I FINALLY saw a knee doctor—and in fact, let me pause to say what specifically I mean by “finally,” here. (TLDR: After roughly 10 years. You can skip to the next paragraph.) I don’t know exactly when my knee issues began, but I know it was more than seven years ago, because it was more than seven years ago that I was having enough trouble walking that I was willing to try the keto diet to help with inflammation, in case that was the issue and in case keto could help with that. I had already mentioned the problem to my doctor at AT LEAST one annual visit and had her brush it off (yes, yes, it has occurred to me to switch doctors, and I am working on it, for this as well as other reasons) (I do love her, which makes it difficult), and my assumption is it was more than one annual visit of mentioning, because I had gotten to the point that I was willing to take a fairly drastic experimental measure on my own. It was just over one year ago that she finally did an x-ray (and only after saying for the second year in a row “Well, we COULD do an x-ray, but I don’t think that’s necessary”—but that second time I was ready for her, and cut her off after the word x-ray and said “Yes, let’s do that! That sounds good! Yes!”), and she added that I could try turmeric, or maybe glucosamine & chondroitin, or a periodic regimen of ibuprofen. It was two months or so ago that she did a second x-ray and said it was time to see an orthopedic doctor. It was only today that I saw an orthopedic doctor. That is what I mean when I say finally. It has been some time. My guess is that it has been roughly a decade of knee issues.
I was stressed about the visit, in part because I thought there might be a long path ahead, or a lot of treatment options. That he might say, “Well, we could do THIS with THIS percent chance of success, or we could try physical therapy and then maybe cortisone shots, or I could give you a referral to this OTHER specialist, or we could…” etc. Or I thought he might say, “You are only 50! It is far too early to do anything about this. Come back in another decade.” Or I thought he might say “If only you had come in ten years ago, we could have done something, but unfortunately now….” Instead he said, “You have Very Bad arthritis in that knee: it’s bone-on-bone at this point. You’re like a car with a tire that’s riding on its rim. We COULD do cortisone shots, but those will fix nothing: they will add no ‘tire’ to your ‘rim,’ they will only give you some pain relief from the rim hitting the road. The only real option is knee replacement.”
Well. Well. Well. Well. Well. Okay. Okay. Yes, okay.
HERE ARE MY PRIMARY CONCERNS:
• I feel I should have a better primary concern, but actually the “no showering for two weeks” after surgery is pretty paramount. But, Edward once couldn’t shower for a few weeks after surgery, and we figured it out. We got some “body wipes”—bigger/clothier than diaper wipes. In Edward’s case, because of the surgical location, we couldn’t use dry shampoo, but I will be able to use dry shampoo. Maybe I can even wash my hair in the sink, once I can stand up long enough. This could be the incentive I need to cut my hair. (It is getting overlong, but as it gets longer and longer I get more and more reluctant to cut it. Plus, I’ve had recent success forming an artfully messy bun.)
• The set-up of our house. Beds and shower are all upstairs. Couch and recliner and TV and half-bath and kitchen (including nice big sink for hair-washing) are downstairs. Would I…somehow get myself up the stairs right after surgery, then not come down for a couple weeks? Or would I set up a sleeping location downstairs, since I can’t take a shower for two weeks (!!) anyway?
• “Someone coming to my house to do physical therapy for the first two weeks” also gives me considerable stress, but I think I will calm down about that as soon I’ve had time to adjust. In fact, I think I am already calming down. I know they don’t care what my house looks like. I know they travel from house to house on purpose, and that I am not inconveniencing them by needing them to come to my house. I am already feeling better, and like this shouldn’t go on the list of primary concerns. I am leaving it here because it was initially a big source of surprise and adrenaline.
