Tell me about your knee replacement

Miscellaneous and Personal Stuff I Must Share
1

One week from today I am getting my knee(s) replaced. I am bone-on-bone in both knees. The plan was to do one now, one later, depending on how my primary care doctor felt about my heart, but he wants me to do both at once so Friday the surgeon and I will meet to discuss whether we have a new plan or if we are sticking with the left knee only.

My sister just had one of her knees done about three weeks ago and she is just getting ready to leave the rehab center and head home for outpatient physical therapy. She’s done pretty well so far, dealing more with depression from an inattentive family than anything, though she did run a fever they couldn’t pin down and had some odd bruising, but all in all her pain meds have worked well. But she is four states away and I have been unable to visit her and see what she is dealing with.

I expect to be out of work for a minimum of three months…that was the plan for doing one knee, I don’t know if that will change if we do both. That is a little bit longer time out on disability than I had heard from other people, but the surgeon said that is based on me being in a retail job that requires standing on my feet for hours on end, climbing ladders and lifting heavy boxes.

So I know this has to be done if I am to continue working for a living. I know it is going to hurt and be tough and in time I will be glad I went through it. I know it won’t do anything to ease the pain I have in my feet and ankles from bone spurs, but I’m hoping the break from being on my feet all the time will help. I know I am taking a huge financial hit with this, but it will be even worse if I have to do this all again in a year for a second knee…I’d rather endure extra pain to have it all be done. And next year, my daughter will have a newborn AND a toddler to contend with, and won’t be able to help out with my elderly mom (who very inconveniently ended up having a three-week hospital and nursing home stay NOW, and will be getting out just as I am going in (to possibly the same rehab center!) and will need extra attention from the family while I am unavailable. And then it is going to be dueling walkers and canes in this tiny house!

I’m looking for good thoughts and practical advice and reminders about things I should take care of/take with me/ take heed of before I go for broke on this. Tomorrow is a orientation at the hospital. The rehab center I may go to is good, but boring, and has crappy cell phone reception, which they are working on, but that is almost a deal-killer for me…I really rely on texting! They do have wifi, but that doesn’t help when I just need to give my daughter a quick list of things to bring me!

Plus…I’m scared. I’ve done gastric bypass surgery, and did fine with that, except for the almost dying bit afters when my blood pressure went out of control for a while. I don’t want to know much about the actual procedure…some things I’d like to stay innocent about, like bone saws… I’m just nervous. And this is all happening so fast, an with my mom now so fragile…sigh. No wonder I can’t sleep. So much to do to get the house ready. Sorry this is so long…so…cheer me up?

2

Not me, but my husband: He says that, aside from marrying me*, knee replacement was the best decision he ever made, and that he’d have had 'em both done at once if he’d known how vastly his life would improve. And the advice he offers to anyone who asks is to suck it up and do the therapy, dammit, and to go ahead and take the pain meds in time for them to help you through the therapy. He had his knee replaced in June of 2010, was walking the next day, and climbing stairs at the hospital before being released. He came home from the hospital, vs. a rehab center, but had in-home therapy for about 3 weeks, plus outpatient PT for about 2 months afterwards.

My aunt had knee replacement around the same time as Tony. She was a wimp, and wouldn’t do the therapy, and spent far longer than she should have at the rehab center. Now, several years later, she looks back and wants to kick herself. Her mobility is so much better, and pain is so much less, that she’s like a different person.

I don’t know whether this is an issue for you, but both Tony and Rosemary were able to lose a significant amount of weight after their surgeries because the decreased pain levels allowed both to be much more mobile and active.

My father-in-law had surgery about a year after Tony and Aunt Rosemary. FIL doesn’t take orders from anyone, ignored all kinds of doctors orders, and regularly does brilliant stuff like drinking a couple of beers to nerve himself for his morning insulin shot. Unsurprisingly, he developed a post-surgical infection, didn’t follow through on therapy, and might as well not have had the surgery.

*That’s the bit he probably leaves out when I’m not in earshot. :smiley:

3

Had my left knee done last year. 3 days in the hospital, then home for in home therapy. Before leaving hospital, therapy had started and importance of gaining flexibility was emphasized. Basically you got a limited period of time - say 30 to 60 days - to get all the flexibility (range of motion) that you can expect to get. You can build strength and endurance later.

The stretching hurts. But it hurts less each day. And by the end of 2 or 3 weeks, you’re wondering why you waited so long. Listen to your therapy professional and push yourself those first few weeks and you won’t regret it.

I wouldn’t want both knees done at the same time, but that’s me.

In my area of the country most rehab services of this type are done in home. My therapist came 3 times per week for 90 minute sessions and scored me everytime on range of motion. If there was no change, she knew I skipped my exercises the day before and gave me holy hell.

