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PKR How much do you tell to someone considering surgery?

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Well, my nightmare is going on a year and a half now. I would not do a BTKR and would choose a surgeon very carefully next time. Once the knee is in, you are forever under threat of infection and god help you if you don't have insurance down the road if that happens. I take everything these guys say now with a grain of salt even here on the forums with the overly sunshine and roses feel good attitude. The threads with people who are suffering the ultimate complications drop off the page pretty quickly never to be heard from again all the while many threads go on and on about stuff that is redundant and not relevant. This industry needs to get real about this procedure and dare I say Bonesmart should try not to be an enabler. Sorry, I just needed to vent tonight. I know there are allot of success stories out there and I guess my right knee is one of them. It's the left knee that has been a blood bath. If I knew what was ahead of me, I would never have undergone this surgery, there, I said it. Perhaps by this time next year I'll feel differently, who knows.
 
I don't know if I'd have a BTKR or recommend anyone having one. Just having a RTKR was tough enough for me. I suppose if both my knees were terrible it might be preferable to get them both over at once but it seems too rough for me. When I got home from the hospital I depended so much on my good leg to do everything. My knee was so worn out that it was completely unstable. Pain was not really an issue but the instability drove me crazy. I couldn't do 3/4 of the things I used to do. My surgeon told me about the risks but it was either have a life or sit on my butt and get fat. I really feel for the people who have not had a good outcome but thankfully the percentage of people having bad outcomes is small. Of course it's small consolation if you happen to fall in that percentage. I think for most people having a TKR is the way to go. The recovery is so much harder than I ever imagined. I would caution anyone considering having one to go to this site and read up and read all the stories of people who have had these surgeries. Like others have said make sure you can take the opiate pain meds. If you can't be sure they have other meds available. Trying to find a pain med after the surgery is not recommended. Be prepared for the weeks of being unable to sleep at night. Don't think you will be back to work or everyday activities in a few weeks. It won't happen. After reading most of the threads here I suppose I'm one of the lucky ones. I'm 10 weeks out and am walking, climbing and descending stairs normally. I haven't done that in years. I'm going to the gym and rebuilding my right leg. I can't believe how weak it is. My knee is still somewhat swollen but pain is minimal and my flexion is 0 to 128. All in all I'm so happy with my new knee. Having this surgery isn't for the weak of heart but with information and determination it's well worth it. The official line on recovery though is extremely misleading.
 
Jamie and Jo...It's great that you had doctors react positively to Bonesmart. I wish you had talked to mine. Perhaps it's because you were talking to them as fellow professionals and they put more weight behind what you were saying because you have more knowledge than we "common" patients. They see you more as one of them in the healthcare profession. In my experience whenever I have mentioned things to doctors about what I have learned here or elsewhere on the web, they kind of just dismiss it or get kind of a look on their faces like they are thinking "nothing you learn on the internet is really reliable or scientifically based".
 
Plexiburg...I am so sorry about your complications with your infection. I do hope you will get better soon. I can't imagine what you are going through. Can you trace it back to what might have caused it? I was very nervous because I went to the dentist this past June and was sitting in the waiting room and realized I had forgotten to take my antibiotic before I went. I went ahead and had the cleaning done anyway, but I hope I didn't make a mistake.
I feel jealous when I read on these boards that people actually get relief from their pain meds because I did not. People say "Oh, just take your pain meds and it will be fine." Not the case with me, so I don't think I can assure a friend that it will be fine for them. Although I do realize everyone is different and I am the exception, evidently.
 
I think you should be honest, but I also think you should stress that everyone is different. I'm really glad that I found Bonesmart, and it has been very educational to read all of the different types of recoveries. My anticipation was the worst thing I dealt with as I knew of people who had had horrible pain and long recoveries. Yes, I also had the "You'll be so glad you did it" people, but I did my research and knew it was an extremely difficult surgery and rehab. Imagine my surprise when I have had little pain and seem to be on a fast track recovery. I have followed the Bonesmart mantra and am very grateful for those words of wisdom. I have another knee which will probably need doing, and it could be different, but based on what I have gone through with my first, I would do it again.
 
Sounds like one very important key to being informed and not having false expectations is finding this site BEFORE your surgery and not 8 weeks after like me when I was in dispair and had not followed the "Bonesmart mantra". I will certainly tell my friends to visit this site and I hope they do it. Some people are hesitant to look at these types of sites though because some are full of horror stories and crazy people.
 
What a wise man you are! :wink: And you are quite right about those other sites. There are one or two that should be avoided like the plague!
 
I think being honest about the fact that this is major surgery and has a long recovery time is important. I am so glad my doc was up front about it taking up to a year to get back to normal. I think the decision aids like the Oxford knee score ( do I have that right?) are important too.
I think one of the things Bonesmart is great at is being able to help with the "is this normal?" type of questions after the surgery. And helping with those who have been under the impression everything will be fine in a couple of months. For me, realistic information is helpful.

