Yet another knee surgery thread

[SonofCohoes]

If you've never had synvisc before you may get some partial relief, however, that product takes a few days to work. I've had several rounds with each treatment being 3-5 injections but don't get relief anymore.

I'm due for new knees but have been putting it off until fire. I think I can stand it another year or so. A good friend had both his done a year apart, he sent me pictures of him skiing this winter. I couldn't even think about skiing now.

Go for it ASAP, you won't regret it.

 

[MBSC]

So, I am speculating that maybe Medicare requires one or two cheaper options to be tried before they will pay for surgery. Who knows? Not me.

Medicare's standard requirements prior to surgery are NSAID/injections, use of a brace/cane/walker, and 12 weeks of PT. If the Medicare enrollee reports the PT is too painful to complete, a waiver can be granted with documentation from the provider.

 

[eytonxav]

My friends wife (about same age as you), had knee surgery about 1.5 years ago for one knee, and then last month had the other knee done. I know she was very diligent about losing weight and doing her rehab work post surgery. She was delighted with both outcomes. I believe she got custom knee replacements vs some of the off the shelf type replacements.

I know you are very diligent in working out, so hopefully dropping some additional lbs and rehabbing post surgery will be very easy for you, best of luck.

 

[Bingie]

My sister at 68 last year had both knees replaced at the SAME time. The surgery was harder on me and DH than her...I suffered greatly. She has custody of a nine year old grandchild !!!! I was also the caregiver for both of them and driver for all appointments. Sister did fine and was even driving to her PT in three weeks. She did use a walker for about two weeks and her house was already set up for handicap. Have a good support system for after care and you will be better than new after a few weeks.

 

[W2R]

Thanks, Bamaman. I probably let it go too long, but hopefully the doctor can help. He has great qualifications and his patients seem to love him. I hope your DW can find some relief. Her situation sounds pretty dire.

Right now I picking up the Meloxicam he wants me to take in the meantime, and cut back on my morning coffee since NSAIDS usually mess with my stomache. Actually I am glad he wants me to lose 25 pounds because I wanted to do that anyway and that is a reasonable goal.

 

[Lsbcal]

...
For now, the surgeon gave me an NSAID to take until my next appointment and I will be dropping 25 pounds ASAP.
...

This comment stuck out for me. How are you going to do this W2R? Would be real tough I would imagine if you cannot do active things like walking to increase calorie burning. Maybe a lot of heavy swimming? If you are going to increase activity, my only advice is to ramp up slowly to avoid overuse injuries.

W2R, I wish you all the luck with the knee issues. There are plenty of people here with good experience and possibly useful advice.

 

[Meadbh]

My sympathies, W2R.

As it happens, I have just been reviewing the literature on the outcome of knee replacement for a friend. The results are generally excellent and over 90% of prostheses are still working even 15-20 years after the surgery. Most people achieve significant improvements in pain and mobility (about 30% better) but 10-34% of people report some ongoing pain. Approximately 85% of people are satisfied with the result and 15% are not (you can't please everyone). Aquatic resistance training helps mobility during the first three months after surgery but the effect is lost if people stop going. People who said they couldn't lose weight because of their painful knees didn't lose weight after surgery either. High impact sports such as skiing are not advised after knee replacement, but golf is fine and handicap may improve!

I'm sure you will do well because you are motivated and have Frank for support.

 

[REWahoo]

1. Pick a surgeon who's done thousands of surgeries.
2. Do the PT religiously.

^ What he said.

One other very important thing to check is the post-surgery infection rate for the hospital:

Your Risk of Infection After Knee Replacement Depends on Your Hospital

 

[W2R]

This comment stuck out for me. How are you going to do this W2R? Would be real tough I would imagine if you cannot do active things like walking to increase calorie burning. Maybe a lot of heavy swimming? If you are going to increase activity, my only advice is to ramp up slowly to avoid overuse injuries.

W2R, I wish you all the luck with the knee issues. There are plenty of people here with good experience and possibly useful advice.

Thank you! I'm going to count calories and do what I can as far as exercise. My gym has an "arm bicycle", and now that I am using the walker I can probably manage to walk far enough to get to it. Swimming is another good idea and one that my internist suggested. I have a stationary bike at home, and if my knees are shot anyway I tend to think maybe it doesn't matter if it makes my knees hurt. But it would be more sensible to use the arm bicycle I would imagine.

Meadbh, thanks, great post and great input! It's encouraging to read how successful these surgeries often are.

ReWahoo, I'll try to find out about the infection rate and I'll read your link carefully. Right now, F is coming over so I've got to skedaddle (sp?). The hospital is the biggest with the best reputation in the area, but who knows about the infection rate so I'll look into it.