4

I think it is amusing that my sister, who was so adamant to me in the weeks leading up to her knee replacement that she would be coming straight home and have home therapy, is now lecturing me on the importance of going to a skilled nursing facility as if it was HER idea. When she first told me she was not planning on going into a rehab facility, I was stunned…her house is simply not set up so that she would be able to maneuver. There are (albeit) short flights of stairs everywhere…bedrooms and bathrooms are on one level, kitchen and living room on another, family room on another, basement even farther down. Plus several steep stairs to even get into the house. And her family is less that attentive…she’s been struggling for years to get them to help her with a major clean-up and out project that they insisted on. Her husband lives elsewhere, her adult daughter is always whiny about doing things (despite working part-time as a home care aide!). My brother and I urged and nagged her to go into a rehab center if the option was given her. She was so adamant it would be boring, she wanted to be home…

Now she is like a newly-converted Christian…extolling the virtues of not having to prepare her own meals, the therapy twice a day that she can’t procrastinate on, the activities that are arranged, the ease of getting pain meds, the regular schedule…you can’t shut her up about this! Except for virtually no one visiting her (and then three people visiting on one day, just before she gets sprung) she seems to have thoroughly enjoyed the last month. Today I think I’m going to force her to say, “You were right.”

5

I had a knee replacement about ten years ago. Data points:

I was in my early forties at the time.
I was not overweight at all.
The damage to my knee came from an accident and some bad surgery after the accident, not arthritis or any kind of joint disease, so there were no ancillary issues.

So, here’s how it went. I went in for surgery at the crack of dawn on a Thursday. I don’t remember the surgery, obviously (although I had spinal, rather than general, anesthetic, they gave me IV Valium or something so that I slept through the whole thing).

I woke up in a hospital bed. I think it was the same day that the physical therapy people came and got me on my feet. They then set me up with some kind of machine that kept my knee flexing. The next day I snuck out of my room (with a walker) and went downstairs for a smoke.

Home (well, my then-girlfriend’s apartment, because her building had an elevator and mine didn’t) after two days. I had a sort of liquid-cooling thing, like a cooler full of ice that pumped cold water through a hose to a coolant pack that wrapped around my knee. No in-home therapy (I was offered, and rejected, a visiting nurse/physical therapist), but I started phyisical therapy a day or two after I got home.

By Wednesday, I was bored out of my mind, so I went back to work on Thursday. I used crutches, and I was fine. Mostly I didn’t have to take any painkillers other than Advil. I did take the Percosets or Vicodins or whatever they gave me at night, basically using them as sleeping pills, because there was still enough pain to keep me awake.

After about a week (not sure, can’t remember exactly, this was a long time ago), I switched to a cane. After another week or two I got rid of that.

So – my story may not be typical, but I had a really easy time with the whole thing. Of course, I only had one knee done. And I may have been younger/lighter/in better shape than you are, I don’t know. I worked then (and still do) at a desk job that doesn’t require me to get out of my chair other than to go to the men’s room, if I don’t want to.

The thing that worked for me, I think, was that I decided that this was going to be a temporary inconvenience, and I was going to make the recovery as brief as possible.

The best exercise I got was getting back on my bicycle. It was great for range-of-motion and just strengthening my leg, which had lost a lot of muscle in the years leading up to the knee replacement.

So – good thoughts? Knee replacement is truly a miracle fix for knee problems. All my knee problems, which were extremely severe (I really couldn’t walk more than a block or two) just went away after the surgery, and they have never shown so much as a sign of coming back in the last ten years.

Practical stuff – you’ll be in the hospital for a few days. Take what you need. Toothbrush, comb or whatever, that kind of thing. Some kind of easy-to-put-on clothing – sweats and a t-shirt, otherwise you’ll have to wear what the hospital gives you, which I refused to do (I remember having to argue with a nurse about this). Bring books or your Kindle or iPad or something. Being bed-bound in a hospital will make you want to die from the boredom.

Finally, just remember that this surgery is proven. It works. And it’s routine these days. There’s nothing experimental about it. It’s been done a million times before, they know what they’re doing, and the results are absolutely life-changing.

6

It’s official…I’m going to have both knees replaced at once, barring any complications.

7

Keep us posted on how this goes, please, kittenblue. I’m going to be doing this one of these days and would really appreciate the updates. I hope it’s as easy for you as some of the others have suggested. And I hope your mom is better soon. And I hope you can get your sister to say “you were right” (although I have my doubts).

Good Luck!

