Right TKR planned for July
Posted , 11 users are following.
Happy to find this site and the many folks ready to share their experience.
I am 66 and have had Rheumatoid Arthritis for 13 years quite reasonably well managed on a parade of drugs by NYC and Asheville Rheumatologists. Now on Rituxan 4 doses a year. My knees started giving real pain 4-5 years ago, getting worse as time went by. I have TKR scheduled for July in North Carolina and find the positivity and tips here very helpful. I know to do leg and arm exercises now to strengthen them before surgery, and to eat a high fiber diet etc. Any other tips from TKR patients? Things you wish you had done before the surgery for example?
I am a bit concerned that the surgery might trigger the RA to become active again but my doctors seem to have the meds etc under control, what to stop and what to keep taking. The Rituxan infusions are due about now but have been postponed until August.
Thanks.
0 likes, 52 replies
susie07313 cynthia60780
Posted
So good luck, and keep in touch.
Susie
cynthia60780 susie07313
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Hi Susie,
I would love to share experiences with you.
If this is your first TKR we certainly have many things in common.
The tips and suggestions so far have been great. The hospital I am to have surgery at
has a one day pre-operative day of blood work, xrays, EKG, physician assistant interviews etc which was very helpful.
The last event of the day was an instructive class presented by a Registered Nurse. She showed us every piece of equipment that will be made available to us in the hospital plus all kinds of info about Physical Therapy available in the hospital and as home is its once we are discharged. We came home with lots of handouts and feel Iing a lot more prepared.
My surgery is a little over 2 weeks away on July 18. So you will get to do things first. ??
I can't figure out how to set up the line length on this reply box
so I am entering lots of line breaks that may not be needed.
Thanks for contacting me. We can switch to email if you wish.
It is hot here today so I decided to splurge on an ice cream sundae on my way home from getting my hair cut. My rationale was that
soon I will be limited in how esily I can get out and about.
susie07313 cynthia60780
Posted
Hi Cynthia, sounds like your hospital is very well organised - I certainly feel good about mine after the pre-op stuff, and the physio teaching me the exercises that you have to do almost immediately - I imagine that the mix of pain and morphine might make them difficult to do properly at first! It is raining and grey here (near London, UK), typical British summer, so I am envious of your ice cream. I do feel that I am doing a lot of 'last for a while' things before I am incapacitated. Final countdown now.
It will be nice to keep in touch
Susie
sue37592 susie07313
Posted
Hi Susie and Cynthia,
?Best wishes to both of you for your forthcoming operations.
?My top tips for post op are rest plenty during the day, as sleep is hard during the night. keep taking your meds regularly at the start, don't try to do without it is harder to get on top of the pain than keep on top of it. Invest in an ice pack, I got one that came with 2 ice packs and went into a sleeve with velcro to hold it in place...meant one pack on and one in freezer. Others just use a bag of peas...either is a must as ice becomes one of your best friends. Elevate as much you can too it helps to reduce the swelling. Go for little walks on your crutches round the house...even just to the loo every hour or so to keep circulation going.
?When you come home take it as easy as you can and let others look after you, cook for you and as for house forget how it looks you are more important, as is your recovery, you need and want this to work.
?Both of you take care and keep us posted on your recovery. xxx
susie07313 sue37592
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Warm regards
Susie
cynthia60780 sue37592
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Thank you.
cynthia60780 susie07313
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Quiet morning for me although I have did do my first set of exercises.
We are invited to friends this evening for an informal pizza and chat. Idea is to get us out often before the surgery. Before we do that though, I have to have the cardiology consult at 2pm.
My energy levels are generally low because of the RA so I am a bit nervous about how low will they go after surgery. No point in worrying. Just plan to give it my best shot and will definitely will rely on my husband for a lot.
What have you done to treat yourself before surgery?
I see others on the forum will be watching our posts too. As long as only one of us is crazy at a time, we'll be good.
sue37592 susie07313
Posted
cynthia60780
Posted
The thing that worries me most is the swelling in my right knee. The nature of my knee prone is joint damage from Rheumatoid Arthritis with a vagus deformity that needs to be corrected with TKR. This knee has been twice the size of my left knee for 5 years plus. After the exercising this week the swelling has increased even with icing.
