TKR #2..... Lessons I am learning

Last week I introduced my new series entitled TKR #2 with a discussion entitled "I'm still learning." It has been 10 years since my initial TKR. The entire process has changed. Identification of the what's and the whys are easier with contemporary technology. Robotic guided techniques make the surgery more accurate, faster, and minimally invasive. As I move into recovery and rebuilding, I am still learning. Knowledge is power and I am finding out that as a patient, I am responsible for asking the right questions, researching the plausible answers, and helping to resolve the medical issues by paying attention and following instructions and guidelines.

#1 this week was to learn how to use one of the assists......a walker. My PT noticed that I was leaning over the walker with my behind sticking out....very uncomfortable and not very stable. She showed me how to place my body inside the walker so that I am standing straight instead of leaning over. Wow...what a difference.

#2 was a thorough evaluation and shared decision about post-surgery medications. I am highly sensitive to opioids and have only found one, Dilaudid, that can be helpful in a surgery situation. My current surgeon and his Rx designee reviewed my previous surgery injections. An exception was made because of my experiences and Dilaudid was designated as the pain control opiate for surgery. We had another review of medications for post-surgery and recovery which included an appropriate dosage of Dilaudid. No one started with a self-prescribed answer and we all shared the decision-making process that led to an appropriate starting point.

#3. Introducing medical cannabis to the post-surgery options for pain and comfort control was also at the top of the list for shared decision-making. My choice of medications for small fiber peripheral neuropathy (SPN) has included medical cannabis for 5 or 6 years. An integrative approach was designated for post-surgery that included medical cannabis and ensured a positive and healthful response.

I am very impressed with the compassionate and caring approach of my providers. As I discover more "Let's get it right" opportunities.....that enable the best decisions, I will share them with Connect members. Please add your positive experiences and/or provocative questions.

May you be mentally healthy
May you be physically healthy
May you have peace and ease.
Chris

Hi Chris-thank you for sharing your knee replacement story! You've got it right utilizing a team approach with your surgeon along with their medical staff. It's no longer just the dr's word or orders if you will. Modern day patients are armed with a wealth of information right at their fingertips. A team approach in healthcare lends itself to optimal patient outcomes, and a meaningful relationship with the healthcare provider. I'm very happy for you in your post surgical experience thus far. Continued success to you.

Last week I introduced my new series entitled TKR #2 with a discussion entitled "I'm still learning." It has been 10 years since my initial TKR. The entire process has changed. Identification of the what's and the whys are easier with contemporary technology. Robotic guided techniques make the surgery more accurate, faster, and minimally invasive. As I move into recovery and rebuilding, I am still learning. Knowledge is power and I am finding out that as a patient, I am responsible for asking the right questions, researching the plausible answers, and helping to resolve the medical issues by paying attention and following instructions and guidelines.

#1 this week was to learn how to use one of the assists......a walker. My PT noticed that I was leaning over the walker with my behind sticking out....very uncomfortable and not very stable. She showed me how to place my body inside the walker so that I am standing straight instead of leaning over. Wow...what a difference.

#2 was a thorough evaluation and shared decision about post-surgery medications. I am highly sensitive to opioids and have only found one, Dilaudid, that can be helpful in a surgery situation. My current surgeon and his Rx designee reviewed my previous surgery injections. An exception was made because of my experiences and Dilaudid was designated as the pain control opiate for surgery. We had another review of medications for post-surgery and recovery which included an appropriate dosage of Dilaudid. No one started with a self-prescribed answer and we all shared the decision-making process that led to an appropriate starting point.

#3. Introducing medical cannabis to the post-surgery options for pain and comfort control was also at the top of the list for shared decision-making. My choice of medications for small fiber peripheral neuropathy (SPN) has included medical cannabis for 5 or 6 years. An integrative approach was designated for post-surgery that included medical cannabis and ensured a positive and healthful response.

