Bilateral Knee Replacement Surgery — Two months and back to yard work

Mark finished physical therapy for his bilateral knee replacement surgery on March 30th. I think he broke all records for recovery there. Maybe they’ll put up a plaque. I’m just very grateful that this whole process went as smoothly and as quickly as it did. We lived with the worry and fore-knowledge that someday we would have to face this knee replacement surgery, and now it is behind us. That’s a very good feeling.

Mark is living pretty much a normal life, although his leg muscles bother him if he tries to do too much, and he is still under prohibition of three movements (twisting his knee back and forth to put his foot in his shoe, crossing his foot over his knee in a sitting position, or kneeling) until the 3-month mark at the end of April. Mark also continues to do his at-home exercises that basically consist of leg lifts using ankle weights. He continues to ice his knees down after he exercises or if he has used them extensively like in the following slide show.

I took these photos April 1st, after we lost our redbud tree. The hill he’s walking down is very steep. I never attempt to go down it, but always go the long way around. Although Mark doesn’t bend his knees to work as he might have before the surgery, as you will see, he is perfectly capable of getting the job done. I offered to help him, but then decided sometimes I am the most help by just staying out of the way.

It’s nice to see him working in the yard, as he loves to do that and I wasn’t sure that would be possible this spring.

It’s also very nice to see him able to take out the trash.

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You can see links to the complete series of posts about Mark’s bilateral knee replacement surgery here.

Bilateral knee surgery — Five weeks and waiting for “normal”

Last Tuesday, when Mark’s physical therapist asked him how he was doing, Mark said, “I just want to be normal again.”

“If you were normal,” the therapist said, “you’d still be walking with a walker right now.”

As I’ve been pointing out all along, Mark has recovered to this point quickly. He can do most things, excepting the three prohibitions mentioned in the pre-op class. He stopped all prescription pain medicines and is back to taking only Motrin twice a day. We think the Lyrica really helped with the pain because Mark’s discomfort level has risen since he’s  been off of it.

Mark is scheduled for physical therapy twice this week and will need to go once or twice next week. After that, we don’t know. We expect he will be finished soon.

Then it is just a matter of time to heal completely. We were told initially that it takes three months, after that he is no longer prohibited from kneeling, etc.

I wanted to include a video of Mark walking down the hall, getting down on the floor and back up again, and walking down and up a flight of stairs.

I took the video over the weekend but somehow lost most of it in the transition to the computer. All I have left is Mark sitting with his legs up on his desk, sipping a Cosmopolitan, straightening up from getting off the floor, a laugh in the background, and a head shot as Mark approached me during his stroll down the hall. Since I think I was lucky to get the video in the first place, and I don’t believe my actor will be willing to do a retake, you will have to take my word for it.

All is well. And we feel lucky to have made it this far in Mark’s recovery so soon.

Bilateral knee replacement surgery—Three weeks post-op and x-rays

Three weeks after surgery, Mark is walking around the house without a cane. He has started doing minor household chores like clearing his place after a meal and emptying or loading the dishwasher. Yesterday he refilled the birdfeeders.

Although he walks well, he still walks slowly, and doesn’t like to be on his legs for very long periods at a time. Since the surgery we have gone out to lunch, dinner and breakfast. Last week he went to Macy’s at a mall with me. I parked at the Macy’s entrance so he wouldn’t have to walk a great distance. While the sales clerk was assisting me, Mark sat in a chair in the shoe department (which isn’t really all that different from what he might have done before the surgery).

Mark went for his two-week post-op check with his doctor last Wednesday where he was told he only needs the cane when he goes out in public. I don’t believe I’ve seen the cane in his hand, here or when we’ve gone out, since. He has been set free from the CPM machine and no longer needs to wear the tight hose, unless his legs begin to swell.

Mark wants to drive to his physical therapy today. His therapist has told him he probably could drive as long as he can move his foot back and forth without pain.  I plan to go with him. I’m not comfortable with him driving on expressways yet, but I think he will do fine going the short distance along primarily residential streets to physical therapy. He is pretty worn out after therapy and I suspect he will not want to drive home.

The doctor recommended he continue to take the Lyrica and Celebrex, neither of which are narcotics, until his supply runs out. The Percocet remains up to his discretion for as long as he needs it. He has not taken any for two or three days. Prior to that, he was only taking one in the middle of the night when he couldn’t sleep because of discomfort in his legs.

