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    What is it really like in the weeks after knee replacement
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    Nanniesmom posted:
    Good morning, I've scheduled my total knee replacement for early Septemeber/2010 and am in the planning stages. I live with my 15 year old daughter in a second floor apartment and need to get back to work as soon as possible. I have concerns about the surgery and recovery as I aslo deal with psoriatic arthritis and type 2 diabetes but feel the outcome will be positive in the long run and will make it easier to control the arthritis and diabetes with exercise that I am unable to do now.
    My questions are what type of assistance will I need when I come home from the hospital? Will I need someone there 24/7? My husband and I are separated but he will be helping out. I just don't want to have to physically depend on someone to use the restroom or get a drink of water. I get that I'll need help with housework, cooking etc but it's the small personal things that have me the most worried. What assitive devices can I use to make these things easier and give me the ability to stay independent.
    I'm planning for 8 weeks recovery before I go back to work. I can't afford to take more time off. I do office work and there isn't any lifting or walking involved but due to the nature of the information I deal with telecommuting isn't an option, I do have to drive an hour each way and it's my right knee that is being replaced. It would be nice to be able to take longer off work but finances are very tight and there is no short term disability in my state and the jobs short term disability is laughable. I'm planning on paying bills 2 mos ahead and hoping for the best. This plan is not most comforting but it's the best I can come up with on such short notice. Am I being too unrealistic in my timeframe? I can't put the surgery off but don't want to end up homeless either. Are there tips to getting back to work?
    Thank you in advance for any advice!
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    _swank_ responded:
    I'm almost 7 weeks post-op TKR. I was in the hospital for 3 days and by the time I got home I could handle the personal details. There are several things that will make your life easier:

    Get a toilet seat lift for your toilet. This will make it higher and easier to get off and on. My insurance company paid for a bed-side commode that can also be put on top of your own toilet to raise it up. I already had a lift from a previous surgery. Depending on how far your bathroom is from your bed you might want the bed-side commode. Getting in and out of bed can take some time so don't wait until the last minute.

    Get a shower chair for your shower. The bed-side commode can also be used as a shower chair. Also, if you don't already have one, get a long hose for your shower head.

    Get a reacher so if something falls on the ground you can pick it up. It will also be helpful for putting on your clothes. You can buy things to help with shoes and socks. The hospital I was in sold a whole kit of handy things. You can also probably get them in a pharmacy.

    Whether you have crutches or a walker get a little bag to hang on them that can carry a bottle of water and other things. I have a crutch bag that has been very useful.

    Get a backpack if you need to carry things.

    You should be fine going back to work after 8 weeks. The surgery kicked my butt and I was totally exhausted for a month afterward. I did go back to school after 5 weeks. Again, I was tired. I was driving in less than 3 weeks but it's my left knee. Sitting is still very uncomfortable, driving for an hour is going to be painful.

    I still can't do stairs well. I'm just getting so I can barely walk up them like a normal person. Going down has to be good leg first. My husband went back to work when I was 6 days post-op and I was fine. He made a lunch for me. I used a grocery bag to fetch it from the fridge and bring it to the bedroom. I drank bottled water which I put in my crutch bag. I was able to use the bathroom by myself. I could take a shower alone but didn't take one unless my husband was home for a couple weeks. I really couldn't stand, even on crutches for very long. I think I used the shower chair for at least 3 weeks. It's still hard to stand for long even though I'm off crutches.

    Carry your phone with you if you are home alone. I had my cell phone around my neck in a little bag we used to hold a passport when traveling.

    Hope this helps. Good luck with the surgery.
     
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    Nanniesmom replied to _swank_'s response:
    Thank you so much, this is very helpful info.
     
