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Old 10-20-2009, 08:59 AM   #1
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Bilateral Total Knee Replacement

I am a 60-yr-old female in relatively good shape 5'5", 140 lbs. 10 days ago I had total knee replacement of both knees. I was 3 days in hospital and came straight home. I started PT in hospital and am continuing twice a week at a local PT clinic. I am interested in exchanging information with others in the same situation, or helping those who are facing this surgery. The biggest problem I've encountered, hands down, is getting control of the pain. I have a high tolerance for pain, have experienced "real" pain before -- ie, two babies. Before the surgery, I knew I was allergic to codeine. Since then, I've discovered that I react to almost ALL narcotics. I am able to tolerate Dilaudid (Ithink it is an opium derivative), but my surgeon will not authorize more than 4 mg every 4-6 hours and that isn't doing the trick. I have to supplement with Ibuprofen or naproxen sodium several times a day. I also use a cold water therapy machine for an hour or more several times a day. Honestly, this machine has been a gift from heaven. My doctor didn't recommend it, but when I brought it up, he was willing to write a prescription for it and hook me up to it in the OR. It ran continuously the first week, and I use it several times a day still.
I knew 2-3 years ago that I needed this surgery, but kept putting it off (I guess I thought it would miraculously get better). Finally, this summer the pain got so bad I could barely stumble out to my beloved vegetable garden and pick a few tomatoes. I found a surgeon I felt I could trust, and set a date. I stayed very busy the last few weeks leading up to the surgery so I wouldn't have to think about what I was about to do. I was weepy, and I also tried to put a few things in order "just in case the worst happens". That is always a good idea if you are having a general anesthetic.
At 12 days post op, I walked unassisted into the surgeon's office for my follow-up appointment! I'm not bragging, it is a fact, and it won't be that way for everyone. But it can happen, because it happened to me. Here are some things you can do before the surgery to improve your chances for success and a quick comeback:
1. Do the pre-op exercises religiously.
2. Get your life in order. Make the difficult phone call, have a talk with your spouse and children about your last wishes, tell important people you love them..
3. Make a list of where all your assets are located, including logins and passwords to all accounts. Make sure someone trustworthy knows where this list can be found.
4. Make a list of close friends and family, including email addresses and phone numbers, to take with you to the hospital.
5. Organize a "recovery room" at home, preferably a bedroom with bath that you don't have to share with anyone. If your house is two levels and your bedroom is up a flight of stairs, you will have to set up a place on the ground level where you can camp out until you can manage the stairs. Your sleepless nights and high toilet seat shouldn't inconvenience your caregiver. Put some of your favorite things in this area -- a green plant, some books you've been meaning to read, games to play with the grandchildren, as well as clothes and shoes. I you have a chore you have been putting off that you can do while you are sitting down, such as going through old family photos or reorganizing your recipes, put those items in this room. Move in your computer and a supply of blank thank you notes, birthday, anniversary, and sympathy cards, and stamps. A surprise gift for your caregiver would be something good to stash away and have on hand for a challenging day during your recovery. (I also am using a "mini" computer, or netbook, for times when I am stuck in bed while the cold water therapy machine is working. I can keep up with email, or watch a movie or TV show courtesy of Netflix's "Watch Instantly" library.)
6. Notify your close friends and family, and your minister if you have one. If they offer to help, have a list of ways they can help you -- running errands, making a dinner, doing laundry, driving you to PT, whatever. Let people help you, and let them know how grateful you are for the help.
7. Keep a file with all your paperwork, exercise directions, important phone numbers, insurance card, a small amount of cash, and your ID. You will need this to take with you to the hospital.
8. Take off all jewelry and put it and other valuables in a safe place in your home or in a safe deposit box, especially if you will have paid caregivers coming into your home.
9. Clear your calendar for at least a month, and don't plan any airplane trips or long car trips for at least six weeks. Get your teeth cleaned, your mammogram, your botox, whatever. Get this all done way before your surgery date. Get your hair cut.
10. Stock your pantry with plain food items -- oatmeal, dried fruit, crackers -- and your fridge the same -- yogurt, cheese, juice. Make a list of phone numbers of local restaurants that will deliver. You will get bored with casseroles and cookies your friends bring and want some "real food" at some point. This is a good indication that you are getting better, when the enjoyment of food becomes a part of your life again.

