New here, TKR scheduled for 8/22.

[Kimgrif]

Hello all,

I'm SO glad to find this forum! I'm 45 years old and have fought knee problems/pain for years and years. Long story short, I'm now facing a right total knee replacement on 8/22 and I'm hopeful that this will give me my life back! I have two active kids, ages 14 and 10 and I cannot keep up with them!

I've read a lot of the threads on things to do before surgery, what to expect afterwards, what helped, what is recommended, etc. I just want to thank you all for being so willing to post about your experiences to help us coming behind you!

I live in a 4-level split house, so after the surgery my plan is to go to my mom's apartment for a couple of weeks to recover, as she is all one level, with long hallways that I can use to walk in a climate controlled environment. (Minnesota in August can be miserable outside! LOL)

A close family friend underwent this surgery about a year ago and he raves about how it changed his life, how he was back on the golf course within four weeks of the surgery, etc. I'm worried that his experiences are going to be used "as a yardstick" for my own progress. If I don't progress as fast as he did, I won't be "working hard enough," etc. Silly thing to worry about, I suppose, but...

I do work from home and am hopeful that I will be able to get back to work fairly quickly. (I've only taken 2 weeks off from work based on that family friend's experiences, but after reading here, am wondering if I made a huge mistake?) I do medical transcription so it involves a lot of sitting. I've read about using a skateboard to help keep the knee exercised, I'm wondering if I could simply put my footpedal (for my job) on the skateboard and exercise while working? Does that sound feasible or is this a pipe dream?

I am also diabetic. Is there anything special I need to think about beforehand or something I should do afterwards that would be advisable to make my experience a little easier?

I do the exercises twice a day right now before the surgery. Those heel slides are going to kill me, I just know it! LOL But, I do them!

 

[1jt@atime]

H Kim, Welcome to the forum! You are right about not measuring your progress according to a friend. In fact, you can't even measure one knee from the other on the same person! I'm living proof of that. Two weeks MIGHT be doable since you are working from home but may more then likely be pushing it. You might want to start out working part time and build up. I hope you have a contingeny plan with your employer so that you don't feel too stressed about returning to work because this is just something you won't know until after surgery. You will also need extra time for physical therapy which is REALLY important and some unexpected naps.

The problem with sitting for long periods is that you will want to keep your feet up those first several weeks. I am at five weeks into recovery with my second knee and it has gone exceptionally well. I still have to keep my feet up most of the time so consider whether or not you can work sitting in a recliner chair or something of that sort. I'm the one that has mentioned the skateboard and yes, it has worked real well for me both for gaining flexion and for keeping the knee from getting stiff after returning to work. Maybe your 10 year old has one.

This recovery is very very hard. I am 47. I am young and motivated and thought I could get through the recovery faster then everyone else. But let me tell you this. It does NOT work that way. It's like your knee has a mind of its own and you are along for the ride. It is a frustrating and emotionally difficult recovery. You have to focus on the end point, that you are going to get your life back and be painfree. It really is worth it so I hope I"m not scaring you. I just want to be realistic to you and anyone else reading this.

I'm afraid I can't help with the diabetic question but I'm sure someone will be come along with advise. I wish you the best with your recovery! Karen

 

[hess]

Kim,

Glad you're here! I am not yet 40, and I have 3 very active young boys (11,9,6). I had TKR of my left knee on June 9. I'm still struggling, but am walking without anything, and have a good bend, and am doing fairly well with my PT.

As for the going back to work thing, I'm not real sure about that, I work out of the home, and that has been touch and go! I do what I can when I can, which seems to be getting easier for me.

Karen is definatley right about not comparing yourself to anyone else. You will only upset yourself, and it's not worth it. Plus, will you ever know really just how perfectly your friends rehab honestly was? True, it is a beautiful thing, but there is also a lot of hard work involved.

I'm not nearly there yet, but I can tell you that I am so happy I did it! At least now I know that any pain that I have is GOOD pain!!

Keep up with the exercises, you'll be happy you did, and please keep posting!!

Hess

 

[carolinagirl]

Hi Kim,
Welcome to the forum. Like Karen and Hess said, Do not compare yourself to others. I had a RTKR July 3rd and the recovery is HARD WORK! I too sit at a desk all day. I am a medical coder. I do not plan on returning to work until sometime in August. I am hoping that the hospital I work for can set me up to work at home. But at this stage, it tires me out just sitting up in a chair with my leg up. As soon as I got home from the hospital I realized that this is not gonna be a skip,hop and a jump to total recovery. It is gonna be a long road, but one that I am gladly traveling as the pain before the surgery was unbearable. As long as you are willing to work hard at your PT those milestones you set for yourself will happen! Keep up those pre-op exercises as they do help in the recovery stage. As Karen said,this is an emotionally difficult recovery, but if you set your mind on working hard, the outcome is worth it all. Even though I am only 2 weeks out, the accomplishments I have already made make it all worthwhile!! Good luck with your surgery and recovery!

