Hi! We are the Tippecanoe County Knee Replacement Support Group – the
TippecaKnees. We are an informal support group formed by word of mouth.
The support received from each other has been so helpful to us that we
decided to branch out. This is intended for anyone who is considering
having Total Knee Replacement (TKR) or who has recently had it done.
We’d like to share with you what we have learned.
Note
that we are all patients and are telling you what we have observed and
experienced. The information and advice shared and received by members
of TippecaKnees is for informational purposes. It is not medical advice
and should not be taken in place of doctors’ orders.
Are you thinking about having knee replacement done?
Here are some of the things we get asked:
What made you decide to have TKR done? Was it a hard decision?
You
bet it was! As with any surgery there are risks and, in this case, one
possibility is your knee will be worse. Your regular doctor can advise
you when it’s time to visit an orthopedic surgeon. As a rule, you should
have already tried other methods such as pain killers and injections.
Many doctors recommend that you be at least 50. In my case, I finally
reached the point where I felt so limited by not being able to walk
without pain that I decided to have the surgery. But only you will know
when you are ready!
Did it hurt a lot?
Initially,
yes. You will be on pain medication in the hospital that will pretty
much keep it to a minimum. You can continue to take it at home as
needed. Your nurses and physical therapists will tell you that you can
expect to hurt more after physical therapy so try to time taking your
painkiller accordingly. Most of us went through a period of “I can’t get
comfortable!” in weeks 3 and 4. It helps to know that each week brings
improvement. If your pain is not tolerable, don’t suffer! Talk to your
doctor!
Both of my knees are bad. Should I have one replaced at a time or both together?
Your
doctor can advise you on the pros and cons of each method. In general,
doing both will require about a week stay in a rehabilitation facility
before you can go home. Once you are home, you will need someone there
to assist you with things like cooking, housework and other daily
activities. Doing only one is usually easier since you will still have
one “strong” leg to use. However, you should consider whether or not you
will be willing to return for a second surgery if you only have one
done.
Will my new knee make me “good as new”?
It
depends on what that means to you. You won’t feel like you did at age
20. You probably should not plan on playing high contact sports. But you
should be able to walk without pain, do yard work and housework and
have more freedom to do the things you’ve had to stop doing because of
the pain. You may have more limited motion but you should still be able
to climb stairs and get in and out of a tub. There will still be times
when your knees pop or hurt but that usually fades in time. A lot of it
depends on you.
Would you do it again?
My
doctor asked me the day after my second surgery if I was glad I had
done it. I replied that I wasn’t there yet. Now after 6 months for one
and 8 weeks for the other, I can say “Yes, I am glad I did it.” I am
excited by each little accomplishment like walking around the block or
going shopping without a cart to lean on. I feel like I have my life
back! 85% of our group would do it again. The other 15% “aren’t there
yet.”
I live alone. How will I manage?
It’s
a bit more challenging because you have to plan ahead and you have to
let people help you! (I know that is tough for a lot of us.) You will
need someone to get you home from the hospital, to your PT (Physical
Therapy) evaluation and to your PT sessions. Your sessions will last
30-60 minutes 2 or 3 times a week. Most of us were able to resume
driving short distances at the 4 week mark so you could get yourself to
and from therapy then. Stock up on groceries – especially easy to
prepare food – before you have your surgery. Things like soup, cereal,
granola bars, cheese and crackers are easy to prepare. Get some paper
plates and plastic utensils to cut down on dishwashing time. Stock up on
pet food, litter, etc. if you have pets. I’m betting you have friends,
relatives, neighbors or coworkers who would not mind helping at all.
Don’t be afraid to ask! And if you REALLY hate to ask, you’ll be able to
get into and out of most cars so taking cabs is a possibility. (Because
of the stairs, buses would be trickier.) By the end of the first week
home, you should be able to do most simple things on your own so you
will mainly need help getting to appointments or to stores to pick up
meds. (This is not the same if you have both knees done at once.)
I want to lose weight before knee surgery.
This
can be a tough call. Do some research and talk to an orthopedic
surgeon. It is hard to lose weight when you can’t exercise due to pain.
As a rule, if you weigh less than 300 pounds, you can successfully
handle the surgery and therapy without putting undue stress on your new
knee. If you weigh more than that, talk to your regular doctor about
some options to reach your goal. However, I have known many people who
weighed more than 300 pounds and had it successfully done so don't
hesitate to seek out another opinion if told you weigh too much.
Have you recently had knee replacement done?
GOOD FOR YOU!
Here are some of the things we’d like to share:
What advice can you give me?
•
The #1 piece of advice I appreciated getting was “Expect to cry.”
