TKR Second TKR Done, but still not very patient

[NetballKnees]

Hello fellow Bonesmarties ... I have resurfaced again. Have had terrible time with health issues the last 6 weeks or so. Was taken to hospital by ambulance with severe chest pain in June and following a blood test showing an elevated troponin level, was admitted to the coronary care unit. There followed a lovely week of poking, prodding and more needle pricks than I liked. A number of dye CT scans and an ultrasound guided insertion of a cannula due to horrible veins. However, an angiogram at the end of the week showed clear arteries, so they completely lost interest in me and sent me home.

However an ultrasound showed multiple gallstones and I now have to have my gallbladder removed on 8 August. My second TKR is booked in for 21 August and I am so confused as to whether to go ahead with that or not.

I also had a chest infection/bronchitis for 4 weeks and needed 3 weeks off work, which is severely cutting into my recovery time IF I do have my right knee done.

A quick update on the status of my already replaced left knee is that I still only have a maximum bend of 85 and only on exceptionally good days, with about 75 being normal. Still can't ride any kind of bike. Still can't get up off toilets and most seats without either being helped up or levering myself up by pushing off the cistern or a wall or whatever is handy to the seat. Still have difficulty putting socks on the replaced leg because it won't bend enough. OS is not interested in MUA and says he thinks this is as good as I will get now - maybe a few more degrees - maybe. AND I still feel very envious when reading other Bonesmarties who achieve a 90 degree bend in a couple of weeks.

My right knee is deteriorating very quickly. Have so much pain at the back of the knee (OS always said x-rays showed most of my damage was at the back of the knee). And there is also very bad pain which seems to be in the bone just below the actual knee and I am not sure a replacement would fix it. Also, I could probably only have 6 weeks off maximum this time whereas I had 12 weeks off with the left knee and needed all of that time. And now that I live on my own, there is no-one at home to help.

I know many, many Bonesmarties coped with being on their own, but I know for the first week or two, I was a big sook and certainly needed help as far as looking after the animals went, in particular. I really need some in making any decision and it has to be soon because it is nearly August. There is also the financial consideration of paying for gaps in hospital costs, surgeon costs, anaesthetist costs and assistant doctor costs and this is times two because of the gallbladder removal. What to do, what to do

I apologise for just concentrating on me in this post. I do hope everyone of my Bonesmartie friends is well, recoveries going great and enjoying life. I will catch up with you all next time.

Take care everyone ...
Hugs ... Ellen

 

[Celle]

Hi Ellen, @NetballKnees
I'm so sorry to hear that you have been having such a bad time! You've really been through the mill.
Yes, you really need to get those gallstones dealt with, so removing the gall bladder as soon as possible is necessary.

However, I think that you need to contact your orthopaedic surgeon and tell him about the gallbladder surgery. He might not be happy to go ahead with the TKR on 21st August. It's a bit soon after the previous surgery. At the very least, he has to be aware of it.

Have you thought about seeking a second opinion about your first TKR knee? I don't know your full history, but I would not be happy with the result. Nor would I be happy with your OS's disinclination to do anything about it. It seems a bit cavalier to me.
I'm also not sure that I would be entrusting the second knee to him, after the poor result from your first knee. At the very least, I'd be insisting on an MUA on the first knee while you are sedated for the second TKR.

I am going to be a leetle more aggressive with therapy
this time around though and see if that makes a difference.

About the above, which you said in an earlier post:
That's not what BoneSmart recommends. Remember, you can't make a knee recover by working hard at it - nor can you make it recover faster. What you can do, though, is irritate those healing tissues, so that they get more inflamed and actually slow down your recovery. Work smarter, not harder.

Best wishes, my dear. You have some hard decisions to make.

 

[Jozilla]

Oh my goodness Ellen. So sorry to hear all you have been thru. I was just hoping things were moving along for you. Celle has given you the advice I would have. If it were me I would postpone tkr for another month. It sounds like an awful lot to deal with. I have been thru the angiogram too. I had three positive stress tests a few years ago. Thankfully turned out to be false positives as my body does not absorb the iodine! Then got pneumonia three times. Seems like a long time now but was very run down for awhile.

Please take care and let us know how you are doing. Maybe tag Josephine to give you advice on the surgeries!

