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HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
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Peter_C Offline

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Post: #121
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Just a sidenote - my right knee (done in July) has never fully gone to zero (yet) and is usually sore while bending. So the plan is back to PT after the 1st (when the Medicare clock resets) for some fine-tuning, as I want it to be as good as possible, and I can't seem to do it on my own.

*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."
12-22-2014 06:16 PM
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DocWils Offline

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Post: #122
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
My condolences, Peter - just keep up with proper physio and be patient. Most people have long term post-op discomfort and it takes a long time to get some real progress in most cases.
12-22-2014 07:26 PM
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Peter_C Offline

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Post: #123
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Aye, 14-18 months for 'complete' healing. As this is my 'shot' at improving my mobility and lowering my pain level, I have no plan on failing. It is only a question of how soon it'll be great? It is already much better than it was pre-op of course, so can't wait for March or April so I can start riding again.

*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."
12-23-2014 02:39 AM
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Peter_C Offline

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Post: #124
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
And, yes I know, Herb is the exception, not the rule~! Am not so much complaining, but rather providing both an update, and a comparison to what Herb is seeing.

*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."
12-23-2014 02:41 AM
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DocWils Offline

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Post: #125
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
In my experience, Herb is a freak (the type we doctors like), and the norm is a bit different - motivation is of course part of the equation, as is expectation (the hard part I have to tell ballet dancers and athletes is that there is no artificial joint that will return them to their former mobility, granted that their mobility was way outside the norm anyway). Healing is a long term process, and when you are cutting into bone it takes ages for it to heal, that is just he way it is, and of course, it will never be 100% what it was, if you were at peak form before. So it depends on your expectations. On the whole it takes around two years for things to heal completely to the point where you no longer notice it and you are capable of taking on the most demanding physical tasks, but there are some who are unusual - genetics, general health, age, body chemistry, so many factors get in the way. If you smoke or smoked, your healing is way slower, if you drink or drank, ditto. Same for certain drugs (Rx type) and other types (illegal). From my experience, you are sort of right down the middle there. Let Herb be a shining light for you, the ideal up to which you cannot match, and accept the smaller steps you need to make to get there. Know only that you will get there, just it will take a bit longer.

I am looking at some shoulder surgery right now - my left shoulder has finally started to get so bad that I can't use it much anymore, but I am nervous about it - I KNOW TOO MUCH! One of my mates needs her hip done, and is insisting that I do it, despite my nowadays only supervisory capacity (hips go on surgeons quite a lot, as do backs - all the hours of standing bent over, you know) so I am considering what to do in her case - in my case I am trying to figure out how to do the surgery under a local so I can supervise - I doubt it is possible, alas - and the one doc I really trust is long since retired, maybe even dead (a brilliant saw bones in new york who pretty much pioneered the field of dance medicine). So you see, you need not worry - we all end up dealing with this sort of thing ourselves, and I can promise you that you are doing just fine, and all your fears and nerves are the same we all go through.

Actually, the problem of being in "the biz" is that you do know too much, and it makes it difficult for another doc to deal with you - I am having heart problems at the moment, and despite my having a doc who, at 78, has seen it all way more than I ever could hope for and knows the ins and outs of an EKG in ways I could never hope to, of course, I am pushing for my own therapy regimes and making it harder for him to treat me. Even with me being a good boy and taking the meds he says I should, I have my handy dandy portable EKG machine always standing by, constantly taking readings, questioning if this is the right way to go. We are the worst patients ever. So take heart - you are a good patient - you are motivated, working toward your goal and following the advice of the professionals who are treating you. Give it time and you will find that a day comes where you simply forgot that anything was ever wrong. It happens - around two years or so post op, roughly, often sooner.
(This post was last modified: 12-23-2014 07:47 AM by DocWils.)
12-23-2014 07:43 AM
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herbm Offline

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Post: #126
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Pretty much everything DocWils said (that I am qualified to comment upon). My luck in getting everything together from myself to surgeon to just little lucky things like maybe precise angles of cut (better than average tolerances) or whatever, led to three nearly perfect replacements.

More or less the world record gold medal of THR and a gold and silver for the BTKRs -- all at the same "Olympics of Surgical Outcomes and Recovery".

