An up date, 4 weeks post knee replacement- so far, very good!

[ijan]

Thans to all whose supportive replies strengthened my reslove to go ahead with the knee replacement three weeks after cardioversion for possible perimitral AF.

The good news is that the op, performed under spinal anaesethesia, went smoothly with no sign of AF. I must have lost a fair amount of blood and needed a couple of units top up so was relieved no AF was triggered in spite of some pretty low BP readings.

4 weeks on, I can't believe how good my new knee is. Yes, I work on range of movement and have done a set of exercises when ever opportunity, energy level and incliniation coincide. I am now walking a mile, and using an exercise bike, daily. Pain levels are easily managed by a couple of paracetamol morning and evening topped with a tramadol at bed time. Like others, I had to be insistent with the hospital about not wanting to take ibrupruoen because of its association with AF. I have a sneaky feeling that thirty years of periodic dependence on ibruprofen to control knee "flare ups" may have been the trigger for my first episodes of AF.

My consultant suggested I rent an ice and compression machine. While not cheap this machine more than compensated for not being able to take anti inflamatory drugs. I used it throughout the night- timed to ice, compress, and rest in sequence, and my post op swelling went down very quickly making it easier to increase my range of movement. It also made me less reliant on pain reducing meds.

In the mean time I'm stil in NSR and hoping my EP will reduce my dosage of flec and bisoprolol which makes me rather tired.

I hoping to get the go ahead to drive and planning to be back in my kayak in May. The new knee is already performing better than the one i made do with for all those years.

[Hidden]

Great news! So glad your heart is behaving and you already feel the benefit of new knee!

[Hidden]

Well done - your commitment to the exercise plan has ensured a smooth recovery and stopped the stiffness that sets in if you ‘wimp out’ and adopt the ‘ah poor me, it hurts’ method of recovery!

I’ve had both my knees replaced, the right in 2016 and the left last year and followed the exercise programme to the letter.

I regularly used soft ice packs through the day and at night if troubled by pain. No funky ice/compress machine for me. Once home I took paracetamol with occasional low dose codeine 15mg or 30mg at night but was off them in 4 weeks with the second one. I did need pain relief at night for a lot longer with the first.

I saw a couple of people who didn’t follow the exercise plan at my 6 week follow up appointment, both still walking with sticks which I had ditched at 2 weeks. One was referred for intensive physio and the other had so little bend in the knee, she was listed for manipulation of the joint under anaesthetic. She admitted that she had mainly sat in her armchair swallowing painkillers and going 50 yards to the local shop leaning heavily on her sticks. She was younger and a lot lighter than me at 60, I was 64. Anyone scheduled for this op, please make sure you follow the exercise programme.

Having joint replacements is life changing - I couldn’t walk more than a few hundred yards. I now walk a mile or two each day - good luck with the kayaking 🚣‍♂️ - I’m losing weight but still think I might sink one!

AF was not an issue for me with the ops as it developed after the second one.

Pat x

[ijan in reply to Hidden]

You're so right about sticking to a daily exercise programme......especially the ones that are least comfortable. For me it has paid dividends. My physio okayed me to drive today, a small reward for my earlier efforts.

I'm using gel packs now as the rented ice/compression machine went back yesterday. Now that I can drive I'll be able to get to a local gym and use some of the exercise machines and their pool. The physio has given me a set of exercises to do in water.

Keep going with the weight loss, people of all shapes and sizes ejnoy kayaking so don't rule it out

[007talullah]

Thanks for sharing your knee replacement stories I recently found out I have no cartilage left at 53 yo and need a double replacement but the specialist says I should take painkillers until I’m 60 and then get them done. He said if I replace them, at my age I’ll be super active, wear them out and then have to have a complicated re-do. I don’t think he fully appreciated just how limited my mobility is at such a ‘young’ age. I can barely make it around the supermarket. My teenage children are always wanting me to come out with them but I find walking so painful. The two things I can do are swim and kayak. The kids just can’t understand how I’m so fast in/on water and so slow on land. I feel like I should get my knees replaced ASAP so I can enjoy being active with my kids in their last few years living at home. What do you knee replacement veterans think? I was very encouraged by your stories as all I’ve heard so far are tales of woe and toil. By the way, I have PAF, post 2 ablations, I use PiP. Docs say it’s just rotten bad luck to have AF at 47 and to have my knees wear out at 53. Lani

[irene75359 in reply to 007talullah]

My friend recently had a hip replacement at 63. She was also told to hang on for as long as possible, but couldn't see the point in waiting, the pain was impacting her life so much. Her reasoning was that perhaps in years to come, she mightn't want or be able to do the things she wants to do now, and other ailments may have cropped up. You have my sympathy, you are young to have this.

