The B's Knees or Important Trivia about Knee Replacements
This is about as hot off the press as you can get. I had my right knee replaced about two weeks ago and am now at home doing exercises, taking pain pills, Senokot, Coumadin, Pepcid AC, iron, antibiotics, etc. and walking without my walker, at least in my apartment.
Important trivia may sound like an oxymoron but it really isn't. Here are some of my best little tips as you walk this road.
Knowing when you need this surgery
Nobody else can tell you this. It's your call. You need it when your quality of life is deteriorating. I had already had two arthroscopic surgeries on my knee, all the current pills, cortisone injections, Synvisc injectionseverything out there and nothing worked any more. I could walk around pretty well but dealing with stairs, public toilet seats, low furniture and car seats was really painful. It was time for the BIG one.
Picking your surgeon
Pick an orthopedic surgeon who does at least 100 knee replacements a year. Ask around. Get one who will listen to you and answer your many questions.
Ask him/her for a "Handicapped" parking card for your car, which you can use for a few months if necessary.
If you're a frequent flyer ask for a letter or card saying that you have a knee replacement. This will speed your trip though airport security areas.
Pre-OP
Try to strengthen your arms for a month or so before your scheduled surgery . This comes in handy when you have to lift yourself in your bed and even in using the walker.
Check to see if the hospital has a pre-op class specifically for knees. Many, if not most, do. I went to one that was one-on-one and it was excellent. I saw a video about the whole operation, saw the various devices, including the pain drip apparatus that you can use yourself to administer pain medication when you need it. Then there was the CPM (continuous passive motion) machine that looks like the San Francisco Bay Bridge and which gently makes your knee go up and down after surgery, and even a sample of the prosthesis.
If you're worried about nausea after surgery, speak to the anesthesiologist about a suppository that will prevent this. Mine was Phenergan and it was inserted about an hour before surgery.
Make several copies of your living will and take them to hospital. Several people will probably ask for a copy.
Getting a private room at a semi-private rate
Some hospitals have private rooms for orthopedics and some don't. Mine didn't but I really wanted to be by myself. Just ask the patient care coordinator, or ombudsman or whatever the name of the patient "comforter " in your hospital is, if you could be in the last room that they fill with another patient. This worked for me on both the orthopedic floor as well as the rehab unit.
What to take to the hospital
You probably already know about clothing, toiletries, etc. but here is the BIG one to take. Prunes, prunes, prunesand maybe a few apricots as well. All the pain medications are going to make you constipated. I ate a whole bag of prunes in four days! Licorice is good, too. And order lots of fruit with your meals.
Rehab
If you have someone at home, this is easy. He/she can take you to outpatient physical therapy three times a week. But if you live alone, as I do, you may want to stay in the hospital Rehab unit, if they have one. I stayed for three days and was raring to get out by then. Came home and got the VNA (Visiting Nurse Association) to provide what I needed, including skilled nursing care to take my blood and check Coumadin level. (You'll get Coumadin to prevent blood clots.), a personal care aide to sort of bathe me and make or change my bed (plus more if you need it) and a physical therapist to get me started until I was ready to ask friends to take me back and forth for outpatient therapy.This worked out well and Medicare pays for all of it.
Make sure you get extra pain medication about an hour before each physical therapy session. If it doesn't appear, ask for it.
You'll get a walker in the hospital, if you don't already have one, and you can get some neat bags to attach to the front to hold your telephone, reacher (a gadget to pick up distant things) or any other stuff you want to keep with you.
Another option for a place to get your physical/occupational therapy is in the skilled nursing area of a life-care community, but most are rather depressing.
Don't worry about stairs
This was one of my biggest concerns since I live in a second floor apartment with no elevator. Somebody told me that I would carry my walker up with me and my mental picture was a very clumsy one. But it's easy! Trust me, no problem. You'll learn how in the hospital.
Driving
If it's your right leg it may take 4 to 6 weeks, depending on your ability to bend that leg well. If it's your left leg, maybe sooner.
My most important advice
The speed and success of your recovery depends on a good surgeon, but even more, on your attention to the exercises. I've heard that 75% of your success is in your hands. Sure, the exercises hurt but the more you do, the sooner you'll be out in the world again.
At just a little over two weeks, I'm not ready to kick up my heels yet but it's coming. And I have discovered a wonderful community of friends and acquaintances who have really helped.
If I can answer any questions, I'll be glad to. Meanwhile, here are three good web sites and a really good book to check out.
A Patient's Guide to Knee and Hip Replacement, by Irwin Silber. A Fireside book published by Simon & Shuster. I strongly recommend this book. It tells you everything to expect, from start to finish. It's a paperback and the author has had both hip and knee replacements. It's a must have.
