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Author Topic: Planning surgery? Some things to plan ahead before you go.  (Read 870 times)

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Offline LindaM

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Planning surgery? Some things to plan ahead before you go.
« on: February 27, 2012, 10:44:48 PM »
Hi there,

Sorry to hear you may need surgery, but I hope yours goes very well and you have an easy recovery like I have.  My name is Linda and I have had 4 orthopedic surgeries in the last 4 years.  I think I was well prepared going in knowing about the repairs that needed to be done, but when I headed home I was totally unprepared for some of the things that happened(except for this last PKR).  I am writing these suggestions for you so your post-surgery plans go more smoothly than mine.

For my first surgery (ankle tendon transplant) I had the house sparkling, meals in the freezer, a wedge of blankets built up on my bed reaching from my hips and about 8 inches high at the end to elevate my feet.  I thought I was set to go.  MISTAKE! I forgot to figure out how I was going to get into the house!  When I arrived home somewhat groggy on crutches (it was day surgery) and absolutely no weight bearing on my operated ankle I looked at the steps like Mt. Everest.  There was no railing, or handhold, I wasn't very skilled on crutches, and the second step included stepping over a raised threshold. I ended up hopping into the house with my husband poised to help if I fell.  I was lucky not to break the other ankle.
 SUGGESTION: Plan you strategy to enter and exit the house.  Grab bars are cheap and easy to install.  Do you have stairs to climb to the bedroom or stairs between your bedroom and bathroom?  You may need to move a bed to the first floor for a few weeks.  Can you safely exit the house in an emergency by yourself?  If not you may want to have someone stay with you until you can.

Once in the house I crawled in bed, and hooked up the ice machine.  What a godsend!  What I hadn't planned for was the amount of ice it used.  I thought our ice-maker on the fridge could keep up.  Not true.  I used a 20 pound bag up every day and a half.
SUGGESTION: Make room in the freezer ahead of time for all that ice and have a bag waiting when you get home. 

Big surprise here-surgery hurts.  You will be given pain medication, but expect that there will still be some pain.  If the level becomes intolerable don't just be a martyr-call your doctor even if it is 11 P.M. on a weekend.  There will be someone on call who can help.  Over the last four surgeries I have used several different medications for pain.  Two kept me up all night, one made me nauseous, and one was perfect- took care of the pain and didn't even make me feel tired.  Every body is different and what works for me may not work for you, so get something that works.  Also a caution for in the hospital pain relief- if your pain seems to be increasing talk to the nurse (and call your doctor if she blows you off).  My sister had self-administered morphine last surgery but spent a miserable night pushing the button with no relief only to find out in the morning the thing was clogged.  HERE IS THE GOOD NEWS ABOUT SURGERY PAIN.  IT GOES AWAY.  I felt so much better after my first PKR leaving the hospital the next day that we ran three errands and went out to lunch before going home(and it wasn't the drugs).
SUGGESTION: Plan ahead with your surgeon what medication you will be taking and who to call if there are problems.

Knee surgery will leave you at the very least stiff and sore.  You may not trust your knee to hold you right away.
SUGGESTION: Practice with crutches or a walker ahead of time.  At the very least, go to the AAOS website and learn how to use them properly before you need to.

The first night home is the hardest whether you have had day surgery or inpatient surgery.  They have pumped you full of IVs, and now you are home and have to go to the bathroom every hour!  My considerate husband moved to the guest room so I wasn't accidentally bumped or disturbed, but he slept through my calls for help to get up.  I had to get up on my crutches (no weight bearing with a cast) and go down the hall without help that first time and it was not easy.
SUGGESTION:  Keep your cell phone next to your bed and make sure he has one as well so you can get the help you need, especially at night.  And get yourself a raised toilet seat before you go for surgery.  You will need it.

I never had much bruising from my first two surgeries, but when I had my first PKR I got a shock.  I was put on a blood thinner to prevent clots like most folks are with a replacement.  I just didn't realize that it would cause me to bruise so much or continue to get worse for a couple of days after surgery.  This last PKR I started with a bruise the size of my palm when I went home that grew to about 6 times that large over the next 3 days.  It goes away pretty quickly, but I don't want you to be worried whether something has gone wrong like I did the first time.
SUGGESTION:  This time my PT put kineseotape on my bruises and they went away in a week.  Look it up on the internet.  It really works.  Helps with swelling too.

Most likely you will be prescribed some physical therapy.  You will be moving almost immediately after surgery and really need to keep up your exercise regimen.  Don't think for a moment that skipping your second set of exercises for the day won't have consequences.  You are trying to get back to 100 % and you won't without 100% effort.  You have been limping for a while, and all that limping has left you with muscle weakness and an uneven gait.  It is going to be work but it will be worth it to get back to normal.  Your PT may ask you to do the impossible.  Physical therapy sometimes hurts.  Try your best.  If after icing and a day's rest you feel excessive pain, back off on that one exercise only until you see your PT again.  Don't stop doing everything.  Your exercises are helping you avoid the development of scar tissue that will limit your range of motion.
SUGGESTION:  If you for some reason aren't prescribed PT or can't afford it, there are tons of youtube videos made by physical therapists demonstrating appropriate exercises for knee issues.  Just google exercises for your problem.

