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

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Post: #31
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Congratulations on the 'growth spurt' Smile

Glad to hear your comfort is increasing and most of the day at 1-2 sounds a universe better. Hopefully those excursion beyond low numbers will become lower and less frequently rapidly today.

Delaying the knee brace sounds like the most effective course of action. You aren't doing that due to laziness nor wimpiness, but rather to get a good day and continue your improvement first.

I don't do much actual specific exercise around the house -- maybe I will go to the gym today, or at worst maybe tomorrow (Manana Senor).

Probably the best thing for me to do is the CPM machine right now although trying a bike up at the gym MIGHT work.

At the moment, I am giving myself my first real break of doing not much at all but watching TV.

With the hip, I didn't do the cycle on the 5th day (today is also 5th day) because the KNEES could not tolerate the ROM for that.

That sounds like a good plan. Thanks for the ideas! Smile Smile 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."
(This post was last modified: 10-29-2014 03:51 AM by herbm.)
10-26-2014 08:46 AM
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herbm Offline

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Post: #32
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Sunday, Day 5 Post-Op

My BTKR is a piece of cake -- having fun.

Feeling good. Vitals nominal. Virtually no pain.

I am on vacation.

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."
10-26-2014 02:58 PM
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Peter_C Offline

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Post: #33
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
another good day for you-good to read. i slept well again last night, and pain seems pretty much under control for me now-i know its normal, but it's still weird to hurt worse in the evening when i was careful not to do anything to set myself up for a more painful evening.
some sau it's "your body-clock", i disagree as my day starts late and 7pm is like lunch time to me. oh well...

*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."
10-27-2014 01:19 AM
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herbm Offline

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Post: #34
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Day 6 Post-Op
In some ways it is even better that YOU (rather than me) are experiencing some relief and improvement.

People who haven't gone through something like what you have experienced where pain not only occupies all of your conscious waking hours but prevents you from really ever sleeping probably haven't even an approximate idea of that is like you.

It's not JUST the pain, nor just the LOST sleep which adds to you discomfort all day long but also includes the simple inability to ever fully relax and rest, whether awake or asleep.

The pain with my hip earlier in the year was far less severe than your pain, yet after a month of basically not sleeping due to that hip pain, my life was becoming increasingly miserable

I really hope the improvement continues for you Peter!

Today was my first visit Outpatient Physical Therapy (no real therapy today, just an evaluation along with some small recommendations for getting started. (Mostly my own rehab methods and plans are already beyond these methods.)

We scheduled PT for 3 times per week from Tuesday through Nov 5th.

This was built a despite my repeated and explicit attempts to increase the initial frequency because.

Think of all the trouble those of us with Apnea have trying to get a DME to give us the equipment and services that WE know we need. It was pretty much the same.

The rehab center (St. David's on 32nd St.) scheduled PT 3 times per week from Tuesday through Nov 5th.

This was despite my repeated and explicit attempts to increase the initial frequency until I must return to work.

I have the first (next) two weeks off, and it would be easy to go to PT now but will be more difficult after I return to work,

Most sessions will be 'land' physical therapy (PT) followed by 'pool' therapy.

My legs (not just my knees) have a LOT of edema and swelling from mid-thigh on down -- I am taking diuretics for this, drinking a lot of water, urinating a lot, performing all the suggested physical training and rehab that is likely to reduce the swelling.

To be clear there is certainly SOME swelling in the knee joint itself, but my entire legs have the skin stretched taught, almost to the point of pain.

As soon as the swelling and water retention dissipates, my condition will likely improve by a large amount almost immediately.


Current stats:

  • Right leg extenion -- 2 degrees
  • Righ leg flexion -- 105 degrees
  • Left leg extension -- 3 degrees
  • Left leg flexion -- 100 degrees

This is beyond amazing for Day 6 Post-Op.

As I said, the swelling it likely the main limitation and I fully expect to get 0 to 125 degrees in both legs very soon.


I walk mostly with a cane (or right side due to the left not being QUITE as strong), but I can walk well enough with no assistance.

Occasionally I use the walker, mostly around the house when my hands would be full.

