For JRE.....Knee Surgery Advice & My Journey

One of my readers, JRE, is having a TKR of the right knee joint later this month.  This post is for her....especially the part after the retelling of my journey to Ohio.

"Hope you can give an update on how your post op is coming. I get my new knee on the 14th and terrified! How is your pain and ambulating doing? Mine is my right and I can’t imagine not being able to drive for 4 weeks plus (do you feel you’d be able to drive?). How’s the walking? Sorry to bombard you but I’m a widow on my own (my kids and grands will help but I’m very independent and don’t want hovering or maybe I will when I’m that down and desperate ha!). Sorry very sad about your daughter not showing up and ? You moved towards her to connect more ugh! Jre"

The Monday before surgery I had 4 appointments in Ohio-the office in the building that did the pre-op workup(and gave a yeah or nah to the surgery), a visit to the PT area, an appointment with the DME office(to pick up my walker and they tried to upsell me on a magnetic device that the doc in charge of the DME office had invented(call me skeptical)that was suppose to lessen your nerve pain.  Then the meet and greet with the surgeon and his clinical assistant.

The Pre-op Testing kept me waiting for over an hour before anyone came in to review my tests and talk to me.  The nurse came in and weighed me and then measured my height.  Much to my dismay I had shrunk 2 inches over the past couple of years since I was last measured in PA.  Given these new figures my BMI was higher(and there was a massive chart in the exam room of the BMI scale).  So as I sat there waiting for that hour I was becoming despondent and was convinced they were going to "nah" me for the surgery.  Anxious much?
But finally the doctor came in and went over all my test results and gave me to thumbs up.

Went to PT to see what they were going to have me do, then to the Surgeon's meeting, asked a few questions, got my Hibiclens to shower with twice(once the night before and again the morning of surgery)and then down to the DME office to pick up my chariot of the correct size for my small statue.

Tuesday we went into the hotel pool and sat around and ate and then it was Wednesday morning.  I showered again, then drank a Gatorade Zero one hour before I was suppose to report.  We ubered over to the clinic and I got registered.  They called me back and Nurse Janie started getting me ready.  The anesthesiologist, Dr. Conner, came by to discuss what he was going to give me to knock me out and ask if I had any med allergies.  He also gave me two nerve blocks on my right thigh and said he'd see me in the operating room.

After awhile they wheeled my gurney into the operating theater, and a few assistants/nurses moved me from the bed onto the operating table(after injuring my back a bit).  Then they strapped me on and one of them put a mask over my face and after a few deep breaths I was out.

When I woke up I was in the recovery area groggy as hell, and moaning in pain to beat the band.  Two nurses were there to check my vitals and yell me into consciousness while I yelled back at them some vulgar words about being in so much F***ing pain.  One of them shoved a pill cup with what I assumed was 2 Oxycodone and 1 Fentanyl into my mouth, followed by a cup of water, urging me to swallow the damned things.  I tried to tell them that Fentanyl has NO effect on me(ask me how I know!)but nobody would listen to me.

After about 15 minutes the one nurse tied a strap around my waist and forced me to sit up on the bed.  Then they let Hubs back with me and then made me walk around the recovery room, with one of them holding onto that strap in case I started to fall.  Man, was that painful as hell and I cursed like a sailor at the both of them.  They refused to give me any other pain killers(I guess I should have had noted in my chart that my pain receptors or not normal).  Then they had Hubs dress me as I moaned loudly for all to hear.  I was so loud they kept trying to shush me up so I didn't scare any other patients(like I cared!).

I got sick to my stomach so they forced a couple of peanut butter crackers into my mouth(nice thing to do when you haven't had any liquids and felt like you were chocking).  They did give me a nausea pill and some water after that.  Once I was done being sick to my stomach they led Hubs and I out and down to the PT facility.  Yeah, I REALLY felt like exercising at this point!  Mostly they had me elevate and ice the knee and talked to me about what I was going to have to do on Thursday there but I was still not very lucid so who the heck knows what they said.

Then they took the strap off me and set me free to try to walk out of the building into an Uber to go the 1 mile back to the hotel.  I kept thinking what if this hotel ketches on fire and us being in a room on the 3rd floor, there was no way I was going to make it down to the the lobby and outside.  Hubs put me on the bed and then caught another Uber to the nearest pharmacy which had my pain killers ready.  I think I blacked out for awhile and when I regained consciousness Hubs was back.

