37 year old scheduled TKR in May

[daisey]

Hi All,
     I am 37 yo female and have recently scheduled TKR for Lt knee in May.  I am starting to get nervous about the surgery, but ortho feels this is best option due to my demanding job as paramedic.  This was a hard decision to make...but after it takes days to recover from a busy shift and not wanting to go out for the essentials due to the pain I feel I have made the right decision.  There is not a day that goes by that I do not experience pain and sleeping is out of the question. I have questions about using a femoral or spinal block during surgery -vs- general anesthsia.  What is the best option?  What is the true recovery time?  I am aware that my recover time will be longer than normal due to the demands of my job.  My surgeons only concern is that I will have higher expectations of the TKR than older patients and that I will out live the replacment.  Anyone who has had a TKR before the recommended age please share your experiences. 

[suntan toes]

Daisey,
My suggestion is to read the postings by the others in this forum. The time investment is worth it and take notes on the suggestions.  I have learned so much from this board because everyone has walked the walk.   Most of us are young TKR patients.  As you read through the threads you will realize that all recoveries are different no matter your history.  I am a 45 year old 37 days post op and feel amazing for 5 weeks out.  I had very high expectations for recovery but also had very realistic goals to just be able to do certain things I was unable to do....quality of life.  We are all here to support you and understand the pre-op nerves.  Check out Bombero, she's a young paramedic or firefighter.   READ READ READ!
Eileen

[teachmath912]

Daisey;
I am a 36 year old who is preparing for my 2nd tkr.  I had a left tkr last summer (at 35) and will have my right knee replaced this summer.  I am a teacher so summer is perfect since I have almost 9 weeks off!  Last summer I returned to coaching Varsity soccer just 7 weeks after my knee replacement.  I sat down a little at practice, but was basically on my feet for two 2-hour sessions each day.  The week after that I started school and taught all day before going to a 2-hour practice in the afternoon.  I got tired and my knee would feel a little stiff at times, but I was able to do almost everything I needed to do.  Granted, my job is not as physical as a paramedic, but coaching can be a pretty demanding position sometimes. 
As far as age- my Dr. has informed me that age is just a number and when someone's knee demands a replacement, then it is time to give it a replacement.  You can't spend time worrying about what could happen a few years down the line, you need to just go along with things.
Everyone's recovery is different.  I know there are people on here who talk about having flex of 130 degrees or higher, but every person is different.  My numbers are going to be different than yours and as long as you can do what you need to do, what does it matter what the numbers are? 
I had a spinal with femoral block  for my replacement last summer (and will have it again this summer).  My dr. does not do general anesthesia- but I had enough "Twilight sleep" to not remember anything before or during the surgery.  I woke up to wiggle my toes in recovery and then slept all the way through checking into my room and the next hour or so.
I was told by my Physical Therapists that I pushed it harder than some of their older patients and I often had to be told to slow down.  I got "grounded" twice... But, at the same time, pushing it was what helped me get to where I am now and what helped me have a great recovery.
I know that it is hard to go through this process at our age.  I know that outside of this board, I do not know anybody my age with a total knee replacement so I have no one to talk to about certain things.  That said, if you have any questions feel free to ask!
Good luck!
~ Kit

[daisey]

Thanks EIleen and Kit for the post.  I am trying to keep the nerves under check...but they get out of hand at times.  I just remember that the post-op pain will go away with time and what I am experiencing today will not with out the TKR.  Today has been a really bad day due to a weather change and all the running I needed to do for the Easter holiday.  I have felt like there was a knife jabbing in my knee all day and know that sleep tonight will almost be impossible. I am trying to use the narcotics only when absolutely necessary because I do not want to build a tolerance to them before surgery.  Did any of you do PT before your TKR? 

Thanks again,
Daisey

[Julie42]

Hi Daisey

Yes I had PT before my op they came to my house and gave me a few excercises to strengthen my knee.

Straight leg raises

Bending the knee in from a sitting postition

A rolled up towel under the knee and then straightening the leg.

Legs straight out and pushing the knee into the floor.

Sitting in a chair with your thigh supported and then straightening you leg.

Sitting on a chair with you leg striaight then bending back as far as possible.

These are some of the same excercises you will be given to do after your op.

Hope this helps all the very best

Julie 

[daisey]

Thanks Julie,
     I had an idea that it would probably be the same exercises I did for my other knee surgeries.  I have been doing those over the past few weeks.  I will probably call my ortho and get some orders to meet with PT prior to surgery.  Thanks for the info.