[007talullah in reply to irene75359]

Thanks for sharing this with me. I feel the same as your friend. If having AF and osteoarthritis has taught me anything it’s to carpe diem because who knows what lies around the corner

[ijan in reply to 007talullah]

I know how that feels, I was bone on bone for nearly ten years, waiting for the right moment to get my knee replaced. To be honest, I had learned to live with it and am only now beginning to realise just how much I had adapted to take account of the limitations. Getting in and out of a kayak was in no way graceful, but once in, like you, I was fine.

One of the reasoms I posted was to balance t the many tales of woe associated with TKR. I think most people don't think about posting unless they are seeking advice because of a problem,

Enjoy your kayaking and know that when the time comes you for TKR you have an excellent chance of a great outcome.

[007talullah in reply to ijan]

It's so rare to read a thumbs up account of a TKR. Thanks for the encouragement!

[ijan in reply to 007talullah]

That was one of my reasons for posting

All the negative accounts given by people who, understandably, are seeking advice and reassurance when things have gone wrong made me think twice about going ahead.

Luckily I'd met several people who had successful TKR stories and that, along with support from my consultant, gave me the confidence to go ahead.

Onward and upward!

J

[Hidden in reply to 007talullah]

My knee surgeon was of the opinion that delay causes more joint deformity and makes the eventual surgery more difficult. Mine were done at 62 & 64yo respectively. If you look after them e.g by keeping a normal weight range & are lucky enough not to fall on them, they should last 25 - 30 years. If you need them done again then they’ll probably be growing them in a bottle ha ha!

Pat x

[ijan in reply to Hidden]

Good advice. My physio said much the same

[007talullah in reply to ijan]

I definitely wasn't advised about the possibility of deformity. Good to know

[Hidden in reply to 007talullah]

Hi talullah. 7 years is a long time to walk around in pain and if it is very painful and limiting now think how much pain you will be in at 60.

Is this doctor going to sit around in pain for 7 years, missing fun with his kids while life excludes him more and more? I don't think so.

There is also, imo, an unknown here.

I'm facing imminent knee surgery replacement (both) and am 75. I've been putting it off thinking " I'll do it after this happens or that's over." I've been bone on bone for at least 10 years. I know better (former nurse).

Because of my procrastination I now have mild joint pain in my hips, ankles and sometimes lower back. I'm not worried about it as it's minor and is related to knees.

When we walk around long enough with our bodies out of alignment because we are accommodating our ongoing worsening knee pain we risk permanent damage to other joints.

I'm seeing my ortho surgeon tomorrow to fix surgery date. I don't want this surgery but I also want to stop putting other joints at risk.

The decision is yours-not this cavalier doctor. If he won't help you get back your quality of life before it's too late, move on.

Take care and good luck to both of us.😊 irina

[007talullah in reply to Hidden]

Hi Irina,

I really chuckled reading your reply. You have a lot of spirit! Good on you! It really fired me up. I've now made an appointment with another ortho in a few weeks and I'll keep shopping around until I find someone who thinks I should be getting back in to life on new knees instead of pill-popping on the sidelines.

Good luck, hon

[Hidden in reply to 007talullah]

You too talullah. You know I spent years working in surgery and rarely have I heard age take precedence over the need for surgery- especially if it improves quality of life and reduces pain. There are no age parameters when health and especially mobility can be improved.

And most good surgeons would rather do the surgery before too much damage occurs which can greatly reduce the chance of a good outcome no matter how skillful the surgeon. There is no magic number regarding age when health is being compromised as time goes by.

Keep looking-there are good doctors out there.

In a way, I believe sometimes the Universe watches out for us in ways we don't realize til later. If this doctor changed his mind and was willing to operate it wouldn't be on me.

It would be interesting to know the real reason he is discouraging you. Is he doubting his abilities? Has he had some surgery problems in his past? I always wonder what someone's private agenda might be when the advice they are giving me doesn't make sense.

I will be thinking about you and wishing the right doctor comes your way soon.

