Posts Tagged ‘Robotic Double Knee Replacement Surgery’

Bilateral Double Knee Replacement-Part 1: Surgery

A lot of you have been following me on facebook but I wanted to document my experience as a help and reference to others anticipating the same procedure. One thing that I am being told over and over and am learning the hard way is that everyone is different, each knee is different even if done at the same time by the same doctor. There is no standard, only guidelines which makes the law of averages. It is easy to overlook the stories of those who struggle and only hear the voices of those who got along exceptionally well and then set that bar for yourself.  Before surgery I asked lots of questions, talked to others in the “knee club” and it was very helpful but it also set my expectations very high and I assumed I would be one of the “wonder” persons. It  did give me an idea of what to expect but somehow I missed how hard and painful it would be. For me, my journey became filled with struggles and several setbacks as you will see as my story unfolds.

Day of surgery: Day 1 (Monday)

Prepped and ready for surgery.

Our pastor came, prayed for me and sat with Gene and Jill as I headed off to surgery.

My two and a half hour surgery went well. I awoke in recovery with my family standing around my bed laughing. They were laughing at me! I knew they were asking me questions and I knew they were laughing at my responses but I could not control my answers. At least I provided good entertainment for them and at that point I didn’t care!

Jill took a selfie with me during my silly spell!

After I was awake and settled in my room (5 p.m.), my family left. It had been a long day and they were tired and hungry and I was sleepy, in no pain and had the most wonderful nurse, Barbie Adams, as my night nurse. She is a neighbor and I have known the family for forty plus years.  They put foot pumps on my feet to prevent blood clots and ice-wraps on my knees for swelling. They had me wiggle my numb toes and brought me a light supper. In the middle of the night I craved party mix. I finally asked Mrs. Adams if they, by chance, had any crackers I could eat. She brought me orange juice, saltine crackers, peanut butter and two cups of Hershey’s Chocolate Ice-Cream. It was a feast and tasted so good. I had a good night and they let me sleep with almost no interruption.

Day after surgery: Day 2 (Tuesday)

I awoke at 3 a.m. and was wide awake. I decided it was a good time for my devotions as everything was quiet and dark in the hospital.  I still had no pain, my knees did not hurt, and I could now feel my toes.  A one point I pulled my knees up and said to the nurse, “look at what I can do!” I felt like wonder woman. Two different nurses said they had not seen anyone do what I could do at that point.

 

At 8 a.m. my doctor made his rounds and took the large band-aid looking bandages off my knees. Now I could see my battle scars. There were no stitches or staples on the outside, the wound was super glued together.

Because my surgery was in the middle of the day and it was late until I got to my room, they did not get me up to walk yesterday  I was still too numb. But by 9 a.m. this morning, physical therapy was in my room and it was time to get out of bed, take a few steps and learn to take care of my personal needs. They let me sit in a chair for half an hour. Jill was in early and stayed with me all day. We had a good morning with lots of laughter and conversation.

In the afternoon they decided to give me 5 mg of Oxycodone as my knees were starting to ache and to prepare me for the afternoon physical therapy session. The spinal and nerve blocks in my legs was wearing off. They wanted me to sit in a chair and have a sponge bath before therapy. I sat on the edge of the bed and they took my blood pressure.  The top number was 166.

They moved me to the chair and I immediately started feeling bad-really bad. I turned very pale, started sweating and became nauseated.  They said I yawned, asked to get back in bed and slumped over. They took my blood pressure and buzzed for help. The top number was 77. I was in and out of consciousness as they lifted me back in bed. Fortunately we don’t have a picture of this! They restarted my IV and put ice on my head until they could get my blood pressure settled. We finally decided I had reacted to the Oxycodone. They switched the pain medicine to Tramadol and that worked well for me.  During the afternoon my level of pain started increasing as my legs were starting to swell and became very, very tight. It was a rough night and I was not allowed to get up to go to the bathroom as I was still too woozy.

Day 3: (Wednesday)

Physical therapy couldn’t do much with me today as my blood pressure was still unstable and I felt dizzy. Later they did get me out of bed and I walked 20-30 feet down the hall and then sat in a chair for about 45 minutes. I was so sleepy and at one point went to sleep in mid-sentence. My ankles and knees were so tight and swollen and very tender to the touch. They had me do a few exercises but my knees were so painful. It was a rough day. Usually they keep their bilateral patients two nights but there will be no going home for me yet.

My night nurse was not very helpful and acted like she didn’t want to be there. The rule is you have to ask for pain meds. If you don’t ask, you don’t get. I was on four different pain medications; one was twice a day, one every six hours, two I could have in between. My brain absolutely could not keep it straight. I could not remember the names of the meds, what I could have when or when I took what. I quickly learned the value of a family caregiver who watches out for your needs.