My question is : if the knee is going to swell significantly after surgery, will its being swollen to start with, make the actual surgery more difficult for the surgeon?
I plan to call the surgeon and my rheumatologist this morning and ask:
1. About the swelling I am starting out with
2. Whether e
I should continue the exercises if they are likely to trigger RA flares.
Trying to be CALM as recommended but I would love to find an RA patient who has had TKR done. Anyone?
Love this forum. It is 9.30 am here in NC coming into July 4th holiday weekend. Nothing too energetic planned. Rather, I invited friends over tomorrow for Pizza and movie watching! Not exactly the traditional barbecue, swimming, baseball and fireworks! But it is air conditioned and easy.
.
Sorry UK friends, but Happy 4th to everyone on this side of the pond.
susie07313. How are you doing?
susie07313 cynthia60780
Posted
Hi Cynthia, Happy holiday weekend to you, and to everyone else on here. I hope you get some answers about the swelling - I really feel for you, it is bad enough needing a TKR, never mind all of your issues to deal with.
I'm doing well thank you, honestly wish I was in hospital now, instead of on Tuesday! I am it that last minute panic of getting everything organised for the family and my business, assuming I won't feel capable of doing anything other than concentrating on myself for some time!
My husband is retiring from full time work as of now, so we have lots to look forward to, just need to get through this and out the other side. It was his retirement event last night, which was so moving and rewarding - I wonder if in the future I will be able to stand up and chat at events instead of having to sit down all the time, giving me a pain in my neck as I spend the time looking up to talk to people, and feeling out of place physically?
Had a chat with the pharmacist today when stocking up with my medications - his brother is a physio professor, and he said the exercises we have been doing pre op are vital, but not as vital as those after. His mantra apparently is "exercise should not be pain free, but should not be unbearably painful", i.e. don't overdo it.
So, happy weekend, and look forward to telling you how it goes.
Warm regards
Susie
cynthia60780 susie07313
Posted
HI there, Susie,
Tomorrow is the big day for you! Sounds like you have done all the recommended things to prepare and it will soon be behind you. You'll wake up after surgery tomorrow with a brand new knee.
I am doing OK but last week had some issues with doing the preop exercises. Ten reps of each exercise on each limb - I did two entire sets with one ice application to the operative knee afterwards. When taking a shower at this point, my legs suddenly felt like jelly and I was pleased that I did not fall. So, I realized this wasn't good. As well as the jelly feeling I developed pain in several joints that haven't hurt in years. My Rituxan has been sput on hold and is now overdue. I think the exercises were triggering an RA flare.
I called both the orthopedic surgeon and my rheumatologist and asked them to talk to each other. HORRORS! They actually did and I got word back from both practices to cut the exercises by 50% from now till surgery on the 18th, and to take a Flash dose of Prednisone over the next 5 days. 15mg for 5 days then back to my usual 3mg. Today is day 3 of the 5 and I am a new woman!!!! I know from past experience that it is a false 'cure' that will only last as long as the higher dose of the prednisone it took me so long to reduce to 3. But it allows me to do the exercises religiously, albeit at 50%. No pain at all and no fatigue at all. Being careful not to go nuts doing stuff and focusing on getting the exercises done religiously.
The best of luck to you tomorrow, Susie. Take good care of yourself and I look forward to hearing how it went. But, only when you are ready. Don't push yourself to do anything you are not ready for.
Cheers
Cynthia
sue37592 susie07313
Posted
You have had a lovely weekend and at least your hubby will be there to look after you. Take care xx
susie07313 cynthia60780
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I am sorry to hear about the difficulties of balancing exercises, treatments etc., and I hope you continue to have some good days before the op. You have so much more of a challenge than me, so I will be thinking of you too.
I will report back when I can, but thanks for the thoughts.
