Home Community Member Stories Robert's Knee Replacements

Robert's Knee Replacements

Oldretiredman@aol.com 

The knee replacements, for me, were a Godsend. The increase in mobility and the pain relief that I got from them far, far outweighed the pain from surgery. I got my right knee in September of 99 and the left knee in January of this year. 

I was ready for the knees as there was tremendous swelling in both of them, having to get fluid drained every couple of weeks, very limited mobility and extreme difficulty in trying to walk. The situation improved greatly after getting the right one replaced and I began to walk off and on with a walker. Because of my shoulders and elbows, the walker I have is one that has forearm rests with hand grips - have to strap myself into it. The day before I got the second knee replacement, I went to my daughter's school to eat lunch with her and it took me about 20 minutes to walk the 50 yards to the cafeteria (without walker) and, admittedly, I looked pretty awkward. After the second knee, quality of life greatly improved. I'll try my best to describe what I went through with the knee replacement surgery, good and bad.

First, I was a prime candidate - not just because the original equipment was worn out but my GP, Rheumy and Surgeon all knew that I was highly motivated and would work at rehab as hard as I had to. I was using a wheelchair most of the time and it was difficult mentally. Additionally, because of the shoulders and elbows, I had to have someone to push me. I still have the chair. Keep it to remind me that I don't want to go back to it. Anyway, my docs knew I would do whatever I had to do.

Second, the hospital had a class about what to expect during and after the surgery and gave me some exercises to do before the surgery to strengthen the muscles in my legs that I would need during recovery and rehab. These helped a lot because they were dead on about those muscles. At the class was a physical therapist, an OR nurse, an orthopedics floor nurse, a caseworker and an occupational therapist. They talked about the surgery, told how painful it would be for awhile, talked about the different surgeons and the different methods they used post op, talked about therapy after the surgery and talked about devices available for dressing, etc. They also talked about items available for the home to make life easier but I already had all of these, i.e., high bed, special chairs, handrails, tall toilet, shower chair, pull bars, etc. They warned that the pain would be very bad immediately after the surgery but I didn't believe them. Know this now. They were right. It hurt BAD when I woke up.

From this point on, I will speak of the second replacement since most people only need one.

Surgery: I was asleep during the surgery (local was available for people who were at risk from general anesthesia) but when I woke up, I had sincere doubts about what I had just done. I was in recovery and they waited for me to wake up before starting the morphine. All I wanted to do was roll on my side and bend my knee but they kept me on my back with my heel propped up off of the bed forcing my knee straight. Later, my surgeon told me that they had to restrain me because I tried to get up and leave recovery and tried to take the four orderlies and nurses with me that were trying to keep me in bed. I had the really bad pain for about two days and, after two days I asked to be taken off of all pain medicine (morphine, demerol) so that I could concentrate on therapy. Docs and nurses told me that most knee replacements have that really bad pain (the kind that makes you wonder if you did the right thing by having the surgery) for up to two weeks. Man, was I grateful I didn't have it that long!

Room: Doctors, nurses, everybody was great. Knee was replaced on a Tuesday afternoon and physical therapists showed up on Wednesday morning to get me started. They tried to get me to do things that I couldn't yet do like slide my leg from side to side, lift my leg, etc. Knee was still in lots of bandages and in an immobilizer. Therapists got me to stand up, leaning on my walker, and had me walk / shuffle about 15 feet to the door of the room and back to the bed. I was pouring sweat after accomplishing this feat and the therapists were truly impressed. Therapists came by twice daily to punish me, I mean give me therapy. During down time I was on a machine that passively bent my knee and straightened it very slowly. Second day after surgery, I walked about 150 feet down the hall and back to the room. Therapists were very impressed because I put so much effort into it. Third day I walked all the way around the floor of the hospital because one of the therapists dared me thinking I couldn't do it. Being a Type A personality, I couldn't pass up this opportunity to do or die. By the time I got back to the room, there was a trail of liquid following me down the hall (sweat) and I was absolutely no good for the rest of the day. Going home day I walked around the floor of the hospital twice. Required for discharge: had to be able to lift my leg off of the bed 15 times consecutively at least two feet off of the bed and bend knee to at least 70 degrees. This is where all of those exercises before the surgery came in handy. The muscles I had worked on I could keep tensed and this allowed me to keep the leg going. I was also able to bend the knee to 90 degrees on my own.

Going Home: If a friend or relative has something LARGE for you to go home in, borrow it. Although I had thoroughly impressed docs, nurses and therapists and although my Chrysler 300M is normally very roomy and very comfortable, I'm 6'4" tall and it was very difficult trying to find a way to comfortably get in and make the ride home. Finally laid down on back seat and, since I was too wide for car, laid legs across passenger front seat (seat back was laid back). Once home I managed to get out of the car without a crane.

At Home: Was I ever glad that I had all of the handicapped stuff already at home. I managed to get in and out of shower by myself but I understand that I was the unusual case. Docs told me that my progress was far above what was "normal" plus I had grab bars, etc., already installed to help me. Docs seemed to think that I did so well because I was so highly motivated to do well and I was relatively young compared to most knee replacement victims, I mean patients. I had a physical therapist come to the house three times a week for two weeks. Home health therapist was more convenient and also cheaper than going to hospital, at least in my case. My therasaidst, I mean therapist, was very demanding and I think that it was what I needed. She really pushed me to my limits of endurance and I am grateful for that. We made magnificent progress and after her first week with me, I could bend new knee to 120 degrees and within 5 degrees of completely straight. Understand now that this is far better than most people do in such a short time but, as I said, I was very motivated and she was very good at getting the most out of me. Of course, the therapy hurt some but not very much and for not very long. After one week of the therapist, first post-op visit with surgeon. Staples taken out. He told me to start putting full weight on the knee so I tossed the walker aside and began to take short walks. I also began driving at this point. Walks would tire me out and the knee was still very swollen from the surgery but I gradually increased length. Am now walking around a mile a day. I have to rest for an hour or two afterward but it's great to be getting the exercise again.

Well, that's about it. Pain immediately after the surgery was awful but didn't last long. As I said before, within two days after surgery, pain was less than before the surgery. I would do it again in a New York minute. If you and your doctor are contemplating a TKR (total knee replacement), remember that a lot of the progress you make is up to you and how hard you work at it.