With the removal of the outside bandage, Mark is now allowed to take showers. This hasn’t been as big of a deal as he anticipated because he felt the sponge bathing he was able to do worked out pretty well. I shampooed his hair periodically.

The removal of the staples was a non-issue because there were no staples.  Mark’s incision had been closed with a single internal stitch that will dissolve, and steri-strips on the outside that will curl up and drop off. Overall we both think his scar looks good, much better than I, for one, had anticipated.

We didn’t actually see the surgeon at the appointment, but saw his physician assistant. Later, Mark’s physical therapist said that it was a good sign that the assistant did not think it necessary to call the surgeon into the room. The physician assistant gave us prints of the x-rays of Mark’s bionic knees.

Bilateral knee replacement - front view, Two weeks post surgery.
Right knee- side view

If you look closely at the above picture, you can see that the knee cap also looks like it was resurfaced.

Mark is experiencing a little numbness on the outside of his knees. It is noticeable, but not particularly problematic. He knew this was a possible side-effect of the surgery.

Mark continues to do the physical therapy exercises here at home: front leg lifts, side leg lifts, and bending knee lifts (not the proper name for this exercise). He does them three times a day, 50 repetitions on each leg. He’s started adding leg weights to his ankles.

We are grateful that Mark’s recovery has gone so quickly. Last week the woman beside him at therapy was four weeks post-op from a single knee replacement and was still using a walker. I don’t think Mark’s recovery made her feel better. We can’t really explain it except to say that Mark had an excellent surgeon, he’s relatively young, strong, and healthy; and he prepared himself by doing the recommended exercises prior to surgery; and faithfully continues to do them now. And he is extremely hard-headed determined.

And maybe an angel or two in heaven are looking out for us.

You can find links to the entire series on Bilateral knee replacement surgery here.

Bilateral Knee Surgery – Two weeks post-op and walking with a cane

Two weeks ago today I was sitting in a hospital waiting room while Mark was having his three-hour total knee replacement surgery. Last Thursday Mark put away his walker and started using a cane. His physical therapist continues to tell him he is way ahead of schedule on his recovery. We don’t really have an explanation for that except that his surgeon did a great job with the most updated techniques and appliances, and Mark is determined and has been aggressive with following his recommended exercise routine. I’m thankful for how fast he is recovering and proud of him for how hard he is working at it with little complaint.

Last Friday at therapy he was told he could cut back even further on the CPM machine, but the therapist did not want to  make the decision to stop it, and wanted to wait until the doctor released him from it. So Mark is using the CPM 2hrs on the left leg, which is a little stiffer, and one hour on the right every day.

Mark is finished with the blood thinner shots. He still takes the Lyrica and Celebrex pain meds every day, but has cut way back on the narcotic Percocet and primarily uses it at night if he has trouble sleeping.

He will see the surgeon on Wednesday for his two-week post op appointment. After that we hope to be done with the CPM machine. Mark also hopes to be done with the tight hose he has to wear to promote blood circulation in his legs. He will undoubtedly ask the doctor when he can drive. He also wants the doctor’s advice about when he should back off the other pain medicines. On Wednesday we expect that Mark will have his staples removed and we will see his incisions for the first time. He has been wearing some kind of silver-embedded bandage on each knee since surgery that is supposed to prevent infection. And finally, Mark should be able to shower following his doctor’s appointment.

Mark has three physical therapy appointments this week and again next week. Then we will find out what comes next. The time has gone fast for me so far, but the day of surgery seems a great distance away in my mind. It’s a funny thing about time.

You can find links to the entire series on Bilateral knee replacement surgery here.

Three days after bilateral total knee replacement surgery

Thursday, February 2, 2012
8:00 a.m.

What should I blog about? I’ve asked this question before in a different context.

When I started this blog I claimed I would write about whatever was on my mind in the morning. The reality is that I’ve extended that to included whatever is on my mind at some point in the previous day or two or three.

I recently had an idea to post my lifetime bird and wildlife sightings, so I made a page for that. Those posts are typically not what I’ve had in my head upon rising in the morning.

Earlier I thought it might be helpful to share my self-publishing journey, so I have a series on that. I felt the same way about Mark’s bilateral knee replacement surgery and recovery. I know it was helpful to us to talk to others who had had knee replacements.

