Quick Summary

Donna reached out to X10 in the spring to talk about using the program for a single total knee replacement planned for later in the summer. She did some exploration on doing both knees at once and ultimately went in that direction. Donna discusses deciding on bilateral knee replacement and her recovery here.

One Highlight

This was one of the best decisions I’ve ever made ever. If I had known then everything that I was going to have to go through, everything that my family was going to have to go through, I would have thought harder about doing two knees at once from the beginning.

Favorite Quote

“When I go to physical therapy now the therapist is like, “Oh my goodness, you are our star patient,” because my flexion is at 120º and my extension is at 0º. I’m walking with a cane now instead of a walker. And they’re like, “We wish everybody could be like you.” So I feel successful.

Is this for you?

Listen to the podcast or read the text below if you are considering knee replacement and want to make sure you know about the latest recovery technology. The audio interview provides a very detailed explanation, from a patient’s perspective, about how the X10 can make quick work of a bilateral knee replacement recovery.

Donna had bilateral total knee replacement surgery. What follows is an interview with Donna conducted by PJ Ewing from X10 Therapy.

My name is Donna. I live in Winston Salem, North Carolina. I am 65 years old. I have a son and a daughter and am a grandmother of four.  I have three granddaughters and one grandson ranging from ages nine down to three. They are the joys of my life.

I am a born-again Christian. Praise the Lord for watching over me, taking care of me during this process. He’s been so good to me. That’s probably my number one praise, and I think that’s why I’ve been able to do as well as I have.

I’m exactly four weeks out from bilateral surgery, four weeks ago today. I was in the hospital for four days and came straight home. I am doing wonderfully, wonderfully well. I have been able to rest and relax, do some things that I’ve been wanting to do. I’ve done a lot of reading in the last four weeks, a lot of studying and things like that I don’t usually have time for.

This has kind of slowed me down somewhat and giving me a little bit of personal time to do some things that I wanted to do. I am very thankful for that. So even though it has been quite a journey so far, not being completely pain-free, but it’s not been an unhappy or bad journey, that’s for sure. And I’m super-glad that I’m four weeks on this side of the journey instead of four weeks on the other side.

Four weeks before surgery, how would you describe yourself?

Life was very painful. I had two really bad knees, bone-on-bone, both of them. One was a little worse than the other. I had meniscus tears in both knees, arthritis in both knees. Every step I took was a jolt of pain. I endured it for probably two years. It gradually got worse and worse. I have done everything possible that I could have done leading up to the surgery. I’ve had physical therapy. I did cortisone shots, two different sessions of the gel injections, everything that I could to prevent having surgery.

Finally, it just got so bad the doctor said, ‘you just have no other choice. You’re going to have to live with this pain, or you’re going to have to have it replaced.’ At the time I was only going to do my left knee, which was a little bit worse. I went into all the preparations. At the very last minute, I decided to do both at the same time and get it over with.

Tell us more about that. How did you make that decision to go for two at once?

I had done a lot of research. I’ve done a lot of reading about the surgery, about what was going to happen, about the recovery, and about the physical therapy. I am not the type of person that likes to go into something without my eyes being wide open. So, I knew that there were things that I needed to plan for. There were things that I needed to do ahead of time.

Actually, this is kind of funny. You, PJ, were the first one that mentioned to me that maybe I should look at bilateral surgery instead of just doing one. It was in a conversation that you and I were having one time. You said, ‘well, have you ever thought about doing both knees at once?’

It kind of opened my eyes a little bit because I never had even thought about it. And, I said, no, not really. But after we hung up I talked to my husband about it and I thought, ‘Man, what do you think about this?’

I realized that it would make a difference. I would need more help, I wouldn’t have a good leg to stand on, so to speak. I did a little bit more research on the bilateral process. Fortunately, I had the perfect situation as far as coming home after the hospital. My mom lived with us for 10 years before she passed away earlier this year. My husband made her an apartment downstairs on the ground level of our home. So everything was already set up. We have a handicapped bathroom and a bedroom and a little kitchen all on the ground floor.

Then I went to the doctor for my pre-op visit. I told the PA that I was speaking with that I want to do both legs. And he quite frankly said, ‘No, we won’t do that.’ And I said, ‘well, I want to do both legs. I want to get it over with.’ And he said, ‘well, your surgeon will not do that. He doesn’t do both legs at the same time.’ And so I just said, ‘well, if I have to change surgeons, if I have to change practices, I want to do both legs at one time. I want to get it over with and do what I need to do and be well and not have to repeat the process in six months or a year.’