I also think for those of us with conditions beyond osteo, like RA and fibromyalgia, it is important to remember that though the knee may be fine, the surgery doesn't deal with other underlying issues so you may still have pain in the areas around the knee if not problems in the joint itself.
 
Well there are BTKR success stories too. I stopped taking prescription medication (Tramadol) 14 days after surgery, daytime pain relief on day 16, drug free in week 7. Just through doing nothing but rest and a bit of stretching.

And not through assiduous preparation, either. I was too terrified even to open the recovery side until after surgery, for fear of what I might see.

I suppose I might be the wrong person to say what information we should give out -- but my example shows that not all, nor even a majority, of TKRs are horror stories.
 
Hi I agree this surgery is not always explained well to the patient before surgery. I was shown a small film clip showing what the replacement knee would look like but had no idea what would be involved. So many people have great results no great amount of pain and high flex no complications. I am struggling at 90 degrees and it took a lot of work to get there. I cannot say that I was prepared for what we experience but finally at the start of four months have actually strarted feeling like things are getting better. I spoke to my surgeon the other day he was telling me that I would be finished till next spring and then have my 1 year checkup. I mentioned to him that it has been nice over the past few weeks no longer waiting the same for the time to take pain meds tylenol but said that it felt like during this process that I was always trying to meet the expectations that were basically set trying to get flex to acceptable range and going to pt always trying to do beter before next visit so that wouldn't feel like I had basically failed to attain what would be expected. My surgeon replied that they were trying to help me and didn't intend to make me feel uncomfortable and I said but they did.

I had no idea that during the processs of healing that the results would be based on pushing rather then healing. Thought for the first few weeks at least I would have time to rest and heal and that that would be the main focus. I had a very damamged knee and the left knee which is needing surgery is the same. My doctor does not believe in rushing and has actually no intention of doing the surgery on my left knee until he is sure the right knee is healed and working to make me comfortable. Massages helped and I suggested that this be my choice next time more positive helped so much quicker and much happier doing them. I am not how I had expected to be after surgery but trying to make the best of it can function quite well still get some crazy pain occassionally and hoping over the year the flex issues will improve. Even without the bend my extension is now 0 and basing my progress on my own personal standards. Wishing you the best Holly
 
I'm sure if I could have taken opiates and/or NAISDS, then of course I wouldn't have had so much pain in the begining. I ended up only taking 7.5 mg of morphine and it wasn't close to being enough.
Josephine will like this. Last week at physical therapy they told me I was where I should be in recovery so I only have to go once a week. They said I'm doing the home exercises so well that I'm recovering on schedual. That shows me how wrong they are because I'm not doing half of what they told me to do. In fact I'm probably doing only a fourth of what they said I should do. They don't know that I'm trying to follow the Bonesmart way of healing so I am mostly elevating and resting, and thats probably why I don't have alot of swelling.
When I have doubts, and think I should be doing more like they told me to, I look at my unswollen knees and it only proves to me that the Bonesmart way is the way to go. But would they listen? Nope, not the pts at the rehab nor the pt's at my hospital. I don't know why people are so bullheaded? :heehee:
 
nothing in life is a given. Having any kind of surgery, any kind of replacement of body parts, is taking a chance. That is life. So one decides... do I want to live miserable in a wheel chair in pain everyday at 57 years old.... or take a chance with knee replacement to have my life back? There are terrible things that can and could go wrong... but you have to be willing to take that risk. It is a gamble of sorts. All I know is that I was miserable before. And I was willing to take the gamble. If you are not a gambler... then do not have surgery and live your life as it is.
 
I read this thread last night and found myself thinking about during my sleepless times. I definitely agree that there is no need to make people aware that the pain may be excruciating. This site was such a godsend to me in the weeks before my surgery. Thanks to this site, I knew there would be pain, that could be extreme, so I made it a point to ask at my Pre-op about their plan for pain management and knew ahead of time that they wanted me to stay as comfortable as possible so that I could do the therapy afterwards. They asked me to commit to taking all of the meds by the clock for the first two weeks after I indicated that I typically like to start weaning off fairly quickly. So I tried that after my two week appt. and quickly decided to go back up:-). Also, I don't think it is really possible to understand the pain and how it will affect you until you are there. I have really only had a few times when I was REALLY in severe pain and was able to remedy them in fairly quick order. I also
had a valgus deformity that I understand can cause additional pain, but I want to share with you my before and 3.5 week post photos. I am so excited to see the changes and my new straight and pain free leg. It really is all worth it! [Bonesmart.org] How much do you tell to someone considering surgery? [Bonesmart.org] How much do you tell to someone considering surgery?
 
