Overhauling Health and Mobility - Phase 2 The Knee Replacement

Background
As I mentioned earlier a key factor in my decision to retire early is my health and the need to focus on some long-neglected changes. My knee problems started in the mid 1990's with a snow ski accident. My insistence on going back to work too quickly, my failure to follow up when the pain didn't go away, and general neglect of my injury is the cause of all that I face today.

Over the years some torn ligaments snowballed into three intermediate surgical procedures (two on the right knee and one on the left), many bouts of physical therapy, fluid injections and cortisone injections, and substantial pain and limitation in daily life. Had I taken care of the injury when it happened and not continued to push on with life, there is a good chance I would not need a knee replacement. Young people: pay attention!!

Today is Day 15 after surgery for the full left knee arthroplasty.
This is a difficult surgery and a painful recovery. For me, it is 5 times more painful than the hip replacement was. I am thinking now that I rushed into this too soon after the hip; perhaps I should have waited for several more months to get totally recovered and strong before taking this on. I underestimated the severity and complexity of this surgery and my own difficulty being able to take pain medications to get me through the initial weeks of recovery.

Well, I am here now and going forward. I see small improvements daily and finally now can count on 6 hrs. of sleep a night before I have to get up and go to my recliner.

The next few posts will be about preparation and recovery from knee replacement surgery.

For now, here are a few key points to consider if you are anticipating a similar surgery:

1. Make sure you have a good surgeon that you trust. Do your research and talk to others. Find out about rates of infection, blood clots and other complications, rates of revisions, etc. for the different ones. Medical workers will always tell you if someone is really good (they can't tell you if they are bad though), so if you know nurses or PA's or CNAs at the hospital who work with your prospective surgeon, listen to what they are saying, or NOT saying.

2. In my experience surgeons are like good engineers/mechanics but they are not very people-oriented. Make sure you get a good relationship with your surgeon's nurse or PA so you have someone to contact for patient comfort care issues. I have home health care nursing and physical therapy for the first 4 weeks after surgery and they are my first line of resource.

3. Make sure your in-home caregiver is prepared. The first 10 days or so after surgery they will be up and down with you all day and night, going to the toilet, getting you fresh ice, meds, drinks, helping you turn in bed, adjusting pillows and covers, bringing you meals, and whatever your need, helping with showers and dressing, etc.  Line up some respite for your caregiver so they get a break too.

4. If your hospital or medical center offers a preparatory class, take your caregiver and go. They will give you lots of information, you will know more what to expect and how to prepare your home.

5. Have plenty of palliative comfort measures on hand. Normally you only hear about palliative care in connection with severe and terminal illnesses. I believe there is a huge gap in the medical community not realizing that patients who undergo major surgery such as a knee replacement, need this kind of care as well. I designed my own program. This is a huge one for me since I was unable to tolerate the prescription pain meds after just a few days, so it is essential to endure the pain.

Some of my measures are:

• The Ice machine - I have a machine that circulates ice water through a pad over your knee; this is wonderful and if your hospital doesn't provide one to take home, go get one! It is well worth the money. 
• foods or favorite drinks - I have very little appetite after surgery and want only mild, comfort foods
• music, games, tv, computer, magazines, books and other things to distract your mind for periods of time
• massage - rubbing the foot and ankle of the surgical knee gives me good temporary relief; a full body massage on Day 14 really helped me let go all the tension and sleep better
• heat packs (for other places on your body that will ache), soothing lotions or gels
• spiritual support of family and friends - I just needed to know people care about me, they are praying for me, and are there if I need them
• epsom salts and a foot soaking tub (the foot and ankle on your surgical leg will be really sore, bruised and swollen)
• over the counter sleep aids such as melatonin (check with the doctor to make sure it is safe to use them with your other meds)

 6. To research ahead of time on the Internet or not; this is a question. Some will say be totally prepared and will go to the extent of watching the surgery on YouTube ahead of time. That was not for me. I had a good idea of the general procedure but didn't want that mental video playing over in my mind in living color. My nerves are pretty raw and I am sensitive to sad news so that even the evening TV news is hard to watch right now. I did read up on the prescription meds I was taking since this is where I ran into trouble.

Don't go into the Dr. telling him how to treat you based on something you read on the internet. There is so much unsubstantiated garbage out there on the net and people tend to think they read about one study or story where something worked, and then think that should be standard medical practice. Trust your doctor to use tried and true, proven techniques. If you don't trust them, find someone else!