Take care. xx irina🐱PS And stay fired up! 👍

[007talullah in reply to Hidden]

Actually, I think I know why he is apprehensive. He kept repeating that with new knees I’d be more active, wear them out and then require a revision which he said are very difficult and any decent surgeon would balk at. It’s putting the cart well before the horse, isn’t it ... I haven’t even had the first TKR and he’s already planning the second one. Ridonkulous

Now I’m all fired up again 😆

[jax53]

I am glad you have a positive outcome, I am not able to take Paracetamol as I am allergic, I refused my knee operation because I had a bad experience when I had an operation last March for Carpal Tunnel, the very next day My hands were covered in blisters due to my PSA, so it seems that for people like me who have Psoriasis, it does attack scars, and loves nothing more than to aggravate your healing time, I get on well with the Tramadol, even though it does not take all the pain away, it takes the edge off. Good luck with your Future, Happy Driving.

[ijan in reply to jax53]

Thanks Jax. sorry to hear of your bad experience with paracetamol- good to hear that Tramadol does the trick.

[Hidden]

Very happy for you. I'm facing 2 knee replacements-see the ortho doc next Wed to settle on the date for the first one.

I know how we follow our post op therapy plan is key. I was an O.R nurse for years and in a way it doesn't always help to know too much about what's coming. LOL. For me it can bring on the "what ifs".

I felt good reading your comment about already feeling better than before and in only 4 weeks.

I'm just being a baby about the post op rehab pain.

Fortunately my Afib situation is well controlled. Have a pacemaker (old pace and ablate) plus a Watchman last year and have been off all cardiac meds since the P and A and anticoagulants since last year.

Please keep the updates coming. They are reassuring.

I live in a senior community and it's discouraging to see how many residents are still using their walkers and canes long after their surgery. I plan to be super compliant about those exercises.

4 weeks is a very short time for the progress you've made. From my experience you are in the minority mainly because patients don't "get" that their final result is as much dependent on them as on the surgeons skill.

Post a picture in your kayak when you first get back in. Instant encouragement.

Take care. irina

[ijan in reply to Hidden]

I had similar qualms as the date for my knee replacement approached. I'd had a nasty slip back in the summer and four weeks of being unable to bear any weight decided me that the time had come to get on the waiting list. My knee improved during the wait without any random flare ups or slips to remind me why I wanted a new knee. I'd read many posts about severe post op pain but can honestly say mine was bearable, apart from the first night when I couldn't tolerate the oramorph and ended up having a nerve block which worked perfectly. I do thinks the ice and compression machine made a big difference. It was expensive to rent but I'm already wishing I'd kept if for another couple of weeks.

Luckily my consultant, along with others on this forum and elsewhere, answered my questions and offered the support and reassurance that enabled me to go ahead.

The physio okayed me to drive yeserday- this will make life much easier as we will no longer need to rely on friends and taxis. It also means I can get to the pool in the next village and begin water based exercises.

I do take my crutches when walking the dog- they provide a useful buffer if one of his friends looks like running into me. I'll swap them for a single walking pole, on the operated side, in a couple of weeks.

I will post some photos- working out how, will obringanother set of challenges!

Good luck with your forthcoming procedure!

Jan

[Hidden in reply to ijan]

Thanks ijan. Please keep your updates coming. Most afraid of the post op therapy pain. I'm a retired O.R. nurse and usually can deal with all aspects of my illnesses. But I have heard such horror stories from other senior living residents.

Though knowing which ones complain the loudest I have to say I know which residents like to "one-up" others who are dealing with the same problems they are. "If you think your operation is bad let me tell you about mine." And also I know who doesn't really follow their doctors recommendations and then complain the loudest when recovery doesn't go well.

You sound like a go-getter- someone who knows much of their final surgical outcome depends very much in how they participate in their treatment plan.

One question: I'm in the US and how long does your surgeon recommend you wait before having your second knee done.

I know it depends on how fast the first knee heals but my doc says 2 months "or so"!! This seems a short cavalier time- like he might be rushing me. Also since I haven't had the surgery yet why would he make a decision like this without all the post op facts at hand? (rhetorical question). Makes me nervous. Anxiously awaiting sequels. LOL.

Also he made this statement when I asked if he would give me the pain meds necessary to be comfortable with the post op therapy: "When the replacement is inserted correctly in the knee joint post op therapy doesn't play such a big role."

