Zhash - Pre-op Help.

[Zhash]

I'm scheduled for a left total knee replacement for May 15th, 2019.

I had arthroscopy surgery on my left knee in April, 2014. Osteoarthritis filled in where the meniscus was cleaned out and the pain is constant especially worse with weather changes. I live in Connecticut.

I had arthroscopy on my right knee in August, 2014. I'm hoping to have total knee replacement on the the right knee in October, 2019 if everything goes okay with the left knee replacement.

I'm currently going for pre-operative physical therapy to strengthen my legs for this surgery. I must say that I'm nervous about having the surgery. Any support is welcome. Thank you.

 

[Celle]

Hello @Zhash - and

I've copied you post from the May Marvels thread, so we can post information to help you prepare for your knee replacements.

First of all, we understand that you're nervous, because we all were. It's a big step to take, but it's well worth going through the surgery and the long recovery.

Here are some articles for you to read:
If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing knee recoveries

 

[Celle]

And this is the approach to recovery that we recommend:
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Care In Hospital​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[kneeper]

You found the right place for encouragement and support. We've all been there or are going through the process. See you around!

 

[Irish471]

Hi @Zhash, yes, we were all nervous! It's a big decision but I think each of us knows deep down that it is necessary. I thought I was going to have a partial replacement and ended up with a full. The thought that this surgery alters your joint permanently was what scared me the most. The fear of the unknown is scary! But living in pain is not a good alternative. Sometimes you have to take a leap of faith and trust that this will allow you to live your best life possible, free of the pain that holds you back from enjoying life. You came to the right place and have lots of support to help you along the way!

 

[floridoris]

You are not alone in being afraid. I am very afraid, too. I haven't had a surgery like this before, and I've been postponing it for, well, years, hoping for a miracle I suppose. However, the pain in my right knee has now gotten so bad that I am unable to do much of anything. Getting out of a chair or a car requires summoning all my mental and physical strength. I'm terrified of sitting down in a public place because I don't know if I will be able to stand up again! I can't walk much, either, because of the pain. I avoid steps at all costs. Traveling? Out of the question.

I know this isn't any way to live, so I am facing my fears and finally having the surgery. I'm still absolutely terrified of the surgery and can hardly sleep at night thinking about it. But I try to remember that I am already so limited in my activities and in such pain as it is. I'm trying to focus on the idea that the surgery represents a path to a freedom and a life I'd given up on. Best of luck to you!

 

[Woodpusher]

Mine is 5/21 and he's thinking he can do a partial knee from looking at my xray but that it might have to be a full if what he actually sees is different.

I just heard a story yesterday about a woman who had a terrible result with a partial and had to have it quickly revised to a TKR.

 

[Irish471]

Great that you have a date! What area are they proposing for a partial?

 

[Woodpusher]

The medial compartment of the right knee.

 

[CorpHippie]

@Zhash, your story could be mine. Literally aside from the fact that I had my left knee done 3 weeks ago. Like you I had meniscus repair on my left knee with osteoarthritis filling in the gap leaving me bone on bone in 2014. If you look you can see how scared I was about surgery. I can tell you now that I am on this side of it, that having my right knee done in October (like you!) is a no brainer. I’m not saying surgery was easy. For me it was not, I had a very hard time coming out of anesthesia and had to have 2 doses of narcam. So that pain was horrible. But I survived and even did my therapy the next morning. My staples are out and I’m getting around on a cane now. I don’t relish I the thought of the pain but I already have so much more ROM than I did before. That alone has made it worth the pain. I still elevate, ice and do my slow gentle exercises daily. When I was in therapy at the hospital, and in tears from the pain a woman in there with me told me something I tell myself every day “This is healing pain. It will not be forever.” That really helps me. I wish you the very best of luck.

 

[maryo52]

Just know that it's normal to be nervous. Is there anything specific that you're concerned about?

 

[Zhash]

Great that you have a date! What area are they proposing for a partial?

I'm not having a partial. I'm having a total knee replacement - left knee. When I'm sufficiently recovered from that surgery, I'm having a total knee replacement - right knee. Thank you for caring.

