Anyone have Knee Replacement Advice?

[asta]

I am about a week and a half away from total knee replacement surgery and am getting very nervous. I have all of the official things that I need to do from my surgeons office but I would like to hear any advice from people who have had this surgery. Particularly any hints about what I can do around the house to make life easier after the surgery.

I have put this replacement off until I just can't function anymore but I still don't feel prepared. I don't scare easily but I am frightened.

 

[februarydisgoer]

My husband had total knee replacement at age 35 due to college football injuries. I can give you some advice from my experience being his caretaker.

1. If you are going to have a continuous passive motion device (CPM) at home, go to the Dollar Tree and get some of the rubber shelf liner. This will keep the machine from sliding around in your bed.

2. Take your pain medication as prescribed. If it says every 4-6 hours take it at 4 hours. If you stay ahead of the pain, you will be far better off. It is hard to get the meds to 'catch up'.

3. Eat with those pain meds or your stomach will be a mess. Also, drink lots of water.

4. A stool softener is always a good idea when on narcotic pain meds.

5. Do NOT be embarassed to ask for help. If a friend or family asks what they can do for you, send them out for milk, ask them to run the vaccuum, see if they can toss something in the oven for your family. Take the help. You can return a favor later.

6. Work hard at physical therapy. The harder your work, the faster you will recover.

7. If you can buy a shower chair. It makes getting in and out a bit easier and you can rest in there.

8. If you have a low sitting toilet, see about getting a riser. It will be easier to get up right after the surgery once you are home.

Try to relax. My husband was all kinds of wound up for weeks before his surgery. It's a big deal, but you will be so much better off. He is thankful he did it everyday since. Yes, even including the days immediately following surgery.

Take a deep breath, clean the house, get some food prepared ahead of time and love your family. My husband went up and down a flight of basement stairs 11 day post knee replacement. He says it changed his life.

 

[rkandmjsmommy]

Ortho Nurse that used to teach a class to patients and their families before surgery! Get up ASAP after surgery, YOU WILL BE SCARED, IT WILL HURT but its the best thing to do. DO PT in hosptial and when you get home! Take your pain meds, they are your FRIEND!!!
As for when you are home, Make sure your clothes are within reach, you dont want to have to constantly be bending down to get into drawers. Make sure foods you eat are also within reach, if you keep cereal on the top shelf you wont want to get on a stool to get it. I suggest a basket where you sit during the day with tissues, meds, remote, phone, books etc. those thigns you need near by! Nothing worse than the phone being across the room and it stops ringing by the time you hobble over to answer it! TAKE PEOPLE UP ON HELPING YOU, but do as much as you can! and have something fun planned when you are back to yourself with a new knee, a vacation, hike, something to look forward to!
any other questions let me know, I LOVE ORTHO

 

[Saphire]

Great advice already! I am a physical therapist and work in a rehab unit. My best advice (I could talk forever!) is to keep moving after surgery!

Walking is a great activity, but you need to work on those very important motions...flexion and extension. The next six weeks must be devoted to increasing that range of motion. Follow the directions you receive after surgery, work like you have never worked before, and two months from now you will be SO happy you went through with this.

There is a window of time that is crucial after your surgery and the success of your operation depends on your commitment to exercise during this time. Listen to your therapist, and best wishes!

 

[Breezy_Carol]

I am a home PT and have lots of post total knee patients. Most do very well.

Have some good shoes. Non skid soles and that stay on your feet. Not backless. And be aware that your foot may be a little swollen so something adjustable is good. I know they give you those nonskid socks in the hospital but they aren't good outside.

Do you have a cane? They will probably get you a walker or crutches in the hospital but you will want to progress to a cane so go get a pretty single point cane now.

You will be fine. Go in with the attitude that in a few weeks (not the first day after surgery) you will have much less pain.

Saphire and I should be your inpatient and outpatient therapists. Think of the fun we could have.

 

[minniecarousel]

My sis had a total knee done a few years ago (after the opposite hip was done first). I had never seen her sweat. I took her to her outpatient PT - oh, she perspired!! Do everything they say. Take your pain meds. Get out of bed at the hosp ASAP.

EVERYONE that I have heard of who has had this done is glad they had it done...and wonders why they didn't do it sooner.

Good luck!

 

[Caradana]

My mother had a total knee replacement in 1975. She woke up and cursed at the doctor. It hurt. Six months later, all was forgiven and she married the doctor. Three years after that, she had me. So I owe my existence to total knee replacement. My advice is, if you are single and the doctor is too, give the guy a chance. Just being silly (mostly). Good luck with your surgery!

 

[teacherforhi]

I've had a partial replacement, a total, and a revision in the past 6 years (on the same knee). I've found that I could alleviate a lot of the pain using ice packs. My leg would be swollen and the pain meds didn't touch it. The doctor gave me an anti-inflammatory in the hospital and it worked better than the morphine drip!