That first night......it was HELLL!!  I couldn't get comfortable(I'm a stomach sleeper)and those opioids were NOT strong enough(fucked up pain receptors, remember?).  I cried, moaned, cursed and regretted this surgery.  At one point I begged Hubs to just shoot me in the head or chuck me out the window it was so bad.  Finally I conked out from exhaustion around 4 am.  Only to wake again around 6 am and repeat this cycle again.

Now I have had numerous surgeries before this-an exploratory abdominal surgery where they found a ruptured appendix(plus I was pregnant-lost that baby), a c-section and a gall bladder removal(cholecystectomy).  All these were a walk in the park compared to this TKR.  OMG!

So we dressed and I cursed and took another UBER back to the PT where they tortured me some more.  Back in another UBER back to the hotel.  I laid in bed when I wasn't trying to use the walker to ambulate and Hubs dished out some meds(not enough!)between eating his food.  Food was the last thing I wanted though I did drink.  That night I passed out a little earlier than the previous evening/morning from pain.

Friday morning we packed up and dressed(more cursing), got another UBER back to the clinic and had my post op appointment with the surgeon and he released me to go home.  Back down to PT for more torture and then we got yet another UBER, stopped at the hotel for our luggage and continued on to the airport.

I had to check the walker at the ticket counter after I sat in the designated area for handicapped folks and waited for someone with a wheelchair to wheel me off to the gate.  Then at the gate I was transferred into a transfer chair, except the two guys in charge of that debacle couldn't agree on how to move me from one to the other.  One guy who had no clue what he was doing was quite loud and adamant while the other guy who knew what to do was quiet and didn't take the lead.  At one point the two chairs were separating and I almost landed butt first on the ground!

After that fun then they brought an "aisle chair" and transferred me into that.  This is a barely wide enough chair for a toddler's butt that they strap you into(if they didn't you'd fall out!)and proceeded to wheel you backwards into the plane.  Of course, "Mr. Didn't Know What He was Doing" grabbed my knees to hold onto me(YIKES!)  Then the jacket I was wearing got caught on an armrest in first class and they tried to keep moving down the aisle anyway until I yelled for them to stop and back it up.

Finally at my seat and they had me on the aisle seat but it was 3 seats across the aisle so the flight attendant had to find the window person to change with me so I had the window.  There was no way I could have stood up and let someone go to the restroom.

So we land and here comes that damned aisle chair again(I felt like Hannibal Lecter being wheeled out but without the mask).  At least these chair guys knew what they were doing.

So they transfer me to a transfer chair and up the jet bridge to the next gate in Dallas.  The flight attendant on the flight we were deplaning said ALL jet aisles were wide enough to accommodate the aisle chair.  Oh was she ever wrong!

The plane from Dallas was a "puddle jumper"(aka small).  My travel program idiots had booked us into the next to last row on this flight.  Hubs went up to the gate agent and asked about at least getting me a seat closer to the front of the plane, but she said, "Sorry, this flight it totally booked" and walked off.

So it's time to board and they load me into the Hannibal Lecter chair and strap me in.  This little plane had 3 rows of "normal" first class seats and then the aisle cut in half.  So here I am stuck at row 3, having to get back to row 16, and there is no way on earth that was happening.  One of the flight attendants got off the plane and called the gate agent's manager to get someone to "do" something.  I was keeping anyone else from boarding the flight sitting in the aisle at row 3.  I had no walker or anything to help me claw my way back to row 16.

Finally the attendant remembered that row 5 seats are reserved for military personnel so she found those 2 folks and asked if they would change with me and Hubs.  Thankfully they said yes, otherwise I might still be sitting in the Dallas airport.
But I still had to stand up and claw my way 2 rows back from where the aisle chair was stuck.  This was not a pretty sight but I managed to fling myself into row 5.

We landed and I flung myself 2 rows forward to as far as the aisle chair would go, got strapped in again a la Hannibal Lecter and got taken off the plane, transferred to a transfer chair and then into a wheel chair.  Hubs collected our luggage and my walker and I sat with all that while he went to get the car from the long term parking.  Drove home and then I had to climb the ramp into the back of the house, undress and fall into bed(asking for pain pills of course).

We got home on a Friday evening so I didn't have PT here until Monday.  Hubs made me get up and walk and try a few exercises that Ohio PT folks had given me on a sheet of paper.