However, don't overlook the surgeon. I am totally convinced that Dodgin (here in Austin) is literally the Best in the World a the THR -- not to say there can't be others AS GOOD, but an outpatient surgery with 1/ second of pain TOTAL (on the night of day 3 when I sneezed) and immediately as good (with a little stiffness) as the original BEFORE it went bad is as good as it is ever likely to get.

Dodgin trained with Joel Matta, and helped Matta develop the Anterior THR in the US. Matta adopted -- and significantly improved -- the anterior approach from the French. He (and his students) changed the Hanna table and some other equipment and techniques that make the surgery go more efficiently and put less stress on the leg.

Dodgin is (likely) the only one doing "outpatient THR" in this area as a regular thing -- and he COULD have done my BTKR as an outpatient had I gotten my way.

(Again a BTKR this good is pretty FREAKY, but he has the outpatient THR down to almost routine.)

If/when I get the other hip done, I would let no one else but Dodgin do mine -- unless he were unavailable, then I would seek out Matta (if he is still doing them) or someone else who studied closely with them.

For the knees, Dodgin is likely close to the best there is -- I don't have ALL the evidence as in the hip.

Steve Howell in Sacremento, CA perhaps has a slightly better TKR approach than the current standards: Kinematic alignment. The evidence is not all in on this yet, but my strong suspicion is this is going to be the main way it is done n a few years (unless something even better appears.) http://www.drstevehowell.com/practice/total-knee-replacement/

As further evidence:

I am right at 2 and 4 months post op.

Last night I "fought fast" (knife defense and attack) on all three joints, at age 62, did extremely well in the sense of staying alive (or killing my friends Smile ), and this morning have no ill effects from the almost 2 hour practice.


Peter, wishing you all the best -- the very best recovery that YOU can possibly have.

Let pain be your guide and do as much as you can within the limits it sets. Everyone will tell you (or me) "Don't do too much."

[Or the Physical Therapists (usually) will tell you "Don't quit".]

Well: don't do too much and don't quit too soon. Smile

However, too much is likely best measured by how *YOU* feel, not by the expectations of others while quitting sooner rather than after you suffer a setup is generally better.

It's a bit of a knife edge to follow but err SLIGHTLY on the side of safety and then go far it as much as you are willing and able without suffering increased swelling, inflammation, or pain in subsequent days.

I wish I could share some of my luck -- you need it even more than I do -- so instead:

Have the Merriest Christmas and Happiest New Year you can.....as well as your family!

And the same to DocWills and everyone else reading this thread.

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: 12-23-2014 09:55 AM by herbm.)
12-23-2014 09:49 AM
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Peter_C Offline

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Post: #127
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Yup, yup to all of the above. I've seen the entire process with my left knee (done NOV '09) - realizing it was the worst knee (first surgery in '79 after some 13+ patella dislocations, nine surgeries before the TKR, on and on). Today it is great~! Not pain-free, never pain-free, but no more pain with use, just a 1-3 all the time, but strong!

I did expect it to be easier with the right, not so much history, only one dislocation (out 20+ minutes) and one scope. But a bit older now, in some ways more healthy, in other ways worse - but I can't stress, it is already better and less pain than pre-op. I just want to walk normally, and be able to ride my recumbent trike (my reward for all this). Pain meds have easily been cut by 50% already. Am hoping for more progress there.

I know I never was Herb, and never will be. I've already given up to pain - too many years of constant pain, am done, quits, and my primary goal is simply pain reduction.

Unlike last year, no hospital this Christmas for me~! I do wish a Merry merry and a Happy Happy, and all those other holidays to those that have them.

And Doc, you deserve much more credit than you get here, a voice of reason and knowledge that I for one cherish. And yes Herb, you still amaze me~!!

*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."
12-23-2014 07:26 PM
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herbm Offline

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Post: #128
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
That 50% reduction in pain meds speaks volumes for your improvement -- congratulations!

Glad you will be at home for Christmas this year!


BTW, if anyone is interested, here is the 38 second video showing me walking Day-1 Post Op of the BTKR -- mostly with 2 canes.
https://www.youtube.com/watch?v=dZCLGV3wUlA

Mostly Smile with 2 canes.

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."
12-24-2014 10:14 AM
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