It's been an interesting few months

Ladybrown

Hello all
I've been quite quiet for the last few months (partially because my OH broke his laptop and has been using mine so it's been harder to get online, partly because it's been a really tough term) but there have been a few developments so I could do with some advice.

Last time I posted I was asking for advice about crutches and I have to say I love my 'chic' crutches 8)

Work is getting more and more difficult and the big 'flare-up' I had in the winter hasn't settled at all. The GP gave me more pain relief in the end (tramadol for when I really need it, on top of the cocodamol - generally only need it at work because teaching is either on my feet in the classroom or at my desk, neither of which are popular in kneesville). I got (another) referral to the persistent pain service and this time I got an appointment. Waited a few months, had an assessment, only to be told that the physio who assessed me wasn't really sure that it was the right service for me as she wanted to investigate the possibility of surgery. Some of you may remember the trouble I've had with my GP over this avenue because I am only 40. So, an appointment with the specialist lower limb physio, discussion of how hideous winter/spring was and another set of x-rays (she was very much going down the stress and pain management avenue until she saw the results). It turns out she could see degeneration in the left knee (last x-ray 2 years ago) and the right (1 year ago) so she is sending me back to the surgeon as there really isn't anything else she can do.

So, here is the thing - I have an appointment at the end of the month so I am trying to lose the bit of weight I put back on (only half a stone, but still...) and get stronger (really slipped on my physio when I was struggling) but I feel I need to be prepared for the appointment. I know there is a strong possibility that he will say he doesn't want to replace my knee (it's apparently where we are at but I'm too young etc) but it's also possible that he will suggest it. Logically, I want the surgery; I can't carry on like this and reducing my teaching any more would mean losing almost half my income because of the role I have (I also worry about my pension and just can't see the point of putting off something which could well give me 15 years of good working life). But when I sit in a doctor's office, I am terrified by the idea. I feel like I'm hobbling from the frying pan into the fire! I am quite worried that I will be offered what I want and will talk myself out of it in the consulting room. Can anyone offer any wisdom on a TKR?
Sorry for the long post
xx

GraceB

Hi, I had a partial knee replacement at 44 so don't be fobbed off by anyone saying you are too young. Mind you, at my last clinic appt before I had the op I said if they wouldn't replace my knee I wanted the leg amputating. Sounds drastic but I'd had enough of the relentless pain by then.

If your life is severely limited and you are in pain that can't be controlled, then you need to talk about your choices and options. Take a list of questions with you to the appointment and make sure you ask those questions.

When you have an indication of a timescale for surgery, do some "prep". I stocked up with as much non-perishable goods as I could store, borrowed books, DVD's, got puzzle books. I got as much housework and washing, etc., done before the op as I knew I wouldn't be doing it after for a long while. I also stocked up with my regular meds. I accepted offers of help from friends with little things like getting magazines, paper, etc.

When I was post-op I was pleased to see friends, family & colleagues but I was also some days pleased to see them leave! Be ready to firmly but politely make it clear to visitors that you are tired, would they mind leaving but you'd love to see them again another day.

If you decide to go for surgery do some research on the physio they'll want you to do afterwards. Learn those exercises and start doing them as soon as possible. If you can strengthen your muscles it will probably help you after the operation, even if it's just that you are familiar with what you need to do.

After the op follow instructions re moving around, resting, pain meds. I was told to take my pain meds 4 times a day whether I thought I needed them or not for the first 4 weeks. I did as I was told and will follow this advice again when I have my left knee replaced.

Don't try to go back to work too soon, and make sure when you do you have a phased return to work. Your employer may want you to see Occupational Health either now or after the op. My experiences of Occy Health have all been good and they've been very supportive to me.

Please feel free to PM me if you need anything more specific. I'm sure other "knee" Forum members may also have ideas to pass onto you.

Good luck, keep us up to date and take care,
GraceB

stickywicket

There are lots of us on here who have had very successful TKRs. I've had three, having had my first two aged 31. It's an extremely successful operation and, given your sensible attitude to weight loss and exercise, you are making your chances of a very successful outcome higher.

But, you know all this. I think what you really want is some sort of guarantee that all will be well and your life will continue essentially as before but without the pain. No-one can do this.

I was lucky in that I had no decisions to make about mine. For the first two I couldn't cope, looking after my two young sons. It was a no-brainer. For the revision, the original TKR had skidded so far out of position that, too, required no decision from me. More recently, I opted not to have the other knee revised as, despite being told about 5 years ago that it was 'officially knackered' and offered one then, I was in no pain from it. At my annual appointment last year, now intending to ask for it doing, I got a registrar who clearly knew nothing about RA and was nervous of operating. I thought it'd be a bad move so didn't push it. (Retrospectively, I realised he wouldn't have been the guy operating.)

Some people tend to push for operations. I've never done that. Indeed, I've never needed to. But surgeons don't usually offer operations unless they think it's a wise move. If offered a TKR only you can decide what's best for you and whether or not this is the right time. I hope you'll feel happy with the outcome of your appointment whatever that may be.

barbara12

Hi
Like SW says there are many that have had good results with knee ops..I am a lot older at 66 but just had my second THR..so I understand some of what you are going through I did talk myself out of my first hip..for 3 years ..surgery is so scary but Im so glad I had them done..I do wish you well..

Ladybrown

Thanks all. I think it is the surgery itself that scares me (I actually think that if it doesn't work out well, then at least we will have tried - it's only going to get worse anyway!), but there is no way I can carry on working if this continues. I think what swung it with the physio was the fact that the other knee is deteriorating so quickly now and I am no longer able to manage my back problem well (having been pretty in control of it for over 25 years). Still, no point worrying about it until I see the surgeon, I suppose.