I KNOW that's not true. But he gets points for a creative evasive answer. I got a quick image in my mind of a US politician answering a CNN reporter's question!!

Maybe I've just had too much experience reading between the lines of information from doctors.

I'm hoping you are 100% very soon. BTW I agree about crutches and canes. As well as support they encourage others in crowded places to give us more room with less pushing and shoving. Useful tools!

Take care. irina

[Hidden in reply to Hidden]

My surgeon visited me a few horns after my op and advised me to start bending the new knee as soon as sensation returned after the spinal and before any post op pain set in. This proved easier the second time as the anaesthetist injected a ‘nerve block’ around the knee and I had little post op pain for 27 hours which allowed me to get up walking with sticks on day 1. BUT... boy did I know about the pain when the block wore off - I had OxyContin for a day or two, then just paracetamol & codeine & was fine.

Pat x

[Hidden in reply to Hidden]

Thx. Good to know about how much the nerve block helped. I didn't know they would do that. I would have no problem asking. Take care. irina

[Hidden in reply to Hidden]

Just been reading more of yours and ijan’s posts. I had my knee replacements 2 years apart, but that was because, though I had some arthritic changes in the second (left) it didn’t become painful until I fell on it, after which the pain was unbearable.( I am always glad I didn’t fall on the new one!). My friend aged 70 had hers done 4 months apart with no problems.

I found a specialist physio who runs aqua therapy sessions for people who’ve had joint replacements, accidents or sports injuries at my local, old fashioned and warm swimming 🏊‍♀️ pool. I started her classes at 3 weeks post op, going for an hour twice a week for about 6 weeks. She ran a programme of specialised exercises and stretching in the water using simple equipment such as weights a wobble board and a weighted step. She included a five minute one to one where she massaged & manipulated the new knee under the water. All this for just £10 a session. If you can find something similar I would highly recommend it.

Pat x

[Hidden in reply to Hidden]

This is wonderful news. I didn't know such a thing existed. I am going to start looking around Atlanta to see if anything is offered. Also ask my surgeon who I am seeing this Wed (Apr 10).

Atlanta has many fitness centers with pools and also Emory University which is on the cutting edge of everything medical. This isn't my 'home-base' hospital but it is where my orthopedic doctor is and where I would have surgery.

I am also going to look for videos with post op swimming exercises. Even if I just used it to supplement reg therapy it would be a good way to make therapy less painful.

I grew up in Miami Beach within walking distance of the ocean and when I was 12 moved to a house with a pool. Saltwater backyard pools were inexpensive and common in those days as Miami Beach is a long thin island connected to the mainland (Miami) by causeways. So not hard to get salt water access for pools back then. (Plus I was our pool maintenance person.) I could really clean a pool.

For me, swimming has always been my 'go-to exercise. And even now when I feel anxious or stressed the best way to feel calm again is to get in water and tune out.

Thanks for sharing this.Also the physical therapy dept of my hospital has a very small "pool" as part of their equipment. Not big enough to swim in but warm with easy entry for patients to use. I think they use it a lot for stroke rehab.

This makes sense as water is a great pain reliever.

Thanks, Pat. 🐱 irina

[Hidden in reply to Hidden]

PS I just googled water exercises for post joint replacement and there is a lot of info about this including videos to teach patients what to do. The information is out there.

Thanks again, Pat

[ijan in reply to Hidden]

I had a nerve block too. The anaethesist gave it because I couldn't keep the liquid morphine down. I was pain free for the first day after surgery. After that tramadol and paracetamol were more than enough to keep any pain at bay and I never used the stronger meds that were on prescription.

Hope all goes well.

I rented a Gameready ice and compression machine. Regular use kept pain and swelling at bay and, I'm sure, contributed to my recovery

I've started exercising in the pool and am comfortable waling with out aid though I take a walking pole when I walk the dog- mostly to use as a barrier if a distracted pooch looks like running into me.

[jedimasterlincoln]

Great news pelased its going so well

[ijan]

FIrst paddle completed today. Nothing heroic just a gentle paddle upstream and back. Entering and exiting the kayak easier than before the op.

Getting the go ahead to drive after 4 weeks made a huge difference as it meant i could get to the pool for daily self imposed hydro therapy.

Sadly my IT skills are rubbish and I have failed to attach the promised photo.

Cest la vie!