Hello to all

[Josephine]

Hi Everybody,I have another question. I've read a few posts about revision. Is this a surgery to fix or make adjustments to the knee replacement parts? Why is this revision surgery done?
Bob
Florida

The biggest issue about lower limb joint replacements is that they can wear out. Time is a big question - some say 10-15 years, others 15+ though I know of patients who have had their knee/hip in for 20+ years with no problems.

What wears varies; in a metal or ceramic on plastic, it's the plastic, in ceramic or metal - well, unsurprisingly it's the ceramic or metal!

Sometimes, and if the base implants are still sound, the metal liners/inserts can simply be changed. But if there is any wear, loosening or other damage to them then the entire joint has to be removed and a totally new one inserted. If this is because of the aforementioned problems, then the prostheses can be removed and reinserted in one go. And if cement is use, it can just be reamed out and new cement put on top of the old.

However, if there is infection involved then the leg may need a period without any prostheses in it whilst the infection is eradicated and the every scrap of the old cement has to be removed before a new one is put in.

That, in a nut shell, is what revision is all about.

 

[bobb]

Wow, that sounds scary, more so than the replacement, especially the infection. So many things, it's not over when the surgery's over. Man oh man.

 

[Josephine]

Well, don't forget the odds - out of 250,000 THRs done every year somewhere, less than 2% have infection problems and not many more have problems with loosening and such. It's a very, very low factor.

 

[Simon]

Bobb

I had a BTKR on June 3rd. I work from home and it involves sitting at the computer. I went back to work part time in a month but did find it hard to sit for long periods of time. I did buy a laptop so that I could sit in my recliner and that really helped. I was going to return full time after 6 weeks but it took a week longer as I had sleep problems and I was just too tired.

As others have said you need to get up every 60 to 90 minutes and walk, do a few ROM exercises. I bought a peddler which is basically a frame with bike pedals that you can sit in a chair and use. They are small enough you could stick it under your desk.

As for pain, discuss it at length with the OS and make sure you know the office procedures for renewal. For heavy duty narcotics you will need to get written Rx from the OS as renewals are not possible. Have a back up plan with your primary care physician if that is more convenient for you.

Also, if you have time check out the outpatient physical therapy services and locate a PT you can work with. This is very important.

Good luck and remember we are here to help you. Everyone on this forum is great.

Simon

 

[patfinch]

Hi Bobb
Hope all went well at your pre op with the doc today, have you got a date for your surgery yet?
I am just 50 and 9 weeks post TKR, like you I was that scared that I thought I would pass out with nerves...but my fears were totally unfounded, the pain relief they give you via epidural or femoral block post op is more than adequate to get you thru the first few days......Like someone else previous said the pain you will get, is later due to stiffness and swelling, but think or it like this...no pain..no gain..the muscles and ligaments have to be moved regular to increase blood supply and healing......and even this pain gets les and less as time goes on..I am still using morphine patches 9 weeks post op and tried to reduce dose last week without sucess, but dont need any other pain meds, like I did pre op...I was taking them to max as well as the patches....
I still feel uncomfortable when sitting for long periods but if I get up and walk about for it bit, the pain disappears.......
I jump on my exercise bike and do 15 mins now twice a day...pre op I had never been on one in my life......
So dont worry life gets better post op...it takes time and all of us have different recovery periods...but we all get there in the end....
The guys on here are wicked and always someone here to chat to rom advice, support, help, shoulder to cry on, someone to have a laugh with.....they are all on here
Keep posting

Love and hugs Pat xx

 

[bobb]

Thanks Pat, great support, I'm grateful to all.

All my questions were answered yesterday, but now I have a couple more after researching some answers. Surgery is Next Wednesday, 10/22/08 at 1pm.

I'm getting the Zimmer CR-FLEX implant. When I read about it the site says it's great for next generation, gives better flex, lasts about 20 years, is excellent for CR surgeons. It says CR over and over, but never explains what CR means? Anything I look up about CR surgeons I get Colon/Rectal. lol Does anyone know what this means?
Next I have to get injections in my stomach for 10 days post for the anti-clotting medicine. I freakin hate needles, now I have to get 10 in my gut, oh man, I would have backed out if I knew this 4 weeks ago. How bad is this gonna be, I'm sure not as bad as my knee, but geez, enough is enough you know.
Finally. The told me about the femoral nerve block. He said it helps with post op pain and also helps use less anesthesia. I asked then why do some people not get it, and he explained cuz it's another needle in the groin. MAN are you kidding me I said, can they do this after they put me to sleep, NOPE. I know this has to hurt, I've seen them give needles to people down there on that show Trauma, Life in the ER. Seriously, how much does this needle in the groin hurt?
On top of all this, I have to get a catheter. I swear, this is like torture. Why? How come I can't pee into a bowl? What if I have to poop you know? I mean I'm gonna be up the next day walking, so why do they have to do that? I had that done once when I was a kid and all I can remember is how much it hurt to pee after that take out that tube. I could not stand it, it burned so bad to pee my mom had to hold me up.
So next wednesday I get 200 needle pokes and a tube stuck down my buddy. I'm worried about the nerve block at this point. I don't want less anesthesia, I want more, I don't want to wake up, or remember anything.