All the above preparation takes a lot of time and thought, but is well worth it for the day you come home from the hospital. I elected to come directly home from the hospital, even though we live over an hour away, instead of going to a rehab facility, because I knew I would be well looked after and there would be more rest and fewer chances of infection. One of the nicest things friends did for us during the first two weeks at home was to come into our home and prepare dinner. It was social, undemanding, and a very nice way to visit. And the leftovers were nice to have for another meal or two.

I am now 13 days post op, and looking forward to life getting back to "normal", whatever that is. Your most important recovery tool is your attitude. When the PT first came into my hospital room the day after my surgery and announced that she was going to get me standing and walking, I said "Great! I've been waiting for this. Let's do it!" She looked at me as if I'd lost my mind, and said, "You do understand that this will be a bit uncomfortable, don't you?" Yes, I'd heard the stories from other patients. And it wasn't uncomfortable at all. It hurt! So much so that tears came to my eyes. But you know, it didn't kill me, and I'm a firm believer in the saying that "whatever doesn't kill you makes you stronger". That was the first step on the way to full recovery and I really wanted to get it over with. For inspiration, you might want to watch the movie Braveheart again.

Last edited by floating island; 10-20-2009 at 09:10 AM. Reason: make clearer

 
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Old 10-20-2009, 03:50 PM   #2
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Re: Bilateral Total KneeS Replacement

Hi Floating Island...I had bi-laterals done 10 years ago and I agree with everything you posted. And the pain meds...I did Dilaudid as well and no, 4mgs doesn't do it but trying to get them to approve more than that is impossible(idiots....let them try this surgery!). I couldn't take ibuprofen or naproxen as I was on Coumadin for 12 weeks to thin my blood and prevent clots and those drugs interfere with that. So like you, I used ice. If I really got bad, I took 1 1/2 4mgs. Dilaudid(6mgs) but then I was down by a half a pill and he kept watch on how many I used. So I took Benedryl to help me sleep and found I could miss a night time dose and used that during the day...problem solved!

Many have asked me if I would do it again that way and I have said no due to the pain. What would you say now? I also have a high pain threshold and I was going nuts with the pain at times. Anyone with a lower pain threshold would certainly have big problems, I imagine. Doc told me of people stroking out from the pain.

Anyhow, I go to see him in 1 week to see if I'm headed for revisions. They started hurting for the first time this year. They were 10 year knees and it's been 10 years. And I worked retail, on my feet for up to 12 hours a day for years after they were replaced. May need some new ones.....one at a time this time!

Hang in there...you're doing great. Glad another "bi" is here...I feel alone at times

gentle hugs.....................Jenny

 
Old 10-25-2009, 05:21 PM   #3
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Re: Bilateral Total KneeS Replacement

Thank you so much for being here. I have looked many places and just found some people that might be able to help me. I am having bilateral TKR on Dec. 8. I have asked some people about exercises before surgery and get no response. I am doing the exercises that I learned in the spring when I went to pt for knee and hip pain. Yes, the right hip is also a possible candidate for replacement. I would do more if I knew what to do. Thank you Floating Island for your "things to do before surgery" What a help. I have printed them and am on a countdown for completing them all. I am open to anyone giving me any help on what I should do before surgery. I am a retired teacher and have used a cane for the past two years and a walker for the past 4 months. It is time.
Thanks for any help you can give me,
Jeano
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Old 10-26-2009, 08:36 AM   #4
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Re: Bilateral Total KneeS Replacement

