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Questions about MAKO surgery

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pdlinda

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Jamie:
Jockette:

After hours of research I was able to fine ONE ortho knee surgeon who was in network with my insurance. I was able to make an appointment to see him in his office near my home on Friday.

I was surprised he had an available appointment so soon but maybe it's a sign of positive things to come.

He is in practice for over 25 years and has excellent patient reviews, is affiliated with Banner hospital network (teaching hospital for the univ of Arizona) and has impeccable credentials (mayo clinic among others).

I have my X-rays.

I don't know if he uses robot assisted surgery but will find out.

I'll report back after my visit and aside from the questions regarding volume of these procedures he does per year if any other questions come to mind, please let me know.

Thanks so much.
 
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pdlinda

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Jamie:
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I had a very successful appointment with the new surgeon today. He is a 30 yr veteran of doing more than 150 replacements a month. He was very informative and caring. He answered all my questions with clarity and precision. He listens and is direct. I liked that about him.

He does NOT use any robotic assistance in his surgery. He received the training but doesn't believe the generation of software currently available is precise enough for him to rely on it. He thinks the software will improve in the future.

He took a # of x-rays of both my knees. He was glad that the ligaments and tendons on the knee I need the replacement on are in good shape. He told me he would be able to correct the valgus that I've developed. He said my left knee looks good and should be even better when the surgery on the right side is done.

As a bonus, his office is 5 minutes from my home and his PT facility is right up the road from my house.

He has a post-surgery planner who will assist me (with him) in determining how long I should stay in the hospital and whether I need skilled nursing afterward.

I am going to have the RTKR with him on October 9, 2019.

Now I have to cancel my surgery with the MAKO Doctor. Any suggestions as to how best to accomplish that task would be appreciated. I want to keep the call to the scheduler "short and sweet."

I feel so much better after meeting this surgeon. You really changed my thinking on this important decision for the better and the info and ideas you gave me were extremely valuable!! Thanks, again.
 

Jamie

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I'm glad you found someone you are comfortable with. That's very important. To cancel, just call the doctor's office and ask to speak with the surgery scheduler. Tell them you need to cancel your surgery date. No reason should be needed. They'll probably be happy to have the opening to plug someone else in. Should they push you about why or rescheduling, just say you'll get back with them, but something has come up that will not allow you to have the surgery that day.
 

Jockette

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If you must explain anything tell them something came up (which it did, you found another surgeon) if they persue further tell them “ it’s personal.” I would end the call then by adding thank you and hang up.

If they ask about rescheduling tell them you’ll call when you are ready. I use this line often as who knows when I might be ready to reschedule, if ever.
 
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pdlinda

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Sounds good!

Also, the OS I'm using is part of a very large practice as you suggested and they recently launched a patient portal so I can can ongoing dialogue with support staff and OS by email. I thought that was great!!
 
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pdlinda

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Jamie:
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ETA: In my post about the new OS, should have read 150 per YEAR
 

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Jamie:
Jockettei

ETA: In my post about the new OS, should have read 150 per YEAR
:heehee: Boy, my eyes read what I thought it should say.....I didn't catch the "month" and read it as 150 per year anyway. Thanks for the correction, though.
 

Jockette

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I didn’t notice it, either! :rotfl:
Fine advisors we are!
 
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pdlinda

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Jamie
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LOLOL....I know this OS Is very conscientious and experienced but 150 TKP per month is a bit TOO MUCH!!

The practice has a nurse scheduler, and a nurse case manager for transitional issues from the hospital. I will call this week to ask about transportation to the hospital and from the hospital home (24 steps to my apt)

I also will need home nursing and the doc said case manager (and he) would get that arranged once he sees how I do post surgery.

I have nobody to assist me. My daughter lives out of town and has 7 young children.

I made contact today with a very well recommended house cleaner because I will need help with laundry and housekeeping for as long as I am unable to do these chores myself.

I am a planner so am glad I have these weeks to get myself organized!
 

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Hopefully this case manager will be of great help. When you're on your own you definitely have to strategize a bit. having help with laundry etc. will be of help for your recovery because you can focus on the icing and elevating and controlling your activity level. Depending on your laundry set up you may find you can do it after a few weeks if you pace it.
 
