TKR both knees

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KayeKaye

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I am so confused. So glad to have found this forum, an it's wealth of information.

The first thing I am confused about is the doctors attitude. I've see 2 now plus my own GP who is on maternity leave for a couple three months. I am on my third doctor in a couple weeks and possible a fourth.

:what: 1. The first one took an MRI and found nothing.

:what: 2. The second one said MRI's don't work and took an X-ray that showed both knees almost bone on bone with meniscal tears that were un-operational. He then and there gave me a Syvistic One shot in the better knee and told me I had to wait 10 years because I am 60. Told me I have to loose at least 70 pounds. I told him I am dieting and just lost 56 pounds and he was unperturbed and continued.
This doctors' office was extremely full of very elderly people who all get shots regularly. One patient told me to refuse all surgeries and do these shots only.
I had a bad twist 3 weeks ago that left me totally wracked in pain and off my feet for almost 3 weeks. Couldn't get into see him, saw his emergency PA who just said yup you're hurt, offered another shot which I didn't do, and goodbye.

:what: 3. I have an appointment with a third doctor who is a team athletic doctor. He treats pro football players. My mind says some of these guys are easily 300 pounds and he treats them, what's the difference?

4. A friend gave me her doctor at the Mayo Clinic so I called and established a case number and setting up an appointment. The last question was how much do you weigh and when I told her she said the doctor would take it under advisement and see if I was a likely candidate and get back to me in 2 weeks. Didn't know that was how they worked.

So... frustrated. I don't understand how a doctor could tell someone to be in constant pain for 10 years. I take Ibuprofen 800 4 times a day. I have some generic Vicodin to help me sleep but they really don't do anything for the pain. I have all the exercises but I can't even bend my knee to do those. I had a foot operation in 2005 that is still giving me referred pain, and last February Pt and diagnosing this is what led to the knee discovery. I was totally surprised, guess the knee pain was disguising itself.

Did you all have to work so hard to be listened to? :scratch:
 
Unfortuantly, many people here did have to work hard to find a surgeon who would listen. I was lucky, the first one I talked to was willing to do the surgery on 48 year old, way overweight me. His take was that my age wasn't ideal because I'd have a higher chance of a revision in my future, and my weight wasn't helping, but that my knee was shot and there wasn't anything better he could offer.

So, keep looking until you find the right surgeon. They are out there, and no one should have to live with pain for 10 years to meet some magic age some doctor has in their mind.
 
Kaye, welcome to the forum. So pleased that you have joined us here. I am so sorry that you are having such a difficult time finding an OS (orthopaedic surgeon).

You most certainly do not have to wait 10 years for a TKR. What an idiot! And I am not sure that a sports doctor is really for you either. Weight and age should not be considerations for knee replacement---quality of life is the real issue. I am giving you a link to an article that may help you with this: How to choose a surgeon and a prosthesis

I can hear and feel your unhappiness and frustration in your post. Unfortunately this has happened to many of our BoneSmarties before they were able to find a really good surgeon who was also a really good doctor (cared about the patient).

Please keep looking for the right OS for you--he's out there somewhere. We are here to answer your questions and concerns, to give you a place to vent when you need to, and to support and encourage you.

Take care of yourself and keep us posted. We care.
 
Thanks lh25 and bottomhollow. I'm glad I wasn't just imagining this attitude. I will look at the article asap! I just couldn't imagine living like this for 10 years.
 
KK- Welcome to this excellent forum; you have found THE BEST place for info and support for TKA.
It sounds to me like you do need to locate a better OS.
You definitely want a good, trusting relationship with someone who will be performing this surgery on you.
There is a referral clinic feature on this site, maybe you can find a helpful OS with that!
Good Luck and keep us posted!
 