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    j0422l responded:
    I had my left knee replaced on May 26th, and am returning to work (office job) next week - 9 1/2 weeks out. I'm a 57 yr old female. I strongly recommend that you check into a rehab center for a week after surgery. Most insurances will pay for this. The type of rehab you get in the hospital for the 4 days you're in there isn't much more than learning to walk with a walker. The rehab was great and got intensive therapy. Went to a cane after 3 days. We live in a 3 story townhome with 1 flight just to get up to our living room. The stairs were surprisingly easy - but you have to go up with the good leg and down with the bad leg, 1 step at a time like a toddler, not stair over stair like an adult. I couldn't do them normally until my 6th week home, & still need a banister to hang on to. Drove after 3 weeks - don't try more than 1 hr., it'll hurt. Do your PT every day! It might hurt, but it helps. I went to a PT center 3x a week for 8 weeks, and do them at home in between. Plan on continuing them at home too. I couldn't grocery shop alone till my 5th week, and still can't carry them up the stairs very well. I went with my husband for groceries my 1st week home (3rd week after sugergy) and felt like collapsing in the store! Therapist said that was way too much too early. Keep it elevated as often as you can and use lots of ice. I use a toilet lift to make it easier and a suction grab bar to help get in the shower. Got one of those "as seen on TV" suction bars. You'll spend the 1st month taking pain meds, doing PT, watching alot of TV with the knee elevated and not much more physically. I was able to cook and get around the house, take a shower, even house clean slowly ( cell phone in pocket at all times). After 9 weeks, the knee is still swollen and hurting off and on, but good enough to go back to work 1/2 days to start. Still taking Vicadin, and Aleve. It is taking longer than I thought. Doctor & therapist says total recovery won't be until 6-8 months, and that I'm doing great. I'm just impatient. This was much harder than I had anticipated, but I'm sure the final result will be worth it.
     
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    Noogie98 responded:
    Hi... I am 1 month post-op on my Left TKR; I was in the hospital for 5 days, up walking and doing PT exercises my second day. I had a nerve block, and they would not let me out of bed my first day. I had a CPM machine in the hospital that I used when I was in the bed. By my 3rd day, I was sitting in the chair in my room & going to the bathroom on my own with minimal assistance. It wasn't until I came home that my troubles began. Since being home, the CPM machine that they sent me home with literally beat me up at night; it was an older machine, and needed to be retired. I had horrible bruises the entire length of my leg & my ankle was very bruised and swollen. The daily blood thinners I had to take (shots) did not help with the bruising. They came out to the house & replaced the machine with a newer model, and I have had no problems with it.

    Last week, I went to get up from the couch and fell. My leg was asleep and just went out from under me, knocking over my walker, my laptop and I fell to the floor. My PT says I haven't lost any ROM, but I have major swelling now in both legs and they are both painful. Just be careful getting up after sitting for awhile.

    I am still not allowed to drive and I am still using my walker. My doctor told me the last time I was in to see him that he was not probably going to release me to go back to work until the first of September. I had anticipated going back to work the middle of August, around the 16th, but that doesn't look like it is going to happen.

    Swank had some really good suggestions; the most important thing I can recommend is to keep a phone with you at all times, even when you are going to the bathroom. You never know when you are going to need someone, and it will never fail; you will be without the phone & no one will be within hearing distance of your cries for help! Funny story; I had a meniscus repair last year, was home from the hospital for a week, alone in the house & got stuck on the toilet with no phone and no one to help me. I ended up taking the belt from my robe, swinging it to the bathroom doorknob and pulling myself up!! Make sure to get an elevated toilet seat; you don't realize how low the traditional seats are to the ground until you cannot get up from them!

    One thing that they don't tell you is that you will be walking and all of a sudden your knee will tighten up on you; it will feel almost like a band around your knee. Everyone I have talked to about it, from others who have had the surgery to PT's to the PA's and Doctors have told me that this is normal. It is frustrating to deal with, but completely normal, so don't think something is wrong. My therapist told me she is working with several other knee patients and they all have the same thing happening to them.

