How can i delay TKR for simply 4 months?

Good morning Martinarvelo.

I think you may be onto something. I've heard the same thing from different sources.

I personally find it hard to believe. It's not as if i was on my back for 5 months. After 2-3 months i even went to the gym to work on my legs with cardio exercise.

But there was something you said that interested me ("...it happens almost immediately") Please tell me about that.

I don't understand why...especially considering the above.

But i do know that i was playing at a high level even with the torn rotator cuffs. When i was diagnosed i was stunned to hear such a dramatic diagnosis...if my cuffs are torn then how could i be playing like i am? They said because the muscles surrounding the cuffs are so built up from decades of playing they are compensating for the torn cuffs underneath.

Id also like to express my sincere appreciation that you were even ' thinking' about [ME]! A big part of my resistance to giving into the TKR is that im alone. It's just me and my beloved dog Venus. I know I'm acting out like a spoiled child fighting this...but im scared. I'm prone to catastrophizing...and all sorts of awful scenarios build up in my head...what will happen to Venus the 3 days im in the hospital? She's everything to me...i can't just put her in some kennel-i saved her from off the streets. What's going to happen to me once i get home- who's going to cook, clean and tend to Venus and me? I like being independent...but what if "they" (a ficticious THEY that i create in my mind) decide to send me away to some nursing home at 50 yrs old never to see freedom again and Venus is thrown to the wolves.

I know...all absurd thoughts. But that's what's going on in my mind...let alone losing my vocation...my means of self support.

Im very grateful Martinavelo for your thoughts. I am in the gym trying to rebuild those leg muscles but-OMG 5 minutes after i stop the pain is excruciating.

I'll end with this...i found a study about something called REGENERX...some kind of stem cell therapy where they rebuild the cartilage somehow. Im desperate i know and grasping at anything and everything to avoid "the death penalty."

But Martinvarelo to think that someone, somewhere over the rainbow 🌈 was actually thinking about my well being brings a tear to my eye.

From the bottom of my heart-

Thank you

Aw shucks!  Actually, Tenerife . . quite a long way from you and over quite a few rainbows I suppose!  the reason I said how quickly you lose muscle, is that when I had my first arthroscopic exercise, the surgeon said I couldn't put the leg to the floor for ten days. . He says he told me to do exercises, but if he did I don't remember that!  So I didn't / / and when I went back after ten days my quads did not even respond . . the leg was visibly thinner from lack of any muscle, and in the end I needed electrical stimulation to get the muscles working again. . . Mind you, I am not an athletic sort of person, so I probably didn't have anything like the muscle tone that you would have . . .but I believe once you stop using a muscle it degenerates very fast.  Most unfair how a cat can sleep all day , never exercise, and yet leap huge heights  when they need to!  Regarding all your other worries, you do need to find a solution for Venus . . and if he/she needs a lot of exercise, someone who will  cover 'walkies' for a while, but I'm sure they will not incarcerate you in a home at the tender age of fifty!  the opposite will almost certainly be true. . out and on your bike as soon as possible!  the first couple of weeks it is difficult to cope. . One of the problems with using a walker or crutches is that you don't have another hand left to carry a cup of coffee for example, or pick something up from one place and move it to another. . . .but if you DO finally have to have the TKR, come back ot this forum and people will give you all sorts of useful advice about preparing for the op . . and making you home TKR friendly!  My only experience of Chicago was a touch down on a flight home from LA . . Looked lovely from the air!

Lol...the cat analogy is funny!

Chicago is a wonderful place in the summer, and an equally awful place in the winter.

It's one of the few places where it can literally be 80°F sunny blue skies one day and 40°F freezing and windy the next!

Thanks again Martinvarelo, i shall keep in touch.

Btw...you never explained what that cartilage replacement injections were about

I don't know a lot about them . .I thought it was still in the experimental stage? Although, our nextdoor neighbour is having some injection next week, which is not the halyuronic acid one. . something more sophisticated.  As she is over eighty, they recommended not having the TKR and are going to try the injections, but I'm not really sure what it is. . .  I'll try to ask her about it but she is German, and my german is very very basic!

Thanks...let me know what you find out.

In about 2 wks i have an appt to take part in a study that sounds very much like what you were talking about. It's something called REGENEREX...they take "cells/marrow?¿" from your spinal cord and inject them into your knee (or something to that effect) so I'll let you all know what becomes of that too#

Sarah...but i AM afraid.

I'm afraid of everything... lol

I live alone

I have a dog im afraid they'll take away from me..

Ill wake up from surgery with only one leg..

IM A BIG BABY 🚼

lol

Awwe Sarah...thank you for your advice.

But why does the cortisone after working sooo great for sooo long just STOP working?

Is degeneration of your knee David.   Injections only work in the short term I am. afraid.   Lots of people live on their own and are a lot older than you David.   Why would anyone take your dog away??? Have you friends that can help you? Do you belong to a church or community group at all?  I am sure you would be able to find someone to walk your dog if you cannot do it yourself.  TKR is not an easy operation by any means and recovery is long term but you will get through it if you need to.