 

[Kimgrif]

Thank you, everyone! My husband is designing a board that my footpedal can go on and be put up on the back panel of my desk so that I can work with my leg up, as well. (I've had a footstool under my desk for years to put my leg up when my knee aches).

My job is pretty flexible so I'm hopeful that I'll be able to take the time I need, and work as I feel up to it.

I keep telling myself that the pain is going to be bad, but it's a pain with an END. The pain I live with now has no end if I do not take these steps to correct it.

I've been given the choice of a spinal block or general anesthesia, but my surgeon really prefers his patients use the spinal. At first the thought horrified me but after talking to a few people and researching it myself, it appears the spinal is actually the way to go. I just do NOT want to hear/see/feel anything!

I've been investigating the Polar Care and Donjoy icing systems on Ebay. Is there a preference, one over the other? It appears that this would be preferable over constantly switching out ice packs. I do plan on making up a few refreezeable icepacks with the rubbing alcohol and water, just to have on hand, as well. Does anyone know if these systems can be used concurrently with the CPM machine? Is that advisable?

So many questions. LOL

 

[beachcomber]

I've been given the choice of a spinal block or general anesthesia, but my surgeon really prefers his patients use the spinal. At first the thought horrified me but after talking to a few people and researching it myself, it appears the spinal is actually the way to go. I just do NOT want to hear/see/feel anything!

I think the spinal is a great option. I had the epidural left in for 36 ours after my surgery and it was great for pain control. I had "something to relax me" just before going into the OR and "woke up" back in my room in no pain whatsoever (for the first time in a year).

I've been investigating the Polar Care and Donjoy icing systems on Ebay. Is there a preference, one over the other? It appears that this would be preferable over constantly switching out ice packs. I do plan on making up a few refreezeable icepacks with the rubbing alcohol and water, just to have on hand, as well. Does anyone know if these systems can be used concurrently with the CPM machine? Is that advisable?

I had a Polar Care unit sent home with me. SOP for knee replacements at my hospital. They told me to be sure to take it or they throw them away--- and my insurance had already paid for it! So you might want to check if you will get one and not buy one from ebay. Call your OS office and find out.
I like the Polar Care but also keep the flexible gel packs in the freezer for icing the back of my knee and/or my "other" knee.

.....................................

 

[1jt@atime]

I had a spinal with both of my knee replacements and found that preferrable. I did wake up a few times with the second knee. They keep a sheet near your face so you won't see anything though I did see an Xray on the wall when I was being wheeled out. I did hear some drilling/sawing and the anthesiologist told me once that they were almost done. Though I heard the sound of drilling, I was feeling loopy and it didn't quite click in my head that it was me they were drilling/sawing on. I wasn't coherent enough to say anything. It didn't really bother me. Several years ago, I was having a rod removed from my tibia and another one placed in the bone. They did a spinal but no drugs to put me out. I felt like a 2X4 getting a nail pounded into the leg. Now that was NOT fun......

I have a Polar Care but used a DonJoy in the hospital. I think they are very comparable and you would do fine with either one. I love it. I never used a CPM with either knee. My doctor thinks the patient should do all the work themself which I am glad about. I can't imagine having to lay for hours attached to a machine but I guess some people really like them. In the end, I don't think they make a huge difference in ROM which is why my doctor does not use them. Have you confirmed that your doctor uses them?

Keep asking the questions and someone will have the answer or a suggestion. August 22 will be here before you know it. Karen

 

[Simon]

Welcome

I also work from home reading and assigning keywords to medical journals. I also thought that I could go back to work pretty quickly but that did not happen. I have been working partime since June 29th about 4 weeks post op. The only way I can work is I bought a laptop so that I could work in my recliner. I found sitting at the computer even with my legs up (which is how I have sat for 20 plus years) was just not comfortable.

As for the diabetes. I have type II that is controlled by diet and exercise. I have noticed that my overnight blood sugars have gone from the 80's to 105-110. My doctor is waiting for another month to see if getting back into my regular routine brings them down. I did notice when I finally got a good night sleep they went down to the 90's for a couple of days. I have had major sleep problems that are ongoing and I hope I can solve soon as I have found without sleep things don't go well.

I am going to try full time next week.

As everyone has said, you will just have to follow your body.

Good Luck

Simon

 

[hess]

Kim,
I am just getting ready to put on my PolarCare ice machine right now!! I LOVE that thing! I did use it with my CPM machine. Sometimes, it felt good to use it, sometimes it didn't. Oftentimes, the CPM felt good, and others it didn't. It just depends on the moment.

