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3rd L TKR tomorrow.. why am I nervous this time?

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Jill0606

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Hi All,

I leave for Boston later today and admitted to the hospital tomorrow morning for surgery in the afternoon. This is my third (yep... count 'em 3!!) L TKR (or total revision) in 26 months.

The first one I was actually excited for, as it was a long time coming, and I had high hopes (as we all do) that things would go fabulously and I'd be a new woman! When that didn't happen... 17 months later I found myself facing a second total knee. That time I was hopeful the TKR would help with the pain and maybe give me even a little bit more function. While it helped with the hip and back pain (not the knee pain unfortunately), my function didn't improve. In fact, here we are 9 months later and I'm still trying to get back to the 70 degrees flexion I had prior to the second surgery.

Now here I am... the day before my third replacement and I'm putting it out there... I'm scared this time. I'm not sharing this feeling with my family and friends at home, because no one has quite understood why I haven't been more scared about most of my previous 17 orthopedic surgeries (I'm more the type of person who just feels... let's get in there and get it done!) . If I tell them I'm scared, then they will be even further concerned for me.

I've laid awake the past couple of nights... making my lists, pre-planning for everything at home after, etc. You all know the drill. I'm trying to figure out where my fear this time is coming from. Is it because it seems if there is even the most minute chance of a "fluke" thing happening... it seems to find me? Is it because starting this entire process over again-AGAIN (as my friend says) from square one makes me feel like the last nine months (or 26 months) of pain, PT, co-pays, etc have been for nothing? (Some say the 3rd time is the charm, right?) Is it because I don't have my dad looking out for me post-op this time? (Dad passed away a few months ago. My family has lived with him for the last 21 years, and he's always looked after me after my surgery while my husband worked, and boys were in school). Is it because with this third TKR my doctor is beginning to run out of options, should something else go wrong in the future? Is it because I'm worried about the flu epidemic in Boston at the present time? Maybe I'm just scared because I haven't packed yet??? :)

This surgery was planned very quickly, not giving me too much time to grind on it and get used to it. I had a couple of months with each of the first two surgeries. Regardless of the reason, I am scared (which for me is different than being nervous-which is how I typically feel beforehand) this time, which is a new pre-op feeling for me. My expectations are in tact, as I know this isn't a "miracle" surgery and won't fix the underlying nerve damage or quad weakness/loss of function - it's being done because of the lateral ligament that gave way and I need a more stable knee in there now.

As always, thank you for reading. I've said it before... tapping my thoughts out on the keyboard here is like therapy... I feel better and maybe even a bit more relaxed knowing again that at least a few of you know what I'm feeling. I'm off to pack and make a few meals for the fridge for my boys while I am gone. I will check in when I get back over the weekend. I hope you all have a great day... and that maybe today is a low-pain day for anyone in chronic pain.

~Jill
 

Fernie

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Hi Jill, wow, that's some post :). I wish you all the very best for your surgery and look forward to hearing how you got on. I really hope it is successfuway sounds like you've spent so muchtme already in surgery and recovering. Good luck :flwrysmile:
 

Josephine

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Yes, what a trial by fire! Did you have the same surgeon do the previous surgeries and is doing this one as well?
 

Jamie

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Jill, I'm glad you posted and you most certainly will be in my prayers for this surgery. You certainly have been through the mill and deserve a chance to move forward. Please let us know how you're doing when you are able to post.
 

1ELISEA

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Wishing you the very best!
May everything turn out perfect for you this time!
 

Pumpkln

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Jill,
Wishing you all the best for this 3rd surgery :angel: .
I can understand your being scared, after being through so much.
Keep us posted on how you are doing.
 

sheryl7

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Jill, Welcome to Bonesmart, hoping 3rd time is a charm, and Josephine had a good point, are all 3 by the same surgeon?
Just throwing that out there.
I wish you had more time to be prepared for this one.
So sorry to hear the passing of your dad, I am sure he was a great help, and will be greatly missed.
Well wishes and prayers go out to you, please keep us posted..take care...Sheryl
 
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Jill0606

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Hi All,

I'm posting from my hospital bed.... Morphine is my friend. :) Surgery went well. He did find a boatload of scar tissue in there which he removed. Not moving my leg much for the last nine months, I guess it makes sense that scar tissue formed. I remember speaking with my surgeon in recovery, but don't remember much. I'm anxious to speak with him tmrw to hear what he has to say.

To answer the question above, my original TKR was in Nov 2010 and was done where I live in Upstate NY. My current surgeon (in Boston) did the second and this one. Nothing had happened to the prosthesis per se, my lateral ligament just blew, or stretched (I'll get more details tmrw), making the knee unstable.

Thank you all for your kind words and support. I'm off to try to get a little bit of sleep. G'night!!
 