Hello Kay and welcome to BoneSmart.
I am so confused.
The first thing I am confused about is the doctors attitude. I've see 2 now plus my own GP who is on maternity leave for a couple three months. I am on my third doctor in a couple weeks and possible a fourth.
You see four surgeons, you'll get four opinions; see six and get six opinions. There's no protocol cast in stone about this. It's all down to the surgeon's experience, training and personal overview. All being human beings, they will all have their own point of view on it. Don't seek a consensus, just information. At the end of the day, you are the one to make the decision. But you need to start choosing better surgeons - more later!
:what: 1. The first one took an MRI and found nothing.
Hardly surprising - an xray is by far the best way of getting primary information.
:what: 2. The second one said MRI's don't work and took an X-ray that showed both knees almost bone on bone with meniscal tears that were un-operational. He then and there gave me a Synvistic One shot in the better knee and told me I had to wait 10 years because I am 60.
That's appalling and confirms my previous comment that you need to start choosing better surgeons.
Told me I have to loose at least 70 pounds.
What is your current weight and height? I'll work out your BMI and tell you if it's a problem.
One patient told me to refuse all surgeries and do these shots only.
Well that's just silly! The shots have a diminishing return in that they don't always work for everybody, don't always work for long and sometimes, just don't work! I met a man in the out patient clinic once who for two years had been putting off surgery by having arthroscopic washouts every six months. But I'll warrant that a) they didn't go on being effective for much longer and b) the surgeon and/or hospital declined to continue with this notion if only on financial grounds.
:what: 3. I have an appointment with a third doctor who is a team athletic doctor. He treats pro football players. My mind says some of these guys are easily 300 pounds and he treats them, what's the difference?
Just because he treats pro-footballers doesn't make him a good knee replacement surgeon, in fact, quite the opposite! He probably excels at treating injuries but if you ask him, he probably doesn't do all that many knee replacements each year.How to choose a surgeon and a prosthesis
4. A friend gave me her doctor at the Mayo Clinic so I called and established a case number and setting up an appointment. The last question was how much do you weigh and when I told her she said the doctor would take it under advisement and see if I was a likely candidate and get back to me in 2 weeks. Didn't know that was how they worked.
They work on body mass index (BMI) which is why I asked you for your weight and height. But not all surgeons consider obesity to be an issue and understand that it's a vicious circle where decreasing activity can lead to increasing weight. Also that it's phenomenally difficult to lose weight when disabled like this.

My BMI was 46 with a weight of 280lbs when I had my knee done. Many, many patients I looked after were much heavier and one I particularly recall weigh 400lbs! They all did very well.

What you need to do is use the "Find a Clinic" on BoneSmart. Just follow the directions and when you have a list, start phoning round. Ask each clinic for the names and telephone numbers of their knee surgeons. Then phone the office of each one and after a preliminary exchange of information, ask the staff if weight is an issue for him; they would know this. You can also ask how long for an appointment, etc., and if it's a long time, whether he would preview your case from your xrays if you sent them. When you have made a short list, then phone back and make appointments.

Stick with us, we'll try and help you get sorted! :wink1:
 
Wow great information. It's not that I was trying to get a consensus, in fact I got no answers. I just want a doctor that made sense and would actually talk to me. They just seemed to busy to care and just blew me off. With the questions that were linked I will be much better equipped.

jancat thanks. I will look at the referral. What do you guys think of Mayo? My friend had a great outcome...

Josephine I am 5' 6 1/2" at 248. I just lost 56 pounds and am continuing. But being immobile is making it take a while. Oh -and I gained the weight from my foot surgery and dealing with that since 2005, ugh. (had a tendon taken out half way up from my ankle and my heel bone sliced off so I don't walk on the outside of foot, which had led to numerous sprained ankles, which led to the destroyed tendon, which led to...)
 
Hi, Kaye....welcome to the forum. I'm so glad you are beginning to feel a little better about this whole process. Sometimes it can be quite frustrating until you find that surgeon that you "click" with. He's out there!!!

The Mayo Clinic is excellent. Just be sure you select a surgeon who specializes in knee replacements and does a lot of them, as Josephine and Judy suggested. This is the MOST critical factor (choice of surgeon) in your quest for a new knee.
 
I also concur with what the others have said. My one OS, who scoped my knees on several occasions, is a former All-American football player and is a team doctor; however, he does not do any TKR's---he referred me to an excellent OS who does NOTHING BUT TKR's and BTKR's. That is the one you want----one who does nothing but TKR's and 100's of them a year

It is of the utmost importance to select an OS who has this expertise---it is not the implant, it is the OS's expertise that is paramount..
 
Jamie and referee54, thanks I will be calling on Monday to see how many and what kind of knee surgeries they both do, now that I am 'armed'. :)

I just went through the list on how to find a doctor. I've seen, or will be seeing 4 out of the 10 listed but didn't ask any questions so will do that.

Josephine, Great resources thanks for pointing them out. I've been lurking for a while and didn't see them.
 
KayeKaye,

All BoneSmart people sing from the same hymn book!

Your challenge looks to me to be, as everyone has said, finding the right surgeon. A knee specialist for certain, and someone who does hundreds of TKRs a year. Having said that, the guy that did mine is semi-retired and does fewer than that nowadays -- but has been a knee man for at least 30 years.

One good way to find out if they're any good is to walk about the hospital where they work and chat to the staff, especially the nurses. They know who's good.