I am very impressed with the compassionate and caring approach of my providers. As I discover more "Let's get it right" opportunities.....that enable the best decisions, I will share them with Connect members. Please add your positive experiences and/or provocative questions.

May you be mentally healthy
May you be physically healthy
May you have peace and ease.
Chris

I had my right knee done about ten years ago and my left knee done within the last five years. I have had a right shoulder replacement and carpal tunnel surgery on both wrists. I include that info as I have found commonalities in preparation and recovery.
Do the pre-exercises to the best of your ability. They gave me confidence.
Read and/or watch instructional videos. There are many on you tube produced by reputable universities and medical practices. Pre-surgery I learned what to expect. Post surgery taught me correct form, how to best negotiate sleeping, barriers in the home…tons of stuff.
I learned not to listen to horror stories or people who claimed to have no pain, etc. This is surgery to your body and relaxing, trusting your doctor, getting excited about benefits of the surgery, educating yourself and believing in yourself will make a world of difference.
Plan to need help and ask for it. Having a plan for someone to assist you for at least the first week to two weeks post op is comforting.
Use ice. I had the ice bucket thingy that forces ice water out and into a small mat that draped over my knees. Big blessing!
Be a good patient. Do your physical therapy.
Give time, time.
Any sacrifices I have made in modifying exercise, etc have been well worth it!
You can do it!

evie66 (@evie66); Sep 14, 2021 - 7:50 am

Good evening evie66, welcome to Connect. We are a group of patients, former patients, caregivers, and providers. Our mission is to facilitate the sharing of personal experiences in a manner that will encourage thought, research, and reason for everyone. And so tonight, I want to welcome @evie66 from Scotland. I can't hide my excitement as Scotland is where my grandmother was born, in Kintore actually. We are part of the Christie and Cruickshank Klans.

@evie is by her own admission, a newbie here. She had an unremarkable recovery until month 5.
Now that a year has passed, both knees are unstable with "zip" feeling and swelling at night.

And I understand that you are now looking for stories from folks with similar problems and hopefully some advice about similar problems.

What would that other surgery do for you? What else might be helpful? I am comfortable telling you @evie66 that swelling can be controlled by icing and elevating. Also, if you have therapists who have Myofascial Release training, they can move the fluid that is causing the swelling on up your leg so that it can be extracted naturally upon urination.

Would you please explain what you mean by "spacers"? Have you had physical therapy to increase stablity? You can practice that by standing on one foot for 20 seconds three times in a row and several times a day. The best way to strengthen the supportive muscles is by doing squats.

What other suggestions and advice can you share with @eviie? And @evie66, how often to you deal with pain or other discomforts?

May you be free of suffering and the causes of suffering.
Chris

I am 8 weeks post-op TKR. I cannot remain seated in a regular chair or a car seat for more than 45 minutes without pain in my knee. I subsequently have to get up and walk around for a minute or two to relieve the pain. Has anyone else experienced this?

Hello, 8 weeks really is very "early days" in recovery from major surgery. It is definitely not unusual to have symptoms while you are healing, and pain from sitting or lying in one position is fairly common. Remember that, in addition to bone and skin healing, all the muscles, ligaments, tendons and nerves must heal too.
In my experience, even though annoying, it is actually a good thing that your body is "reminding" you - through pain - to get up and move frequently. After one of my hip surgeries, it was almost 6 months before I could sit for any length of time - my coworkers laughed at me - but our meetings got a lot shorter!
If it gets worse, or standing u and walking doesn't relieve the pain, you may want to contact your surgeon.
How is your recovery going otherwise?
Sue

Hello Sue, thank you for providing the information and the upbeat analysis. From what my physical therapist tells me I'm doing pretty good on my recovery. My range of motion is 128°. I can ride my bicycle with no problem but going upstairs is still a bit painful but not excruciating. My therapist has told me that it may take 6 months to be comfortable driving my car for any length of time due to all the factors that you mentioned in your reply. Thank you for your contributions to this website. I think you give a lot of people hope and encouragement.