• “Missing work for who knows how long” is stressful. I like my job and my co-workers; I know it’s pretty difficult when I’m out. I know they can figure this out, especially with advanced notice, AND that it’s not my job to figure it out—but it still makes me feel stressed. I asked the doctor how long I’d be out and he said it really varies, but certainly I’d be back…wait, what DID he say? Four weeks? Six weeks? Three months? My brain did not record the information. I know he said that after two weeks I would be able to leave the house and go to the physical therapy location, instead of having someone come to my house. But that doesn’t sound like I’d be anywhere NEAR back to work. He digressed into things I wouldn’t be able to do for awhile, such as kneeling, and said things that didn’t apply (like that I’d be able to sit at a desk), and I’m not sure we ever got to a time estimate. My lingering impression was that it would be around six weeks, but that it varies.
• The TIMING. He said it takes about three months to recover. When should I…schedule that? Certainly not over Thanksgiving/Christmas. January through March, maybe? Although then my parents mentioned it might be better to do it while the kids were home over winter break, to have more people to do my bidding. Also, Elizabeth is qualified to cover my library shifts, if she’s willing. I wonder if I would get a cortisone shot in the meantime? I have heard from more than one person that the cortisone shot was one of the most painful things they’d ever experienced (one friend said she was braced for the pain and still literally screamed, but that was in her shoulder), but maybe it wouldn’t be, or maybe it would be worth it? Or maybe I could just continue on as I have been.
• The timing with THE PRESIDENTIAL ELECTION AND INAUGURATION AND ALL THAT POTENTIAL CHAOS.
• I have never had physical therapy but William had it, so it doesn’t seem TOO scary to me—but I have had repeated trouble in the past following in-person verbal instructions for physical things. Like, if I KNOW what they’re going to ask me to do (“scoot down a bit, to the edge of the table”), I have no trouble; but if I don’t know ahead of time, it’s harder for me to understand/do it. I’m a little worried about this. But presumably I can SAY SO to them. Also, presumably they will get used to me, and I will get used to what they are going to ask me to do.
• Of course all the long-odds things. Infection. Blood clot. Repeat surgeries. Losing the leg. Unexpected death on the table. Etc.
Other thoughts:
He said I will need an assistive device at first, like a walker or a cane. This is interesting to consider, and something I have never shopped for before.
I wonder if this means that inflammation was/wasn’t an issue? I guess I don’t know how any of this works. It DID seem that when I was taking days off of keto, my knees (and other joints) hurt more—and not, like, I wondered if they would hurt more and I paid attention and it seemed that they did, but more like it happened repeatedly that I thought “JEEPERS, my KNEES today, and also my KNUCKLES and ANKLES, what is WITH this??”—and then remembered I’d had two days in a row off keto.
Does this mean the Osteo Bi-flex (glucosamine chondroitin) I’ve been taking for a couple months is USELESS? I guess, again, I don’t know how any of this works.
He said the fake knee will last 20-30 years. I am 50. My grandparents lived to be 80-87ish. Well, that is going to have to be a worry for another day.
He said that after the knee replacement, I should not plan on doing much running or jumping. He said if a bear is chasing me, sure, but otherwise, don’t start either of them as new hobbies. I wasn’t planning to, and yet I feel anxious about this. When I used to walk more vigorously for exercise (currently I have to limit it to shortish strolls), I used to do little 30-60 second intervals of jogging, just to increase the intensity/challenge; can I do that little amount of running, or no? Can I do 30 seconds of jumping jacks and 30 seconds of running-in-place as part of a strength-building/keeping routine? Is he maybe just saying, don’t get so excited about your new knee that you start training for marathons? I will need to ask more questions of the doctors and physical therapists, I guess.
He said I will have a little CLICK in my knee, always, after the replacement. This is interesting.
I hope it goes without saying that if you have any knee-replacement information, I am hanging on your every word.
I get steroid shots in my knee. They do not hurt AT ALL! I mean, I feel it, but it doesn’t hurt. I have gotten the regular cortisone shots, and the first couple of them helped tremendously. However, the last time I got what my doctor called a gel shot, and it is even better. It seems to last longer.
Oh! I think I can help with this.
My Dad had his knee replaced a few years ago. He was older than you–right around 70. But he came out of it really well (except for an unrelated Parkinson’s diagnosis a few months later….but that was going to happen no matter what). Here are some things I noted with him.