    The most important part of your recovery is going to be doing your physical therapy exercises religiously. I slept at night with my CPM machine for the first 2-3 weeks, and did my exercises 2-3 times a day. My therapist is so sweet, she calls me when she is about half an hour away so I can take the pain meds. It helps with making it thru the sessions. Just follow the advice of your Doctor, home nurse & therapist. They are there for you; use them to your advantage. Good luck and my prayers are with you!!
     
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    Geradine4733 responded:
    I was in the hospital for 6 days and rehab for 10 days. I could take care of myself but I could not do housework.

    I had cooked lots of things before I went in the hospital. I put them in the freezer like skinless, boneless chicken breasts, chili, hot dishes, etc. I could thaw out food and hobble around the kitchen coming up with a meal. I just ignored the housework

    Have your house clean, food prepared in the freezer, the raised toilet seat, the reacher, etc. Have a well stocked cupboard including regular oatmeal and brown rice in your cupboard. I found them easier to digest for the first week after I came home along with yogurt.

    I had a PT who came to my home three times a week, and I did the exercises every day by myself when she did not come. There was a Health Aid that came a few times a week to help me with a welcome shower and shampoo and change the bedding.

    My husband helped by picking up the meds and washing clothes. I could fold them.

    God bless you on the hour ride each way. That is a real challenge with the right knee. It depends upon how much the swelling goes down and how much pain meds you will need. That is the only thing I would be concerned - the rest will be OK so do not worry.

    It sounds like you are pretty young with a 15 year old daughter. I am older than you. Usually younger people heal faster than older people.
     
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    kteachok responded:
    I am amazed at the hospital stays and the rehab length! Actually, I'm a bit jealous. I am 58, good health, and had my left knee replaced almost 7 weeks ago, on a Monday afternoon. I was discharges on Wednesday, not 48 hours later, with a home health nurse scheduled to visit 2 times, once to take blood for the blood clotting level, and once to take out my staples. I also had a PT therapist visit 6 times over two weeks. I was in a walker for 3 weeks, and used a cane for 3 weeks. I am now walking on my own, but if I am to be out for a while (shopping, etc) I was encouraged to use my cane. I have just about my full range of motion, but I started having burning sensations around my knee, on the outside and the backside of my knee. I haven't been on any painkillers since 10 days post-op as I didn't really have any pain, but this burning is getting to me, and I'm about to start them up again. Has anyone had this burning sensation? I don't believe it is a clot; instead, my mom, who has had both knees done, said her doctor told her it was the nerves healing.

    My hospital is among the top 5% in the nation for the past 5 years (almost since it was built) for knee/hip replacements, and my doctor is the #1 in the metro area for this surgery, so I have no complaints about my care, but it seems so different than everyone else! I have more or less been left to myself on rehab, which I am keeping up with. By the way, my replacement did not use "glue" but is the type that the my bone will grow to.

    I was out shopping 10 days after surgery (I am a teacher, and a local store had 20% off all educational supplies! Couldn't pass that up!) I was given the go-ahead by my PT as long as I came home and iced. I report back to school next Friday, but will have to go in starting tomorrow for classroom set-up. I teach kindergarten, and I expect that I will be very tired, more than usual, for the first several weeks.

    Good luck to everyone who is recuperating, or is planning for surgery! I feel that it is totally worth it, and I just wish I could have had it done earlier!
     
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    _swank_ replied to kteachok's response:
    Hospital stays and post-op care are often dictated by insurance companies. It doesn't really matter if your doctor or hospital is #1 or #1000. Your insurance company and hospital negotiate your length of stay ahead of time. If your doctor wants you to stay longer he has to clear it first. I was allowed three days in the hospital. I asked my doc if I could leave after two and he said maybe. Once I had the surgery it was clear I wasn't going to be out of there in two days. I didn't even argue. In fact I almost ended up staying a little longer due to an infection.

    I had home therapy for only two weeks. It was pretty useless so I was glad to go to my regular therapist. I'm still going at 9 weeks post-op. But otherwise my life is back to normal.
     
