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Less than 3 weeks to go and getting really nervous

Discussion in 'Knee Replacement Pre-Op Area' started by newpartial, May 15, 2019.

  1. newpartial

    newpartial junior member
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    Hi All- well it will time in 3 weeks it will all be over . I am starting to really over think things a the moment. I have my work 'to do before surgery list', family 'to do list before surgery', a things to buy before surgery list and trying to keep busy. I am a big reader and that normally helps me to relax but think my mind is working overdrive so cannot keep focused on any books at the moment.
    I also keep thinking that maybe my knee is no that bad, but really the other side of my mind knows it is and what has to be done.
    I am also really anxious about the anesthesia - i know the spinal with sedation is the norm now but i want a GA. i have had GA's before with no problem, read 100's of articles and papers re pros/ cons of spinal vrs GA, read the hospital handouts and i still will oped for a GA. But in the UK you do not meet the anaesthetist until you are very nearly ready to go to theatre so not at your best for a big debate of the pros and cons of different methods. I guess i just wanted to know if anyone else is wanting a GA?
     
  2. rosieNZ

    rosieNZ member

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    Hi. Im the queen of over thinking! So happy to hear Im not alone. But at least we are prepared eh. So enjoy it. This site is great for helping you evaluate what you need.

    I chose a spinal without sedation for knee no 2.
    Sure there was hammering, sawing and chopping (and a weird chemical smell) but truthfully we know that has to happens. It was totally boring.

    If I was having the surgery again I would choose this as there was no post op sequelae. No sore throat or grogginess. No nausea or vomiting. I had a nice chat with the anaesthetist until we ran out of conversation. He did update me on where we were at (you cant see due to drapes and the surgeon is too busy to chat).
    I spent the rest of the time thinking about many things like work, remodeling the house project, winning lotto, planning a holiday etc.
    I was glad when it was over as I really was getting very bored. Just wanted to get on with it.

    If you need sedation you can ask and they can zap you quickly. So dont worry or stress about this option. It was fine and if you choose to be sedated you will have a nice sleep. If you stay awake you will probably be bored like me! There's nothing to do but lie there. If you chose a GA it will also be ok. The important thing is you will have a lovely new knee. Best wishes xxx
     
  3. Atlas_aus

    Atlas_aus member

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    @newpartial

    I am with you on this, full GA for me thanks !!

    I see my Anesthetist next week and will make sure he knows my wishes. I have had 2 lower back ops so I think epidural is out anyway as I understand it. I will beat you by a week, good luck.

    @rosieNZ I knew you kiwis were crazy ! :heehee:
     
  4. newpartial

    newpartial junior member
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    @Atlas_aus
    I will be following your recovery when you get there :elevate:
     
  5. BCSAnna

    BCSAnna member

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    @newpartial

    I am right behind you in the line up for surgery and I think it is normal to be nervous when facing major surgery. What has helped me to relax is listening to relaxation recordings that are specifically aimed at upcoming surgeries and pain control. I purchased the compact discs on Amazon for a prior surgery; have since loaded them to my ipod; and have found that they work so well that they put me to sleep!:sleep:

    I can truly relate in your thinking that your knee isn't so bad. I am the "Queen of Denial" in that area. Despite the fact that both of my knees are stage 4 OA, bone on bone; I am in pain 24/7; use a cane to get around in my home; and to get around any distance outdoors my husband must push me around in a wheelchair. My current quality of life is in the toilet. And yet, until very recently, I was still questioning if I really needed to have my knees replaced!:chinstroke:

    @rosieNZ

    Thank you for your lovely description of the actual surgery. As a result, I will be sure to request an extra strong sedation cocktail from my anesthesiologist prior to my surgery!:heehee:
     
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  6. Rick951

    Rick951 junior member

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    @newpartial When I had my PKR I had a spinal, and nerve block, with light sedation with Propofol. I told the anesthesiologist I was concerned about the spinal, they gave me something just as we were entering the OR. I don't remember a thing till I woke up in recovery. I was a little disappointed that I did not see the OR. I had ZERO pain while I was in the hospital.
    I will need to have my left knee done at some point. I would request the exact same thing Spinal, nerve block, Propofol for anesthesia.
    And look on the good side, after surgery and recovery. You will have a pain free knee!!!!
    Best of luck! Rick
     
  7. Cynof4

    Cynof4 member

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    @newpartial,
    I am general anesthesia all the way! No needles near my spine. :bignono: Fortunately, I’m able to make that choice. Hopefully, you will be too. I’ve never had issues with GA either.
    ~Cynthia
     
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  8. rosieNZ

    rosieNZ member

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    Ha! Not going to the dark side then? ! There's a reason why they offer epidural....cant be only for the crazy kiwis surely?? Although since our health system is always looking to save money so you could be correct!
     
