View Full Version : Simultaneous knee replacements for 70+ woman. Good idea?
02-09-2009, 09:01 PM
My Mom is 74 and is going to have both her knees replaced. Previously, she was planning on doing one at a time so that she would have one leg at least moderately better off while the other replacement was healing. That seemed like a good idea to me and the rest of the family.
But she heard from someone who had both done at the same time on the grounds that she wouldn't have to endure the pain and discomfort twice, so now that's what my Mom wants to do.
Personally, I don't think it's a good idea in her case, since while both her legs and knees are pretty bad and she has a lot of trouble standing and walking, one leg/knee is a bit better than the other. If she has both knees replaced at the same time, she'll have two very poor legs and knees at the same time, and I can't help wondering that if that happens, she won't be able to walk or otherwise navigate to the bathroom. (She normally has to go upstairs to sleep, but she plans on renting a hospital-type bed or something so she can sleep downstairs.)
Her overall health is not good, I'm afraid, but it's not awful, either. She has some shortness of breath (she hasn't smoked in decades, though) and a moderately high degree of balance problems. Probably her biggest problem is that her kidneys are in very bad shape (just short of needing dialysis, but her doctors have been saying that for years).
I told her about the very sharp Teeming Millions at the SDMB and assured her that we'd get the Straight Dope. What do you think, especially those who have undergone the procedure and medically knowledgeable folk?
ETA: She believes for some reason that she has to wait 3-6 moths of solid good health before she can undergo the procedure. Any validity to that?
02-09-2009, 09:14 PM
After watching how much pain my mom and grandma were both in after having one done, I honestly fear to think about how bad it would be to do both at the same time. My grandma just had her second one done a few days ago, actually. It's been worth it for them both, but it's major surgery.
Can't help on the health questions front since it wasn't an issue for my family, but I would VERY STRONGLY recommend against doing them both at once, for pain reasons if nothing else.
02-09-2009, 09:25 PM
An old farmer that comes in the Post Office had them done one at a time. He was happy with the doctors and the procedure but said he wished to God he had them done at the same time.
He was miserable during the recovery the first time and had to look forward to it all again.
02-09-2009, 09:56 PM
My wife's knees were shot by the time she was 55, so she had the worse (worser? worst?) one done. The rehab was really painful. But the funny thing is, now that she has one good knee, the other one doesn't bother her nearly as much. So replacing one bad knee has helped her delay replacing the other bad one for more than five years now.
As for the kidneys, etc. I'd trust her doctor's opinion a lot more than any message board.
02-09-2009, 10:12 PM
I hate to be this way but good luck trying to tell a 74 year old woman what to do
02-09-2009, 10:33 PM
I hate to be this way but good luck trying to tell a 74 year old woman what to do
LOLActually, she's pretty open to revising her opinions when given a good reason. For example, she'd been voting Republican for decades, but when I reasoned with her about what Obama stood for and how desperately we needed not just a solid president but specifically a Democratic one, she jumped on board right away. Then she changed the minds of some other Republican family members.
Also, after I explained the SDMB to her, she immediately asked me to post this thread and get other's opinions and hear their experiences.
02-09-2009, 11:06 PM
My wife's knees were shot by the time she was 55, so she had the worse (worser? worst?) one done. The rehab was really painful. But the funny thing is, now that she has one good knee, the other one doesn't bother her nearly as much. So replacing one bad knee has helped her delay replacing the other bad one for more than five years now.Thanks! That's very helpful.
As for the kidneys, etc. I'd trust her doctor's opinion a lot more than any message board.[/QUOTE]In general, you're certainly right about that. But her doctor is an emotionally needy man who so fears that his patients will switch doctors that he'll say just about anything his patients want to hear, or at least he'll push the boundaries pretty far. If they leave anyway, he and every member of this office will call those patients at home and beg them to come back. So I don't trust his advice to be particularly reliable.
But the other thing to recall is that there are a goodly number of medical professionals and med students who frequent the SDMB, and I hope to hear from one or more of them...