FYI: I am taking the pain mediation (Percoset = Oxy + Tylenol) "by the clock" but if i forget otherwise delay there is no problem. I will do this for a few more days or weeks until my capabilities and stamina approach normal.


I walk mostly with a cane (or right side due to the left not being QUITE as strong), but I can walk well enough with no assistance.

Occasionally I use the walker, mostly around the house when my hands would be full.

FYI: I am taking the pain medication (Percoset = Oxycodone + Tylenol) "by the clock" but if i forget or otherwise delay there is no problem. I will do this for a few more days or weeks until my capabilities and stamina approach normal.

For this week my scheduled PT (both traditional and that beyond the doctor's Rx) the doctor did explicitly clear me for massage work though:

Tuesday Tomorrow
(Tuesday), 3:15 pm Pool (only) 32nd St.

Wednesday
2:30 Wed Jay Lyons stretching on Anderson
Dr. Chris Olson Chris Chiropractor at 4:30 Wed

Friday
9+ Carol & Herb @ Dodgin
1:00 pm dry and pool therapy St. David's 32nd St.


More soon.

More 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."
(This post was last modified: 10-28-2014 01:48 AM by herbm.)
10-28-2014 12:17 AM
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Peter_C Offline

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Post: #35
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
After seeing the Ortho today, I spent a large part of the day with my arm out of the sling. Unlike with my right shoulder, the doc said nothing I do will create a risk of further damage - so I am basically limited by pain. Start PT in a week, use the sling as needed for comfort, and at night. Pain is controlled better than prior to either the right TKR or the left shoulder repair.

Meaning, if I am not moving the arm, both shoulder and leg are more comfortable than before surgery (major goal achieved). Plus my total daily dosage is down to 105mg, and other than random stabs, my pain level is staying under a '3'.

Herb, you should be thrilled with those RoM numbers, even if they don't improve for a few weeks. Many people are 5-7 weeks post-op before they reach those numbers.

As for the whole leg swelling, you did not mention "TED" hose (compression hose) or the like? Are you not wearing the hip-high hose on both legs? That was/is the only way I could get the swelling down. And, am sure you know, but just in case? Elevated means raised above your heart level - those with your water pills and time - nothing you can really do about time but doing all the others.

Just remember as you are rehabbing, swelling is the sign that you are either doing too much, or, too soon, or both.

*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."
10-28-2014 02:02 AM
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herbm Offline

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Post: #36
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Glad to hear your pain control is better than you previously experienced.

We bought (new) TED hose for me yesterday (Monday) -- hospital took mine off on Friday for pool, promised to get me more, then neglected it at discharge so we didn't have them.

Since Yesterday/Monday noon, I am wearing the hose constantly. They only come to mid-knee.

On Friday, the swelling/edema problem was not prevalent so Carol and I didn't think of them or the TED hose at discharge. (I should have been wearing the TED hose from Friday evening through Monday, and continuing until now.)

> "'Herb, you should be thrilled with those RoM numbers, even if..."

[Drugs, bathroom, and being tired interrupted me at this point this morning and it was only tonight after returning from water PT that this message could be finished and posted.]


Yes, I am very thrilled and delighted with those numbers, but I am uncertain if MOST of the people reading this would understand the significance.

I fully expect to hit 0 and 110 this week, though it might be next week, and you are quite correct that my ROM is so far advanced that this is probably a done deal -- if not now, then if a few weeks.


> "Just remember as you are rehabbing, swelling is the sign that you are either doing too much, or, too soon, or both."

I don't agree with this as a general rule although it might be true in some instances.

It can just as easily, probably easier, be that I am not doing enough. Ankle pumps or walking might be useful for alleviating this fluid build up. (Remember we are NOT talking about swelling and inflammation 'in the joint' but a more general fluid retention

Moving the big muscle of the leg is key to assisting the pumping of blood and fluids back up towards the upper body. This is likely part of the reason that the CPM machine helps many people control pain (without offering any measurable improvement in long term success.

It is a fine line but much of my athletic expertise provides guidance on distinguishing 'bad pain' from 'good pain.

Pool therapy was excellent more details to follow....