Give it to me straight, please. I've given myself the runs I'm so nervous.lol seriously

Thanks all,
Bob

 

[ship4]

Bobb,
You made me laugh when I read your message! The femoral nerve block you do not feel at all. I had 2 of them when I had my BTKR's in June. Most times with the femoral nerve block you do not get up and walk the next day as they do not want you up walking on jello legs you have no feeling in........
So, they wait until the block wears off before getting you up. This is why you need the catheter too. You will not be feeling the pain of the needles because your knee will over ride it. Sorry. You will be taking pain medication and they will most likely give you stool softeners to help with the bowel movements. As long as you are on pain pills take the stool softeners!
Good luck next week. We all were scared "to death" before we went under the knife. Just so long as you know what to expect, you will recover great!
Best,
Crystal

 

[Nursepair]

Hey Bob, I know it all sounds scary. It is so worth it though, to get away from the pain in your knee!! They gave me my nerveblock after I had my epidural and sedation so it wasn't bad for me. Also had the catheter without knowing. If they didn't catheterise you, you would pee the bed. I had a cystoscopy the other week, they put a metal tube up into your bladder, just a local. Wasn't as bad as I had feared. You shouldn'k have a problem with pooing the bed if you can go the night before or in the morning before. You won't be eating for 12 hours before.

The coumadin (blood thinners) are nothing, needles are really tiny and thin, the sort diabetics have to use daily. When you go home ask your doc if you can have it in pill form. That's what they send you home with here in Ontario.

Try not to get too upset, it will be over before you know it, then the tricky stuff starts!! RECOVERY!!! We will be here for you. I am usually the biggest wimp going, these guys got me through it. You will be on so many painkillers you won't know what is going on half the time... LOL...You will feel down, then you look up all the old threads from Jan-April and find a lot of humour from Pattipoo, Doug and GAT and Skeet.

Oh yes, make sure you take the stool softeners they prescribe, you will need them!!!

Good luck!! Sue

 

[bobb]

Hi,
I asked about taking the pill at home, bu they said nope. If me or the wife did not want to give me the shot, the home nurse that comes over everyday will give it to me. I'll let the nurse do it, I don't want my wife having a chance a getting me back for birthing pains only she had to go through by having a needle to stick in my stomach. lol
I'm real nervous about this nerve block. Now I understand catherizing me, don't like it but understand. I'm just scared that's gonna hurt bad when they do the nerve block. I hope they catherize me when I'm asleep. And I don't know about that metal tube thing, I remember when they did it to me as a kid they rammed (lack of better words) a rubber tube down my Johnny.
I feel like a ghinny pig, pin cushion, like man you would think they could make this a little bit more easier on someone rather than putting tubes in their bladder, needles in their groin, stomach and arm. I told the Dr. yesterday if they had let me know all this a month ago, I would have cancelled. But if I cancelled less than a month away I would be responsible for $500. I can see it now, next Wednesday I suppose to go in at 10:30 am to get all setup before 1pm surgery. I'm gonna vomit on someone before 1 o'clock comes. As soon as they start all this mumbo jumbo ****, my panic alert system is gonna go into overdrive. lol

 

[Nursepair]

Bobb, it will all be OK. You won't have much in your stomache to vomit by then anyway...LOL...You won't have the metal rod, just a thin soft rubber tube!! The needles don't hurt, maybe a tiny sting, I had a bit of bruising on the skin of site, but that didn't even hurt a bit.

Good luck Wednesday. let us know how you are after eh? (((((HUGS)))))

 

[carolinagirl]

Bobb,
Hope all goes well for you next Wednesday. I was TERRIFIED of the femoral nerve block, (remember Jo?). The morning of my surgery I asked the anes. doc if she could wait and do it after I was asleep. No problem she said.
The block stayed in until Sunday afternoon. I was up Saturday, walking and
sitting up in the chair. It never bothered me once. It did not even bother me when they took it out. Tell the anesthesia doc the morning of your surgery that you are very nervous about it and you would REALLY like for them to wait until they got you in the op room to get it. I was given a shot of versed in pre-op holding and I don't even remember leaving the cubicle to go to the operating room. My surgery was at 11 am on Thursday July 3. Next thing I knew it was mid morning Friday, the 4th of July!!! That was fine by me too!!
My surgery was originally scheduled for 7:30 am and got pushed by due to an emergency. I was a nervous wreck by the time they came to get me.
I mean to tell you I had REALLY worked myself up into a tizzy!
I think everyone of us was stressed out and scared before the surgery.
You hang in there. I have never regretted having this done. In fact I have to have my left knee replaced also, and I am more than ready, but I am gonna have to wait until next spring/summer. That is only because I need to build up more leave time.

I am 3 months post-op and I do look back and think why did I get myself so worked up over something I knew was gonna make my life better? I can walk without pain, play with my grandboys, and ENJOY life again!
My thoughts and prayers are with you!