I asked the night nurse to please give me my meds during the night whenever I was allowed to have them. She was a follower of “the letter of the law”, insisting I had to ask, in spite of my pleading. It was very frustrating. I had ice packs on my legs around the clock and the ice packs needed to be changed every 2-3 hours. I had to ask for them to be changed regularly also. Sometimes I would sleep through the time when I could have meds and then would hurt so bad as it took a while for the meds to catch up. When the night nurse would come in, she would call someone else to come help me to the bathroom, take off the foot pumps, change my ice. She did only the basic. I was very glad when the night shift change and I did not see her again.

Day 4: (Thursday)

Therapy got me up and we walked down the hall and then I sat in a chair again for about 45 minutes. My blood pressure is still fluctuating but not as bad. I felt a little more encouraged today and walking with the walker is going better. My knees hurt and because they are so swollen and tight, they do not want to bend. It is hard to stay focused on the anticipated goal and stay upbeat when you hurt. However, today I began to think about going home and when Dr. Kerr came in for the night rounds he said that in the morning, I could go home.

Day 5: (Friday)

Today is the day and it is time to go home. It feels a little bit overwhelming and intimidating. In the hospital they are set up to handle me and there are medical people to answer my questions. I wondered, can I really do this? Am I ready? Can I handle my home set up? I know I can walk with the walker but I haven’t had a shower yet. How will I handle that?

In preparation for going home, therapy consisted of learning to do a 4″ and 6″ step so that I can get into the house. Oh the little things we take for granted!!! The therapist had not been able to do all that she wanted to do with me in the hospital because of my blood pressure episode and asked if I wanted In-Home Care therapy. That sounded like a wonderful idea and she signed me up for two weeks.  This soon proved to be a mistake-it will be written about in part 2. By 11:30 the paperwork was signed, I was released, and ready to go home.

The night nurse did not do a good job keeping my legs iced and by morning my knees were extra swollen and so tight they could hardly bend. The first issue in getting me home started when they brought a transport chair to take me down to our vehicle.  The seat on a transport chair tilts slightly backwards which means your knees have to bend more than normal to reach the very narrow rests for your feet. It hurt so bad I could not stand it. They insisted that was my only option. I reminded them that they had me in a wheelchair earlier and I knew that would work, to please let me use that. They finally consented and even provided pillows to help support my legs. The second issue was that I was now signed out of the hospital and no longer were they allowed to help me.  The strapping young transport fella that was to wheel me down to the main entrance to our vehicle could do only that-wheel me down.  He was not allowed to help get me into the vehicle.

Our daughter, Jill, came in to get me as we decided her vehicle had more leg room in the front to get my legs in and out. Getting me in the vehicle proved to be very difficult. I could not bend my legs enough to get in regardless of how I tried twisting and turning. The young fella just stood there and stared. Finally, we decided to have me sit on the edge of the back seat and scoot across with my legs straight out in front of me on the seat. Without a finger lifted from the strapping young fella, Jill finally maneuvered me into place and off we went on the twenty minute ride home.

By the time we got home, I was really hurting and exhausted.  I went straight to bed. While I slept, Jill got my prescriptions filled and organized. Now we began the process of figuring out how to function at home. The white wicker chair seemed to be my best sitting chair (arm rests on a chair are very useful in getting up!) and I instantly knew I had to have a high rise seat for the potty. Our bathroom is narrow but fortunately we had remodeled it several years ago making it more functional.  I had to go in the door with the walker sideways, park my chariot by the sink and hold onto the sink to shuffle to the toilet.

Gene and Jill took turns getting up during the night to give me my meds and change my ice. The long awaited surgery week was over. It was good to be home.

Other blog posts about my surgery:

Bilateral Knee Replacement-Part 2: Recovery and Therapy

Rahab and Ruth

Ready or Not, Here I Go

Domino Effect

Highly Motivated

I Can Help You!

 

Rahab and Ruth

 

I was lying in bed the day after surgery thinking as I gently rubbing my swollen, sore, stiff knees when I had the idea of naming my legs Rahab and Ruth. I am sure your first thought is, “how did you come up with those names?” Both were Old Testament women with fascinating stories. The struggles and decisions of life had been hard and bruising on both women but when God got a hold of them and changed their hearts, they had new purpose in living. The results were life changing with New Testament implications.

So, with that introduction, meet Rahab (left) and Ruth (right)….

