (and do so PROPERLY -- and yes there is a real technique), REST a LOT.

I definitely took the meds until it was clear there was no significant pain (I had some minor right quad stiffness and soreness but only about like going to the gym after a long layoff and doing a BIT too much too soon -- no real pain.)

At 6 days, I told the surgeon that I was (by then) only taking the meds at bedtime to make sure I FELT GOOD during the night -- he absolutely told me it was FINE to take the meds to "feel good" in this sense and rest well.

So yes, I will fill the Rx and take it "by the clock" AT FIRST, then keep it handy once it is no longer needed.

I have neither any fear of narcotics nor any desire for them either, so it's of no consequence to me to take them or leave them (and I didn't even get constipated which opioids are notorious for causing.)

They will just be another tool to be used as prescribed at first and then as needed once that is understood -- and I will NOT hesitate to call to ask for a greater dose or different med if needed as well.

My basic method is to do everything possible to plan and prepare then just "DEAL" with whatever happens (which is where infinite flexibility of response comes in.)

Not only is each person different, each day is different -- so even what was easy 'yesterday' may be difficult today, but if done correctly (and nothing catastrophic occurs) each day will TEND to be better than the previous ones.

It's similar to our sleep therapy -- one night doesn't make constitute meaningful numbers nor total evidence of effective treatment. These are MARATHONS and not sprints.

In fact, they aren't JUST a marathon but rather similar to the PREPARATION for a marathon AND the RECOVERY after the race itself.

All advice is appreciated and will be factored into my actual response to the recovery that fate hands me. (And yes, a big part of this will be that *I* set the odds strongly in my favor by my prep, my choice of surgeon with his known skill and excellent methods.)

All this constitutes a statistical advantage however with no guarantees of any particular outcome.

This won't stop me from PREPARING to walk immediately on waking from surgery, nor prevent me from calmly going to a week or more of inpatient rehab if that is what my body needs.

Smile Stacking the odds in my favor and just PLAYING whatever cards are dealt is not just the way to win at poker. Smile

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."
09-21-2014 12:32 AM
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Peter_C Offline

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Post: #29
RE: Blather, clicking knees and Hi Herbm!
I both agree and understand the above. It's nice when people can be on the same page.

I can remember my first surgery (back in 1979) and I was so phobic that I refused to have the surgery unless the Doc agreed to give me no pain meds until and unless I asked for them (the dumbness of youth). He agreed, and noted it in my chart. I lasted all of about six hours before begging for my shot (back then it was Demerol by shot every two hours - big reusable needles that really hurt) and, of course, my pain was so bad the first shot didn't even faze me one bit - so had to wait two hours til I got the second shot.

That was my first 'taste' of pain meds. it does seem weird to me that you must stay ahead of the pain "by the clock", rather than only taking when hurting. And, what I find stranger still, is the fact that I can have a headache and my pain meds will do nothing for it. Must take aspirin or tylenol, etc...

*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."
(This post was last modified: 09-21-2014 02:18 PM by Peter_C.)
09-21-2014 02:18 PM
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herbm Offline

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Post: #30
RE: Blather, clicking knees and Hi Herbm!
For those following along (if anyone), what Peter and I are discussing and agreeing about meds is this:

It is much easier to keep pain at bay, than to stop it once it starts.

This is something pretty much everyone in pain management agrees upon: stay ahead of the pain because once you get behind it is not trivial to deal with the pain.

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."
09-21-2014 03:05 PM
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