Quote:
Originally Posted by Jeanob View Post
Thank you so much for being here. I have looked many places and just found some people that might be able to help me. I am having bilateral TKR on Dec. 8. I have asked some people about exercises before surgery and get no response. I am doing the exercises that I learned in the spring when I went to pt for knee and hip pain. Yes, the right hip is also a possible candidate for replacement. I would do more if I knew what to do. Thank you Floating Island for your "things to do before surgery" What a help. I have printed them and am on a countdown for completing them all. I am open to anyone giving me any help on what I should do before surgery. I am a retired teacher and have used a cane for the past two years and a walker for the past 4 months. It is time.
Thanks for any help you can give me,
Jeano
Hello, Jeano, I know how you are feeling right now. And being well prepared is the best way to deal with the anxiety. As for pre-op exercises, I was given a book which had some exercises in it, by the PT department at the hospital where I had my surgery. They also teach a class once a week to those facing knee repl surgery, and it was very helpful to attend this class with my husband. There are only four exercises, but the descriptions are too lengthy to repeat here. Focus on getting your quadriceps strong(leg raises), on ankle rotations, and on knee bending (sitting in a chair and moving the foot back under you). It would help if you can reach your feet while sitting in bed or in a chair (to put shoes and socks on yourself). The stronger and more flexble you are going into the surgery, the shorter your recovery time. Understand the day after surgery, when the PT comes into your hospital room and announces, "We're going to get you standing up on those new knees", that it is going to hurt. Embrace the experience (you'll shock the PT!). My surgeon was very helpful when he told me, "It's not the new parts that will hurt. It's the muscles and ligaments that have been stretched to get the parts in place. Don't be afraid to put weight on the new knees." It will hurt less the next time, and the next, and so on.
I had some stomach muscles that were annoyed at being called out of retirement. They were necessary at first for simple things like sitting up in bed from a lying position. You will probably have a bar over your bed to help with this, but no one pointed that out to me at first.
Best of luck, and be sure and let us know how you're getting along.

 
Old 10-27-2009, 12:56 PM   #5
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Re: Bilateral Total KneeS Replacement


Floating Island Thank you so much for the wonderful ideas. I will check with the local hospital. I know they have a "new" ortho section they are advertising in the paper. I asked the Dr. if I should go to their classes and the nurse said the Dr. doesn't send his patients because some of the information does not apply to how he does his surgery. I would really like to see the facility, so I may contact them myself. I took your exercise ideas and copied, printed, and posted them next to my chair in the living room. They will be added to my arsenal of exercises. Thank you!
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Old 10-27-2009, 05:11 PM   #6
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Re: Bilateral Total KneeS Replacement

Hi ladies....just found out I'm now going for revisions. Don't know if they'll be bi-laterals again but I bet he will. I have more trouble with my lungs than my legs so he wants to minimize the amount of anesthesia I get.

So maybe we'll have to start a new thread...bi-lateral revisions.

gentle hugs................Jenny

 
Old 11-15-2009, 12:08 PM   #7
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Re: Bilateral Total KneeS Replacement

Hi all,
Well, I have now officially done the class at the hospital for joint replacements. There were 22 people there for hip or knee surgeries. It was very well done and I was glad I got to see some of the equipment that they will use for the proceedure. I am getting a bit more nervous as I get closer to Dec. 8. The nurse giving the class was wide eyed when I said bilateral TKR. Then she said you are a brave person. Oh, that makes me feel real excited about this adventure. I was the only one there for bilateral TKR. I am guessing it doesn't happen too often. But I know I will go through with it. It has been a 14 month process of losing 120+ pounds but in the meantime I have gone from limping to cane to walker. This past week I am hurting big time and I don't care what anyone says...it is time!
A question for the experienced people. I am guessing that I need no real night time clothes in the hospital except for a robe. Is that correct? I read on one of the posts that I would need shorts for PT. I am not a short wearer, but have ordered some knit shorts for when I am supposedly in an aftercare facility for up to two weeks. Is that what works best? I would prefer my knit pants---I now have lots of them in much larger sizes that should accomodate swollen knees. I'd love to use them instead. What do you think?
Thanks for all the help,
Jeanob
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Last edited by Jeanob; 11-15-2009 at 12:09 PM.

