Scheduling knee replacement surgery

[rapmarks]

the ortho led me to believe there was a couple of weeks wait for the surgery, but his earliest in end of January. I have my yearly visit from my son and family feb 17 for nine days and want to enjoy that, so now thinking of end of February.
What I really need are honest answers.
How long before I can do things like get to the kitchen to get myself something to eat, get to bathroom, take showers.
What can I expect each week as far as progressing.
Dr, says he will send me home next day with a physical therapist coming to my house. Is it better to go to a rehab place.
I can't take pain medications and the dr says Motrin will work as well as anything. I had triple surgery and once they gave me pain mess in pill form, I was so sick had to stay in hospital an extra day an went home on combination of ibuprofen and acetaminophen in terrible pain and vomiting.
I don't heal fast and often have complications, so I don't expect too much, but what is realistic expectation of going for walks, going to stores, playing golf, etc,
I won't have help and will have my husband, who will need help with a lot of things, he probably can make himself a frozen dinner if he can find it in the freezer but that is about it.
So I would like some realistic answers from people who have had the surgery.

 

[Chrisky]

Hi. My husband had 2 hips replaced. I know the recovery is not quite the same, but IMHO if you have problems with pain meds, either prescribed or over the counter and your other healing issues, I would definitely go to a rehab centre for at least 10 days. There are daily things that you will not be allowed to do and if your husband cannot help you might even need a home care worker to help you at home.

 

[Phydeaux]

Here's my honest answer:

Talk with your orthopedic surgeon, and pose each of these questions. Then listen. If you don't understand something, or disagree with something, this is the time to speak up.

People on this forum do not know you, your age, your sex, your medical background, your weight, your physical and mental condition, why you cannot take pain meds, why you feel you don't heal fast, what your 'complications' are, and what your diagnosis was that lead to this prescribed surgery. Would you agree with that statement? Even if we did, what would make us better qualified to answer your questions as opposed to someone that spent a minimum of 13 years of their life in medical training, and have undoubtedly conducted this surgery many times?

Internet forums are a great resource for many things, but imho, medical conditions and medical advice is not one of them. Each and every patient is different, I can assure you of that. As a retired medical professional, I write this with the utmost respect, and certitude.

 

[DaveNV]

My experience: I had a total knee replacement five years ago. Surgery went well, no surprises. Hospital kept me three nights, mainly because I had a fluid retention thing happen, and they wanted to be sure there was no problem. There wasn't. They had me up and walking (slowly) around the hospital the day after surgery. When I went home, I used a walker for stability. I spent the next three weeks at home (because I had that much sick time. I could have gone back to work within two weeks.) I started physical therapy the week after surgery, two visits a week, at a PT clinic away from home. I couldn't drive myself yet, so needed a ride for that at first. I was off all prescription pain meds within a week of surgery, but I did continue OTC stuff as needed. The rest was healing.

The hardest part was wanting to do more than I was able to. I had to force myself to relax, and give myself a chance to heal. I used my time in bed to exercise the new joint, to try and get more flexibility. The PT visits are NOT intended to heal you - they are to show you what to do for yourself. You'll have "homework" to do between appointments. The people I saw who had the most issues were those who did nothing between appointments, thinking the PT would fix them. Not true. Do the exercises and stretching they tell you and show them at the next appointment how far you've come since the last appointment. After six weeks of PT visits they told me I'd gone as far as they could take me, and I was on my own.

Once my stability was better, maybe a week after surgery, I graduated from the walker to a cane. I continued to improve, walking further and further each day. After the three weeks I returned to work on a limited-duty basis, and continued to attend PT. About six weeks after surgery I was off the cane, and returned to full duties at work.

It's been five years next month since my surgery. I have no regrets. The thirty-plus years of arthritis pain I'd experienced was instantly gone, replaced by transient "soft tissue" pain from surgery. But once that was healed, I've had no pain in the knee since. My doctor and I are now in discussions about replacing my other knee.