Look at your house now and scope out the likely paths you'll be walking with your walker. Make sure to remove any rugs that could slide under your feet and that you have room to manuever down hallways and such, especially to the bathroom.

I never used a shower seat, but a raised toilet seat was a godsend. The average toilet is just way too low, and it was probably a good 3-4 months after my total before I could stand up from the toilet without it.

 

[nursebetty]

The only thing I have to add is that if you have a spinal (anesthesia) be sure to get some pain meds on board before the spinal wears off. It's very hard to play catch up with pain. I personally would take the nausea medication even if I wasn't nauseated. It might help him relax. I just thought of sometime else take deep breathes. Also agree that narcotics are very constipating.

 

[tzolkin]

My MIL is staying with us (she lives alone in another state) and is now two weeks post- knee replacement.

Honestly, she is way less mobile than any of us were expecting. The Drs, PAs, and PT acted like it was no big deal that DH and I both work so we all assumed she would not need much care. They even tried to insist that she could likely drive herself to PT after 2-3 weeks, but I don't see how that would be possible for anyone. DH stayed home for the first week and between our schedules we're only gone up to 6 hours, but she really just stays in her bedroom and gets up to use the bathroom during that time.

DH is an RN and does orthopedic surgery (including hundreds of total knees), so he knew exactly what the surgery would entail, but not the recovery.

We have not had any problems with caring for her, but it would have been helpful if we were given a more realistic idea of what to expect. She is definitely getting better each day, but she has had many moments where she has felt discouraged because she expected to progress quicker.


Two suggestions aside from being mentally and emotionally prepared:

Get a Cryo-Cuff and have room for lots of ice in your freezer. MIL says this is the best thing for her pain management and issues she has had with swelling. We refill it about 3 times per day and go through about one bag of ice. It was not covered by insurance, but was well worth the $100 they were selling them for at the office.

Make sure your toilet will work for you. The bathroom connected to MIL's room has a low-sitting toilet that is not near any walls. We got a commode with arms that we have positioned over the toilet for her to use. There is absolutely no way she could use the regular toilet, but with this she can get up and down without assistance so she has some privacy and we don't have to worry about her getting "stuck" while we're not home.

 

[powellrj]

I have had both done. It was about 6 years ago and it was the best thing I ever did! I had a pretty easy recovery compared to some of the stories I have heard.

I will say the 2nd one was easier than the 1st one. Not sure if it was because I knew what to expect or if it really was easier. I was driving at 2 weeks, but I think it was because I knew I had to be because there was nobody to get the kids back and forth so I had to get better quickly! I also stopped with the pain pills after 5 days and just went with the Tylenol. I did so much better and found it was the pain pills that were worse than the surgery.

Good luck and I hope you do well. I am looking at having my hip done, but not sure when.

 

[Katie Dawn]

My Mom had this done 2 years ago & I was her main support person (stayed with her in hospital & for 2 weeks post-op.) She is definitely glad she did it! (But I'm sure you have heard you may not feel that way in the beginning)

Lots of great suggestions here, and I will add: my Mom's PT told me to time her pain meds in such a way that they would be in full effect during her therapy appointment. This way she was able to really push herself during therapy. As a pp said, being able to bend your knee as much as possible (flexion) and straighten your knee out as much as possible (extension) is hugely important; your PT will be measuring this regularly & your doctor may do the same during follow-up appointments.


tzolkin, I'm sorry to hear you guys were not given the information you needed to be prepared. It is strange to me they told you that. My Mom was told she had to have someone who could commit to being home with her all the time for 2 weeks, and if she didn't have that she would have to stay at a rehab facility for those first two weeks.

Lastly, if you have it in the budget (or if you have a friend that might let you borrow theirs) a recumbent bicycle was super helpful in her recovery/therapy. If you can imagine, slowly turning the pedals on the bicycle does a fantastic job at forcing you to bend and straighten your knee.

 

[EdiePA]

Didn't have a knee replacement, but had hip surgery.

Plan ahead. My sister sent me something from Amazon Hip Kit
Sure helped with putting on socks, anti-emb stocking, picking stuff up that I dropped, etc.

A shower stool and toilet seat extender were helpful, too.

If you use a CPM machine (I was in one for six hours a day,) get one of those wedge reading pillows. That way, you can sit up enough to read or play on your iPad.

Dress for success. I knew that I didn't want my son helping with dressing, etc. So I had plenty of easy to pull on yoga pants, tops, etc.

Have everything you need on one floor -- I stayed on my first floor (bedroom is upstairs), so I had a bed in the livingroom, a basket with clothing in the powder room and my personal grooming stuff in the powder room.

Good luck! I know it's scary, but everyone I know that has gone through it only regrets not having it done sooner.

