Questions, answers and advice about knee replacement
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.
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 for help. You will have friends, neighbors or family ask if you need anything. Don’t be afraid to say “You know, I could really use a ride to pick up my meds” or “Can you pick up some milk for me?”
- Call your doctor or nurse with questions. Contact your support group (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!
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.
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! J
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, eat more fiber or 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 to be held so the strain is not on your knees.
I’m done with physical therapy but my knees and/or 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.
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 getting your shoes on for the first time, 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!
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