Nervous about TKR

[sugargirl]

Hi
I found this site by tonight quite by accident but it's a good thing to have a place to talk about my fears.

Several years ago I was told I needed a TKR... about that time I developed a heart condition and a kidney condition.

We sold our home and purchased one that requires us to take a ferry to Seattle where my medical team is located. Just after we signed the papers I had a heart event that put me in the hospital for 5 days trying to get things under control. It freaked me out to realize that my heart/kidney team were going to be across the water from me but we had already sold the old home and purchased our new home prior to this event.

It is at that point that I absolutely need to do something about my knee.. I was also told my leg was turning.. not exactly sure what that means or the future impact of that issue.

My Concern is not only that I have a heart issue with a pacer (take warfarin daily) ..I also have 3 aneurysms 1. Carotid 2.thoracic aorta and abdominal aorta aneurysms.

I have a clotting issue of Factor 5 Leiden. I know they will take me off warfarin 1-2 weeks before which scares me.

I know that with some knee replacements ..clots happen. That's probably one of my bigger fears.. and my heart.

My new town has some new orthopedic surgeons that get high reviews... my old orthopedic who put a pin in my hip fracture is a ferry ride away from our new home.

I just don't know what place would be best for me and if the doctors here are good should there be any complications during or after surgery. But as I told my husband today.. if I fell and broke my leg the ambulance would take me to this hospital and not across the sound.

I'm probably babbling but it gives you an indication of my fears and wondering where to go for surgery. I also cannot tolerate narcotics and I've read how painful this is after surgery.

I'm hoping someone out there has dealt with similar circumstances... new doctors or serious health issues.

I wanted to go to Hawaii for my upcoming 75th birthday but thinking it's probably best to wait because of walking involved. A short road trip instead and then thinking of November or December for surgery.

I will go for a consult here locally with one of the New surgeons but hoping for some put from others.
Thanks for listening

 

[Pk4tmjsd]

Hi Sugargirl: Welcome to Bone Smart. You have come to the right place. You will find there are great resources on the site and you will receive personal input from several people who have a medical background and first hand experience with TKR. Your surgeon (s) and physician (s) will proceed with the surgery only when you are medically cleared. With regard to pain management, there is an educational section on Bone Smart and a new initiative called PACIRA - alternative pain management. It was only launched in the past few days; perhaps this will be helpful to you. Rest, elevation, and ice - with an emphasis on ICE - are mentioned by many of us as effective ways of managing the discomforts associated with moving forward and healing after TKR. Welcome - you will receive a log of support....... Good luck with your surgical/physician consultations. ~ Pat

 

[OJ2]

I did a lot of research online before I chose my surgeon- where did he get his medical degree, where did he do residency/internship, What reviews online, etc. when reading reviews, look for trends. Do several people say he is hard to work with? One bad review does not necessarily mean anything, so look for trends. Ask people for referrals. Some people say the best people to ask are nurses, some say the best to ask are anesthesiologists. You can do a lot of research beforehand, but then you have to trust your gut when you meet with the surgeon. And I would recommend taking someone with you when you do meet the surgeon. Two guts are better than one.

 

[Teri59]

Hello @sugargirl I am glad you found Bonesmart. There is a lot of good reading. Bonesmart also has a nurse. Her name is @Josephine . I will give her an alert for you. I see you have some medical questions she may be able to help you out with. There are also some very knowledgeable folks that will be along as well.

 

[KarriB]

Welcome! Yes, a TKR is scary, but when you need your life back without the pain of walking this what you do. My advice about finding an OS (orthopedic surgeon) is to look for one with a lot of experience with knee replacements who you also feel comfortable with and have confidence in. I saw one OS for a few years, but when the time came for surgery I did not want him to perform the surgery and found someone I was more confident in. Take a look at these links, they may help you in making a decision.

Whomever you choose will be aware of your other medical issues and work with those.

Welcome to BoneSmart, glad you found us!

Here is some pre op reading for you.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?


If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?


Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:

Stories of amazing knee recoveries

 

[Josephine]

I was also told my leg was turning.. not exactly sure what that means or the future impact of that issue.

I would imagine that a) who ever told you that was not a surgeon and b) that they just meant it was getting worse.

I have a clotting issue of Factor 5 Leiden. I know they will take me off warfarin 1-2 weeks before which scares me.

You need to trust in the team that will be looking after you. I've nursed a great number of people who have had joint replacements but also had a variety of heart problems. You don't mention if you've ever had a problem with clots, DVT (deep vein thrombosis in the leg) or anything similar. If you haven't then your care might be sufficient to take care of you. Read this how do I know I will be safe during the operation?

If you have had such problems, then preventative measures can be taken to forestall a pulmonary embolism Pulmonary embolism, past history and Greenfield filters

I know that with some knee replacements ..clots happen. That's probably one of my bigger fears.. and my heart.

Well I can't deny that isn't true but it's uncommon. But again, you need to trust the team that is looking after you.

As for the hospital across the river, I'd certainly recommend you go the closer one.

 

[SusieShoes]

Have you considered asking your former doctor, the surgeon who pinned your hip fracture, if he can recommend an orthopedic surgeon on your island? He may not know anyone, but if he does, it's a worthwhile reference. It would be convenient to have your surgery close to home. Your husband could visit more often. You would have only a short ride home instead of a long ferry ride. However, you must have full confidence in one of the surgeons who practices there, because having a good surgeon is the most important part of this surgery.

Your heart issues are something to discuss with the new surgeon. A surgeon won't operate if there's a problem he or she doesn't feel confident about handling through surgery and recovery. One thing to keep in mind is surgeons who do a lot of surgery (you definitely want a surgeon who has done lots of knees) has seen just about everything and will know how to deal with your issues. Combine that with a good hospital and medical team and you have a winning combination.

If your knee is making you plan your life around it... it's time to get it replaced so you can enjoy your life!

 

[pdx]

Have you been able to talk with your cardiologist? (Or whoever handles most of your care for your heart/kidney/blood issues.) He/she may have some ideas/options to consider and have names of surgeons.
These days, you're in the hospital only a couple of nights, so maybe your husband could stay at a nearby hotel rather than having to take the ferry back & forth. (It is a pretty ride in the summer/fall/spring! Winter, though ...) A lot of big hospitals have deals with nearby hotels that give special rates for patients' families; some even let families stay in the rooms.
I know Virginia Mason has a good reputation overall, as does UW. (My son is a Husky, so I have to say that!)
I hope things go well for you.