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wifeofpatient 05-12-2011 05:54 PM

Total Knee Replacement
 
My husband had Total Knee Replacement surgery 13 days ago. I came across this website and it was so helpful to me that I decided to tell our story.

My husband is 58 years old and has suffered with severe knee pain (in both knees) for the last several months. Due to the pain level, he had been VERY INACTIVE for a very long time. He had gotten to the point that he would drive to the end of the driveway to check the mail and wait in the truck while I went shopping. His quality of life had gone down so much that we felt that it was time to do something.

We made an appointment with the doctor. On the first visit, they took x-rays and saw that he knees were "bone on bone" in both legs. Although he was considered young for this surgery, it was basically his only alternative. After discussing our options, we chose to go with a partial knee replacement in hopes that it would buy a few years before eventually having to have a total knee replacement. The doctor was concerned that a partial would not support his weight (because he is over 300 hundred pounds), but felt that he was a bit young to do a total knee replacement. So we scheduled a partial knee replacement surgery. I informed the office that I was scheduled to attend a conference out of town 5 days after surgery and they assured me that I could still go ahead with the plans - he would be able to take care of himself by that time. NOT!

He had the surgery on a Friday. Before starting, they scoped the knee and determined that a partial would not be effective since his entire knee was in bad shape. They had to end up doing a Total Knee Replacement.

The surgery lasted for 2 hours. He was awake during the entire procedure. When he returned from recovery, he was talking and laughing and doing fine.

The following morning, we were so excited with the outcome. The physical therapists came in and got him up. He walked around the hospital floor with no problems. We realized later that the nerve block was still in effect!

That afternoon, after sitting in a chair for most of the day, he was ready to get back in the bed. He made it to the bed and began feeling lightheaded. He completely passed out while sitting on the edge of the bed. I had my arms around his waist and was afraid that if I let go that he would slide off of the bed, so I had to call for help. Help arrived and when he woke up, he began throwing up. They didn't seem to be overly concerned. They felt that it was medication related and likely from the trauma to the leg/body.

The following morning, he did his exercises again, but was beginning to feel pain and asking for pain meds.

On the 3rd day after surgery, they told us that they were sending us home. Of course it took most of the day to get the paperwork done, so we didn't get home until that evening. While waiting to go home, they made sure that we had access to a walker and had a potty chair delivered....that is when I began to get a little concerned....I am not cut out to be a nurse.....

When we got home, we put him in his recliner - big mistake. Although he was very comfy, when it was time to get up, he was unable to. We had to call his sister and our daughter to help. Needless to say, he has not used his recliner again. He has been sitting in a chair from our back patio (because it has two hard armrests that he needs in order to stand up).

The following day, I realized that I would need to cancel my trip because there was absolutely NO WAY that he would be able to take care of himself while I was out of town. At this point, he was unable to get in or out of the bed without help. He was also unable to do his physical therapy exercises without help. He had been told to do "straight leg lifts" and at this point, he was not able to lift his leg at all. He was having to use a portable toilet (because it sits up higher than a regular toilet). Also, we had a rented a device that had to be filled with ice water every 3-4 hours that was connected to a wrap that went around the knee and provided cold and pressure to the knee to reduce swelling. I am not exactly sure who the doctor's office thought would be doing all of this when they told me to go ahead with my plans to attend the conference....

Each day has gotten a little easier. He found a way to use his belt to lift his leg to help him get into the bed. After doing the exercises 3 times each day, little by little he was able to do a little more on his own.

Today is the 13th day after surgery. He had his staples removed today. He took his last shot in the stomach today (to prevent blood clots). He was finally able to remove the stockings (to prevent bloodclots). At this point, he is able to do his physical therapy exercises without help. He can lift his leg, but has difficulty holding it in the air for 5 seconds.) Yesterday was the first day that he stayed at home all day without someone there to help him.

So, to the spouses of those scheduled to have this surgery, I would suggest that you make arrangements to be there to help for at least a week, possibly longer. I think that the length of recovery depends on the physical shape of the patient, but in our case, it has taken a little longer due to his weight and his inactivity prior to the surgery.

I will do my best to give updates as time allows. Please let me know if our story was helpful to you.

SpineAZ 05-13-2011 06:05 PM

Re: Total Knee Replacement
 
I'm amazed they sent him home so quickly without sitting down with you to talk about home care, to see if he needed a home visitation nurse, if you had a two story house, etc.