Daisey

[teachmath912]

I did not have PT before my tkr.  I never even had it for any of my other knee surgeries as I have always been so active and have always done so much on my own that my dr. did not worry too much about me being ready. 
Don't stress about things- and as the date gets closer, think positive things!  I have said before that I think recovery is at least 50% mental and the more positive you are, the better off you are going to be.
~ Kit

[Merry]

I have been in PT for over a year..will be about 18 months when I have my BTKRs in May. I could not imagine going through the surgery (and this is just my opinion and for my body) without it. What it also got me is a marvelous PT who has shared the good, bad and ugly with me (you do that after all of this time) and I feel really prepared (knowledgewise) for this. Without a doubt I will be biting my acrylic nails before the big day.

[daisey]

Kit,
    I agree definitely with it being a lot mental.  I am trying to be very positive!!  I got some exercises from PT to do this month before surgery.

Merry,
    I am already biting my acrylic nails...30 days till surgery and counting.  I have started my exercise for surgery.  I have a great PT, who knows how to push my buttons to get me motivated and where I need to be. 

Thanks for all the post,

Daisey

[JamesJamesJames]

Hi Daisey - I've not been on the site for a while but I am just 33 and I had my left TKR last October so I am now 6 months post op.  Like you I was really worried about what if it went wrong but I have to say its the best thing I ever did.  I've always been really active - first damaged my knee playing rugby.  I swim alot to keep fit as it was the one thing that didn't hurt my knee beforehand and I have continued to do a lot of swimming now - this evening I swam 3.75km with no knee pain at all.  Before the op I couldn't sleep or anything but now its perfect. 

I only had 3 PT sessions after surgery and was walking without a limp after about 4 weeks. 

During surgery I had a general and a ful leg nerve block.  In younger patients I believe the risks of a general are not as high - I'd have whichever you feel most comfortable with.

Good luck,

James

[daisey]

James,
     Thanks for the post,  I have been really nervous about this...but it is a big deal.  It helps my feelings to know people are out there going through the same thing.  Since you are at six months post-op I have a few questions.  My PT said I would be back to work on the ambulance in 12 weeks,  but my doc seems to have a different opinion.  He is talking more like 4-6 months just depending on my recovery since I do heavy lifting, lots of stepping up and squatting.  Could you give me an estimate of when you might have been able to do some of these task?  (I know everyone heals different)  I also have a pool and plan on using it lots this summer while I am unable to work.  I have read that it is really good exercise for the knee.  Any info on the recovery you or anyone else can provide please post, all information is appreciated.

Thanks,

Daisey

[Redwing]

  I also have a pool and plan on using it lots this summer while I am unable to work.  I have read that it is really good exercise for the knee.  Any info on the recovery you or anyone else can provide please post, all information is appreciated.

Thanks,

Daisey

Hi Daisey

I'm a swimmer and have been doing a lot of post op work in the pool.  Before my TKR which was 11 weeks ago I swam up to a mile two or three times per week.  This was practically my only exercise as walking was painful due to OA.  At 6 weeks post op I was able to start swimming again with light kicking and can't yet do breaststroke but it's fabulous to be back in the pool.  I do all the physio exercises I've been taught in the water and find it easy and beneficial, all those squats and lunges, walking sideways and backwards, standing on one leg etc.

Lucky you to have your own pool!   

[JamesJamesJames]

Hi Daisey - I was really nervous about it all too and that is only natural.  As your also young I think you will naturally heel quickly.  I think after 12 weeks you would be able to go back to work but you will probably adapt how you kneel which you probably do now already.  For eaxample when you kneel only kneel on one knee if that makes sense.  I do kneel on both knees when I have to but try to avoid if possible.  After about 8 weeks I swam 2.5km and then went on a 5k walk and I was absolutely fine.  To be honest as your going to have a TKR you must be having a lot of knee pain so I'll think from the moment your back in your room you will find that the pain is less than it was before.

Good Luck,

James

[daisey]

Thanks all for the information and encourgment.  As of today it is less than three weeks till the surgery.  I am trying to continue to work until surgery, but after this week I just might not make it.  It seems that the pain has really increased over the past few days and medication does not touch it.  I am so ready to get on the road to recovery. 

Hoping to have a quite, relaxing weekend of being really nice to the knee, except for the fact that I feel like there are hundreds of things that need to be done before surgery.

Thanks,

Daisey

[Plumb]

Just my two cents..  I would always take a doctors advice over a PT's advice.    The doctor is pretty much on target that  at 6 months you would feel on the better side of your recovery to start working in the field again as a paramedic.  Unless you have a sit down job and your biggest demand is getting up to go to a printer.   I say 8-12 weeks you start feeling human again..   But than again..   It all depends on what the outcome of your surgery is.    There are young folks zooming around and young folks who never regain the same range of motion and struggle for every movement.     I am fairly certain your doctor has told you the worse possible outcome and you weighed all the pro's and cons.   3 weeks to the big day..    It is a hard surgery..  I hope it provides you the pain relief and mobility you are seeking .