Maine girl - revision

[maryo52]

How does one get questions answered leading up to surgery?

I saw my (new) OS Nov. 1st. What came of that was the diagnosis of aseptic loosening and decision for surgery. I brought up my nickel allergy (my ortho LTT panel came back "highly reactive"). The OS says he has two implant choices after expressing skepticism about the issue, and said we'd have the chance to discuss it later. So yesterday I called up Orthopedic Analysis with some questions and ended up with a helpful conversation with Dr. Hallab. I feel even more convinced of the need for non-nickel implants. However, how do I continue this discussion with my OS (who is 5 hours away)? I have sent a question by patient portal and so far have not heard back. I am scheduled for revision Jan. 9th.

 

[Jockette]

How was your loose implant diagnosed?

 

[maryo52]

X-rays

 

[maryo52]

@Celle @Jockette @Pumpkln How does one ask questions leading up to surgery if there is no appointment scheduled before surgery? I live 5 hours away from my surgeon. I have posed a question through patient portal and have not heard back. I know they are inundated with those kinds of communications. When you call, you get to push 1 for medication refills, and 2 for making an appointment. There are no other options. I'm trying to settle the matter of choice of implant. At my Nov. 1 appointment he said we'd have a chance to talk about it later. I have other (less important) questions as well. Thanks in advance for any advice.

 

[Jockette]

My surgeon’s office had the same phone options. I finally pressed the button about making an appointment and got to actually speak to a person, who then directed my question to the right person. When you talk to that right person, ask for their extension number. If not, just keep calling the make an appointment option.

 

[Celle]

I would do the same as Jockette, Mary. Push 2 and speak to a real person.

With the possibility that you are allergic to some metals, it would be a shame - and totally inappropriate - if you were given an implant to which you might react. That is an important consideration - and your surgeon did tell you that he would talk about it later with you, so he owes you that.

It's the squeaky gate that gets the attention, so be a squeaky gate!

 

[Pumpkin]

I agree with Jockette and Celle, keep trying until you get ahold of someone. The OS's nurse, or PA can relay your questions to the surgeon.
IMO, you need a revision with a knee for people who are allergic to nickel.

 

[maryo52]

So I have messaged my care team via patient portal twice over the last two weeks, and left one phone message for my surgeon on Monday. And have received no reply, none. I am just trying to discuss implant choice in light of my nickel allergy, and find out whether or not a planned trip (4 hour flight) will be possible.

I know about surgeons and how they operate. But I'm 4 weeks out from surgery and of course a little nervous, and the lack of response is concerning.

I'm starting to consider a plan B, which is a different surgeon I saw in NYC, should this lack of response continue. But with aseptic loosening since mid-September, I can't wait a whole while longer.

Thoughts?

 

[Jockette]

It is definitely disconcerting that you haven’t heard from them. I think I’d be seriously considering plan B, also.

This kind of surgery is a big deal. It may be routine to them, but not to those of us having it.

 

[Pumpkin]

I hope they have gotten back to you, and addressed you wanting a nickel free knee. I agree, if you cannot be reassured, plan B may be a better option.

 

[maryo52]

I (finally!) heard back from my surgeon after pestering them with messages (phone, patient portal and fax) the last three business days. I guess my components will be Zimmer Biomet. My surgeon says this is what he's used most. I asked about a CPM machine. Not sure any have escaped being discarded but my last time around, it was a useful tool for combatting arthrofibrosis.

So now I can relax.

 

[Pumpkin]

Glad to hear you are receiving a nickel free knee, you must be relieved.

 

[maryo52]

I'm getting nervous about surgery next week. I have picked a top notch surgeon in a top notch facility and have every belief that things will go well. However, my original TKR was a nightmare from Day 1 to this day, and that's my only experience with knee surgery. I've had phone appointments with anesthesiology and case manager nurses (I live 6 hours from the hospital), and various remarks lead me to believe that Dr. Freiberg's patients do quite well. I guess his regular TKRs who are otherwise healthy stay a day, and she thought in my case it would be a day or maybe two because it's revision. Whatever. I am definitely looking forward to that first injection, the versed, at which point all my cares dissolve!

 

[Jockette]

I understand your nervousness and how your first and only knee replacement was not good and that’s all you know. That is my situation also. I have not yet found the courage that you have, to try again.

 

[Pumpkin]

maryo52,
Being nervous before your surgery is normal, you have done all you can to ensure a successful outcome.
I agree about the Versed, all your worries will disappear.
All the best next week,

 

[alexthecat]

I felt the same way before my THR. I'd had other surgeries and just seemed to be worse and worse off. My quality of life was already so awful. I couldn't go on as I was, but I was terrified about going forward.

Things worked out for me and I know they will for you too. You've done everything you could to get a good outcome. No one could have done more than you have done to prepare for this surgery. You know so much more than most other people do. You've got this.

Sent from my SM-S327VL using Tapatalk

 

[Jockette]

I agree about the Versed

What is Versed?

 

[maryo52]

@Jockette I had the option to revise way back in the beginning but the knee has been mostly pain-free and usable. I kinda knew that some day something would go wrong, and this past fall the tibial and femoral components came loose from the bone. It was a relief to no longer have a choice but do it, and I'm pretty psyched about this hot shot surgeon. Maybe I'll keep a journal of the experience.

 

[Jockette]

It was a relief to no longer have a choice but do it,

I totally get this and have half heartedly wished for the same. But in that case, I may not have time to choose my surgeon.

I wish you all the best!

 

[maryo52]

Well my PCP had suggested a second opinion, actually two second opinions. That was 1.5 years post op. I got the second opinions with top surgeons in Boston and NYC. So when I was found by a local OS to have aseptic loosening, I already had a surgeon in mind. They are amazingly accessible. Was able to get an appt. within 2 weeks of calling (Nov. 1), and surgery set for Jan. 9. I have to go back and look at your thread so I know what you're up against.