As for the fainting/vomiting, it probably was a combination of pain meds and simply getting up quickly and the blood not keeping up with his movement to a standing position. This is common after surgery, especially significant surgery like his.

wifeofpatient 05-14-2011 05:02 AM

Re: Total Knee Replacement
 
He does have home health nurses coming 2 times a week and physical therapists coming 3 times a week, but overall, I felt very unprepared mentally for what I had to face.

SpineAZ 05-14-2011 06:37 AM

Re: Total Knee Replacement
 
If it helps, the need for you to be home/assist is normal. In a good hospital release they'd check with you to see if there were any barriers to coming home and if so they frequently offer 1-4 weeks in a rehabilitation hospital for care that is nearly hospital level. The use of these type of facilities has increasesd as insurance approved hospital in-patient time is reduced, so it is not unusual for minimum of a week in a rehab facility before actually coming home. Hospitals either through social work/patient advocate or nurses assigned to home readiness evaluation check on if the person can go right home. Even a working spouse may be enough to lead to consideration of rehab care.

2 mo before my 02/2010 extensive spine surgery my husband had been laid off. Turned out tone a good thing as I needed extra help innthe hospital and a medium level of help when I got home. The big event was hubby needing to go to Tucson (2.5 hr south) about 10 days after I got home. We set up a few reserve friends who could help if needed and we had our cat sitter come over to feed the cats and clean the litter box. But actually 2 days alone after surgery and stress of that and coming home made those 2 days very peaceful and a chance to be alone. I just had to agree to have my cell phone in KY pocket at all times in case I fell, etc.

In 1993 when I had back surgery I was just about to loose my roommate as our lease was ending and she was set to leave before that to get her kids into new schools (we shared a home after I finished grad school and she divorced and moved from FL to IL). Funny thing was the nurse came to me and said I had to go home (had been in 10 days) and their social worker was unavailable so they'd send out a home care nurse in 2 wk to evaluate if it was safe for me to be at home. 2 wk after discharge.....made no sense. I could fall and be stuck on the floor or in the bathtub by the time they arrived 2 wk later!!!

If you go back with hubby to the surgeon, or if he goes alone, one of you should say "we were surprisingly unprepared for (hubby mame) coming home. Maybe your practice can provide a brief but useful information sheet on what to expect, the fact that a someone has to he home and available during the day (if working) for at least X amoubt of time.

kneedsurgery 08-14-2011 11:27 AM

Re: Total Knee Replacement
 
Thank you. This is very informative. I just learned (ok I knew I've just been in denial of the meaning of all this pain) but I've just acknowledged that I will have to have total knee replacement surgery for both knees. I am 311 and losing and have much to figure out and learn. These boards have been a Godsend.

33kat 08-14-2011 09:59 PM

Re: Total Knee Replacement
 
I hope I can find this again when my time comes. :) I hope it is still a couple of years off, but even with that I doubt my husband will be ready. I am trying to get him to understand what a big deal it is going to be when I have to have my knee replaced, maybe by then he will get it. Weekends like this last one will probably help, I was having a hard time even getting out of the car... :(

wiz156 09-27-2011 10:26 AM

Re: Total Knee Replacement
 
I had a right TKR on 8/25/11. After reading many posts about it and seeing that I was a lot younger than many of others before me (59). I felt confident that I would not have trouble getting throught the operation and my recovery adn rehab should not be to bad. I actually pictured myself back to normal in 4 weeks. Well 4 weeks have come and past and I am having trouble with my flexation, which is at 80 degrees when forced and my extension at 5 degrees. I m starting to get a little nervous althought the Theropist insist that I'm doing well. Most others say that they have at least 90 degree flexation at an earlier time. Should I be concerned?

glennxyz 09-27-2011 05:09 PM

Re: Total Knee Replacement
 
Flexation is a function of your muscle tone as my PT tech explained, my muscles fought back as we went thru the exercises. Stay the course and it will get better, 6 weeks for me was key, significant gains almost exponential after 6 weeks. I was back bowling after 6 weeks and I am now approaching 1 year post TKR and flexation and all bending is perfect no issues at all.