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."
10-28-2014 08:06 PM
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herbm Offline

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Post: #37
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Early morning Day 8 Post Op (woke up refreshed after about 1.5 hours sleep)

The following is just copied verbatim from my post on KneeGuru:

Apparently this forum just doesn't have enough 'critical mass' to keep the discussions growing and evolving so without further input I will probably post only a few more small updates here.

If you want more detail, then please ask a question (I should get an email notification) or check out my detailed thread here: http://www.apneaboard.com/forums/Thread-...t-2014-WOW

A few of my friends on ApneaBoard were interest and they were actually asking and encouraging me so most of the posts went there.

My BTKR was a piece of cake. By day 6 (probably sooner, that's just when we measured) my knees were moving from 2 degrees (near straight) to 100-105

I am pretty tough guy, and was totally prepared to tough it out as much as needed but none of that has really been necessary; it is just that easy for me.

To be clear, if you or someone you love is planning a BTKR, they likely will NOT get results similar to mine, most people have a lot more trouble (from what I read and see on the Internet and from discussions with therapists and my surgeons.)

But knowing this is POSSIBLE on the "good side" of the scale gives you something to aim for: Prepare for the worst, hope and work for the best.

For reference, the other night at the hospital I bumped my toe on the heavy hospital room door. Ouch! It wasn't a big bump so it only hurt for 1/2 second.

That was the WORST actual pain I have experienced in the last week since the surgery. (Really!)

I had one other brief pain that SCARED me more but didn't actually hurt quite as much: My popliteus (look it up) had to unlock my right knee suddenly and was probably doing it's intended job for the first time in decades. It stung a bit for an instant and was gone -- the scary part was that I had no idea or memory of being able to do that since my knees haven't been locked straight since the 1970's.

There have been few if any times where my pain momentarily reached a 3, it seldom reaches a 2 (never while resting) and the nurses pr9

I turn on the CPM machine and just max it out (=10 to 120) at the highest SPEED it will go with 8 second pauses at the turn arounds.

Had the surgeon kept his promise I would easily have been able to do the BTKR as an OUTPATIENT, without narcotics post-surgery, and walked out of the hospital that evening even though it was a late surgery and I didn't wake up until 4:30pm.

The surgeon kept me an extra day and I decided to stay an additional day for an extra session of pool therapy, so it ended up being 3 nights in the hospital. That was useful for some pretty darn good food and to have the nurse and tech running and fetching ice, setting up the CPM, taking videos of me walking with 2, 1, and 0 canes Day 1 Post-Op.

They were pretty good about not waking me up UNNECESSARILY too often (most annoying was the 4-5 am blood draw and vitals, and I don't even mind the needle stick.)

Using a portable urinal turns out to be a boon for males.

Tomorrow (Wed) is Day 8 and I can't drive yet -- don't have a "fast and strong right foot" for the gas and brake, and in an abundance of caution I am taking the Oxy "by the clock" but don't really need it.

The swelling is a little annoying, not so much in the knee itself but in the entire lower leg there is a lot of fluid retention.

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."
10-29-2014 03:53 AM
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herbm Offline

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Post: #38
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Very few replies or new posts here so my posts are slowing down in response.

FYI: I am very busy doing everything in my power to rehabilitate my knees an entire body and to ensure that I stay as healthy as possible.

(Today Carol drove me to 4 different 'therapy' sessions.)

Doing anything is very slow of course; everything from putting on pants to getting into or out of the car takes longer.

The pool therapy felt really good, not just therapy but immediate comfort relief. I might consider just dumping some of the therapy and going to our Y for my own pool therapy.

The Meridian stretching session with my friend Jay was likely the most useful and productive, but afterwards a visit to my chiropractor was also highly valuable.

The final therapy was dry land therapy (same place as pool) which was useful but not immediately so restorative.

I didn't feel wonderful for a couple of hours this evening (probably related to bowels) but that passed.

On recommendations of the therapists I am trying Arnica cream as a rub on for the bruising and edema all over my feet and legs.

Did I mention that my feet and much of my lower legs look like the surgeon used a ball peen hammer to massage my legs.