Pumpkln

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Glad to hear all went well, now get some sleep. Keep us posted on your progress. :)
 

BJ Mac

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Jill, glad to hear that the surgery went well. Get a good night's sleep. Here is wishing that you have an amazing recovery and that you have a bright new future with this knee now. ((((hugs))))
 

tashia

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Welcome to the forum. Glad all went well. When you wake up in the morning relise that you are one more day closer to recover. Rest, Ice, Elevate, and pain control. For right rest. Take care Tashia
 

RestAssured

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Hello Jill! I have been through 3 surgeries on the right. 2 knee replacements and one washout, debridement, and spacer replacement! I am glad that surgery is over for you and now you can get on to the business of recovering! Take care and keep posting! We care! :happydance:
 

sheryl7

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Jill, i am glad you came through surgery well, will be praying positive recovery. Continue to keep us posted ti your status, we care and want to know how you are doing.
Take it easy on your self, and don't let PT over do you. Prayers and thoughts still with you:flwrysmile:
 

Fernie

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HI Jill - I'm pleased to hear you are now in recovery. I wish you all the best, get lots of rest and remember the Mantra.. take care.:flwrysmile:
 

Jacky48

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Jill, I'm glad all went well with the surgery, and you will be able to move forward from here! I look forward to hearing more from you. Stay well and stay positive!
 

sheryl7

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Jill hope all goes well from here on out, you continue to be in my thoughts and prayers..Take care...Sheryl:flwrysmile:
 
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Jill0606

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Hi All and thank you once again for the kind words and support. It's 4am and I'm laying in my hospital bed unable to sleep, which is odd given that the hospital is uncharacteristically quiet tonight. I have been blessed again with some amazing nurses! I swear my 7pm-7am nurse is psychic... knowing exactly what I am about to ask for... before I press my call button or open my mouth. And she's happy and friendly and you can tell she loves her job!!

Things are going relatively well. I was up and walking to the bathroom an hour or so after I got to my room after surgery. PT arrived at 8:30 the following morning and we did some very passive exercises - heel slides, ankle pumps and then a short walk. I was surprised how well it felt and even took a step or two without my walker or crutches while in the bathroom. It hurt, but it wasn't horrible. Between the morphine, OxyContin, Oxycodone and all the numbing meds he put inside during the surgery, I was feeling pretty good... cocky even...and even took a second walk.

The PT said our plan was to send me home Friday (today) so the nurses stopped the morphine the morning after my surgery and I was still feeling okay. Then noon hit and the numbing meds started to wear off. Reality set in... and I was no longer a happy camper. The pain is much different this time with a radiating sharp burning pain.

They gave me Toradol into my IV which helped settle things down a bit anyway for about 2 hours, but I can only get that q 6 hours. The 10 mg of Oxycodone does nothing for me, as that is what I have been taking everyday at home (10mg 4x day) for two years and it was doing very little for my pain even BEFORE the surgery. That dosage has been upped and we are trying to figure out what they will be sending me home with.

My surgeon came in yesterday afternoon and went over more details of the surgery with me. He said that once I was asleep before he did anything, they only got 80 degrees flexion. He said my knee was chock full of scar tissue... far more than he would expect to see at 9 months post-op, and called me the queen of scar tissue. He then explained that he did a lot of other work while he was in there and that he had to use a hammer to break/chisel away at the scar tissue. He did some muscle and ligament work as well... along with the new sturdier knee. I believe he said they got 105 degrees in the OR, but given my nerve damage knows I won't do that on my own.

He reiterated to myself, my husband and my friend who came with us, as well as his NP and PA who was with him, that he had never seen this type of ligament problem after TKR. He also said he's only ever seen someone with a permanent femoral nerve palsy/damage once or twice before and thinks he maybe only operated on one one other time...but couldn't recall. One of them said if there was a contest for odd things happening after TKR, that I'd win. Then proceeded to ask if I played the lottery. :) Seems I read about a lot of folks who unfortunately have damage to the femoral nerve during TKR. Thankfully, most heal.

So hopefully I hear the news this morning that I get to go home today. My surgeon said as long a I "passed" PT today he'd discharge me, so I think I should be okay. On that note, i do think I'm going to try and get a little more sleep now so that I'm rested when PT shows up. Thanks again for your support!!

~Jill
 
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cool & awesome.jpg
and lord knows, you've had plenty of that. Take good care of yourself and that revised knee. Follow the mantra:
- rest,
sleep1.gif
elevate,
elevate.gif
ice
ice-cube-smiley.gif
and take your pain meds
chill-pill-smiley.gif
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!

We care!
hug3-smiley.gif
 

Pumpkln

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skigirl had a fair amount of scar tissue removed last summer and can give you some information about her recovery. BTW she is back skiing this season.
 

sheryl7

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Hi Jill, glad you came through surgery, and OS got rid of a lot scar tissue,worked on ligaments, and what not. Hopefully that will lead to a more productive recovery this time round.
Ditto to what Judy said follow the the Bonesmart mantra, i am even having to do that today and I will be a pre-oper for a quite a while. Long day.
Glad to hear only passive PT for today, cant do too much, too quick, set you backwards.
I sorry to hear the pain med you are is not doing the job, perhaps they may need to add a break through med to help keep pain at bay, or try another type of med. Many out there, (Dilaudid, Demerol etc.) I do hope you get that situated with your doctor, so you will not remain in pain.
Keep us posted to your progress, take care..Sheryl:flwrysmile:
 
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