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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: #41
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
(10-30-2014 08:54 AM)Peter_C Wrote:  Have you tried any 'TED' hose, or compression hose/socks? That is what really helped me with the swelling.

From above

[...but if you are like me I have having trouble typing out even one email without either falling asleep while typing or inventing an entirely new language (at least I don't think it is Klingon.) ]


(10-28-2014 08:06 PM)herbm Wrote:  ...
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.)
...

I took them off early Thu morning (2am?) and will consider putting them on again later tonight (after 5pm probably).

I am pretty active and also getting a lot of therapy and massage.

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 11:17 AM
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herbm Offline

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Post: #42
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Day 10 Post-Op for my new knees.

Visiting the surgeon today; the time has just flown by while I've had a ball AND a bit more work than with the the new hip back in August.

Of course the Oxycontin (Percoset) might have added to the enjoyment.
The only real issue and discomfort has been the edema, and that seems to be coming under control nicely

The surgical wounds look really healthy and the functionality is already even better than the originals. I was originally concerned they would be "good enough" but now it seems pretty clear that excellence in joint replacement is a modern reality.

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."
10-31-2014 06:32 AM
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herbm Offline

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Post: #43
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Today's accomplishments:
  • 925 ml in a 1000 ml urinal while LYING DOWN (and without combining and while thoroughly doped up Smile ).
  • Arranged surgical spinal injections for my wife's chronic back pain
  • Day 10 Post-Op followup with orthopedic surgeon, Dr. David Dodgin of Austin TX and lodged formal complaint due to delayed development of my Moon Walk (and yes, I DID it to demonstrate)
  • BP 111/59, Temp 98.8
  • Single leg "minimal"* squat with each leg on new TKA (only a few degrees but each leg broke straight and squatted a LITTLE! by itself)
  • Moon Walked for first time (technically, but it needs artistic refinement through practice)

The Back Surgeon and Pain Management doctor doing Carol's (my wife's) spinal injections for an L4/L5 herniated disk is the same guy to stick MY orthopedic surgeon's neck -- Counting on THIS recommendation to be SOLID.

I raced through physical therapy, land and pool, with my therapist Vickie today so that my wife and I could keep the SPECIAL APPOINTMENT the Back Surgeon (Dr. Thai) arranged on request of my orthopedic surgeon.

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."
11-01-2014 10:00 AM
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me50 Offline

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Post: #44
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
TMI. Maybe you could keep the bodily function parts personal.
11-01-2014 10:17 AM
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herbm Offline

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Post: #45
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Day 11 Post-Op


Holding my own with the edema.

Early this morning, while changing my bandages and soaking my legs in epsom salts (trying to calm the nerves and reduce the swelling), I left the puppies sleeping in the living room.

Usually they are fine for a few minutes or especially when sleeping and it was still before daylight. I figured that worst case they would start barking and wake my wife to take them out.

My wife burst into the bathroom at 7:20 to tell me that the Sugar the giant puppy had "eaten all the medicine and torn up the living room."

I had visions of needing to spend the day at the Pet Hospital waiting to get her (the puppy not my wife) stomach pumped.

Fortunately she exaggerates and speaks very imprecisely (my wife not the puppy) so it turned out to be more of a cosmetic mess (upended a trash can and tore through the garbage) and she (the puppy not my wife) had only cracked on old, almost empty puppy medicine bottle and even those pills were all present.

So catastrophe averted and I was even able to encourage my wife to laugh about it.

(By the way, it was totally *MY* fault. I got busy and forgot they might wake up and need supervision. I had been up most of the night in my easy chair and therefore had let her (the puppy not my wife) stay loose all night rather than being in the penned area.

Later she (the puppy not my wife) tried to eat a stick of butter while my wife was making toast.

Weight is holding down but no new progress so I am holding at least 7 and perhaps up to 15 lbs in my lower legs.

Blood pressure and temperature are normal or better.

No narcotics since midnight Friday. I am testing to see how important they are.

My wife's surgery procedure requires she has a driver if she opts for a general anesthesia so it would be helpful if I can drive.

My right leg may be strong and fast by then.

I drove about 45 feet yesterday in a parking lot [long story] but I definitely wasn't legal to go on the road.