Xoxo JoAnne

 

[maryo52]

You have three main areas of concern: One is just catching your breath after a series of non-knee health challenges. Two is your limited ROM TKR. Three is your "bad" knee.

Surgeries are not like haircuts ("Don't worry, it'll grow back.") I think you should continue what you are now doing, and consider your options long and hard. Do you have a friend who is a nurse? Such a person would make a great ally.

How are you going to deal with a new post-TKR knee when you're "good" knee isn't bending well? Are you having this knee done with the same person who did your first knee (if so, I'd think again)?

You need a plan of action for each knee, working with an ortho consultant to time it and think it through with you. I don't know what your 75-85 degree knee has been through (too lazy to go back through the posts), but if you've had a MUA and you're still stuck, either your knee was put in wrong, or the arthrofibrosis has "glued" your knee together. An arthroscopic removal of scar tissue might be just the ticket.

This would be a time to get some second opinions (more than one if possible). I sought two, and they both came to the same conclusion but had some different things to say, and between the two, I was able to wrap my mind around the problem.

Good luck! Cases like yours underline how lucky I am to have a knee that's not great but OK.

 

[knees]

I'm sorry you have been through so much! I don't know enough to give you advice but I will pray for you. Praying for good health and good knees for you. That everything will be well. God bless

 

[Nana moon 27]

Hi @NetballKnees it's lovely that you are in touch again. I'm sorry to hear of your health issues. If it's any consolation I cannot get up and down off the loo now, I've had to out the frame back up, I got stuck on a garden chair and had to be lifted up by my 86 yr old father in law and my eldest daughter. Still no driving, shopping, work, nothing. My health issues are not as bad as yours but they're there. My TKR is swollen and will not straighten after all this time, Recurrent chest infections, three angina attacks (I had the same CT/dye scan as you) and I'm awaiting results from a load of different clinics and hospitals. Like you I'm fed up with the lot.

Ellen this is YOUR thread and you are allowed to focus in yourself. This is why it is your thread for that reason so you can have a discussion about your current health issues and situation. Lord knows you deserve to after all you've been through. I'm so sorry about that.

I'm sending you the biggest virtual hug I can, from across the pond to you!

Love from Nana moon 27 x x x x

 

[chestnc]

Hi @NetballKnees, wo when one thinks they are having a hard time, you look at someone else who is having it 10 times worse. I am so sorry things are so tough for you. I can only hope and pray that things get better. My prayers are with you.

 

[kneeper]

My feeling would be to postpone the tkr a bit so you're fully recovered from the gallbladder surgery and can go into the tkr strong.
Glad it wasn't cardiac.

 

[Jozilla]

I do think whole heartedly you should see another surgeon. I believe your tkr knee could be much better. If it was me I would see someone else. Xoxo

 

[Ellejay]

Hi Ellen, great to hear from you, but not great to hear how unwell you have been. I so hope that you have lots of kind and supportive 'real' friends that can give you physical help. We can give all the virtual support you will ever need, but you need a real pair of arms to give you a hug, (and a lift you off the toilet).
I would definitely think about postponing the 2nd TKR until you have recovered from the gall bladder op, and also get more advice on the bend of your 1st TKR, it doesn't sound as if it's good enough for everyday life. I am so sorry that things have turned out like this for you, you deserve so much better. I only wish I could do more, but I'm always here for you, to listen to you, to chat, and it can only send you a really big virtual hug. My thoughts are with you as you make your very difficult decisions xxxx.

 

[GimpyGal]

@NetballKnees , I've been thinking about you and your situation ever since you posted this. You've had a rough go of it, haven't you? But, what choice do you have but to keep looking forward?

Firstly, get that gallbladder out! You'll feel so much better and it's not a difficult recovery. Then, that's out of the way. Problem solved.

Secondly, frankly I don't like your OS much. You should have better results as you need that knee to be ready for your next surgery. It's probably already 'better' than your other one, but it's not good enough. I would not want to have that surgeon do another knee, based on his past performance and attitude.

If a second unbiased opinion offers the same projections, you'll have lost nothing.

I want to send you some Internet hugs and tell you to stay strong. Man, I wish I lived close by to be that person to help you in your recovery. :(

 

[NetballKnees]

OMGosh ... thank you all so much for your heartfelt responses. I have felt very alone while I was in hospital and ill, although my daughter was a tower of strength and is still supportive. My boys are too but in different ways. I should have been on here annoying you all.