1. He slept on the couch for a week or two. I doubt it would have been necessary for that long, but he was careful. If it were me, I’d plan on being downstairs. But I’m guessing you’ll be back in your bedroom in a week.
2. The compression socks that my mom had to help him with seemed to be the biggest issue for both of them.
3. My mom bought a walker at an estate sale for him. I don’t think he really would have needed it—he found himself accidentally walking without it.
4. DO ALL OF THE PHYSICAL THERAPY RELIGIOUSLY. His doctor made comments about that and told him that one of the reasons he recovered so quickly was that he was doing the PT. A lot of those that struggle with the surgery’s aftermath, aren’t good about PT. Also follow the PT’s instructions for at-home movements and exercises. He never had the at-home PT. My mom drove him while he was still on the pain meds and once he was off of them he drove himself.
5. His doctor did the surgery in a city hospital and a small town hospital. The small town hospital allowed an overnight stay that was helpful for my parents. It was nice for them not to have to go home late in the day and get settled. Instead the nurses helped him walk several times that evening and my mom picked him up in the morning. But, again, they are older than you.
6. They might offer you a machine that constantly runs ice cold water around your knee. One person I know loved it. My Dad found that it wasn’t especially good for him and he felt his knee was better when he wasn’t using it. So don’t be afraid to try it, but also trust your body.
7. Don’t be a hero with the pain meds. They help you have less pain which means you move more which helps you heal.
8. I think you’ll be a lot better within a week or two. My Dad was getting around fairly normally by then and while he was careful for the whole three months (he was off of work and had to hire someone for snow removal), my guess is you’ll be back to a lot of normal stuff within a couple of weeks.
If it were me, I would wait until after Christmas. The election will be over. The holidays will be over. You might be in the right frame of mind to be burrowed in a warm, cozy house for a few weeks.
My parents had a lot of people tell them how awful a full knee replacement was. And that wasn’t their experience at all. And the doctor really made it seem like it was the dedication to the PT that made the difference. You’re young, I think you’ll come out of it great.
I so agree with everything you said. One added note, if you have a recliner that might be the answer for sleeping until you can get upstairs. My Mom had knee replacement and slept in her recliner for a week because she was able to keep her knee more elevated. She was bad about doing her PT so that made things a lot harder on her, but other than that everything you mentioned I would second!
Good luck to you on this.
I feel like everyone who gets one says it’s life changing for the better. I can’t wait until my husband gets one, alas they say he’s not a good candidate right now.
I’m going to reread what you wrote about keto and turmeric…
I can tell you that my doctor said take turmeric until I’d used up the bottle, and if I hadn’t noticed a difference by then, never mind. She said some people report really good results, but that it’s more common for people not to notice anything.
My experience is with new hips rather than knees, as I have had both replaced. But from what I see of the people around me, it’s not dissimilar.
I have never found cortisone injections very painful at all. But if you’ve been told it’s bone on bone, I don’t think I’d bother, unless you can get one immediately just to test it out.
Jenny above has great info, and I’d agree that the first 1-2 weeks will be tough; but after that you’ll likely be ok on stairs; probably won’t need a walker after the first 2-7 days; maybe a walking stick for a week or so after that.
Other than that: do the exercises; take the pain meds and take your stool softeners!
Are you advised not to leave the house at all in those first two weeks? My mom once had an injury that meant no showering, and after the initial first several days of being bedridden/totally hopped up on pain killers had passed and she was wanting to feel more human again, we helped take her to like a Hair Cuttery to just get her hair washed. Since that’s not going to impact your hair in a long term way the way cut or color might, she just opted for the cheapest place around. Plus the hair wash is the best part of a haircut anyways, so that was like a relaxing treat while she wasn’t feeling well.
What a great idea, I hadn’t thought of that!!
Over the past two years, my mom had one knee replaced, and my dad had both. They are very happy with the results and say it was definitely worth it. I think the PT was instrumental to their recovery. How lucky that your physical therapist will come to your house!
