My husbands upcoming TKR

[dmort]

My husband is scheduled for surgery in 1 month. Yesterday he went for his pre-op tests and his EKG had a 'blip' on it. Friday he goes for his stress test. I'm slightly concerned because his EKGs in the past have never shown anything irregular. What would happen to his scheduled surgery date if he cannot pass his stress test? He of course will not be on the treadmill but will be injected with the medication that will make his heart race. He is mentally prepared for the TKR and is in so much pain every day that I would be so bummed if something were delay or cancel the surgery. Does his heart have to be 100% for him to be cleared for surgery? Thanks for your answers!

 

[Josephine]

My Lord! If we stopped operating on people just because they had 'other' conditions, we'd eradicate about a quarter of the patient load!

No, it's not a case of him 'passing' his stress test but the doctors need to know what his condition is and what his 'normal' base lines are so they can spot anything else that might occur. If there was something that made the anaesthetic and/or surgery inappropriate at this time would only be until it had been sorted with some medication or somesuch. It's all part of the pre-op exam to make sure they know all there is to know about his present state of health. Don't worry.

 

[dmort]

I do tend to worry, I know. And he's been in such horrific pain for about 6 months so we are putting all of our hopes into this surgery. Thank you for your kind words!

 

[Karen54]

Hi dmort and welcome! When I had my first EKG prior to my RTHR 2 weeks ago, the EKG had several what they called "artifacts" showing. When my primary care dr. saw it, and I told her that I had been sitting up in a chair and talking and laughing with the nurse doing the EKG, she immediately said we were going to run another one lying down and being quiet because sitting up changes the angle of the heart. And guess what, the second one was perfectly normal, not one single blip! So maybe before the stress test, your husband could suggest that they do one more EKG?

Karen

 

[dmort]

Hi Karen,

Thanks for the reply. Part of his pre-op screening is a stress test, so he has to get it. I was just worried that something was going to happen with it that would prevent his surgery from happening. Like I said, in the past his EKGs have always been completely fine. And I don't really know what the criteria is for the stress test - if he fails it will they cancel his surgery, etc. Thanks!

 

[Josephine]

dmort - read my post again. I said they're most unlikely to do that. I've looked after patients with all manner of ailments, heart problems, lung problems, diabetes, you name it. We just deal with them, it doesn't stop them getting their new knee/hip. And if they've always been A-ok before, no reason to suppose there'll be any problem now.

 

[dmort]

Thank you, you are right. I think the whole thing has got me so nervous that I am inventing reasons to worry. This will be the first time either of us have had surgery - we have both been blessed with very good health. So I'm a little scared. Thanks again!

 

[Josephine]

No worries! It's quite natural to be anxious and we are very happy for you to come and ask questions - several times if you need to! That's what we're here for.

 

[dmort]

Thank you so much. I am so happy to have found this message board. I will visit it several times before and after the surgery, I'm sure. He's having the minimally invasive surgery so hopefully the recovery will not be as bad as I'm imagining. Thanks again for the replies!!

 

[Josephine]

Well, sorry to disappoint but minimally invasive only refers to the incisions, not the operation! It's still a major surgery and the recovery will be a trying experience for both of you! Is he having a total knee or a partial? (not that it makes an awful lot of difference!)

 

[dmort]

He is having total knee. He actually needs them both done but his surgeon suggested he do them one at a time and the right knee is not as bad as the left so he may be able to wait a year in between.

I thought the recovery time is less with minimally invasive surgery? He has a very physically demanding job so we are prepared for him to not be able to return to work for a few months.

 

[Josephine]

MIS and total knees don't much go together. True MIS is like keyhole surgery. So what your surgeon is doing - I would imagine - is a reduced incision. Some surgeons can get the incision down to quite a minimalist size! And whatever the size of the incision on the outside, the size of the operation on the inside will be the same as with any other approach.