The edema has my lower leg stretch to near bursting as well. This is really the greatest discomfort and likely the biggest limitation to my amazing recovery and mobility.

One therapist recommended "lymph massage" and the chiropactor says he'll call with a referral to someone who does that.

Another suggestion was "wheat grass" (juice) which sounds horrid but supposedly will help detox the blood and all this fluid.

BTW: The surgical incisions looks great and is starting to heal nicely (externally glued.)\

Each incision is just under 6" long (5 3/4 or 5 7/8), and not very sensitive (e.g., sore) to the touch.

Energy is still very high (2am now and not really ready for bed.)

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."
10-30-2014 02:13 AM
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Peter_C Offline

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Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

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Post: #39
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Have you tried any 'TED' hose, or compression hose/socks? That is what really helped me with the swelling.

*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."
10-30-2014 08:54 AM
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herbm Offline

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Machine: ResMed AutoSet S9
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CPAP Software: ResScan SleepyHead

Other Comments: Backup Mask: Innomed Hybrid FFM -- Oral+Nasal Pillows

Sex: Male
Location: Austin, TX

Post: #40
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Early morning Day 8 Post Op (woke up refreshed after about 1.5 hours sleep)

The following is just copied verbatim from my post on KneeGuru:

Apparently this forum just doesn't have enough 'critical mass' to keep the discussions growing and evolving so without further input I will probably post only a few more small updates here.

If you want more detail, then please ask a question (I should get an email notification) or check out my detailed thread here: http://www.apneaboard.com/forums/Thread-...t-2014-WOW

A few of my friends on ApneaBoard were interest and they were actually asking and encouraging me so most of the posts went there.

My BTKR was a piece of cake. By day 6 (probably sooner, that's just when we measured) my knees were moving from 2 degrees (near straight) to 100-105

I am pretty tough guy, and was totally prepared to tough it out as much as needed but none of that has really been necessary; it is just that easy for me.

To be clear, if you or someone you love is planning a BTKR, they likely will NOT get results similar to mine, most people have a lot more trouble (from what I read and see on the Internet and from discussions with therapists and my surgeons.)

But knowing this is POSSIBLE on the "good side" of the scale gives you something to aim for: Prepare for the worst, hope and work for the best.

For reference, the other night at the hospital I bumped my toe on the heavy hospital room door. Ouch! It wasn't a big bump so it only hurt for 1/2 second.

That was the WORST actual pain I have experienced in the last week since the surgery. (Really!)

I had one other brief pain that SCARED me more but didn't actually hurt quite as much: My popliteus (look it up) had to unlock my right knee suddenly and was probably doing it's intended job for the first time in decades. It stung a bit for an instant and was gone -- the scary part was that I had no idea or memory of being able to do that since my knees haven't been locked straight since the 1970's.

There have been few if any times where my pain momentarily reached a 3, it seldom reaches a 2 (never while resting) and the nurses pr9

I turn on the CPM machine and just max it out (=10 to 120) at the highest SPEED it will go with 8 second pauses at the turn arounds.

Had the surgeon kept his promise I would easily have been able to do the BTKR as an OUTPATIENT, without narcotics post-surgery, and walked out of the hospital that evening even though it was a late surgery and I didn't wake up until 4:30pm.

The surgeon kept me an extra day and I decided to stay an additional day for an extra session of pool therapy, so it ended up being 3 nights in the hospital. That was useful for some pretty darn good food and to have the nurse and tech running and fetching ice, setting up the CPM, taking videos of me walking with 2, 1, and 0 canes Day 1 Post-Op.

They were pretty good about not waking me up UNNECESSARILY too often (most annoying was the 4-5 am blood draw and vitals, and I don't even mind the needle stick.)

Using a portable urinal turns out to be a boon for males.

Tomorrow (Wed) is Day 8 and I can't drive yet -- don't have a "fast and strong right foot" for the gas and brake, and in an abundance of caution I am taking the Oxy "by the clock" but don't really need it.

The swelling is a little annoying, not so much in the knee itself but in the entire lower leg there is a lot of fluid retention.

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."
10-30-2014 10:40 AM
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