First knee replacement

Thank you Barbara and Rose!:-)))  Great to know I've landed in the right place LOL!

First of all....Breath! In the US, our recovery is pretty much the same. Before surgery, you will have time to tell them in pre-op about your allergies. They must plan for transfusion, just in case. But typically there is not much blood loss. I had general anesthesia for both my right and left and had no ill effects at all. But there, again, depends on which drug is used. You get catheterized through the first day. So no loo worries. You will be gotten up to stand, walk and some light physical therapy-maybe not til the next morning. It all depends on how well you're doing. So just go with it. Accept the sleeping pill and pain meds. Check in here for questions. This group is so helpful as we don't get very much info about this whole process.

Thank you Melinda LOL!  They did explain about a general anaesthetic and a spinal but they prefer to do a spinal unless that doesn't work, so then they go on to the general, but I'm happy to go with the flow on that.  I asked about a catheter but didn't really get a clear answer on that, apart from they told me that many ladies have some bladder voiding  (which I understood meant they might not use a catheter) so not to be worried if that happens.  I bought some urine leakage pads to take with me, in case of that happening.

Funny the things that worry us isn't it!  I too worried about a catheter etc.  My surgeon doesn't use them.  When I came out of surgery the nurses but some incomtinence pads under me.  I could not go to the toilet on the bed pan but was able to when they got me out of bed and I got on the loo he next day.  Good luck for your surgery.  

 

Thank you Jane!!!!!  Yes, I have to admit - it's really the ridiculous things that are worrying me!  My husband thinks I'm mad!  I'm a daily hair washer and when I wake up my hair's sticking up all over the place and I was in a panic about not being able to shower and wash my hair, but have discovered 'no rinse shampoo' that you put on, rub in, and towel dry so can then come as you normally would when it's wet.  They told me not to take Movical (for constipation) the night before or that morning, so now I'm worrying about constipation if I've missed two doses, but hoping that will rectify itself once I get back to taking it normally.  I've bought wipes for every part of my body but I think all of this is probably panic:-)  Having said that, I am SO looking forward to the surgery.  I spent last night awake with the pain of one knee, despite tablets and cream.  So I'm optimistic that it's going to be something I'll always be grateful for doing!

Hi Chris I suppose it depends where you live. Im in the UK and didnt see the team until I was in theatre. Im allergic to nikel so told the pre op nurse. You would only have a tranfusion if absolutely necessary.I got up within about 3 hrs after having a spinal and general anaesthetic and went to the toilet myself which I was very proud of! You should start physio the next day and the excersises are so essential to your recovery. Hope it goes well

Thank you Rose:-)  My panic has reduced already from talking to some of you on here.  I'll make a list of things I need to tell them then, and let them know when I go in:-)))  I gather they get you up very quickly after a spinal and since they've asked me to be there by 6.30 am I guess I'm on the morning list:-)  Thank you so much!

You can call your doc to inform them about osteopenia in case they missed you saying it before. While on phone you can tell them about allergy. Hospitals usually as about allergies ALL the time but sometimes not...

A spinal, which is different than an epidural, gives quick recovery. They give sn iv sedative to put you to sleep. This is NOT general anesthesia- that is different.They usually place a catheter for surgeries over 3hrs (usa). Sometimes with spinals as you dont feel the urge to void and can get bladder distention so they place a catheter. Our rule was 1. As soon as youre drinking the iv is out. (They want to make sure you're not nauseated) 2. as soon as you walk the catheter comes out.3 you get to walk when you have sensation/movement back in your legs-r/t spinal.

I came out at 530pm, iv was out at 630pm. I walked the hall at 930pm and went to bathroom and catheter was discontinued.

I had bilateral partial knee replacements.

Blood isnt just given unless really needed. Risk/benefit situation. Usually very little blood loss.

