New here....TKR soon! Help, please...

[Dewey]

Hello.. I've been reading lots and lots on this site for a few weeks now. What a wealth of information! I have already learned so much that I didn't know! Some of the information helps, some of it really scares me! I see an OS next week to see if I am finally ready for surgery. I've been babying my bone on bone knees with cortisone injections for about a year, and suffering with pain for about ten. I am miserable most days now.

I'm 55, a full time teacher, and really afraid for this surgery. My arthritis doctor said I'll be back in the classroom in 6 - 8 weeks, but what I'm reading here says otherwise! Im allergic to all anti-inflammatory medications and narcotic medication scares me to death. I'm amazed that some people are on those drugs for months! I'm so afraid I won't be able to manage the pain.

I guess my most important question is what can I be doing NOW to help make this surgery and recouperation a better experience? Should I insist on some PT before the surgery? I really want to lose some weight beforehand, but......I'm trying, but it's slow.

I guess I just wanted to say thanks to all of you that spend so much time on this site to help people like me. Those of us that are afraid and worried are really helped by your experiences and knowledge. I know I will be back for support and advice once I know what my OS wants me to do.

Thank you from a petrified newbie!!

 

[Titianlady]

Hi Dewey, and welcome!!! Oh, my dear, we were all nervous about surgery, but you will do just fine. I, too, cannot take anti imflammatory meds so I used an anti inflammatory cream the Dr called in for me. It goes into the system transdermally, so bypasses the tummy!
Now, don't worry about the pain meds.. You won't be on them for recreation, but for pain relief, and you will not become an addict.

For most everyone, time on pain meds is a must!! You will need them. How long you stay on them is an individual matter..some don't need them after a couple months, some need them much longer.

Some folks did PT before surgery, but really, most of us didn't and got along just fine!

The best thing you can do is relax for a while!! Get your ice packs ready, make some meals for the freezer, and get your family support system ready to help you for a few weeks.

And don't stress yourself about loosing weight before surgery. You will do just fine the way you are.

Remember, we are here for you!!!!! Here is a huge (((((((((( HUG ))))))))) for you!!!!

 

[Scrappy_tink]

Hi! Kind of in the same boat as you..I'm 53, been dealing with the pain for 19 years, cortisone shot "band-aids" for as many years. I can't stomach NSAIDS any more (not allergic, but it has torn my stomach to pieces), so, unfortunately, I rely on narcotics for pain relief. I've been using narcotics for many years now, and don't feel like I'm addicted to them. I can go weeks without any withdrawal symptoms or "cravings", and only take them as needed for pain (NOT for "fun"). If you are careful and know yourself, you should be fine. I do think (just my own opinion) there are some people that do have addictive propensities, but I think most people know if they are at risk. If you think you may be one of those that could be at risk, you could always have a love one monitor your meds for you (plus doctors should not be prescribing more than you need). I would definitely not worry about it after surgery, you have to be able to control your pain to recover properly.

I too am concerned about the return-to-work schedule, as I think most people (who aren't independently wealthy!) are! The pamphlet I got (that I swear was printed in the 1970s) said you should be able to return to work in 4 weeks. But, like you, I've read so much on these threads, I know this may be unrealistic....I, personally, have "planned" on six weeks off full-time, and two weeks part-time before returning full time back to work. Fortunately, I've been saving up sick leave literally for YEARS in anticipation of this surgery. Being a teacher, could you possibly hold off until summer break, so you'd have the summer to recoup? My surgery is scheduled for 19 November, so I could have sick leave during the holiday season. Having Thanksgiving in the hospital will suck, but hopefully the few weeks before Christmas I'll feel good enough to enjoy a nice little Christmas vacation.

Anyway, just wanted to say "Welcome", and hang in there....there are so many people here with so many different stories, which just goes to show EVERYBODY is different. Just because it took one person 9 weeks before they felt they could return to work, doesn't mean that will be you. I think the most important thing of all is to maintain a positive outlook and pray, and do what needs to be done.

Take care, and keep up on the boards!!

 

[Josephine]

Dewey, welcome, to BoneSmart. I suggest you tell us all the things that have frightened you so we can put them into some context for you. As for the return to work, I always recommend 12 weeks as a starting gambit. I know it's difficult for you American folk but it's more about the body's ability to cope with a day's work that I am concerned. I suggest you read these articles which might give you some insight into my reasoning. You too, Scrappy Tink.

- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
Energy drain for TKRs
How Long Does Healing Take ......
Chart representation of TKR recovery
Progression of activity for TKRs
The importance of managing pain after a TKR and the pain chart
Elevating your leg to control swelling and pain
Using ice
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?