 
Old 11-15-2009, 01:38 PM   #8
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Re: Bilateral Total KneeS Replacement

Dear Jeanob:

Big congratulations on losing all that weight! They do say it is good to keep one's weight down - easier on the joints. I could lose a few myself and my joints would benefit.

I have not had any knee replacements - mine have been both hips but not at the same time. I admire your courage in getting both knees done at the same time. I am glad that you will be going to a rehab facility. They do a wonderful job for joint replacement rehab.

I can't imagine having both knees done at the same time! Your determination and positive attitude ought to be great helps in rehab.

I wore just ordinary slacks and tops while in the rehab place I was sent to. Everyone else there wore the same kinds of clothes as I did. No one wore shorts - and it was August - there was AC, but I don't know if there were knee replacements represented there. In the hospital for the 2 days I was there I wore the hospital gown. That worked best for me.

Maybe some veterans of knee replacements here can advise you on what you should wear in rehab. There will be others there doing the exercises too - so you will want to look fairly presentable. And shorts in the fall/winter might not be warm enough?

Shirley H.

Last edited by Silver Swan; 11-15-2009 at 01:39 PM. Reason: typo

 
Old 11-15-2009, 02:51 PM   #9
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Re: Bilateral Total KneeS Replacement

Although mine were almost 11 years ago, I had just a short robe for the hospital as you don't want anything to trip on and I had shorts for the rehab. Both of my legs were in immobilizers so pants did not fit over them. And since bending is a big thing, I figured shorts would work better. But what I did have for outdoors(mine were done in Feb in New England..snow time)was the type of nylon exercise pants that snapped down the sides so I could easily unsnap at a trip to the docs or snapped for going out for blood work. They fit nicely and it was nice to not have to take them off when getting staples out or dressing changes. My doc insisted on immobilizers for 4 weeks as my knees were so loose due to ligament injuries.

It was nice to have shorts for rehab as they had their big exercise platform facing the hallway so if you only had a johnny, you were exposed to everyone walking by. I spotted that when I went there ahead of time...always a good thing to do...check the place out ahead of time.

But the biggest problem you are going to have is that you won't have a good leg to stand on. You will always hurt when standing. You will always feel unstable when standing. I told my doc the difference between having 1 knee and both knees done was like having twins. Twins isn't just having 2 babies...there is a whole different set of problems when you carry 2. Having 2 knees replaced is that much different. You can't stop while walking to rest your bad knee...their both bad knees. If you feel unsteady, you can't shift your weight to the good knee...there isn't one. And the biggie...you can't take the pressure off the painful knee as they are both painful. And since you've lost more blood, you are weaker. And since they've chiseled away at 2 knee joints, you are more liable to get bone marrow in your blood and get a fever post-op(I was up to 102+)but it will go down. Basically, everything is doubled+, especially problems.

At rehab, if you are the type who gets yeast infections form antibiotics, you may get the infection of a lifetime due to the post-op antibiotics. Have stuff at home that can be brought to rehab if you get one(otherwise it has to be prescribed and done by the staff). BTW, my rehab wouldn't let me take a shower because I had to pay for my own shower chair to take one. So if you are getting a seat of any kind for your shower at home, consider getting a stool that someone can bring to the rehab so you can shower there once the staples are out. At rehab, if you want it, you have to pay for it so bring what you want and need and might like.

Would I do it again that way? I don't know. It was nice once it was all over and my doc was super careful and put me through 6 months of medical tests prior to doing it so he had all sorts of specialists on call and ready if I needed them...I didn't. I sailed through....and I was awake for it. But those first 2 days I don't ever want to hurt that much again...I can tell you that. Once in a lifetime was enough for me. I have allergies to pain meds so I was under medicated for pain.

