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[JenniferG]

Hi everybody, I'm Jennifer. My bilateral is coming up march 18th 2008. Scared, excited, ... Lots of questions. Right now I'm concerned about Lovenox after surgery. I hear it hurts when injected, alot and has strong warning about spinals. How does that work if you are getting a spianl for the surgery?! Are there any alternatives I can ask for. I'm also pretty young,almost 40, so I worry about the effects on a femALe body.

 

[Pattipoo]

Hey Jennifer....I can't answer your question but I'd like to welcome you aboard! If you want to venture over to the "After Surgery" board, you'll learn a LOT of info that will serve you well before and after surgery.

Josephine will be along to answer your questions. There's lot of us here that can tell you of our experiences and we have some pretty good tips.

Glad to have you.....
Patti

 

[Rowdy66]

Hi, Jennifer, Wanted To Tell How Glad I Am You Found This Forum. I, Too, Am Having A Bilateral Tkr And This Forum Has Been So Important To Me And I Have Gotten Such Good Information From The Guys On Here Who Have Already Been Through The Surgery. I Might Add You Won't Find A Better Group Of People And Josephine Will Do Her Very Best, Which Is More Than Adequate, To Give You Any Information Or Help She Can. She Is A Total Sweetie. I Don't Know About The Medicine You Asked About But Tell Me About It Anyway. Since I Having The Surgery I Should Probably Know, Lol. Anyway, Like Patti Says, Even Though Yu Haven't Had The Surgery Yet They Will More Than Welcome You To The Board For Those Who Have Already Had It. Hope To Hear A Lot More From You. Jan (rowdy66)

 

[Nursepair]

Hi Jennifer, welcome!! Can't help you with the Lovelox, never heard of it. I had an epidural for my TKR on 9th Jan 08. It went well, they give a sedative too. I drifted in and out of the surgery, never felt a thing. Heard a bit of hammering at one point. Apparently I kept asking the surgeon lots of questions as he operated, he apologized to me after that he couldn't always respond as he was a little busy and couldn't always hear the questions!!! They also gave me a leg block and after a surgey I had hardly any pain for a day or two, I was also on a pain IV thingy, you administer it yourself. Then on the third day, I felt my knee!! Yeooooooooooowwwww!! That's when you start on the real pain meds!!!
Josephine will be along to give you lots of help with medical questions, she's on UK time, so puts in different hours.

Anyway, you must be glad to be getting your knees done now eh? It will be a long haul for recovery but worth it in the end. Just keep hanging out here, there are some really fun people on this forum, a few really nutty ones too eh Pattii...just kidding!!!

 

[Nursepair]

P.S. Jennifer, make sure you get plenty of sleep before your surgery as I think they remove the sleep ability part of the brain when thy operate. Never mind though, there are usually one or two people up on this board through the night for the same reason to keep you company.

 

[Josephine]

Hi Jennifer - welcome to BoneSmart. We'll do our best to answer your questions but even if we can't always, this community will surely help and support you in anyway we can.

Now about Lovenox - aka Enoxaparin - I just rang my sister to confirm what I was going to tell you (she has had two knees done in the past 18 months) and she confirms that it is no more painful than any other injection. The only bit that is 'stingy' is when you insert the needle. I don't know about you guys in the US but here, the patient continues on the treatment for 4 weeks and is required to self-administer. She also reports (!) that if the syringe is not fully emptied before being withdrawn, the last remnants of the fluid can sting when it reaches the skin with all it's little peripheral nerves.

As regards spinals, I've done some searches and can find nothing pertaining to any problems. Enoxaparin is also a form of heparin which is regularly used during surgery for a variety of reasons so I'm not quite sure what it is you found/heard. In any case, it's the anaesthetist's job to take all this into consideration in order to make your surgical experience as safe and comfortable as possible so I suggest you talk it over with him/her when they visit you just before the op. To be safe, have your questions written down so you don't forget anything.

And please post again is you have any more questions.

 

[JenniferG]

Josephine, Thanks for the info on Lovenox. I read it is painful when injected. But maybe the folks were self injecting incorrectly and letting some discharge into the layer with the nerve endings as you noted. Hopefully with that in mind I'll be sure to get it all out of the syringe before getting the syringe out of me (or shall I say my husband, cause I'm won't do it!). The issue about lovenox and spinals is actually on the Lovenox brand web site, still a concern to me. My DR (US) puts us on a 28 day course, similar to what you mentioned as well. Here's another question for all who know. They keep saying the standing walking pain in the beginning is a different kind of pain, incisional v. bone on bone. OK different but is it any worse? also, how about pain from bones being cut & sawed to fit new joint? Sorry if that's a little rough. Thanks again Jen.