Sorry I didn't answer everybody! I'll get back to the thread in a few hours. Your posts have been outstanding and I promise I will read and carefully reflect on each and every one of them.

 

[braumeister]

A good friend was recently visiting, and we spoke quite a bit about this. He's 76 and had both knees replaced years ago, and just had his second hip replacement last Spring.

He does pretty well, except for one of the knees that still gives him some trouble when standing up from a chair.

His main point was that if he skips one day of his PT exercises, it takes him nearly a week to get caught up again. He often does his daily exercises twice some days, just because he understands how important it is.

So PT seems to be the key. FWIW, he has never been an athletic type person, but also has never been really overweight.

 

[braumeister]

My gym has an "arm bicycle", and now that I am using the walker I can probably manage to walk far enough to get to it.

You might already have experience with them, but if not you could also consider a rowing machine. Most gyms have them (like the Concept2 that I bought after reading haha's experience with his). I can get a great aerobic workout on it with very little stress on my joints.

 

[Walt34]

W2R, I will be reading your posts about this with great interest since I'm fairly sure there is a knee replacement in my future as well. My mother had three (one done twice after it wore out) but that was nearly 20 years ago. I'm sure they're better now.

Still, like you, I'm not keen on somebody cutting out an important joint and replacing it with something I don't know much about.

 

[braumeister]

I'm not keen on somebody cutting out an important joint and replacing it with something I don't know much about.

How could it possibly be as scary as cataract surgery? That turned out to be a snap (to my astonishment), so the knee replacement for some reason doesn't worry me nearly as much.

 

[Ronstar]

You might already have experience with them, but if not you could also consider a rowing machine. Most gyms have them (like the Concept2 that I bought after reading haha's experience with his). I can get a great aerobic workout on it with very little stress on my joints.

Wouldn't a rowing machine be rough for someone with bad knees?


Sent from my iPhone .using Early Retirement .//82339)

 

[W2R]

Amethyst, I'm going to lose weight by counting calories and doing whatever workouts I can tolerate. Obviously no walking and right now and even a brief time on the stationary bike at the lowest intensity is enough to mess me up for several days.
　
Braumeister, I think that even the Concept 2 would probably be too much for me right now, but I will try it. Sounds like PT would have to be part of my daily regimen for the rest of my life.
　
Donheff, thanks for the idea to look for those "knee and hip kits" on Amazon. I do love Amazon! I'll also check concerning the raised toilet seat and stock up on Miralax. If the sweet spot is in one's late 60's, then I'm there since I am 68.
　
SonofCohoes, thanks for the report on Synvisc. If that works I'll be in 7th Heaven, although I'm not counting on it, but still. It would be great to not have to have the surgeries. If you are close to Medicare age, that might be another reason to put off knee surgery since apparently they pay for the whole thing or very nearly so.

Medicare's standard requirements prior to surgery are NSAID/injections, use of a brace/cane/walker, and 12 weeks of PT. If the Medicare enrollee reports the PT is too painful to complete, a waiver can be granted with documentation from the provider.

MBSC, thanks so much!! I just KNEW somebody here would have that information, and you came up with it, and I am so grateful. That is very helpful. I will have had the NSAID and injections and I will have been using my walker for some time before surgery. He didn't mention PT but probably thinks it would be too painful to complete. I tend to think so too given my condition at this point. But he works with a staff of physical therapists and if he wants me to give it a whirl, I'll do that too.
　
DFW_M5, I am hoping that my results are like those of your friend! I do plan to follow whatever my doctor wants me to do because I'd love to end up with good results like that.
　
Bingie, that does sound like a lot of work for you and your DH! Glad to read that it wasn't as hard on her as it was for you two. At first I didn't like the idea of having both knees replaced at once, but now I am thinking that is a possibility if I stay in rehab afterwards, and then I'd be done with the whole thing. Hmm. I'll discuss with the doctor when the time comes to make these decisions.

W2R, I will be reading your posts about this with great interest since I'm fairly sure there is a knee replacement in my future as well. My mother had three (one done twice after it wore out) but that was nearly 20 years ago. I'm sure they're better now.

Still, like you, I'm not keen on somebody cutting out an important joint and replacing it with something I don't know much about.

