Pre Op Depression & Questions

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Roo73

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I finally have my consultation visit with a new surgeon (a second opinion sort of) but it is a month away. I've been REALLY depressed (I've been on an anti-depressant for many years and I normally feel pretty good) and so lethargic waiting for my records to get transferred. Is this normal? Is it only the pain that's eating at me? I have so many questions and being a worrier, I would like to ask Josephine and the forum some of them. I'm sure the surgeon will answer them too, but it seems very far away. Should I be FORCING myself to exercise even if it hurts in preparation? I'm overweight but inactive because I am just exhausted from fighting pain every day. I work full-time and take mild pain killers to keep me focused at my job. Should I be trying to lose weight before the surgery? I am 53, 210 pounds, 5/2". I know the risks of the weight problem, but is it a good idea to start something before the surgery? Also, in regards to my job - I am a bookkeeper so I have a sit-down job. My boss is a really nice guy who says I can work from home (since I live across the alley from work). My question is a) will I FEEL like being up for a bit at first - maybe an hour a day for work once I get home from the hospital? (I know it's different for everyone but just a generalized answer would be helpful) b) I live alone in a second story apartment with 22 stairs. In fact I think that's why I've stayed as mobile as I am. I HAVE to go up and down them every day to go to work. My sister works in the office below my apartment and can check on me during the day, but will I NEED to have someone with me all of the time at first? I am SO excited at the prospect of walking again without pain and losing weight and feeling good about myself. But I am also afraid - I'm a wuss when it comes to pain and I've had a baby!! I'm am so impressed with this forum - everyone here seems very positive, very helpful and honest, and the posts are intelligent and address questions so well. Thanks in advance!
 
I didn't feel like doing too much except resting and existing the first week or so after my surgey, even with pain pills. The pain pills actually made me drowsy which was good because I needed to rest. This is major surgey and your body needs time to heal. If you have some vacation/sick time uuse it. Maybe you will go to rehab for a few days. Anything you can loose in weight will be helpful. As far as hurting the bad knee, I can only say what my PT said to me before surgey. To do what I could tolerate as far as pain level because they were inevitably going to remove all the broken parts of the knee anyway. That was me and my knees. But it made sense, use my pain as a guide.You just have to make sure you don't hurt anything else. Checking with a DR.is always prudent if you are noot sure. As far as mental stuff, I don't know for me if I would have called it lethargic or depressed, but focused. There were a lot of tests and preparation needed to get ready for the surgery and the closer it got, the more I focused on it.
 
Constant pain can make you depressed. But yes, you should be trying to lose weight. Even a few pounds off will make a difference to the way your body copes with the anaesthetic, the ease with which you start to get around afterwards and your rehab in general. Much easier to move a normal sized leg than a big one!

As for will you feel like work - I can pretty confidently say you won't! You will be more than happy to spend your first few WEEKS(!) snuggly in your home, trying to cope with your new knee. Trust me, it's not worth thinking about. Apart from which, this is MAJOR surgery and you are going to need some MAJOR rest in order to give your body all the help it needs for your healing. Healing takes a LOT of energy and you will have none to spare for even an hour at work - cus it's not just the hour at work, it's the getting up, getting dressed, getting down those stairs and to your place of work. Don't even think about it!

I would suggest you will need someone with you for a few days at the very least. You are not going to be able to do much because your new knee will demand all your attention!!! Plus you will be very grateful to have help with all sorts of things like getting in and out of bed, never mind getting yourself a meal.
 
Roo

I think finally making the decision and scheduling the surgery will help. I found the mental back and forth exhausting.

I was doing some exercise all along even though it does increase the pain and I am really exercising now that surgery is a month away. It is making the pain worse on a daily basis but I figure the trade off that rehab could be easier worth it. I am taking a few more aspirin. What I really am worried about is having to stop the aspirin 10 days before surgery as that will really send the pain up. I am talking about 12 to 14 aspirin a day and that just takes the edge off. Fortunately after all these years the pain tolerance is pretty high.

