Knee Replacement Surgery - What You Need To Know From Someone Who Has Been There
By Mary Hanna
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
"A night light for the bathroom
"Bedside Commode/Toilet paper
"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.
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
"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
Copyright © 2005 Mary Hanna All Rights Reserved.
Mary Hanna writes eBooks, Software Reviews (for people who are technically challenged like her) and Practical Articles on Internet Marketing, Cruising, Gardening and Cooking. 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 a very helpful medical supply store: http://www.medicalcheap.com.
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