preparing for surgery

Bones, joints and muscles
1

Hi

I have just been placed on the waiting list for total knee replacement of one knee. I have read a lot on here about people's experiences - much of it bad- but have done a lot of other research and have a fair idea of what to expect afterwards such as sleep problems, pain, swelling, but then have most of those now. Had a lot of swelling after arthroscopy so expecting that too. Am also a nurse so fairly realistic about things though that might all change when it's me going through it!

What I would like to ask is how did other people prepare for the surgery? Did you do any specific exercises pre op to strengthen muscles?, take any supplements or anything else that might help. I am already working on weight loss. Does it help to start the exercises I will need to do post op now? I live alone so also need to arrange help for afterwards. Should I think about buying things like bath seats and raised toilet seats or is that overkill and money I don't need to spend? All advice welcome. I am expecting surgery to be around August and will be 50 by then

2

I did prepare by doing exercises for the quads.   Most important.   You don't need bath seats etc if you have a shower.  I had raised toilet seat for a few weeks but again, not vital.  You need done thing to lift the leg in and  out of bed.  I used a dressing gown belt myself, looped around the leg.  Have you a downstairs toilet, this is helpful.  I didn't want to pic have stuff myself.  I did have a grabber thing and a rucksack to carry pills etc is helpful.   

3

Sorry, have you anyone that can help for a few days.   When you first come out I think you need someone there.   It is daunting being on your own.  This operation isn't an easy one to get over.

4

Hi 

yes it's the best when I got a raised seat. Just take your tome it's a big surgery .. I wish you the best good luck !

5

Hi ,

  I had both of my knees done last year. I had no prombols with them.Are you having the true match done on them ? I had my TKR 3 months apart and i don't regret it..The only thing i used was my walker,but everyone is different. So good luck on your surgrey .

 

6

Hi Ruth, I wish I had found this site before my TKR as would have known a bit of what to expect. Yes doing the quad exercises would be a good idea as my quad took a while and is still healing. I didnt get aids for bathroom just used sink when at toilet but it was only a day or two then you find you can start to get up easier, the bath i was told is not recommended for a couple months as difficult to get out of. Shower if possible, at first i was told to have someone around when i showered incase you need them, you say you are on your own, have you a friend who can stay, just to be there, it is hard at first, you are so tired, sleep is hard, when you move you waken and then i found it hard to get back over. You will at first doing your physio, TAKE your medication regularly, dont let the pain get on top of you, drink plenty of water, ice knee elevate it regularly. Do what your body tells you, if you are tired rest, Even if you donot have someone to stay with you have you someone to come in, make food for you as you, for first few weeks will not feel/be interested in cooking and anyway will find it hard to stand to do it.

I was 50, 2 weeks after my surgery and best thing I have done, there have been hard days...lots of them but at 9 weeks I do feel i am getting there. Good luck x

7

Raised toilet seat and bath chair were very helpful!

 

8

do have a shower but it is just one over the bath, so would still need to be able to climb into the bath to be able to use it, which was why I was wondering about a bath seat. have seen some bench that go across the bath,  am in a flat so is all on one level and there is a lift to the flat. have been invited to stay with my brother afterwards but he only has an upstairs toilet. hve had various people offer to come to help at first but will have to be on my own a some point. although maybe could stay with my brother after the first few days.

I will look up some exercises then and that grabber thing sounds like a good idea

9

what is the true match. haven't heard aout that

10

True match is where you have a MRI of your knee and when the DR. gets your results. Them they have a mold made lie your own knee and then then have your knee made . I haven't had any pain in either knee . If you go and look up TRue match it will explain how its done and it don't take as long to heal. How is your DR. oing your TKR ? With the rod

 

11

had a MRI of my knees last year as both are affected, but haven't been told anything about making a mold. are you in th UK?   just assumed that the surgery will be done in a standard way, which from videos I've watched of the surgery seems to involve measuring at the time.but will look this true match thing up

12

Hi Ruth!

I didn't do much to prepare for surgery. I figured that I wouldn't know what I needed until I needed it!

My neighbor had hip surgery a year before, so she brought me her raised toilet seat and her walker. I ended up using both, so I greatly appreciated the loan!

My home-care physical therapist showed me how to loop a belt and slip my foot into it. She showed me how to use the long leftover part to help move my SURGICAL leg wherever I wanted it to go as I was sitting or getting into bed. Very helpful! Used that method for quite some time because LIFTING my leg high enough to get into bed or onto the couch was one of the biggest challenges for me.

I graduated from walker to cane once I found my walker ANNOYING. The cane was better, then THAT became annoying, so I practiced walking going from one counter to another in my kitchen and would hold onto furniture in the house if needed. I gained more confidence the more I did balance exercises at Physical Therapy sessions. Soon I wasn't needing anything as an aid. That was at about two months post surgery.

Ice packs that have gel in them and are longer so that they wrap around the knee are VERY HELPFUL. I got them from my physical therapist. I wrapped each in a towel so they didn't get too cold. I kept blankets near me because I got really cold when those icepacks were on me!

