anxiety about pulmonary embolism

[Daisy2012]

I had a partial knee replacement about 3 1/2 yrs. ago, but now I have a lot of pain and the knee is unstable. So I have gone ahead and scheduled surgery for this June for a total knee replacment. After my partial replacement, as I was about to leave the hospital to go home, I had a pulmonary embolism and can only remember waking up to about 20 people staring down at me because I had to be rescusitated. Ended up in intensive care and months on blood thinners. I was told I have a good chance of getting another blood clot with the new surgery. I seem to be getting more and more anxiety as I think about the upcoming surgery and am wondering if I'm doing the right thing. I wonder if anyone else had this experience. I am not sure if I should go though with this, but then again, I want to be able to get back to being able to walk normal.

 

[bottomshollow]

Hi! Daisy, welcome to the forum. We are happy to have you here. There's a wealth of info in the Library, wonderful Admins, Moderators, forum members to answer questions, give advice, support and encourage you.

Since your medical team is aware that you had a pulmonary embolism with your PKR and feel there's a good chance you could have another, I would think that they will be monitoring you closely during and after surgery and will be medicating you appropriately for the condition. And yes, we have members that have experienced blood clots, and I am sure they will be along to share with you.

I can understand your anxiety because of this, and also your desire to have your life back with a knee that functions normally. The ultimate decision on surgery is yours to make. Spend some time with us and maybe things will become clearer and a little easier for you.

Please keep us posted. We care.

 

[Daisy2012]

Thank you. I do look forward to hearing from anyone else who has had a PE.

 

[Josephine]

Oh dear, poor you! That's a nightmare experience you had. And it's true that people who've had a PE are at risk of another ... except that they are usually on long term anticoagulants and under surveillance as well. I can assure you that in your next surgery you will have your a/c ramped up some and the surveillance will be increased.

You might also talk to your surgeon about having a Greenfield filter fitted. This is a device implanted into the vena cava, the large vein that takes blood from the body back into the heart. It catches blood clots that travel up from the legs, preventing them from reaching the lungs. A number of previous members with similar histories have had them fitted a couple of weeks prior to surgery and felt more confident for it. The procedure is normally carried out by a cardiologist under local anaesthetic with a little sedation.

 

[RunA42K]

I would think that since this is known to have happened to you the first time that they will be well prepared and take all precautions going into the surgery and post surgery. Since the first time it snuck up as a surprise it was not prepared for. I had a blot clot or a fat embolism that went into my right eye. Thankfully it went into a branch vein and not the central artery of my eye, or I would have lost sight completely. As it turns out I just lost a small amount of vision. If you were looking at the clock and where the '5' is on the clock I now have just a blank white space. It's been a year now and the doctors say it won't go away, that part is gone now. But you brining up the question, I wonder that for myself should I ever have another surgery???

I always say, "don't worry about things that you cannot control" so talk to your doctors and put your trust in them if they feel like they can handle this so you can walk pain free for the rest of your life.

 

[Jamie]

Welcome Daisy! I'm so glad you joined us here on BoneSmart. I agree with what the others have said. Your medical team will be watching out for you now that they know you have this in your history.

Please don't hesitate to post any concerns or questions you have. We're always here to listen and hopefully lift you up if you're having a bad day. As you know because you've had surgery before, the worst part is the waiting!!!

 

[newnee]

Hi Daisy and welcome to BoneSmart looks like you have already received some excellent advise. Keep us posted as to how things are going and come back if you have any questions.

 

[Daisy2012]

I really appreciate all the replies. Not sure I'm even using the forum correctly since I don't think I've ever used one before. I guess my fears are that I was not put on long term blood thinners after my pulmonary embolism and was only on warifin for about 3 months - not that I wanted to be on it longer. I also have atrial fibrillation which makes me at higher risk for strokes also, and I guess this contributes to my fear. I am not having the same orthopedic surgeon do this surgery as last time because I could not even get an appointment for like 5 months. I picked a new surgeon and went to see him because I had a lot of pain. He told me to call him when I was ready to schedule surgery - which is what I have done. But I've only seen him this one time and it seems kind of like I should know him better, even though I'm sure he is a good surgeon. He specializes in TKR's. He told me that I would be put on blood thinners and that this would be coordinated with my heart doctor. But, I am not really crazy about my heart doctor lately because he seems to be so busy that you also cannot get in to see him. I called his office to schedule an appointment and told them about my surgery and how the orthopedic doctor would need instructions about blood thinners from the heart doctor. His nurse told me that he had no openings before my surgery, but they would put me on a wait list. That was 5 weeks ago and I actually don't think they will call at all because that seems to be the case lately where they just don't get back to you.

Anyway, I feel like I'm the only one looking out for me, and when I go in for surgery, I guess I'll have to bring it up again that I hope they take extra precautions this time. Does it seem like I'm overreacting? Maybe I'm just making too much out of this.

Also I am wondering if anyone has had a partial knee replacement and then followed up with a total replacement. Is there a big difference in recovery as far as time, pain, etc?

 

[Jamie]

Needing a full TKR at some point not too long after a PKR actually does happen with some frequency, so you are certainly not alone in having this done. While I don't recall that we have any BoneSmarties active on the forum right now who are dealing with this, you should be just fine!

The recovery is certainly no worse than with the TKR and may actually be a little easier. There is less trauma to the bones an soft tissue this time around which can translate into less pain for you afterwards. The time required to get back to normal will likely be about the same as with your PKR.

 

[MapMaker53]

Hi Daisy2012. I don't like the situation with your cardiologist and the nurse's lack concern to get you in for an appointment before your surgery. My advice would be to contact your OS office, explain the situation, and request a pre-surgery appointment with the hospital cardiologist that your OS usually works with. Not only did I have my own cardiologist, but Hospital for Special Surgery required me to also see their own cardiologist in the weeks prior to surgery for clearance. I got the impression that he was the only cardio I really had to see. I would recommend making an appointment with the hospital cardiologist and then contact your cardiologist's office and arrange for them to forward a copy of your records to the hospital cardiologist prior to the appointment. I think it is ridiculous to not be squeezed in for an appointment knowing you are headed for surgery. Frankly, your doctor probably isn't even aware of the situation if it is a busy office, leaving a nurse to make that decision. I once resorted to faxing an important message addressed directly to my doctor when I was being blown off by an uncooperative receptionist. He got the message and action was taken.

 

[Josephine]

You took the words right out of my mouth, MM. Daisy, I suggest you tell your OS and get him to sort you out. He has a vested interested in ending up with a healthy patient at the end of this, you know! :wink1:

and no, I don't think you are over-reacting. I think you are being entirely suitably responsible and advocating for yourself which is how it should be. Phone the OS office and tell his nurse of this issue, then take it from there.