Have you watched any of the YouTubes on knee replacement? Though very educational they are also quite graphic so don't watch unless you have a strong stomach!

Recovery is a difficult thing to quantify. First stage when the early healing is occurring and the maximum pain is experienced (along with the PT) can be anything up to 3 months. A return to work could be contemplated then depending upon the degree of the 'physically demanding' bit. A secretary might manage a couple of weeks earlier but a builder/labourer might need much longer.

Second stage when you're working on the ROM and PT, another 6 months perhaps. But some people manage it sooner, others later. It's one of those 'how long is a piece of string' questions!

Had he thought of having his other knee done say, 6 weeks or a month later rather than wait a year? Would cut down on his overall sickness absence.

 

[Simon]

Dmont

The person I was sharing a room with in rehab had severe heart disease. It was so bad, that her cardiologist actually went with her to the OR and did not leave till she was back in her room. She came through just fine. I am not sure what all her problems were but she took so many meds that in the morning they had to due in in 2 parts as the protocol was that the nurses had to tell the patient the name of every drug as they opened it (they used the prepackage individual dose system)

Simon
Simon

 

[dmort]

Wow...Simon, thanks for sharing that. It makes me feel a lot better. Like I said, I am just nervous and a little scared and am inventing reasons to worry I think. Now that the surgery is less than a month away it's all starting to sink in. Although, every time we have a change in weather or it's damp outside my hubby is in even more pain, so in a way, I wish the surgery was tomorrow. I hate seeing him hurt.

Josephine - He didn't want to take even longer off of work. With the unstable job market Michigan is in, he just felt being off the least amount of time possible was the best thing to do now. His right knee was not as bad as the left and the doctor thought that when Tim goes back to walking properly on the left leg it would also help the right one. I hope that is true.

Thanks for letting me ask all of my questions here

 

[Josephine]

No worries, dmort. As I said - I have recovered inumerable patients with all sorts of conditions from unstable diabetes to advanced heart problems (like Simon described) and they all did just fine! But, as you said, your husband's EKGs have always been fine before so you may well be worrying unnecessarily.

 

[Judles]

Dmort,,,,,,Just extending a welcome! You've come to the right place! Since I'm on the hip side,I just wanted to wish your husband the best of luck! He's very fortunate that he has such a wonderful caregiver! Tell him to pack his patience when he's ready! Keep posting!

 

[dmort]

Thanks for the welcome. I am finding out so much on this board - it's great! And everyone is so nice and encouraging! It's a true blessing.

 

[Gretchendz]

Wow...Simon, thanks for sharing that. It makes me feel a lot better. Like I said, I am just nervous and a little scared and am inventing reasons to worry I think. Now that the surgery is less than a month away it's all starting to sink in. Although, every time we have a change in weather or it's damp outside my hubby is in even more pain, so in a way, I wish the surgery was tomorrow. I hate seeing him hurt.

Josephine - He didn't want to take even longer off of work. With the unstable job market Michigan is in, he just felt being off the least amount of time possible was the best thing to do now. His right knee was not as bad as the left and the doctor thought that when Tim goes back to walking properly on the left leg it would also help the right one. I hope that is true.

Thanks for letting me ask all of my questions here

Hi there

I had my RTKR in April and the LTKR in October. My doc said about half the people needing both done felt they were able to support themselves better once the one was done and were able to postpone the second for a few years; the others said "Wow it feels so good to have the pain gone I want the other done right away." I was in the second category obviously


Hopefully he will be in the other group Best wishes to him

 

[Judles]

Simon,,,,,,,I just was reading some posts and noted you had a female room mate? Was this ICU? Hope you are feeling tip top! ;)

 

[dmort]

Thanks Gretchendz. I am hoping it works out to wait a year or so before getting the other one done too.

My hubby had the stress test on Friday. Now we have to wait for the hospital to send the results of that and of the chest x-ray to our doctor. Waiting is hard for me. But hopefully we will have the results this week and he will be given the green light for surgery.