I am going to ring the OS rooms today to leave a message (I know he is overseas at a conference or something). I have decided to go ahead with the gallbladder surgery. I really don't want that pain again.

As for the knee, deep down I think I am scared to go back to square one. My patience has not improved and I know what a trial the first 4-6 weeks are. I know no two knees are the same and the right one may sail through, but what if it's worse???? Couldn't stand that.

I am a bit emotional hearing from you all and reading your heartfelt wishes and thoughts.
@Celle ... thank you for your considered and wise words. I appreciate it very much.

@Jozilla .. JoAnne ... lovely to hear from you again. Strange that you should get pneumonia after all the stress of cardiac tests and after mine, I get a bad chest infection and bout of bronchitis. It feels so nice to be "in contact" again after all this time. I can see, and greatly admire, how you are going around the forum offering support to others.

@maryo952 ... More lovely wise words. FYI - I have not yet had manipulation and OS seems reluctant to do one. I must admit he seems "disappointed" in me for not having a better recovery.

@knees ... Always so happy to have a new Bonesmart friend. Thank you for your prayers.

@Nana moon 27 ... Thank you for the hug ... I so need one, although I do get plenty from the kids. I am so sorry your recovery is not going well either. I am not sure what is worse to have a problem with - straightening or flexion. My replaced knee straightens beautifully I must admit, but the right knee (still to be done) does not straighten any more, and still bends okay, but with pain. I so hope things improve for you. xoxo

@chestnc ... Thank you too for your prayers. From the sound of it, you are not having too good a time of it either and I do hope things improve for you.

@kneeper ... Thanks for the advice. I think it will be easy to follow.

@Ellejay ... How wonderful to hear from you. I haven't checked out your thread yet, but hope everything is going well for you. Thank you so much for your thoughts.

@GimpyGal ... Absolutely fantastic to hear from you. Thank you for wishing you could be my "recovery person".

Because my "undone" knee seems to be deteriorating so quickly and the pain gets that bit worse every couple of days, I am a bit frightened that it will be so bad by the time it is done that it will make the recovery not as good as it could have been - if you understand.

I think a second opinion may be called for, but I am one of those people who hate to "rock the boat" so to speak, but it may be necessary in this instance.

Once again, thank you all so very, very much for taking the time to reply to my post and send such wonderful hugs, good wishes and prayers. You don't know how much it means to me.

Hugs to everyone ... xoxo

 

[Nana moon 27]

Hi @NetballKnees

I do agree that maybe you should go for a second opinion but I am not going to stand here and say y have to. Only you can make that decision. You should not be afraid to do this. It is yr body and it is yr human right xxx

Love Nana moon 27 xxx

 

[GimpyGal]

I agree with @Nana moon 27. It's your body and your decision. And we will be here for the long haul, whatever you decide.

Maybe your decision on whether or not to get a second opinion should ride on your answer to this. Let's pretend I wrote your post. What would be your advice to me? Because you need to treat yourself as kindly as you do your friends. You deserve the same treatment you'd want us to have.

 

[NetballKnees]

Thanks again @Nana moon 27 and @GimpyGal. I always have a hard time treating myself the same as I treat others. My daughter always tells me that if I treated other people the way I treated myself I would be a very lonely person.

I have spoken to the OS office and to the General Surgeon (who will do the gallbladder). I had a thought today. I wonder if I am going about it the wrong way. The knee is booked in for 21 August and rather than have the gallbladder op first, I am wondering if I should have the knee as planned, recover for the first 6-7 weeks and then have the gallbladder op and recover at home for a further 2-3 weeks, giving me 8-10 weeks before returning to work. I do have the leave left to do this without having to go on leave without pay (which I can't afford anyway).

The OS office staff were very friendly and helpful the other day and will get him to contact me once he returns from his overseas conference. They said they did not see a problem with asking him to give the left a little bend while I am under.

If I have the gallbladder op first, everyone feels that 13 days from one to the other is really not long enough and I also need to factor in the remote possibility that perhaps the gallbladder op may need to go from keyhole to open for whatever reason. That would then be a longer recovery time.