Good for you for taking charge and making this big decision! Sending you all my best wishes!
My grandma had bilateral knee replacements. She was up and walking with a walker either that night or the next day.
I’m not sure about the cortisone shot. I don’t think it helps bone on bone. But I got one in my hip and it didnt hurt at all. The did a swab of numbing gel beforehand.
I always thought January was the best time to get surgeries if you’re somewhere it snows. It is a good point about possibly needing the kids. Will they be help? Is there a spring break you could coordinate with?
My mum had one knee replacement in her 60s and the second when she was 78. Both times the surgery went well as did the recovery. She did say the first week is pretty painful; but physios were getting her up and moving the same day/next morning. Like the others have said; I think her diligence in doing the exercises made a huge difference in how well she recovered.
Others have terrific advice and experience with the surgeries… here’s my $0.02 when going to these major medical appointments: record it as a voice memo on your phone. It allows you to repeatedly listen to what you inevitably miss the first time when they’re rattling off more information than your brain can hold at the moment. Also good for when you ask your list of questions or express concerns.
This is excellent advice!! Never thought of it before but it would have been so helpful in the past. Thank you, KinAK!
YES to voice recording (if the doctor allows). Also take your list of questions on paper, two copies, one to give to the doctor and one to keep in your hand so if they sorta skip a question you can see that and decide whether to ask them again or not.
That is great advice, and also, I love how you wrote two cents :).
If it will help you feel less anxious about the PT, maybe check out the types of exercises they’ll likely have you do beforehand. Then you can read about them and feel some familiarity with them before you hear them from the therapist. I googled “post knee replacement pt” and got this link: https://orthoinfo.aaos.org/en/recovery/total-knee-replacement-exercise-guide/
And I think I would choose camping out downstairs over trying to get upstairs afterward.
Good luck!
You can take or leave this knee story – but I wanted to share this perspective! I also have very bad arthritis in my left knee and last year after some ongoing pain, it got REALLY bad to the point where walking down a hall was almost too much. I started physio, which did help a little, and was just really nice to talk to someone about movement and pain – but eventually, she recommended I follow up with an orthopedic doctor. I was so nervous, assuming he would blame weight and age and be judgemental and say surgery was the only way forward – especially because I have good insurance. He was very kind, listened, looked at the x-rays where you could see the bone on bone and he suggested moving in steps, trying a brace first. Didn’t help. Then he said we could try a cortisone shot, and I was nervous – but it didn’t hurt at all, it kinda surprised him that I didn’t feel anything. But so far – over 8 months now? the cortisone shot has lasted and helped so, so much. I still go to physio once a month, do my physio exercises 4 times a week, and rent a Peleton bike to get movement without weight bearing – that seems to help, I notice if I go a few days without using it. I went from having to take Advill multiple times a day to occasionally taking an Aleve and being able to walk so so so much better. I know it won’t last forever, I’ll likely try another shot though I know it has diminishing returns – I think there is something to be said for an operation earlier in life when healing is better, perhaps? But I kinda want to make it to 60 if I can? If it makes sense? But whatever helps mobility and pain is a good thing!
It DOES make sense: I am a little worried about a 20-30-year knee replacement when I am only 50! Being at 60 would make me feel as if the new knee could go the distance.
So, I came her to say that my dad got his knee replaced probably 30+ years ago and has not needed it replaced yet (he is currently in his early 70s). His doctor monitors it but it doesn’t appear to be breaking down/in need of replacement.
A lot of the data on how long it lasts is based on very old data because you have to wait 20-30 years to assess whether folks are getting it replaced. I would not worry about this now!
The doctor was hesitant to replace my mom’s hip because she was younger (early 50s?) but it was bone on bone and she was in pain and her mobility was affected. She got it replaced and now, at 76, she hasn’t had any issues with it and it hasn’t needed to be replaced at all. Her life improved so much after her surgery.
With her second hip replacement, she was not good about doing her PT and it has affected her walking. Take everyone’s comments to heart – PT is important and incredible.
