TKR Anxiety about TKR - now it's done!

[icep707]

Hey young one ! There was no way i could have went back to work by week 3. I really hate to burst your bubble. Most teachers here on bonesmart have their surgeries during summer, for the obvious reasons. Are you aware of the trauma your knee will go through ?? The first few weeks are very difficult at best but can be managed with proper medication, proper elevation and excessive iceing. Being young during a recovery is not a advantage at all. In fact it can be a disadvantage. And when you do go back to work , go back part time . TRUST ME. Going back fulltime , full bore was without a doubt my biggest mistake during my recovery. And i had a very successful, pretty easy going recovery and i owe that whole heartedly to this forum. We know !! As Elisea said in a earlier post i did have very little assistance , other than my GF. She played a huge role in my recovery. Without her it would have been outright scary. On the bright side , my knee is excellant and couldnt be any happier. Its truly miraculous. So look at the end result , not the long road to get there. Its so worth it. I will follow your recovery . Have you read the mantras ? Gotten any home recovery aids. Ice packs, pillows for elevation, toilet riser, shower chair , protein drinks , prune juice, miralax , etc. . The more prepared you are the better. This is unlike most other surgeries. Best of luck , Iceman

 

[jenng2003]

I have shower chair, pillows, chair, cryo cuff and ice packs. I am moving my bedroom to the family room for a couple of weeks. We have the dogs' care lined up so we don't have to worry about them.

I have had other knee surgeries. One was not arthroscopic. I remember the pain was unbearable for about three days and then I was fairly mobile (except I couldn't put weight on it and I had to wear a brace). I returned to work as a nanny after two weeks, but the kids were older and it wasn't a big deal.

I know three weeks is soon, and I would love to wait until summer, but I can't put it off 8 more months. I have been using crutches since August when I fell. I have very little stability. I am second guessing doing this though. Maybe I should just live in pain. I don't know.

I sent an email to my doctor so hopefully he can answer my questions. I would love to see him in person, but his office hours do not match with my work schedule. The joint class is only available during the day, and I wasn't wasting a sick day to attend it. I am hoping he won't use staples as I have sensitivities to some metals (nickel). He uses titanium in the replacement so I should not have any trouble with that. They know about the nickel sensitivity. I signed the paper and wrote that I had a nickel sensitivity.


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[Josephine]

I am unsure how well pain will be managed at home.

Better than it would be in hospital, that's for sure!

I am also concerned about the amount of time off of work. My doctor said I could go back to work in two weeks if I wanted. He said because I am young and strong it should be fine. I am also unsure how my age will impact recovery.

Actually the stats show that older people do better than younger ones who generally tend to have a tougher time. My own belief in this is that younger patients tend to be much more fanatical about their post-op exercises than older folk do and that probably accounts for the difference. More on that later .... Other than that, your age will not negatively impact it at all.

I am a teacher, so I can sit and ice as needed. I need to be off medication, but like I said, I have reactions to most pain meds

So what pain meds can you take? Is Tramadol okay? Tylenol?

I had a rough time with the transplant when I had it. I couldn't even go to the bathroom alone, and it frustrated me very much.

That's quite different to a TKR. You will be able to go to the bathroom unaided from day one!

The one thing people forget about this surgery and going back to work early is that it's almost nothing to do with the recovery or pain management and much more to do with the Energy drain for TKRs. This is going to be your biggest foe when you return to work. And of course, this won't be any better if you have pain as well. Or swelling which is another issue.

However, if your surgeon is as quick and tissue gentle as you say, this may just be your salvation! Another of my beliefs is that the degree of post-op pain is in direct proportions to the amount of rough handling and use of retractors (instruments to hold back tissues) and also the amount of time the wound is open.

Anecdote: many years ago I needed to have a hysterectomy. Working in the theatre (OR) I knew the three gynae surgeons well and how they worked. Two would take upwards of 1½-2 hours to do such a case and their patients were always in pain and bed-bound for 3-5 days (this was back in the old days!). My choice was a lovely chap who could do a hysterectomy in 20 mins flat and his patients were always up and about the next day! Naturally, I chose him and on day two, I took a walk around the hospital car park on my own while a fellow patient who had had her op at the same time by one of the other surgeons, had yet to get out of bed, looked like death warmed up and was still on an IV with injected pain meds! The moral of this story being that gentle surgeons create great outcomes for the patient!

Sounds like you will have a good start.