As for weight loss, it will help. I have delayed surgery to lose the 40 pounds I gained after losing a lot of weight in the two years before. Check with your doctor or a dietitian for help. I found on the second go around that reducing the amount of carbohydrates (by eliminating bread, pasta, rice, potatoes and corn) did the trick. I am not saying the extremes of things like Atkins but depending on your needs to something like 30 or 40% carbohydrates and those being veggies, fruits, legumes and beans.

I give you credit for living in a place with stairs. I have avoided apartments like that for years. I also live alone and I am working with the hospital case manager about staying in a inpatient acute rehabilitation place (in my case the hospital where I will have surgery also has an approved inpatient rehab floor) for about a week. My family is all out of state and I just moved to the area so I really don't have anyone that I could ask for major help. Of course this depends on your insurance company.

I work from home so it will be interesting to see how fast I want to do some work. I am having bilateral tkr on June 3rd and will let you know.

Good luck

Roberta
 
I I'm am so impressed with this forum - everyone here seems very positive, very helpful and honest, and the posts are intelligent and address questions so well. Thanks in advance!

"the posts are intelligent?" Are you sure you have been reading THIS side of the forum? You are not confusing us with the "hippies" next door? LOL! We've had some pretty "out there" threads and posts to threads that *started out* intelligent! But laughter is a great healer-- and we've had a lot of healing to do!

Seriously, welcome and yes-- do everything you can to prepare for your surgery. It can only help in the long term. And DON"T try to go back too soon--- even to a sit-down job---isn't that right, Patti? You tell her, girl!
 
Okay, the smarter eating starts right NOW. That I know I can do with the motivation that healing will go better with a smaller leg! (I knew that - I think I just needed reinforcement!)

The work thing DOES concern me though. I will be taking a week of vacation time for my hospital stay but I know if my stay there should be extended for any reason, they will understand. And I wouldn't have to actually be completely dressed or even go down the stairs for anything except dr. visits or healing/therapy as people will be bringing everything to me, but if I schedule things right, I won't have a lot of pressure and can stay home as long as necessary with VERY minimal work. I guess I was just anticipating feeling well enough to sit at my computer briefly to do my minimum daily work. I actually thought having something to distract me might be good for me - guess that was wishful thinking, huh?

And I will look into the rehab center near here for a short stay if I can. I'd RATHER be in my own place because I am a homebody anyway, but there really isn't room for anyone to stay with me even if I knew someone who could. I am the baby of my family and the rest of my family is older and really wouldn't be in a position to help me in and out of bed, etc. I will explore some other options in that area though. I have a feeling that I am totally misjudging the incapacitation and severity of this procedure. I guess I need to be more realistic. I will exercise more patience until I speak with the surgeon too. Thank you so much for your help and if anyone else has experience to share I will be more than happy to hear their stories of recovery!

And Jennifer, walking or being on my feet is of course, very painful and I have become concerned about the pain in my hip as well, wondering if it is damaged now or just inflamed. Again I guess I will know more after I talk to the doctor, right?

Everybody, keep talking to me so I will stay on the right track. You are all so positive and hanging in there and I'm embarrassed to be such a wuss!
 
I guess I was just anticipating feeling well enough to sit at my computer briefly to do my minimum daily work. I actually thought having something to distract me might be good for me - guess that was wishful thinking, huh?


Laptop? Maybe------ Desktop?--- not for a while.

I have a laptop and could sit in my recliner with my leg elevated... but couldn't sit at a desk comfortably for ---- a couple of weeks and then not for long....
sitting on the *toilet* was painful.....

What do the rest of you "desktoppers" think?
 