Oh, i can tell you lots, i had both mine done six months apart when i was 59. Everybody recovers differently, but i was out walking for exercise within four weeks, and this summer while traveling i did 17 miles in one day. The first week is not pleasant, but keep up on the pain pills. Use the ice machine round the clock. My husband put frozen water bottles in there and switched them out as they melted, they kept the water good and cold, and then he put a timer on it so it was 30 minutes on, 30 off. My house is a split level so you have to go up and down stairs to get in and out. Obviously you don’t bend that knee, but you can take a step at a time and only bend the good leg. I used a walker for like one day, then used trekking sticks, i liked those much better. And do the PT. Take a pain pill before, it will suck for a few weeks but do it anyway. Feel free to email me questions, i feel like we have this process down now. You’ll be very glad you did it once it’s over.
Oh, I have trekking sticks!! I got them because of the knee issues: they helped me feel less wobbly and less like my knee might suddenly hurt, while hiking. Kind of fun that they’ll now be used for post-knee-replacement care!
I’ll add my note here. My community has a medical lending closet. It generally has walkers, canes, braces, toilet seat bars, knee scooters. You check it out and return it when complete. Beats buying something you may or may not use!
Following up to add, I am doing PT right now after my most recent knee surgery (not a replacement, but a follow up). The therapist demonstrates exactly what they want me to do, then helps me do that, making corrections if it’s not quite right. Very low stress, and very easy to copy. My surgeon told me to get a couple of PT sessions in before the replacement, both to set a baseline and also so they could show me how to use the walker, etc.
Can I recommend against proudly proclaiming on Facebook less than 24 hours after surgery that your knee feels so great and you are walking better and more pain free than you have in years. My mother in law did this. I assumed that she was just still hopped up on pain meds from the recent surgery, but it turns out she crowed about how good she felt post knee replacement when she still had an active nerve block on that leg. Do I need to say my mother in law is not my favorite person.
In regards to the in home PT, my mom recently broke her leg and arm and had them come for a few weeks. One of the things they worked on with her was figuring out how to get around the house with a leg out of commission. They figured out some very good strategies for using the stairs so she could get from her preferred lounge area and to the bathroom and back.
Good luck with the surgery!
I had the experience of supporting my mom through a knee replacement about 5 years ago. All of this advice rings true and I’ll add my 2 cents:
1) it possible, find a doctor that uses a robot for the surgery. This helps a lot with swelling and recovery.
2) get up on the knee right away! The nurses had my mom walking to the bathroom a few hours after the surgery.
3) I’ll underline about doing the PT religiously. You have to keep everything moving!
Oh, good: this doctor IS using robotics! He says I will have a little SET of scars: a vertical line on my knee, plus two sets of “vampire bites” (two holes), one set above and the other set below the knee, for the robots.
This sounds like scars for a badass!
Did he really say you can’t shower for 2 weeks? I’m a hospital nurse, and generally we tell people they can shower after 48 hours. Usually they have an adhesive dressing over the incision and water can just run over it no problem. No baths though.
It is very possible I misunderstood: he was saying a lot of things all at once and I was a little overwhelmed! I’ll bet I’ll get a clarifying printout at some point.
My mom had knee replacement surgery two years ago at the age of 79 (so her healing might have been slower than yours will be). I just skimmed the blog post I wrote about staying with her afterward and it would be more helpful if I had mentioned how long it had been since the surgery when I arrived, but I want to say a couple weeks. My sister (who lived closer but not in the same town then) had been staying with her before that.
At the time she needed someone to massage her leg and help with her PT exercises daily. She was using a walker and taking short walks every day (a block when I got there, almost a half hour by the time I left a week later). I did all the cooking and most of the housework and ran errands for her. I imagine you will need something similar. She spent most of her time in a recliner in the living room, but her house was all on one level so she could get to her bed by herself.
I remember the stiffness in her knee persisted long after the pain was gone. I don’t remember how it was resolved. I last saw her in July and she still can’t walk long distances, but there’s a difference between 52 and 81, so I wouldn’t necessarily expect that.