Deciding on Bilateral Knee Replacement

So at the very last minute, the week before my surgery was scheduled, I switched surgeons. People told me I was crazy, but it’s what I wanted to do. I had prayed about it and I had peace about it and I’m looking back now, would not change it for anything. I know it was the right decision.

When the PA told me at my pre-op visit that my original surgeon would not do two knees, he said, ‘let me speak to one of the other doctors here in the practice. We really normally don’t do two knees at one time, but let me speak with him.’ So he went and spoke with Dr. Calvin Maxwell McCabe. Dr. McCabe looked at my history. Fortunately, praise the Lord I am, other than arthritic knees, very healthy. I am not diabetic. I don’t have problems with my blood pressure, my sugar. I don’t have anything else wrong with me other than my knees. So Dr. McCabe took a look at everything and said, ‘yes, I’ll do both knees for her.’

I actually only met him the Friday before. He did my surgery on Monday.

The Right Choice?

He was wonderfully patient. He explained why he chose to do both knees when it’s something that they normally don’t do within their practice. He said, ‘the only reason that I’m going to do your surgery is that you are as healthy as you are’. I felt quite confident with him.

One of the maybe more humorous things is that my sister-in-law actually works for that practice. She was on vacation and I called her and said, ‘are you sitting down?’ And she said, ‘Oh my goodness, yes.’ And I said, ‘I just talked to Dr. McCabe and we’re going to do both of my knees Monday morning.’ And she’s like, ‘have you lost your mind?’

I left the office that day. after speaking with a PA but before talking to Dr. McCabe. By the time I got home, which was a 20-minute drive, they had already switched my surgery date to two weeks later so they could be on Dr. McCabe’s schedule. All my physical therapy already switched all of my other appointments. They took care of everything for me before I could even get home.

I’m telling you they were phenomenal and have been ever since. I can’t say enough about the care I’ve gotten from them. His physician’s assistant, oh my goodness, phenomenal. Her name is Laura. She came to the hospital several times. I have absolutely no complaints, none whatsoever. I couldn’t have asked for anything any better.

It was supposed to be just one knee originally. What did they find in the other knee? What was the consensus after the fact?

He did my left knee first, which was supposedly my bad knee. He told my husband after the surgery was over, ‘I am so glad she decided to do this because her right knee was just as bad as her left, if not worse.’ He said, had I not done both knees I would have had more problems with the other knee, possibly affecting my hip and my ankle. It could have done a lot of damage. And then we’re talking about other surgeries down the road. In the x-rays, my right knee did not look as bad as my left knee did. He said so. But when he got into the knee, it was as bad if not worse than the other.

Well, praise the Lord. I made the right decision.

I do recall the conversation we had way back. Did you end up poking around that bilateral group on Facebook? Was that of any value in deciding on bilateral knee replacement?

Yes, definitely. When we spoke that day, you said to me, now, don’t take my word for it. Let me get you hooked up with this bilateral knee group, and you did that same day. And, oh my goodness, I’ve read everything there since then. It’s been so very helpful. And I hope that the comments that I’ve made there make sense about my surgery, I hope that I’ve been able to help somebody else. When people go on there, pre-surgery, they’re nervous and they’re afraid and don’t know what to expect. And it just so very helpful to have somebody say, okay, I’m a week out or two weeks out or six months out or whatever… and this has been my journey. It’s just been so very helpful to have had somebody literally walk in my shoes.

The people there have gone through what you’re getting ready to go through. I think this gives you the peace and calmness that you need knowing that they’ve gone through this. They’re doing well. They got past this. This thing helped them. This other thing didn’t help them. Maybe I should do that. It was just so very helpful, and it still is helpful. I check it four or five times a day.

Tell us about post-surgery the first two, three, four weeks since the surgery.

My recovery has been really good. I’ll just start that way. Of course, not pain-free, but pain-manageable. I was in the hospital for four days; a wonderful hospital, by the way, Clemmons Hospital here in Winston Salem, North Carolina. And I felt like I was in a four-star hotel. They took such great care of me.

They kept my pain under control, kept me comfortable. Of course, I had two Iceman machines constantly going. The nurses and the doctors there were phenomenal. I felt like the queen of England or something.

So, I was really pleased with everything.
I had one extra day in the hospital. My iron level dropped probably due to blood loss during the surgery, so they decided to keep me an extra day and give me, some iron through my IVs.