All kidding aside...tell them to become knowledgeable about the procedure :ok: have a good
Relationship with their os & his staff.
No one wants this surgery, but as you can see from the responses...if we wanted any kind of life..
We had to have it. I couldn't walk before my surgery, some of us were headed for a wheelchair, some of us
Have lost years of sitting on the side lines...watching our world go by. This is no kind of life, we are happy,
Young, energetic, folks who have a life to live :happydance:
To the bonesmartie friends who have a tough time....they are in our thoughts & prayers & we wish them well.
We give encouragement to everyone...in our bone smartie family :friends:
We feel their accomplishments & their troubles....
This truly is the place to be, so spread the word.... :yahoo:
Diana.....June sunbeams :SUNsmile:
 
Travelingirl- Your legs are so BEAUTIFUL!!! you had the opposite problem I had. I wish I had taken before pictures as I was a bowlegged as a personcould be... and now my legs look straight like yours. My husband always comments on how straight my legs are.... and when I am out shopping and people look at me.. I am not thinking that they are looking at my bowed legs and thinking how funny I look... now I feel NORMAL. It is such a huge thing .:)
 
[Bonesmart.org] How much do you tell to someone considering surgery?
Travlingirl04, your new straight legs are the bomb!!!! I know you love them. My hubby's valgus was twice as bad as yours and he also had -17 degrees hyper-extension (legs bowed backwards); and today he has neither---just nice straight legs! He could hardly believe it when I showed him is before and after pictures. Glad you took those---because we do forget how bad things were. So happy for you.
 
[Bonesmart.org] How much do you tell to someone considering surgery?
I think we have to be honest with others about knee replacement surgery and its aftermath. But we don't have to scare them to death. So many are scared anyway, and we don't need to make it worse for them.

Pain has to be addressed. For those who have problems with opiate drugs, this truly is a very painful recovery for at least the first 6 weeks. They need to be prepared for this. Those who can take the drugs need to be helped to understand that they will not become addicted (maybe dependent which can be resolved by slow weaning off), and understand that they must be taken on a schedule to be effective.

The length of time recovery is going to take needs to be stressed with everyone. And more importantly, they need to embrace this and not think that they'll beat the system.

The issue of sleeplessness also needs stressing. This is one of the reasons lots of rest and catnapping is so important. Being prepared to be up in the wee hours and having something to keep your mind occupied is important.

The fact that pain meds cause constipation must be stressed, prepared for, and taken care of. Severe constipation can be worse than the surgical pain.

Understanding that aggressive PT is a BIG NO-NO really needs to be stressed. But some just have to find out the hard way----but they should be forewarned.

If we could get everyone to follow the BoneSmart mantras to the letter, most would have very good recoveries with few problems. But human beings just can't be trusted not to think that they know better and insist on doing some things their way----and then paying dearly for it.

I'm sure the reason that OSes and their staff do not better prepare their patients is that they do not really know anything about what recovery is like. Usually none of them has had knee replacement. But it is a shame that they do not make some kind of effort to know what it's like and how difficult it can be.

As I always say, the secret of success with joint replacement is TIME & PATIENCE---having the PATIENCE to give our hips or knees or both TIME to heal at their own pace.

I found this forum 7 months after my hip replacement but 4 months before my 2 knee replacements. I was well prepared for the surgery. And I am one of the few lucky people who is just not afraid of surgery. I am also a cockeyed optimist with a very positive attitude. I never "what iffed", I just saw myself as being the miracle patient who got up and walked on water the day after surgery. I wasn't exactly that good, but I did have remarkable recoveries from both hip and knee replacement. And I did follow the BoneSmart mantras pretty much to the letter. I can only tell others what my experience was, but I would also caution them that we all recover individually and that there are exceptions that do not have good recoveries (but wouldn't spend a lot of time stressing the possible negative recovery).
 
You tell them EVERYTHING warts and all! But by everything I mean all the rubbish as well as the things like 'I can sleep at night', and 'I can just pop to the shops' and 'I think about how my knee is feeling at the end of the activity' rather than 'I won't do that my knee won't cope'.

AND and this is a BIG AND tell then about BoneSmart! As it is real information from real people!

Shortie x
 
Hi I forgot to add to my post that I am actually very pleased that I had this surgery as I can now walk without the fear of falling off the top of my knee. I am thankful that it has basically started to stabilize and that my knee is doing more then before according to the measurement taken recently of my left flex I am still bending better then I had before used to bend from the waist now bend my leg. I was on a waiting list before surgery that can take up to a year and I was called 4 months into the wait for surgery a month before date of replacement. The surgeon apologized for the wait and I was very anxious to have it done. My Mom recovered from two knee replacememts so I did have an example to look at but her replacement surgery was different lots of pain but no issues with flex and she did not have any pt just went about her life other worries filled the gaps. I think when all is looked at as has been said the option of replacement was not available years go and the the chances of spending years unable to walk were probably high. I am not sure if I would have had any easier time with knowing what would happen as it happens and sometimes that is how it is but thinking today when going through the park had a longer walk to the bench we wanted that this has actually openend up my ways of getting back to the way it was before my leg was damaged and now actually thankful that my name came up and I was able to have this opportunity think maybe I love my knee now.Holly
 
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