My legs: Rahab and Ruth:

Each leg is so different. Ruth is more flexible and responding to therapy but Rahab is more stiff and swollen. Both of my knees had severe osteoarthritis, bone spurs and was bone on bone. The surgery on Rehab was a little more intense.  When I got to my room after recovery, full of drugs, spinal and nerve blocks, I lifted and bent my knees and exclaimed to the nurse, “Look what I can do”! That was a short-lived wonder woman proclamation!

I had several setbacks along the way and very quickly “wonder woman” became “I wonder if woman”! At two weeks, the  therapist is looking to see a 90 degree bend in the knee and at three weeks, 110. At three weeks, I am just getting to 90 on Ruth and 55 on Rahab. This is very concerning to me as I am not sure what has gone wrong. What have I not done right? Everyone says everyone is different and even legs on the same person are different. I have done my exercises faithfully, before and after surgery. I think Rahab is holding Ruth back because some exercises such as the squats, you can’t do with a “straight wooden leg”.

Therapy is working hard with me and talking to my surgeon to break up the scar tissue and get more movement. Yesterday was a rough therapy day but we got 10-15 more degrees in each leg. If we still can’t get what I need, they will put me to sleep (as it is very painful) and manipulate the knees to break the adhesions.

Biblical Rahab.

Rahab first appears in the Old Testament in Joshua 2. The Israelites were poised to enter the promised land. Joshua sent out two spies to survey the walled city of Jericho and the surrounding area. Before the city gates were closed for the night, the two spies slipped into the city and went to a house built on the wall, the home of a prostitute, Rahab. This was a perfect place to stay because “visitors” were always coming and going. It wasn’t long until the king was notified that strangers were in the city. After a thorough search of the city, the men were not found because Rahab had cleverly hidden them under piles of flax drying on her roof. Rahab had heard about the Israelites and revealed to the spies the great fear of the people for them because they had heard how their God had done mighty things. After assuring Rahab that she and her family would be saved when they conquered the city if she followed the guidelines laid out, she let them down with a cord out of her window and the spies escaped to the mountains until it was safe to return to Joshua. A very short time later the Israelities marched silently around the city once a day for six days and on the seventh day seven times. At the designated time they blew their trumpets and shouted and the walls fell in a heap of rubble except for Rahab’s house. She and her family was rescued. The detailed story is in Joshua 2. Hebrews 11:31 records that Rahab did not perish with those who did not believe because she received the spies in peace.

Her next appearance in scripture is Matthew 1:5 in the genealogy of Jesus Christ. Salmon and Rahab begot Boaz.  Wouldn’t you like to know the love story of Salmon and Rahab?

Biblical Ruth.

The next line in the genealogy states that Boaz and Ruth begat Obed , Obed begat Jesse the father of King David. Twenty-eight generations later the family line ends with the birth of Jesus Christ.

The whole book of Ruth in the Old Testament is given to the story of Ruth.  This also is an amazing story. Elimelech and Naomi and their two sons, Mahlon and Chilion, lived in Bethlehem during the time of the judges. There was a severe famine and they moved to the land of Moab where the sons eventually married Moabite women, Ruth and Orpal. After ten years, Elimelech and both of his sons died leaving three grieving widows. Noami decided it was time to go back to her homeland and her people.  The two daughter-in-laws started out with her but Naomi begged them to stay with their families as she was too old to produce more sons for them to marry. Orpal turned back but Ruth refused to leave her beloved mother-in-law.

Ruth’s heartfelt response to Naomi has gone down in history as a beloved commitment which is frequently used in Christian weddings.

“Entreat me not to leave you or to turn back from following after you.

For where you go, I will go; and where you lodge, I will lodge.

Your people will be my people, and your God, my God.

Where you die, I will die, and there I will be buried.

The Lord do so to me, and more also, if anything but death parts you and me.”

Ruth 1:16-17

 

It was harvest time when they arrived in Bethlehem. Ruth asked permission of her mother-in-law to go and gleam grain behind the reapers in the field. She “happened” in the field of Boaz who was close kin of Elimelech. Boaz noticed Ruth and inquired who she was. He had already heard her story and knew of her loyalty to Naomi.  Boaz invited her to only gleam behind his reapers, provided her with food and water, gave her extra grain to take along home, and admonished his workers to watch out for her and not harm her.

The culture in those times was very different from what we know and understand. It was the responsibility of the closest kin to marry a widowed woman to produce a son to carry on the dead man’s family name. The details of the story can be read in the book of Ruth. There was one man closer kin but he declined to marry Ruth so Boaz willingly took her as his wife. Rahab is now the mother-in-law of Ruth.

