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Pre op

Posted , 12 users are following.

daisymay2
daisymay2

Hi again,

You were all so good helping me put a list of things I need to do before my TKR.

I searched the forum looking for any ideas on what the actual pre op assesment entails but can't see anything.

I know it varies from hospital to hospital and Consutant to Consultant buy wondered just what does happen?

I think bloods and medical exam to determine you are fit pre operatively but is there anything specific to TKR's I should be aware of?

Sorry if this is a bit of a stupid question.

2 likes, 48 replies

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  • pat87964
    pat87964 daisymay2

    Posted

    They were beyond wonderful pre-op. Kind & gentle & before I knew it I was back in my room...don't remember anything... It only took one hour and I don't remember getting the block before surgery in preop. Good luck
    • martinarvelo
      martinarvelo pat87964

      Posted

      Good heavens. . my surgeon took nearly three hours!  And I remember every damned minute of it . . . 
  • donna4434
    donna4434 daisymay2

    Posted

    Hi Daisy...I am in Canada so might be a bit different but I had blood work, spoke to the physio for evaluation on ROM pre op , also spoke to a nurse about any med I was taking (I don't take anything so was a short chat...but I expect that if you are diabetic for example they'll explain what to take or not take before you come in) I also spoke to the anesthesist ...he was actually the one who told me that this is one of the most traumatic surgeries...due to what they actually do to the leg...that was about it...it took about 2.5 hours what with seeing one then waiting to see the next...good luck
  • Oldfatguy1
    Oldfatguy1 daisymay2

    Posted

    The medical & blood work pretty much tells the story of your physical fitness. I doubt if there is anything that can test the mental aspect, which there probably should be. They know everyone will bleed during surgery they want to be prepared so the can have transfusion available. Personally, I have needed blood on 4 of the 5 complete knee openings and had to take iron pills on the other. Once they have worked through the coagulation part of it, possible diabetes that was previously undetected then they look for any type bacterial or viral infections. Urine analysis does the same for urinary tract infections. With all that info you are pretty safe. All of the rest is based on what they run into once the incision is made and the work starts. You will be closely monitored after surgery. Most of us wake up with a catheter inserted which stay for about 24-48 hrs and each surgeon has his/her favorite pain abatement method. The last 6 surgeries I've had they inserted a nerve block that goes into the groin area immediately prior to surgery and is a continuous drop. This stays in 24-48 hrs. I've also had a pump so I could get a paid med boost if needed. They will probably start you on pain meds orally several hours before removing the Cath. The biggest 2 concerns post surgery: staph infection and blood clots neither of which can be totally eliminated as the individuals system takes over and controls much of that. I never experienced the blood clots but have had the staph. All these things can be treated and all hospitals are well equiped to take care of them. I don't know if I've given more information than necessary, muddied the water or even answered your question directly. You will be in good hands and they will have your best interest at the top of their list.
    • irish_linda
      irish_linda Oldfatguy1

      Posted

      hi OFG can i pick your brain !! im wondering with all the ops you have had on your knee did you get rods put in after your first revision and if so how did you find it ,as ive had a revision 15mths ago and im still struggling ive tried to get fitter by doing some gym work to strenghten the leg but it still feels of metal ,ive ben on anti inflamatorys since the op and to be honest ive been on them since the first op nearly three years so last week i decided to see how i would be without taking the anti inflamatorys (arcoxia 90mg) it was fine for the first few days but now a week has passed and the inflamatorys have worn off and im in pain and im starting to carry the leg abit because of the ache .im now thinking i might have to live with permanent pain .my surgeon that put in the revision told me this is the end of the road .i was wondering how many revisions have you had ?and how were they put in do they giveyou more metal im worried that in time if this revision dose need replacing will it be possible as ive got tods belowthe knee and also above the knee how would it be put in im also wondering would losing the leg be the worst thing !!
    • daisymay2
      daisymay2 Oldfatguy1

      Posted

      Thanks Oldfatguy,

      That pain control regime you had sounds good to me! biggrin

       

    • Oldfatguy1
      Oldfatguy1 irish_linda

      Posted

      As mentioned, I have a rare tumor that caused horrific bleeding and pain. I had 4 surgeries + radiation before finally having the tkr. The original always bothered me as my foot flew out and I continued to walk with a limp. It lasted for 9 years and finally broke loose and was moving every time I moved. Of course it was hitting raw nerves when it moved an the pain was horrible. I had to take a trip to the west coast (4 hrs flying) and was about to scream when that was over. Had the revision and the surgeon removed the prosthesis with his fingertips and the femur part fell off with just a tap from a hammer. The new one was inserted and the next day I fell and twisted the femur into at a 20 degree angle. The next day they inserted a steel plate against the bone with 8 screws. 6 weeks later the bone healed beautifully and I was well into rehab. 6 months later the plate began to rub the skin causing a painful irritation and was getting worse. 10 months after the surgery they took out the plate and my real trouble started. 30 days later they had to open the knee completely, clean and flush and replace the plastic disc. Then I was on 2x's a day antibiotic infusion for 8 weeks then 900mg of clindimicin daily. Then back throug the rehab process. Evidently the antibiotics failed and a year after the surgery I passed out, landed on my knees and the staph came back with vengence. In April of the year the had to completely remove all of the hardware, reclean and flush the wound and reintroduce antibiotic infusion for two months while my leg was immobilized and I was restricted to toe touch weight bearing. After 4 months like that a new, different style prosthesis was introduced and rehab started again. The stem of the prosthesis had to be inserted in a hole that had been drilled deeper for the second time. This prothesis has a prong on the bottom so it doesn't have as much pressure on the bone from the inside. However it will be much longer healing as there is continual movement and until the bone reviews it will feel bruised. I am looking at another year from now before I can consider it being as good as it will get. The Dr told me this week I mace residual pain the rest of my life but one I'm through with therapy in the next 90 days it will settle down.

      Sorry, I didn't mean to writ a bookbut didn't know how to expain it without starting from the beginning. BTW they were never able to clean up the tumor as there is a pocket setting in a nerve cluster and Its to dangerous to mess with it.

    • irish_linda
      irish_linda Oldfatguy1

      Posted

      thanks OFG yep you have been through sooo much more than i have , i agree that like you il have pain for good it can be controlled i supose i just wanted not to end up with pain like everyone that gets the op you do it to stop pain im 58 and i hate to think that ill always have to take meds !!!  im still hoping that it will settle down im not that bothered if ive got a little limp just no pain ! . im thinking am i expecting too much ? im doing the gym to strenghten it but it still feels of steel and bone .i hope yours settles down and lets you live without hospital visits it would be well deserved !!
  • martinarvelo
    martinarvelo daisymay2

    Posted

    I never had much information before the op , but somebody mentioned that they were told not to shave their legs for a couple of weeks before the op because of the risk of breaking the skin . .never heard it again from anyone, but I suppose it sounds like a good idea!
    • daisymay2
      daisymay2 martinarvelo

      Posted

      That's a good tip martinarvelo -  one I would never have thought of but makes perfect sense.biggrin
    • pyesangel
      pyesangel martinarvelo

      Posted

      Yup! When I had my TKR this past April, I was told not to shave before my surgery too...for the same reason, you might break/nick the skin. They don't want any chance of infection!

       

  • martinarvelo
    martinarvelo daisymay2

    Posted

    I never had much information before the op , but somebody mentioned that they were told not to shave their legs for a couple of weeks before the op because of the risk of breaking the skin . .never heard it again from anyone, but I suppose it sounds like a good idea!
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