 

[patfinch]

Hey Bobb
Dont worry chick, all will be fine, trust us lot who have been there read the book, done it ,and are now wearing the T shirts.......
Like you and everyone else, I was a bag of nerves and thought that I would have a heart attack with the nerves, but please trust me, go with it...things REALLY AINT AS BAD AS YOUR IMAGINATION TELLS YOU.......
The staff know how to calm you and each procedure will go very calmly...with me I was taken to the anaesthetic room after waiting on the ward from 07.00 hrs- 14.45 hrs
I was whacking it I tell you, but the porters kept me laughing and took my mind off the op slightly, then I was put in a room with a HCA who had a laugh and joke with me until we went thru to the anaesthetist.........( I had been having probs with the "runs" ) due to nerves, so just informed the nurse to be aware.......
Then I met my anaesthetist, after a lot of laughing and joking very shortly later the epidural was in and I had """"NO LE£GS"""" from waist down. As you have to be sat on side of trolleywhile they do it, trying to lie down was HILARIOUS.........
then it was time for the catheter and being totally numb I never felt a thing....then it was Hi to my OS who popped in, and NO to my anaesthetist who asked if I was sure I didn't want to stay awake to chat and keep him company during the op, as he was on his own outside the Charnley tent......
The next thIng I know, I woke with my leg just 4 inch from my nose as they were dressing my leg POST OP.......
after that I was taken to recovery 17.30hrs, and stayed there all night.....NO PAIN....JUST DEAD LEGS DUE TO THE EPIDURAL, the nurses came round very regular to check the level of the block, and if it was creeping down, they would increase the dose of the meds to bring the block level up......ABSOLUTELY NO PAIN.....
Trust me hun......I was a complete wreck pre op but if I had to go thru it again...I would absolutely have NO HESITATION.........
Like childbirth the mind plays games and we imagine the pain as horrendous, but it's nothing like it......just think of all the others who have gone before us...and c9ome out the other side, with thanks
Anyhow at least you dont have too long to wait, next weds eh thats damn quick
GOOD LUCK........YOU WILL NOT REGRET IT HUN...Iknow I havn't....
Before you know it you will be back here saying you don't know what you were worried about....

Love and hugs Pat xx

 

[patfinch]

PS excuse the spelling, but I had my nails done for my 50th birthday party last week, and its a bummer trying to type properly, I keep hitting the wrong keys LOLOL
and NO ITS NOWT TO DUE WITH THE VODKA AND COKE THAT I AM ENJOYING....

 

[marennorge]

If you can arrange your office so you can elevate your leg, you will probably be ok. I found after surgery that my legs started bothering me after awhile when sitting at my home office desk where my computer is located. In fact, I bought a laptop between surgeries so I could sit in my recliner with my legs and surf the internet (the house is wireless). But know I alternate between the desktop and the laptop.

 

[patfinch]

Bobb
If you have time to read this....
GOOD LUCK FOR TOMORROW HUN...
My thoughts and prayers are with you

Love and hugs Pat xx

 

[bobb]

Thanks to everyone these last few weeks for all your comments, suggestions and help. Times up for me, last day is here. One more day of having my own knee and then it's Zimmer CR-Flex for me.
I will write back once I have access to a computer again and let everyone know how things went and how I'm feeling. I'm be on the other side now and be able to offer some experienced words of wisdom myself.

Talk to you all soon.
Bob

 

[beachcomber]

Bobb,
Best of luck to you! Honestly, the hospital is the easy part. Wait--- that might not have been very comforting.... oops!

What I mean to say is that the people at the hospital are used to nervous pre-op patients and have really good ways to deal with your nerves. I was very stressed when I went in for my surgery--- not scared-- but very stressed about job stuff left undone and staying up most of the night trying to get things taken care of. While I was waiting in the holding area the anesthetist said I seemed nervous and asked if I would like something to "help me relax." I said ok------ felt a little drifty....... and woke up about 8 hours later back in my room, surgery over, and in absolutely no pain for the first time in years. I found out later he gave me Versed and I was actually awake and talking to people until after the spinal/epidural was set up, then asleep. I just didn't remember any of it..... (has an amnesiac effect in addition to the "relaxation" component) BTW--- they assured me they are very professional in the questions and conversations--- no one made me cluck like a chicken or anything... LOL!

My advice is to let them help you relax and ask for assistance when you first start to feel pain afterward. Don't wait until is REALLY hurts because it will take longer to take effect. There are many different pain treatments available. Make sure you find one that works for you.

For the vast majority of us--- it is all so worth it. It will be some of the hardest work you ever do but it can give you your life back.

All the best to you! I will look forward to having you back on the other side.

Beach

 

[Roo73]

You should check back into some of MY posts before my surgery. I felt like someone was going to have to put me away...I was so obsessed and trying to make everthing perfect while I'd be gone from work. I worried about EVERYTHING - I'm surprised I didn't have a heart attack while trying to decide which toothbrush to take to the hospital. But guess what? I survived! I'm one of the lucky ones with a PKR and it has now been 9 weeks since the surgery. I am taking fewer pain meds and feel pretty good. And I am the biggest wuss you could ever meet!