So, How Was YOUR Orthopaedic Operation?

stickywicket

I’ve been extremely lucky with my ‘arthritic ops’ – 2 hips, 3 knees and every one a winner. It’s clear to me, from reading this forum, that not everyone has it so good.

I’m fortunate to have a large teaching hospital with excellent rheumatology, orthopaedic and physiotherapy departments.

OK, let’s forget the first two knees and the hips as they were all done over 6 years ago – some well over.

For my last knee, in December 2008, I was given exercises to do beforehand to strengthen the muscles, supervised physiotherapy every day while I was in hospital, more exercises to go home with and further physio appointments to monitor my progress for about 2 months until I was walking in with no aids. (I was also sent out with 6 weeks worth of antibiotics as there was a very slight possibility of infection on the 27 year old TKR they’d just taken out.)

As a result of this excellent care I have a knee which has never given me a moment’s trouble despite now being an enormous implant which necessitated bone grafts.

So, mine was great but, looking at this website, it seems to me that standards vary enormously throughout the country.

So, how was it for you?

dreamdaisy

I have been under the care of an orthopaedic surgeon (and may well be gracing his consulting room again soon) but my synovectomy was not a replacement, tho people think it was, due to the scar that I now have. Preparation? None, in terms of exercise etc, but I do remember being called in for a pre-op chat. I cannot remember now what was discussed. I was promised keyhole surgery but on the day of the op he realised that was no longer an option and it was - suddenly - a much bigger deal. Aftercare? Very good, phsyio began immediately, the exercises were difficult intially and they kept me in for about ten days. They said they wouldn't let me out until I could do a certain manoeuvre. I managed it about two years after the op so I am glad they changed their minds on that front!

My hospital is a large teaching one - does that make a difference? I was sent home with some information about the exercises and why they had to be done, a diet sheet and long lectures about being sensible. I was taught how to cope with stairs before I left the hospital (good leg to heaven, bad leg to hell is still my mantra) I had twice-weekly physio for about a year, then they decided it all had to be done again as the inflammation had returned. At about this time rheumatology gave a great big sigh and said 'OK, you can come and play with us, you ARE in our gang.'

What I did not expect was the emotional response to it all. I didn't expect it to take so long to recover, I wasn't expecting the teariness and weepiness that persisted for some good while after, and I wasn't expecting the emotional devastation when it didn't work. Never mind, it's all water under the bridge now. DD

hileena111

My THR......Orthopaedic surgeon was lovely. BUT.....I didnt get any physio before or afterwards.....had the usual pre op assessment, vist to the physio with 5 others who were having a THR and she just told us basically what would happen and gave us a sheet of paper with exercises on it and that was it.
I was in for three days, physio came on the last day, gave me a sheet of paper and showed me how to do a couple of the exercises and that was it....no further up visits to her at all.
It seems so different in different parts of the country....I remember when I had problems someone on here saying talk to your physio.....what physio
Love
Hileena

chris7

Hi Sticky

Very interesting point and as yet I can't comment but will be interested to see the replies as it really does seem to vary so much across the Country. Though I have only once seen my Consultant 18 months ago, he gave me absolute confidence in his ability to do a good job when it comes to it but just having watched despatches on channel four I am now left with rather more questions than I had ever imagined. :shock:

I do know that this forum has made me a good deal bolder in asking the right questions, in gaining much needed information and dare I say being a bit more demanding in asking for help to prepare for my inevitable THR's!. I hope others feel the same. It is a pity we often appear to be fighting to find the information and support we need, pre or post op. Sadly Hileena as she says here will not be alone with her lack of support post op!

Chris

dreamdaisy

I am staggered by hileena's post. I cannot understand how someone, after such a major op, can just be abandoned in such a way (same with constable). Sent home with a couple of sheets of badly photocopied A4 exercises and no human input as to how to do them, when to stop, what may hurt whilst doing them and what shouldn't - staggering. Is this because joint replacements are just seen as run-of-the-mill mechanical surgery? We are not cars which are having old bits replaced with new bits - we are human beings, we feel pain and distress and emotional and scared, and stuff bloody hurts. There has to be a psychological component to the knowledge that you are having an important bit of you cut out and replaced with summat plastic or metal, even if it is goping to make life so much better. I suppose that the surgeon has to distance himself from the human lying under the green sheet (I hate those green sheets) and see us as mechanical problem which he can solve but ye gods, surely we need help after. DD

julie47

I can only answer by thinking of my MIL.

She had her knee done one day and was doing physio the next......well, not much physio as it hurt too much (the physio was not pleased).
Mil was given a sheet of exercises to do while laying on her bed inbetween the visit from physio. She was in hospital 10 days and had to be able to walk with crutches and be able to make a sandwich and cuppa before being released. (she does live on her own).
She came home to quite a bit of equipment to help make it easier for her.

