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Knee Replacement Anxiety

Discussion in 'Knee Replacement Pre-Op Area' started by rah2435, Jul 9, 2013.

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  1. rah2435

    rah2435 senior
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    thanks for your response Roy. Quad sparing "standard practice" ? That's the first time I heard this. I know someone who just had both knees done and they did NOT have quad sparing.

    hmmmm......
     
  2. Roy Gardiner

    Roy Gardiner FORUM ADVISOR Forum Advisor

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    I will get the Guvnor Josephine online but I'm pretty sure it's correct. If I'm understanding you and it's full TKR you're going for, that is.

    Further, there is no way to speed recovery. After three weeks one is still pretty much incapacitated, twelve weeks is considered (on BoneSmart anyway) par for the course to go back to work.

    And to rain further on the parade, there's no real difference between 'minimally invasive' and any other kind of TKR. It's still brutal surgery, sorry but that's it.
     
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  3. referee54

    referee54 omega

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    I do believe that There are quite a few of this that also believed the same thing. I was quite active up to my BTKR---I even umped a state baseball final that year---while on cortisone.

    I was very active and worked out quite a bit, so I though that I could speed up the recovery/rehab process.

    I learned, though, that it is not what shape your body is in, it is just your body. Your body, regardless of physical condition, heals at its own pace, and pays no heed to what kind of conditioning you have done.

    Some people do actually recover very quickly---I do hope that you are that kind of person. Most of us, though, recover at our body's pace (actually at the knee's or knees' schedule) and that is slower than we would like it to be.

    At three weeks, I was still on heavy duty pain meds and in the "Dark Days" of recovery---I was still sleeping a great deal and using crutches like a cane.
     
  4. juniper

    juniper senior

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    Rich, Dr. S's P.A. told me six weeks, after my first visit. It was clear I was too swollen to go back and she felt I needed to focus on icing and exercising. Yes, I think some of his patients do go back to work quite quickly, and I don't think you should discount the fact that you may be one of those people. I hate to think that you would avoid the surgery altogether based on my story. I know it's one of several hundred stories. I just would hate for you to go into this without understanding that the information you are getting on this site is more the norm. I saw people in PT who had had a regular knee replacement and they were farther along than I was. You may heal more quickly, but I think that the pushing most U.S. physical therapists do is likely to slow down the healing process. You might try connecting with skigirl. She is very athletic and is back to skiing. However she had to have adhesions removed and that set her back for a while.

    I think people are just trying to help you be more realistic about the possibilities as well as the benefits. Look at how many people describe the pain and the recovery and still say, "I am so glad I had this done."

    The length of my recovery and the amount of pain I experienced for months was not what I expected, but I know some surgical intervention was necessary. I just find myself questioning whether I could have held off for a few years by having my meniscus cleaned out. Once you do go ahead you are committing to following your knee's healing rather than your own, or Dr. S's timetable. If you don't, and push your knee to do what it isn't ready to do, you may find yourself in my situation--increasing recovery time exponentially. I don't think docs are always able to predict how each individual will heal although I am sure that your being athletic and in good shape works in your favor. Good luck with whatever decision you make. I am feeling that I have learned so much about myself through this experience...including gratitude to all the people who supported me, toward my current physical therapist and the woman who has given me massage, as well as the incredibly smart, kind and honest people on this site. I've also learned humility and patience...neither are my strong suits. When You ARE ready, you'll have great support at this site.
     
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  5. rah2435

    rah2435 senior
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    FWIW - I had this done years ago and it did absolutely nothing for me. Sometimes I think it made my knee worse.

    :iagree: I won't. But it is nice to hear from someone who has had the same doc. Thanks for being so kind and for responding to me!!!