As for the spinal or anesthesia, my doc did both. I had a general, but they also put in the spinal. Needless to say, I was very comfortable.

Keep the questions coming,
Hess

 

[Nursepair]

Hi Kim, welcome!! I couldn't sit at my computer for weeks after the surgery, and then only 45 mins at a time after about 4 weeks. Definately don't assume you will be the same recovery rate as your friend. I have a friend in her 70's who has had a great recovery, I on the other hand have suffered long term with swelling and could only achieve 93 degree ROM befor my manipulaion a week ago. (iIam 6 months out) I was at 97 last week but since then am having problems with swelling and a possible strained medial ligament. However I am still glad I had it done, there is no more joint pain at all. So work on the assumption that it can take 6 months to a year to heal, then you won't be dissapointed.

Good luck. Sue

 

[AlaskanTKR]

hi kim
I had right tkr this am and am sitting in a chair next to my bed as I write. I had general anesthesia and a femoral nerve block surgery was at 7:30 and I was up in my room at noontime. So far so good. I have a donjoy ice thing which I have also used in the past. They already gave me a cpm home and one was brought in here to be used starting tomorow. I am using a pca pump for pain and the awesome rn I'd bringing an oxycotin and caumidin at 5. The pt helped me to a chair at like 2:30. Way more comfy. Pain is controlled well. I am 42. Was out of options. Surgeon seemed very pleased and thinks I will very good results. I have a 9 yearold and a husband who works remote. As far as the golf. Yikes. The pt I dealt with today would not be pleased. She and I already talked about my retrning to work and how wecwill handle that.

Anyway. I know tomorrow will not be this easy. But I am so glad I finally was able to do thisbb. Better. Go. Eyeballs are closing. Ughhh

Marianne

 

[hess]

hi kim
I had right tkr this am and am sitting in a chair next to my bed as I write. I had general anesthesia and a femoral nerve block surgery was at 7:30 and I was up in my room at noontime. So far so good. I have a donjoy ice thing which I have also used in the past. They already gave me a cpm home and one was brought in here to be used starting tomorow. I am using a pca pump for pain and the awesome rn I'd bringing an oxycotin and caumidin at 5. The pt helped me to a chair at like 2:30. Way more comfy. Pain is controlled well. I am 42. Was out of options. Surgeon seemed very pleased and thinks I will very good results. I have a 9 yearold and a husband who works remote. As far as the golf. Yikes. The pt I dealt with today would not be pleased. She and I already talked about my retrning to work and how wecwill handle that.

Anyway. I know tomorrow will not be this easy. But I am so glad I finally was able to do thisbb. Better. Go. Eyeballs are closing. Ughhh

Marianne

So glad that you made it okay Marianne! Sounds like you are doing very well! See you on the other side soon!! Good luck to you and keep us posted.
Hess

 

[JudyS]

Marianne,
You are incredible. The only time I made it to the chair was waiting for my ride out of there. I am so very impressed, I am shocked. I just talked to my son, he is in Anchorage to bring a buddy to the hospital tomorrow. I was hoping it was yours but it is not. Anchorage Regional Hospital.

I was not even able to use my cell until 4 days after.
Way to go

Judy

 

[AlaskanTKR]

maybe its the fresh Alaskan air or something. I called my dad and my big sister an seemed to have coherent coversations. I think. I am getting a bit tired but am sure sleeping will not be as easy as this sitting. I figure if I feel good today I had better make the most of it. I have a feeling tomorrow may not be as easy. I think the staff here has tons to do with how good things are going.

AK regional is around the bend. All three of our hospitals are located close together. Lots of sharing of resources. Hope his friend is ok.

Kim
I was really nervous about this. The people on this forum are fantastic and will share their experiences which really made a difference this am as I headed in. I think their information was soooooo important. I could have never remembered to ask my doc all the things I would have had to had I not read from here.

Marianne

 

[Kimgrif]

Marianne, you are my new hero! Sitting in a chair and typing ANYTHING on the same day following your surgery??? WOW!

I will call my OS tomorrow morning and ask about the ice machine. And yes, they do require the CPM machine, I had to get that ordered already to be delivered right before my surgery date.

Nursepair, you have now given me a jolt. My family friend with the R-TKR was 69 at the time of surgery and he just breezed through this! I'm thinking at age 45, it should be easier on me than it was on him. UGH. Oh well, it HAS to be done, I'm too young to be this crippled up! I am SO looking forward to being able to WALK again!

Simon, thank you for your input on the type 2 diabetes. Mine is newly diagnosed so I haven't "leveled out" yet for sugar ranges, etc. I'm on metformin, as well as watching my diet. Breaking that carb monster was a nightmare. If I can do THAT, I can do ANYTHING! *roars victoriously* LOL

I want to thank everyone for all of your input, you are helping me immensely!