I am a catastrophizer. My mind always goes to the worst case scenario.

It's rediculous i know, but its real.

Additionally ...what about my job?

As i mentioned in my introductory message im just now in my 5th month of recovering from major rotator cuff surgery. I had planned to be back on court in June. NOW for no reason whatsoever my knee gives out??? ITS NOT FAIR!!! How can i go from one major surgery to another? Does God hate me? I'm a nice gent...lol

I laugh only because it's the only thing that keeps me from crying.

Tennis has been my career for years...its all i know. Im no doctor, no lawyer, no butcher or baker or candlestick maker...lol...it's funny but its not....i want to work 😢 i don't want to be alone again recovering through ANOTHER major surgery after another!?

It's bloody ludicrous!

Ok David...stop crying...lol

Thank you all for your support

David

Have you spoken to your GP about how you are feeling?  I definitely think you need some support, albeit someone just to offload to.  I think you need to be things into perspective and the only way you will do this is to talk to someone.   I think you are doing too much worrying about what ifs, in my opinion, for what it's worth.  Lots of people do have wonderful careers that they have to give up for some reason or another and manage to go on with their lives in different ways.   It isn't a death sentence having a TKR, far from it.  Please consider getting some help, for your own peace of mind.   I wish you well.

The cortisone stops workling because your knee is now too damaged. It's called wear and tear arthritis getting older, whatever you like to call it.

Ofcourse you are afraid that's OK.

Let me tell you a story.

When I saw my consultant before my operation he ws pointing out to me the risks of the operation. He siad it was possible that my new knee would start dislocating again. He saw the look on my face of COMPLETE TERROR11

I WAS NOT BOTHERED ABOUT ANYTHING ELSE AND WAS ACTUALLY AWAKE WHILE THEY OPERATED, JUST HAD EPIDURAL

When I had my follow up appointment six weeks after op I said to consultant "You mentioned that my new knee might start dislocatlng again. What do you think now that you have done the operation?"

He siad "I think it is very unlikely that will happen I've dealt with it!!"

MY ONE AND ONLY FEAR, HE COMPLETELY DEALT WITH IT!!

Out of all the patients he sees he had remembered my fear and dealt with it. 3 years down the line and my new knee has never dislocated.

Take heart and courage

Sarah xxx

You're right Susan. I am consumed with "what ifs" and my mind "catastrophizes" it constantly goes to the worst case scenario.

But what really eats away at me is the fact that im just coming off the 5th month of a major rotator cuff shoulder surgery. It all is so overwhelming.

I know there care soo many people in worse situations...young men coming home from Afghanistan with missing body parts, people suffering with cancer, people losing their jobs and homes.

I need to count my blessings. Look at all the positive things in my life. Life is suffering.

Aging isnt fun.

And look at all you folks across the proverbial pond sharing their experiences, support, concern and love.

Thank you Susan...sincerely thanks!

No David, the ageing process is no joke.... Just be positive xx

Sarah...OMG you actually were AWAKE during surgery with only an epidural?

WOW...you are a strong woman!

You're beyond strong...you're my hero

Thank you Sarah! I shall take heart and courage and keep you in mind whenever the terror starts to rear its ugly head within me!

Xoxo

David

Being awake is so much easier because you are not getting over anaesthetic so in a way I was taking the easy option.

Be awake now there's a challenge!!

Being offered spinal block instead of general anaesthetic is the norm in UK David.   I think most of us had that.  I certainly did!  Quicker recovery and pain relief is instant.  

If that's the case, i think i changed my mind about moving there. LOL

Id just faint at the sight of the OR, so id be asleep anyways.

I think you ladies are used to epidurals from giving birth.

We men ( I'll speak for myself) are big babies. I ask my dentist to put me to sleep when he does work on me.

Lol...thanks Susan but that's not a challenge I'll be taking on anytime soon

I've never had anything but general a d never had the option. Also, never had a y problem recoveimg.

Last two times I was eating full menu meals within hours. The hospital I go to offers menu service from 6:30 a.m. to 7 p.m. so the most you have to wait is 30 mins after calling room service. I was still in recovery the 1st time. The old being sick and feeling terrible is almost a thing of the past with the new anesthetic cocktails they use. Of course, abdominal surgeries are a whole different situation. Had a whole different 3rd overt with colon resection

Epidurals .....used to them....I think not David.   I certainly never had an epidural when I had my son.  And you are right, men are babies on that we will agree!

😉

i have never been ill after a general either but I had the choice and opted for spinal and glad I did.   It's just nice to have a say, I think, in your treatment when you can.   I know that some that had a general in the hospital I was in seemed to recover slower than those that had a spinal.  

😜

But it also wears off pretty quickly, unfortunately!  I came out of theatre at 4.45 and by six O clock I was desperate for some pain relief!  I think the ideal is where they give you the spinal, but also something to make you drowsy or not quite so aware of everything.  i did get a bit fed up with the noise of it all, especially the chatter of the surgeon with the nurses.  I was trying to figure out what stage the operation was at. . but I couldn't, until I heard the stapler!  Oh great, I thought that has to be the last stage!  Oh, and I;m afraid there was no epidural for my two children!  I wish . . .. 

