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Knee Replacement Surgery - What You Need To Know From Someone Who Has Been There
BEFORE
Knee Replacement is pretty scary, but you can do it since I, the
biggest baby in the world, did it! After you and your Doctor
have decided you need your knee replaced, it's time to make
preparations.
First and foremost, check with your insurance company to make
sure which benefits you have. Find out specifically how long
they will allow you to stay in the hospital. Many insurance
companies will make you leave the on the fourth day after the
operation and they may send you to a "rehabilitation facility",
which in their jargon could mean a nursing home.
In my experience, I was transferred to the nursing home on a
Friday. This meant I would not be evaluated by their visiting
physical therapist until Monday. Because of that I declined from
a 90 degree bend in my new knee to a 70 degree bend, in just
three days. All my rehab in the hospital had just gone down the
drain and I had to start all over again. Just so you know, you
will be working towards a 125 degree bend after the Knee
Replacement Surgery.
I won't even go into the other down sides of being in nursing
home. One funny thing that did happen is that I was the hot new
chick; remember this is a nursing home. So, it is very important
to know how the insurance company will deal with you before,
during and after the knee surgery.
Call the number on the back of your insurance card and ask the
following questions:
* Find out with whom you are speaking, their position and their
extension number.
* I want to know what benefits I have for a total Knee
Replacement.
* Do I have skilled Physical Therapy benefits in the hospital
where the surgery takes place for the Knee Replacement? Yes or
No? If yes, what are they?
* Do I have Rehabilitation benefits for the Knee Replacement?
Yes or No? If yes, what are they? Where may I go for the
services?
* Do I have Rehabilitation equipment and supplies covered for
the Knee Replacement? Yes or No? If yes, what are they? Is there
a co-pay?
* Do I have ongoing outpatient therapy benefits for after the
Knee Replacement? Yes or No? If yes, what are they? Where may I
go for services?
* Do I have home therapy benefits after the Knee Replacement?
Yes or No? If yes, what are they? Which Home Health agencies may
I use after the Knee Replacement?
To maintain your independence at home, after your Knee
Replacement Surgery, buy a bar refrigerator that will go on a
table next to your bed. This will be invaluable when you do come
home. Stock it with water, sodas, milk, Jell-O's and individual
pudding snacks. Fresh fruit is also a good snack. Purchase the 2
oz boxes of cereals and stack them beside the refrigerator. Put
a large plastic drinking cup next to the bed and weight it with
a golf ball, which will hold plastic utensils, knives, forks and
spoons (the golf ball keeps it from tipping over). Use a plastic
bowl for the cereal and throw it away when you're done.
Bumblebee Tuna makes an individual lunch kit that comes pre-made
with crackers and a little wooden spoon.
These little things will help you feel independent by being able
to get breakfast, snacks and an occasional lunch on your own. It
also gives your care giver a little break. I found that there
were some days that I had no appetite due to pain and/or
medication so I kept a stock of Slim Fast or Boost in the
refrigerator for basic nutrition.
If you smoke, now is the time to stop or at least cut down.
Smoking constricts your blood vessels which is not a good thing
when you're going in for major surgery. If you tend to be a
little over weight try to lose a few pounds. A little less
weight on a new knee joint, means a little less pain. Okay, no
more preaching.
Line up the people that will be helping you after your Knee
Replacement Surgery and, believe me, you will need them. If you
can afford it, hire someone to come in for 4-6 hours a day. They
will help you get out of bed, shower and get dressed. They
prepare your meals, help you with your therapy exercises, keep
you company and give your spouse or significant other, a break.
Interview them now and let them know what your timing is. Your
church would be a good place to find someone, or if you live
near a retirement community, many times they have companions of
their own that are looking for some extra income.
This isn't essential but I think wise. Donate two pints of your
own blood in case of an emergency. Make sure that this is
completed at least a week before the surgery. You have to donate
one pint per week. If you are taking antibiotics wait five days
before giving blood. The blood bank will give you a card with
the unit number on it that you present upon admission to the
hospital.
You will need Grab Bars put into your shower/tub (don't use
your towel bars). Put them in before you have the surgery,
installation is not that difficult and you will be grateful for
the assistance over the next couple of months. This is a major
safety issue. Balance will be tough after your Knee Replacement
Surgery especially the first couple of weeks. You should buy a
shower stool so you can sit while bathing. Your doctor may
supply you with a cast protector to keep your new knee dry.
Purchase three rubber mats, one for in the shower/tub and the
other two to be lined up parallel outside the shower/tub. You do
not want to slip on a wet bathroom floor.
There is a product; a disposable body wash cloth, available that
you can use to bathe in your bed. They can be placed in the
microwave to be heated up and you can use them on days that you
just can't face the shower. They come in packs of eight. While
they say to use all eight for one bathing I found that four were
sufficient. Just close up the remaining four and use save them
for the next time.
You will need a pair of slippers that cover the entire foot with
a non skid bottom, flip flops are just too dangerous. You will
also need a pair of lace up shoes for stability.