FYI: The one thing they didn't tell me before surgery, and I wish they had, was that after surgery there is no more getting down on both hands and knees. They kept my kneecap, rebuilding the underside of it, but the pressure of kneeling on it, with the artificial joint putting pressure on it from behind, causes a pain unlike any I have ever experienced. I have to kneel on the other knee, and figure out how to get flat, if I need to retrieve a shoe from under the bed, or whatever. So getting up and down like that requires forethought. A small price to pay, all things considered. But I wish they had told me ahead of time.

Good luck with your surgery. Fear of the unknown is far worse than the actual experience. Others here have had the surgery, Moderator Karen G most recently. I hope they'll share their experience.

Dave

 

[AwayWeGo]

No regrets after (successful) total left knee replacement surgery in 2010. Had the operation in early June & was traveling via airliner by the end of June. Good outcome not only because of the excellence of the implant & the skill of the surgeon & his staff, but also from 6 weeks of heavy-duty physical therapy (interrupted only by that airplane trip).

Went back to the same surgeon for (right) hip replacement in January 2016. Also a big success. Thanks to daily exercise, I am now getting around better & more comfortably than before my joints started going bad.

That surgeon has since retired, so if someday I need replacements for my remaining natural joints, I'll have to get recommendations for a new orthopedic surgeon. Fortunately, lots of good ones are in practice around here.

-- Alan Cole, McLean (Fairfax County), Virginia, USA.​

 

[rapmarks]

thank you Dave and Away we go. why do I ask people who have been through it instead of doctor, because my experience is they underestimate the recovery time. They underestimate the pain.
When I first asked doctor about going to rehab, he said yes. Second time, no, people are old there and you would be at risk of catching infections. why I cant take pain pills, I am allergic to something in compound, get violently ill and go on bad trip.
If I could go to rehab facility, I would have help, and I would not have to take care of my husband too. I am going to have to talk to dr about that again.

 

[vacationhopeful]

My ex-friend had both knees replaced at the same time. He lived ... but could not drive for 6 weeks. 6 months later we did a 2 week trip to Eastern Europe .. without a group. The cobblestone .. paving bricks .. bother his walking some. But he was still 40-50lbs OVERWEIGHT and did not complete his PT.

And his knee placement pain & suffering convinced ME to lose 50+lbs ... and I totally learned from his pain, do everything possible to NOT need my own knee replacement surgery. That was 20+ years ago .. the year after the "the Wall fell" in Berlin ... opening up flights to Eastern Europe. ... 25 years

Get in the BEST physical shape you can .. before surgery. Wish you the best ... and EVERYONE I know has NOT regretted getting the surgery ... as their ability to get around with less pain, improved their lives.

 

[rapmarks]

I know it will be better to have it done, I am unable to enjoy many things now

 

[VacationForever]

thank you Dave and Away we go. why do I ask people who have been through it instead of doctor, because my experience is they underestimate the recovery time. They underestimate the pain.
When I first asked doctor about going to rehab, he said yes. Second time, no, people are old there and you would be at risk of catching infections. why I cant take pain pills, I am allergic to something in compound, get violently ill and go on bad trip.
If I could go to rehab facility, I would have help, and I would not have to take care of my husband too. I am going to have to talk to dr about that again.

I concur that everyone's experience is different. You feel that your doctors underestimate recovery time and underestimate the pain. My experience is the complete opposite. I underwent 2 surgeries, not for knee replacements, in the past 11 years. With my first surgery, the nurse insisted that I must be in alot of pain and it was my right to have morphine while I was in the hospital. I had just woken up from my anesthesia and I said I was not in pain. I had to reject morphine at least half a dozen times when the nurse and my doctor insisted that I was in pain and I must have my morphine. I was discharged the following day and went home with Vicodin. I was walking around the neighborhood the following day and did not take any of the Vicodin. I was given 6 weeks of medical leave but I could have gone back to work the following day.