I didn't know a thing until near the end, as I did say I didn't ant to be fully awake.   Also pain was more controllable, I can honestly say I felt no pain for the first couple of days.

You were lucky then!

 

No I don't consider myself lucky as I had a lot of pain when I started to move around but the drugs I was given in an NHS hospital were enough I think.   I don't know where you had your surgery, if it was in UK you would have had sufficient pain relief I think.   I have a lot to thank the NHS for, I think 

There is a lot of difference even between NHS hospitals. I have seen some people on the forum who have been in considerable pain within hours of the surgery. and I think not to experience pain in the first couple of days is unusual rather than the norm.    My nearest NHS hospital was 1500 miles away, so not an option in my case anyway!  As a non resident, I wouldn't be covered for treatment under the NHS anyway . . well, actually the laws have just changed, and in fact i may now be eligible, but certainly not last January!  

I worked in the OR for an orthopaedic surgeon and the one and only patient that was awake was a girl having an arthroscopy she was a physio student and wanted to see the inside if her knee. Every single person that had a joint was asleep.. Most bad spinal or epidural some general but they were not aware of what was going on.

Lots of variation in the way anaesthetists work it seemsQ  I've had two arthroscopic ops, and one TKR, and I was wide awake for all of them.  It was quite interesting watching the arthroscopic ones on the tv monitor, but with the TKR you don't see anything . . just follow the noises and it gets rather tiresome, especially as my surgeon seems very slow. .three and half hours. . and oh it was SOOOOO cold!  I imagine it has to be cold to keep infection risks down etc. . . I think if I ever have the other ne done (heaven forbid) I shall request something to make me sleey at least!  I didn't really know that it was possible with the spinal to also have a sedative.  But hopefully, I shall not need another one!

Never once in the 10 surgeries ive had on this leg was I offered the option of being awake, which I would have rejected anyway. The newest method of 48 hr pain relief that my team used is really great. They run a wide through the femoral artery and start a drip shortly before surgery. When you wake up you are nearly pain free and you have a pump that allows you to supplement the drip. The next day they start the pills on a regular schedule. The last combination I had was oxycodone every 3 hrs, m s contin every 12 hr's and an antI inflammatory 2x's a day. I think some Dr's are so afraid of medication for some reason. I don't know if they see it as a reflection on them or if it's just a cost cutting thing and a way to save a buck. My surgeon says there is no reason for anyone to have to suffer any more than absolutely necessary. All of this is not to say this is a totally pain free process especially when you start throwing in therapy, etc.

Yes OFG when i had my shoulder surgery i had something similar to your 48 hr procedure...they called it a "block"

It kept me pain free for 48 hrs also, but they were adamant about staying ahead of the pain by starting up on

I actually said to anaesthetist I didn't want to be awake and so they gave me sedative.  Also after op I had top up of long lasting painkiller put through the spinal block, hence no pain for a while.   Perhaps they were stingey with the painkillers abroad!

There are 2 kinds.... One goes in the spine and the one I had went directly in the artery. I had the 1 st type when I had my original tkr and a somehow it got turned off and I didn't have pain meds for about 6 hours till I convinced them I was hurting. The nurse went full run out of the room to get permission to start me on morphine iv. They started pumping that stuff to me every 1t-20 min to get me called down. My wife kept telling at them they were going to kill me and I in turn was yelling at her to leave them alone, they were professionals and she wasn't.

After day two all I got was paracetamol!  And I really can't understand why .. . I would have thought they would have liked to be able to charge the earth for expensive painkillers!  However, it's the surgeon who  says what to give you, and the hospital just follows his orders, so someone needs to tell him how painful his operations are!  He's done thousands of them, so you would think he would know by now that peopleneed more than paracetamol.   the first phsyio session I had in hospital was day 3 (weekend in between . . no physiotherapists!) and they gave me a 500 paracetamol at 8 am and the phsyio came at twelve . . . I'm afraid I was not too nice to her!

I had problems as I couldn't take Tramadol and the doctor discussed with pharmacist what they could use for two days until they got it right.  I can't fault the care I got under NHS, although I was working for them at the time!

If someone offered me paracetamol for any joint replacement  I'd tell them where to shove it, that's just down right cruel and unnecessary ..

pits a known fact the better pain relief you get the better the recovery, it's documented,..

That, in fact, is what I said when I finally got to see the surgeon at 13 days. . He was complaining that I only had about a 60 bend at that time, and grumbling that however good his operation was success depended on my participation . .so I told him that unless he gave me something better than paracetamol there was no way I was going to be able to s tand the pain which the physiotherapist was inflicting on me at that time.  With quite a lot of grumbling and groaning he finally prescribed tramadol for me and immediately I started to be able to make progress.  I still feel very annoyed about the wasted two weeks when I should have been concentrating on getting the bend.  If I could have got to my GP he would have prescribed them for me, but couldn't drive, husband can't drive because of stroke. . so I was housebound! Wish I had found this forum before the op!  (mind you, it may have made so scared I would have chickened out!)