TKR What would you do Differently Next Time? TKR

[beralc]

Hi Everyone, hope you’re all doing ok whatever stages you’re at.
I’ll be having my TKR in the New Year (no date yet) but I wondered what you would do differently, if you had a TKR again.

What would you tell yourself if you could, before your op. Are there any absolutely essential approaches that you would adopt again. Any practical approaches to aspects of daily living and anything that really made life easier in those early weeks and months.


Think it would be really helpful for me if others could focus their thoughts from one question. TIA.

 

[mendogal]

I know you've already seen the pre-op guidelines we posted on your recent post.

My practical tips revolve around home prep.

Precook small servings of your favorite entrees and freeze them. During the month before my first replacement, every time I made dinner I tripled the recipe and froze two.

If you can, get an ice machine for your knee instead of relying on cold packs that just don't last long. Most of us ice almost continuously during the first month, and 45 - 60 minutes at a time after that. Many machines allow for using four frozen 16 oz water bottles to chill the water rather than continually refreshing the ice.

Figure out where you are likely to want to "nest" during the day - recliner? sofa? - and have within reach surfaces (table, etc) to hold electronics, beverage, meds, snack, pad and pen, etc. Comfy throws (icing knees chikls the body!) and lots of pillows!

 

[mendogal]

The other thing that really helped me: psychological preparation. I told myself that as many months as it took, my knee and it's needs were my number one priority; that I would simply surrender to whatever combination of rest and activity it needed regardless of how long it kept me away from my routine, responsibilities, etc.

 

[fireball84]

1: I would have a better understanding of what recovery is going to be like. I was told 'you're young, you'll bounce right back." What I wasn't told that despite being young, there's still things like nerve pain and numbness to deal with, as well as just the extensive pain from this surgery. I also wasn't informed on the remote possibility of drop foot, so waking up with that was quite the shock. Also learning that full recovery doesn't happen at the 6 week mark when most end PT was kind of a shock. I don't feel like the actual aftermath of knee replacements is explained that well by most surgeons.

2: An ice machine is a blessing. I was lucky enough to have a rental through my insurance, and it's one of the ones that you don't have to fill with ice. It cycles 30 minutes of cold with 30 minutes of no cold, so you can turn it on and forget about it. I have that one upstairs and the one from the hospital that takes ice down stairs, so I can ice on either level of my house. You should ask if they give you one after surgery if you don't have one already.

3: I took that machine that uses the ice (Berg) in the car when I had appointments. We have a Jackery, which is basically a portable power station, and we plugged the ice machine into it so I could ice wherever we went in the car. In the beginning I would sit in the back seat with my leg propped up on the seat to avoid having to bend it. This worked well while I needed to do it.

4: For me, it was incredibly difficult to get off my couch at first. It sits lower than other chairs, and because of it's shape there's not really anywhere to help myself up. I spent more time in my bed than down stairs for the first month, because of that. Look at your options and make your plan before you end up not being able to get up.

5: Get all the items the recommend like the shower chair and toilet assist. It's better to have and not need than need and not have. I used my grabber a lot in the beginning as well.

 

[mendogal]

@fireball84 I have the Bregg. It works even better with four 16 oz bottles of well frozen water than with ice!

 

[Layla]

Hello and Welcome to BoneSmart. Thanks for joining us!
Great question, beralc!

What would you tell yourself if you could, before your op.

Honestly, having been through surgery and recovery, the first thing I'd tell myself is
"Recovery Is Not As Bad As You're Thinking It Will Be"

I think I believed if I imagined the worst, it could only be better...right?

Following is a list of recovery aids and an article on recliners -

Recovery Aids: A comprehensive list for hospital and home

This is the list for the rest of the thread. post #2 Toilets and toilet aids post #3 Pre-prep for the house and for you Post #4 dog walking Post #5 Make Them a Meal scheduler Post #6 tick list for prepping Post #7 Books, CDs, and DVDs on Surgery Post #8 stationary exercise bikes and...

bonesmart.org

Recliner chairs: things you need to know if buying one for your recovery

Recliner chairs are God's gift to recovering hip and knee patients! But there are lots of variations so I've put this article together to guide you. Recliner chairs come in two types, basic recliners and riser-recliners that lift you to your feet so all you have to do is walk away! Great for...

bonesmart.org

Stop back often and we'll do our best to advise and support you on your journey.
A great rest of the week to you!

 

[EalingGran]

Agree wholeheartedly on the ice machine.
I just had a cheap Aircast Cryocuff and it worked well for me- I don't think I would have coped otherwise.
The one thing I would have done differently is I would have done the Oxford knee score before my surgery and every couple of weeks afterwards.
This recovery is very up and down in the early months and it is very easy to get discouraged and worry that you are not improving. Also you tend to forget exactly how bad things were beforehand.

 

[Pat29627]

In January I started classes given by a nurse about a whole food plant based diet. I cut out all junk (I love sweets and especially ice cream.) It was difficult at first, but I watched so many videos and read books (listened, actually) by Dr. Michael Greger and others. So I lost 20 pounds since then without being hungry.

I made lentil soups and smoothies to freeze.

I did a month of PT before surgery….I’m convinced it helps after surgery to be strong beforehand.

I put wooden risers under the legs of the loveseat in the bedroom and we moved the bed farther from the wall so I could get a walker through.

I found my old crutches which I haven’t needed, and the frame which goes over the potty. The hospital provided a walker.

I found my 15 year old ice machine but never used it. They gave me a thing that hold two ice packs with Velcro straps and it has two extra to keep ready in the freezer. It’s a good thing! Our power was out for almost 8 days.

 

[benne68]

I did make changes pre-op for my 2nd TKR based on what I learned from the first one, @beralc.

