Do I or Don't I

[Sudhir]

Hi all,

I am 57 year old and suffer from osteoarthritis in both knees and specialist has told that only thing he can offer is total knee replacement. He has left it to me decide when I want it. And this is what has brought me to this forum.

I suffer considerable pain every day. Painkillers taken regularly give some relief from pain. My sleep is regularly disturbed by pain. I have reasonably sedentary job and I can do all that I need to do for the job. However, once I am home, I can’t do a thing other than basic personal activities of daily living – wife has to do all housework and I feel guilty. Going up and down the stairs hurts and I go up stairs only when necessary. On occasional good day most I can walk is couple of miles, on other days I have to limit walking to bare essential. I can bend my both knees almost fully and straighten them fully. My hobby is flying in an ultralight aeroplane and I am able to do all activities on the airfield and these can be pretty demanding – this puzzles me and my wife when I feel I can’t really do much in the way of housework. So, its all getting very confusing and I can’t decide whether my constant pain is bad enough to go for the replacements or I should grin and bear and delay the operation as much as I can. I am having a great difficulty in deciding how bad does it have to be to make knee replacement worth going for. I would appreciate any suggestions and thoughts that would give me some guidance.

 

[*gmac*]

Sudhir-
Welcome to the site. I am not qualified to talk to you about your knees, I am a hippie (recently had my hip replaced). I think I'm just one of the first ones to read your post. If it's OK to speak in generalities; here goes. You have been told that your joints are bad and need to be replaced. You are in pain (some good days and some bad days). The quality of your life has spiraled downward? If your comfortable with your doctors summation, good. If you are not get a second or third (or more) oppinion. If its not going to fix itself get it fixed. I always thought I had a reasonably high pain and discomfort threshold. I finally came to the realization that like all of us in the forum have is that WE WANT OUR LIVES BACK. Hopefully you can convince your surgeon to start in 2 to 4 weeks or sooner. That way your not too worried and apprehensive about it. (The longer you have to wait the more likely you will get cold feet). There is a recovery period. It varies with each individual. The unique thing about that is you will be able to see and feel (albeit gradually) yourself getting stronger and healthier. AND that is something you can't see without the replacement. Cruise this web site find folks with similar situations and questions. I think you will "meet" a unique bunch of people who have been there. Our Monitor and resident nurse (Jo) has been in this field for over 40 years.
This is my second attempt to respond to your post. Got almost done an hour ago and hit the wrong button. Once again Welcome Aboard and I'll type to you later.

 

[Sudhir]

Thank you very much for your very helpful comments, GMAC. I have had two arthroscopies so far and they gave limited and short term benefit. I am convinced that the next step is replacement. Your comments encourage me to think more in favour of not leaving it much longer. There is just this concern of ending up worse off if things go wrong. I dread to think of complications with a possibility of ending up having more limitations on my abilities. That would be OK if I am pain-free in return but a terrible situation if pain is no better anyway. I am surely reading through contributions in all other threads in the forum. Thanks once again for your comments.

 

[Josephine]

What an extremely sympathetic and helpful surgeon you got sent to .......... not! Or was it an orthopaedic surgeon? Was it a rheumatologist?

Either way, you need to takes some action on this. If you would like to tell me to which hospital and specialist you were referred, I can give you an opinion on that. You need to see someone who is going to be more pro-active and supportive because, in my opinion, you are way past wondering if you should have this done.

TKRs (total knee replacements) are done by the thousand every week in this country and the longterm outcomes are excellent. Sure there are risks - as with everything, even flying ultralights

(my nephew flies an ultralight and used to hang glide as well!) - but were this operation so fraught with danger as you have been led to believe, then surgeons would not touch it with a barge pole!

You've read all the other stuff in the forum so you should be well informed by now. I believe this forum gives people a much more realistic picture of what is involved post op than many medical sites that seem to gloss over the physio and pain issues. But that pain is one that is going to get better. The pain you are suffering now - not to mention the disability - will be gone. Plus, if left, it is only going to get worse. This situation never improves with keeping. Don't leave it too long else your bones might get deformed and make the surgery and the recovery, more complicated for both you and the surgeon!

