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TKR Thinking of backing out

The surgery itself is absolutely nothing to worry about. The after-surgery is awful. For both my gnees, I was a basket case for 5 weeks but I'm 4 months now, still stiff when I get up or start to walk but I can control the pain with Tylenol and complaining(!).
The entire point of all this is to leave your years-long chronic pain behind. It will never get better and Cortisone shots are a temporary, at best, panacea.
After the surgery, you will get better. The pain subsides and will eventually be ZERO. Your old knees will never be like that and your life will continue to contract until you can't walk.
The opiates are many and varied. If Oxy doesn't work, try Dilaudid/hydromorphone. I was taking Tramadol without side effects and they switched me to Tramadol ER which you only take once a day. Much better than waking in pain in the night for more pain killers. I had no side effects.
I did have mild withdrawal when I stopped taking Tramadol but it was just me being crankier and grumpier than I usually am, plus restless-leg at night. That took about 5 days and except for the destroyed sleeping, was really nothing. They gave me a minuscule pill to fight the leg-thing and me and my gnees now sleep happily and I have stopped the tiny pill.
Plan to pee in bed for a couple of weeks and use plenty of ice on your new gnee. Get up when you feel like it it not when nature calls.
I know you can do it, many of us have and many of us are still in recovery. Think of how many oof us on here, over the years, just went on and recovered and vanished!
Listen to Layla et al and read their advice. Invaluable.
 
@Xsbank - PLEASE bear in mind you had both knees done at once!!!

@Scaredofsurgery - his experience absolutely shouldn't be yours, even from day 1!

Everybody who has one knee replacement is up with walker or crutches and walking to the bathroom before being released home - in my case, each knee was same day surgery; for some folks it might be an overnight stay. I was expected to take a very short walk every hour (other than that, icing and elevating and doing some basic leg movement).

On my first knee, I needed my husbands help lifting my leg getting in and out of bed for the first dew days. After that I started using my good leg to lift my surgical leg. With my second knee, I could from the start transfer in and out of bed using my other leg, although my husband prudently insisted on being present for all bed transfers the first couple of days.

So from day 1I was independent walking into the bathroom and using an elevated toilet seat, washing my hands and face, brushing my teeth.
 
I was fine walking to the toilet the first day too, then the blocker wore off...I still walked with a walker every hour and for the 2 days I was there, I refused stairs because I had no good leg but you should see me go now!

Yes, you got me, I did 2 knees.

I guess you could say I'm an example of how bad it can be without surgical complications and I'm still absolutely convinced that this is the correct thing to do for me. I have none of the arthritis pain any more, it was all cut out!

It gets better every week (sometimes not every day!) and I can do so much more now, but the surgery itself is still a piece of cake.
 
@Scaredofsurgery
I was just like you, in every way, I think I kind of talked my brain into the worst case scenario and at times seriously wanted to cancel the surgery (TKR on 8/7/24) I am now 13 days post Op and can honestly say I'm relieved!!! Compared to my THR the pain is slightly worse but nowhere near what I had "talked" or "Imagined" myself into by worrying?? I'm guessing you deal with pain quite well, re your previous surgeries? You will be able to deal with this too and remember that everyone is different and has a different experience! Try not to be influenced by other 'cases' Yes its totally scary but once you're on the other side your nerves and worries will settle, and you'll be on the road to recovery....with a few swear words occasionally....or is that just me :chinstroke:
 
Scaredofsurgery said:
Getting closer to surgery date of August 8th and feeling so anxious.
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I think you said you have an adjustable bed frame. I have one as well and I didn't need to prop my leg up anymore at night than a pillow or two could do once the bed was adjusted. I also have a recliner that can go knees above nose but most won't do that. I bought one of those big support pillows (lounge doctor? I can't remember the name) and returned it because I could tell I wouldn't use it. Perhaps make sure you could return it if you get it and don't end up needing it? Seems like it was over $100.

Are you perhaps reading other knee replacement boards like Facebook? I surely do not discount anyone's experience of pain post-surgery but reading those comments made it sound like I would be pummeled by ice picks for weeks along with being forced to do painful knee exercises by the PT or I'd never walk again. I think - if it makes you feel any better - it's probably just as well going into surgery with the thought that might happen and if it doesn't then you're like - OK this is manageable.

I was able to get up and go to the restroom and get to bed from the start.

I suggest really talking to your doctor about pain management - usually they can go with something else besides oxy if that doesn't work well for you. Oxy makes me a bit nauseous but I can take it - I just need to be careful - and maybe have some other meds to help with nausea. But there are other pain meds that may not affect you like oxy so it's worth asking about since you know already that was a problem in previous surgeries.

Also it's normal to feel anxious - very anxious. I felt like a zombie in those days leading up to surgery just wanting to be over it already.
 