Some suggestions for home physio (PT) and activity progress
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

 

[referee54]

Hello.. I've been reading lots and lots on this site for a few weeks now. What a wealth of information! I have already learned so much that I didn't know! Some of the information helps, some of it really scares me! I see an OS next week to see if I am finally ready for surgery. I've been babying my bone on bone knees with cortisone injections for about a year, and suffering with pain for about ten. I am miserable most days now.

Don't let the information scare you---be informed and you will make much better decisions. We were all somewhat scared and nervous of the surgery---but some of us---myself included---were also excited to be ridding ourselves of not only the pain, but also the sedentary lifestyle that limited us and our activities.

I'm 55, a full time teacher, and really afraid for this surgery. My arthritis doctor said I'll be back in the classroom in 6 - 8 weeks, but what I'm reading here says otherwise! Im allergic to all anti-inflammatory medications and narcotic medication scares me to death. I'm amazed that some people are on those drugs for months! I'm so afraid I won't be able to manage the pain.

I am also a classroom teacher, and my OS said that I could go back to the classroom at eight weeks---and I looked forward to it. It was much, much too soon, and it slowed down my recovery. I would wait until at least ten weeks, preferably twelve weeks. Regardless of how much you work on "taking it easy" in the classroom, you have to plan on getting up in the morning, getting dressed, traveling to and from school as well as round the school, etc. I found out that it all adds up.

I guess my most important question is what can I be doing NOW to help make this surgery and recouperation a better experience? Should I insist on some PT before the surgery? I really want to lose some weight beforehand, but......I'm trying, but it's slow.

I would actually concentrate more on strengthening your upper body; you will be surprised to see how quickly your leg muscles in your surgical leg will atrophy, but you will also be hoisting yourself up and out of the bed, the chairs, etc, so you need to have strong upper-body muscles. Losing weight is something that I would not really worry about right now; it can be done, but it will be much easier later on after your surgery when you are much more active.

I guess I just wanted to say thanks to all of you that spend so much time on this site to help people like me. Those of us that are afraid and worried are really helped by your experiences and knowledge. I know I will be back for support and advice once I know what my OS wants me to do.

I had a BTKR five years ago this November 8th. I cannot begin to tell you how much for the better my life has been since my BTKR! No pain, and I am more active now than I was seven years ago! You will be amazed at how great you feel after your recovery!
Thank you from a petrified newbie!!

 

[Dewey]

Thanks to you all! I've read the articles, and I feel a bit more "educated" now. I know I will be back with lots and lots of questions and the need for some serious encouragement once I've talked with my surgeon. I'm sure glad I found this forum and all of your knowledge! Thanks!

 

[Josephine]

Oh we excel at questions!

 

[Scrappy_tink]

Dewey, welcome, to BoneSmart. I suggest you tell us all the things that have frightened you so we can put them into some context for you. As for the return to work, I always recommend 12 weeks as a starting gambit. I know it's difficult for you American folk but it's more about the body's ability to cope with a day's work that I am concerned. I suggest you read these articles which might give you some insight into my reasoning. You too, Scrappy Tink.

- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
Energy drain for TKRs
How Long Does Healing Take ......
Chart representation of TKR recovery
Progression of activity for TKRs
The importance of managing pain after a TKR and the pain chart
Elevating your leg to control swelling and pain
Using ice
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?

Some suggestions for home physio (PT) and activity progress
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

Thanks Josephine!! Believe me, I've been studying those articles since I've joined Bonesmart!! I don't know what I'd do without you all!

 

[RestAssured]

Hello to a teacher from a former teacher!

I waited too long for the surgery because I thought I could tough it out! Well, it doesn't work that way! What I can tell you is my knees have given me a life of quality again! I have lost 150 pounds, and gained a few lately due to stress, but, life has changed. Do I regret having the surgery? Not in a million years!

Good luck to you as you travel down the path that so many of us have trodden. When your family doesn't understand because they haven't been in your shoes, we do! We are a family, and we support each other, celebrate the great times and commiserate with you and encourage you through the tough times!

 

[Dewey]

Can I just say I am so very glad I've found this site! I love reading others' experiences, and you all give such great heart-felt advice! I've learned so much already. I'm certainly not looking forward to the journey I'll be on soon, but I really think this site will make things a bit easier for me. Thanks, in advance, your your caring support and encouragement!

 

[kneeper]

Don't worry about the narcotics. You will need pain meds on a schedule so the pain doesn't get ahold of you, but it will be very manageable. And you will come off them naturally as you start to heal. Ice and elevation will also be your friend.

 

[noddy]

Hi Dewey,

Everybody worries before this surgery - there would be something wrong with you if you didnt! Everybodies recovery is different but with recurring threads, so as preparation I suggest you read as much as you can on here so nothing will be too much of a surprise. Incidently I was back to work within 6 weeks and off pain meds within a week!