If you want more detail, here’s the post. It’s a snapshot of week 3 (or maybe 4?) after surgery. https://allfortheloveofyou.com/oregon-equinox/
In my family there have been 7 Total knee replacements. And the one thing they all agreed on was “should have done it earlier” The second was, in the time before surgery, ride a stationary bike every single day. Go to a gym. Start with 10 minutes. It is the exercise that best strengthens the muscles around your knee, leading to a much more successful outcome.
Try not to obsess about the details. The doctor and staff will tell you everything. They will make sure you have everything you need for the couple of weeks post-surgery. Your PT people will pick up from there. In truth, you will have a staff of highly trained professionals looking to set you up for a good outcome. trust the process.
FYI there are about 790,000 total knee replacements IN THE US every year.
Oh!! We have a stationary bike in the house!! (A Covid purchase.)
I am very happy you said the thing about “should have done it earlier,” because I have been fretting all day that maybe I should put it off.
I had my knee replaced when I was 51, (6 years ago) and it was so worth it. One thing that my doctor sent in my last minute instructions was to ride a stationary bike afterwards- luckily I found a free one online. It helps with recovery exercise (and I was using one at the Y before surgery). I did the surgery when my daughter was home from college on Christmas break, so she could drive me to the first PT sessions (no in-home therapy here). I got a shower chair which I only needed for a short time but made me feel more secure. I liked the ice machine. Anyway, you’ve got lots of good advice here!
I’ve had various surgeries on my ankle (so take this with a grain of salt) but you have already gotten the most important advice – DO THE PT!
One idea since it sounds like you haven’t done PT before and are a little nervous about it. See if you can get a few PT sessions BEFORE the surgery. It probably won’t help too much with a bone issue, but ask if they can show you the key exercises that they would do afterwards. Then you can learn them when you’re not in pain, and learn what your baseline is.
In my experience both primary care doctors and orthopedists are happy to fire off a PT referral if you ask in the portal. (I’ve done this even without being seen.)
I had brain surgery last October (I’m doing ok now!), so I can comment on recovering during the holidays. For me, the option wasn’t a normal holiday or a recovery holiday. Instead, it was a holiday in pain and worrying about major surgery or a holiday recovering. I wanted the surgery done, so I picked option two. I live alone about six hours away from my parents and brothers. Mom came and stayed for two weeks after surgery. I asked her to put up the Christmas tree before she left, and was ok with it being up for a long time in January. I was supposed to rest and do what I felt up to, including cooking, so once I was up to driving, Mom went home. Thanksgiving was a little sad, but I wasn’t up to the things I was missing, so I tried to find alternate things to do. I traveled for Christmas, but didn’t do some of my normal activities like baking. I’m glad I got the more fragile part of my recovery done before there was any snow/ice outside.
I am another one with no experience with knee surgeries but I have been a support person to 5, count them, 5 hip surgeries — 3 replacements for my DH (the first of which when he was 55 was both hips at once and yes, that is obscenely early to need hip replacement and also, his surgeon said he should have had it done years earlier) and 2 breaks for my octogenarian mom, the second of which occurred — I am not making this up — less than 24 hours after she came home from the rehab facility where she had been post-op (see below for more thoughts on this less-than-24-hours issue).
So! My experience may not be directly relevant, but first, my DH was told the same thing about joint replacement duration and his would have lasted much longer than they did *except* that they were metal-on-metal (metal cup, metal ball) and that turns out to be bad (not known at the time they were done, widely known now, I believe) and was releasing all kinds of heavy metals into his bloodstream which is Not Good. So he had to have the darn things replaced again in his early 70s, but they were in fine condition. Which is to say that the replacements they do and the longevity estimates they provide, I think may be based on what they’re re-replacing now. But as the technologies and practice are presumably generally improving, I like to figure that each year the actual longevity of today’s replacement is getting better. So who knows? Anyway, that’s thought 1.