+100000
Walt, I am the same about this. My knees have been hurting for 19 years but I was determined to "tough it out". It finally got to the point where the problem was not toughing out pain, but immobility. For me it was like a cliff, with things deteriorating very rapidly in the past year or two. You'll know when you get there because if you tried standing too long or walking too far, along with hurting you would just collapse. (I visualize a cartoon x-ray, showing an empty space inside my knee instead of a joint). So I am at a brick wall and decided now is the time. I am glad that I waited because I can only see two paths: what the surgeon does for me, or becoming wheelchair bound from here on out. There's no way that the results of surgery could be any worse than that, so I will have no regrets no matter the outcome. Well, assuming I survive, which sounds like a very likely outcome according to Meadbh's post above and the high success rate of TKR surgeries.

If I forgot anybody, trust me, I read and thought about what you posted and I thank you very much for your insights and input. I'm just a little scattered in these responses.
　
　

 

[Walt34]

Medicare's standard requirements prior to surgery are NSAID/injections, use of a brace/cane/walker, and 12 weeks of PT. If the Medicare enrollee reports the PT is too painful to complete, a waiver can be granted with documentation from the provider.

I'm pretty sure they require the cheapest options be tried first, which makes sense. Before I could have the cardiac ablation (a six or seven hour procedure and definitely not cheap) I had to try and fail two out of three drugs for afib. One didn't work and the other made me weak and short of breath. Only then was I a candidate for the ablation.

 

[braumeister]

Wouldn't a rowing machine be rough for someone with bad knees?

I don't know, but I don't think so. It's often recommended because it's so much less stress than running, walking or other upright activities.

 

[nuke_diver]

I know several people who have had knee replacement and every one of them is glad they did. Only 1 person had some issues with one of her knee replacements and had to get it redone (sadly I don't know much details outside of that). But she is very happy now and walks 2-3 miles a day without a cane. She is in her mid 70's.

Losing the weight might help some but not if they are too far gone. Still according to some information I had during my last knee surgery 25lbs of extra weight results in 3X more force on the knees. So less is going to be better.

My grandmother had bad knees but they didn't think her heart could handle the surgery and she likely wouldn't live that long anyways...I think she was in her 70's at the time....she made it to 97 but those last few years were hard because she was always in pain

 

[Moemg]

My Mother had a knee replacement at 92 and did fine . She aced rehab and then was able to walk without a cane for a few years until falls scared her into using the cane .

 

[Amethyst]

Re meloxicam: I took it for a shoulder issue that had been hurting for months (it's better now) and wow, did it work. Knocked the pain right out. Did not upset my stomach. Your situation is obviously much more dire but I hope you get good relief from this drug.

Re weight loss: although technically not overweight, I was almost 10 pounds heavier than my usual weight some years ago, and my feet were aching constantly. When I gave up sweets to try to save my teeth, I dropped seven pounds, and my feet stopped aching. So weight loss can help pain in some cases. GOOD LUCK - you are very disciplined financially, so you can do this thing too!

 

[W2R]

Thanks, Amethyst.

Meloxicam seems to be working very nicely for me, and while it doesn't remove the pain it has taken the edge off. What a relief even a little damping of pain can be.

Because the pain is less with Meloxicam, I can ride my stationary bike a little at the lowest intensity. I want to exercise as well as count calories because I am supposed to lose 25 pounds for the surgery.

I could be totally trashing my knees by doing this, but hey, they are already trashed, so why not.

 

[mamadogmamacat]

To avoid the risk of any further knee trashing, suggest you see if the PT at your Dr office can give you some appropriate exercises. For my muscle strengthening, I have a dozen or so different exercises. With 10 to 20 rep's each, it makes for a decent workout, apart from the muscle strengthening aspect.

 

[W2R]

To avoid the risk of any further knee trashing, suggest you see if the PT at your Dr office can give you some appropriate exercises. For my muscle strengthening, I have a dozen or so different exercises. With 10 to 20 rep's each, it makes for a decent workout, apart from the muscle strengthening aspect.

But does it really matter? My thinking is that if my knees are going to be replaced, so what if they are trashed more than they are now? Out with the old, in with the new.


Well, you're probably right. I will find out tomorrow how much pain results from doing this and I may find that this is not a good idea.

 

[Marita40]

I had a bone spur taken off my big toe last March. It was the first time I'd ever been to PT and was initially surprised when most of the exercises were for strengthening the ankle and legs. But of course it made sense in the long run.
I don't have knee issues but gained weight because of nearly a year of inactivity with first a slow healing broken foot and then toe surgery. I'm having a hard time losing it. So I sympathize with your need to lose weight. I sure wish there was a magic bullet. While the knee replacement sounds daunting most people apparently do very well with it.

 

[mamadogmamacat]

I was actually focusing in the pain aspect. Particularly, if you do not replace both knees at the same time. With recovery, it may be at least a few months between surgeries.