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  • RAFH
  • Have a life, already.
Total Knee Replacement
Starting in 2010, I began to have serious and increasing pain in my knees, primarily the left one but both contributed. It was intermittent but but gradually became more and more chronic. By 2012, it was a regular drag on my life. However, being the determined twit I sometimes am, I carried on. Fortunately I lost my courier job in July of 2013 so wasn't continually stressing the knees. As time passed, the situation got steadily worse. By two years ago I had to curtail beach and trail walks, was always on the lookout for places to sit and consumed a lot of OTC pain medications, most of which had little to no effect. In 2014, with ObamaCare, I entered into a campaign to diagnose and treat the problem.

Initially, my PCP was in charge, unfortunately under most insurance systems, the patient has little to no choice in their PCP. In the past two years I've had 9 different persons and two of those I never met because they were assigned to me and then gone before I needed any care. The initial program was to treat my knees with Steroid injections which could only be used every 4 months. These were nominally effective. Some rounds helped quite a bit, others did next to nothing. Overall, they all ran out before I could get the next round.

At this point, I was referred to an Orthopedist. Her staff evaluated me and determined I was a candidate for knee replacement, initially partial compartment but over the ensuing year, that escalated to Total Replacement. I was told to lose weight, about 30#, and get my PCP's clearance for surgery. In the meantime she started a program of Euflexxa injections as a possible alternate, since I needed something anyway to keep sane and it might have eliminated the need for surgery, which she assured me I really didn't want to do unless it was the only possible solution. 

I started working on both issues. Initially, losing the weight did not go very well. It was when I got the full report back on the surgery clearance that I got both the information I needed and more impetus to use it. All was good except I was pre-diabetic (AC1 = 6.0, Blood Sugar = 120 to 140 after 8 hours fast). and there was an issue with my heart. For the former, I undertook a massive change in my diet (exercise was not possible given the pain in my knees). I switched to a very low calorie very low carbohydrate diet and lost the weight and got my AC1 down to 5.2 and my daily Blood Sugar down into the 80s and 90s. For the latter, I was referred to a Cardiologist who did a regular EKG and then based upon that did an EchoCardioGram. Based upon the last, he cleared me for surgery, said my heart wasn't that of a 20 year old athlete but within normal range for my age, 60s.

The orthopedist scheduled me for surgery and I reported to the hospital on Nov 7. I had, on the recommendation of both the orthopedist and the anesthesiologist, opted for a Spinal Block and sedative rather than the full gas anesthesia, shorter recovery time and much lower risk of complications. In the meantime I had done a lot of research, eventually having extended conversations with about two dozen who had undergone the procedure. All of them recommended going for one at a time, all but one had done so. The one gal that had done both knees simultaneously said the only advantage was when it was over, she didn't have to go back and do the other one and she's not sure she could have done so. It's a very painful and disruptive procedure. I got estimated of the pain ranging from horribly excruciating to unbearably awful. Thanks folks. And for the length of recovery, estimates ranged from 6 to 13 weeks. The 6 week recovery was by a single young athlete, most of the reports were in the 10 to 12 week range with two at 13 weeks. However, everyone agreed it was one of the best things they'd ever done.

So, thus buoyed, I reported for surgery on November 7. I had taken a thorough shower the night before and wiped down with chlorhexidine. Donned freshly washed PJs and got into freshly washed sheets. At the hospital, I did another full wipe down with the chlorhexadine. Donned the special climate controlled gown and was taken to surgery. There the anesthesiologist administered and checked the spinal block and then gave me a sedative. Lights out.

Came to in my room. to be greeted by my daughter and the Girl. I was still under the influence of the spinal and sedative and they had started me on the demand pump IV for morphine. So, initially I wasn't in any pain. Unfortunately I didn't avail myself of the pump as much as I should have and so fell behind the curve until two days later. That was no good.

My daughter had made arrangements for me to stay with here. She's a PT so had the relevant medical experience. Plus her house is large and comfy and the ground floor where I'd be staying had it's own guest bath. And I had my grandkids to take care of me as well.

I would have preferred to stay with the Girl but her house is tiny and two story with the bedrooms on the second floor along with the only full bath. And we are still in the midst of an extensive remodel.