BTW, I am going to tag our Tim for you. He was a teacher, had both knees done and returned to work at 6 weeks. I'll let him tell you the rest! @referee54

 

[sjnyc323]

I cannot believe the surgery will only take 25 minutes but if your surgeon says it possible more power to you. I had revision July 31 and returning to work 10/20/14 after being home almost 12 weeks and could never have returned to work in 3 weeks

 

[Lovestoread]

@jenng2003, I also had glue, rather than staples and think that also helped with a quicker recovery. Another advantage is that I could shower the next day! Although it's not the popular opinion here, I'm living proof that going back to work early can be done with no lasting problems.


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[kneeper]

I can't imagine having to return to teaching in 3 weeks. But do your best to have all your lesson plans etc. ready to go before your surgery. And accept that you will be grading etc in short bursts. Energy and attention span will likely be an issue for you. Also rely on your family to do all the household tasks.

 

[jenng2003]

Thankfully, most of my grading will be electronic. I have the kids use bubble sheets for their reading assessment, so all I will have to grade is writing. Writing grading is slow anyway. I will have my grades done for the quarter before surgery. I plan to have all my lessons up to thanksgiving finished as well (4.5 weeks). I watched the surgery on YouTube (my surgeon). It is literally 25 minutes and absolutely astonishing how fine tuned the process is. I watched from incision to stitch. I would figure the faster the process, the less trauma. I am small though so I am not sure how that works.


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[icep707]

Hey Jenn , sounds as if you have all your ducks in a row . You have most of your post op home aids. Way to go ! Thats really gonna make your recovery alot smoother. Is there any way you can take more than 3 weeks off ? Any way at all ? Im hoping you go through with this as it is the best thing ever. My new knee rocks , and everything i do now is done pain free .!! By the way , my incision was closed with glue. Its pretty cool. Have you been reading the mantras and other recovery threads.? As i said , my recovery was fairly uneventful and not as painful as i feared but being a butcher for a costco , there was no way i could of went back that soon. I was very very fortunate to have been given all the time i needed. Do you have a surgery date ? Best wishes , Iceman

 

[Nana Mo]

Good luck with the surgery and getting back to work so quickly. I also had my knee done as outpatient and even thought the thought of it completely freaked me out at first I am really glad I did it that way. So much nicer to be at home and in control of your own pain meds!! Take them on schedule before you need them and ice, ice, ice! I can't stress that enough. I iced probably 20 out of 24 hours and did so for at least the first 5 weeks. Getting around will be the least of your worries. Like others have said it is the energy drain that will get you. I actually fell asleep once while I was shuffling cards!! I tried to go back to work at 5 weeks and I only made it 2 days a week for 3 hours a day and I was able to sit with my leg elevated and iced. No one is trying to change your mind but just want to prepare you. I am an avid reader and was so looking forward to my stack of books and I couldn't read more than 2 pages at a time for the first 3 weeks. Just couldn't stay awake!! Good Luck and keep us posted!

 

[RedRider]

@jenng2003 I can attest to @Josephine experience that most younger candidates tend to freak out more than the older crowd. And why not? We ultimately have more on the line.
I'm 33 and just scheduled my procedure for November. Had my first bout with panic immediately after I made the appointment and I'm sure there's more to come. Just know you're not alone; there's plenty of people your age who have been through this. It's definitely uncommon but not unheard of.

 

[jenng2003]

I do have most things lined up. I wish I could take longer off, but I will be able to sit as much as possible and ice and elevate. I wish I didn't have to go back for a week before thanksgiving, but I am out of sick days. I remember the drain with my meniscal transplant. I have two six inch scars from that procedure (it became a little more intense). I spoke with the head nurse in my OS's office today. She laughed at his optimistic projection of my return to work schedule. I told her the doctor approved and she said it was possible, and she has seen it done before. I am glad to hear that the anxiety is not uncommon. Every time a colleague wants to talk about it, I get that "oh no what am I doing" feeling. I passed my cardiology exam today. One step closer...


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[jenng2003]

My surgery date is October 27th. I figured with the holidays, it would give me a few extra weeks/break between the work weeks. I also fall often at work and I am suppose to be using crutches and there is no way I can stay on crutches much longer. The first few times I fell, the kids tried to catch me. They now know to just let me do my thing.


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[Josephine]

I also had glue, rather than staples and think that also helped with a quicker recovery.