Let me know who you saw and where and I'll come back with some more advice, ok?

 

[JenniferG]

Good Morning Sudhir. Welcome to our forum. When should you get the surgery? When you are ready to stop hurting. If you're asking that question you are probably there. Have a great day and keep posting!

 

[Kimgrif]

Welcome Sudhir, I haven't yet had my TKR but these people are amazing with their wealth of information and willingness to help! My TKR is in August, so I'm sure I'll be driving them ALL crazy with my last minute questions and concerns, but I am SO ready to get my life back!

 

[hess]

Sudhir,

Glad to have you here. I had TKR on June 9. Still fairly new with this, but I would not trade it for the world! I am thrilled that the pain that I have now is a good pain! I'm going in the right direction!! I'm an almost 40 year old mother of 3 young boys, and it had gotten to the point where I could do NOTHING with them! True, I am still in the recovery stage, so I can't do much with them, but I know this time will pass. Before, the pain wasn't going to pass, only get worse!!

Not to throw opinions on you, but I feel strongly about getting your life back and enjoying the best quality of life possible!

Good luck with your decision,
Hess

 

[Sudhir]

Dear All,
You are all so positive about TKRs and that makes me feel reassured and your comments have boosted my confidence in this opeeration. Thank you all for your comments.
I am little surprised not to have, so far, even one person making any negative comments and this is very reassuring.

 

[Sudhir]

Dear Josephine
Thank you for your comments.
I need to make a record straight about my orthopaedic surgeon, and clarify some misunderstanding my posting has caused. I last saw him 2 years ago when he discharged me following my bilateral arthroscopies. At the time of discharge he took time and efforts to explain about what next if things start going wrong. In that discussion he explained that arthritis in my both joints is extensive and I shall need TKRs in both. This would happen in due course and asked me to contact him if and when my troubles are bad enough. I need to be clear about TKRs before I contact him as; if I make an appointment to see him I know that is what he is going to offer me. So, that is where I am. In live in Northamptonshire in the UK and my orthopaedic surgeon is at our local NHS hospital.

 

[Josephine]

I'm in the UK too and know pretty much all the hospitals and a many of the surgeons in the UK.

Which hospital is it exactly? Northampton, Kettering?

What else can we help you with in regard to this?

 

[*gmac*]

Sudhir-
Just out of curiosity, to fly an Ultralight in the UK do you need a Sport Type license that they need over here. I'm a bit of an aviation enthusiast and curious. Does it require annual medical certification? Thanks.
_Gary

 

[Sudhir]

Hi Gary,
So pleased to meet another aviation enthusiast. To fly an ultralight (we call it microlight in the UK) we need a pilot license. Minimum requirement for getting a licence is 25 hours of flying instruction, out of which at least 10 must be solo. Most seem to need much longer than that. At the end of instruction, passing a general skill test that is about an hour long, doing 2 cross country solo flights with a landing at a place at least 20Knts away from taking off site and passing theory test in 5 subjects gives you a licence. One needs a medical certificate from a general medical practitioner to say that you are medically fit to fly a microlight. Up to 60 year’s of age, you need a certificate only once, then every year, I think.

Following is the URL for my flying club that you may find interesting.
broken link removed: https://www.sackvilleflyingclub.co.uk/

Also may visit British Microlight Aircraft Association (BMAA) site at https://www.bmaa.org/

What do you fly?
Sudhir

 

[Sudhir]

Dear Josephine
Going by your note, you probably personally know Mr Ed Crawford at Northampton. He might feel offended if he knows I have been visiting website forums without meeting him first, so don’t tell him!

I wanted to know views and comments from fellow sufferers. I felt although we medics are good in explaining (I am a general medical practitioner giving primary care to people in Wollaston in Northamptonshire), there would be more to get from other people who have actually have had a TKR.