On returning home though she too was given more exercises and it was family and friends who went round and encouraged her to do them.
She only had two proper physio apps and was then dismissed.


My Mil was one of the lucky ones, with our help she was walking unaided after about 6 weeks and now is truly brilliant on her new knee.

Juliepf x

hileena111

Hi,
Yes DD I was shocked as well after having read posts on here about physio afterwards....anyway....I cant complain about the equipment....I live with hubby but still had loads of equipment ready to come home to.
Oh well the 2nd THR which was supposed to be done last Oct (7 months ago?}still hasnt been done and they are still working on my back??? Acupuncture starts again today ...6 appointments. I'm not sure I want the 2nd one done now LOL
Anyone due to have one or just had one dont worry.....looks like I'm in a very small minority of people that has come out worse than before....most people have fantastic results and a few come out the same as they went in but I'm one of the VERY VERY FEW that it has made worse.


Love
Hileena

skezier

Hi Sticky,

Some of mine have been good and some haven't.....

First was the knees and that was fine and I had a quick recovery (apparently) but they only took the cartilages out. Was back riding dressage in 6 weeks

Next came the head. i was so out of it I don't know how that went It was plated and it took but there is a bit of arthritis in my skull now and might not have been had I not had a vendetta against it Oh had a bur hole done 2 years earlier as well... don't remember much about that one either.

hey Sticky on reflecting they are the best

Toe removal was fine but painful. Done as a day case.

Joints in the foot removal again was fine but very painful cus my brain couldn't cope with not trying to bend them....

The back was not what i had signed for but better it was done rather than wake me up and have to wait again. besides they found the chances of paralyzation were very high as the cord was badly compromised and bent in two places.

Woke up in recovery almost upside down cus of low bp problems and was kept in recovery resuse room in case. Went back to the ward after 48 hours and it hurt..... Got infected in 5 different places and hit a Temp of k=just over 106.... bit spaced out again so all I remember was it hurt Well do remember being thrown into a bath of ice.....

The recovery went on for ever (3 months hydro to get the legs working etc, physio for another 3) but they said I was up before I was up so I was quick back on my feet according to them. To me it dragged so badly.... The month in hospital especially.....

Couldn't sit for the first month. Hovering over the loo was the hardest I guess (TMI maybe) but rode a dressage test 6 months to the day of the op and was placed so it worked..... for a while.....

The feet rebuild.... first one was fine and the actually rebuild was brilliant. The second, third and forth i reacted badly to the anesthetic so much and the feet proved the circulation issues had got critical but I had the first drip of the ilopsost (been having it ever since) and it mended really all 3 mended really well after the infussion.

They deemed me an anaesthetic risk after that and now if they have to they use the white stuff.. much kinder to your head!

All in all I been lucky. The back didn't work out quite as well as he had wanted but it did for me as before it I could hardly walk and after it i could.

If they offered me any surgery for the bones now I would jump at it ... but.... they told me they wont now..... I hate palliative care... might have mentioned it ((( ))) and get that work out done! Cris xx

stickywicket

DD - My only 'emotional response' came after my first knee. In those days you'd to stay with it propped up horizontally (in a huge bandage) for 10 days. By the time I was allowed to walk both ankles had packed in. The 'walk' round my bed, half carried by the physio, was the longest I've ever done. When I reached the other side I found a good friend had arrived (I'd been so concentrating I hadn't noticed) and I collapsed into her arms in floods of tears convinced I'd never walk again.

Skezier - I am speechless! How much of the original you is still there? Well, I guess they must have done a good job/jobs as the original skezier couldn't possibly be better than the one we all know.

Hileena - I've got to say, I'm not very impressed with your 'aftercare' - or should that be 'after-couldn't-care-less'. In your situation I think I'd have been asking my GP for help (and I'd have got it) or, if necessary, finding a good private physiotherapist to advise me.

Julie - your mother-in-law's treatment sounds fairly standard to me. I think the 'family and/or friends' and are absolute must for all sorts of reasons.

I forgot to mention earlier that I was also given, on discharge, a phone number with which to contact my physio if I'd any problems. I wouldn't have done as he was the only physio I've ever had (in dozens) who was pretty useless, insisting I'd to be able to get up from the low chair unaided before I could go home. I did explain I hadn't got up unaided from a chair that low for some 30 years but he was uninterested so I asked my surgeon, who knew me from a previous op or two, & he said no problem.

dreamdaisy

skezier? :shock: I have re-read your post a number of times and still cannot take it all in. Blimey-oh-flaming-Riley girl, how the hell do you do what you do?

sticky, I think I didn't define the emotional enough. What got to me was my propensity for dissolving into tears over stuff that normally doesn't cause any reaction at all. I know that I may come across as having a heart of stone (or perhaps slightly-warm-to-the-touch-stone) but that has always been a coping strategy for me: toughness = strength. That went completely post-op, and for some little while. YUK. So not me, and very disconcerting. DD

skezier

Hi DD,

I have to do it or give up... giving up ain't an option cus of what I would have to do....I was also lucky to have it young as your more likely to fight back young I think.

