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Discussion in 'Knee Replacement Pre-Op Area' started by Mollymax, Jun 10, 2018.

  1. Mollymax

    Mollymax senior
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    Hi all. I am scheduled for left knee replacement on 27 June and am terrified.

    I have had 7 bouts of cellulitis in that leg and have lymphodema in it but surgeon seems ok to go ahead with replacement. My biggest fear is I am petrified of needles and even more petrified of pain. The idea of a spinal is scaring me witless. I have already told them at pre op that I won't let anyone put the canulla in the back of my hand If they try I will be out of there sharp.

    I am so petrified I still haven't ruled out cancelling. I am so scared of the pain after the operation but I really want to get better knees. I do long distance walking and I am struggling with the miles. I have forgotten what it is like to walk normally.

    Had anyone else gone through fear like this? How bad really is the pain on recovery? Sorry for such a long post but I am terrified.
     
  2. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi and Welcome to Bonesmart, best place for information and support in anything related to knee replacement!

    There will be pain, yes, but it’s temporary. Keep that in mind. How much pain, no one can answer, we are all unique, so we can’t compare ourselves to others.

    All of us here on Bonesmart have been through replacement. Many of us were as terrified as you, :console2: so we understand.

    Hang out here with us here, both before and after surgery, ask your questions, rant and vent all you want, and share your accomplishments. We are an awesome group!
     
  3. Celle

    Celle FORUM ADVISOR Forum Advisor

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    @Mollymax,
    You know that you have to go through with this surgery, because your knee is never going to get better without it.
    If you don't have the surgery, your knee will continue to get worse and worse, until eventually you're an invalid.

    You need help to get over your fear of needles. Did you realise that it is possible to have your skin numbed first, so that you don't feel the injection? They do that for children. They put some anaesthetic cream on your skin and cover it with a dressing. About quarter of an hour later, the cream will have worked and you won't feel the injection.

    You will need to have a drip, and you will probably have a spinal anaesthetic, but you can be given some sedation, so that these don't seem so frightening.
    Having the drip means that you can be given pain relief through it after surgery, instead of having further injections, so it's a good thing to have.
    No one is going to stick needles into you unnecessarily.

    You can deal with this. Having a few injections is much better than continuing to suffer long-term knee pain and becoming more and more disabled.

    Tell your surgeon and anaesthetist about your fear of needles, so that they are aware. You won't be the first person they've encountered who has this fear. If they know in advance, they will be able to help you.
     
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  4. Celle

    Celle FORUM ADVISOR Forum Advisor

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    @Mollymax - Ask you surgeon for help in dealing with this before your surgery date. He may agree to your own doctor prescribing something to calm you, but he must know what medication you take.
     
  5. Roy Gardiner

    Roy Gardiner FORUM ADVISOR Forum Advisor

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    I am 6 feet tall and ain't scairt of nothin' nor nobody. And if you believe that, I have a fine motor car for sale, carefully maintained...

    Seriously I too was PETRIFIED before the surgery. You are not alone.

    Explain to the medical people how you feel. It is bread and butter to them. Request a tranquilliser before the thing starts, a big dose. You will not feel the spinal, trust me, I know; you will experience Time Travel - from pre-op to the recovery room without anything happening in between. The day of surgery is (a) without all the lead-up fear, because it's The Day (b) pain-free because of the medication. It is the easiest day of all!!

    It's bad, but different. It's not that stabbing, murderous, relentless pain you have now. It's controllable (you get medication) and reacts well to the correct treatment (sitting and watching telly. That's it, no more than that). It's a blessed relief by comparison.

    On The Day you will need to face your fear; but you will - if I (the biggest Girls Blouse on the planet) can, you can.
     
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  6. Mollymax

    Mollymax senior
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    Thanks for replies. I am not in too much pain at the moment. I can't walk properly or go up and down stairs and going down hills hurt. Turning in bed is very painful and I can't get comfortable.

    My surgeon says knees are pretty knackered and doesn't understand how I am managing to go out and walk marathons. Maybe the pain isn't as bad as the xrays suggest it should be. For this reason I am terrified that the pain after the operation is going to be unbearable. I have a very low pain threshold. The thought of being in unbearable pain for weeks after is really putting me off.

    Yesterday I walked 4 miles and was in a fair bit of pain but is it enough to make me go through with the operation. Then I have to get the other one done later. I have told the nurse they will be dealing with a 4 year old not a 64 year old as I am so terrified off it all and the pain. Am I being really stupid?
     
  7. Roy Gardiner

    Roy Gardiner FORUM ADVISOR Forum Advisor

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    It won't be. It's what medication is for, and it gets better pretty quickly
    No. It's perfectly understandable.
    ASAP is my advice, otherwise you're just marking time.
     