There is no point in merely reducing the oxy (during the day) since I need to be either clear of it or avoid driving altogether.

We have a couple of contingency plans lined up just in case -- even a taxi will do.

I tried to joke with my wife that I would Uber her around but she just stared at me blankly despite that fact that she has seen a half dozen TV SHOWS with Uber in the plots in the last few months.

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."
11-01-2014 10:27 AM
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herbm Offline

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Post: #46
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
(10-28-2014 08:06 PM)herbm Wrote:  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....

(10-30-2014 08:54 AM)Peter_C Wrote:  Have you tried any 'TED' hose, or compression hose/socks? That is what really helped me with the swelling.

(11-01-2014 10:17 AM)me50 Wrote:  TMI. Maybe you could keep the bodily function parts personal.

You probably would be happier if you stopped reading this thread.

Anything and everything about my recovery may (or may not) appear here at any time.

A big part of *THIS* recovery is going to involve body fluids (i.e., retention) and a whole lot of information about urine (and perhaps bowel movements).

So far I haven't said much about constipation, which is a big focus in many post-op recoveries, because it has been only a small issue for me.

But I do find myself noting the locations of Accessible and merely Commercial toilets near my house or places I commonly visit.

You should see what narcotics will do to otherwise healthy male genitals.

This can cause significant problems of simply ACCESSING the facility even after you are seated.

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."
11-01-2014 11:59 AM
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Post: #47
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
Herb - I will agree that swelling can happen from lack of moving around - I wasn't thinking that way when I wrote that post. I was thinking more cause and effect. As in swelling keeps reoccurring-which could be caused by doing too much. Point agreed with.

As for the TMI stuff - fluids, their removal, and BM issues, are very much part of a major surgery recovery. It's not my favorite subject, but knowing that Herb is peeing a good volume removes the possible need for a hospital visit. The edema/swelling must come down for the rehab to be considered successful. FYI - MiraLax is the only reason I even have BMs.

Herb, I have forgotten if you said so, are you taking any 'water pills' by prescription?

*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."
11-01-2014 05:24 PM
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herbm Offline

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Post: #48
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
The following is copied from my post on KneeGuru forums:
Post-Op Days 10 & 11 (Friday and Saturday)
Updated at Day 12 Post-Op Sunday Nov 2, 2014 2AM

Friday Day 10 was really tough but not due to my new knees

The day started quite enjoyably with the first post-op check after discharge.

The surgeon and his assistant (who closed them both during surgery) were delighted with my progress and their work.

We literally had a lot of fun, especially when I showed them my NEW Moon Walk -- it was technically correct, but artistically lacking due to the delays from the serious edema the 2nd week.

The serious side of this visit was relating difficulties the severe edema (25 lb water weight gain) has cause and the plan my cardiologist and I were using to undo the damage the hospital had helped cause.

My surgeon had trusted that the attending internist was going to help me get everything straight and that the nursing staff would remember to put on the TED hose before seeing me to the door.

Contrary to what you might think, orthopedic surgeons are about as clueless at managing such things are internists are at replacing and balancing a new knee. The OS had referred me to the hospital doctor who was supposed to keep me healthy and had no clue how badly that would go.

Again at land and pool PT on Day 10 each of the knees were better than 99.9% of other single knee replacements, even days or weeks later.

My wife's medical issues (especially her back trouble) required me to exert myself all day (literally no time for food or rest) to make sure she was getting treatment and I ran myself right to the edge of what everyone really means when they say, "Don't do too much."

Midnight Day 10 I stopped all of the narcotics which I had almost literally been taking "by the clock" (1 or 2 every 4 hours had meant, "I TAKE 2 of them 6 times per day.")

The narcotics needed to stop to determine if it would be safe to begin driving, to take my wife to her surgical back procedure on the following Monday.


Saturday, Day 11, was also required me to pull back from going out to the nearby YMCA because I didn't know if my wife would be able to pick me up quick enough if my energy and resources began to run out.

Stopping the narcotics was no issue at first, and my wife and I began to prepare for our scheduled Walmart run in the afternoon. We needed lots of juices, snacks, medical supplies (4 x 4's etc.), flashlights, and had been collecting the list for over a week.

Her back was hurting and my lower legs were still holding 15 lbs of fluid -- about an extra GALLON EACH leg -- but we both felt good about the trip.