So it worked out for my daughter as I could watch the grandkids when they weren't in school. Even though there's not much I could do if something when awry, I could call 911 as well as keep the kids in line.

So, no more pump, I miss that a lot. But the surgeon has been kind and provided me with acceptable levels of pain meds. I'm getting full PT here at home (daughter can't, officially, due to ethics) and I'm making progress. It's been very painful. The incision is gruesome . It's hard to get around or do most anything. That's all complicated by the right knee acutely needing it's own procedure and now I'm having to shift the load to it. It's not happy with that role and lets me know in no uncertain terms it's unhappy. My primary directive, other than doing my exercises is to not fall down. So far I've been a perfect student.

At least I will know what to expect when I do the other knee. As it was, I had only the reports of others to go on. I was very apprehensive prior to the surgery. Now I have a much better idea of what's involved. Mostly it's not the least bit fun but I will survive it.



Are we there yet?

Re: Total Knee Replacement
Reply #1
Good luck. Let me know how it goes because I am in the injections and pt phase of that process. I have decided that I am going to power through it as long as possible and being a little fanatical about the doing my pt. I had gained about 15 lbs since it got too painful to ride my bike and I started taking the train to work. I think that weight plus the reduction in exercise was making it worse.

I get violently ill from most pain pills so I was taking way too much advil. Now I am taking naproxen and doing a lot of pt but the weight is hanging on. I'm 6' 2" and at least was in good shape so it isn't something terrible, although I am well and truly out of my 34 waist pants now. But all the people I know who've had the surgery (which is 3) had real problems afterward because they weren't in super good shape when they had it done so rebuilding was more difficult. At least, that's my superstitious model. In all 3 cases, it took about 6 months before they were using it normally, but like I said, none of them were in great shape when they did it.

I can take Dilaudid but it gives me terrible itches all over. That's one thing that worries me.

Anyway, that's my story. I do hope you recover quickly and I'll be interested to hear about your recovery. I think Raven had it done a year or two ago.
Love is like a magic penny
 if you hold it tight you won't have any
if you give it away you'll have so many
they'll be rolling all over the floor

  • SkepticTank
  • Global Moderator
  • Calmer than you are
Re: Total Knee Replacement
Reply #2
I need a 2nd arthroscopic surgery on my left knee (torn meniscus).  I've been putting it off for a bout a year, but my exercise has gone way down, so the weight has gone up.

  • ravenscape
  • Administrator
  • Triggered
Re: Total Knee Replacement
Reply #3
I'm a happy owner of a bionic knee.  The first 2-3 weeks are the worst, then things start to incrementally and almost unnoticably improve.  I think the best thing about PT is actually the metrics.  If you work at it, you'll see improvements every time you check your degrees of flexion, and you'll definitely notice when you can move a stationary bike pedal through a complete revolution without screaming.

I'm very happy I finally had the surgery.  My right knee will also eventually require surgery, but now that it's not my "good" knee that day has receded into the indeterminate future.

One thing I still have to deal with is the after effects of favoring my left knee for years.  Hips are tweaked, and I have occasional lower back pain on the right side.  I had a hellacious bout of sciatica a little over a year ago.  I wish I had known to focus on unkinking all the muscles that had spent so long trying to protect the left knee via PT in the months after my surgery.

Re: Total Knee Replacement
Reply #4
My meniscus surgery was super easy. It hurt less as soon as I woke up from the anesthetic. The post surgery pain was way less than the meniscus pain.
Love is like a magic penny
 if you hold it tight you won't have any
if you give it away you'll have so many
they'll be rolling all over the floor

Re: Total Knee Replacement
Reply #5
I'm a happy owner of a bionic knee.  The first 2-3 weeks are the worst, then things start to incrementally and almost unnoticably improve.  I think the best thing about PT is actually the metrics.  If you work at it, you'll see improvements every time you check your degrees of flexion, and you'll definitely notice when you can move a stationary bike pedal through a complete revolution without screaming.

I'm very happy I finally had the surgery.  My right knee will also eventually require surgery, but now that it's not my "good" knee that day has receded into the indeterminate future.