 

[Zhash]

@Zhash, your story could be mine. Literally aside from the fact that I had my left knee done 3 weeks ago. Like you I had meniscus repair on my left knee with osteoarthritis filling in the gap leaving me bone on bone in 2014. If you look you can see how scared I was about surgery. I can tell you now that I am on this side of it, that having my right knee done in October (like you!) is a no brainer. I’m not saying surgery was easy. For me it was not, I had a very hard time coming out of anesthesia and had to have 2 doses of narcam. So that pain was horrible. But I survived and even did my therapy the next morning. My staples are out and I’m getting around on a cane now. I don’t relish I the thought of the pain but I already have so much more ROM than I did before. That alone has made it worth the pain. I still elevate, ice and do my slow gentle exercises daily. When I was in therapy at the hospital, and in tears from the pain a woman in there with me told me something I tell myself every day “This is healing pain. It will not be forever.” That really helps me. I wish you the very best of luck.

Thank you so much for telling your story that is exactly like mine. I happen to have an intubation problem from a previous 9 hour surgery that I had over 20 years ago. I'm 69 years old now. I had bilateral mastectomy for breast cancer and TRAM flap reconstruction. It was a 9 hour surgery. The seal on the intubation tube was so tight that the anesthesiologist literally had to yank out the tube leaving me with 3 months of vocal cord trauma. I couldn't speak for 3 months. You're probably asking why am I so nervous about knee replacement surgery when I had that surgery when I was 41 years old? Two reasons - 1. The anesthesiologist decided it would be best for me to have a spinal along with a drug to knock me out so that I'm not awake. I am worried that I might wake up during the surgery. That would freak me out. 2. I have issues with pain medication. I vomit profusely with many opioids. I will never be a drug addict. The only two pain medications that I can take are morphine and tramadol. The doctor told me that they can give me morphine in the hospital but he doesn't think that tramadol will do the trick in alleviating the pain at home. He is going to give me Dalaudid (Hydromorphone). I have a high tolerance for pain and very rarely take any type of pain medication. I'm worried that Dalaudid will make me vomit. The vomiting is so bad that it becomes more of a problem than the pain. I have an excellent orthopedic surgeon (one of the top 3 in CT) - Ivy league trained. Plus, I'm such an active person and so involved in everything that I can't imagine sitting still for a very long time. It will drive me crazy. I'm not a couch potato - never have been. I get like this before any surgery but afterwards, I deal with it successfully. I just hope all goes well.

 

[Zhash]

Mine is 5/21 and he's thinking he can do a partial knee from looking at my xray but that it might have to be a full if what he actually sees is different.

I just heard a story yesterday about a woman who had a terrible result with a partial and had to have it quickly revised to a TKR.

You will be better off with a total knee replacement!

 

[Doxielover]

@Zhash you sound like me. Opioids nauseate me profoundly as well. My R TKA is June 27th with a spinal as well. I had a total hip in 2017 with spinal and never awoke until recovery room. They use great sedation medications. Zofran which is an anti emetic never works for me but Phenergan does.

We are all different but Dilaudid makes me vomit every time, I am unable to handle that one at all. I will be discussing pain management options with my surgeon this month. I do not want to be nauseated my entire hospital stay either.

 

[kneeper]

With the spinal they usually give you something in an IV to knock you out. We sometimes jokingly call it "happy juice" around here. I had the spinal and "happy juice" which I think they started before doing the spinal. I don't remember the spinal and I woke up after the surgery feeling like I had a nice nap.

I'm pretty sure they gave me an anti-nausea drug automatically with the first knee as I didn't throw up at all. With the second I did (I think it was dilaudid) so they switched me to oxycodone and I handled that ok. I think like others have said you should talk to your surgeon so they can give you something for the nausea and be prepared to figure out which pain med will work for you.
These days many surgeons are doing a combination of drugs that help with pain control but aren't so exclusively reliant on opioids.

 

[Woodpusher]

You will be better off with a total knee replacement!

Hmm..... his aide said that of the Xrays he sees where a partial is indicated, about 90 percent of the time he actually does the partial replacement.

 

[Celle]

Just make sure your surgeon is prepared to do a TKR if he sees any indication at all of arthritis in your other knee compartments.

 

[winemama]

On my first TKR, they woke me up during surgery, I had a spinal and no gas just the propanol. Waking up was kind of cool, everyone said hi I could hear the tools and hammering. When it was done, they put me back out, to transfer me too recovery . I had an easy time we can up getting something to drink I was very clear headed. So don’t worry if they wake you up everybody’s there to talk to you it’s kind a cool