Apparently crying and feeling depressed is very common after knee
surgery! Your body has gone through major surgery and it can be a
struggle to get the pain under control. You will be very frustrated at
not being able to sit or lay comfortably for longer than short periods
of time. Everybody tells you it gets better but it seems like you should
be better by now! (This usually happens around week 3.) If you find
yourself crying and saying “Why did I do this? Will it ever stop
hurting?” rest assured that you are normal. It DOES get better! However,
do not hesitate to talk to your surgeon or your regular doctor if these
feelings become overwhelming.
• Waking up in the middle of the night is also common. We watched movies, read, worked crossword puzzles…
•
Don’t be too tough to ask for help! If you’re like most of us, you
don’t like to depend on others. You will have friends, neighbors or
family ask if you need anything. Don’t be afraid to say “I could really
use a ride to pick up my meds.”
• Call your doctor or
nurse with questions. Contact your friends and family for help or just
to chat. Contact one of us if you have questions about what you are
feeling or experiencing. We’ll tell you how we handled it or suggest you
call your doctor.
• Do your PT exercises! This is key
to your recovery. You’ll want to stop but keep at it!
• Use ice for swelling (after PT especially) and heat for stiffness (a
warm shower or hot water bottle does wonders for a stiff knee!).
• Ask your PT about deep massage – it helps prevent scar tissue from forming under your scar.
My scar itches!
If
the staples are still in, try putting ice on it to minimize sensation.
If the staples are out and there are no openings in the scar, try
rubbing on Vitamin E oil, lotion or a scar ointment like Mederma.
My scars are embarrassing!
Show them with pride! It takes a brave woman or man to make the decision
to have the surgery! Whether you think of yourself as a pirate or the
Bionic Woman, you can be proud of what you have accomplished. They’re
also a great conversation starter!
I still feel numbness near my incision. Should I be worried?
Probably not. That sensation is very common. It fades somewhat but you may always have some degree of numbness.
I’ve been having a problem with constipation since my surgery – should I be worried?
Probably not. Most of your pain meds have that
effect on the body. Eat a healthy selection of foods and drink plenty of
liquids. Once you taper off your pain killers and start to move more,
you’ll return to normal. If it’s bothering you, talk to your doctor
about using a laxative. One thing we can tell you – “passing gas” in the
hospital is VERY normal. My roommate and I apologized at first and then
started congratulating each other since according to our nurses that is
a GOOD thing!
What kind of exercises can I do after TKR? Can I still lift my grandchildren?
Walking
and light aerobic exercises are fine. You should avoid exercises that
put a lot of strain on the knees such as deep squats, yoga, weight
lifting from a standing position, etc. Use caution with activities that
might result in you being hit or falling on your knee.
As a rule you should not be lifting more than 40 pounds on a regular
basis. Lifting babies and toddlers should not be a problem. Ask your
older grandchildren to sit with you so the strain is not on your knees.
I’m done with physical therapy but my knees and muscles still hurt.
Most
of us went through some type of painful movement from swollen legs to
pain when using a treadmill or trying to step up. We tried different
things such as doing hamstring stretches, keeping legs propped up and
wearing support hose. One person noticed a drop in pain when she went
from wearing the shoes she usually wore to athletic shoes with a
different heel and support. Don’t be afraid to ask others or try some
changes on your own. Don’t hesitate to take some pain meds if you need
them. If the pain continues, call or visit your surgeon or physical
therapist. He/she can recommend additional things for you to try.
Last Words of Wisdom
You
may have guessed by now that it’s important to keep a sense of humor.
Call your doctor and therapist sadists – it’s hard to believe them when
they say “it’s for your own good”. It helps to laugh at yourself and the
silly things you will do. It is also most important that you applaud
yourself for each little step you make – be it walking the length of
your house without support or just being able to stand on your own and
fix a meal. You will notice more and more of these little “victories”
each week. A turning point seems to be six months. Many of us noticed a
marked improvement in pain level and function about that time.
Make up your mind that you CAN and WILL get through this! I can almost
guarantee that you will be thrilled by how much less pain you will have.
You’ve been living with a lot of pain and inconvenience as your knees
got worse – you can tough it out a little longer.
Be sure you have realistic expectations. You’ll still have some
limitations and occasional pain, stiffness or a numb feeling. You won’t
feel like you’re young again but you’ll almost surely feel better than
you have in a while. Expect to cry, expect to feel some degree of pain
for up to six months, and expect to work hard at physical therapy and at
doing your exercises at home.
There are three key
parties involved in this process: your doctor and his skill, your
physical therapist and her training, and YOU. You all need to work
together to make this a success. And, as we have found, having the
support of others is icing on the cake. Ask for help and contact one or
more of us. We will tell you what it felt like, how long it lasted, what
we did. We’re all good at listening, too.
Take care of you!
Suggested
reading -
Total Knee Replacement and Rehabilitation – Daniel Brugioni & Jeff
Falkel (helpful, easy to understand information about before, during and
after TKR)
Stretching For Fitness, Health &
Performance – Christopher Oswald & Stanley Basco (good variety of
exercises that can be done before surgery and after rehab)