Two women: a prostitute and a Moabite. Two women who knew heartbreak, sorrow, disappointment and the bruising rigors of life. Two women who met God and married into the Israelite tribe which was strictly forbidden by God. Two women whose lives were given new purpose and from whom our Lord and Savior Jesus Christ was born.

I kind of like the symbolism of their stories. My worn out knees need new life and purpose.

Other blog post relating to my surgery:

I Can Help You!

Highly Motivated

Domino Effect

Ready or Not, Here I Go

 

I Can Help You!

Even with prescription inserts, my feet have hurt for years. I have blamed it on genetics and my lot in life. An everyday pair of shoes last me about six months. By that time, the sides are blown out and it is obvious that I walk on the outsides of my feet. In the last number of years, I have become more and more aware that I am getting very knock-kneed and have wondered if maybe my feet issue are a result of a larger “structure” problem. When I am sitting in the lazy boy chair with my feet straight out, it is startling how crooked my legs have become. I have developed an unnatural gait that is uncomfortable and frankly very unbecoming. Try knocking your knees together and roll your feet to the outside as you walk.

I finally went to see an orthopedic specialist last week that looked at my feet, knees and hips.  One of the first things I said to Dr. Kerr was, “I’m not sure you can help me but this is what i am dealing with.” After listening to me and looking at my x-rays he said, “I can help you!”  I had prepared myself for the worse; that there was nothing they could do. How do you fix such a mess?

I was ecstatic.  He. Can. Help. Me! There is actually something that can be done.

My Problems:

  • The tendons in my feet burn, especially in the arch area.
  • My feet always hurt. I can’t go barefoot and have to wear good shoes with prescription inserts. I am always aware I have feet. I only have one style of shoe that is comfortable for me to wear– my “granny shoes”!
  • Knees are larger than they should be and it often feels like my knee cap could give out.
  • When I get down on my knees,  I have a very difficult time getting up.
  • It is very difficult to stand for long periods of time such as waiting in line, standing at the kitchen stove or standing in church for singing.  I need to sit. It is much easier to keep moving. Long walks, particularly on concrete or uneven ground kill my feet. Running is out of the question.
  • My hips ache and often my lower back bothers me.
  • Coming down stairs, I like to use the handrail and it is right foot down, then left foot; not a continuous stepping action.

Diagnosis: Osteoarthritis.

I have severe arthritis in both knees, a bone spur, and the knee caps have gotten off center. It is bone on bone. I knew there was probably some arthritis in my knees, my little fingers show “Uncle Arthur’s” presence,  but I had no idea my knees were in that bad of shape!  It is truly amazing but I do not have pain in my knees. They ache and bother me, but no pain. My lower back actually bothers me worse than my knees.

He asked me if my knees clicked. I said, “no”, but as he moved them around you could hear, “click, click, click!” When I left the office and walked down the hall I could feel my knees clicking away! I simply had not picked up on it. He also noted that I have developed a little bit of a “squat” stance. When standing straight, my knees bend slightly forward so I am not really standing straight.

The good news is that it is not rheumatoid arthritis.  Dr. Kerr looked at my hands and said, “See how the end joints of your little fingers are affected. That is arthritis.  If it is the first joint on your finger and goes back into your knuckle, it is rheumatoid arthritis. That is worse”

I Can Help You:  Robotic Double Knee Replacement.

I was stunned as I had never even considered the knee replacement option in my brain.  The first thing I have to do is six weeks of physical therapy to strengthen the leg and knee muscles. The middle of April he will see me again and we will talk.  One thing he did say was that he needed to do both knees at the same time; it is the only way to get my knees and legs straight.  He said, “When I am done, I am going to walk out to the waiting area and tell your family that you legs are straight!”

How Do I Feel?

I have been doing lots of reading online and talking to a few people trying to gather information so that I know what I am facing. It is daunting to think of doing both knees at once and not having a good leg to stand on. I will admit, it is a little scary, but I am also very excited. I have to get through the busy spring months in the store before I can schedule this ordeal. It is a bit overwhelming to think about and at this point I have lots of unanswered questions. I feel this is something I have to do while I am still healthy and “young enough” to prevent more severe and untreatable structure problems later on.  After all, I have a surgeon who says, “I can help you” and I know a “Great Physician” who can help the surgeon.

It is very distressing to me to see pictures of how I actually look and how far I have slipped.  I think, this can’t be me.  I want you to see why I am so excited for surgery! The video is a very short “now” picture of me walking. In a few months I hope I can post another one that I can title, “Look at me now. He helped me!”

I will be writing my journey as it unfolds; I am hoping for surgery in June. I would love to hear from others who have had the same experience.

Other blog posts about my knee replacement surgery:

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