Bilateral Knee surgery week two

I started back on my Humira and I am anxious for it to start working.  My ankles and hands are swollen from my RA.
After 30 days I will be able to stop the Warfarin and start Aleve.  That will help.   I am still stiff and sore.  Yesterday was a bad day.  I am so tired all the time.  I can't wait to have this all behind me.  My surgeon says he has had patients tell him that they did not feel normal for up to a year.  I hope it will not be a year. 

Bilateral knee surgery Day 10

Today there is still a significant amount of swelling in  my right leg.  These are before and after photos.  I had the staples removed and I am still receiving Physical Therapy 3 X week.  I am still on Warfarin and will be for 30 days.  I get tired easy and it is easy to get discouraged.  I went shopping with my daughter and after walking all over the stores for an hour and half my legs are starting to hurt.  They are stiff and aching.  I am still riding my stationary bike and it helps reduce the pain.

Bilateral knee replacement Day 3

I left the hospital that morning.  I made sure I had an appointment to start Physical Therapy on the third day after I was released.  I was given a prescription for Percocet and Warfarin to take home.
When I got home I slept on my couch as the stairs in my two story house deterred me even tho the doctor said I could go up and down minimally.  Also my dog sleeps in our bed and likes to lay on my legs.
My right leg was still swollen twice the size of my left and the bruises were bad.
Elevate and ice your legs.   This is important.  And listen to your body and control the pain.   I had a stationary bike at home so I started using it immediately.  I rode the bike three times a day five min each.  I can't emphasize enough how much that bike helped me.  The PT gave me exercises which I did faithfully three times a day.
There will be good days and bad but it does get better each day.
I went to my Physical therapist for the first time on the third day and was told I did not need my walker anymore and they were amazed at how well I was doing.   Again I believe it was the prayers. 
Everyone is different and the results will vary.  My right knee hurts bad when I try to bend it.  I was told one knee is always worse and it was true in my case.    My left leg hardly bothered me.
Also I made sure I was stocked up on Milk of Magnesia as I was constipated due to pain meds.  It worked well.

Day two Bilateral Knee Replacement

Day two went well.  I was amazed at how big my right leg was.  The swelling was horrible.  I was allowed out of bed.   When the nurses stood me up for the first time it hurt terribly till I straightened out my legs.  I had the catheter removed and by the afternoon I was doing so well they took me to PT and OT where I was able to skip it because i was doing so well.  That is where the prayers came in.  The nurses called me wonder woman and was told I could be released if they could get a hold of the doctor.  It was his birthday and they couldn't get a hold of him so I stayed another night.

Day 1 of Bilateral knee replacement

I arrived at the hospital in the morning with my husband.  I had prepared a bag with some essentials I would recommend.  Chap stick, moisturizer, lysol wipes, pajamas and warm socks. 
I was prepped for surgery and then the anesthetist came in to talk to me.  He reviewed my medical chart and asked questions.  He then explained the  anesthesia he would use.   In my case he was going to use a spinal.  I sat up while I was given the spinal.  That was the last thing I remembered before waking up in the recovery room.  I remember telling my husband my knees were up and I couldn't get them down.  I asked him to push them down.  I was told they were flat but because the last thing I saw before I was sedated was my knees in a sitting position that is what I saw.  We laughed about it later.

Before my surgery I had asked all of my church friends and Facebook friends to pray for me and  it proved to be a godsend as I will explain in day two.  The first night was not too bad.  I was given pain pills and milk of magnesia for constipation.  I had a catheter in and compression stockings.  I slept most of the first day and night.

Before bilateral knee replacements

Bilateral knee replacement surgery means that both knees are replaced at the same time. It’s relatively uncommon to have the arthritis in both knees reach the same degree at the same time where a bilateral would be a consideration.  I had a torn ACL and miniscus and it couldn't be repaired so I was contemplating that knee replacement.  I tried physical therapy first because I was told that it might help me with my knees as they kept giving out on me.  I got a second opinion after the physical therapy did not fix the problem.  My next doctor took a Arthritis profile and it showed my other knee was shot.  It had no cartilage in it.  That is when we decided I would get new knees.