I make your BMI just over 39, but weight is not an issue.

The historian's recovery thread

http://bonesmart.org/public_forum/historian-recovery-diary-t14859.html?t=14859


Big Gene's knee number 1

http://bonesmart.org/public_forum/will-new-knees-good-enoughi-t9499.html?t=9499

Big Gene's knee number 2

http://bonesmart.org/public_forum/my-2nd-new-knee-will-good-enough-toooo-t12914.html?t=12914
 
HI KayeKaye, welcome to the forum. You are definitely on the right track now. It sounds like you are already more comfortable now that you are armed with knowledge and better prepared to find a good knee surgeon. :yay:

We are here for you and are interested in your story and your progress. Keep us posted. :friends:
 
Hi KayeKaye,
Many of us have been in the same boat, Told to wait while we're in pain, for some magic number. Not true, there are many OS's who will want you to be out of pain. How can you lose weight if it hurts to walk? This is a hard decision to make and it will be tough going getting better after TKR, but you can get pain free or be in less pain. There is hope and there are solutions.
Good luck finding the OS that will make things right for you.
 
Roy I'm starting to see that it's not unreasonable to not wait 10 years.

Thanks BJ Mac, I'm glad to have found this forum, I've learned more here in one post than all last year searching.

Thanks AussieBill1962. Yes I've been losing weight but exercising is extremely hard.

Exercise is the second thing that I am confused about:
The knee doesn't hurt as much as the meniscal tears. So if I keep moving the knee doesn't it just make the tears worse? What to do. No advice from the doctors, the PT's I've had since my foot operation in 2005 told me that exercise would make the knees better and this can be fixed. I just don't understand how moving this tear, that can't be operated on because it's torn the wrong way, can be made better. It's my understanding that the debris from the tear is getting caught in the knee mechanism. Really confused. Has anyone had this dilemma?
 
I was bone on bone before TKR, and still am with my left knee. Had miniscal tears 31 years ago which would lock up knees along with bone chips and my knee cap was resurfaced 27 years ago (Right Knee). I do remember they would get inflamed with exercise, but I just iced them to get the swelling down. Mostly from skiing moguls. I just wore out my joints with too much activity. The pain was bad, but just pushed on for the love of sport. Nothing left inside joints for the past few decades, but no REAL pain until the last few years. Cycling, Walking, Swimming. Swimming is the best cardio exercise I find with bodgy knees. Is swimming an option for you?
 
Tooth troubles. Now I've read some threads about root canals and tooth problems which reminded me I need to either get my root canal fixed or tooth extracted. I put that on the back burner because the pain is minimal compared to the knee so much that I forgot about. Of course no doctor told me anything about such things.

So if I'm reading right, I should get my root canal resolved before any knee operations? Thanks.
 
Swimming is the best cardio exercise I find with bodgy knees. Is swimming an option for you?

Actually it was in the deep end swimming PT that they discovered the knee problem, it hurt so much I couldn't do a thing. I do love swimming but haven't been back since Feb. Can't really walk from the car to the pool.

Amazing that you could do so much for so long. This just started for me in Feb or so and I can't manage to do anything. I guess I noticed my knee hurting on the inside but thought it was just a sunburst spider vein about the size of a quarter. Not.
 
Hi KayeKaye,
To bad about the swimming pain, I use a cross trainer as well which has no impact on the joints like a treadmill or walking/running. Also very good cardio exercise. I have been lucky to have stayed active with no pain. I did give up skiing and running a decade ago as that caused pain and swelling, but I was able to crew for yacht racing doing Headsail/Spinniker trim, bush walking, weight lifting, and most activities with stiff joints, but no pain. Just a few weeks after my first hangliding experience last year my right knee just would not bend much and became chronically painful. This was what brought me to needing a TKR. The flying experience was fantastic, but landing required an impact on my knees and with my weight, the hanglider and the pilot my knees just buckled on impact. My knees seemed OK on the day, but soon after the right knee just would not bend much. The straw that broke the camels back perhaps.
 
Ooh that hangliding landing just hurts even reading about it.

For me, it hurts
standing up,
sitting down,
walking,
swimming,
sleeping,
exercises from PT,
so I have idea what to do. I do ice and Ibuprofen.
 
Kaye, 2 Tylenol 500mg along with a couple of ibuprofen do a better job--the Tylenol for pain and the ibuprofen for inflammation. Just not more the 4000mgs of Tylenol in 24 hours and not more than 3200mgs of ibuprofen. We call it the BoneSmart cocktail. This is all I have used since I was 3 months post op.
 
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