Roo....you sound like you are very much in control of your situation at this point. I wish I could say I was when I was at your stage! I would recommend you doing some things for yourself in advance. Find out if your insurance covers both a walker and a cane. You'll need both. Find out if you can have home health come to your house for therapy. Get gel ice packs (more that one so you always have fresh ones in the freezer) or make some with alcohol and water in double bagged ziploc bags. Even better if you could have a small cooler or frig by your bed or couch where you will be most of the time. Many of us have ended up sleeping on the couch because it was more comfortable. Sleep may be disrupted at several points during your recovery and you have to get it wherever and whenever works for you. After the first week or so, you may feel good enough to do work if people brought it to you. But honestly, I wouldn't recommend it. As Josephine said....your JOB during this time is to heal and you need to focus on it. It will help you get your range of motion back faster if you do little bits of exercise all through the day (and sometimes in the night, if you can't sleep). Don't worry....you will always have this group 24/7 to talk to! I wish you the best and keep asking as many questions as you want! Information is POWER for what you have ahead of you.
 

What do the rest of you "desktoppers" think?



I use a desktop and had no problems sitting at it for short periods even the first week. That's when I joined this forum!! But.....in addition to using the computer, also took my 'pooter time as an opportunity to bend and stretch my leg....that really helped. But it probably has a LOT to do with how much swelling you have after surgery. I had relatively little swelling and was able to be up for periods of time. I also iced almost every hour for the first couple of weeks, though....it may have helped.
 
Roo,
It sounds like things are flexible, workwise, for you so that's good. Personally, I couldn't have done anything related to work the first two weeks. Too many drugs and you just need rest and exercise. I think two weeks is the minimum before you should consider putting even an hour into your work and then at home as you described. It's going to be hard to sit in a regular chair with your feet on the floor for any length of time. I wanted to keep my feet elevated for several weeks.

You just never know how quickly or slowly you will recover so keep that in mind. Keep reading and gaining knowledge between all of our Tom Foolery. We're here to help you. Stay positive! Karen
 
I couldn't even think about going near my computer (desktop)for at least 2-3 weeks, and I can't stand not being able to be on it usually. I didn't actually even think much about it, I was in pain and on a lot of pills then too. It hurt to sit upright, underneath my thigh, almost as if I was sitting on my sciatic nerve. At about 5 weeks I started to do some computer work, but could only sit half an hour at a time max then.

Surely you will be able to take sick time for a while with a doctors note right? Then use you vacation. I am also a big wuss, so if I got through it you will too, guaranteed!!

Get busy before you go in and freeze small portions of home cooked meals. Then later a slow cooker is a real assett!

Good luck. Keep your chin up. ((((HUGS))))) Sue
 
Jamie, why alcohol and water? Why not just water? I've been reading about Polar Care units too - what is everyone's general opinion of them? I have collected a walker, a raised toilet seat and I've had a cane and a "chair" cane for over a year that I take with me to auctions (which I love and am REALLY looking forward to enjoying again NEXT summer after the surgery). I also have crutches from my last scope but I find them extremely awkward. I think I'm more likely to fall down and break my leg with them! I will ask my insurance company about the home health care issue too. I have a loveseat (not exactly conducive to comfort in this case) but I have a recliner coming for recovery. I was glad to be warned that there will be rough nights of insomnia and some twitchy legs! That would have really freaked me out had I not read about it in advance.
 
If it was just water, it would freeze solid and be unusable as an ice pack. The alcohol make it pliable and sort of slushy so you can mold the baggie to your knee. Everyone raves about the Polar Care units, so if you could, it would probably be a better option....easier to use.
 
My hubby just bid on a Polar Care unit on ebay for me, got it for $30.09 US. can't wait 'til it arrives. Beach sys they are great.
 
Laptop is the way to go if you can. Never mind what I felt comfy doing, DOC's orders were to keep the leg(s) up. I was allowed to be in a normal sitting only 20-30 mins a time for about 3 times a day. They said if I wanted to sit at the table with my family for meals. That was the first week at home or so. Other wise up and walking around or feet up. Blood clot/swelling thing.
Roo, I have had some relief (alot) with my hips since the surgery. I had both knees done and was to a cane before and after the surgery. Now I only use the cane for stairs, not walking. Once I fixed the knees and retrained my walking so it wasn't straight legged and ditched the cane which added a hiccup to my giddy-up the back & hip feel better. Keep moving! Stay as nimble as you can before, it helps later.
 