We also had planned or considered a secondary stop at Lowe's and a massage at the walk-in Chinese spa right by the house.

I decided that it was far more important for *ME* to go the the YMCA pool and get some relief, with the massage as a possible follow-up.

She was actually good with going to Walmart alone and wanted to 'drop me' at the pool while I wanted to drive myself on what would be very short first drive. (It's the same first drive I made on Day 4 of my THR in August.)

My car however wouldn't start, and I returned to admit that we would need to follow my wife's plan to leave me at the pool while she went to Walmart.

I was literally headed out the door for the second time, when I called off my trip, and immediately went back to my pillow stack in the bed, staying there the entire 3 hours she was actually gone on HER solo Walmart trip (good call!)

By the time she returned, we had dinner, watch one TV show, I had to return to the bed pillow stack -- the pillow stack in my easy chair was insufficient to keep my legs comfortable or allow them to keep draining sufficiently.

So I rigged up both Polar Ice machines again, retired to the bed pillow stack and mostly slept until midnight, refreshed, as she came to bed.

I ensconced myself in the bathroom for wound care -- damns those incisions look good -- and checked to discover that I had dropped another 5 lbs of the added water weight. (I also took off the TED hose for a couple of hours to let my legs rest further.)

10 lbs of the 25 now remain.

So I am headed to the CPM machine for a short session on each leg (elevation plus motion should move more fluid as well) before I intend to return for sleep.

It was during this 2 hour period that the idea of a book first occurred to me.

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."
11-02-2014 03:11 AM
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herbm Offline

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Post: #49
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
(11-01-2014 05:24 PM)Peter_C Wrote:  ...

As for the TMI stuff - fluids, their removal, and BM issues, are very much part of a major surgery recovery. It's not my favorite subject, but knowing that Herb is peeing a good volume removes the possible need for a hospital visit. The edema/swelling must come down for the rehab to be considered successful. FYI - MiraLax is the only reason I even have BMs.
(11-01-2014 05:24 PM)Peter_C Wrote:  Actually we must ENJOY talking and dealing with these issues IF we wish to benefit from the experience of others and to help ourselves.

Several people asked me to post on my experience, and dealing with this has been the MOST CRITICAL issue for my BTKR.

The knees are easy for me -- the art of recovery is in body fluids management, especially when things go badly.

Herb, I have forgotten if you said so, are you taking any 'water pills' by prescription?http://

I thought that I had posted this entire screw up (here) but perhaps not, perhaps not in detail, or perhaps you too foggy to see it SOMEWHERE ABOVE in this thread Peter.

Seriously, you are dealing with YOUR surgery and pain management while I am doing the same and it's unclear to me what exactly I have posted or where (I post versions or alternatives on 3-4 different forums/locations.)

The friendly, family, short, version is on Facebook. The "for my very good combatives friends" version is on http://CombativesTrainingGroup.com

I intended to post on KneeGuru but practically NO ONE over there responds. I was banned on BoneSmart so I am not posting there, but I also send updates to my massage therapists, chiropractor, etc.

The story with the diuretics is a long one and will need to wait, but the short version is this:

I have been on "DOUBLE lasix and spironolactone" with the support of my cardiologist since Day 7 Post-Op (today, Sunday, is Day 13 starting).

This requires blood tests this Tue or Wed, and we'll switch to a different diuretic if the improvement is insufficient by then.

Lasix/Furosemide 80 mg 2 x day
Spironolactone 25 mg 2 x day

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."
11-02-2014 03:24 AM
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herbm Offline

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Post: #50
RE: HerbM Bilateral Total KNEE Replacement surgery Oct 21st, 2014 -- WOW!
I posted this on FaceBook today, to thank my Systema Instructor Gene Smithson...

Gene will understand this best as he was both my Systema trainer and my trainee junky training partner for years.

He has seen me avoid side pressures or get up off the ground in odd ways to protect those old knees (47 years in the making).

i am finding that when my brain says, "Don't push up THAT way, my body and new knees say, "Aw man, go ahead and try it, we've got your back."

UP I GO -- NO PAIN IN THE KNEE

Oh sure, they are pretty stiff but they don't have all the wrapping paper and packing tape off yet.

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."
11-02-2014 08:04 AM
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