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    Noogie98 responded:
    Hi Nanniesmom,
    Just looking over some stuff I had previously posted, came across this and was wondering how you are doing? Did you have your surgery yet? I am 2 months post op now, and my Dr refuses to let me return to work until I hit 3 months. That was pretty devastating for me, as I had originally planned to return 2 weeks ago. Now it is looking more like I will be returning the end of September.
    I just got the OK to start driving; I can only drive short distances and no freeway driving yet. I have had 2 falls since posting last; my first fall, I went to get up from the couch & my left leg was asleep & gave out from under me. The second fall was from the pain meds they gave me 6 weeks post op; the meds made me extremely dizzy & I passed out while I was walking. When I came to, I had knocked over my walker (which my Dr had me still using because of the previous fall), my laptop table & a oscillating fan I had next to my chair.
    I am up most of the night, because it is very difficult to get comfortable. I sleep most nights in a recliner in my living room as to not disturb my husband in our bed.
    I had planned on returning to work @ 2 months, but my Dr told me he rarely released patients that early, regardless of their jobs, because the surgery is a very traumatic one & the recovery time is very long. He told me the other day he has some patients who are 6 months out still having difficulties. I told him I refused to be one of those people, and will do everything in my power to ensure that I will be back to work by the end of September.
    I wish you luck on your recovery; I hope you have a good therapist who can help you achieve your 2 month goal.
    Best wishes for a speedy recovery~ Noogie98
     
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    Nanniesmom replied to Noogie98's response:
    thank you for the well wishes, I haven't had my surgery yet, had to postpone due to a fall. I tripped on a flat floor in flat shoes......go figure and ended up brusing my bad knee and my ribs when I landed on my work badge. More embarrassing than anything, I felt like a turtle. So I missed a week of work and had to postpone to give my ribs time to heal and to give me a chance to make back the money lost from missing work. As it is every penny counts right now. As the surgery gets closer I'm finding out more, some of which scares the heck out of me. The scariest is the epidural anesthesia, which I've never been through, plus I do not want to see, hear or know what they're doing, while they're doing it. Creeps me out to just think about it. I have the pre-anesthesia appointment next week so hopefully they can take away the fear of the unknown. I've gotten most of the medical supplies/equipment that they've suggested except for ice packs, bandages, and a basket for the walker.( I can't think of any other way to carry drinks, food, ice... etc from one room to another while I have to use a walker and there will be times when I'm on my own and need to get something. I'm too independent so waiting for help is going to get really old fast.
     
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    _swank_ replied to Nanniesmom's response:
    Most doctors prefer to use general anesthesia for TKRs and not epidurals. I would never consent to an epidural unless there was a very good reason why I couldn't have a general. I had a spinal for my first surgery and it was a nightmare. I won't ever do that again.

    I did have a nerve block for my TKR which just numbed my leg. This was for pain control when I woke up. The real pain started when that wore off.
     
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    CCPD172 responded:
    My right knee was replaced on June 21st and I was discharged on the 24th. I live alone with only two steps to negociate. I'm a 240 pound 63 year old.

    I had a nerve block following surgery that completely killed the feeling in the front of my leg. I also had a CPM in the hospital, but it was painful to the back of my knee. The surgeon used Dermabond instead of staples, and that was great.

    I had friends help get me home and settled; after that, I was alone except for visitors every two or three days. I had filled the freezer and refrigerator with everything I thought I would need for three weeks. The PT came three times per week for a month and was great. So, the answer to your 24/7 question is: probably not.

    I set up the toilet riser in the spare bathroom, but never used it, although it was a life saver after a hip replacement. I was able to use the sink and the edge of the door frame for support.

    I used a 36" metal stool in the shower; the shower chairs mentioned previously just don't fit very well in all tubs. I also have grab bars at elbow height above the middle of the tub and at each corner. Great confidence builders when stepping over the top of the tub.

    Since I live alone, I did not hesitate stand up from my recliner to use the urnial for the first three weeks if didn't want to make so many trips to the bathroom. It hooks perfectly over the walker bar to transport it to the toilet.