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  8. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Molly, nothing you have said is either stupid or unreasonable. Let me tell you some examples:
    - for most of my life I worked in the operating theatre and I helped with many, many spinals. The idea of them made me feel very squeamish and I always said that if anyone ever wanted to give me a spinal, they'd have to catch me first! However, when it came to it, I complied and found it really wasn't that bad after all! and I had another 6 years later!
    - during mu career, I've spent a lot of time reassuring patients in the prep area while they waited to go to the anaesthetic room. It got so I could tell a phobic patient as 20 paces and would always take time to speak with them and reassure them. I can say quite honestly that if I'd had a pound for every time my scrubs have been soaked with tears from these patients, I'd be a very wealthy woman! So you see, it's a very very common thing.
    - Celle is right about the anaesthetic cream - it's called Emla. Feel free to ask for it for both the cannula and the spinal. Theatre staff want patients to be calm and reassured and will do almost anything to make them so.
    - you should be seen by an anaesthetist in the ward or the pre-op room, which ever your hospital has. Feel free to tell them about your phobias. They'll not be unfamiliar with the situation and will do everything they can to make this experience easy for you. Trust them
    - as for after the surgery, the pain you will have after will be nothing compared to what you are experiencing now. And if you have even the slightest pain, tell the nurse and ask for some pain meds. It's their job to see your pain is under control.
    - when you get home, you will be in charge of your own pain meds. You need to read the instructions on the label carefully and make sure you take them strictly as prescribed.

    One other thing - in hospital, the staff will ask you a pain score which is usually 1-10. 1 being no pain at all and 10 being the worst pain you can imagine. Here's a chart of it

    pain scale.jpg

    And here's a tongue in cheek version!

    PS 1-vert.jpg


    And another chart describing the progress of pain but do note this is by no means a 'set in stone' thing and varies greatly from person to person

    pain progress chart TKR.jpg

    Hope this all helps and do try to bear in mind that absolutely everyone is scared ranging from seriously anxious to terminally terrified! You are not alone in this. You have lots and lots of company, trust me.
     
  9. KenUSA36

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    Don’t worry Molly. I’m 36 and a big guy. In my head, I’m seriously dreading and freaked about having a TKR in the near future. I’ve had plenty of surgeries before on my knee and shoulder.

    But think of the relief on the other side? Once it’s done and you’re out of surgery, the feeling is almost euphoric. I keep reading it’s one of the safest surgeries. They’ll take good care of you, and this forum is like the greatest support center ever. You can do this!
     
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  10. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    You've gotten such excellent responses on being afraid of pain. Your anesthetist is your best friend for this. I had the loveliest anesthesiologist; she did everything necessary to put me at ease. You will need an IV (no surgery without one) but again you can take the nurse into your confidence and let her know how you feel. As others have said, you will not know they are performing the spinal and you will wake up magically in the recovery room, clear-headed and with a new knee.

    There's pain after surgery, but you will be given strong pain control to help with it. That pain gets better, though, and especially if you spend most of your time off your feet with your legs elevated, resting and cooling your knee with ice. Most of the pain post-TKR is when bending the new and walking. For me, just resting was nearly pain-free until I moved. :heehee: And of course as healing progresses, moving becomes less painful too.
     
  11. Mollymax

    Mollymax senior
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    Thank you everyone. Your responses have been excellent. I have read them several times and will do again. My phobia of needles is very severe. Just the very thought of them sends me into a panic. I cannot let anyone put a canular into my hand. That is a big no no. When I was last in for cellulitis they had to put it in the bend of my arm. I freak out when they try to put it in my hand. The Orthopedic nurse has noted that it may be a good idea for some sedation before the spinal seeing as the state I am getting into. I have said to her they need to keep me sleeping and not let me wake up till its over. Someone told me they were awake the whole op. Jings that would be my worst nightmare. I am so very much a coward and the thought of severe pain after the op is horrifying to me. Susieshoes you say the pain is worse when bending and moving the new knee. Is this helped by the pain meds? Do they give you enough pain relief to stop major pain?
    You have all been so nice here and helping me with my fears. I should have been in work this week but took it as leave and came away to my caravan to try relax and take time to think. I do have to go back to work next week as I have a lot to sort out before going off. I will let you know how I am feeling as the next two weeks go on.
     
  12. SusieShoes

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    Everyone's pain (how much... how long) is different, so do keep that in mind. The pain is worse when bending the knee because that stretches and moves the parts that were cut during the surgery, but that doesn't mean the pain is going to be terrible. With pain control -- pain killers, other meds, and ice/elevation to control swelling -- the pain will be bearable and maybe even minimal. Everyone's different.

    One tip: Take your pain pills on schedule. If the prescription says every four hours... take the med every four hours, even if you aren't feeling like you need it. Sometimes when at rest, you might not feel much pain because your knee isn't moving -- but you will wish you'd taken the pills when you get up to go to the bathroom! Which you will have to do. By taking the meds on schedule you will avoid playing tag with your pain.

    Though I felt pain after surgery, it was never horrible. I had good pain meds and my surgeon made sure I had enough for the time I needed them. I used ice at every opportunity. I was off my feet with my legs up on a foam wedge 98% of my day (yes, I slept that way too), which kept swelling down... and swelling is what causes a lot of the pain.