 

[Dewey]

Hello, again.

I see my OS on Wednesday morning for the first time. I have read all of the articles about what to ask him and have quite a list prepared. Here's my question for you all today.....

I've heard from the nurse in my arthritis doctor's office and a PT friend that this surgeon is "the best in the area" and does knees exclusively. His patients seem to get along great. They both said they would most definately have him do their surgery if they needed it. But.......they both informed me that he is "not a talker", and has a pretty bad bedside manner. Of course, his skill and expertise are the most important things, but I feel like I need a surgeon who is compassionate and encouraging and one that will TALK TO ME and LISTEN TO ME! My husband says I'm crazy, and that if he's the best, that's the one I should use. Am I being silly?

Hopefully, he will be kind and answer all of my questions on Wednesday and I won't have anything to worry about. But.....what if he isn't???

Any opinions on this?

 

[referee54]

It is interesting---I have met several surgeons who are not good at bedside manners---but their surgical skills are amazing. I was lucky, as mine was really good in both points.
To be honest, though, you need a good surgeon, not a good talker. I saw my surgeon once a day for maybe ten minutes while I was in the hospital; I was more concerned about his surgical skills---as that is, what is most significant. I was also pretty loopy on pain meds while I was in the hospital, too.

I am sure, though, that your surgeon will meet your needs and answer your questions. It is is job; however, he may not be quite gifted in verbal skills. IF you feel really uncomfortable about it, investigate other surgeons; but the most important aspect, I believe, is what you posted earlier---that this one does only knees. That is the type of surgeon that does 100's of them a year and is highly skilled and gifted at his surgical craft.

 

[kneeper]

Being a knee specialist and coming recommended from a few sources sounds very promising to me. If the OS can also communicate well with patients that's ideal, but if not I wouldn't consider it a deal breaker.
I'd consider being a good communicator much more important in a primary physician, personally. My guess is a lot of surgeons go into that specialty in part b/c they like the hands on work, not the dealing with patients part.

 

[Dewey]

You are all so right! I do know that he's a qualified surgeon and his patients do well. I will just come here for my support and encouragement! Thanks, once again, for your wise advice!

 

[referee54]

You are all so right! I do know that he's a qualified surgeon and his patients do well. I will just come here for my support and encouragement! Thanks, once again, for your wise advice!

Do not worry at all! We will be here for you throughout the process! From the pre-op through recovery and beyond!

 

[Elsie Yan]

Hi Dewey, I had bilateral TKR 19 months ago and it was the best thing that I have ever done. I would suggest that you schedule TKR at the shortest possible time otherwise you would go through a lot of anxiety just waiting. Of course, I realize that it would depend on the schedule of the OS as well. In my case, I scheduled my surgery about 2 to 3 weeks away and in the interim, I helped my daughter organize a charity event. So that really kept me occupied although I was struggling around in pain. But my mind was on the event not so much on the surgery. Right after the event, I went in straight for my surgery so I didn't have any anxiety at all. I was fortunate that my OS can communicate quite well and he had excellent skills too. So good luck with your plans.

 

[kneesrus]

Hi Dewey, if your PT friend is going to be doing your rehab, you can gather a great deal of information from them. I know many patients that would like to know all the details of the procedure: what is the implant that you use? how long is the procedure? what type of closure do you use? when will I be able to return to work? etc... You may just stick to some basic questions and meet up the PT to obtain details. You will have more time and not feel so rushed in getting the information you desire. Many times, there is a great deal of stress in the doctors office.
This website is great for answering questions. Just put it out there and you will receive answers quickly.
Best of luck,
David

 

[referee54]

I have to say that, a a classroom teacher, I thought that I could "take it easy" and stay seated throughout most of the day---i attempted to, but there was more walking around than I thought. I had a parking spot close to my classroom, and I was able to get somebody to go to the office for me to run off copies, but I always found that I was more active than I planned on being. I have 280 sick days built up, but I refused to take any more time, and I was excited to get back to my classes.

I did find time---and I think this is important for you, too---to ice and elevate during the school day. I stayed in my room during my planning and conference period as well as my lunch period, and I iced and elevated during both of those times. It is very important to continue to ice and elevate; I am lucky, as I have a small refrigerator/freezer in my room (along with the obligatory coffee pot and microwave...) When you do go back to the classroom, take it easy and let others do as much for you as they can. ICE/ELEVATE DURING THE SCHOOL DAY.

Eight weeks for me was"do-able", but I paid the price with a slower recovery, and many times I was stiff and sore by the end of the day. The longer you can wait to return, the better off you will be.