    I'm beginning to see that. :thankyou:
     
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  6. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I've heard this so many times and it usually turns out that the surgeon did "a little tidying up in there"which means he got busy with a power tool and made all the rough spots look nice and smooth. However, there is a big difference between maybe removing an osteophyte (bone spur) or two and really getting stuck into the rough areas all over. All that does in ten minutes is what the arthritis would have done in several weeks! It's like so many similar jobs, you've got to know when to stop!
    Well, many years ago, by which I mean back in the 80/90s, it was standard to make a small snip in the quads to allow extra exposure of the joint. But in those days we also used to make 12-14" incisions as well! Gradually it was realised that this was making for very protracted recoveries so incisions got smaller and the 'quads snip' fell out of use - the hands of sensible surgeons, that is! It's still used on occasion when difficult or complex revisions are done, but generally never for routine primary knee replacements. In the UK it's never used in primaries and I have been astonished to hear that a few US surgeons are still doing it. There have been oodles of peer reviewed articles showing how detrimental it is to good recovery and long term outcomes. I still attend international hip and knee conferences on a regular basis and have made a point of asking surgeons if they use it and have yet to meet one that does. So I suggest you friend was extremely unlucky in his choice of surgeon!
     
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  7. kymamaw

    kymamaw junior member

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    Hi Linda, your post sounds like I could have written it except I haven't given in to having surgery yet. I wish you the very best with your surgery. Take care.
     
  8. maddoxsmama

    maddoxsmama senior

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    I too put my surgery off for two years. Had scopes and cleaning of the meniscus on both knees. Worked great on my left knee and still not having any more problems with it. But my right knee was never pain free after the scope and I finally bit the bullet and had knee replacement in April. I dreaded and dreaded it but it was absolutely the best decision I have ever made. I am a retired teacher and just wish I had had this surgery when I was still an active teacher. I would have eliminated so much pain that I went through. It is not an easy surgery and the recovery is slow. But I can now get out of bed in the mornings and the first thought I have is NOT about my knees. I am doing things that I quit doing two years ago. I feel like I truly have my life back.

    You will know when the time is right. No one can make the decision for you. Keep reading the posts and articles on this forum--they truly are a wealth of information for you. Good luck with your decision!! :)
     
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  9. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    If you absolutely can't take more than 6 weeks off, see about the phased return or doing some work from home for a while after the 6 weeks. If you can work from home and can get some rest and elevation time in during the day that could help. :scratch:
     
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  10. rah2435

    rah2435 senior
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    If this is true I don't think I'll ever get it done - LOL! Thanks.
     
  11. juniper

    juniper senior

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    Okay, I didn't know that I was ready. You'll know when most of the physical things you love to do, you can't do; when everyone in your life tells you it's absolutely time; when you aren't dancing at weddings; when you're worried about picking up a grandchild, niece or nephew because you're afraid you won't be steady. And. I think there's a good article in the library. My wake up moment came when I couldn't walk off the beach...and another, when my knee locked while I was sitting in my classroom and I couldn't move it and began to cry. The kids had to go out to a second recess and it took a half hour for the knee to unlock. Then, of course, it was good for the three months prior to surgery, but it had locked before and I knew it was a matter of time.
     
  12. rah2435

    rah2435 senior
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    Yeah - this is happening to me. I always tell them that they'd feel differently if it was THEIR knees we were talking about. :)
    I've never had them lock on me and I do have full range of motion. However, I wear soft braces ( elastic OA braces) everyday and would be afraid to walk without them. My pain level is all over the place. Sometimes, when sitting, I hardly feel anything. But walking for any significant distances causes them both to burn! Sometimes the worse part of working out in the gym is walking from machine to machine or standing. Walking and standing are the worse things for me. Just 10-15 minutes before the pain starts. There has only been one incident that I can remember being awaken from sleep due to knee pain. I was never a very good dancer but I couldn't imagine trying right now. No grandchildren yet - but I think I could lift a toddler if I needed to - as long as I have my braces on!

    thanks again for your reply!
    Rich
     
  13. patient 99

    patient 99 Sr Bonesmartie

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    Hello Rich, Everybody I have heard about who has had the minimal invasive surgery, where the quad muscles are not cut, seems to do extremely well. So the advice above, which suggests that you should go ahead does seem very sensible.

