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Knee & Hip Problems Message Board

Knee & Hip Problems Board Index

I am a 60-yr-old female in relatively good shape 5'5", 140 lbs. 10 days ago I had total knee replacement of both knees. I was 3 days in hospital and came straight home. I started PT in hospital and am continuing twice a week at a local PT clinic. I am interested in exchanging information with others in the same situation, or helping those who are facing this surgery. The biggest problem I've encountered, hands down, is getting control of the pain. I have a high tolerance for pain, have experienced "real" pain before -- ie, two babies. Before the surgery, I knew I was allergic to codeine. Since then, I've discovered that I react to almost ALL narcotics. I am able to tolerate Dilaudid (Ithink it is an opium derivative), but my surgeon will not authorize more than 4 mg every 4-6 hours and that isn't doing the trick. I have to supplement with Ibuprofen or naproxen sodium several times a day. I also use a cold water therapy machine for an hour or more several times a day. Honestly, this machine has been a gift from heaven. My doctor didn't recommend it, but when I brought it up, he was willing to write a prescription for it and hook me up to it in the OR. It ran continuously the first week, and I use it several times a day still.
I knew 2-3 years ago that I needed this surgery, but kept putting it off (I guess I thought it would miraculously get better). Finally, this summer the pain got so bad I could barely stumble out to my beloved vegetable garden and pick a few tomatoes. I found a surgeon I felt I could trust, and set a date. I stayed very busy the last few weeks leading up to the surgery so I wouldn't have to think about what I was about to do. I was weepy, and I also tried to put a few things in order "just in case the worst happens". That is always a good idea if you are having a general anesthetic.
At 12 days post op, I walked unassisted into the surgeon's office for my follow-up appointment! I'm not bragging, it is a fact, and it won't be that way for everyone. But it can happen, because it happened to me. Here are some things you can do before the surgery to improve your chances for success and a quick comeback:
1. Do the pre-op exercises religiously.
2. Get your life in order. Make the difficult phone call, have a talk with your spouse and children about your last wishes, tell important people you love them..
3. Make a list of where all your assets are located, including logins and passwords to all accounts. Make sure someone trustworthy knows where this list can be found.
4. Make a list of close friends and family, including email addresses and phone numbers, to take with you to the hospital.
5. Organize a "recovery room" at home, preferably a bedroom with bath that you don't have to share with anyone. If your house is two levels and your bedroom is up a flight of stairs, you will have to set up a place on the ground level where you can camp out until you can manage the stairs. Your sleepless nights and high toilet seat shouldn't inconvenience your caregiver. Put some of your favorite things in this area -- a green plant, some books you've been meaning to read, games to play with the grandchildren, as well as clothes and shoes. I you have a chore you have been putting off that you can do while you are sitting down, such as going through old family photos or reorganizing your recipes, put those items in this room. Move in your computer and a supply of blank thank you notes, birthday, anniversary, and sympathy cards, and stamps. A surprise gift for your caregiver would be something good to stash away and have on hand for a challenging day during your recovery. (I also am using a "mini" computer, or netbook, for times when I am stuck in bed while the cold water therapy machine is working. I can keep up with email, or watch a movie or TV show courtesy of Netflix's "Watch Instantly" library.)
6. Notify your close friends and family, and your minister if you have one. If they offer to help, have a list of ways they can help you -- running errands, making a dinner, doing laundry, driving you to PT, whatever. Let people help you, and let them know how grateful you are for the help.
7. Keep a file with all your paperwork, exercise directions, important phone numbers, insurance card, a small amount of cash, and your ID. You will need this to take with you to the hospital.
8. Take off all jewelry and put it and other valuables in a safe place in your home or in a safe deposit box, especially if you will have paid caregivers coming into your home.
9. Clear your calendar for at least a month, and don't plan any airplane trips or long car trips for at least six weeks. Get your teeth cleaned, your mammogram, your botox, whatever. Get this all done way before your surgery date. Get your hair cut.
10. Stock your pantry with plain food items -- oatmeal, dried fruit, crackers -- and your fridge the same -- yogurt, cheese, juice. Make a list of phone numbers of local restaurants that will deliver. You will get bored with casseroles and cookies your friends bring and want some "real food" at some point. This is a good indication that you are getting better, when the enjoyment of food becomes a part of your life again.

All the above preparation takes a lot of time and thought, but is well worth it for the day you come home from the hospital. I elected to come directly home from the hospital, even though we live over an hour away, instead of going to a rehab facility, because I knew I would be well looked after and there would be more rest and fewer chances of infection. One of the nicest things friends did for us during the first two weeks at home was to come into our home and prepare dinner. It was social, undemanding, and a very nice way to visit. And the leftovers were nice to have for another meal or two.