My last surgery was the same. I woke up from anesthesia and was sent home by the evening. I was given another 6 weeks off but I went to work the next day.

I agree that people do catch horrible infections at rehab places. MRSA and Norovirus to name a few. Going home with Home Health is a much better arrangement.

 

[vacationhopeful]

Suggestions:
Get lots of menus for prepare food delivered to YOUR home.

Get a stash of cash to pay for the delivered food. Most grocery stores here will delivered food to your home now also .. order on the internet. Pizza & Chinese is easy to get; go for more exotic dishes like Japanese, French, salads, etc... less weight gain also.

Hire a 2 times a week housekeeper ... to change the beds, clean the bathroom and do laundry.

Get the phone number for Uber-type car service (set up an account BEFORE surgery).

If you live by yourself, realize that at times, YOU might need a set of hands to assist you. ASK around and make a list on your cell phone .. of who you could call to help you for 10 minutes. Have more distance friends call/text you on a schedule ... esp if they have had this surgery or to just help past the daily boredom.

 

[Karen G]

I'll put my answers in blue--I had my left knee replaced Sept. 12 and spent three nights in the hospital. My husband is a great help and I don't think I could have managed at home without him. I have a girlfriend who is single and she highly recommends spending as many nights in a rehab place as Medicare or insurance will allow.
What I really need are honest answers.
How long before I can do things like get to the kitchen to get myself something to eat, get to bathroom, take showers.
Initially I used a very sturdy walker with front wheels to get to the bathroom, get to the kitchen, etc. Having a wide enough walker that fits around the toilet is essential because it will help you have something to push off of to get yourself up. I had a waterproof bandage and was able to shower soon after coming home but we have a very big shower. We put a sturdy plastic chair in the shower and I sat with my back to the shower so that I could lean back a little to wash my hair. I avoided getting the surgery site wet and basically did a sponge bath in the shower.

What can I expect each week as far as progressing.
It gets better as the weeks go on. A nurse and a physical therapist came to our house for the first couple of weeks and that worked out well. I also started physical therapy twice a day while I was in the hospital. At 16 days after surgery I started going to a physical therapy office and did that three times a week for six weeks. The surgeon wasn't satisfied with the way I was walking (said I didn't straighten my leg enough) and ordered six more weeks of therapy. I saw him today and he said everything looks good & to come see him in 9 mos. unless I think I need to see him sooner. Yay! The first time I drove myself was on Oct. 16. Since it was my left knee that was operated on, it wasn't a problem to drive. The criteria for driving was that I had to be off the pain medication.

I can't take pain medications and the dr says Motrin will work as well as anything.
I hope Motrin will help. Ice helps, too. A tip I had from another friend was to put Palmolive Liquid Soap in a gallon size ziplock bag (double bag for extra protection from leaking) and freeze it. Be sure it lays flat in the freezer. It makes a nice, pliable ice pack that lasts a long time before it thaws. I made two gallon-sized bags and two quart-sized bags from one big container of liquid soap. It was nice to put the bigger bag across the top of my knee and rest the back of my knee on the smaller bag.

what is realistic expectation of going for walks, going to stores, playing golf, etc,
Everyone heals differently but the advice everyone gave me was to be diligent with home exercises. I felt comfortable going to the grocery store once I was finished with the walker because I could hold on to the shopping cart and that helped a lot. I used a cane after the walker and now don't need either one. I find standing for a long time to be uncomfortable and I need to sit down after the first two songs at church. After about six weeks I started going to my water aerobics classes and that was a great way to exercise my knee. I would say that six weeks after the surgery I started to feel pretty good.

My knee is just stiff when I get up each morning or if I spend too much time sitting, but it is much better than it was before the surgery.
Best wishes for a great experience. Just know that there will be good days and bad days but gradually the good days will outweigh the bad.

