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First Surgical Consult - PKR Recommendation

Discussion in 'Knee Replacement Pre-Op Area' started by JDinCT, Dec 15, 2018.

  1. birdwatchr

    birdwatchr graduate

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    @Jeffntate
    I was denied a 10 day opioid prescription before the first of the year; pharmacy said the 7 day was accurate, then told me it was an insurance policy already in place. Here is what CVSCaremark told me: the first prescription is for 7 days, but after that I should be able to get any (reasonable) amount my doctors prescribe. I have not yet had a chance to prove that, as I have not had any more prescribed. At any rate, those last three days are gone for good and need to be “re-prescribed” into a new prescription. Hoping someone else may be able to confirm this with their prescription management company.
     
  2. JDinCT

    JDinCT member
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    Well.... today was decision day.

    Went to my second OS consult yesterday at Hospital for Special Surgery (HSS) in NYC. My prospective OS spent 45 minutes with me discussing my case.... VERY good sign in my opinion. His "technical" surgical opinion was similar to my first surgical consult in that I was a good candidate for a PKR.

    Based upon my activity level, age, weight, body type, etc. he estimated that 8 years was a best case life expectation for a PKR that would then very likely require a TKR. He estimated that 5 years for the PKR was likely the lower expected life of the PKR barring any unforeseen or unusual circumstances.

    He stated whether I decided on a PKR or TKR is my decision and he would support and perform either surgery.

    Weighing all the options, I've decided to have a TKR. My surgery date is March 6, 2019. My OS recommended implant is the Zimmer Biomet Cementless. He is somewhat unusual as he does surgeries with more than only one type of implant. The reason he recommended the Biomet Cementless version for me was that his experience is that this device tends to allow more ROM and durability for active lifestyles. He stated that I should be able to do any sport or activity that I had done prior to a TKR with no restriction and this includes downhill skiing.

    Interestingly enough, he himself had a TKR only 7 weeks ago. Recounts of his own recovery process to date were very good including the following:

    - Driving after two weeks (he had a RTKR)
    - Performing surgery after four weeks
    - Able to do "ride" stationary bike after three weeks
    - Did not require use of a walker
    - Walking without a cane after 4 weeks

    He credited his recovery to the unique surgical processes and procedures employed by HSS and utilization of a post-surgical cryo system called "Game Ready" which employs not only cold therapy but also compression therapy simultaneously.

    Based upon some of my personal research, the Game Ready device is highly recommended but also very pricey (~$2000).

    Thanks to everyone here on BS that provided input to me along the way to this decision. This is an in valuable resource!

    My pre-op tests are scheduled for February 13, 2019. I will keep everyone posted on my progress throughout pre-op and into post-op.
     
    Last edited: Jan 9, 2019
  3. Rick951

    Rick951 junior member

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    @JDinCT I wish you the BEST!!! of luck!!! We are about the same age, and activity level. I am now 14 weeks post op. I am doing very well!! Today for example, I loaded the entire bed of my truck with brush and hauled to the dumb, and unloaded it. I could not have done that before my PKR. I am down to minimal pain pills, Just Tylenol. I might not need that.
    From experience, Eat well, healthy food, manage swelling before surgery. Post surgery, Let your body heal before you push it to hard in recovery!!!!!!! I did not.....:headbang: Result... A lot more swelling, and a slower recovery, than I could have had.
     
  4. JDinCT

    JDinCT member
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    Thanks @Rick951 …. hope my recovery goes as well as yours.

    I decided to take the plunge and purchased a slightly used Game Ready 2.1 cryo/compression system from ebay to aid my post-op recovery. There are several of these units advertised there if anyone else is interested. Was able to get one for about 60% of the cost of a new one.
     
  5. JDinCT

    JDinCT member
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    I am preparing for three weeks of overseas travel for business. My knee has been not so happy on many days and thought that I would get a cortisone injection before my trip to ease the pain and swelling. My TKR is scheduled for 3/6/19. When I contacted my OS office to ensure that it was OK for the cortisone shot, I was surprised to learn that it is my OS protocol NOT to have any injections in the knee within 90 days of surgery. In lieu of an injection, I was prescribed an NSAID...naproxen... 500 mg twice daily.

    Other OS may have similar protocol and just wanted to pass this along to the BS community.
     
  6. Rick951

    Rick951 junior member

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    @JDinCT Good luck on the travel! I was on Naproxen for about 2 years trying to avoid surgery. It worked, but I paid a price. My gut suffered the consequences. As a result I am very sensitive to any NSAID now. In my experience, they are fine for a short time.

    Safe travels!
     
    • Informative Informative x 1
  7. JDinCT

    JDinCT member
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    T-Minus 13 days and counting....

    Had my pre-op last week (2/13) and all went well.

    Hospital for Special Surgery (HSS) in NYC has asked me to be part of a clinical study for genetic testing to determine if osteoarthritis of the knee is caused by a genetic defect. I will be one of approximately 165 patients for the study that will conducted in 2019. It is my understanding that I will get a copy of the study once completed and will share here if allowed.

    I have to give a shout out to HSS for their patient care, scheduling and professionalism. Every part of the pre-op process was conducted thoroughly and on schedule... even earlier than scheduled in most cases. My blood work was performed an hour before I met with the admitting physician and the majority of the blood work results were completed by the time I got to the pre-op admitting physician. I'm confident this will continue into the surgery, post-op and post-surgical follow-up phase of this journey. I must say this and the experience of my OS Dr. Mark Figgie gives me a very high level of confidence for the successful outcome of my surgery.

    I received my Lounge Doctor today which is one of the seemly endless list of post-surgical punch list items.

    I'm ready to get this over with and move on to recovery...

    See everyone on the other side very soon..... :)
     
  8. Rick951

    Rick951 junior member

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    @JDinCT Sounds like you had a very good experience with your pre-op exam. I had a similar experience with mine. In my case it went a long way to giving me confidence in the hospital and support staff. After my good experience with my pre-op exam, I had no concerns going into surgery. I was totally relaxed, ready to go. I do think that helps a LOT.
    Hope everything with your surgery goes smoothly!
    See you in recovery.
     
  9. Vansan

    Vansan junior member

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    @JDinCT.

    Best of luck with your surgery. Thanks for your
    Support.


    Sent from my iPhone using Tapatalk
     

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