Edie

 

[asta]

Thanks for all of the advice. In addition to the encouragement, I have picked up some helpful pointers. I already know how critical the PT will be but everyone is convincing me of the need to stay ahead on the pain medication. I also think I need to buy one of those toilet seat extenders that everyone is recommending.

How about the length of time before I will be able to climb stairs? My bedroom is on the main floor of our house but I just discovered a week ago that the shower pan is leaking. There isn't enough time to fully repair it before surgery so I hope to be able to use one of our upstairs showers at some point. In the meantime we are going to put silicone around the tile edges so that I can use the downstairs shower at first.

This is going to be one long week. I just hope I don't drive my family crazy with worry.

 

[Saphire]

How about the length of time before I will be able to climb stairs?

You can climb stairs as soon as you return home. The PT will show you the proper sequencing, and as long as you use the right technique, you will be fine. You should be taught on training stairs in hospital or rehab, and then just follow through at home. If you still aren't comfortable, the home PT will practice with you so that you improve your confidence...that's where Breezy Carol comes in!

 

[teacherforhi]

Thanks for all of the advice. In addition to the encouragement, I have picked up some helpful pointers. I already know how critical the PT will be but everyone is convincing me of the need to stay ahead on the pain medication. I also think I need to buy one of those toilet seat extenders that everyone is recommending.

How about the length of time before I will be able to climb stairs? My bedroom is on the main floor of our house but I just discovered a week ago that the shower pan is leaking. There isn't enough time to fully repair it before surgery so I hope to be able to use one of our upstairs showers at some point. In the meantime we are going to put silicone around the tile edges so that I can use the downstairs shower at first.

This is going to be one long week. I just hope I don't drive my family crazy with worry.

I had to practice stairs in my PT before I left the hospital after my partial and total. It's "up with the good, down with the bad". Basically, when going up stairs, step up with the leg not operated on, and bring the other one behind it. You just keep stepping up with the good leg, letting it bear the weight of moving up the stairs. When going down the stairs, step down with the leg that was operated on. The good knee bears the weight of stepping down.

The hardest part of my PT was getting to the point where I could trust the artificial knee to do its job. After five years, I didn't believe I would ever be able to do stairs normally. However, about four weeks after my last revision, I was able to walk up and down stairs normally. I'm sure my PT thought I was nuts since I burst into tears.

 

[Shelly888]

Great advice! Keep a close eye on your bowels. The first BM after surgery is the worst. Hopefully they schedule you a laxative Senna S is good, I see 2 at bedtime frequently.

Yes, stay on top of your pain meds. The more you are up and moving, the quicker you'll recover. Some people are in SO much pain before surgery, post-op is a welcome relief. DOn't be afraid to take them.

Ice is your friend. 3 parts water to one part rubbing alcohol in a ziplock baggie is perfect. It will get frozen, but with the alcohol, it will stay pliable. Knees get very swollen, and the ice seems to really help. You can wrap ice pack in a pillow case.

Wishing you a speedy recovery

 

[jeminni]

I climbed steps to the second floor when I got home from the hospital. It took about a week before I could descend them for the first time and about 6 weeks before I could walk down them well. Take your pain pills every 4 hours at first- I tried to tough it out and it's very hard when the pain gets ahead of you. At 5 weeks my bend was 130 and I went back to work.
My other recommendations are the same as others have said: work hard at your PT, take stool softeners and get a raised toilet seat.

 

[Breezy_Carol]

I also think I need to buy one of those toilet seat extenders that everyone is recommending.

How about the length of time before I will be able to climb stairs?

I might wait until you are at the hospital to get the toilet seat. Your insurance may cover it with an order.

You can climb stairs as soon as you return home. the home PT will practice with you so that you improve your confidence...that's where Breezy Carol comes in!

 

[tzolkin]

I came back to this thread to see others advice, since we are right in the middle of recovery with my MIL.

I mentioned earlier that our biggest issue has been unrealistic expectations given prior to the surgery by the doctors and PTs. And, unless there's something really off about my MIL I feel like I'm seeing it here too.

The only two people who have commented that one should be able to go up and down stairs with no issues as soon as one gets home are both PTs. Do you really expect that OP should be able to get to/from the second floor of her home immediately after surgery?

Yes, MIL was taught how to do stairs and yes she can technically go up and down (we have 5 steps to get into our house), but it is extremely difficult for her to do. Every time she leaves the house or returns (basically just to go to PT) just doing those 5 steps she is shaking, sweating, and about to collapse. There is absolutely no way even now almost three weeks out that she could get up and down from the second floor, and it would be incredibly dangerous if she tried with no one home.

Are we just completely off from the norm? Every time she goes to PT, they say she is doing very well and progressing along on schedule. She is quite overweight, so she knows that is a factor, but she's also only 53 so I would think her recovery should be easier than an elderly person.