For the 2 months prior to my second TKR (last December), I really focused on good nutrition. I got rid of all the "junk" food, cut way back on sugar, added more fruits and vegetables to my diet, and -- more importantly -- incrased my protein consumption significantly to ensure I was storing up the amino acids necessary for healing.
It made a big difference. My fatigue resolved -- and my energy came back -- much sooner than during the first recovery.

Since you still have several months before your surgery, check out these articles and get started now:

Dietary Tips

Pre-surgery Dietary Tips Preparing for surgery is like getting ready for a marathon or a big game. Good nutrition prepares your body to deal with

bonesmart.org

Nutrition Basics

For an average healthy adult, surgery can mean: INCREASED ENERGY NEEDS. Your body burns a lot of energy during and after surgery. A MAJOR WORKOUT. You

bonesmart.org

 

[beralc]

Wow! These are all brilliant. So much more advice from actual lived experiences, exactly what I was hoping for and more.Can’t thank you all enough for taking so much time over answering . It makes me far less anxious about the whole thing.
I’m literally going to write things down so I can keep a list handy with me pre and post op.

In terms of nutrition totally agree I’ve been using an app for that and I never eaten so much protein before. Although I’m one month post left knee arthroscopy I am being religious about my exercises to include the right one too.
I’ll definitely look into ice machines and other practical aids mentioned too. Thanks again.

 

[Rockgirl4]

Someone else mentioned the mental preparation, and I just want to add to that....

1) You can't outsmart or outwork recovery---no matter how fit or healthy you are, your body will heal as it likes, and there's no way to speed things up or "work harder" at recovery. Working harder actually sets you back most of the time. I guess I'm saying be patient and trust your body. I've had people tell me I didn't prepare well enough before surgery, otherwise I wouldn't have taken so long to return to "normal." It was insulting and infuriating, as no one knows YOUR body. I've also had people tell me I didn't work hard enough AFTER surgery if I still couldn't bend my knee yet----no, I actually DID do too much and kept the knee swollen/angry, hindering my recovery. No one ever tells people THAT can happen!!!

2) Along those same lines, be prepared for those that healed quickly/miraculously to give lots of advice if you're not one of the ones that bounces back fast. People tend to only share the miraculous stories and the horrible ones, leaving out MOST of the normal recoveries. While some people are back to their normal activities at 2-3 months, that's not realistic for most. It truly is a 12-MONTH recovery, not a 12-week recovery.

3) Be prepared for any sleep problems that arise. Many, MANY people struggle with sleep after TKR for months. It can affect your mood a lot. Just know you're normal like everyone else struggling to get comfortable.

4) The thing I did differently this time that helped the most---I accepted more help from family and friends (especially food), and I told people I wanted visitors. I tend to be introverted and a home-body, but the cabin fever cans et in quickly, especially having a TKR in winter, where you might stay home more to avoid slick roads/sidewalks. I get stuck in my head with TOO much alone time, so I told people I needed visitors occasionally, even if only for 15-20 minutes. It broke up the monotony of recovery.

We'll be looking for you on the other side, and please keep us up to date with how your surgery goes.

 

[EalingGran]

Be prepared for any sleep problems that arise. Many, MANY people struggle with sleep after TKR for months. It can affect your mood a lot. Just know you're normal like everyone else struggling to get comfortable.

Agree with @Rockgirl4 on this.
Even mild pain/ discomfort is enough to keep you awake or prevent you getting back to sleep in the night.
I slept with my knee resting on the opened Aircast Cryocuff cool jacket and changed the icy water if/ when I woke in the night.
I also got my GP to prescribe Zopiclone. After the very early period I didn't need any opiates providing I had Zopiclone and a cool/ cold resting place for my knee.

 

[eaglemom]

These are all excellent. One that I didn't see mentioned was music / earbuds / headphones. Personally I find music very relaxing / calming. When I couldn't get comfortable or sleep just wasn't happening, I could put my music on and it would relax me. Usually enough that I would fall asleep.

You also can try music from your phone. YouTube has free soothing music.

 

[Jockette]

If I have to ever do this again I would have a toilet seat riser, or additional piece, that has handles. It never occurred to me that I would need that. I did have the riser, just not the handles.

I will also not go to formal PT. I had a very bad experience that I now know was totally unnecessary.

I will worry less about the entire healing process and just allow my body to heal in its own timeframe, which it will do, just fine. Sadly, looking back, almost everyone who was not a part of Bonesmart caused me so much stress about what I couldn’t do, and when I couldn’t do it, as I was healing, that it made my whole PKR experience a bad one.

Being a part of Bonesmart now, you have good, sensible guidance, and you will be much better off than I was. Best Wishes!

 

[beralc]

Thanks for sharing your stories and the difficulties you encountered so others can learn from them.

 

[Pat29627]

My PT guys are taking it really easy, except one had me do sit to stands. If I have trouble, they tell me not to do any more reps,

We love sleep stories to help us sleep. They start with voice and end with train sounds or rain or whatever.

 

[sistersinhim]

I think these could be quite helpful.

 

[beralc]

Once again thank you, for all these brilliant suggestions. I’ve made notes of everything. Even if I don’t use them all, the fact that I have those suggestions to hand if and when I do encounter similar problems I’ll definitely feel more prepared and feel great about having you all to ask if I get stuck on my journey. Thanks so much again everyone.

 

[Layla]

Thank YOU for sharing your journey with all. Please don't be a stranger here. We love progress updates.
Have a lovely weekend!
@beralc

 

[Layla]

Two months to date since your arthroscopy. I hope you're doing well. Let us know when you have time.
Happy Two Month Anniversary!
@beralc