One thing I still have to deal with is the after effects of favoring my left knee for years.  Hips are tweaked, and I have occasional lower back pain on the right side.  I had a hellacious bout of sciatica a little over a year ago.  I wish I had known to focus on unkinking all the muscles that had spent so long trying to protect the left knee via PT in the months after my surgery.
I had Sciatica too! It's almost like we're siblings or something. I thought suicide was the only option but after 2 weeks of pt I could tie my shoes and after 4 weeks it almost totally disappeared. I couldn't believe I lived 3 months like that. That was the experience that turned me on to the amazing power of pt. Now, if someone even suggests that there is a possibility of a pt solution to any ailment, I am down at the pt getting my new exercises. Because of that, I now have a spin cycle in my dining room and a large contraption for doing pull ups and various core exercises on my back porch. I spend about an hour a day doing all that because getting old.
Love is like a magic penny
 if you hold it tight you won't have any
if you give it away you'll have so many
they'll be rolling all over the floor

  • SkepticTank
  • Global Moderator
  • Calmer than you are
Re: Total Knee Replacement
Reply #6
I've done PT and chiropractic treatments for lower back pain.  I found an inversion table works amazingly well also.

Re: Total Knee Replacement
Reply #7
How long do these things last for, it sounds awful  :ohdear:

  • RAFH
  • Have a life, already.
Re: Total Knee Replacement
Reply #8
Good luck. Let me know how it goes because I am in the injections and pt phase of that process. I have decided that I am going to power through it as long as possible and being a little fanatical about the doing my pt. I had gained about 15 lbs since it got too painful to ride my bike and I started taking the train to work. I think that weight plus the reduction in exercise was making it worse.

I get violently ill from most pain pills so I was taking way too much advil. Now I am taking naproxen and doing a lot of pt but the weight is hanging on. I'm 6' 2" and at least was in good shape so it isn't something terrible, although I am well and truly out of my 34 waist pants now. But all the people I know who've had the surgery (which is 3) had real problems afterward because they weren't in super good shape when they had it done so rebuilding was more difficult. At least, that's my superstitious model. In all 3 cases, it took about 6 months before they were using it normally, but like I said, none of them were in great shape when they did it.

I can take Dilaudid but it gives me terrible itches all over. That's one thing that worries me.

Anyway, that's my story. I do hope you recover quickly and I'll be interested to hear about your recovery. I think Raven had it done a year or two ago.
So far, it's going according to plan. Lots of pain. Seriously decreased mobility. And yeah, the pain meds often cause horrible itching. I'd like to get one of those cow scratchers, has a rotating brush. Cow steps on the pad below and the brush rotates.

I've done a lot of painful things, and this isn't the worst, not even close. But it is bad.

Key principles, don't fall down. Don't over medicate. Don't self-medicate. Don't reach to far. Nice and slow and easy. But keep at it. Fortunately I have my daughter whose is merciless when it comes to PT. And she's backed up by the Girl. Finally, my brother, former USAF Colonel has said he'd come out and make sure I do the work.
Are we there yet?

Re: Total Knee Replacement
Reply #9
You will be a success story then. That cheers me up. And you too, Raven. Thanks to both of you.
Love is like a magic penny
 if you hold it tight you won't have any
if you give it away you'll have so many
they'll be rolling all over the floor

  • RAFH
  • Have a life, already.
Re: Total Knee Replacement
Reply #10
How long do these things last for, it sounds awful  :ohdear:
I got titanium, it's supposed to last longer than the bones it's glued into. When I needled the doctor enough, she said 20 years, maybe more. Depends on how you treat the joint. If you subject it to a lot of shock stress and out-of-plane/axis bending, it's not going to last as long. If you're careful and keep up the exercises, it will last longer.

And, yeah, it is awful. Incision is about 7" long, right down the middle of the knee. Then they push whatever they can to the side, muscles, blood vessels, nerves, ligaments, tendons, everything. The kit comes with a set of test parts as to what the final shape of the bones will be. So they grind away until the fit is perfect, no gaps, no high spots, perfect. Then they slop on the glue and put the pieces in in place and somehow hold them there.

Put everything back the way it was, well, mostly. There's one nerve that has to be cut and it generally doesn't grow back, so you end up with a numb spot on the outside that's about the size of a silver dollar. Not really a problem. However, the new joint is longer than the original, so you get a tad taller.

My doc told me at discharge that if I had any second thoughts, I should dispel them immediately, that knee was totally done. Had I waited much longer it might not have been possible or they have to use a different joint which is much harder to install and much more intrusive.