I am now 13 days post op, and looking forward to life getting back to "normal", whatever that is. Your most important recovery tool is your attitude. When the PT first came into my hospital room the day after my surgery and announced that she was going to get me standing and walking, I said "Great! I've been waiting for this. Let's do it!" She looked at me as if I'd lost my mind, and said, "You do understand that this will be a bit uncomfortable, don't you?" Yes, I'd heard the stories from other patients. And it wasn't uncomfortable at all. It hurt! So much so that tears came to my eyes. But you know, it didn't kill me, and I'm a firm believer in the saying that "whatever doesn't kill you makes you stronger". That was the first step on the way to full recovery and I really wanted to get it over with. For inspiration, you might want to watch the movie Braveheart again.
[QUOTE=Jeanob;4108339]Thank you so much for being here. I have looked many places and just found some people that might be able to help me. I am having bilateral TKR on Dec. 8. I have asked some people about exercises before surgery and get no response. I am doing the exercises that I learned in the spring when I went to pt for knee and hip pain. Yes, the right hip is also a possible candidate for replacement. I would do more if I knew what to do. Thank you Floating Island for your "things to do before surgery" What a help. I have printed them and am on a countdown for completing them all. I am open to anyone giving me any help on what I should do before surgery. I am a retired teacher and have used a cane for the past two years and a walker for the past 4 months. It is time.
Thanks for any help you can give me,

Hello, Jeano, I know how you are feeling right now. And being well prepared is the best way to deal with the anxiety. As for pre-op exercises, I was given a book which had some exercises in it, by the PT department at the hospital where I had my surgery. They also teach a class once a week to those facing knee repl surgery, and it was very helpful to attend this class with my husband. There are only four exercises, but the descriptions are too lengthy to repeat here. Focus on getting your quadriceps strong(leg raises), on ankle rotations, and on knee bending (sitting in a chair and moving the foot back under you). It would help if you can reach your feet while sitting in bed or in a chair (to put shoes and socks on yourself). The stronger and more flexble you are going into the surgery, the shorter your recovery time. Understand the day after surgery, when the PT comes into your hospital room and announces, "We're going to get you standing up on those new knees", that it is going to hurt. Embrace the experience (you'll shock the PT!). My surgeon was very helpful when he told me, "It's not the new parts that will hurt. It's the muscles and ligaments that have been stretched to get the parts in place. Don't be afraid to put weight on the new knees." It will hurt less the next time, and the next, and so on.
I had some stomach muscles that were annoyed at being called out of retirement. They were necessary at first for simple things like sitting up in bed from a lying position. You will probably have a bar over your bed to help with this, but no one pointed that out to me at first.
Best of luck, and be sure and let us know how you're getting along.
[QUOTE=Jeanob;4124114]Hi all,
Well, I have now officially done the class at the hospital for joint replacements. There were 22 people there for hip or knee surgeries. It was very well done and I was glad I got to see some of the equipment that they will use for the proceedure. :) I am getting a bit more nervous as I get closer to Dec. 8. The nurse giving the class was wide eyed when I said bilateral TKR. :dizzy: Then she said you are a brave person. Oh, that makes me feel real excited about this adventure. :jester: I was the only one there for bilateral TKR. I am guessing it doesn't happen too often. But I know I will go through with it. It has been a 14 month process of losing 120+ pounds but in the meantime I have gone from limping to cane to walker. This past week I am hurting big time and I don't care what anyone is time!
A question for the experienced people. I am guessing that I need no real night time clothes in the hospital except for a robe. Is that correct? I read on one of the posts that I would need shorts for PT. I am not a short wearer, but have ordered some knit shorts for when I am supposedly in an aftercare facility for up to two weeks. Is that what works best? I would prefer my knit pants---I now have lots of them in much larger sizes that should accomodate swollen knees. I'd love to use them instead. What do you think?
Thanks for all the help,

Jeanob: Additional congratulations on the weight loss! I know how difficult that is, and you will benefit so much from that struggle in the next one. Bilaterals are a challenge, though I don't think I agree with the writer who compared it to having twins. I'm almost embarrassed when people tell me how brave I am, when I'm really kind of a wimp about pain. I just wanted to put hospitals, doctors, shower chairs, PT, and drugs behind me and get back to my real life. TKR and recovery are a long stretch of time out of your life and I wanted to minimize the time loss.

OK, about the pain: bilateral is not a higher level of pain, i.e., it's not twice as painful as having one knee done; but it's spread out over two knees. They certainly didn't give me twice as much painkiller! You're going to do well if you're in good shape to start off with, are lucky in not having complications, exercise and go to PT, and push yourself a little.

