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I decided to have my knee replaced when..
How my life changed after knee replacement

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Two TKR, two completely different experiences

GPCpower
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On 28th June 2016, aged 49, I had my first TNR on my right knee (in Ireland). I wrote about why I needed these surgeries in the other section.
I was considered High Risk because:
(a) I am obese (235lbs)
(b) Damage to both knees was very severe, I was knock kneed and legs needed straightening and both knee caps were located in the outer quadrants instead of in the centre so needed relocating
(c) I have lymphedema and as a result am prone to infection such as cellulitis
(d) I have drug allergies (penicillin and many antibiotics) and am allergic to many dressings

I checked in early in the morning of my surgery and was the first brought down to theatre. I met the very experienced anaesthetist and I explained I was anxious about the spinal anaesthetic and asked if I could have a general instead. He explained that the spinal was the way to go and the pain after a general was must more severe. Then he started working on my back as I sat on the side of the theatre bed It was horrible. I felt it in spreading in my sides but not down my legs. On the fourth attempt I heard him ask was I okay, as I fainted. They put me lying down and when I came around fully then rolled me onto my side and asked me to bring my knees up into a ball and in that position he tried 4 more times without success. Then he put me sitting on the other side of the bed and another 4 attempts before giving up and explaining I'd be having a general anaesthetic after all, and he put blocks in my knee, thigh and groin. The whole anaesthetic experience was the worst part of the whole surgery and recovery. I woke up in recovery, was brought to the high dependency post-op ward for the first night. I had no pain. The physiotherapist came and said that she wouldn't be taking me out of the bed until the following day. I spent the night asking for the bed pan (I never peed so much in my life) and every time the nurses removed the pan, it spilt so they were rolling me from one side of the bed to the other to put on dry sheets. I felt so helpless.

Day 2 I was moved to a private room and was taken out of the bed on a walker by the physiotherapists and later put on a CPM machine. Day 3, more walking, more CPM machine. Day 4 I learnt how to level my leg in and out of bed and was constantly on the move up and down the corridor on crutches. Visitors commented on how straight my leg was already (as in not knock kneed any more). Generally patients are released after 4 nights but I was kept in 6 nights due to the severity of my surgery and to have the benefit of more physiotherapy. On discharge, getting into a car was one of the most awkward and painful things. I was bored 24 hours after I got home so I left the house and hopped onto a bus and spent the rest of the summer doing just that, getting out in the city, walking around the park which had loads of seats, people watching and doing all the bus routes having a laugh with the drivers and some passengers.

I got my staples out on day 13, had physio about once every two weeks, the bend was poor as was straightening it but improved a little between each session. I was religiously doing my exercises at home. Sleep was difficult and I saw 4am every morning for a couple of months. It was difficult to move in the bed and I'd wake every time I tried to turn. I had an icepack and I often wore the support which the ice sheets were put into for the night, even though the ice had melted. After 6 weeks I was allowed back to the pool and encouraged to go to the gym. The water made a huge difference. It began to feel like my knee not some alien knee. I did aqua-aerobics almost daily and lots of stretching in the pool also. It took me about 10 weeks to walk without the crutches and after 11 weeks I went back to work without knowing my doctor was supposed to sign me as fit to go back so by the time he saw me two weeks later, I was definitely fit enough.

Over the next few weeks the left knee became really troublesome and some days I could barely bend or straighten it. I had to take my crutches out again and use them some days. I had a few massages to loosen the muscles and after these I could walk again for a few days and then the muscles would tighten again. This was from compensating with this knee while I the other one was recovering.

On 8th November, I had the second knee surgery. I was so ready to have this one done. At my 6 week check-up with the surgeon he had been surprised that I wanted the second one done asap so he had put me on the waiting list for sometime after the 12 weeks mark. I met the same Anaesthetist and I asked could I just be giving the general anaesthetic straight away this time. He looked in his file and said he would not be putting me through the same torture as last time but he has a female colleague with him and he would like her to make one attempt at giving me a spinal and if it didn't work, I could have a general. Well one attempt was sufficient and I felt the numbness spreading down my leg. I have some memories of the surgery, like seeing my leg up in the air being bandaged and the noise of the stapled being put in my knee. So after being given some pain relief, I was wheeled to the high dependency post-op ward. 6 hours later I was in absolute agony. I remember I was lying there with tears streaming down my face when a nurse called the on-duty anaesthetist and he gave me an injection for the pain. It hardly touched it. I was then put on a morphine drip for the night. It helped but not a lot.