I get the 32 staples out next Tuesday and we'll see what the doc thinks about it at that time. She's definitely not a warm cuddly type, but had really high ratings on the results. I don't need cuddling, just a working knee.

Are we there yet?

Re: Total Knee Replacement
Reply #11
Surgeons technique far outweighs their bedside manner in matters of importance.
Love is like a magic penny
 if you hold it tight you won't have any
if you give it away you'll have so many
they'll be rolling all over the floor

  • ravenscape
  • Administrator
  • Triggered
Re: Total Knee Replacement
Reply #12
Agree.  If you can get the surgeon that the hospital staff rave about, that's a good sign.

  • RAFH
  • Have a life, already.
Re: Total Knee Replacement
Reply #13

Absolutely. Fortunately, I had an advantage. My daughter used to work at that facility and still works for the company. She has many former co-workers still at the facility. As PTs, they're supposed to fix the surgeon's mistakes. My daughter inquired with her former co-workers and they inquired with other PTs, nurses, aides, etc. The rating was pretty much unanimous, positive.

So far, I'm happy with the results but more importantly, my daughter and the actual PTs and nurses and aides, etc, all say it looks good.

If you have any reasonable option, take it. With very few exceptions, you can always opt in for the surgery.

But you never know until the fat boy hollers. I haven't yet but ... ...
Are we there yet?

  • Bilirubin
  • Ain't nothing ta fuck wit'
Re: Total Knee Replacement
Reply #14
I'm a happy owner of a bionic knee.  The first 2-3 weeks are the worst, then things start to incrementally and almost unnoticably improve.  I think the best thing about PT is actually the metrics.  If you work at it, you'll see improvements every time you check your degrees of flexion, and you'll definitely notice when you can move a stationary bike pedal through a complete revolution without screaming.

I'm very happy I finally had the surgery.  My right knee will also eventually require surgery, but now that it's not my "good" knee that day has receded into the indeterminate future.

One thing I still have to deal with is the after effects of favoring my left knee for years.  Hips are tweaked, and I have occasional lower back pain on the right side.  I had a hellacious bout of sciatica a little over a year ago.  I wish I had known to focus on unkinking all the muscles that had spent so long trying to protect the left knee via PT in the months after my surgery.
I had Sciatica too! It's almost like we're siblings or something. I thought suicide was the only option but after 2 weeks of pt I could tie my shoes and after 4 weeks it almost totally disappeared. I couldn't believe I lived 3 months like that. That was the experience that turned me on to the amazing power of pt. Now, if someone even suggests that there is a possibility of a pt solution to any ailment, I am down at the pt getting my new exercises. Because of that, I now have a spin cycle in my dining room and a large contraption for doing pull ups and various core exercises on my back porch. I spend about an hour a day doing all that because getting old.
I too had sciatica dating back to a groin pull from ballet waaaaaaay back in the late 80s. Had no idea that subtle alterations I had made to accommodate that would persist for so long and to such effect. Anyway, PT is wonderful and I have been back pain free for several years now.

RAFH hope the knee is feeling better in short order! E. you too Testy!

  • RAFH
  • Have a life, already.
Re: Total Knee Replacement
Reply #15
I'm a happy owner of a bionic knee.  The first 2-3 weeks are the worst, then things start to incrementally and almost unnoticably improve.  I think the best thing about PT is actually the metrics.  If you work at it, you'll see improvements every time you check your degrees of flexion, and you'll definitely notice when you can move a stationary bike pedal through a complete revolution without screaming.

I'm very happy I finally had the surgery.  My right knee will also eventually require surgery, but now that it's not my "good" knee that day has receded into the indeterminate future.

One thing I still have to deal with is the after effects of favoring my left knee for years.  Hips are tweaked, and I have occasional lower back pain on the right side.  I had a hellacious bout of sciatica a little over a year ago.  I wish I had known to focus on unkinking all the muscles that had spent so long trying to protect the left knee via PT in the months after my surgery.
I had Sciatica too! It's almost like we're siblings or something. I thought suicide was the only option but after 2 weeks of pt I could tie my shoes and after 4 weeks it almost totally disappeared. I couldn't believe I lived 3 months like that. That was the experience that turned me on to the amazing power of pt. Now, if someone even suggests that there is a possibility of a pt solution to any ailment, I am down at the pt getting my new exercises. Because of that, I now have a spin cycle in my dining room and a large contraption for doing pull ups and various core exercises on my back porch. I spend about an hour a day doing all that because getting old.
I too had sciatica dating back to a groin pull from ballet waaaaaaay back in the late 80s. Had no idea that subtle alterations I had made to accommodate that would persist for so long and to such effect. Anyway, PT is wonderful and I have been back pain free for several years now.