Im 10wks out now. Driving, since 4wks. Shopping etc. Still up n down days but progressing well. Not back to work yet. Building stamina

Chris I'm a daily hair washer too!  It was the least of my worries though for a couple of days...  if constipation is a problem for you do emphasise this when you go in.  It's a problem for me,and I didn't really say enough and I ended up in awful trouble which meant I stayed in an extra two days as the constipation was bad and I was sick!  Asked for some suppositories to take home which I used a couple of times until I got back to my usual routine.  Easy to say but try not to worry x

Oh that is BRILLIANT!  And SO encouraging! I'm delighted to hear how well you did!  I'm determined to do as well as I can and am doing the treadmill and recumbent bike almost every day, just to try and get things as good as they can be before the op.  They did ask about allergies but I only remembered penicillin and forgot about the surgical tape until just now!  So it wasn't their fault - it was mine:-)

Is the fact that the other knee is so bad with arthritis going to give me difficulty with standing - will they expect me to take more strain on that leg than I can?  I live in a bungalow, so will they make me do stairs before I leave?  I've not done stairs for many years!

Jane - THANK YOU!  It's SO good to be able to ask about these things that seem trivial really, but when you don't know the answers, can cause anxiety.  I've got a shelf pessary because of prolapses and certainly don't want to make them worse because of constipation.  It might sound funny but I'm not worried about the knee replacement bit, but just these little things that I didn't know answers to.  I'm thinking if I have a dose of Macrogol as soon as I'm drinking after the op, I'll have only missed one dose, so hopefully constipation won't be a problem, then I can have the other dose last thing at night that day.  I normally have it morning and night.

Those exercises b4 surgery are realling going to help. Do stretches too cuz your hips are going to get tight. Remember all those muscles and tendons that attach to ur knees also attach to ur hips! Have confidence in new knee is what they told us in class. I had a fantastic surgeon.

We have bathrooms in every room so u walk there w ur walker. I cleaned up when i was in there. ANYTHING i could do,I did, so i could fight off the depressed feeling from the pain and swelling.

My sister knitted me a prayer shawl and it sure kept the chill off my shoulders! Plus very comforting...

Pooping is REALLY important as u have to take ur pain meds so u move and rest. They constipate Everyone! Stool softners are part of our post op regimen. Ha, i cleaned out starting 3 days b4 the hospital! I figured that would buy me time if i hadnt been able to get up, lol. But lucky me getting out of bed no problem.

Your questions are great, well thought out.

The other knee will feel the strain but thats where you have to trust your implant despite pain, swelling and bruising...

Thanks AuntEG!  I also have Ehlers Danlos so ligaments can be a bit vulnerable to over stretching but I'm certainly doing all I can now and will continue to as well.  I love your point about having confidence in the new knee - it wasn't until a few weeks ago that I realised you could even put weight on it!  I imagined it had to be kept off the floor for about six weeks LOL!  If they tell me that walking on it won't damage it, then I'll be walking on it and so on:-))))  I put the op off for about 8 years - it was that long ago when it was first offered, but the time is right now:-))))  So I'm really positive about it.

Chris, I have Hypermobility Syndrome and its similar to EDS. I was so worried about putting weight on my other knee in case of dislocation and the pain of osteo arthritis but it held up well. The new knee is so much more stable, I kept dislocating it before. My surgeon used a different kind of knee because of the JHS.

Rose, that's very helpful.  I've pulled ligaments in the other knee (which will be the second to be done) a few times because it's twisted but haven't dislocated them.  I mentioned to my surgeon about the EDS but he didn't appear to take it on board, even though he was recommended as someone who had been experienced with it.  I'm wondering if I should have asked more at the time now!  He did get me to straighten the leg as far as it would go and though it was within 'normal' range though, so perhaps he felt it didn't need anything special.  I'm wondering if I should be asking now!

I did need a blood transfusion, as I was dangerously anaemic after the operation, and could hardly breathe or find the energy to sit up, let alone walk! You could ask if they would let you give blood in advance which could be used for your transfusion if needed. . although, time is getting rather close!  I don't think they would do a transfusion unless really necessary.  they left mine for several days to see if I could make up the loss on my own, but I couldn't.  I believe the spinal is different in the USA andf the UK, and not sure where you are.  In the USA they seem to leave a spinal block wich minimizes pain for qite a while. . .not so here in spain, and I believe neither is it in UK . . . Going to the loo was an absolute pain, as I had cistitis . . probably due to a catheter being used during the operation.  

I took Zaldiar (mixture of Tramadol and paracetamol (acetominiphen) and didn't have a prblem with constipation, but everyone is different. .. 