Yoga pants or any really soft fabric pants are very helpful. Your incision will be tender for awhile. One day I wore jeans. Bad mistake! I was very uncomfortable after awhile, and my incision got all red, too! Lesson learned!

Drink plenty of water.

Walk with your shoulders back so you don't develop a backache from leaning over.

Rest when you are tired.

Naps are GOOD! I got my best sleep from naps throughout the day in those early months.

Stay positive. Try to be calm and not worry.

Keeping a progress journal will help you see how far you have come.

Be patient, and if any exercise hurts, STOP! Many have regretted doing too much too soon. Your body will guide you.

Eat well. Avoid junk.

Let us know how things go!😊

13

Yr hospital occasion health team will sort what you need prior to surgery so it's in place for when you home at no charge but you will need help in the house n personal help for first few weeks x

14

Hi, If your in the UK occupational therapy will supply you with bath seats and toilet raisers etc on loan. They will check your needs before you leave hospital. I had my left TKR last June and am having the right one done beginning of this June. I'm doing quad squeezes and squats to try and strengthen up before surgery, but it seems to be luck of the draw how recovery goes. Just be realistic and take one day at a time. OFG has plenty of good advice, he's a veteran of TKR and knows his stuff, so he's well worth listening too 

15

I am on my own too, and it's hard to say how you will be.  Toilet seat might

Be a good idea, but bath seat that slipped over edge of tub was a life saver.  You can slide into the tub, and shower that way.  I took off shower head and used hand held unit for several weeks. If you are alone you really have to be more careful than someone living with a family.  Try to stand straight from the beginning when walking and roll uour foot.  Walk heel to toe right away, even if you go slowly.  This will help you walk so much better and you won't have to relearn.  Do have someone call you every day for the first bit, just in case. One slip or twist and it could be important to have help.  I borrowed the bathseat from my group, but check charity shops or rentals.  Won't cost you too much that way.

16

Hi Ruth. Had left knee total replacement on 29 April a little over 2 weeks ago. Like you I read everything to do with the after affects of the surgery but the reality although is as we have read, is quite daunting. I was advised well in advance to strengthen the quads and was given specific exercises to do prior to surgery. I have no doubt they have helped because I started my physio this morning and had a 90 degree bend which surprised me but was so pleased. I have an elevated toilet seat in the downstairs loo and bought the little bode that sits into I. I have a shower over bath so the top and tail downstairs was best xi could do. I got a suction grip bar for the bath which came in handy for my first shower there. You will definitely need someone to be with you for at least the first 2 weeks if not then maybe arrange a rehab programme? Hope this helps and all works out well for you. Regards Nuala.

17

Hi, wish I had knowledge of this group before my PKR and TKR as they have been amazingly helpful. YES, get hold of the excercise series either online or from your doctor. Building up muscle and strength before definitely helps recovery. It also made me just feel better prior to surgery. Work out Both legs--as the good one will be doing lots of compensation...which probably contributed to the second knee TKR a year and half later. So being in good shape and weight loss might be helpful as well.

As far as the potty riser: it is a helpful appliance for a few weeks. A small thing that makes one wonder why "loos" aren't all taller not just handicappers! LOL! I only have tub with shower. Since I was told to keep the incision dry until the staples were removed, I needed the shower bench. So I would wrap the knee in plastic, a towel, sit on seat, hang leg out with shower curtain draped over it. The shower was a wonderful thing. That hot water and good scrub was very rejuvenating. Fortunately, my caregiver husband was at hand to help stepping in and out. Although with the one leg hanging out already, I could swing the other over and outside the tub and be in a good place for drying off and standing up. I become "tub independent" after one week. Once released to wash the surgical knee, (what a blessed relief!) it was a little difficult to drag the poor knee inside but that gets better too. So long story short- these items aren't too expensive. Maybe even available to borrow from someone or find at a second hand store. Long story short, I personally found these items gave me security and comfort. Having someone with you for a few days really is good to have. My doc and hospital required that I either have a caregiver or go to a rehab center for a few days just to assure my own safety from falling and follow up care. 

18

Hi there Ruth, and welcome to our little band! 

As youve no doubt worked out, Knee Replacements can differ massively from person to person (Ive had both mine done, and THEY were both different experiences!)

From my perspective, anything that makes your recovery easier and your life a bit more comfortable is vital!

I couldnt have managed without my bath bench - its on loan from the NHS, and a lovely chap came and fitted it acouple of days after I was discharged. The same with the over-the-toilet frame - I would have found things very difficut without them.

I used a rucksack to carry stuff round - meds, books, magazines, a bottle of drink, snacks.....youd be surprised what you need whan you cant get up to get it yourself lol! Some people use a big across-body bag, but I found that it swung round too much.

You need to consider the layout of your flat/house - if youre on your own, how will you manage to carry food/drinks from prep area to seat? I got myself a little walker thingy with a tray on it and a basket on the front - the family dubbed it my Chariot! It was very useful for quite some time. 

DEFINITELY start working on strengthening your knee and quad muscles STAT! I was better informed for my second surgery and worked like a demon - the difference was obvious within a few hours of coming out of theatre, when I was able to lift my leg up - it had taken several WEEKS with the first one.