Mark’s mom is the only person we know who had bilateral knee replacement surgery and that happened over 20 years ago. So much has changed. I remember visiting her in the hospital after her surgery. Her room was empty because she was at therapy. In those days rehab was done in a rehab room. All of Mark’s rehab has been done in his own room. Mark’s mom returned to her room sobbing from the pain. She stayed at the hospital on the rehab floor for a month.

Mark is going home today, three days after his surgery. A lot has changed in the past 20 years. The pain medicines are better; the implants, the procedures, and the therapy are all better now.

Don’t get me wrong, we still have a long road ahead of us. My biggest concern at the moment is getting Mark into and out of the car. I was going to bring the truck because it sits up higher, but I talked it over with his therapist yesterday and she thought he might try to twist himself getting into the truck since he usually swings one leg up first. I brought the car.

This morning before I left the house I removed all the throw rugs from the bathroom and the pathway to our bedroom from the front door. We usually come and go through the garage, but for now we will be using the front entry because of the step situation. I also pulled the top covers off the foot of the bed so that Mark will be able to sit down and get into the bed right away.

Although I made the best effort to obtain all the medicines he will need in advance, we are leaving the hospital with instructions for Mark to take iron pills. His hemoglobin continues to be low. Fortunately our youngest son will be helping me get Mark home today and will be able to run any errands I did not foresee.

I never intended to make this blog a family newsletter. But it feels disingenuous right now to post about the cardinals on my bird feeder or the most recent book sales numbers and promotional efforts (which have fallen completely by the wayside), when the first thing on my mind in the morning, the last thing on it at night, and what occupies it most of the time throughout the day is Mark and his needs.

So in some ways I’m being more true to my initial plan than ever.

4:30 p.m.

We’re home now and Mark is resting comfortably in bed with the CPM machine running on his left leg. The ice machine is cooling off his other knee. He did a great job of getting in and out of the car. Our son Joe was here to help and he also got us the items from the store we still needed. Now I’m settling in for a house-bound stay with my recovering hubby. It’s good to be home.

You can find links to the entire series on Bilateral knee replacement surgery here.

Double knee replacement surgery update — Making progress

Tuesday, January 31, 2012

2:00 p.m.

Mark is sleeping in his bed with the CPM machine working his right leg. I am sitting on the loveseat/bed with my feet up. The loveseat is in a little alcove by a very large window that affords me a panoramic view from the 8th floor where we are.  Last night the city lights below were beautiful. Mark has not been able to enjoy the view yet, but I hope he will soon.

Things are progressing very well for him, according to the physical therapist. Mark’s right leg has caused him more pain from the beginning and is not as flexible or strong as his left right now. The therapist says his right leg is typical, while his left leg is something to write home about. I am so very proud of how hard he is trying and how well he is following recommendations.

The big thing with knee replacement surgery is the angle of rotation he can achieve. The doctor measures the possibility right after surgery, and then it is up to the patient to try to achieve this maximum level. Mark’s doctor said Mark should be able to achieve 140 degrees of rotation. He will need to continue to use the CPM machine until he reaches 120 degrees. The therapist said they would like him to get to 90 degrees before he goes home.

The day of surgery, yesterday, the therapist measured 60 degrees for his right and 70 degrees for his left. Today when she left after two physical therapy sessions and 2 hours per leg on the CPM machine, he measured at 85 degrees on his right and 95 degrees on his left.  This is super.

This afternoon Mark walked out of the room and partway down the hall with a walker and the help of a therapist. You can’t imagine how good it is to see him on his feet, even though I know it is a struggle for him. He said it felt good to be up.

3:00 p.m.

Medically, the discharge or bleeding from Mark’s knees has slowed way down, which is a relief as this has been a source of concern. They removed the drains from his legs just now. His IV was removed today.  I love to see them remove the tubes and things.  I asked the nurse if he was out of the woods for needing a transfusion and she said not until after tomorrow. If there is a problem with blood counts it will be the second day after. So let’s just keep our fingers crossed on this one.

The latest thinking is that he will go home on Thursday. As scary as it is that I will be on my own taking care of him, it will be nice to be in the comfort of our own home again.