If I put off the knee op, the next available operation slot for this OS is not until 18 December and as I am going on a cruise on 30 December, that is not acceptable, which means it will be put off until next year and it is deteriorating so fast that I am afraid I cannot wait that long. For example, I could barely get the right leg into the car this morning as the pain behind the knee was so severe.

I have appreciated the advice to perhaps seek a second opinion, and I am not sure what specialist appointments are like in other countries, but here in Brisbane, it is likely I would have to wait a couple of months at least to get an appointment with another OS and then would have to fit in with their available operation slots, which could be months ahead anyway.

I am going to contact both surgeries tomorrow and advise that having the knee done as planned first and then the gallbladder may work better for me.

Thank you for listening to me talk around in circles about this.

I hope everyone on Bonesmart is having a great day and all recoveries are going well ...
Hugs ... Ellen

 

[Nana moon 27]

Hi @NetballKnees why don't you tag Josephine in and see what she thinks? That would be a good base for a second opinion. She has extensive medical knowledge and over 50 years experience. She might be able to put your mind at rest a bit. Only a suggestion but think it might help you xxx

It's lovely to hear from you

Love Nana moon 27 xxx

 

[Jozilla]

Hi Ellen - what to do what to do, I think tagging Jo is a good idea as she had the medical background as well as Orthodoc who pops in and out! Your logic of doing the knee first is good. The keyhole gallbladder surgery is great and way less invasive than regular surgery. I only give you advice that I would use for myself but I am not you! I think you have to think the tkr recovery will go well and not like your other knee. It will be wonderful if they can do MUA on other knee at same time. That knee has not been good to you and I believe can be better. Don't settle for anything - you deserve it to be functioning better! I will have my tkr in September so we will be recovering buddies. There are a bunch of us getting second knees done. We are either all crazy or happy with our new knees!

How are your lovely doggies and Sebastian??? I am going to be a gma again in February so I need tkr to keep up with the babies!

I have missed you - you were there for my recovery from day one. Glad you are back now! Xoxo JoAnne

 

[leejaa]

Ellen, oh my, you have been through the ringer more than once. It is so hard to decide when there is so much going on and now having to consider time off from work and pay. Keep considering options as you have. Your last idea seems really good if the surgeons agree. Make sure you stay on a low fat diet during this time to keep the gallbladder issues at bay. My husband had his gallbladder out a couple of years ago and it was keyhole so he was back at work in 1wk and really no issues. I hope the same for you.

It is just as hard to get an appointment with a specialist here - that is a specialist that has a reputation for good work and not just anyone. I have a great OS for most things but for my knee I wanted to go to someone who specializes in knees and hips and had to wait 7 wks to get in just for the first appt for a opinion - all that time I continued working but with a cane and extreme pain with walking. After that, had to wait 4m to get on his surgical schedule. It was worth it in retrospect but very hard to get through. I know how hard those choices are but only you can make them - I wish like so many others that I was closer to give you a hug, a cup of tea and an ear so you could just talk it out and then a helping hand in recovery.

Your daughter and sons will rally around and help you -- especially if you make plans and they know they need help. It definitely sounds like they want to be there for you but they will need to be told what you need. Maybe they can split up the neds and some of them take dogs for walk and others come and check up on you regularly or maybe you can stay with one of them for 1-2 weeks post knee just to see how you are before moving home. You have options and ask them for some help as much as you would help them or any of your friends. Maybe you can contact a nursing school and see if a student would be able to live with you for 1-2 weeks and offer a hand- might cost money but it would give you someone at home.

Keep posting - I am trying to check in somewhat irregularly but knowing you will be posting will keep me checking. We are still here for you and we care. Sometimes it just helps to get it down on paper (screen) and get it out - it can help to think.

Keep us posted on your decisions - and what the doctors say about reversing the surgeries. Many hugs for you. Lee

 

[bottomshollow]

@NetballKnees, if you have your gallbladder removed laparoscopically, you should be feeling pretty good in a week's time. I had mine out as an outpatient on a Wednesday--home the same day--and went back to work on Monday. Only restriction was no heavy lifting.

 

[Ellejay]

Hi Ellen, just popping in to say "hello" and let you know I'm thinking of you. I know nothing of gall bladder ops, so I can't give any opinion, but just wanted to send a big hug xxx