Since bilateral knee replacement is a longer surgery there are health risks.  One knee takes about 1½ to 2 hrs therefore a bilateral will take 3-4 hours. Such a long time on the table and a long anesthetic might not be well tolerated by physically compromised patients (such as those with cardiovascular problems, pulmonary disease or are a frail 80+).

I was very lucky to not need home health care.  But normally it is a good idea to have a home support team to help when you get home.

In the weeks before you enter the hospital, your orthopaedic surgeon will order tests to make sure you are healthy enough for surgery. These include:  blood tests, EKG to check your heart, urine tests to check for infection or pregnancy and xrays to check your lungs.  You will also have had both knees x-rayed before you decide to do the surgery.

I researched doctors and found an amazing surgeon.  In fact my insurance company looked him up for me and assured me he was a premium doctor who had an excellent record.My doctor was in Colorado and I made several trips to prepare for the surgery.

I prepared a months worth of meals in the fridge for my husband.  I also stocked up on groceries and the essentials.   I bought lysol disinfecting wipes to take to the hospital to wipe down the rails before and after visits.  My insurance company nurse gave me this advice.

I looked up the procedure so I would know what to expect.

I made the decision to have bilateral knee surgery. Here is what I experienced.

I am a 56 year old woman and I have had Rheumatoid Arthritis for 30 years.   It has taken its toll on me and I have had several joint replacements over the years.  My Rheumatoid Arthritis started in my knees back in the late 80's.  Back then there was not a aggressive treatment and it was not as well known as it is now.  I started taking aspirin round the clock for years to control the pain only to end up in the ER and Intensive Care for acidosis of the stomach. 
In 1993 I started going to a Rheumatologist who put me on steroids, Plaquenil and Methotrexate.  Blood tests were required to check my liver while on these drugs.  I began getting sick and was tired all the time.  I had a sore throat all the time and never felt well.  I gained 40 pounds from the steroids.  I suffered for 7 years.  My little fingers became deformed. I found another Rheumatologist who prescribed gold.  The gold worked well for a year then quit working.  I found an amazing Rheumatologist in 2005.  I learned some very valuable tips over the years,

1. See a Rheumatologist!!! 
Research your Rheumatologist and try several till you find one who answers all your questions and listens to you.  I could not research mine in the beginning because the internet was not around.   Your Rheumatologist will be your biggest ally in fighting this disease.  Make sure you look till you find one you trust.

2.  Stay Active.
It is hard especially in the beginning when the pain is so bad but with RA you need to keep the joints moving.  Range of motion exercises maintain joint movement.  Even when you are having a flare up keep doing gentle exercises and keep moving.  Water exercises are a blessing.

3.  Don't miss medication or Doctor Appointments.
This disease is so hard to stay ahead of without making it worse for yourself.  You and your doctor need to monitor the course of your disease, look for harmful side effects and adjust your treatment if needed.
When I was diagnosed the biologics were not around now people with RA can lead normal lives with very minimal damage due to new medications.  I started Enbrel in 2009 and it was amazing.  I felt like a new person.  Unfortunately it quit working after five years and I started Humira.  Research and discuss the newest medications ans work with your doctor.

4.  Take your medication when you are supposed to and do not skip your medication.

5.  Do not skip it when you feel good as you need to be consistent to get the maximum effectiveness.

6.  Accept depression.  RA is a horrible disease and very hard to live with.  Pain and fatigue are common side effect and you will find doing the things you once did impossible at times.  

7. Naps are your friend.  I found it helped me immensely to take a fifteen minute power nap every day at 11 a.m.

 8. Accept help from your loved ones and seek a support group.  Having others who know what you are going through helps your outlook.

Anyway after 30 years of RA with no aggressive drugs in the beginning I ended up with total joint replacement in my feet and hands.

 I fell and tore my ACL and my miniscus and found out it could not be repaired.  With RA they cannot repair your knees because the body will reject it so they take the ACL out and replace the knees.
Now I am looking at bilateral knee replacement and I researched it in depth before I decided to do both knees at the same time.  I want to share what I have learned.

That will be my next entry in my blog.