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  1. PLEASE NOTE THAT ONE RECOVERY THREAD ONLY IS PREFERRED. PLEASE DON'T START ADDITIONAL THREADS ABOUT YOUR RECOVERY.

How do I convince Ortho I need TKR? Appt on Friday Dec 8

Discussion in 'Knee Replacement Pre-Op Area' started by Life' a Beach, Dec 3, 2013.

  1. Life' a Beach

    Life' a Beach New Member

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    I am so happy I have found this forum! :)
    I have doing a lot of reading and searching since Thanksgiving on here and have learned SO much!
    Back in 2011,I had a "mini" stroke on my left side and ever since then all three major joints
    Have been causing me nothing but trouble, my knee being the worse.
    I had an arthroscopy for torn meniscus at the end of 2011, and everything worked out great!
    But since then I have had blood tests in which only one came back positive for RA.
    Which I think is weird, so my RA has me on meds keep it from progressing?
    Well my left knee has had 2 cortisone shots and the 2nd one did nothing.
    I have had both X-Ray and MRI done on knee, and Dr. Suggested the rooster comb injections.
    After reading on here and other forums, that these series of shots are like putting a band-aid
    On the enevtible, I can only walk for short periods of time, stairs kill me, I can't walk on beach,
    Or go hiking or any of the other things I enjoy. I can't sleep through the night or get down on floor,
    Play with Grandkids, run, etc.
    Kneel down? Forget it,
    I have appointment with Ortho who has my prescription ready for injection on Friday.
    I would rather him go ahead and just to replacement and be done with it.
    I will be moving early next year to retire in Fla. And would like to have him do it here
    Rather then starting over again with a new Dr. In Fla.
    I have downloaded and printed Josephine's list to give to him,
    Other then that what words can I use to convince him?
    I am nervous I'll say the wrong thing and he'll say no :boohoo:
     
  2. bottomshollow

    bottomshollow Moderator

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    welcome 10.jpg Life' a Beach, so pleased that you have joined us here on the forum. Josephine's list may be about all you need, but don't downplay the pain you're in or how miserable you are being unable to do so much. Tell your doc you'd like to be able to enjoy your life not just endure it. Insist that you have no quality of life at the moment. And if he dare mention age, let him know you expect him to treat you the patient not your age. Sometimes insurance requires a doctor to try everything before they'll allow the surgery. But if you're bone on bone, then nothing is really going to help except TKR.

    We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish; giving you a place to vent, whine, complain if you need to; sharing experiences with one another; and having fun and some laughs along the way.

    Take care and keep us posted. We care.
     
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  3. referee54

    referee54 Moderator

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    Welcome! We are very, very glad that you have found us! We will be here for you and help answer any and all questions that you have or help deal with any concerns, too.

    Yes, basically, they are, but they can give you some time before you have the TKR. Plus, many insurance companies have you get the injections prior to a TKR as part of their protocol. (My SynVisc shots lasted all of three days, but I had to go through all three of them.)

    Many of us have felt the same way. I just wanted to get it over with and move on.

    That being said, I would talk openly and honestly with your OS. You did not mention your age. Is your OS hesitant because of your age? Many more OS's are losing the "You're not old enough" approach. My OS said nothing about my age when looking into a BTKR---I had mine six years ago at the age of 53.

    It does sound like yo have lost a great deal of activity and that your quality of life is going down hill. I would mention all of this to your OS and tell him that you would like to reclaim the life that arthritis has robbed you of.

    Have you taken a look at the forum library? It has tremendous article full of very useful information---there will information there that just may help you deal with this, and the more informed you are, the more you can understand what a TKR entails and what will or may happen during the recovery.

    The first set is essential reading, the second is useful and the third just good information but you will need it all

    First are the mantras ....
    - rest, elevate, ice and take your pain meds by the clock
    - if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
    - if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
    - if you won't die if it's not done, don't do it
    - never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

    And then the articles in order of importance .
    Group A
    The importance of managing pain after a TKR and the pain chart
    Myth busting: no pain, no gain
    Swollen and stiff knee: what causes it?
    Progression of activity for TKRs

    Group B
    How Long Does Healing Take ......
    Chart representation of TKR recovery
    Energy drain for TKRs
    Elevating your leg to control swelling and pain
    Using ice

    Group C
    Knee Replacement - Where Am I in Recovery?
    So What Is It Going to Take? The Five “P’s” of Knee Recovery
    Work “Smarter” and not “Harder”
    About recovering a knee - from one who knows!
    Some suggestions for home physio (PT) and activity progress
    Myth busting: The "window of opportunity"

    Group D
    MUA (manipulation under anaesthetic) and adhesions
    It's never too late to get more ROM!
    It's Worth the Wait for ROM
    Myth busting: on getting addicted to pain meds
    Post op blues is a reality - be prepared for it
    Again, welcome to the forum. I would have an down-to-earth talk with your OS and tell him honestly how you feel and what you are missing out on in life. Let him know of your schedule---but I will warn you---many of us had to wait to get into the OS's queue----some are very lucky and move in quickly, but I had to wait from February until November.

