Finally, your doctor has sent you to a specialist and the decision has been made that there is no alternative but to do a total knee replacement. The scenario is likely preceded by bone on bone arthritis, a tissue injury or both. Likely, you have struggled for some years with pain upon movement, sleepless nights and decreased life activity. It is also likely that prior to a replacement being an option for you, you have decided a life of sewing, knitting and reading is now carved out and no longer can you enjoy the pleasures of dog walking, hiking and gardening. Vacuuming and grocery shopping are no longer an option. Sure, your doctor says go swimming but by this point, who has the energy and besides, with the grief of life change, the motivation certainly is not present.
As surgery becomes a reality, you must start to prepare. There are dietary measures, physical measures, practical measures and emotional measures that can be taken to prepare for the event. Particularly for women and if a doctor recommends it, an iron supplement may be needed. This can be diagnosed by a blood test. As well, for most, a vitamin supplement and Vitamin C and D can be helpful, as well as Vitamin B12. If you are taking glucosamine, remember it is an anti-inflammatory and needs to be stopped 10 days before surgery, to help with blood clotting. This is imperative for any non steroidal anti-inflammatories as well, such as Ibuprofen.The hospital will likely ask you to make arrangements for access specific medication that keeps blood clots down, post-op. You can expect to take this up to two weeks post surgery and they will want to make certain it is available to you in your area if prescribed. Prepare yourself for either a spinal anesthetic or a general and ask which will be administered in your case.Each surgeon is different and they will guide you. Absolutely quit smoking and decrease alcohol and marijuana use. Consult your doctor if you are on major pain medication prior to surgery. These all affect the anesthetic.
There are likely classes in yuor area to help you prepare for before and after surgery. It is recommended that you attend. You can enquire at a hospital near you.
It is important to have a balanced diet in the months leading up to surgery. Fruits and vegetables have healing properties, dairy products help keep your calcium level up, to heal the bone tissue, and certain foods can enhance the uptake of iron, particularly certain proteins.It is helpful to consult a dietician for specific examples.
Muscle strength will be key to healing and will need to be incorporated into a daily exercise schedule after surgery, so it is helpful to start prior to surgery. Arm strength is of particular importance to help you sit up, hold yourself with the walker and on crutches and get up and down off the toilet post surgery. Without upper body strength you will find it extremely difficult to move and function. As well, one of the muscles that is greatly affected post surgery is the thigh muscle. Generally, it is sliced to allow for the new knee to be attached to the thigh bone and shin bone.Physio after surgery is largely focused on re-developing the thigh strength as it will feel like you have lost all leg strength and are starting from scratch. As well, because you will be relying on the healthy leg, you will need strength from it.
Practically, you will need to set up physio sessions twice a week prior to surgery so make a phone call regarding that.In BC, Canada, you are given twelve physio appointments covered by health care. Check your specific medical coverage. As well, make sure you have a walker and crutches to use with the possibiltiy of a cane down the road, although you may find canes are not stable enough for you. You may also need a raised toilet seat and a bench seat for teh shower. The Red Cross can provide these for you if you provide a small donation and will lend items for up to three months. Or, you can buy these items at a medical supply store.You may also want to think about whether you will need hand rails placed in the bathroom. The walker and crutches must go with you to the hospital as the physiotherapist will want to make sure they are adjusted to you.You can expect to be asked to get up the first day after surgery and start to be mobile.
In addition, prepare for being in hospital up to five days post surgery, although the regular timeframe depending on your health is 3-4 days post-op. Make sure you are aware of any medication sensitivities or allergies. For some, the pain medication causes nausea, so do not be surprised if this happens in your case. You will need to have a helper with you to drive you home from hospital and stay with you for 2-3 days. This is major surgery and you will be tired from the anesthetic and it takes a while for your system to flush it out. You will need to have ice packs on hand. This is the most effective way to keep the pain down and enhance healing.Have more than one so one can be in the freezer while the other is in use. Keeping the inflammation down is one of the most important things you can do to heal after surgery.
At an emotional level, it is hard to prepare. Chronic pain leading to the operation is exhausting and rest is really important. Feeling positive about the surgery is key, but if you have been experiencing signs of depression and hopelessness, consult your doctor as depression goes hand in hand with chronic pain. You can look forward to the pain alleviating several months post-op. Likely you will want to take 8-12 weeks off work to heal and you will not be driving for at least the first six weeks. Lowering your expectations around the house and yard and of yourself is necessary while healing. Taking on the perspective of the proper timing of things and acceptance can help with the frustrating moments while healing. Have some good books on hand and some favorite movies to watch to help distract you from the pain and healing process. Do not over schedule yourself once you are home. You will likely need 2 short naps a day for the first while. You will need to schedule in time for your exercises each day.
You can see it takes some preparation to help you adjust to knee surgery of this capacity. It is quite an event but I certainly have not regretted undergoing the surgery. It has been three months now and the healing is going well, thanks to the prep work, the physio and a good surgeon.
Read this: Hyperextended Knee Symptoms and Treatment