But I am headed for revisions and have decided I will do them one at a time if possible. I live in a different place now and don't have my kids home to help anymore. I couldn't have done it without them. I have steps and all sorts of obstacles this time. One at a time sounds fine to me unless my doc thinks that I'm too big a surgical risk to do multiple surgeries again. I hope not.

So if you think of anything else to ask, we're here.

gentle hugs..............Jenny

 
Old 11-16-2009, 03:05 AM   #10
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Re: Bilateral Total KneeS Replacement

I would like to have had an education class for me and my wife before my TKR, it would have really helped my wife

 
Old 11-16-2009, 10:12 AM   #11
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Re: Bilateral Total KneeS Replacement

I go into the hospital tomorrow for my knee replacement. I've given the 2 units of blood, had the pre-op tests, everything. Now I just have to do the last 24 hrs. of waiting! I want to thank everyone who has posted in the last 2 or 3 months. You have all been very helpful.

 
Old 11-16-2009, 10:33 AM   #12
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Re: Bilateral Total KneeS Replacement

Quote:
Originally Posted by Jeanob View Post
Hi all,
Well, I have now officially done the class at the hospital for joint replacements. There were 22 people there for hip or knee surgeries. It was very well done and I was glad I got to see some of the equipment that they will use for the proceedure. I am getting a bit more nervous as I get closer to Dec. 8. The nurse giving the class was wide eyed when I said bilateral TKR. Then she said you are a brave person. Oh, that makes me feel real excited about this adventure. I was the only one there for bilateral TKR. I am guessing it doesn't happen too often. But I know I will go through with it. It has been a 14 month process of losing 120+ pounds but in the meantime I have gone from limping to cane to walker. This past week I am hurting big time and I don't care what anyone says...it is time!
A question for the experienced people. I am guessing that I need no real night time clothes in the hospital except for a robe. Is that correct? I read on one of the posts that I would need shorts for PT. I am not a short wearer, but have ordered some knit shorts for when I am supposedly in an aftercare facility for up to two weeks. Is that what works best? I would prefer my knit pants---I now have lots of them in much larger sizes that should accomodate swollen knees. I'd love to use them instead. What do you think?
Thanks for all the help,
Jeanob
I didn't have my own nightgown or robe, and didn't need them, but I also had a private room (all rooms were private).

I brought 2 shorts and 2 T-shirts and wore them to/from the hospital and on Days 2, 3 and 4 in the hospital during the day and evening before bedtime. Wearing long pants would have been a pain for dressing changes and getting caught up on the dressings. Shorts are best.

I also brought a fluffy cardigan sweater that was comfy if I felt cold in bed. I also brought a little makeup and started wearing it on Day 2. It helped me feel human. And I brought my own lotion, toothpaste and toothbrush, even though the hospital had them.

I will repeat the exact process when I have my other knee done as soon as the surgeon will do it (when my TKR knee can take the load). I am post-op day 26 today.

I wish you the best.

 
Old 11-16-2009, 12:08 PM   #13
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Re: Bilateral Total KneeS Replacement

Hi all,
Wow! You are a wealth of information. I am so glad I found this thread.
First of all- Best of luck to Lady Scout. You should be on day two or three PO by now. I hope and pray all is going well for you.

Thank you to Shirley JennyBYC , and GaterGal for all the great information. I know I will be back here often (probably daily)until I get to my magic day of Dec. 8.

Shirley you are so kind. Sometimes I forget that what I have done so far SHOULD help me in the long run. I am so glad I read the old board as many times as I did...before they closed it. I almost feel like I know some of you and have appreciated reading and have learned so much about how you have worked through this time in your lives.