Best regards
Susie
susie07313 sue37592
Posted
Best regards
Susiex
glenda29798 scrannel
Posted
Hi!
Sorry but having two TKRs at the same time and driving home after two days in hospital at 64 sounds miraculous to me! Did you definitely have both knees replaced? I wish I'd had your surgeon and healing power??
glenda29798 scrannel
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Not being rude but if you believe that everyone on this forum is a "woos" why are you visiting it?
jeanne_06699 scrannel
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Just because you are one of the fortunate few who had no problems, don't judge the rest of us and call us wooses. Everyone is different. I have had 2 C-sections, a hysterectomy, 2 heart attacks with 6 stents, a tumor removed from the arch of my foot, shoulder surgery and 3 blood clots in my leg. Nothing prepared me for this. When your knee is swelling to twice it's size it is impossible to push back any further. Plus have done all this without a pain killer.
sue37592 scrannel
Posted
Scrannel
And I'm not being rude either but peopleon here are not wooses we all have been through the same operation and looking for support and advice when they have concerns they do not know how to deal with themselves. I think you were incredibly silly driving after a couple days, you like ALL of us want our lives back but do need to recover...you had not only strong meds given in hospital but the anathesitic was still coming out of your system.
?Do you think we all had this operation just for the fun....no!!! We al needed it. I am only 50 and looking forward to getting my life back, very much so, being able to walk, look after my family and work a full day without being in pain. I have been positive like so many here and we are not wooses!!!!!
sue37592 scrannel
Posted
Hi I have never called you a liar! What is upsetting is you implying we do not want to get on with our lives and calling us wooses! I feel the fact so many people are looking for help here is they want to get their lives back to normal but have run into a wee problem they want advice on. We ALL WANT TO RECOVER do you really think we had a tkr for the fun we did it to recover either from o/a or other problems. As i said I'm only 50 and do not plan to sit around and let my life drift by. We may not all be superman but we are all going to recover IN OUR OWN TIME!!!!
glenda29798 scrannel
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cynthia60780 scrannel
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susie07313 cynthia60780
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Hi Cynthia, not sure how this works and whether others can see this or not! So, day 3 after surgery and the first time I thought I might be able to string two words together, or rather ones that aren't "painkillers please"!
The operation went well, I think, and I certainly came round feeling a lot better than I expected to - full general with painkillers in the wound (not sure what that means). I ate something about 4 hours after coming round properly, and was got up to the comode after about 15 hours - promptly passed out, but to be expected. Since then, incredibly regular painkillers, including morphine, tramadol, at the start and now long acting opoids twice a day until the balance is right - my surgeon is very keen on managing pain so that you can do the correct amount of physio, but takes a very slow approach which I am happy with. Currently only heel slides in the bed, pushing knee into bed, sitting on the chair and bending the knee (worst thing ever), and walking. Walking improves every session, but still feel incredibly vulnerable as I get a bit woozy. Blood sugars under great control which is pretty amazing, the downside being I have to force myself to eat what they give me and I have no appetite whatsoever due to the morphine, I think. Doing ok on the extension, bending much harder - currently at 60 with a real push and gritting of teeth. They keep saying everyone is different so not sure whether that is good or not. With luck will have hydrotherapy the day after tomorrow, depends on the bend.
Main thing is not being able to concentrate anything - as others have said, this is really major and I don't think you realise until you've had it - however positive I am being! Sleeping MASSES but that's supposed to be good, and drinking water for England, which both the hospital and the forum was insistent on.... much better now my bladder appears to remember how to work!
At present, i feel in a nice safe and caring coccoon - this is an amazing hospital. Institutionalised already, so not desperate to go home but will be in a day or so, I think. Anyone else have any views on number of days to stay in hospital?
Hope you are well, Cynthia, and taking care before your op. I can't think of anything I now wish I had done apart from finding the forum earlier - it is such a help. With the exception of the odd one, I should say!