Good luck, and check back in to let us all know how you're doing when you can get back to the computer after Dec. 8. We'll be thinking about you!
Hello everyone,
What great sharing and helping is going on with those of you who are subscribing to this post. I hope as time goes by you are all feeling better and your lives are getting back to normal. I am six weeks PO now, in much less pain, and this past week started driving again. Just around town, but what freedom! I will see the surgeon on Monday for the official version but just wanted to thank everyone for their support.
I do have one question, if you've come down with a UTI during recovery from joint replacement and have any suggestions. Here it is the middle of the night and I'm beginning to realize that the low back pain and frequent urination might mean a UTI. And, naturally, it's Friday night and good luck on getting a doc on the phone on the weekend. Ordinarily, I would start forcing fluids and take an OTC med, but I don't want to take any chances with this. I dug up some fairly fresh Amoxicillin I had on-hand and have started taking it. I think it's better to take it even if it's a false alarm or inaccurate diagnoses than to wait another 48 hours before seeing the doc and risk the infection going to the new knees. Anyone else have an opinion on this?
[QUOTE=KimSaling;4266765]...I am looking at knee replacements for both knees. I have a very low pain tolerance and also allergic to codeine. The doctor that I am seeing is just putting quick fixes trying to buy time before the replacements...[/QUOTE]

[FONT="Comic Sans MS"]Hey Kim! I'm pre-surgical and looking at two knee replacements as well. I questioned my ortho about a "female" joint. She informed me that was much more a marketing ploy than a medical necessity. The surgery she performs uses a Genesis II prothesis (made from oxidized zirconium) she molds to my joint, ergo there isn't a need to have a smaller or lighter joint. She custom fits the joint to my specifications. Along with this type of prothesis, she uses the Visionaire Patient Matched instrumentations, which allow for minimal invasive surgery -- a big plus for the recovery process.

I asked soooooo many questions when we consulted -- made her show me the prothesis, how they fitted together, how the surgery was performed, etc., etc. I'm sure she was glad to see me go! lol I say all that to encourage you to be your own advocate and ask, ask, and ask again all questions. And, believe me, before I schedule surgery there will be another myriad set of questions! This surgery is not something you enter into lightly -- it is major surgery and major recovery.

While I march toward the inevitable surgery, I'm undergoing stop-gap modalities -- Synvisc One and topical Voltaren. They seem to be doing their job in that I can walk like a real person without stiffness and pain. But I know they are only temporary solutions. Also, I'm a complete wuss with pain -- don't do it and am planning to have all the pain meds on-board before surgery... ;-D

Keep us posted -- we're here to help and encourage.

Lator Gator! :cool: [/FONT]
Hang in there, startanew. I remember someone telling me that you "turn a corner" at about six weeks p.o., and I found that to be very true. Day by day, you begin to realize you are getting your life back.
At 6.5 weeks, I had no choice, as we relocated from the Pacific NW to the California desert , into a condo that was up a flight of stairs! After two months there, we left on a three-month, round-the-world trip. If you're picturing me reclining on the deck of a luxury cruise ship, think again. This was the type of trip where you are schlepping luggage from airplane to bus to hotel, and back again -- nineteen times! Well, I survived it (actually I had a wonderful time). I am just one week shy of a full year p.o. and there are days when I don't even think about my knees, believe it or not.
You need to get off the pain meds. That was one thing my surgeon insisted on, and at the time I thought he was being cruel. BUT painkillers don't allow you to think clearly and taking them changes your perception of your situation. Try to switch to Tylenol ASAP. Try the Arthritis Pain Formula, it worked really well for me. I am now taking an occasional NSAID. We went to England (cold and rainy) in August, and I needed something to help me forget about my bum shoulder, and enjoy myself. I discovered that the knees loosened up, too. I had not been aware of any particular problems in the knees, but I have arthritis pretty much everywhere, and was amazed at how much that NSAID helped, everywhere.
Good luck to you. You've made it through the hard part, just a little more recovery to go. Keep those stretchy bands handy, I don't think you can go wrong with a little morning warmup stretch. Go walking! Start with a trip to the mailbox, and make longer and longer trips every day. I am now walking all day, running errands and remodeling a condo. I literally don't sit down until my evening shower and bedtime.
Have you every tried yoga? I did it before the surgery, and was doing it again (modified for the knees) at about two months post op. I find it helps everything.
Get out there and move! And don't ever sit in a rocking chair for more than about 30 minutes. It will kill you!
Floating Island.
Excellent advice! I wish I had the sense to look at these blogs BEFORE my husband had bilateral TKR. The info you provided was more useful than anything the medical people provided. I was very disappointed with the surgeon (not his surgical skill), his PA, the hospital nursing and OT/PT staff. Sadly, they offered alomst no education to me, the person who would care for the patient for many weeks. I basically learned by watching. What a disservice to the patient!

The PT angel who came to our home for the first four sessions was an amazing gift!

Some important advice that our home PT gal gave:

If for any reason you need to call 911 from home early in recovery, use your home phone so you can be easily located and let them know right off that you are NOT ambulatory! That way they make sure enough responders arrive together, no need to waste time calling back-up.

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