RAFH hope the knee is feeling better in short order! E. you too Testy!
Thanks, the sooner this one is somewhat back to normal, the sooner I can get the other one done. And the sooner the whole affair will be over. At least the second time around I'll know what to expect. This first one there was a lot of needless anxiety which probably was responsible for the high BP readings going in and, in turn, made me uptight which likely intensified the pain and anxiety driving a feedback loop.
Are we there yet?

Re: Total Knee Replacement
Reply #16
Sounds painful; Good Luck man. :)

  • Old Dan
  • Senior Member
Re: Total Knee Replacement
Reply #17

  • RAFH
  • Have a life, already.
Re: Total Knee Replacement
Reply #18

Yah, I could see that having a somewhat chilling effect on one's adventuristic tendencies.





Or a serious increase in the consumption of narcotics and alcohol.
Are we there yet?

Re: Total Knee Replacement
Reply #19
I drank like 3 drinks a night for the first week after the election and I have been suffering for days from it. When Raven went and ruined wild turkey for me and I realized I had a half gallon almost, I figured I'd try to get rid of it quicker so I wouldn't be reminded of Trump. Mistake it turns out.
Love is like a magic penny
 if you hold it tight you won't have any
if you give it away you'll have so many
they'll be rolling all over the floor

  • RAFH
  • Have a life, already.
Re: Total Knee Replacement
Reply #20
My original prescription was for 2 x 5mg at 4 hours and between the lasting effects of the pain medfg much other than getting up to use the toilet. With PT starting on Monday, that was definitely no longer true and my surgeon increased the dosage to 3 x 5mg @ 4 hours, which initially seemed good. And as long as I'm not doing much it is, but it's not been handling the PT work. I have been unable to finish the PT exercises even, and most importantly, the stretching ones to get my extension to 0 degrees. It is improving, I've gone from about 20 down to about 10, but this one is critical and if I don't get it quickly, I may not get it ever. It's important as that's what allows one to "lock" their knees and stand for extended periods of time. Prior to the surgery I was only able to stand for maybe 3 to 5 minutes. With the surgery, that's down to less than a minute before excruciating pain sets in.

One problem with what is called "break through" pain is it puts one behind the curve and it becomes increasingly difficult to catch up with the pain meds. They are always much more effective when they are ahead of the curve. So after yesterday's PT visit, I've put in a request for some sort of "break through" pain relief, if such is possible. This is with the PT's support. They need me to be able to do the exercises and I need the exercises in order to make the surgery successful.

I'm also anxious with the incoming administration. I'm on ObamaCare and I suspect that's going to be a major target for Trump and Company. It will take them some time to dismantle things so I'm on a schedule, a tight one, to get the other knee done. At best, I figure that could happen maybe in February. Cutting it really close.
Are we there yet?

Re: Total Knee Replacement
Reply #21
Good luck, and get well soon.
Why do I bother?

  • RAFH
  • Have a life, already.
Re: Total Knee Replacement
Reply #22
Good luck, and get well soon.
Thanks,

Best wishes none of you have to experience this. Sorry Testy.
Are we there yet?

  • ravenscape
  • Administrator
  • Triggered
Re: Total Knee Replacement
Reply #23
Hope your doctor is able to make a prescription change that helps with the break-through pain.  From what I remember, my PTs were concerned about a 3 month window for me to get back 120 through 0 degrees range of motion.  That was way more time than I needed.  I hit that mark somewhere between five and six weeks iirc.

Re: Total Knee Replacement
Reply #24
Good luck, and get well soon.
Thanks,

Best wishes none of you have to experience this. Sorry Testy.
Ima hold off as long as I can.
Love is like a magic penny
 if you hold it tight you won't have any
if you give it away you'll have so many
they'll be rolling all over the floor