    I used a walker for three weeks at home and graduated to a cane for another three weeks. I strapped a backpack on the walker to carry things (something I learned following my hip replacement). Get yourself a few large mugs with secure tops and a straw hole. They fit into the backpack without spilling, and it is a great way to carry ice cream back to your easy chair!

    No one has mentioned a cold therapy unit instead of ice.
    http://www.deroyal.com/FileDisplay.aspx?id=665
    I was discharged with one, and used it at least 10 hours a day to keep swelling to a minimum, and it helped reduce pain. My ice maker was unable to keep up with the demand, so I froze water in small Tupperware containers, then chipped it to fit into the unit. The larger blocks of ice actually lasted longer than ice cubes. I was able to fill it, wedge it into the back pack, and go back to the recliner to set it up. It is temperature controlled, so it shuts off the water is below 37 degrees or about 42 degrees.

    I am a teacher and did not have to go back to work until the middle of August, but could have gone back after four weeks with the use of the cane. If everything goes well, you should be able to go back to work after six weeks. Driving one hour will definitely cause some pain, cramping, and stiffness, but will be earily tolorable if you're off for two months. Learn to use your left foot for the brake, and stretch your right leg every chance you have time during a stop in traffic.

    To be honest, it will take you a while to negociate the stairs when you first arrive home, so you probably won't want to use them for the first day or two. Hint: take your pain meds about one hour before arriving home.

    Start back on the stairs as soon as you can to strengthen your knee. You should be able to take two or three steps before leaving the hospital, so try to add at least one or two steps per day when you get home. Up with good; down with the bad; baby steps - one stair at a time. Always have someone with you until you feel comfortable going it alone.

    I was almost pain free in my knee after eight weeks (but I didn't have two flights of stairs!); the leg is now about 3/4 inch longer than the left, and that is causing some back and hip pain as I walk a lot a work. I wish I had the surgery sooner, even if it wiped out my sick leave.

    You will feel so much better after two months, you'll be glad you did it. Good luck!!
     
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    bethus60 replied to Noogie98's response:
    Noogie -- Did you have the TKR on the same knee that had the meniscus repair? I still have a lot of pain after a partial meniscectomy 11 months ago, and see that a lot of people seem to have TKRs soon after meniscus surgeries..
    Tx, Beth
     
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    _swank_ replied to bethus60's response:
    Some people don't really recover after having a partial menisectomy. The hope is that removing the torn bits will reduce the inflammation in your knee and you will have less pain. But you're also having part of the cushion removed from your knee which can cause its own problems.

    I had my meniscus removed a piece at time. Three surgeries total for just that. But this is a process that didn't start until 17 years after my injury. It was about 17 years after that when I needed a partial knee replacement. So the process happened slowly for me, probably because I was young when I injured my knee in the first place. I also think that lots of biking and swimming prolonged the life of my knee.
     
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    Noogie98 replied to bethus60's response:
    Beth,
    In answer to your question, yes, I had both surgeries on the same knee. And, I still am not back to work yet. My surgeon told me that my knee was one of the worst he head seen in all his years of knee replacements. In the year between the 2 surgeries, I had to use a cane & knee brace all the time. I work in special education at an elementary school and am on my feet 98% of my day. My students are 3, 4 & 5 year olds with varying special needs ranging from mild to severely handicapped, both physically & mentally. I am anxious to return to work, which now looks like it will be September 29th. I am glad my Dr is sending me back mid week, as I will have a couple of days back, then a weekend before trying to work a full work week. My knee still swells considerably with exertion & I am still having trouble sleeping. If someone had told me that I would be having this much trouble post surgery, I might have postponed it for awhile more, probably waiting until I was crawling to the Dr's office. This has been an experience I do not wish to repeat any time soon & I keep telling my other knee not to get any ideas, that we are not going thru this again!!
    Good luck with your knee and if there are any more questions, please feel free to ask. I do not check this that often, but I will get back to you.
    Noogie98


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