I have had plenty of replies and comments and I feel more encouraged to go and see Mr Crawford now. I felt bit surprised not to read any one with any negative comments.
Regards,
Sudhir

 

[JenniferG]

Sudir, just my opinion, any decent doc is not going to have a problem with you seeking a second opinion and/or more information.

 

[AlaskanTKR]

sudhir
I am 4 days since my right tor. I won't lie. Monday night it really hurt until we got all the meds straightened out. And when the hospital p t visited I wanted to scream. But. Knowing I will have less pain than I had is making this all worth it. For me it has been about the quality of life. After my last scope we talked about pkr and synvisc. But when he took the last set of xray he said best option is tor so here I sit. Getting ready to go home. I woulda have gone back. If that was possible. It will all be worth it when i can carry laundry up the stairs

Hang in there and good luck with you decision making
Marianne

 

[*gmac*]

Sudhir-
I don't fly myself. I have taken different types of lessons but have not logged any flight time in. By enthusiast I guess I'm more of a groupie. When I see them flying I have to pull over and watch for awhile. Thank you for the links.
Perhaps when I am retired.-Gary.

 

[Josephine]

Dear Josephine
Going by your note, you probably personally know Mr Ed Crawford at Northampton. He might feel offended if he knows I have been visiting website forums without meeting him first, so don’t tell him!

I wanted to know views and comments from fellow sufferers. I felt although we medics are good in explaining (I am a general medical practitioner giving primary care to people in Wollaston in Northamptonshire), there would be more to get from other people who have actually have had a TKR.

I have had plenty of replies and comments and I feel more encouraged to go and see Mr Crawford now. I felt bit surprised not to read any one with any negative comments.
Regards,
Sudhir

My dear Sudhir, please don't worry - as Jennifer said, no doctor would worry one bit about a patient seeking to inform themselves. Any doctor I know would encourage it!

As for Mr Crawford, I don't know him but I do know the Northampton General Hospital. I am sure he is very nice but from what I have been able to discover about the hospital, it's focus seems not to be on high end joint replacement so personally I would look further afield for a more specialised centre and one that has a higher throughput of cases. With quantity comes excellence in these procedures.

However, if your man can assure you he does 500+ knees per year then that sounds ok. Anything less is means TKRs are just one of many interests and the last thing you need is someone who is not a committed knee surgeon. Generalists do not, as a rule, produce results of excellence.

Why don't you read the list of questions I have put in this thread How to choose a surgeon and a prosthesis. Print it off and take it with you. He should not be at all bothered to answer them and should have the numbers on the tip of his tongue. If he doesn't or is reluctant to answer, then to me that would be a red flag and I would go somewhere else. Even in our NHS you have a right to choose where you go for your treatment.

 

[faith]

Hello Sudhir,
I lived with constant pain for 22 years. I had my TKR on Feb 14, of this year. It was my Valentine's day present to myself. I am totally pain free! For the first time in 22 years I am not medicated. I still have morning stiffness, and I don't move like a teenager, but for a 48 year old grandmother, I look & feel pretty terrific. GO FOR IT!
(And listen to Josephine, she knows)
Faith

 

[Gretchendz]

Sudhir,

I'm 56.

I was not nearly at the level of pain you are but I was slowing down and doing less all the time. I was gradually becoming immobile. I was gaining weight at an alarming rate. I had TKR on my right knee and I am thrilled with the results (I am only 12 weeks post-op).

The recovery is tough, no lies there. But last weekend, we went on an annual family outing and I walked with everyone for MILES. This is something I have not been able to do for several years. And I still have one bad knee!

I have spoken to dozens of people who have had it done and the response is almost always. "It's great. I got my life back. I wish I had done it earlier."

I'm not all healed yet, but I already feel better than in a very long time. I am now anxious to schedule my second TKR.

Good luck on your decision.