The Second Stone
02-10-2009, 12:36 AM
I knew an 80 year old woman with arthritis who had previously done two hips and an elbow. All separate. She then had one knee done with the intent of getting the other done. She said it was far more painful and wished she had both done at the same time. I don't know how she could have done the rehab had she done that. I knew a guy in his mid-50s who had both done at the same time and managed the rehab.
I think promises of adequate morphine and other narcotics during the recovery is a must either way.
02-10-2009, 02:07 AM
I'm 63, and plan to have both knees replaced as soon as I'm on Medicare (I have no health insurance now, and really painful knees). I'm afraid that if I have only one done, and recovery is very painful, I won't have the second one done. And some relatives who have been through it tell me to definitely do them both at once.
02-10-2009, 07:48 AM
My mom had both of hers replaced at the same time at, I think, 64. Her doctors recommended it that way, and said that many patients who think they would rather do one at a time often end up not doing the 2nd one to avoid going through it again.
Her recovery was impressive. She did her therapy diligently and impressed her doctors with the speed of her recovery. My parents travel quite a bit and my Mom was unable to walk, her knees were so bad, so her motivation was the goal of traveling to different cities around the world as she has done for the past 30 years or so. She said yes, it was difficult and painful, but she'd do it the same way if she had to do it again.
My friend's father needed a double replacement but only had one done. He's putting off having the 2nd one done. The doctors say this is common with men- most women go for the two-fer, but most men do one at a time and often don't come back for the 2nd one. They just live with the pain.
02-10-2009, 08:03 AM
I've had one knee replaced, and will in all likelihood have it replaced again (I had the replacement unusually young, in my early 40s).
Things will go differently for someone who's 74, of course, but my experience was that the recovery from the surgery wasn't all that bad, really. I had the surgery on a Thursday, and was back at work the next Thursday. I'm a white-collar worker, and if I had a different job, one that kept me on my feet all day, or moving around or lifting, I wouldn't have been back quite so fast, of course.
If I'd had to have both knees done, I definitely would have elected to do them simultaneously.
02-10-2009, 08:12 AM
You might want to check into partial knee replacement, though you might have trouble finding a doctor that does them.
Roughly speaking, with total knee replacement, there is a bunch of crap cut up, hacked out, or seriously disturbed.
My SO had a partial. They make one (a couple?) small incision and do all the work through those small holes.
What they do with a partial is basically replace the worn SURFACES with artifical ones. But most of the bones, muscles, ligaments, whatevers are left intact.
Its almost an outpatient procedure. My SO was walking on it (and supposed to be) like the next day or two. A couple hours of therapy every day for like 2 weeks.
Its cheaper, simpler, much less invasive, and much quicker to heal from. It also has the advantage that if it doesnt work, or wears out too soon, you still have the backup option of going for the full knee replacement. My very limited understanding of full knee is that if it goes bad/wrong or wears out, you are pretty much SOL.
We know people who've had the full and there is no comparsion between the two in terms of apparent pain and recovery effort.
02-10-2009, 08:54 AM
My ex-husband's mother had both her knees replaced the year after we got married. She was in her late sixties at the time, and her son reported that he had not seen her walk (as opposed to hobble with a cane) ever in his life.The doctor who recommended the replacement was astonished that she was still walking at all, from the condition of her joints.
Three days after the operation she was out of the hospital and hobbling around again. She'd given up the cane pretty much completely about eight months later.
The problem with doing them one at a time is that you're stuck with twice as much recovery time - let's say each knee requires six months recovery and physio -- by doing both at once you may end up with seven or eight months, but by doing them one at a time you're dragging it out to a year.
02-10-2009, 09:34 AM
My own mother who is 62, has had both knees replaced due to arthritis. She has told me often that she wished she got them both done at the same time, there was an 18 month wait between surgeries. She had the worst of the two replaced first and during the waiting period her other knee got worse. She feels if she got them both done at the same time her recovery would have been a lot faster. She got them done on the National Health Scheme, they won't do both at the same time for some reason. Yet a woman in her post surgery ward had both hips replaced at the same time, I could never figure that out. Next up is my mother's shoulder.