 

Chris,I didnt get a chance to speak properly to my surgeon until just before the op, thats when he told me he was using a different kind of knee. I had to be at the hos for 7 in the morning but didnt go down to theatre till after 11.30 so be prepared to be bored! I took an MP3 with me. I think it depends what country you live in. I had mine done in a private hos but as an NHS patient. I imagine he is well aware of your EDS so dont worry

Thanks for this reply martinarvelo.  We did ask while we were there if my husband could give blood (he's O Negative, so I could use his) but they said they didn't have the facilities to do anything like that.  Ah, but seeing they left you to see if you could make it up without a transfusion is encouraging - I'm sorry you couldn't.  I'm in the UK.   Oh, so sorry to see about the cystitis!  I had a bladder infection when I got home after an operation before - that knocked me out more than the op!

I do take paracetamol now, but whereas the GP told me to take it four times a day, I only take two at night for a few nights on the trot and then try to leave it off for a few nights, so it's more effective again. But I'll have to see how painkillers affect me and up the dose of the Macrogol if need be.

Keep on top of it Chris, make sure the nurses know you really need to take it.  I was prescribed lactulose and it does nothing for me - at home mynpreference is for fybogel - it's gentle and it works for me, although I told them this they insisted the lactulose was the thing to take!  I should have been more insistent - you know your own body. 🙂

Thanks Rose.  I've just emailed the hospital to ask if they've taken the EDS into account regarding choice of knee (apologising profusely for troubling them).  You didn't go to Barlborough, did you?  Yes, it did go through my mind that they've probably asked the whole morning list to be there at 6.30 am but I'll take my Kindle anyway:-)))) 

Thanks Jane.  You are SO right.  My GP had left me struggling on Lactulose but in hospital last time they put me on Movicol (macrogol) and I've never looked back.  So I will insist on taking a dose as soon as I'm drinking after the op.  I'll get my husband to have a sachet handy that I can drop in a bottle of water:-))))

Hi Chris, no i went in the Spire in Southampton. Very good food and my own room but I found it boring when I didnt have visitors. I was only in for 3 days though. Also I had to bath in Hibiscrub for a wk before and it made my hair very dry. Might sound trivial but use a good conditioner if you have to do this. My surgeon used a Zimmer Persona knee if thats any help. Im supposed to be having the other done too but Im holding off cos I had 13 wks off work and dont want to have it done too soon.6 mths later and it all seems in the distant past. This site will help you through it

 

Ah They've given me Hibiscrub to use for the last two showers before I go in, but said to only use it from the neck down.  I am wondering if it should be used round 'delicate bits' though?  I also wondered about putting all my clothing that I'd be wearing after the op through a Dettol wash but wondered if that was going a bit overboard?

When it is a struggle to get on a loo and back up again, you really don't need to be getting up seven or eight times a night!  I'm afraid I resorted to a bedpan the first two nights!

 

Hi Chris I am a daily hair washer too, but because you have sleep on your back your hair doesn't seem to stick out so much.  I'm now back to tossing and turning and I looks like ' aunt sally ' in the morning lol. You do worry about the silliest things only natuaral. Just make sure you do your exercises.

I suggest you call and write/email the hospital/dr and tell them about your allergy PRIOR to your surgery so they can prepare the operating room!

They should already be aware of it when you get there and everyone on your team who comes to see you should acknowledge it.

Chis, I didnt wash any clothes in Dettol so unless you been told to i wouldnt. I had to bath in Hibiscrub so it doesnt do any harm to other bits!

Right, I won't bother then - thanks Rose:-)  I did wonder if I was going a bit over the top:-)  And thank you about the Hibiscrub - I was worrying about that a bit.

Rose, I emailed the hospital last night and asked if a particular knee will be used because of the EDS and they've already come back and said they have taken that into account and are choosing the best one for me.  I have to commend Barlborough because you can ask anything at any time.  Before I even asked my GP to refer me I asked lots of questions and got good replies to them all - I'm so impressed!

Chris, sounds like you are in good hands! I can understand you being worried, I was petrified! It helps to have a good medical team.