For the first week or so while you are on pain meds you won't be driving, but if you are anything like me as soon as you are feeling a little better you will start to get sick of daytime tv and pulp fiction and want to get out.  Even after I was fine walking around the house and could drive(about 1 1/2 weeks after PKR), walking any distance was a challenge.
SUGGESTION: If your surgery is going to have a recovery period longer than a couple of weeks, ask your surgeon for a form for a handicapped sticker to take to the Department of Motor Vehicles.  You are probably already in a lot of pain or you wouldn't be having surgery.  Get it right away and you will find life a little easier as you wait for your surgery date as well.

As I said earlier, my surgeries were uneventful as most are and I pray for the success of yours.  Hopefully these suggestions and any that other members post in the future will help make your experience as you recover a little simpler.

Linda

 

 
>20 yrs. osteo and inflammatory arthritis, fibromyalgia
meniscus repair Sept. 2009
right PKR June 2010
left PKR Feb. 2012

Offline DennisKnee

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Re: Planning surgery? Some things to plan ahead before you go.
« Reply #1 on: February 27, 2012, 11:47:59 PM »
Linda,

A different surgery coming up for me but some fantastic suggestions nonetheless! I'm already peeping the kineseotape - hadn't heard of that before so thanks for sharing your experience. I certainly found it valuable. I am extremely fortunate in that my work will be sending an OT and PT to my house to make any necessary adjustments prior to my next op just to make life that little bit easier - non-slip mats, shower chairs, handrails etc so I'll be sure to mention a few things you have raised.

 :) Karen
Sep 10 - confirmed ACL & medial meniscus tear
Dec 11 - chronic patellar dislocation - MPFL tear
23 Feb 12 - scope, MUA & 50% medial meniscectomy
17 Apr 12 - ACLr and MPFLr

Offline LindaM

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Re: Planning surgery? Some things to plan ahead before you go.
« Reply #2 on: February 28, 2012, 09:15:03 PM »
Hi Karen,

You certainly have had your share of knee issues already.  Hope you are recovering well from the meniscus surgery.  And how wonderful to get both OT and PT at home.  Great PT is the key to recovery in my opinion.  Good luck with you future surgery as well.

Thanks too for mentioning the mats and shower chairs.

Linda
>20 yrs. osteo and inflammatory arthritis, fibromyalgia
meniscus repair Sept. 2009
right PKR June 2010
left PKR Feb. 2012

Offline ShoeCrazy

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Re: Planning surgery? Some things to plan ahead before you go.
« Reply #3 on: March 01, 2012, 01:02:26 AM »
Hi Linda

Definitely great suggestions for planning knee surgeries! Oh the things we wished we had known before having to go through them. I am sure your post will help many!

I am soon going through #2 on my knee. Trying to learn from my past history and reading everyone's experiences on this site.

I have trouble with pain meds and was wondering if you could share what work well for you? I am hoping for an easier recovery this time around!

Thanks
3/8/11 Broke right patella
5/8/11 Surgery- 2 pins, figure 8 wire, zimmersplint 24/7, no weight bear
17/8/11 Staples out
13/9/11 splint off, weight bear & start physiox2 week
17/11/11 OS recommends MUA on 5/12/11(canceled)
18/12/11  JAS
02/03/12  Scope, debridement & MUA
23/04/12  125 rom

Offline LindaM

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Re: Planning surgery? Some things to plan ahead before you go.
« Reply #4 on: March 01, 2012, 07:19:55 PM »
Hi Shoecrazy,

I have no idea what you have taken and why it wasn't effective for you, but all the medications I have tried have worked well for the pain, I just have had problems (not common) with side effects.  Hydrocodone has worked fine for mild-moderate pain but it keeps me awake.  Same for Oxycodone which took great care of post-surgery pain.  For most people they tend to put you to sleep, but I get insomnia from both.  My OS has also prescribed a 12 hour time release Oxycontin(doubled up with Hydromorpon for the first 5 days after surgery), but for 7 of the 12 hours I was very nauseated by it.  Again, great for pain.  The one that has been my most effective has been Hydromorphon, but most doctors are very reluctant to prescribe it since it is the most addicting.  I am sure that if something else had worked for me my OS wouldn't prescribe it either.  You can find the relative effectiveness for doses of these and others as well as the prescribing information on the internet.  I wouldn't consider taking any medication until I had read the prescribing information myself.

If you talk with your OS before your surgery about pain management hopefully this next surgery will go better.  Best of luck!

Linda


>20 yrs. osteo and inflammatory arthritis, fibromyalgia
meniscus repair Sept. 2009
right PKR June 2010
left PKR Feb. 2012

Offline ShoeCrazy

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Re: Planning surgery? Some things to plan ahead before you go.
« Reply #5 on: March 05, 2012, 12:03:03 AM »
Thanks for your reply Linda.
I tried all of those after my surgery. At the top dose they were ineffective(only for about 20 min) for pain. Then the pain got ahead so everything else made me vomit. Three days in a row, and I had enough. Pain is one thing but not able to to eat or drink anything and keep it down was worse.

Thankfully this second time was a totally different experience. No nausea after the general and really no pain! :)
Didn't really feel any soreness until 24 hrs after the scope/MUA.

You're right in that it can make a world of difference when you can plan ahead and speak to the doctors before you have a procedure. And they listen to you!!!

SC
3/8/11 Broke right patella
5/8/11 Surgery- 2 pins, figure 8 wire, zimmersplint 24/7, no weight bear
17/8/11 Staples out
13/9/11 splint off, weight bear & start physiox2 week
17/11/11 OS recommends MUA on 5/12/11(canceled)
18/12/11  JAS
02/03/12  Scope, debridement & MUA
23/04/12  125 rom















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