The next day every time I moved I had a horrendous burning sensation in my thigh. The Physiotherapists got me out of bed and walking up and down the corridor and I was back on the CPM machine controlling the settings of the degrees it was moving myself. The next day when I mentioned the burning sensation to the Surgeon he said it was nerve damage from the tourniquet. He said that while he had described the last knee as as bad as it could get. this one was even worse, and the kneecap was in the wrong location totally and they had to do a lot of cutting and patching up instead to move it to the correct location. His colleague had never even seen anything like this.

This time I was kept in 5 nights. On removing the dressing in the hospital, there was some rashy areas. I was prescribed antihistamines. The day after I got home the community nurse called and wanted a look at the wound and she put a different dressing on it to prevent the rash. On day 13 I had the staples out. The Doctor prescribed Lyrica for the nerve pain. When the Doctor removed the dressing the whole area was covered in an itchy rash as obviously I had been allergic to the adhesive in the dressing. He then said I should leave it uncovered but I got some hypoallergenic non stick strips with a tubular dressing and used that instead. Because of my lymphedema, I did not have to wear stockings with either leg. Again I was out and about most days on the buses with my crutches although some days I was sitting in the park rocking back and forth as the burning sensation in my thigh could hit at any time. The leg felt strong.

Within 10 days I was walking without crutches within the house. At 4 weeks my wound had healed sufficiently to go to the pool. Physio was not going well however. The bend was at 60 or 70 degrees and with some massage it increased maybe 5 degrees and then I would have to try to maintain that little increase until the next session in 2 weeks. At 6 week I had my check up with the Surgeon. I went without crutches. He was fairly pleased but asked that I try to watch my weight (which was ballooning thanks to having been pretty immobile and sitting in front of the tv eating chocolate all the time). but he wasn't an asshole about it like some of them can be. Physio continued and I started Knee class. Bend was still poor. it was disheartening seeing people in the knee class who were 20-30 years older than me and 1 or 2 weeks post surgery and had a better bend than me. But the physios kept telling me that my surgery had been much more severe and everyone progresses within a different timeframe. Also they were trying to encourage me to take rest days from the gym and pool and from doing too much. The problem with me was, having always been sporty, I was trying to run before I could walk, had been weight bearing too early, was trying to do exercises too early in my recovery and was in fact causing mini traumas in my knee by exercising to try to get it to bend or straighten, and these prevented the swelling from abiding and the swelling was preventing me from bending or straightening it.

Now I was actually grateful for this swelling as one day I took an awful tumble down the steps outside by back door. I know my newest knee replacement went in every direction but thankfully it felt okay. I had it x-rayed the next day and it was fine (my nose was not so lucky). Sure it was like it had been wrapped in bubblewrap it was so swollen. I did get an awful fright. After 12 weeks I was due back to work so went to my Doctor for my fit to return to work letter, feeling in my heart and soul that I wasn't actually fit to go back. He agreed and felt the heat emanating from my swollen knee so he signed me off for another 5 weeks, gave me anti-inflammatories and increased the Lyrica for the nerve damage. The anti-inflammatories made a big difference and the physiotherapist noticed a big improvement from 2 weeks before. I now had a bend of over 90 degrees and straightening was better. After 3 weeks I returned to the Doctor and was allowed back to work and discharged from physiotherapy.

I'm now on week 5 at work, delighted to be back, and doing fine. I'm in the pool either before work in the morning or at aqua-aerobics 2 evenings per week. I also try to fit the gym in about 4 times a week and finally I can rotate my leg on the stationary bike without winching at the top every time.

The nerve damage is still nasty. Today I contacted a Chinese Medicine Doctor to see if he could do anything for the nerve damage or give me Chinese medicine as an alternative to Lyrica.

But life is getting better every day. People always comment on how straight i'm walking and that I look taller. I'm looking forward to being able to make plans to go on holidays which I haven't done for years because I knew I wouldn't have been able to walk around and do any sightseeing etc.

So at 50 Im a new woman
Comments
Sashagirl
happy for you
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