 

[JenniferG]

Rowdy, When is your Bilateral? Nursepair, when you heard the hammering, did you remeber you were in surgery or thought you were dreamin of building a house? I don't want the surgery, but I want the end result... Yes I will be glad for the end result of My surgery. Are all those pain meds that far out after the norm?

 

[Pattipoo]

I, too, keep asking Rowdy when her op. date is.....she hasn't answered.

This is going to show my ignorance, but WHY would anyone want to be awake during this surgery? Is it for medical reasons? I had a nerve block on my operative leg and was put OUT.......before I went OUT, I looked around at all the saws, drills, hammers and other things they were going to use on me......YUCKY....I was VERY happy to be in La-La land. When I had my two c-sections, I was just numb from my waist down....I could feel pressure sensations and such BUT I don't think I could STAND knowing that that buzzing sound was my leg bone being shaved off!!!

Just some useless questions by someone who CAN'T go to sleep!!

ROWDY....WHEN WHEN WHEN WHEN?????????

 

[Josephine]

Josephine, Thanks for the info on Lovenox. I read it is painful when injected. But maybe the folks were self injecting incorrectly and letting some discharge into the layer with the nerve endings as you noted. Hopefully with that in mind I'll be sure to get it all out of the syringe before getting the syringe out of me (or shall I say my husband, cause I'm won't do it!).

I think the issue is the speed with which the needle is withdrawn. When inserting, best to do it not too quickly as that is more painful a prick but withdrawal is best done sharply so any little drop left in the tip of the needle doesn't have a chance to discharge in the epidermal layers of the skin. So says my expert witness (my sister!!).

The issue about lovenox and spinals is actually on the Lovenox brand web site, still a concern to me. My DR (US) puts us on a 28 day course, similar to what you mentioned as well.

Yikes!! I never saw that one! In your shoes I would want a long conversation with the anaesthetist beforehand! And I don't blame you one iota for being concerned.

My best interpretation is that it is warning against the simultaneous use of the drug in concert with an epidural/spinal. When what actually (usually) happens is that the first dose is given at the conclusion of the surgery or maybe even in the ward the next day. As far as I am aware, what is more commonly used in theatre is standard heparin not the low molecular weight heparin that enoxaparin is, but then that is in UK hospitals.

However, if this is generally known information - in that it is put up front on the website - then it is also known by the anaesthetists and I would be most surprised if they transgressed that safety requirement else they'd have been litigated out of existence!

I would also point this out to you .....

LOVENOX® was approved in the United States and Canada in 1993, and it has been available in Europe since 1987. LOVENOX® is the only low-molecular-weight heparin in the United States approved by the Food and Drug Administration in 7 approved indications for the prophylaxis and treatment of thromboembolic disease.


So it's been in use since 1933 - not a bad track record!

.

 

[Nursepair]

Jennifer, Yes I knew I was in the OR when I heard the hammering. I assisted in quite a few TKR's back in the 70's so I guess I was used to the fact they use all the Black and Decher tools.

Pattipoo, I never requested an epidural, it was the anaesthetists choice. We had a colleague of Kevin's staying with us for 2 weeks just before Christmas, he was an aneashetist from Austria. He had also said that epidural is a good way to go, that the pain is less afterwards, short term that is. They give you a strong sedative too so you don't worry or remember much. The only thing I didn't like aboutit was that awful feeling after that you are paralised. It took a couple of hours for my left leg to get feeling bac, and a couple of days to feel my operated leg, so that was an added bonus re the pain.

 

[Rowdy66]

I apologize to Patti, I thought I told you, honestly. My surgery is scheduled for April 7. Right after spring break is over. Would have been the third weed of March but Spring break took the residents in my surgeons office out and he was going on a weeks vacation and didn't want to do the surgery and then leave me here without him. (I don't think he meant he wanted me to go on vacation with him, lol). And Jennifer I am with you, the end result is what I want, not the surgery but as it is even minimal walking is now causing me terrible pain so nothing could be worse afterwards than the way it is now, at least after there will be an end to the pain, there sure isn't an end to it the way I am now. So April 7 can't come too soon. As for the injections of Love^&%% afterwards, Jennifer you are really lucky your husband will do them for you. Mine would pass out, he has a terrible fear of needles. Turned dead fish white when I got my last knee injections, was just glad he wasn't on the floor. Maybe my son who is at the University will do the injections for me but since it is about 35 miles to my house from his I doubt it. Damn! I hate causing myself pain. Maybe I can inject my husband, huh?