Last night I went home, primarily because I didn’t realize I could stay and I wasn’t prepared to. I felt bad leaving Mark last night and plan to spend tonight here. I hate to leave him alone when he is so dependent on others right now for every little thing. And he hasn’t been great at keeping track of his medicine schedule, so I can help make sure he stays on top of the pain.

4:00 p.m.

I started this post two hours ago and am now able to finish it with all the interruptions we’ve had. We have recycled back to 2:00 with Mark asleep in his bed; the CPM machine is on his left leg, and I am on love seat.

Anna just called to tell me she is on her way back home to Columbus with Arthur. She went to the grocery for me to get some bottles of water to freeze for use in the cooling machine for Mark’s knees. You can fill the little cooler up with ice and water, but the technician said a good tip is to freeze bottles of water and reuse them as needed. So our second freezer at home is now full of bottles of water. I have obtained the prescription for pain medicine that I will fill tomorrow. We made an appointment for physical therapy on Monday.

Last night I was afraid we might have bitten off more than we can chew by doing both knees at once. Today I feel very optimistic.

View from our 8th floor room - taken with a telephoto lens and cropped.

You can find links to the entire series on Bilateral knee replacement surgery here.

Knee surgery day schedule

Surgery day schedule:

3:45 a.m. – Mark gets up 15 minutes before the alarm is set to go off and I wake up with him.

4:30 a.m. – We leave for the hospital a half hour away.

5:10 a.m. – We  arrive at the surgicare unit and check in. A few minutes later Mark goes back for pre-op preparations while I continue to wait in a very crowded waiting room.

5:45 a.m. – I join Mark back in his pre- op room.

6:45 a.m. – Someone comes and rolls Mark away. A nurse shows me where the surgery waiting area is. I am the first family member there. They give me a pager and I set up camp at the single table in the room.

7:30 a.m. – Mark’s surgery begins. Our daughter Anna arrives to keep me company.

10:10 a.m. – My pager goes off and I am led to a small conference room to wait for the doctor who arrives about 20 minutes later. He tells me that the surgery was an A+ for both legs and that Mark would be in the recovery room about 2 hours.

11:00 a.m. – Anna leaves to get us lunch at Pot Bellys. She brings back the walker and Mark’s suitcase from my car when she returns with the food at 11:30.

12:15 – My pager goes off again and Anna and I are escorted to the recovery room where we see Mark briefly. He is wide awake and very alert. I tell him every single little thing the doctor told me. I read from my little notebook the notes I took because I knew Mark would be asking me questions. The nurse gives us his room number. We take his and our things up. I wipe every surface area that he might come in contact with using antibacterial wipes as the nurse who called from our insurance company recommended.

12:45 – Eric rolls Mark in his bed into the room. Mark’s spirits are high and he is joking with the nurse. The nurse is very busy checking Mark’s vital signs and setting things up. Mark has three bags hanging from his IV pole.. He is wearing oxygen. He has drainage tubes leading from each knee to a receptacle. Later the blood collected will be infused back into him through his IV. I think this  is a very brilliant invention and handy device. Mark’s right knee hurts worse than his left. When asked he says it is a 5 or 6 on a scale of 10. He is likely still receiving pain relief from his spinal and the nerve blocks he received post surgery.

1:15 – Our son Mark Joseph stops by. Mark takes a cat nap.

2:00 – Anna and Mark Joseph leave. Mark sleeps and I relax on this nice sofa in his room.

3:00 – The physical and occupational therapists arrive. With the help of the nurse they get Mark into a standing position and move him into a recliner. He does GREAT. The OT said he is the best bi-lateral patient she has ever seen. Mark starts shaking in the recliner and the nurse gets him warm blankets. She assures us it is probably from the anesthia and it is quite common. The therapists leave. Mark falls asleep in the recliner. The nurse stops back periodically.

4:00 – The nurse brings him more pain medicine. She has gotten approval from the doctor to give it to him every 3 hours instead of 4.

It’s 4:30 and we are waiting for the nurse to come with helpers to get him back in bed. He is using his breathing device to exercise his lungs every hour. The physical therapist has just returned. She’s going to have him do some exercises. I’m a little worried it might be a rough night when all the spinal and nerve block medicines wear off. I plan on going home tonight because I didn’t realize I could stay. I may decide to stay tomorrow night and will decide later.

Thanks for all your thoughts and good wishes.


You can find links to the entire series on Bilateral knee replacement surgery here.