Good luck,
Glenn

SpineAZ 09-27-2011 05:27 PM

Re: Total Knee Replacement
 
I'm 45 and my right TKR is tomorrow. A rep from medical supply company just dropped off my CPM and knee coolant/compression machine. She said with the CPM as long as I make sure it gets to 0 during the motion cycle I should be able to maintain it. I have the machines for 21 days from the date of hospital discharge. Hubby now knows he has to sleep in the guest room as too much machinery in the master bedroom.

33kat 09-27-2011 05:44 PM

Re: Total Knee Replacement
 
Good luck tomorrow SpineAZ!! I will be thinking of you!

I just schedule my LTKR for October 24th and I am incredibly nervous and already second guessing myself. I know it is the right thing to do, but that doesn't stop the nerves. I am both wishing it was tomorrow and a year from tomorrow. Just need to get the brain to slow down! I want it done, but the procedure scares me. I haven't had anything stronger than local anesthesia since I was 7 and haven't taken anything but OTC meds for pain (although sometimes at prescription strength).

waldosmom 09-28-2011 06:28 AM

Re: Total Knee Replacement
 
[QUOTE=wiz156;4850542]I had a right TKR on 8/25/11. After reading many posts about it and seeing that I was a lot younger than many of others before me (59). I felt confident that I would not have trouble getting throught the operation and my recovery adn rehab should not be to bad. I actually pictured myself back to normal in 4 weeks. Well 4 weeks have come and past and I am having trouble with my flexation, which is at 80 degrees when forced and my extension at 5 degrees. I m starting to get a little nervous althought the Theropist insist that I'm doing well. Most others say that they have at least 90 degree flexation at an earlier time. Should I be concerned?[/QUOTE]


Wow -- your post brings back memories of my TKR recovery!!
I had bilateral knee replacements on 12/21/2010 at age 54.
Like you, my flexion was 'stuck' at 80-85 degrees after 6 weeks of PT.
My surgeon and my PT recommended manipulation-under-anesthesia to break up any scar tissue and get my flexion back on track.
The manipulation was SO SO SO frightening to me, but it had a great result.

Anyway, don't give up on yourself. If you're like me -- and your flexion does not improve -- read more in this forum about the manipulation procedure.
(Did I mention that I was REALLY REALLY REALLY frightened, though???)

Good luck with your therapy!
Keep us posted on your progress.
Lynn

Episcopus 10-09-2011 04:57 AM

Re: Total Knee Replacement
 
I had a total knee replacement about 6 years ago. The procedures in the UK are very similar to those described here. However it is strongly recommended here that you have physiotherapy for a few weeks BEFORE your operation as this helps to speed up the recovery time and get you active more quickly.

SpineAZ 10-09-2011 05:28 AM

Re: Total Knee Replacement
 
Pre-op physical therapy would be ideal. However many of us in the USA are.covered by plans that limit PT visits. I get 20 PT sessions per year. Unfortunately l need all 20 forafter the surgery.

knockneez 10-09-2011 05:53 PM

Re: Total Knee Replacement
 
I had my TKR on Sept 7. I am at 105 on flexion and around 1-2 on extension. I practiced yoga regularly and continued that even when my knee was conking out on me. My teacher is very good at using props and giving alternatives so I can get the benefit of the poses without hurting my knee. I think it set me up well for the post-op PT. I feel like I'm starting all over with the leg, but I have made consistent improvement which is encouraging. If you can't to PT because of insurance, try just doing some basic leg exercises to strengthen both legs, and your arms. You'll want your good leg to be strong and your arms to support yourself on the walker and lift out of chairs.

I had high hopes that I would be off and running in a month without any assistance. I know know that was a bit ambitious, particularly thevway my bodybis affected by anesthesia (takes me a while to normalize). I am still using a cane and having some issues with stamina, but there is measurable improvement, so I know I will be there soon.

SpineAZ 10-09-2011 06:03 PM

Re: Total Knee Replacement
 
Stamina is huge for me too. TKR 9/28 and I'm at 90 on the CPM (however I may have pulled a hamstring today getting to that 90 today). I see.the surgeon's PA tomorrow for my first post-op appointment. I am only day 12 and.worry about progress. I had 10 previous surgeries to this knee and 4 were "open" so the surgeon said the scar tissue was difficult for him to navigate and will be my nemesis through this process. Hubby goes back to work Tuesday after a week and a day of FMLA. I was in the hospital 9/28-10/2 so he worked those days.


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