Some other items that you may need
are:
* TV with Remote Control
* Telephone/emergency numbers
* A night light for the bathroom
* Handi wipes
* Bedside Commode/Toilet paper
* Tissues
* Dental floss, toothbrush, toothpaste
* Bell to ring for assistance
Another suggestion is to clear all the pathways in your home.
Scatter rugs and cords are often the cause of falls, so are
pillows and magazine. Remove articles from around the bed and
chairs. Keep your pets under control. A dozing cat or a playful
puppy in the wrong area can cause accidents.
Get a manicure, pedicure and haircut. They will be the last for
at least eight weeks. Heck, if you can afford it, throw in a
massage. If you like baths, take a long hot soak with lots of
bubbles. This will be the last time you will be using your tub
for that activity for some time.
Draw up a Living Will Directive and Declaration. Sign a Durable
Power of Attorney/Proxy, and designate a Health Care Surrogate.
These are for your protection and are very important.
Do not take anything valuable. Leave your purse, your wallet,
money and jewelry at home. If you're female bring in a little
make up. It will make you feel better and will take your mind
off your knee for a while. Bring in a book, you may not read it
but at least you'll have something to take your mind off of why
you're there.
DURING AND AFTER YOUR BIG DAY
This is how your day of surgery will progress:
Get to the hospital promptly at the time specified by
the admissions office. Paper work needs to be done before you
are admitted.
After being admitted, you will proceed to the pre-op
room, where the nurses will review your test results and
history. They will get you ready for surgery. Whoever brought
you to the hospital will be able to stay with you to this point.
The nurses will insert an IV before surgery and infuse
your prescribed antibiotic.
You will be wheeled on a gurney to the operating room
"holding area".
This is where you will see the anesthesiologist prior
to surgery. He will ask you how much you weigh. Don't even think
about lying. The amount of anesthesia is based on your weight.
After the surgery you will awaken from the anesthesia
feeling groggy. Your mouth will be dry and there will be pain at
the surgical site. You will be given pain medication and ice
chips.
A bulky bandage and a drain will be present at the site.
You may have compression stockings on both legs to
prevent the risk of blood clots.
Once your blood pressure, pulse and breathing are
stable, you will go to a room in the Orthopedic/Surgical Unit.
The balance of the day is to recover from the surgery. You will
be very tired so sleep as much as you can. It will be annoying
but the nurses will come in very often to check your vital signs
and, yes, they will wake you up. Use this day to sleep, relax
and keep yourself calm. Tomorrow the physical therapy starts.
* You may be able to drink water after surgery when fully awake.
Your diet will be soft and will advance as you can tolerate it.
* Your doctor may have ordered a PCA (Patient Controlled
Analgesia) to control your pain medication, or injections and/or
pain pills. If the PCA is ordered, the nursing staff will
provide additional information about how to use its button.
* Nurses will periodically ask you to rate your pain intensity
on a 0-10 scale. (0=No Pain, 10-worst pain ever). Be honest!
* You will be asked to take deep breaths and cough. You should
do this every 1-2 hours while you are awake to prevent
congestion in your lungs. The doctor may even order an incentive
spirometer to breathe into. Exhale deeply and hold for 3 seconds
and then inhale. Do this 10 times every hour while awake.
* Flex your ankles 10 times every hour while awake to decrease
risk of blood clots in your legs.
* Turn from your back to your sides every couple of hours to
prevent skin irritations and to help circulation.
If you want further information on the specific graphic detail
of the operation go to www.JointReplacement.com. You can get
every last detail there.
Okay, it's the day after surgery and the physical therapy
department knows you're here, they know your room number and
they know the bed number. They will come, ha ha. The therapists
know how to handle you, let them guide you. It's going to be
painful. Try to find out from the nurses what time your therapy
is scheduled, so you can time a pain killer thirty to forty
minutes before they arrive.
Things that should be ordered by your Doctor from a medical
supply store, delivered to your house and covered by insurance:
* Over the toilet commode with arms
* A commode for next to the bed to use at night
* Wheelchair
* Crutches
* Cast/wound protector for the shower
One thing that is very helpful is a "Reacher Arm". It's
invaluable for picking up things that you drop or can't reach.
You must do all the exercises the doctor orders. The more you do
them, the faster you will get back in shape. I will not kid you,
the exercises will hurt but they really are essential. If you
have access to a pool, use it to do aquatic exercises, which
will build up your muscles and ligaments, so it won't hurt as
much.
One last thing, sleep as much as you can. While you sleep your
body heals!
I found this website very helpful with all of my post surgical
needs, I think you will too: www.medicalcheap.com.
Good luck with your replacement and I promise you, it will be
worth it!
About the author:
Mary wrote this article because she felt that a lot of people do
not know what to expect when replacing a knee and few know the
tricks mentioned above. Any of the medical products recommended
in the article can be found at http://www.medicalcheap.com
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