    Can I just add, however, that there is another side. I am 5.5 months post op (the usual surgery not the one you are considering) and its not all plain sailing. I say this not to put you off, but simply to give you a balanced response. I am still not sure I did the right thing. But the one thing I do hang on to is that if I hadn't had the op my knee would, without doubt, have got worse and worse. Now, whilst I am struggling, I live in the hope that it will get better and better. One day I may be able to dance again. My very best wishes. Carol
     
  14. rah2435

    rah2435 senior
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    Thanks for your input. May I ask why you didn't go with the minimally invasive method?

    thanks,
    Rich
     
  15. juniper

    juniper senior

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    Patient 99, (by the way, what would you like us to call you? Your screen name makes me feel like I'm writing to acharacter in an Alexander Solzhenitsyn novel),

    I had the "quad sparing"surgery, with the doc Rich is considering, and am still recovering after a year and a half. I think Josephine is right. Most docs do some version of this minimally invasive technique. I don't really care what kind of surgery I have, I want the good recovery kind. I'm doing better, but still am always aware of the new knee, unless I'm sitting. Still, I'm going off to a wilderness area in Lassen Park, a national park in CA. Wanting to hike and canoe there spurred me on to have the surgery. I'll let you know if it made the difference I've been hoping for.
     
  16. referee54

    referee54 omega

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    One thing to remember about any TKR is that, regardless of it being minimally invasive or not, there is tremendous surgical trauma done to the knee joint. Two bones are sawed off and there is heavy deconstruction and construction going on in a very tight space. This surgical trauma to the joint itself---not to the muscles---is what can cause the recovery to be notoriously slow. Consider the surgical damage that the knee is dealing with in healing, and you will understand why things move slowly.

    Regardless of the surgical opening, it is what is done inside the joint that decimates the knee for some time.
     
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  17. patient 99

    patient 99 Sr Bonesmartie

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    Hi Rich,

    It wasn't offered to me. At the time I hadn't found BS so didn't know there were options. I understand that the minimally invasive surgery (MIS) requires the OS to have more training and skill, so may be I wasn't offered it because there wasn't the OS able to do it.

    I've thought about your dilemma and do understand, but for me its a no brainer. Do nothing and it gets worse and worse. Have the surgery and you have a very good chance of things being better. I haven't reached that stage yet. May be I never will. But you have to give it a chance. If you never took chances, you'd never get out of bed in the morning for fear of what might go wrong. And I say this, not as one of the lucky ones who were back to normal very quickly, but as someone still trying to free my knee from the tight rubber band syndrome - my knee feels like a parcel - all tied up. Take care. Carol
     
  18. rah2435

    rah2435 senior
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    I have a feeling that most people that turn to forums like this, especially post-op, are people that have experienced some issue...maybe I'm incorrect, I don't know. I just suspect that the most likely case is - if everything goes fine (which I suppose it usually does) then people just get on with their lives...they don't bother with on-line forums.
    Any comments?

    thanks,
    Rich
     
  19. patient 99

    patient 99 Sr Bonesmartie

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    Hi Rich, No I don't think BS attracts only those who have `issues'. Post op recovery is long and hard for most everybody who has a TKR. Even the 100 per cent success stories are looking for information, practical help, comfort and support for some time. Perhaps what happens is that the lucky ones come on and move on quite quickly - BS having met their needs. The ones that stick around do so for various reasons. Obviously a main one is that they are not doing so well. But there are other reasons. They make friends and enjoy the conversation (which isn't all about knees). They want to put something back for the help they received is another big reason.

    So you have not become a member of the walking wounded, but certainly the inquisitive. But of course that is only my opinion. The only way you would know for sure as to how representative BS people are is if you did some number crunching. Carol
     
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  20. rah2435

    rah2435 senior
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    I like this line! :)
    Some of my friends tell me that I browse the internet too much and end up making myself more anxious. I can't help it though - I AM inquisitive. I want to know what to expect and not just what my doctor's tell me. Real people with real experience. Often what I hear from others is something like - " only the people with problems are going to be posting things on the internet...". i have met some very kind people here and a few who've had phenomenal success. I guess I do get a little worried when I hear things like:
    etc...

    Most people I've talked to who've had TKRs tell me things like; they wish they hadn't waited so long, how quickly they recovered, how great they feel now, I should DEFINITELY get it done.... I know one person who has experienced problems and had to have the replacement worked on several times. But most others are very positive.

    Rich
     
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