--Kim

 

[Nursepair]

Kim, you may be as quick as your friend too, it could go either way, Hopefully it will be quick for you too, (I am 54 by the way). However long it takes it will be worth it in the end!!!

 

[Kimgrif]

AARRRRRRRRRRGGGGGGGGHHHHHHHHHH!!!!!!!!!!!! What an exercise of TOTAL FUTILITY this morning! I am SO frustrated!

All I have been trying to do is find out if my OS and/or the hospital uses cryotherapy such as the Polar Care or Donjoy...whatever...just trying to find out if they supply it or not or if I have to buy my own. After THREE HOURS of being bounced from doctor to hospital to insurance company to hospital to doctor to hospital to number after number after number after number...I'm no closer to finding out this information.

So, I shall sit here and kick and scream and rant in frustration, then go buy my own on Ebay and be done with it. So there. *hmph*

 

[beachcomber]

idea.... why don't you call the hospital and ask to talk to someone on the post-surgical floor where you will be after your knee replacement. Ask them if your doctor's patients have them prescribed. Since they probably send TKR patients home fairly frequently--- they might know....That is how I found out to be sure to take mine home. The nurses said they throw them away all the time because patients don't take them home and they cannot be re-used.....

Mine is a Polar Care 500. When I used it continuously (like they did in the hospital) it lasted about 8 hours before needing the ice re-filled. At home, we froze larger blocks of ice (no ice maker in my refrig) and they lasted longer--- 12-24 hours depending on how much I actually used it.

 

[Simon]

Kim

I started on Metformin as well and stayed on it for about 4 months. You are right about those carbohydrates it is a bear but going low carb is what works for me. The Am. Diabetes Association is just getting around to approving low carbohydrate (I am talking about 80-90 grams a day). If your diabetes educator or doctor prescribe a higher amount try it but if you don't lose weight (if you have that problem) or your numbers don't go down ask about lower carbs. Some people are just more sensitive to carbohydrates (like really crave them) then others. I found I just have to stay away from "white" foods like rice, potatoes, pasta, corn and of course sweets. I also found processed foods are loaded with modified food starch and that starts my cravings as well. I eat alot of veggies, fruit and whole grains (in moderation). I came to this after losing a large amount of weight, gaining some of it back and not being able to get rid of it till I went to more protein less carbs. You will just have to see what is best for you.

I think the recovery period really depends on how bad things are to begin with and how long the problem has been around. I think those that are younger usually have worse knees and a slower time of it.

If you want to talk about frustrating try this. My first roommate on the rehab floor was about 68 and she checked in about 3 days post op. She was well over 100 and could easily get out of bed (though that was a no no rules wise) and move around. She stayed in rehab 3 1/2 days. The next roommate was in her 70's and she was a little slower but was out of there in 4 1/2 days. On the other hand I am 56 and I was in rehab for 10 days and it was 6 days before they thought it was safe enough for me to get out of bed by myself. Now I did have an extra complication of a minor tibia break which kept me at 50% weight bearing on 1 leg but still it was frustrating.

So just focus on your self as there is no normal time line.

Another source of information about the ice thing would be the person that runs the preop class. I asked about the ice machines and they said they found the ice packs they use were just as good. I took them home and for me they work fine.

Simon

PS I am 6 weeks post op and finally have both knees at just over 100 ROM and the left one is now at 0 extension and the right one is down to -5 extension (started at about -15 right after surgery).

 

[Kimgrif]

Thank you, Simon! I did find out that my hospital doesn't really use the Polar Care devices. They told me if I wanted to use one, I had to bring my own. I may just use ice packs while in the hospital and use the Polar Care when I get home. I am still planning on purchasing one from Ebay if I can get one reasonably inexpensive. It was such a frustrating morning!

My OS has not said anything about going into a rehab facility after surgery. My plan is to go to my mom's house when I'm released from the hospital. I hope that holds true!

As for the diabetes thing, my main concern is the affect the surgery has on the blood sugar numbers. I know when my mom had major surgery for lung cancer, her numbers were atrociously high (300-400 range) due to the stress of surgery. She was not well-controlled beforehand though. My numbers are pretty much well controlled at the moment, so I'm hoping the stress from surgery won't impact me too much as far as my blood sugar goes.

I too stay away from the "whites," best plan there is in my opinion! The diabetic education class I went to was a pure joke, I just rolled my eyes at the silly nutritionist who chirpily told us (the class) that if we wanted to forgo our serving of mashed potatoes and our serving of peas, we could have the slice of cherry pie instead! Uh huh. Right. Be gone with you.

I use the glycemic index a lot when it comes to finding appropriate foods. Works GREAT!