You toughness doesn't = strength at all less I am not strong. I really am not tough and have a fair bit of emotion and an empathy and made of something so soft a lab can walk over me to appoint xx

stickywicket

DD – I take your point about the ‘emotional devastation’ thing. I guess I got over my problem the minute I realised my ankles would, eventually, work again.

For you, was it just the op itself or did it kick in only after you started to feel this thing mightn’t be working quite as planned?

Did you get support for it while in hospital or were you required to knuckle under & snap out of it?

Should it be explained beforehand how likely success may/may not be or would that induce negative thinking in some? I recall the big disappointment, after my first TKR, when I realised my leg would still be bent because the ligaments were knackered. (Actually, it’s better now after it’s 2nd one as they managed to tie up ligaments and move tendons) No-one had told me it wouldn’t be bent – that was just an assumption on my part.

Skezier – in my book the arthritis might ensure you’re not physically strong but you are, mentally, a very tough cookie. You make that body work for you. Having empathy doesn’t make you weak – it makes you a rounded human being.

dreamdaisy

I've been thinking back over things since this thread began, and addressing stuff I've never bothered to think about before. It's been an interesting re-visit (well for me anyway!)

In mid-September 2001 I had an emergency op. It turned out to be quite a biggie, a slash and grab on a rancid ovarian cyst: I ended up with a ten inch vertical scar on my tum and guts that were lolling around after their lovely waterbed of cyst (and ovary) had been removed. After, well, I just got on with stuff. Life was painful for a good long while and all I could think about was my damned left knee - how long before THAT would be sorted? As far as I was concerned the ovary thing was sorted, all I cared about was the knee. At this stage I had no idea I had arthritis. None at all.

I saw the ortho guy in October 01, he said the op would be done in January and he was aiming for keyhole surgery. At this stage my knee was just under two feet round and he thought that keyhole was possible. He said it would be a quick recovery time and things would be sorted. Woo-hoo! Bring it on, sunshine, I want this sorted. NOW.

The first synovectomy was eventually done at the end of Feb. For some reason I did not see Mr Ortho again until the morning of the surgery - and that is when it all went mammary-glands up. He was horrified by the size of my knee, keyhole went out the window, as did all the prep for that kind of op. I woke up with another ten inch scar (and about 38 staples, I think) and a much different recovery to the anticipated one. Recovery was hard work. When the staples were eventually taken out they ripped one or two internal stitches (ow, ow ******* ow), the wound was both long and deep - and I had a fight on my hands to regain health. (Health - ye gods, can you hear the hollow laugh?)

The first couple of weeks were OK-ish, I had the focus of getting out of hospital PDQ and that took my attention. What led to the weepiness was a) the lack of diagnosis on my knee (long, boring story but the piccies of my op and what he found in it are in medical textbooks ) and b) the fact it was a second major op in just a few months. GA takes a while to clear one's system and I had two slugs of it in a short space of time (well, short to me). The tum op had worked but the knee one hadn't led to a diagnosis. That's what did for me, I think. DD

dreamdaisy

As for help, well, I never told anyone.

mp1952

An interesting thread, Sticky.

I feel very fortunate indeed with the hospital(s) I go to for rheumatology and orthopaedics, however I didn't have any physio at home after my THR and I do think I would have had a better outcome if I had had some physio advice BEFORE the op, and after I was discharged..


Marion

dreamdaisy

The physio I had at home was done by me, I had to go to the hospital physio dept twice a week for months, in between visits I did my physio homework. It became clear by the August that the op hadn't worked, the swelling came back from June 2002 onwards and they did the whole thing again in June 2003. (Tip from DD - if surgery is on the cards try to get a summer appointment, winter recoveries are dire, summer ones are lovely!) Rheumatology then caved in and said I could permanently be in their gang. Deep, deep joy.

border

I think I was very fortunate in both hip ops. as had plenty of physio pre and post op. However, during the second op. things went slightly pear shaped, as the epidural did not take and had to have GA (makes me sick) and just as I was getting ready to go home, the drain site oozed++. Eventually home and agian plenty of physio. Still have aches and pains in other areas where arthur has decided to take up lodging. But post-op depression is a very nasty thing to have.

stickywicket

There is so much/so many differences.