Recliner is also a good plan. I bought one especially for this adventure. My BR is on the 2nd floor and the bathroom was downstairs. I got a nice one so it looks nice as just part of the LR.
 
I bought a recliner for the last scope (2 years ago) I had but it was a second-hand one and it broke several months ago, but I have since tracked down another one.

I have to tell you all - I slept better last night after reading all of your replies than I have in weeks. Just having INFORMATION was enough to settle my nerves and get me in a more positive mood this morning. I guess it was worrying me more than I thought.

Well, I need to go stop in at work this morning (even though I don't work on Saturdays) to take care of something so it's down the stairs and across the alley. Surprisingly, it is not as painful as you might think since I do it every day. Granted, it's not pain free (especially before my meds kick in in the mornings) but it's tolerable. I'll never be able to run up them, but that's ok. And I've never used a laptop but always wanted one. Maybe that's what I can do with my tax credit!!

I will try not to bug everyone while I prepare for this as I know surgery is actually months away probably but now that I have somewhere to go to read about what others have felt and done, I feel much better.

Please let me know of anything else you think will make this easier or suggestions on how I can sort of maintain my sanity and my job. LOL.

Joey
 
Not bothering us. We love newbies. As your questions come, fire away.
 
Roo.....you will NEVER be a bother if you post to tell us how you're getting along or ask questions that come up! That's the purpose of having your BoneSmart family here for you! Stay positive!!!
 
Roo

I am going to borrow a lap top from the guy who fixes my computer. When I bought my house, one of the first things I bought or rather had made was a u shaped desk that is about 6 inches deeper than your normal desk. I did this as I have always sat with my feet up (I have a great leather bear foot stool) and could never do this at work or with most desk as I am tall so my legs would always hit the back of the desk. This desk has been great. it was a standing joke at all my previous jobs that they knew where I had been as the trash can was upside down (good for foot stool).

Thanks for the info about the polar care unit, my suggestion is frozen peas or corn so that you can mold them. Someone also told me about CyroCuff which has cold and compression as well. In the past I would occassionaly use a pint of Ben and jerry's ice cream as that solved a couple of problems. The problem of course is the weight gain so I dropped that one.

I must have been participating this day as I decorated the living room with 3 recliners. I might even move one out to the enclosed porch. I live in rural vermont and from my porch (as well as all the windows) I look out at a beautiful forest of trees filled with birds. Very relaxing.

I am very lucky as about 3 years ago my company was bought out and the new company has outstanding insurance (what a rarity these days). It looks like they will cover the short time inpatient rehab, home health for some things like nursing, physical therapy and possible personal care as well as necessary medical equipment. You can also participate in a FSA plan which allows you to put aside pre tax dollars into account to be used for deductibles and non covered medical items. This saves money as it comes out your pay before taxes are calculated. Anticipating the surgery I really bumped up the amount that comes out of each check. The main problem is you have to use it or lose it at the end of the year so it is a bit tricky figuring out how much to put away.

I have saved up alot of sick time as well as vacation time so I should be ok for a few months.

The hospital - doctor office have put together a total joint program that includes a preop class to find out about pt, ot, surgery etc and meet with the OR case worker who will work to organize all the pre and post care you need and deal with the insurance guys.

Another advantage I am finding out about Vermont is that all most all the health care institutions are non profit/community based and in most cases you only have a choice of one "company" to deal with like home health. This can be good or bad but I find it working well as you don't have to figure out who is the best and being nonprofit and overseen my the state patient care not profit is number one. Coming from Los Angeles that is a big change.

Take care

Simon
 
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