8

Okay, here is an update on my knee replacement. I went in last Wednesday, on a dark and stormy morning. Had a bit of a delay because the surgeon wasn’t happy with the results of the urine test I’d done Monday…he’d had me on anti-biotics since I had done the pre-admission testing because of some minor concern, and now he wanted them to cath me early and get a truly clean sample to test. So…a lot of stress not knowing if the whole thing would get shut done early. They did all the prep work and talks with anesthesia team and we discussed doing a spinal block that might not last through both surgeries and having to top it up with a general, or just going with the general. I really can’t remember all the details, but I believe we decided just the general.

Urine test came back fine so we went in to surgery…gonna be 2.5 hours for the first one and then an hour for the second one. Remember, second knee gets done unless there is too much blood loss. I wake up (partially) a few minutes later (okay, couple hours) and while I’m not totally alert yet, I can tell only one knee has been done, and I am depressed. And stressed. Blood loss was not on my to-do list. But gradually I can comprehend them telling me there were some technology issues in the OR, but one knee is done and I’m ok.

Ok, but depressed. What it came down to is that that lovely storm caused some power surges, and the air conditioning in the OR was affected. Surgeon told me it just got hotter and hotter and more humid, and he was concerned about the humidity encouraging bacterial growth, plus it was just too hot. They closed me up, and cancelled the rest of the days’ surgeries as well. So, I have a little cry, and he reassures me that if my recovery goes well, he will do the second knee in a few weeks.

I refused to cooperate with the whole bedside commode deal…tried it, didn’t do well with it, moved to commode over toilet and then convinced them to let me just use the regular toilet. So by the next day I was, with supervision, using the walker to get in and out of the bathroom with no problems. I was forgetting to use the pain pump…they had me set the timer on my phone to remind me! Pain ball worked fine, I didn’t really feel all that numb. Pain was a lot less of a distraction than I thought it would be. Had two days of in-hospital PT which was really not bad at all, and he was amazed at the range of motion I had already.

Got transferred to the skilled nursing center on Saturday morning, had my PT evaluation on Sunday and have had two days of OT and PT. I’m doing really well…once again I just sort of refused to follow the rules about being accompanied to the bathroom and went on my own. I walk back and forth to all meals…haven’t used the wheelchair once since they wheeled me in. They expect me to be here just through getting the staples removed next Monday, then outpatient therapy for maybe a week and then HOPEFULLY the second surgery. I walked out of the bathroom today after my shower and forgot to use the walker…walked all the way to the other end of my room before I realized! I’m still taking Percocet regularly, though I forget to call for it overnight and wake up miserable in the morning! They tell me I’m way ahead of where I should be, AND I’ve lost seven pounds! Probably ten since the day of surgery…seven pounds just since Saturday. While I’m still stiff and swollen, and bending is not fun, I’m able to do all the pt stuff, and the pain is really bearable. I’m tired, and backed up, and managed steps with absolutely no problems the first time…hope we do more soon. The incision line (28 staples!) looks good and is starting to itch.

So…so far, so good!

9

Oh good grief. I would be so upset! However, I guess shit happens. I hope you get the second one done soon and it sounds like you are well on track for it. Good luck with everything. And good for you at doing things your own way!

10

It’s been almost 3 years since I became part-zombie via a new ACL. Here’s my advice: do your physical therapy.

Do all of it, as many days per week and as many weeks as your insurance will cover. Do everything they tell you to do while at the PT facility and then do it everything you can at home on the days you don’t go in. Do not skimp, don’t cheat, don’t slack off. If you find that you can do more today than you could yesterday, do more. Basically, look at PT as your new job, with yourself as your new supervisor.

11

Is there ANY cartilage left? If do, I’d seriously contemplate HGH first.

12

I don’t know what HGH is, but I am bone on bone…very very little cartilage off to one side. Surgeon told my brother my knee was “a big mess” once he got inside.

13

Glad that things are working out for you. The sooner you get off Percocet and on to something less narcotic, the sooner the backup issue will resolve itself. Meanwhile, use Miralax!

14

MIL had a knee done a few years ago, and the worst thing about it was listening to the surgeon going on about how crooked his incision was, and it would leave an ugly scar, and on and on. For the next visit she got some coloured markers to draw leaves and a flower on it. (Yes, she’s a strange one.) The surgeon had a good laugh and decided a crooked scar wasn’t so bad after all.

Glad the one knee went well, and hope the other is at least as easy. Keep on kickin’!

15

Did a whole half-flight of stairs today, up and down, with no issues at all. As bad as my non-surgical knee is, it must be ten times better than my sister’s because she said she got scared and cried and couldn’t do it because she didn’t trust her non-surgical knee and the pain was worse in the surgical one.

I’m not overly concerned about being backed up…it hasn’t been uncomfortable at all. Yea for hardly eating anything!