The first week of real PT was not fun(obviously).  I needed help just getting into an out of the car to go there.  I had to take a pain killer before each session just to get through it.  Feeling as helpless as a baby is not something I cherished.

My nemesis was the exercycle bike(and still is).  I had a goal of doing a complete revolution on it by last Friday but obviously that didn't happen.  I did do 7 revolutions on the following Monday and I could bend to 105 degrees on Monday.  I now hate that bike and when this is done I will NEVER get on a bike again!

So some things JRE needs to be aware of that I just went through.....

*  I don't know if your surgeon will keep you in the hospital for a day or two but nevertheless, you will struggle just to walk to leave the facility and then into your home.  Everyone's recuperation is different(we are all starting from different levels of "not being able to do stuff" and if you have other physical issues it just makes it harder to get better).
Make sure you have someone to drive you home as they won't release you otherwise.

*  The first few days are the worse as far as pain, being non-mobile, and needing help with the most basic things(like going to the bathroom, etc.).  If you have an upstairs bedroom you might want to move the bed downstairs for awhile so you don't have to  navigate stairs.  If you are really non-mobile, renting a potty chair to put near the bed is a good idea.  Make doing the basic things as easy as possible.

*  Remember that pillows are your best friend right now.  Finding a comfortable position for sleep is key as you heal while sleeping.  You might need to use a recliner to get comfortable.  Don't try to sleep with a pillow under your surgical knee(though it feels awesome)because that causes more scar tissue to build up behind the knee, which will hinder being able to bend that knee eventually.  I found that using 2 or 3 pillows and elevating my whole surgical leg helped me a lot until I could roll over and sleep on my stomach(which is my go-to position for sleeping).  Use as many pillows as you need to get into a comfortable position.

*  DRUGS!  Remember to take your pain killers on a regular basis.  Don't wait for the pain to get out of control, use the damned meds!!  Keeping on top of pain control is key.  Don't try to be brave or tough it out.  You've got to use them and if what they give you doesn't do the trick them call them and get something else.  Don't worry about getting  addicted to opioids, they are a critical tool when going through something like this.
If you need to, because the meds may make you loopy, write down what you take and when so you get enough pain control.

*  You won't feel like eating at first(if you're like me)but eventually you will need food.  Make or buy some frozen meals up that can be reheated in a microwave.  This is very important if you are going to be alone through much of this.  Or have someone buy you sandwich makings(bread, meat, cheese, condiments)so you can get some protein in you quickly.  And hydrated above all else!

*  Make sure someone can drive you to PT as you won't be allowed or able to drive yourself.  Call an Uber if family can't accommodate you.  You MUST commit to doing your PT regularly!  And walk at home and try to do some exercise on days you don't have PT.  But give yourself grace on how much you can handle the exercise.

*  The one thing surgeons and PT folks don't tell you is about the depression you are going to experience to some degree.  And not even your family will understand why after getting your knee "fixed" you just want to cry and feel miserable(and they certainly don't want you to talk about it to them).  Depression is a real side effect of this whole process.

*  After about a week you will be able to actually get out of bed yourself(that's normal)without help.  At PT, don't compare where you are in your recovery to all the other PT patients(most where I go also had knee replacements).  That will just make you spiral down more into a depressive state.  And if you don't think your PT facility is the right fit for you, go find another one.  The therapists should be open to listening to what YOU think you need and cater your sessions to the specific wants you have.

*  One of the hardest things will be for you to trust your new knee....trust that you can put weight on it and it will hold you up.  It's all a head game there especially if it's been a bad soldier for a long time.

*  You will have bad days and not so bad days.  It's not a smooth climb back to being better.  More like a roller coaster or a cha-cha.  Cold days will go right through the bones they sawed and screwed parts into so be prepared that you may need to medicate more on those days.  Ice helps and elevating too.

* Everyone's situation and recovery is different so be kind to yourself.  Find a friend who you can cry on their shoulder when/if you need.  Go eat something bad for you if you want.  You've earned the right to. 8-)

And for gosh sakes, don't go on You Tube and look at surgeons doing TKRs!  That's just going to skeeve you out.  But do go there and look for online Physical Therapists for ideas on some exercises you can try.  The better shape your muscles around the knee are in before the surgery the better your recovery will be. 

Sluggy