Thought 2: hips aren’t knees, but everyone involved in this experience (my DH twice, my mom effectively once, albeit a once of long duration given the sequence of breaks) found having a comfortable electric recliner absolutely essential. DH slept in his for like 2 weeks (at least) after every surgery.
Also, you can think about home modifications you might need before the surgery. We needed to add a handrail to a staircase before DH’s first surgery although annoyingly, we only figured it out post-surgery. But at least we now know to look for that sort of thing (and with the aging boomers, there are an increasing number of businesses and books focused on designing and/or adapting living spaces to be accessible, so it should be possible to get the information you need to trouble-shoot proactively).
Finally, if you are an octogenarian like my mom and you break 1 hip, you have a 20% chance of dying in the year after the break (as a friend not-so-helpfully told me after my mom broke her first hip), and your chances of returning home and living independently are pretty lousy. Obviously 2 hips in sequence is a disaster and this was exacerbated by the fact that with break 1, my mom also injured her rotator cuff, which initially went undiagnosed and untreated but prevented her from using a traditional walker for maybe the first month post break and surgery and thus significantly impeded her doing PT. But! My mom is nothing if not a “let’s get moving” advocate (which is why she fell and broke hip 2 right after coming home from breaking hip 1 — she had, sigh, gotten up to put the dog out while I had briefly disappeared to the back of the house to use the bathroom. I am not kidding.), which “let’s get moving” attitude meant 2 things. First, she was in pretty good physical shape before her (first) break. Obviously that declined as she recovered (while having very limited mobility) but was still better as a starting point than the alternative. Two, she was insanely diligent about doing PT. Insanely. Also, she found a PT option where she could do PT in a swimming pool (obviously later in recovery) which is just such an effing brilliant system. And seriously, she probably did PT for a year and a half. But she now walks unassisted and with no tools (no walker, no poles) like 2-3 miles every day, which let me tell you what, if you talked to medical professionals about octogenarians with broken hips they’d tell you would never happen.
All of which is to say, yes, get in shape before the surgery (probably worth meeting with a PT to talk about best strategies for this), and do PT after surgery. And I cannot speak to its advantages for knee surgery nor do I know how it relates to your situation and preferences, but PT in a swimming pool makes things that would be impossible on dry land, possible, and can have really good effects.
Oh these are all really good tips. My grandma did all of these (electric recliner, hand rails, PT in the pool). Great!
My mom is hardcore “let’s get moving” octagenerian who broke her femur this year [and also, yes, fell shortly after getting out of rehab because of doing something stupid, but she ‘only’ broke some ribs on the second fall], and who *really* wants to escape the walker, so this is good to hear. (and now I will be recommending swimming pool PT…)
Oh, so sorry to hear, but yes. Don’t know that my mom’s experience will be everyone’s but it is evidence that really committing to PT (and having the “let’s get moving” spirit) at least *can* have phenomenal effects. (My mom broke ribs as a late septagenarian, and that was a tough one too. Sending healing wishes to your mom.).
KC Davis (author of How to Keep House Without Drowning) has a list of hygiene items if you’re bed-ridden. Including: pre-toothpasted toothbrushes, wipes of various kinds, dry shampoo caps, and more.
https://www.amazon.com/shop/influencer-73f222c6/list/1IM0XWTC1ECPW?ref_=aip_sf_list_spv_ofs_mixed_m
Commenting with personal experience for that no-rinse shower cap. A nurse took pity on me when I was in the hospital for longer than expected, and microwaved one for me. I have long hair (mid back, well past under my shoulder blades) and it was so refreshing and welcomed.
Okay, I know some things. My husband needs a knee replacement and cannot have one yet because of the whole “only lasts 20-30 years” thing but that is in my future. And my mom just recently had her knee replaced.