02-10-2009, 12:46 PM
My parents travel quite a bit and my Mom was unable to walk, her knees were so bad, so her motivation was the goal of traveling to different cities around the world as she has done for the past 30 years or so. She said yes, it was difficult and painful, but she'd do it the same way if she had to do it again
This is my motivation. If I just stayed home all the time I could pretty much deal with the pain. But when traveling I can be on my feet from dawn to night, and that kind of pain really takes away from the experience.
02-10-2009, 01:29 PM
My wife had both done at 44 y. o. She didn't have a knee that was better than the other, and had heard about how painful it all was.
She says gladly that there is only so much pain the human body can feel at a time, so it didn't matter. She also says she'd never have the 2nd one done if they went serially.
She was gone just short of a month, either in the hospital or a rehab facility. By the time she got home, she could walk with a cane and handle steps. The pain is worst the first 2 weeks. Rehab was a real bitch.
One consideration is painkillers. My wife has been clinically addicted for years; your mom probably will be by the end of this, if she's not already.
02-10-2009, 02:28 PM
First of all, I am not a doctor. I am however, an orthopaedic nurse. The experience I've had in regard to bilateral knees is that most people do really well. The first post-op day they are a little slower getting started. But by the second day, they tend to be in just as good shape as the patients who had only one done. Today's procedures are quick, and rehab is very specifically targeted to the individual patient. I would recommend your mother listen to her physician, and make the decision between the two of them.
02-10-2009, 03:30 PM
My grandmother got hers replaced in her late 70s. She had them done one at a time, but recovery time was quite fast and she said it wasn't bad at all. Her knees had gotten so bad that it wasn't long at all before she had more mobility and less pain than she'd been in before the operation. She was climbing steps (albeit with a cane) in less than 2 weeks and in less than 4 weeks said "let's do the other one". Her overall outcome was good (she lived to be 93 and was walking well until the last 5-6 months). I wish your own Mom well with hers.
ETA: She always said it was important to stock up on some SERIOUS painkillers and have the available before going in for the operation. Do NOT wait until leaving the facility to fill the Rx, and insist on some no-kidding narcotics. Get ahead of the pain, don't wait until it feels like your legs are being gnawed off and THEN take the pills.
02-10-2009, 03:50 PM
I had no idea I'd be the odd one out here. Hmm. I could well be wrong, but the thought of doing both still makes me cringe.
Whatever she decides, tell her to do the rehab dangit. It can be a real bitch but it's worth it in the end. Promise.
02-10-2009, 05:30 PM
Another thing to keep in mind, if the procedure involves it, is that as people get older, the risk of death while under general anesthesia is greatly increased. So, two knees at once may be much safer than one at a time purely on that basis.
02-10-2009, 07:21 PM
If she has both knees replaced at the same time, she'll have two very poor legs and knees at the same time, and I can't help wondering that if that happens, she won't be able to walk or otherwise navigate to the bathroom. (She normally has to go upstairs to sleep, but she plans on renting a hospital-type bed or something so she can sleep downstairs.)
Good Lord, will she have someone staying with her after the surgery? I hope so.
My mom had one knee replaced at age 62, and thank Og I was able to stay with her for a week (wish it could have been longer). The assistance with everyday tasks, and also with her rehab exercises, was a huge help. I can't imagine a 74-year-old in questionable health managing alone.
02-10-2009, 07:38 PM
My step mother's mother is also 74. She opted to have have both knees replaced at one time.
Then proceeded to bitch for 6 weeks about what a miserable experience it was. And everybody around her bitched because this woman had to be waited on hand & foot 24 hours a day.
But now all is good and she wishes she had the surgery 10 years ago.
02-10-2009, 07:44 PM
Thanks to all. What great input! Many ideas neither I nor my Mom had heard before.
As I said in my OP, my Mom was headed in the direction of simultaneous replacements already, so I'll let her know that a unanimous bunch of my fellow Dopers agree with her (but I won't explain what Dopers are ;) )
02-10-2009, 08:07 PM
I read the title, and thought it was about 70 (or more) women all having simultaneous knee replacements, like some Guinness World Record attempt or something.
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