  9. winemama

    winemama senior

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    I had a problem, with my first surgery using gas. From then on I have had propanol I had a nerve block in my neck from my rotator cuff and a spinal for my knees. I told the doctor I was worried about the spinal and being awake for it they told me not to worry you won’t remember a thing and actually you’re much more levelheaded when you wake, up you won’t have a sore throat from the intubation or any nausea don’t be afraid you got this handled Use the next couple weeks to get your house ready get your groceries and get a shower chair in anything is going to help you get your ice man ready really you’re not leaving the house for two weeks so unless you have someone to help you just get everything ready you’ll feel better
     
  10. newpartial

    newpartial junior member
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    It's really not the seeing what's going on that bothers me, if I am honest. If I was made to have a spinal I would choose not to be sedated as it's the halfway house of deep sedation that I am not too keen of either. As @Cynof4 has put it the fact that I do not want someone popping a sharp pointy needle in close to my spine.

    The main concern I have though, the feeling of numbness when its over - that freaks me out more than anything - not being able to feel my legs etc., even for a short time - I know its going to be really painful when it's over but I would rather know what I am up against from the get go. I know all the evidence is out there which shows it is totally safe. I know all that -but as I have had GA's before. My risk is very low for that too so will go for that... hopefully :roseshwr:
     
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  11. Bionic

    Bionic post-grad

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    @newpartial
    I have had 2 hip replacements and 1 knee and had the spinal with each. Having had GA in the past I have been very pleased with the spinal. The bonus with the numb leg for a while is that it also numbs the pain :yahoo:

    I am in the U.K. too and didn't meet the anaesthetist until just before the op. I think thats usual here. Having said that it was discussed by my OS when we met a few weeks earlier so I knew what I was getting. So if you can't get to your anaesthetist mention it to your OS.

    Whichever route you go down I am sure you will be ok with it.
     
  12. newpartial

    newpartial junior member
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    I mailed my OS secretary when i got the letter saying it was planned for spinal but be prepared for GA. I said then i did not want to spinal. She wrote back saying i could choose on the day - i have my pre op on the 22nd so will mention it then as well. Sure it will all be fine as you say :)
     
  13. possum65

    possum65 junior member

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    @rosieNZ
    Spinal anaesthesia seems to be favoured in NZ for hip and knee surgeries. My anaesthetist did recommend it over GA, but would do a general if it was what I chose . I had my hip surgeries with spinal, minus
    sedation, but did feel uncomfortably restless and tired towards the end. Not particularly pleasant, decided on light sedation for my knees (recommended because I was having bilateral replacements) . That worked really well for me. I felt very alert and good after the surgery.
    Also my anaesthetist said quite a decent dose of pain relief is put into the spinal, which really helps afterwards. I like to go with what the anaesthetist recommends, but then again I am OK with needles in the spine. You have to do whatever is best for you.
     
  14. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I requested GA and they agreed with no argument. I have low back issues and didn’t want any needles in my back.
     
  15. Loopy Lou

    Loopy Lou new member

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    Hi Newpartial
    I've just been nosing around the threads, and see that you are scheduled for a PKR patellofemoral on 4th June, I am scheduled for the same procedure, plus possible Tibial Tuberosity Transfer on 8th June. I too am in the UK. I will follow your progress. You are also a similar age to me (far too young to be having to think about this type of thing in my opinion).
    Hope your preparations are going well. I have been preparing at work for this since the start of the year! Currently nesting at a very high level at home too, spring cleaning etc!
    I've not started purchasing things for my recovery yet, I though it would be best to go for my pre op / physio visit first, as I'm presuming that I will be given the things I need from the hospital? I'm surprised to hear that people are purchasing walkers, etc, I though occupational health found out what you will need at home and then provided it? Or have I got that wrong, I thought that was part of our health system.....
     
  16. newpartial

    newpartial junior member
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    @Loopy Lou - yes the preparations are still continuing as i make my way through the to do list - nice days outside so outside job list being done. My pre op is on Wednesday this week but rumor has it that i will get a toilet seat riser, grabber?, shoe horn and crutches to go home with. Think crutches seem to be more favored that walker in the UK for some reason.

    I know that there are quite a few on here in their 40's but my OS does keep saying its young and, like yours, really is uncomfortable about a total in fact he would not have done a total on me.

    I have had quite a bit of surgery on my knee so far (this will be the 6th time somebody has taken a look inside my knee) but he still thinks that the lateral had years left in it. He has been really honest and said that I should expect a revision at some point with a total but a PF to total is not too complicated, so he says. I mentioned to him re the recent studies that show totals can last 20-30years, he said that the studies look at all replacements across all ages - his feeling, and experience is that younger more active patients will not get to the 30 years and will need to be revised and a total to revised total is more complicated that PF to a total.

    I have done a lot of reading around and am happy with going for the PF - only time will really tell I guess. I also asked if recovery is quicker to which he said no - which is in line with what others have said on the forums.