    Please keep coming back and posting---let us know how things are going and what his /your decision will be.

    We will be here for you!
     
  4. referee54

    referee54 Moderator

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    You beat me to it, Judy!!!

    Yep, what she said!!!
     
  5. icep707

    icep707 Post-Grad

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    Thats strange. But than again maybe not. I get my tkr on February 10. But its already been a long long ordeal, im only 48 and this surgeon is the 3rd one ive seen. Im going straight from cortisone to the tkr. On the way to my 2nd visit to him I had my speech ready with why I need the tkr. I think we all know how that speech goes but I would have threw in some tears if I had too. I was gonna beg!!. So his technician took the xray and I ever so patiently wait for doc. He looked at the x ray and said"your knee is shot " in my head im thinking DUH ! Than he said hes gonna ORDER a replacement. He said hang tight for my last cortisone shot. He stepped out and I started hyper ventilating. I could believe my ears. One problem though. My surgery is some 70 days away and the shot was one week ago and my knee already hurts. Im probably gonna need another shot. So basically the xray should speak for themselves. If not , cry. !!!
     
  6. Roy Gardiner

    Roy Gardiner Forum Advisor

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    Hi, Life's A Beach, welcome to BoneSmart.

    I agree. That's what happened to me, the man's first words to me were along the lines of "When can we do this?".

    If your Dr doesn't, well then there are other doctors. You want a knee specialist who has done thousands of TKRs and who continues to do hundreds a year. And who comes recommended -- the best fount of knowledge is the nurses in the hospital where he (or she) works.
     
  7. Campervan

    Campervan Sr Bonesmartie

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    If he asks you if its keeping you awake at night - say yes. Pre TKR I would go for a review with my OS when I thought it was getting worse and getting closer to needing to be done and he'd always ask me if it was keeping me awake and said that was the final indicator that it was ready to be done. My general doctor said it was "time" when the pain stopped you enjoying the things you enjoy doing, irrespective of how much pain there was etc. My OS would have done mine 18 months earlier than I had it done but I felt I wasn't ready. I left in 6 months too long and that last 6 months I went downhill very quickly.

    My left is getting close to needing to be done, and I'm not going to wait as long this time. OS has already said when I'm ready and he feels it'll be within two years.
     
  8. B's Knees

    B's Knees Member

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    You never said what your x-Ray and MRI showed. Is that the problem?
     
  9. kneeper

    kneeper Forum Advisor

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    Well, first if you have RA, then yes the medication is to keep the disease under control. Out of curiosity what are you taking? I'm on methotrexate and plaquenil.

    Is it your rheumatologist who suggested the synvisc? That would indicate he thinks the pain is from joint damage not the RA (or at least more so).

    When I told my rheumy that my knee was keeping me awake he said "that's usually a sign it needs to be replaced." He has also told me in the past that the synvisc only seems effective early on for osteo.I don't know whether the insurance companies have caught up with that idea.

    I would say just honestly describe your symptoms. As others have said don't downplay that it keeps you awake etc.
    There's "coping" and there's living.
     
  10. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    Print off this form and complete it honestly. Then take it and give it to your surgeon. It's base on all the scoring systems doctors use to evaluate their patient's quality of life so he should understand it.
     

    Attached Files:

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  11. Life' a Beach

    Life' a Beach New Member

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    Thank you all for your great words of wisdom, Yes the pain in my left knee AND my left hip and shoulder keep me up most of the night, I am using heating pads as well as ice packs constantly!
    I have already printed out The form you have recommended and have it ready to go!
    I have not been into OS since the MRI, so the results of that he should be telling me about on Friday.
    I am 55 years young, I still love to hike, and work and I love geocaching, which takes me into the woods quite a bit, but since knee has gotten worse, I would not be able to move real fast if I run up on. Wild animal! :happydance:
    I am sitting here after having 4 of our Grandkids here to decorate tree and ornaments, I really did not do much but watch, but my knee is killing me!
    HURRY UP FRIDAY!
     
  12. referee54

    referee54 Moderator

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    Next year, if all goes right, you will not merely be a spectator!!!
     
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