I found a silk scarf draped over the scar was very comforting - some of us end up with hyper sensitive scars and cant even bear the bedclothes touching it, but a piece of whisper-light silk was nice. 

Leg-lifter and grab stick - absolutely vital for me. The number of times I got myself (relatively) settled in bed or on the sofa, and realised that Id left something I REALLY wanted just out of reach.....and the leg-lifter helps in the early days when your leg feels like an immobile log!

Bio Oil or some nice vitamin cream for when youre ready to start working on that wretched scar tissue!

For me, trying to hang on to my sense of humour helped - and I think a few people on here have said the same. 

Good luck with your journey, and dont hesitate to ask about anything at all - Im sure whatever the question, someone here will have the answer!

 

19

Hi Ruth, I'm 5 weeks post tkr, I had no idea of how much pain I'd be in!!! Horrible! But, take your pain meds regularly. You'll be tired, so nap when you can. The 1st 3 weeks I found awful, that cried every day. These last 2 weeks have definitely been better. I actually wanted to go to town today, and enjoyed it. Couldn't walk far but it was nice to feel normal again! I'm down to 1 stick or crutch now.

Don't expect things will happen quickly, they won't! Take your time, it can take up to a year to recover. But wishes

20

G'day Nurse Ruth,

Well, your're in for a walk on the wild side (no pun intended!). I am in Cornwall, UK. I was 'done' as an NHS patient in a private hospital, surgeon was a bloody great guy, medical team also bloody great, nursing team also bloody great .... physio  - total crap. Absolute crap ! Not fit for purpose. Beware !

If you are an NHS patient and in UK you will get delivered to your home a package, raised toilet seat, crutches, shower seat and a toilet frame -  a call to attend a Physio Assessment maybe a month before surgery ( I think) and things will be explained to you. You will need to bring your crutches and the physios will set the right height for you.

I was 'done' late morning, by early afternoon I was doing exercises in bed, by late afternoon was walking on crutches - THEN -  the surgeon came in and checked things over and said get in that chair and bend your knee and pull your leg back under the chair. Being stupid,and still half witted from anesthesia I did it  .... holy moly, the bloody pain! I was 'done' on 6 Nov 2015 and sent home on 9 Nov - which I gather is standard.

Here is my timeline - 6 Nov surgery; 9 Nov sent home; 19 Nov dressing removed by GP practice nurse; 24 Nov back to hospital for Physio assessment; 29 Dec back to hospital for surgeons review, throw away crutches and drove my car again; 26 January back to work. 29 Feb another surgeons review - Surgeon now doesn't want to see me until 1st anniversay of surgery which will be 1st week Nov 2016.

The only thing I got about exercises was a standard NHS booklet illustrating exercises and during the three days in hospital the physios marked each exercise with frequency of each exercise. Bloody useless. The physio in hospital and intensive - it was OK. To be honest I got more online than I did from NHS - I went onto Youtube -  a video of exercises is worth a thousand words.

For 8 weeks before surgery (at my own expense) I went and saw my sports injury therapist and she worked on strengthening my knee and leg before surgery in an attempt to get my leg and knee in best condition as possible pre surgery. Glad I did that. After surgery she worked on the knee too for some weeks, Worked intensively on the incision scar and manipulating the knee joint too. Big help.

Mind you in my view this should have been part of the NHS Rehab plan but wasn't. So if this applies to you and you can afford it go for it.

Living alone ........... hmmmm! Before hand look at the logistics of your home, set your home up for ease and comfort. Have a good solid chair with arms on. You will need this chair when you come home, by the way, a lounge will be too low for you to manage for a while. Your chair should ideally be about 18" high from floor to top of the seat. You'll need something like this to seat in and to do some of your exercises in, especially bending the knee. A tip - get a clean flat cooking tray and place on floor preferably carpeted, sit back in the chair at first, place your foot on it and slide your leg back as far as possible to get your foot under the seat of the chair. As you progress you can move your bum further forward and this will enable you to get your leg even further back, then as you progress even more sit right on the edge of your seat and repeat it, you'll then get your leg back even more. Try it now with the better of your two legs and see how it works. 

Stock up your freezer with frozen dinners, if you can do your shopping on line and stock up. Make sure you have more than enough pain relief and DO NOT use it like I did like a pill in the pocket only to be taken when needed. WRONG ! Take it as prescribed 24/7. I have a heart arrythmia and because I'm on Warfarin I can only take limited pain relief, mine of choice is CoCodomol 30/500.

Do your exercises regularly as instructed, don't let up on them at all. Ever ! Always RICE. Don't be in a rush to get off your crutches, use them, take your time, you will find inventive/creative ways of getting around your home - frustrating though it will be.

That said, I never ever did find a way of using both crutches while I cracked open a can of beer and carrying it back to my chair - Lol! Ditto for a mug of tea or coffee for that matter.

You won't have much appetite for a while, I lost quite alot of weight in the first month (bloody well put it back on now though), I was eating half childs portions of food. Thats all I could take.

Get a carry bag of some description to put on your crutches to carry stuff around with you. As I said, get creative. Start practicing now!!

Thats about it which combined with other posts should be a start for you.

May the force be with you.

John