 

[rapmarks]

Thanks for the good ideas.i really appreciate them.
As far as doctors over underestimating recovery, after going through two separate cancers with accompanying surgeries and treatments, and having horrible side effects that were supposedly rare afterwards, i an hoping for the best and preparing for the worst.
Do you get sent home with a walker or is that something you have to get after?
I have some nice ice packs but I know from experience that I would have to get up and get them myself and put them back in the freezer.

 

[rapmarks]

Another question. Are you able to wear your regular pants or shorts or are they too hard to get on and off

 

[PigsDad]

I have some nice ice packs but I know from experience that I would have to get up and get them myself and put them back in the freezer.

Look into getting one of those devices that circulates cold water around your knee. A good friend of mine had knee replacement last year and said it was much better than trying to keep ice packs in place, constantly adjusting them, replacing them, etc.

Kurt

 

[Karen G]

Thanks for the good ideas.i really appreciate them.
As far as doctors over underestimating recovery, after going through two separate cancers with accompanying surgeries and treatments, and having horrible side effects that were supposedly rare afterwards, i an hoping for the best and preparing for the worst.
Do you get sent home with a walker or is that something you have to get after?
I have some nice ice packs but I know from experience that I would have to get up and get them myself and put them back in the freezer.

A walker was ordered for me & delivered to my room in the hospital. I didn’t have to do anything—it just appeared! Also my regular shorts fit just fine. We were told to bring comfortable clothes to the hospital as they wanted us up & sitting in a recliner most of the time as opposed to lying in bed. They had me up & walking with a walker as soon as I was awake & out of recovery.

 

[rapmarks]

Look into getting one of those devices that circulates cold water around your knee. A good friend of mine had knee replacement last year and said it was much better than trying to keep ice packs in place, constantly adjusting them, replacing them, etc.

Kurt

I haven't heard of this, will check

 

[VegasBella]

My mom replaced both knees and one hip. She had complications with the first knee. She was up and walking by herself doing all those things VERY quickly. But she was also VERY determined. She wanted FULL MOBILITY, not just lack of pain, that's why she did the replacement. And she got it. Prior to surgery we were going to get her a wheelchair. Now she does long hikes alone! But she had friends who did NOT get up and do the exercises like they were supposed to do and who did not push through the pain to regain mobility and they too FOREVER to heal and walk. So it depends not just on the usual things like age, weight, etc etc, but also it depends a whole lot on your goals and the actions YOU take after surgery.

Even still, the rules required assistance for at least a few weeks. So she needed to be in a transitional care center for a few weeks for one surgery when we didn't have family able to help her out. So make some plans for that if you don't have a spouse or someone who lives with your or can stay with you a few weeks after.

 

[artringwald]

I had my left knee replaced in October last year, and my right knee was replaced 7 weeks ago. Even with the same surgeon, same hospital, and same rehab, it was a completely different experience with each knee. With both I needed a walker for the 1st week, a cane for the next 2-3 weeks, and plenty of pain killers to be able to get comfortable enough at night to sleep. With the first knee, the swelling lasted about 8 weeks, and any side to side pressure was painful, making getting in and out of the car difficult. The cold pack was my best buddy for 2-3 months. I went to PT for 8 weeks before I could go up and down stairs normally. I think I was better prepared for the 2nd knee. I put many miles on my bicycle, and my legs were in great shape. The swelling went down after 2-3 weeks, I didn't use the cold pack much, and finished PT in about 5 weeks. My best advice to anyone, is to do as much biking or exercise bike as possible before and after surgery. Start with the seat as high as you can get it, and even if you can't get your knee all the way around, go 1/2 way, pedal backwards, and go 1/2 way again. As you regain the range of motion, keep lowering the seat. Biking not only flexes the joint and muscles, it increases blood circulation which reduces swelling and speeds healing.

Here are some inexpensive tools you will find very useful for: 1) pulling on socks, 2) pulling/pushing clothes on/off, 3) putting on shoes, 4) lifting your leg in/out of bed and/or the car.

