Knee Replacement Surgery: Boy Have I Been Wrong

On March 25th I had TKR, which for those in the know means Total Knee Replacement.  I had outlined in Shooting Your Age a few weeks ago how I had gotten to this point, and how I was preparing.  

I think anyone who is facing surgery does this.  I do, and have.  We make assumptions and use, as our baseline, what we know as we mentally prepare for the unknown.  And every surgery is an unknown.  What I knew was that in 2011-2012 I had both of my hips replaced, and was using that experience as my baseline.  I also knew that I was the youngest of the guys (everyone was male) and  I looked to be in the best shape of everyone who was in my pre-op “joint camp.”  

Everything "They" Said Is True

I had read different articles and talked with doctors, nurses, cousins of people who “knew a guy,” and anyone who I thought might give me some insight on what to expect.

The general consensus was that knee replacement was harder, and the recovery was more difficult than hip replacement.  

My thought set of assumptions was that I made it through hip replacement with no big issues, so this knee replacement shouldn’t be too tough, regardless of what I had been reading.

Boy, was I was wrong.

The First Day

I was first in line of the three knee replacements scheduled on that Monday, and was taken back to start the process about 7 a.m.  I had asked the surgeon if he would be able to see the knee and see just how damaged it was, and he said, “absolutely.”  I remember being wheeled into the surgery suite, seeing the surgeon one last time, and then I was out.  Next think I remember, I was waking up in post-op.

After getting back to my room, a nurse asked me how I felt and I said other than really thirsty I was fine.  She said, “You’ll start feeling it this afternoon as everything wears off.”

The Surgeon had told my wife Alice after surgery that I didn’t have that much arthritis, but there were several bone chips and fragments under my knee cap, so that every time I took a step they were grinding down my meniscus, and what cartilage was left.  In other words, my knee was bad and nothing other than replacement was going to fix it.

Somewhere around my third can of ginger ale, a different nurse told me I would likely have a rough night.  I remember thinking, “it’s not going to be that bad–I feel reasonably ok.”

Late that afternoon, the anesthesia started wearing off, and my knee started feeling like someone took a hammer and had beat on it.  Which, upon reflection, is pretty much what had happened a few hours earlier.

By midnight, I was is as much pain as I can remember.  I couldn’t roll over on either side, and what little I could move didn’t make much difference.

I didn’t sleep, and as Tuesday morning approached I learned my first important lesson:  When the nurse asks you what is your pain level (always on a scale of 1-10), this isn’t the time to be a tough guy.  My answers of 6-7 moved to 7, then 7-8, and settled on 8 with a couple of 9’s (they asked every hour or so).  Of course, the higher my pain level, the more pain meds I would get, and the less I would be in agony.  Beginning Tuesday morning, 8 was my standard answer.

I don’t remember ever being at the “8” level when I had my hips replaced, and I know I was never in as much pain as I was Monday night.  I spent a lot of Monday night wondering if I had made this unbelievably stupid decision to have this done.

Physical Therapy

Also on Monday afternoon, I had my first visit from the physical therapy crew.  It went something like this:

“Can you bend it?”

“No”

“Can you lift it?”

“No”

“Can you sit up?”

Now that, I could do.  So I sat up, and did some attempts at bending, and that was it.  They asked if I take a few steps, but when I tried, I became really light-headed and dizzy, so we postponed that attempt until the next day.

There were two visits on Tuesday, where I did some walks up and down the hall (on a walker), and up and down a few steps.  Then came back to the room and did what I have come to learn is the go-to exercise:  Heel slides.  A heel slide is an easy exercise.  Simply set on the edge of a chair, and slide your foot as far in front of you as possible, keeping your heel on the ground, then slide it as far back as you can, increasing your knee angle and keeping your heel on the ground.  

It’s easy to do, unless your knee is three times its normal size.

 

 

More Physical Therapy

I only remember snippets of my physical therapy with hip replacements.  I’m not likely to forget the last week, however.

I came home last Wednesday, and had my first in-home PT visit on Saturday.  Every visit has added a more strenuous and aggressive set of exercises.  All of them hurt– in fact, popping one of my two high-end pain pills about an hour before PT is a requisite.

My knee isn’t bending as far as they want so today we added the “bring tears to your eyes and take your breath away” move.  I lay on my back, grab a towel, place it behind/under my knee, and pull it toward my chest while pulling my ankle toward my hamstring.  Hold it for five seconds, and do five of them.  

Nothing I ever did with hip PT caused that level of pain.

What's Next

Right now, I can actually walk without aid, although I keep a walker handy.  That’s mostly because it forces me to walk upright, with a normal gait, which I don’t do if I’m trying to just shuffle along.

Two PT sessions a day, making myself do the painful as well as the not-so-painful exercises.  Keeping ice on it whenever possible.  Keeping it straight (ramrod straight, with ankle weights sitting on my knee) whenever I sit.

With luck and a commitment to doing what I’m supposed to do, I’ll be walking normally in about six weeks, and playing in eight.

 

For What It's Worth

Knee replacement is tough.  

“They” are right– it’s more difficult than hip replacement.

I plan on walking 18 holes before the season is over!

Thanks for reading and enjoy Shooting Your Age

 

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