Okay. So you get home. What happens next?

I came home to the perfect setting, on a Thursday with all kinds of medicine. I had pain medicine, an iron supplement, nerve medicine, so my surgeon kept me quite comfortable. I wasn’t pain-free. I don’t want to give anybody false hope that you can do something like this and not have any pain. But it was quite manageable. On Friday morning, David delivered my wonderful X10 machine and set it up for me, educated my husband and me on how to use it and what to do. I got on the machine immediately that day and started using it. I used it two to three times a day.

It really helped with my flexion and extension, and it was completely pain-free. It felt really good to be able to move my legs like that. I had a friend that stayed with me, to give my husband, some relief from the 24/7 care that I needed. She stayed the first couple of nights here with us. And, my wonderful church family has been delivering meals to us every other day since I’ve been home. So that’s another blessing. Dr. McCabe had physical therapy come here to me for the first two weeks and then I started going outside for physical therapy. So I’ve done my X10 machine, my physical therapy, and the exercises that they have given me.

X10 sent me a lot of information about exercises to do. I’ve tried to keep up with doing all that. I think that’s one of the reasons why I’ve done so well. Movement is so very important. After you get home, you have a tendency to want to sit or stay in bed, but you’ve got to get up and move your legs. And I have done that. So when I go to physical therapy now the therapist is like, “Oh my goodness, you are our star patient,” because my flexion is at 120º and my extension is at 0º. I’m walking with a cane now instead of a walker. And they’re like, “We wish everybody could be like you.” So I feel successful, yeah.

I give the praise to the Lord, that’s for sure.

You worked with your X10 Coach, Tricia, somewhat frequently didn’t you?

Yes, I did. She is such a joy. Oh my goodness. We had the best conversations. She would call to check on me and find out how I was doing. She would look at my results on the machine and things like that. And then we would end up staying on the phone for an hour just talking to each other. Yeah, I feel like I’ve got new friends. She and David are jewels.

So I’m very, very involved in my church, doing different activities, I work with our children at church. I work in a hospice ministry where we deliver food to hospice. My husband used to say to me, ‘Donna, you are going to have to slow down.’ But I have slowed down. These four weeks have been slow. So like I say, I’ve been able to do a lot of reading. I’ve been able to get into my Bible and do some Bible studies that I was really interested in that I hadn’t had time to do before.

I’m not doing steps yet. I haven’t gone upstairs yet. They’re not allowing me to do steps. I do walk without my cane, as long as I have something to hold onto or as long as I’m close to something. I’m being very careful. The last thing I want to do is following through with any damage, but I am practicing walking on my own. So, I do have a ways to go. When I go to physical therapy now, we’re working on my walking and my gait. I do strengthening work at physical therapy and at home. I have a band now and several exercises that I do. Before I get up I do exercises in the bed, and once I get up and I do exercises in the chair. And then I’ll walk. It keeps me busy.

Christmas is my goal. I realized it is a slow process. I do kind of push myself sometimes and I have over-done it and have paid for it a couple of times. I just had to back off for a day or two. The reality is that this is not a quick process. It is going to take time This time next year when I look back and I’m completely recovered and completely myself again, I’m going to look back on it as a year-long experience.

In the bilateral group on Facebook, 100% of them say they would do two again. I think that you’d be on that list.

This was one of the best decisions I’ve ever made ever. As much as I say I researched it and had decided to do one knee, I think going back and doing the other knee would have been difficult. If I had known then everything that I was going to have to go through, everything that my family was going to have to go through I would have thought harder about doing two knees at once from the beginning.

This has not been just Donna’s journey, this has been my family’s journey. It’s taken time and effort on their part, and willingness to come and help me. So, I’m glad that I don’t have to put them through that again. We’re past that.

The Meta-Blog

We call it a “Meta-Blog.” We step back and give you a broad perspective on all aspects of knee health as with this article on ‘Deciding on Bilateral Knee Replacement.’

In this one-of-a-kind blog, we gather together great thinkers, doers, and writers. All our work is related to Knee Surgery, Recovery, Preparation, Care, Success, and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. This is for you if you have a surgery upcoming, or in the rear-view mirror. Or maybe you just want to take care of your knees to avoid surgery. Executive Editor: PJ Ewing

To subscribe to the blog click here.

The link to the research study as presented in the blog episode is here: Conversion to TKA from UKA Risk Factors.

Two resources for you below. Both are email series that we created to help those who need some additional thinking for pre-surgery and post-surgery.