I would never recommend that anyone get both knees at the same time.

 

[VacationForever]

My best advice to anyone, is to do as much biking or exercise bike as possible before and after surgery. Start with the seat as high as you can get it, and even if you can't get your knee all the way around, go 1/2 way, pedal backwards, and go 1/2 way again. As you regain the range of motion, keep lowering the seat. Biking not only flexes the joint and muscles, it increases blood circulation which reduces swelling and speeds healing.

Question for you regarding biking as much as possible before surgery. I have a left knee issue and had a cortisone shot 2 months ago and now the pain and swelling is back. I exercise everyday but excercise bike is one that I avoid as it worsens the pain and swelling. I do lots of eliptical, treadmill and golf everyday because they do not directly aggravate the knee issue. So... why excercise bike as opposed to just doing other leg excercise?

 

[artringwald]

Question for you regarding biking as much as possible before surgery. I have a left knee issue and had a cortisone shot 2 months ago and now the pain and swelling is back. I exercise everyday but excercise bike is one that I avoid as it worsen the pain and swelling. I do lots of eliptical, treadmill and golf everyday because they do not directly aggravate the knee issue. So... why excercise bike as opposed to just doing other leg excercise?

Before surgery, walking was painful for me, while biking and elliptical were pain free. I'd say whatever you can do before to build the strength and endurance. After surgery, by lowering the seat, you keep increasing the amount your knee has to flex. My doctor wanted me to be able to flex the knee 120 degrees by 2 weeks. It thought that was unrealistic for both legs, but if you don't do the exercises, scar tissue forms, and you may never get the full range of motion back.

 

[artringwald]

DePuy Synthes is the company that made both of my replacement knees. They have a good info about knee replacements on their web site:

http://www.depuysynthes.com/patients/knee/patient-treatment-center/knee-replacement

 

[VacationForever]

Before surgery, walking was painful for me, while biking and elliptical were pain free. I'd say whatever you can do before to build the strength and endurance. After surgery, by lowering the seat, you keep increasing the amount your knee has to flex. My doctor wanted me to be able to flex the knee 120 degrees by 2 weeks. It thought that was unrealistic for both legs, but if you don't do the exercises, scar tissue forms, and you may never get the full range of motion back.

Yes, I get it for post surgery that one should always move the joint to promote healing. It also makes sense that you were doing bike before the surgery as you did not have knee pain on a bike.

 

[AwayWeGo]

I would never recommend that anyone get both knees at the same time.

The physical therapist said there's an advantage in getting both knee replacements done at the same time if both natural knees are worn out. I thought he meant just 1 hospital stay, 1 recovery period, 1 round of physical therapy, etc., instead of 2. But he was referring to the physical therapy process itself, in which patients breaking in a new set of knees, both left & right at the same time, would not be favoring 1 side over the other the way patients with just 1 surgically replaced knee often do.

-- Alan Cole, McLean (Fairfax County), Virginia, USA.​

 

[PigsDad]

The physical therapist said there's an advantage in getting both knee replacements done at the same time if both natural knees are worn out. I thought he meant just 1 hospital stay, 1 recovery period, 1 round of physical therapy, etc., instead of 2. But he was referring to the physical therapy process itself, in which patients breaking in a new set of knees, both left & right at the same time, would not be favoring 1 side over the other the way patients with just 1 surgically replaced knee often do.

Interesting. My friend that had one knee replaced last winter developed some back issues this fall due to favoring one leg for an extended period of time. Took additional PT to correct that issue.

Kurt

 

[artringwald]

The first week after surgery, even with the walker, it was hard to get around the house, go up and down stairs, get in and out of bed, and in and out of the car. I can't imagine doing any of those if I had both knees done at the same time. I've also heard that doing both at once is more than double the risk during surgery. If you're out twice as long, they have to put you deeper under anesthetic.