Like DD (Thanks for all your input) I'm starting to remember things. Like, after one of my 1st TKRs in 1981, when I'd to wear this gi-normous special bandage for 10 days, the drain didn't work but I was only up from theatre about 2 hours and they couldn't give me a local so he just yanked it out and put a big cross stitch in.

(For those of a nervous disposition, it's totally different now.)

dreamdaisy

Another reason for the unsettling was that I was only meant to be in overnight - it was originally scheduled as keyhole. When he changed his mind on the day of the op I went down to theatre with the full knowldege that there was no bed for me anywhere after that night - the staff made sure I knew that as they were cross with Mr Ortho. I ended up in a geriatric dementia ward on the following morning.

The NHS is a wonderful, wonderful thing, it's full of ill people who should be in hospital but a major problem it now has is that there are probably just as many ill people who shouldn't be there but they have nowhere else to go. I remember the biting lady (they had her in to remove her natural teeth, after that she just bit the bed rails, it remains one fo the strangest sights I have ever seen) and the lady who soiled herself continually, with a blissful smile and a stream of invective for anyone who tried to clean her up.

That is what no-one can prepare you for, the last-minute alterations, adaptions, changes etc to your circumstances, and the sheer grim reality of being in hospital. You emerge from theatre with bits removed/replaced, you are tired, groggy, upset, in pain and find yourself in a public ward with a bunch of - well, other sick people who are noisy, boring, tedious, smelly and horrid.

I eventually had a go at keyhole surgery when Mr Ortho man did my right knee before it got too bad. Mr DD sprung for a private op - ye gods, how the other half live. The hospital was gorgeous, the private room had an electric bed - that was fun! - and I was in and out in a day, which was slightly disappointing as I wanted to stay in and play with the fun bed and watch a telly that did not cost an arm and a leg (because you had already paid that for the op). The nursing, however, was appalling. I have always had the best care under the NHS, despite surgeons changing their mind and the other ghastly patients. The care in the private hospital was not a patch on the NHS.

I keep thinking of the biting lady now. I need a cuppa. DD

stickywicket

dreamdaisy wrote:

I ended up in a geriatric dementia ward on the following morning.

No comment!

Seriously, last minue changes must be very, very unsettling. I've been lucky enough to avoid them and also any serious post op complications.

I think I almost recognise some of your bedfellows, DD. I've been in with dementia patients who thought I was the nurse (so kept asking me to do things, some of which I could, some of which I couldn't and some of which I certainly wasn't going to attempt). Another lady kept flinging off her nightie & setting off for home.

I've no experience of private medicine but I actually like the hustle & bustle of the general ward. You do meet some bores and some wierdos (and that's only the surgeons! - no, not really) but you get some lovely, inspirational people too. And a fair few laughs. And lots of encouragement, especially for those first faltering steps.

dreamdaisy

Ah, I have yet to meet the lovely and inspirational. Maybe next time, yes?

lindalegs

My experience is purely positive so I'm one of the lucky ones.

When I had both knees replaced 11 years ago I was sent for physio and hydrotherapy 6 weeks before the surgery and then I was given four months of the same afterwards.

On discharge from the physio centre I was furnished with my exercise sheet with written explanations and diagrams.

Interesting thread Sticky.

speedalong

Wow Sticky ... sounds a fab service.

I have a THR (14 years ago) and resurface-replacement (a year ago.) Prep and follow up automatically offered with both poor. However second time round I was a member of this fab forum so more informed and geared up to fighting for my rights - so self referred at intervals for regular blocks of physio before and after, chased up check ups and appointments when they were overdue etc

It totally depends on which hospital and even which surgeon within that hospital that you see, physio services greatly vary too ...

Speedy

stickywicket

lindalegs wrote:

When I had both knees replaced 11 years ago I was sent for physio and hydrotherapy 6 weeks before the surgery and then I was given four months of the same afterwards.

Hydro? Wow, Legs, that was really 5 star service!

Any date for the revision yet? Will things be the same?

Speedy - Can you do that? Self refer? Well, obviously yes as you've done it but how? I know I can ask my GP & he'd probably let me have it but there's always a wait. Was yours via the ortho man or rheumatologist?

lindalegs

Hi Sticky,

I'm about to put up a thread about my revision. I don't think it'll be the same because the physio centre I was sent to has now closed due to NHS cuts :roll: The fortunate thing is that I've kept up my physio exercises, on and off, so I know what to do having been through it all before.

stickywicket

Real shame about the physio centre closing but, I guess, those of us who've done quads never quite manage to forget them, despite trying hard.

I shall expect regular progress reports on here and woe betide you, young woman, if you don't do those exercises. All together now...1001, 1002, 1003 etc etc.