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pdlinda

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I had been going for pre-op PT 2X/week since January at facility run by MAKO surgeon whom I'm no longer going to use.

I have exercise bands at home and know the exercises so I decided to do many of them this morning.

Of course, at the PT facility the PT assigned to me "worked" on my knee every session. They also used a "stimulation" machine. I can't do these 2 things on my own.

Right now, I'm getting ready to clean my bathroom and my bum knee is really hurting!!

I will ice it but am wondering if I should start continuing my formal PT with office of my new OS ASAP.

Any thoughts?
 

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Pre-op therapy is okay as long as it doesn't cause you any pain or swelling in your poor, damaged knee. What you don't want is to head into surgery with an angry, inflamed knee. So please don't overdo things either in exercising or home chores preparing for surgery.

If you were going to try any exercises, you'd probably be better off to stick with upper body ones that will give you more strength to get up from chairs, the bed and the toilet. You'll have plenty of time after surgery to regain leg strength. You won't be immobile at all after surgery....just slower in how you move for a while.

But, it's perfectly okay not to do any therapy or exercising before your surgery. It's only 2 months away. You're not going to gain that much trying to exercise now. Just do what you can do comfortably if you do exercise.
 
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pdlinda

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Jamie:

I do upper body exercises most days and my arms are strong.

Your advice makes a lot of sense. I can do a few things; however the new OS stressed that structurally my bad knee could be worse, thereby necessitating a more complicated replacement surgery. I'd like to keep it that way!!
 

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Whatever lower body work they're having you do, just be sure it isn't aggravating the knee more. Like Jamie said there's no need to work your knee into an inflamed, angry state right before surgery.
Simple things like "quad sets" which are isometric and many pts have you do after surgery are generally not hard on the pre-op knee.
Seated exercise like the NuStep machine may or may not work for you. I found I couldn't use it before my first knee--it was that sensitive.
Bottom line--use your common sense and listen to the knee a bit. (Good practice for after the surgery when listening to the knee is so important. :wink: )
 
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pdlinda

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Kneeper:

When I went to the new OS appointment last Friday, he bent both knees hard to see my flexibility? (Not sure about the measurement). Since then, the bad knee really feels weak and sore. I've been icing and using heat and there is some improvement but until it's not so sore I'm really not doing much exercise on it.

Also, the ortho hospital I'm having the surgery at emailed me a 48 page pre-op packet. In it there are 8 exercises they suggest I do every HOUR!!

I'll consider starting that when the soreness in the bad knee subsides.

Thanks for your inout as I navigate through all these steps toward the big day of October 9th!
 
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pdlinda

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Jamie
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I emailed the MAKO OS surgery scheduler today requesting cancellation of surgery using very simple, short statement as you suggested.

I asked for acknowledgement of my request so I could close my file.

No response today. Any suggestion for follow-up?

Many thanks!
 

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I know you’d rather not but I think you should call the office. It’s really important to make sure this is cancelled.

I would not be doing 8 exercises and most definitely not every hour. This is the time to practice doing what you feel is in your best interest rather than a standard protocol that everyone gets.

Judging by this information you may have to stand up for yourself when you’re in the hospital. There is no need for a lot of exercises in the first days after a knee replacement, so if they push you to do a lot, know that you have the right to decline to do them.

When I was in the hospital I was not given even one exercise. They just took me for a couple of walks. Walks are good.

You really have to take charge of the PT as too many of them have an aggressive agenda and that is not good after this surgery. I trusted mine thinking they knew best. As it turned out, the out patient facility I went to did not.
 

kneeper

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Kneeper:

When I went to the new OS appointment last Friday, he bent both knees hard to see my flexibility? (Not sure about the measurement). Since then, the bad knee really feels weak and sore. I've been icing and using heat and there is some improvement but until it's not so sore I'm really not doing much exercise on it.
Good. Ice is probably better but if heat helps, go for it. Post op don't use heat on the knee though.

Also, the ortho hospital I'm having the surgery at emailed me a 48 page pre-op packet. In it there are 8 exercises they suggest I do every HOUR!!
:rotfl: I would hope it's a typo, but probably not. :umm: Just use your common sense. You might want to do some of them each day but not each hour!
 
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pdlinda

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Jockette:

I just received TKR cancellation email from original MAKO OS.

They were very gracious.

You gave me great advice. Thanks
 

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