Thank you so much! Your reply really helped. I was just starting to have new worries after getting back lab results and one thing was high (RDW) so I started searching on internet and was freaking out. Found scientific article that seemed to have medicate blood transfusions and blood clots very common after TKA. Seems much to worry about!
 
Not sure how to reply to one specific person…so did read both recent posts and I thank both of you immensely!!!
 
Scaredofsurgery said:
Thank you so much! Your reply really helped. I was just starting to have new worries after getting back lab results and one thing was high (RDW) so I started searching on internet and was freaking out. Found scientific article that seemed to have medicate blood transfusions and blood clots very common after TKA. Seems much to worry about!
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Hi!
I have done some research on high RDW. This is a condition in which there is a higher than usual variance among the sizes of a persons' red blood cells.

Two pieces of very good news:

1) The usual reason for this is anemia; if the rest of your CBC is normal, especially hematocrit and hemoglobin, you're likely ok. If your physician has further concerns about anemia, they would order a ferritin blood test.

2) The only identified surgical risk with high RDW is in patients with heart disease who are undergoing cardiac surgery. It is not a reliable indicator of increased mortality in non-cardiac surgery, and its usefulness in non cardiac issues is limited because it highly correlates with a bunch of factors like high blood lipids and being a senior!
References here and here
 
Re: incidence of blood transfusions with total knee replacement, this is from a major retrospective study:
"The NIS database included 115,072 patients who underwent TKR. Among them, 14,899 patients received blood transfusion, and the incidence of blood transfusion was 13.0%. There was a dramatic decrease in the incidence over the years from 2010 to 2019, dropping from 20.4 to 6.5%."
 
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Thank you Mendogal. Amazing, relieving reply! You have an amazing wealth in f knowledge and I’m sorry to inform you that I’ll probably be bugging you a lot in the next 2 1/2 weeks prior to my surgery (and probably afterwards, too!). ❤️
 
Re blot clots: it's harder to get good stats on incidence as most of the studies are focused on identifying and reducing risk.

Here's an article from our library (it will download as a pdf) page 3 notes a marked reduction in the incidence among patients receiving appropriate medication postop .

One study I found notes that risk factors for those of us over 60 include a high hematocrit (the opposite of anemia!), diabetes, and for some reason NOT receiving spinal anesthesia as part of the overall anesthesia.
Within this study, overall the incidence of clots was 31% but I don't understand statistics well enough to parse out how much lower the incidence was for non-diabetics with low to normal hematocrit receiving spinal anesthesia.

I assume you'll receive a spinal, almost all of us do!

Here on BoneSmart we certainly have had members with blood clots; however it's rarely reported by members.
 
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Re exercise: anything that doesn't hurt your knee!
I was pretty much restricted to straight leg raises as everything else either destabilized my L knee (before getting a new one) or hurt my R knee!
I did do knee friendly clamshells for my glutes and some core and upper body work.
 
Decades ago, it was a lot more common for people to need blood transfusions with knee replacements primarily because there was a lot more bleeding. Improved surgical techniques and the move away from general anesthesia have greatly reduced this problem and it’s pretty rare for someone to actually need blood these days. Please try not to worry about this.

Pre op exercises are helpful. As mendogal mentioned, don’t do anything that is painful for your knee. Core and upper body exercises can usually be done by anyone and they will help you in those early days when you are using crutches or a walker.

If it’s a consolation, even those of us who work with joint replacement patients every day and know basically what to expect still get nervous. It would be extremely abnormal NOT to have these feelings. Be reassured by the fact that you’ve done your research, you have an experienced surgeon and medical team, and you’ve make a big decision that will give you your life back. You’ve got this!
 
Thank you everyone! The exercises that I have been doing to strengthen muscles around my knee ( including a lot of pool exercise as of late) have helped so much! I realized yesterday that I really have minimal knee pain except when I first get out of bed (middle of night going to bathroom and first thing in morning ). After I do some movement, the pain subsides and if I take Advil, I often have no pain at all. I have no swelling (never had) so don’t use ice at all and can now walk up stairs normally. I walked about a mile today with just a twinge. So, I don’t think I’m ready for surgery …but it’s scheduled for 8/8 and my pre-op is next week. Think I will postpone. All the advice I’ve received from this group has been very helpful. BUT I was so sick with worry and I now feel so much relief having made this decision. I will probably re-consider if the pain gets worse, but think it’s the right decision for me right now. Thanks to all!
 
As has been stated, it's all about your quality of life. What you are happy with and able to accept. It's wonderful you have strengthen your muscles and aren't having the pain you were having. Now that you've made the decision to not have the surgery I bet you feel like the weight of the world is off your shoulders.

We are here to support you.
 
Good luck. It's important to do what feels right for you and probably best not to go ahead if you don't have ongoing pain.
I would suggest looking at the joint scoring charts available on BoneSmart ( put Oxford knee score into the search box). It would be worth just doing these scores every so often to keep tabs on your knee and see if the function is deteriorating.
 
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