Pre-admission testing/education for knee replacement

I did my pre-admission testing and educational sessions today for my knee replacement surgery.  There were some interesting things that came up (besides my anxiety level). 

First, I was told by the hospitalist (who assists with all post-op aspects of care other than pain management (which frees up the surgeon's time a bit)) to stop taking my multivitamin immediately (since I am inside the 2-week pre-op window).  I can still take the calcium, iron, B12, etc. but no multi's because the C and E can allegedly contribute to bleeding issues.  Huh?!?  I understand not taking large doses of Vit E, but there is not a lot in even two multivitamins.  When i asked about just decreasing to one until a few days before surgery (seemed reasonable to me), he said he would prefer that i not take any, even when I explained that i was simply replacing vitamins that my body is now not capable of absorbing on its own (as people with a normal digestive system can).... not supplementing on top of what I woild normally get from food.  I haven't decided whether to follow this or not... I will probably drop back to one rather than taking nothing.

Second, the head nurse for the joint program indicated that everyone whose surgeon had suggested losing a bit of weight prior to surgery should continue to make an effort to lose a little bit of weight in whatever time they had left before surgery (1-3 weeks) because even a small amount of weight loss has been shown to make a tremendous difference in the amount of post-op pain and healing time.  That's not really "news", of course, but it made me feel less stressed about how much just the arthroscopic meniscus surgery hurt a number of years ago when I was about twice my current weight.

Third, we were told that the joint center in this hospital system (which has a variety of recognitions and is third in volume of knee and hip replacements in the state) discontinued using the continuous passive motion machines after knee replacements over a year ago because the evidence on the effectiveness of it is extremely mixed and they found that some patients justified not following orders regarding being up and around because they believed that the machine was sufficient.  I don't really care much either way, but I thought others might be interested.

Finally, they had trouble doing the EKG because the scar tissue is so thick right underneath and between my breasts from where the tummy tuck incision (a reverse tummy tuck, so a true "T" shaped incision) turned necrotic and took so long to heal up. The one lead wouldn't give them a reading.  It took two people six tries to get what they needed.

Oh, yeah... I also discovered that I have the worst possible house and furniture for recuperating from knee replacement surgery.  Five steps just to get to the kitchen, 9 more to get to full bath and bedroom, high beds, no chairs with stiff arms to push up on when rising from a seated position, and a walk-in shower in a tiny separate part of the bathroom with the toilet  where there isn't really room to maneuver a walker.  Not to mention a Chow puppy who is always underfoot (Chows are ALWAYS in the way, even as adults... They just expect YOU to walk around THEM).  Sigh...  

Lora

You are so brave.  I need knee replacement in both knees and I am terrified.  Having meniscus surgery 2 years ago terrified me.  

I need knee replacements as well (both) but want to lose as much poundage as possible first...I'm aiming for this summer as my niece will be off work then and can help me out.  Hoping to lose another 20 lbs by then. 

Isn't it nice you have lost weight already and are set to go in that respect, one less stressor for you Lora.   Your home sounds about as convenient as mine! 

Best to you.  I've never heard of cutting out multi vits before surgery either.

Lizzie S in OR

Lots of good information.  Can you get a 4 wheeled walker  withnanseat to sit on. Mthat way you can carry things from room to room, and sit as needed and the seat is high enough t make sit to stand easier.  Also, you will need a good cane to negotiate all those stairs.  Maybe good to have a walker on each floor.  I am so glad that you are going through with this and that the anxiety is not taking the lead!  Blessings!  Allison

They actually don't "allow" walkers with 4 wheels... too little stablity and too high a risk for falling. They prefer walkers with NO wheels, but will permit you to use one with two if you already have one.  Also, apparently, the wheels make it impossible to use the folded walker to navigate stairs (makes sense, I guess, since wheels moving on the step would be dangerous.)

They told us they would prefer using crutches instead of a cane as a transitional device for stairs.  I didn't ask why since I already have crutches.

Lora

I also have a home that is difficult to maneuver with a walker.  My bedroom was a real pain when I had my hip originally replaced two years ago as it is up three steps and there is no room to get the walker to the side of the bed, so I moved into the living room and have both the recliner and couch covered as beds.  My half-bath is easy to get to, so I have it set up for washing myself outside the tub.  This is the bath where I put the toilet seat riser (and you will need one of them for sure).  When I need a little more cleaning and shampoos, I have a bath chair that goes in the tub and I have a hand shower.

I think you are going to find that the replacement is actually not as painful as the artheroscopy.  As a former cardiopulmonary person who did umpteen EKGs a day, I cannot imagine such ineptness.  Even with horrid mastectomy scars and other scars, I never had any issues wuth obtaining a good EKG.  There is room to maneuver leads.

You will be fine.

i am a nurse on a joint replacement unit. I  haven't seen CPM machines in use in several years. Depending on what time your surgery is, you will actually be up,  at least for a few steps not very long after surgery with PT.  If you hit the floor later  the day you will start early the next morning. There will also be exercises that you do on your own in bed. The biggest piece of advice l can give to you is to stay on top of pain control. A lot of people wait too long to speak up when they are hurting. We are given  various options of how we manage pain.  It is hard to play catch up with that sort of pain and it will affect therapy/recovery. 

Lora-

I had my meniscus removed last week. The Dr. also told me I had to stop my vitamins a week prior because of bleeding. I went ahead and stopped them. I figured one week without them wasn't going to hurt me. I guess I was very lucky, I had very little pain after the surgery. Even so, it turns out it didn't work. My knee is still locking up. At least when I have the total done it will be minimally invasive and he doesn't cut the muscle, he goes underneath. He says it cuts down on pain and down time. It made me feel a little less apprehensive about having the surgery. 

My wife has had both knees replaced. Each one year apart. All I can recommend is to be real aggressive on the physical therapy which I assume you are scheduled for. Her first knee they used the motion machine and therapy but the technician was not that aggressive. That first knee gives her some problems still after 8 years. The second knee they did not use the motion machine but the therapist was very aggressive and had her crying several times, but that knee is perfect with no problems at all. So be sure and do all exercises as instructed and make sure you get a good work out for the knee. Years from now you will be thankful. Have fun going on an airplane or to a national monument and having the agents there inspect you. They just about strip my wife when her knees set off the alarm at the airports.

Lora, I will be praying for your surgery and for your quick recovery!! I agree with Larry and have always been a strong believer that you recuperate faster and better when you stay active and push yourself a little bit. I'm not saying run a marathon but movement helps with the healing.