    The best thing: The pain gets better as time goes along. :happydance: It takes a while for it to ALL go away, but it becomes less and less and less, becomes just some stiffness... and then, after several months, not even that.
     
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  13. Celle

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    Tell your surgeon and anaesthetist that you want o be kept asleep throughout the operation. You will be sedated so well that you'll only wake up when it's all over.
     
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  14. kneeper

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    I don't remember the spinal at all. They had put some sedation in my IV before that happened.

    A nurse once told me that they like to put the IV in your hand for surgery because they can move your arm out of the way and it gives the surgical team more room to work. Josephine would know if that's correct.

    For me, they did some kind of anesthetic on the hand before they did the IV so it wasn't too painful. But then needles don't particularly faze me as I've had years of regular blood draws. Though I must admit I don't like to look. ;)

    I agree with Celle and the others--talking to the nurses, doctors etc. well beforehand is a good idea. And when they're prepping you. My first TKR was my first surgery in the hospital and I was pretty nervous.
    I found the staff very kind and professional. Wishing the same for you.
     
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  15. Laurenkate

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    Hello MollyMax; I'm going to borrow your phrase and tell people I have a knackered knee when asked why I hobble so much. :) It's so impressive you're able to walk 4 miles with a "fair amount of pain"; when I walk more than 3 blocks, my knee is screaming in pain. You might have a higher tolerance for pain than you realize!

    Can't add much to what has been said above. Everyone's recovery is different but the two absolutely, positively most important things you can do is to take your pain medication on time and use a lot of ice. Elevation is important too but it's amazing how soothing ice is after a TKR. I hate taking medicine and occasionally tried to "push through" the pain after my first TKR; won't be making that mistake after the second one. Whoops; forgot the third thing. Sleep when you can. Pain can be managed but sleeping is a big challenge.

    Two other things which were helpful ....believe everyone here when they say recovery takes about a year. It doesn't mean you'll be in pain that long (you won't) but it takes time for all the tissues to heal, etc. I got a little discouraged about 3 months in because I thought I should be completely well so I started jotting down once or twice a week what I could do, how I was feeling etc. Doing that made me realize I was making progress - at first, it would be every couple of weeks or so and then it was every week so that helped.
     
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  16. Mollymax

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    Thanks for replies. I know it is over a week away to the op but I am getting more and more stressed out. Taking it out on my husband, being very depressed, very upset. Having worked hard to lose 5st over the last year I have found over the last few days I have gone well off the diet and have eaten everything in sight I guess due to stress. I daren't gain weight again and being immobile over the next few months will worry me as bad eating habits are easy to fall back into. A big part of me is still so terrified that I find myself thinking I will just live with the pain and risk further deterioration rather than go through the op. I find myself thinking I am not really in too much pain except when in bed as that really hurts. I have even got it into my head my painkillers (dihydrocodeine and paracetamol) don't work so I am not that bad so a to talk myself out of the op. Sorry folks I just can't help how I am feeling and it's getting worse. My other problem is that they are doing my left knee first and this leg has had cellulitis and lymphodema in it so the risk of infection is greater. However over the last few weeks my right knee has been very painful. I am hoping that putting all my weight on this knee while the other heals won't cause it to be too painful or I am going to be in trouble.
     
    Last edited: Jun 14, 2018
  17. sistersinhim

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    You won't have much of an appetite after the surgery as long as you are on pain meds. I suggest you get a case or two of protein drinks. You need to take you meds with food, preferably high protein foods or drinks. The protein takes longer to digest and helps protect your tummy from the meds. I lost weight the first month after my tkr. I bet you will, too. Just have good, healthy food around!
     
  18. Laurenkate

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    I did what you did - just put off the surgery and lived with the pain far too long which was a big mistake. My pain got much, much worse, I developed ankle, hip and back problems and recovery took longer because I essentially had to readjust my gait and almost learn how to walk properly again. The only reason i'm having my second tkr in July instead of next January is I don't want to make those mistakes again - but you should do what is best for you.
     
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  19. Mollymax

    Mollymax senior
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    Laurenkate I am like you I have forgotten how to walk properly. My knees are so stiff I can't seem to lift them of the ground properly and seem to be constantly tripping over my toes. The unatural gait makes me very tired when trying to walk long distances. I used to be able to walk a marathon but over the last few years I have got so tired and gradually the mileages got less and less. I am so hopeful that after I get new knees I can build up my miles again and by this time next year be back to walking marathon distances. That is the main thing that is keeping me going and overriding the horrible fear I have.
     
  20. beachy

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    Mollymax I can understand you being terrified. I was too, and I’m having the surgery in Oct. still have a way to go. I made myself physically ill and was depressed. Fear of the unknown. Then I found BoneSmart and so many of my questions were answered. I’m a bit anxious but ready to get on with it and have my life back. Listen to these “veterans” and read the stories about the successful recoveries. You can and will have a successful recovery too! Best wishes to you.
     

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