Jenny thank you for the heads up on infections. Yes, I do get urinary infections occasionally, so I will make sure I have the needed meds. etc. Thanks also for the help on clothes etc. I love the idea of the slick pants with the snaps on the side. I don't know if they make them for big ladies, but I will sure look. I live in Illinois so I will probably have the cold weather etc. I liked the idea about the shower chair. I haven't gotten one yet, but may get it before I go in so it is ready. Thank you for suggesting it be portable so I can use it at home and in rehab. I never would have thought of that. I loved your comparison to twins. I didn't carry them but have twin grandchildren (4 years old boy and girl) and have been very actively involved in their care. So, yes, I know what it is like to care for them and the double trouble (and fun and laughter) and work they create. I have three other grandkids all live close by, so I am active in all of their lives. Yes, two is harder than one. Good luck on your revisions. I don't even want to think of something like that when I haven't done step one yet. Good for you.

GaterGal Thanks for all the specifics of what to take. I appreaciate the heads up on shorts. It makes sense. So, I just ordered two pair of shorts from my big ladies shop.I got them a size bigger than I now wear to accomodate dressings etc. I guess I will make sure I take them. Thanks also for the heads up on lotion and makeup. I was thinking I would take those things, just to feel a little bit like home. I love the idea of the fluffy cardigan. I am one of those people that have a blanket throw over me whenever I am sitting reading. I was wondering what to take for the bed.

Beehunters I understand what you are saying about the class. My Dr. does not tell his patients to go to the classs yet, his partner surgeon makes it mandatory. I asked if I could go and was given permission. It was one of the best two + hours I have spent - but reading these boards is also extremely helpful, answers so many more involved questions, and much more personal. My husband couldn't go with me to class because of harvesting, but I brought home all of the stuff for him to read someday (when he can stay awake long enough after very long days on the tractor).
Once again Thanks everyone. I will be back.
Jean
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Last edited by Jeanob; 11-16-2009 at 12:13 PM. Reason: typos

 
Old 11-16-2009, 02:43 PM   #14
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Re: Bilateral Total KneeS Replacement

Quote:
Originally Posted by Jeanob View Post
Hi all,
Well, I have now officially done the class at the hospital for joint replacements. There were 22 people there for hip or knee surgeries. It was very well done and I was glad I got to see some of the equipment that they will use for the proceedure. I am getting a bit more nervous as I get closer to Dec. 8. The nurse giving the class was wide eyed when I said bilateral TKR. Then she said you are a brave person. Oh, that makes me feel real excited about this adventure. I was the only one there for bilateral TKR. I am guessing it doesn't happen too often. But I know I will go through with it. It has been a 14 month process of losing 120+ pounds but in the meantime I have gone from limping to cane to walker. This past week I am hurting big time and I don't care what anyone says...it is time!
A question for the experienced people. I am guessing that I need no real night time clothes in the hospital except for a robe. Is that correct? I read on one of the posts that I would need shorts for PT. I am not a short wearer, but have ordered some knit shorts for when I am supposedly in an aftercare facility for up to two weeks. Is that what works best? I would prefer my knit pants---I now have lots of them in much larger sizes that should accomodate swollen knees. I'd love to use them instead. What do you think?
Thanks for all the help,
Jeanob
Jeanob: Additional congratulations on the weight loss! I know how difficult that is, and you will benefit so much from that struggle in the next one. Bilaterals are a challenge, though I don't think I agree with the writer who compared it to having twins. I'm almost embarrassed when people tell me how brave I am, when I'm really kind of a wimp about pain. I just wanted to put hospitals, doctors, shower chairs, PT, and drugs behind me and get back to my real life. TKR and recovery are a long stretch of time out of your life and I wanted to minimize the time loss.

OK, about the pain: bilateral is not a higher level of pain, i.e., it's not twice as painful as having one knee done; but it's spread out over two knees. They certainly didn't give me twice as much painkiller! You're going to do well if you're in good shape to start off with, are lucky in not having complications, exercise and go to PT, and push yourself a little.

Good luck, and check back in to let us all know how you're doing when you can get back to the computer after Dec. 8. We'll be thinking about you!

 
Old 11-16-2009, 10:20 PM   #15
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Re: Bilateral Total Knee Replacement

surgery on wed, out on sat

for clothes, I brought a pair of loose fiting lite weight sweats with an open bottom, extra t shirt and sweatshirt

 
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