That's a myth, @Lovestoread It's only the very top layer of skin that is closed with glue. Everything it stitched as per usual. So it makes very little difference to the recovery. Have a look here Closing surgical wounds: how is it done?

I watched from incision to stitch.

That's what we call "skin to skin" and takes up about half the overall operating time at most. Add to that the anaesthetic including doing a spinal, getting you positioned on the table, putting the tourniquet on, prepping the leg (with antiseptic), putting on the sterile drapes and getting all the equipment assembled around the table. After includes
applying the dressing, releasing and removing the tourniquet, removing all the drapes, any cleaning of blood spills from your leg. reversing the anaesthetic which could take anything from 5-35 minutes, transferring you to tour bed and then recovery. Once in recovery you could be there for 20-60 minutes having your vitals checked and pain relief dealt with as necessary. Over all that adds at leas another 1-1½ hours to your visit to the OR! Better warn your family else they might start the get worried.

I remember my nephew (grownup) had to have a surgery and the surgeon told her it would take him about an hour to do the surgery. She was also told her would go down about 1pm so she expected he would be back in the ward by about 2-2:30 and was panicking big time because it was almost 5pm and he wasn't back yet. He had a major op on his neck so I knew what it would involve, like 2 hours for anaesthetic, another hour to prep in theatre and at least an hour in recovery. My prediction was that he wouldn't be back much before 7pm and they pre-empted my by 10mins! I so wish they would tell patients accurately how long they'll be in OR.

I would figure the faster the process, the less trauma.

As I said previously, that's absolutely correct.

I am small though so I am not sure how that works.

It makes some difference but the key part to be small is your knee! Even tiny people can have swollen knees!

I passed my cardiology exam today

Congratulations! One step nearer your goal!

 

[jeano]

I ran into Mr jeano's heart surgeon and his chief resident in the hospital corridor roughly half a mile from the OR, a solid hour after Mr Jeano's surgery had started. "Hey! " I said, "aren't you supposed to be in my husband's chest?" This surgeon, mind you, was easily 6 and a half feet tall and weighed at least 300 pounds, just a huge man. "Nah", he rumbled, "they don't need us in there for a while yet."

 

[Lovestoread]

I still think that because I had no "outside" stitches or staples, my recovery was easier. I was able to move around quite comfortably, had no pulling and showered the day after surgery with no worries. To me, that's easier!

 

[jenng2003]

Yeah. I spoke with the coordinating nurse in my OS office. She and I had a chat about some of my fears. She is confident that I will be okay and said if I am off pain killers (which don't work well for me) and I am comfortable driving, I can return to work. She said I will need to ice and elevate, which I can do. Now I need to talk to my supervisor and see what he is willing to support. We don't get subs for classes and I can't have teachers covering my classes for longer than 2-3 weeks. I asked about anesthesia and it will be a spinal. She confirmed I will be discharged the next day. If I have complications, I would be transferred to a regular hospital. I think I am ordering another cryo cuff for icing. I will keep one at work and one at home. I am getting more nervous as the time gets closer. I know this is the right choice, but it is nerve-wracking.


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[bottomshollow]

But it won't be as long as it has been.

 

[kneeper]

I think I am ordering another cryo cuff for icing. I will keep one at work and one at home.

Good idea.

 

[jenng2003]

Ahhh...surgery Monday at 5 a.m. I have so many mixed emotions. One night in the hospital has turned into at least two according to the hospital staff. I am hoping my OS will advocate for the earlier release, like he said. I do better with recovering at home, and he knows that. I have Celiac disease and because it is a small facility, they may not be able to accommodate me except for prepackaged microwave stuff...yuck! I didn't even think about asking until a week ago at pre-admission testing. And because they won't let me up to use the bathroom, I am terrified of eating anything for fear of getting a stomachache. The house is prepared for my return. My husband has been a great support. The hospital says they won't let me up until Tuesday after 9 a.m. I will have to stay in bed the whole first day, even though I'm an early appointment. I wish I was later in the day, so it would be less time down and out. My husband will be bringing my school bag so I can distract myself.
I have everything in place when I return to work. All my plans are done, so I can just do my thing and leave each day and not spend extra time away from home, especially the first week back. I will also be going for only half days, so that will help as well. It's conferences week, so I will stay for the afternoon ones, but not the evening. My boss is very supportive and willing to work with me on a modified schedule for the first few weeks back.


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[kneeper]

Best wishes for a smooth operation and good pain control.