To be really honest Rose, I've been anxious about the trivia (like hair washing etc.) but not the main event.  Until last autumn I was totally against having knee replacements (imagining the worst happening) but then realised how limited our lives had become because I was unable to do anything and with that and the constant pain (I hadn't realised initially that there would be pain when I WASN'T moving!) suddenly did a total u turn and realised the time had come, so instead of feeling totally negative about it, felt very positive about it.  I think, really, it all came down to feeling this was the right time for me, so I'm actually excited about it!  Nuts????? LOL!  I'm excited that it's a step forward in my life that will open things up that I've been unable to do for so long!  Everything has been such a struggle for years and I can't even imagine walking without pain, so I'll be running towards the theatre (I wish LOL!).

I had mine done cos although Ive got end stage arthritis in both knees, my left one gave out when I was coming downstairs and thats the one Ive dislocated before.I thought a TKR would be the best thing but I was unprepared for the lenghty recovery. It really does take a year but if you are in that much pain then it will so beneficial for you. I dont know how old you are but Im 56 so fairly young to have it done.It wouldve been easier if I didnt work and Im on my feet all day.You must work hard at the physio though ,thats the most important part. Its a very different pain to the pain of arthritis and at least it gets better! Its very hard to sleep for a while after but it all gets better. If your arthritis is affecting your lifestyle that much then its the best thing to do

 

I'm 67 Rose.  The arthritis is keeping me awake so much at night now and it's keeping my husband awake, possibly even more than me, because I groan in my sleep as I try to move LOL!  It's the sudden 'ouch' that I do sometimes, going around a supermarket - I wonder if people think I've got tourettes!  But sometimes it catches me unprepared:-)  Yes, you are fairly young for knee replacements but if they need doing, they need doing.  I gathered that about the physio.  My right leg started giving out about six years ago.  I remember my son handing my granddaughter to me in her car seat as a baby and I said my knee might give out and he thought I was joking and passed her over and the knee DID give out, but fortunately I fell against the door frame so didn't drop her!  It really frightened me and it's given out quite a few times since.  I was using two sticks initially but found I was getting weak core muscles so was told to gradually give up the sticks and struggle without them, which I did, but that brought it's own problems....

That was me Chris. Time had come, positive attitude. Everyone has different coping skills, doctors, outcomes. Sometimes there is a lot of negativity rather than encouragement...

At 52 and able to walk had all kind of input "i was crazy" to have surgery. Knees last 15+ years-25 can happen if u take care of them ie dont pound them w high impact activity. There's a 1% deterioration of the spacer starting year 15 based on studies done by STRYKER.

All those people didnt see i had to have 2days off of rest for every one of work. I am so happy its done. At wk 10 i had a grueling 1hr PT on Monday which killed me for 2 days. Todays PT i told him how i did since Monday. We adjusted. I ACCEPTED the discomfort as part of getting better. Pain after is expected and didnt last. Swelling lasts longer but not debilitating. I focus on EVERY MINUSCULE POSITIVE thing, staying aware of the "negative" but i put it in its place- so i dont let it control me. Ive sobbed, laughed and screamed all in the same hour and MOVED ON....

It's a personal thing, isn't it.  Once it's really limiting your life, and the other options don't work, it's the obvious route to go.  Swelling is a nuisance in that it makes the bend more difficult . . but when it finally went down, i suddenly increased the bend miraculously. it was a lovely moment.  And yes, after a 'good' day's exercise  or physiotherapy there is usually an awful day . . but it has to be two steps forward and one back.  the first time i went to the hydrotherapy pool I suppose I did overdo it . .t was so lovely to be in that warm water, and be able to do a lot more than usual . .and the next day was no fun at all . . but well worth it.

 

You and I think alike, I think:-))))  But it was a relief to have made the decision, and then a relief to see the GP who wholeheartedly agreed the time had come, and then a relief to see the surgeon who asked which knee first:-)  And, to be honest, I'm sort of enjoying counting the weeks off and planning everything because it's all moving forwards:-))))  Maybe part of it is not being afraid of pain.  The pain of something positive - the operation, is very different from chronic pain because you know that pain from the operation is achieving something that will lead to improvement of life, whereas the pain of plodding on with chronic arthritis, knowing it can only get worse, is debilitating and depressing.  So to me, to know you're doing something to change that, HAS to be good!