    I will let now if I get any more info from the pre-op. Good luck with yours :)
     
  17. Loopy Lou

    Loopy Lou new member

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    Hi New Partial
    Hope you’re pre goes well tomorrow, I’m waiting for the date of mine to come through.
    My OS has said exactly the same to me, he won’t do a total, and that I will probably have to have a revision to total at some point in the future. He currently has a patient who he did a patellofemeral resurfacing on 18 years ago, and she’s still going strong!
    Like you I have been told it’s more successful to do a total after pf, rather than replacing at total with another total in the future.
    I too have done a lot of reading around over the last 2 - 3 years, and given my circumstances, think it sounds like a viable option for me at least.
    Let me know how your pre op goes, good luck!
    Lou
     
  18. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I disagree with both surgeons.

    Some patellofemoral replacements are not the unqualified success they should be. Patella tracking seems to be a fairly common problem after a patellofemoral replacement, sometimes requiring further surgery. @newpartial your knee has already had several surgeries, which may cause problems later. In your shoes, I'd opt to have the TKR.

    I've had a revision from a PKR to a TKR and my surgeon has told me that, in the unlikely event of my needing another revision, he will have no problem doing it.
     
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  19. lovetocookandsew

    lovetocookandsew FORUM ADVISOR Forum Advisor

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    I've always had GAs in the past for every surgery as I'm a big chicken and didn't want any chance of waking, hearing and/or seeing anything. For my revision, the anesthesia doc took a lot of time right before the surgery explaining how both worked, and why. Being that informed was wonderful and I chose a spinal with deep sedation. I'd always thought a spinal meant twilight sleep where you could wake and become aware; even my husband woke with the one small surgery he had and his doctor told me they had a hard time with him moving and talking. He also remembers the surgery, which I never wish to do.

    I was given the spinal, with deep sedation, and breezed through the surgery. I had no nausea or vomiting afterwards, and was bright-eyed and bushy tailed a few minutes after the surgery with no residual effects from a GA. In the future, if I ever need another surgery for anything, I will choose spinal sedation as it really is a lot easier on my body and recovery than a GA; and believe me, I've had many, many surgeries with GA and only one with the spinal, and it was night and day in regards to recovery from anesthesia.

    I also had an epidural for pain relief after as I am unable to take any narcotic pain meds-it seriously might kill me to take them again, so my OS had to come up with a plan for pain relief for me that didn't include drugs. Having the spinal and the epidural did make my legs somewhat numb, but I still could walk. If I'd only had the spinal, it would have worn off quickly and the numbness would have been minimal, if any, by the time I was ready to get up and walk around. But with the epidural, I did have numbness, but they adjusted the rate so as to allow me to be basically pain free, yet not so numb that I couldn't walk.

    As for your nerves, it's very normal and you will get through it. I had to keep really busy beforehand also as I had kangaroos jumping in my stomach 24 hours a day for weeks before the surgery. I made tons of meals for the freezer so we could eat real food and not fast food or those yucky frozen "meals" you can buy as I'm not fond of either and my hubby doesn't cook (well he can cook, but no sane person wants to eat what he's cooked :heehee:). I did post in the social room how I prepped for meals post surgery, if you're interested. The nerves were still there, but I got through the days before by keeping super busy, and you'll get through your days also.

    I used a walker for approx. 3 weeks, then went to a cane for a few more weeks, then gave that up also. I don't do crutches as we don't get along-they seem to trip me up constantly and I have actually fallen with them more than once, so a walker to a cane is my MO.

    Whichever form of sedation you choose will work for you, and you'll soon be on the other side and heading down the recovery path. Keep busy now and the time will go faster; afterwards take it easy, rest, ice and elevate along with walking around the house as recommended by the recovery articles you'll receive on the recovery forum after your surgery. The key is to ice and elevate a LOT-I spent most of my days and all my nights with the ice machine going and my knee elevated on my Lounge Doctor any time during the day that I was lying down and icing-what a blessing those two items are! I also read the activities progression article every day to remind me not to do too much, or too little, at any given point of time in my recovery. Good luck, keep us posted and see you on the other side!
     
  20. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I'm in total agreement with Celle.
    Depends upon the surgeon!
    I don't care for his blanket opinions. I know many knee surgeons who have given up doing partials because of the very high number of conversions to totals.

    And of course studies go across the ages, but does he not know that activity, sporting and athleticism is no longer confines to the 'young' people? Many in the 60s and 70s and older are still very athletic and still their TKRs and THRs are lasting eons!

    And according to the latest stats, 'younger' people DO get to 30+ years and longer. It's all there. He just hasn't read it.

    In my career, I scrubbed for a number of knee revisions, both PKR and TKR and not including those that had infection or trauma, IOW, just loosening, they weren't that dissimilar to the primary procedure.
    I agree with this also. Since 2011, I have kept a log of PKR failures and so far have 35 cases listed. And that's just on this forum which is a very tiny representation of the entire population of such surgeries.
     

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