 

[Josephine]

Truly, the ready loaded syringes are soo tiny and the needles almost like fuse wire to you wouldn't be causing yourself any more discomfort (not pain) than you would if you pricked yourself with a sewing needle whilst doing embroidery!

My sister (not the one with the TKRs) is diabetic and has to prick her finger regularly to do blood sugar tests. When she got her machine, she had me on the phone while I talked her through doing it the first time. She was sweating and feeling nauseous and faint!! What a palaver! I finally got her to do one and then to do several in quick succession. Well, she's been using it now for around 10-12 years now and hardly gives it a second thought. However, I gave her my old TENS machine and I'm trying to get her to use that ..... here we go again!!

Footnote ... she has been using a computer now for almost five years, has her own forum and does so much other stuff. Two years ago I bought he a memory stick for Christmas and she didn't get around to using it for over a year because - she couldn't figure out how to use it!!

 

[NuNeez519]

I have been self administering Lovenox 2x per day, don't feel a thing. Maybe for a fraction of a second after the needle comes out I feel the rubbing alcohol going in but thats about it. I have a 20 day supply and that maybe the end of it, I will know Mon as it will be my 1st Post-Op OS visit. As far as side effects just google the drug and you will find everything you need to know. Hope this helps. Also I had a spinal and I am 6'1'' and 300lbs and I know the Anasthesiologist had a hard time geting it in dueto my size, but had gotten it in and I will use the same Anasthesiologist and spinal the next time.

 

[JenniferG]

Hubby says no prob now about the shots but we'll see. You should have seen his face when he came to keep me company for the self blood donation. I have nurse & CNA neighbors and a Med assist sister who draws blood and gives injections, so I should be OK. I do feel much better about the Lovenox after hearing all the experiences with it. Thanks guys. I tell you what though. Any & all things I swore I would never submit to; cathetar, spinal, bathing assists, sleep tests, and so on, are reality. Dignity issues. Is taht what I'm trying to say. Never say never I guess is the moral.
Now more on the anesthia. I don't want to "not remember" I don't want to know period. When it happens, during or later next day memory. are there different levels of knocked out aside from General. All your descriptions seem to vary. I don't even want to know that I am getting the spinal. Also, any one live to tell abouth the cathetar experience? I think that only applies for Bi lats beacuse of length of surgery. I can't wait til I'm on the other side and can share hope and experience instead of just anxiety and ?'s Thank Jen

 

[Pattipoo]

The worst part is the waiting to have surgery. It's an anxious time! I was completely knocked out for my surgery....right before I went into the operating room, I was given a nerve block in my right leg. It involved a very "stingy" shot in the front top of my leg and then they turned me over and put another very "stingy" shot in the back of my leg. Before long, my leg was DEAD!!!.....felt so weird....then they took me to the operating room....made me tell which knee I was having replaced and then I was put in LALA land.....next thing I know...I'm back in my room. I don't think I could handle it the other way!!! My hat is off to you, girl! I didn't have to do any of the self injecting thingies....I really don't even know what your talking about. Why do you have to do that?

 

[JenniferG]

Lovenox is the blood thinning agent that my OS uses so we don't get blood clots. 1 shot a day for 28 days after surgey. They tell us our knock out will be spinal & IV "happy Juice" ( my words) The PA said it will make it so I won't care about all the pre-op stuff, (Spinal, cath)

 

[Pattipoo]

Okay....I understand now. I was on a blood thinner in a tablet form....Cumidin. I suppose your spinal is the same thing I had with each of my c-sections. You'll do fine. Make sure you check back in as soon as you can....we'll be waiting to hear from you.

I was very anxious before my surgery....be assured that they'll put you at ease as soon as you get to the hospital. They're VERY good at that.

 

[Nursepair]

Just checked up on the coumadin, I had the same, it's warfarin, rat poison. Didn't know all this other info about vitamins and Advil etc. Here is the website https://www.drugs.com/coumadin.html

 

[Pattipoo]

I took rat poison?? REALLY??