Anyway look forward to hearing how you are
Warm regards
Susie
glenda29798 susie07313
Posted
Wishing you well Susie???? The vast majority of contributors to this forum are fantastic and got me through my first TKR in 2014 and that's why I re visited in 2016 with my right TKR! You always get the odd comment as I found in 2014 but generally everyone is lovely!
Very best wishes from,
Glenda (post op 11 weeks right TKR!)
betty525 susie07313
Posted
Hi Susie, I spent 2 nights in the hospital and then home when I had my RTKR. I'm 6 weeks out now and can tell you my first 2 1/2 weeks were not good. I'm a side sleeper usually but haven't been able to sleep on my side yet so I am looking forward to that. Physical therapists came to my home the next day after I was released from the hospital. I could have gone to an in-patient facility because I am 65 but, really just wanted to be in my own home. My sister came to stay and take care of me and believe me I am so grateful. It is humbling to realize how much you cannot do for yourself. I had home pt for 2 weeks and now I have been going to out patient physical therapy 3 times a week. The meds, exercising, elevating and icing has been my routine. It does get tiresome, but with a positive attitude (that I know you have) it will get better with time.
Best of luck as you leave the hospital and continue your recovery.
Betty
susie07313 glenda29798
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Thank you Glenda, hope you are doing well after 11 weeks. Wonder if it's better or worse second time around? Best Susie
susie07313 betty525
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Hi Betty thank you very much for the encouragement. Gosh two nights in hospital is very short! I am expecting 5, but yes, will have lots of physio or organise after that. There is nothing like home though, is there? I am lucky to have everyone home with me - my med student daughter will be in charge of painkillers and exercises - she's probably going to be even stricter than the hospital! I know what you mean about being a side-sleeper, me too, so I hope you can soon. Best of luck for continued recovery
Susie
glenda29798 susie07313
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Hi!
I was dreading another TKR but pain wise compared to the first one it has been much better but this right TKR doesn't seem to be bending as easily as the left one did and so I've just paid for 4 extra physiotherapy sessions! Yesterday I only measured 90' but after 30 minutes of rather painful exercises etc with the physiotherapist I then measured 100' and so the session was worth the effort!
I was really pleased with my first TKR after about 7/8 months and by one year plus I was practically romping along but sadly my right knee couldn't keep up and so this April I had the right knee replaced but I'm sure that I'll be very happy with both knees by Christmas!??
sue37592 susie07313
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YOu are doing really well with the exercise and so on. I did not have opportunity for hydrotherapy in N. Ireland but have heard so many people talk so highly of it, wish I could have tried. Best wishes and keep sleeping and drinking water and keep on top of those meds xx
sue37592 susie07313
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Take care Sue x
susie07313 sue37592
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Susiex
sue37592 susie07313
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Hi, it gets very frustrating when you can't do things, but gradually you will get stronger and able to do more. Some days I just sat and cried. Just watch you don't overdo it and take care xx
cynthia60780 susie07313
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Susie
First time on the forum for a while. Glad to hear that the surgery went well and having your own I house medical profession.
I have had an eventful couple of weeks. Short version is that after two exercise sessions I began having flares in my wrists, shoulder and ankles. I called the surgeon and the rheumatologist (
RA) and suggested they
talk to each other raer than with me in the middle. They did and came back with cutting the exercises by 50% and also taking a burst series of Prednisone above my regular daily 3 mg.
Next on the menu - severe constipation which knocked me out on days 4 & 5 despite all the usual remedies. Got th r tough that finally then I woke Episcopalian last weekend with a lump the size of a large pea .it was tender and not the first skin infection I have had. Definitely Ju
the biggest.warm soaks and long baths did not have any effect so off to the family doctor. I know the knee surgery won't happen if I have an infection. Dr treated it and now on Day 4 of antibiotic the lump is shrinking.
I have been tired from antibiotic and whatever else and have not gone out of the house in days. Maybe tomorrow since surgery is now only 4 days away.
cynthia60780
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I didn't write Episcopalian. ?? meant to say that I woke up last weekend.....
susie07313 cynthia60780
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Susie
sue37592 cynthia60780
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susie07313 cynthia60780
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xSusie