My mom did physical therapy BEFORE the knee replacement and she discussed the upcoming replacement with her therapist and they did a whole bunch of work to prep for the surgery and the recovery. My mom said this was the single most important thing in terms of her recovery and her doctor was quite impressed at how quickly she recovered. (She is 74 this year but in quite good shape. Golf and tennis and pickleball and water aerobics and all that.) She still had to take six months to a year off from her sports. But she worked pretty hard on strengthening all her muscles before the surgery so that she would have an easier recovery. She worked on her other leg a lot too because she knew she would need it to compensate. She did crutches and her biggest complaint was that she couldn’t carry anything with her. (This became a problem when her cat died in her closet. She lives alone and she called me on FaceTime and we had to troubleshoot how to deal with a dead cat when you can’t walk or carry anything. It was awful and also highly amusing if you are down with the dark humor like we are.) My sister stayed with her for two weeks (I think?) but after that she was basically functional again, albeit on crutches.
Oh wow, that does sound like you’ve been in a lot of pain. My Mum is 72 and has a lot of knee and hip pain. She finally went in and was expecting to be put on a replacement list but they told her it wasn’t bad enough yet – even though it’s affecting her quality of life and mobility significantly. I also know my BIL’s gf got both knees replaced in her 40s so that does happen. I hope you can figure out the best timing.
Just to add one quick thought on scheduling, my mom broke her first hip in mid December, which really turned out to be a lousy time to do that. Now she needed way more medical care and support than you will (hers involved a rehab facility, subsequent follow-up on the previously undetected rotator cuff problem, transportation for a person in a wheelchair to get to follow-up appointments and such), but one thing I quickly discovered is that since healthcare providers (at all levels! Not just surgeons but also rehab support and transport, etc.) also have families and celebrate holidays and such, getting access to care in December/early January is HARD. There were noticeable delays for things like getting the rotator cuff checked out and addressed, and PT was less available than it would have been at other times, and so on. So, kids at home or not, December may not be the best time to plan a surgery (though again, I realize your situation will be very different from my mom’s, so perhaps this isn’t relevant).
I have no firsthand experience with a knee replacement, but I was JUST LAST NIGHT talking about this topic with my uncle, so I feel compelled to give you all the anecdotal evidence I have encountered. 1. My uncle is 78 and said his knee replacement was MIRACULOUS. That he plays pickleball now when he did not before and that he feels like he is decades younger than he was before the knee replacement. 2. This one is going to sound at first like it a vote AGAINST knee surgery, and you will think, “WHY are you telling me this?!”, but I think it is promising anecdotal evidence. My former neighbor, in her sixties/seventies, had a knee replacement. She is allergic to pain medication so the experience was horrific for her. She claimed that she would never do such a thing again, it was so awful, and yet barely two years later she had the other knee replaced. Which indicates to me that it was WELL worth it.
I like the idea of setting up camp in the downstairs for those first two weeks. My own preference would be to avoid sleeping next to someone who might JIGGLE me and also to have access to the kitchen.
My 70 year old Dad just got a partial knee replacement right before New Years because he’d been bone on bone for “years probably,” according to the doctor. He knew he needed it in August, but got cortisone shots for a bit because he didn’t want to do it before Hunting Season in November (he’d rather trek through the forest bone on bone before skipping a year, I guess?) and then it’s the holidays, etc. etc. He got it done the day after Christmas, and was home before lunch and high as a kite for a couple days.
He didn’t have in-home PT, so Mom had to take him almost daily and he managed it. He slept downstairs in the recliner. At first PT took a lot out of him, but he was religious about doing the exercises and got better pretty fast. His range of motion never got back to normal though; he still can’t straighten out the leg to zero degrees without a weight on it. He was walking around the block and riding his bike pretty fast, like as soon as it got warm enough. And he got all indignant in June when I asked if a 5 mile bike ride was too long for him with my kids.
My main concern was that he was having the surgery when the recovery time was going to be the snowy, icy time of year where they live. Not just slipping hazards, but like who’s going to shovel/snowblow at their house (Mom also has a bad back/knees) but my sister and their neighbors helped out. I live far away so that was a big relief to me knowing that everyone local who could help was helping. I helped with sending memes and snarky political commentary to rile the old boomer up.
Glad you worked out what the problem is and that you have a plan going forward. I am commenting to discuss physical therapy. I had a short bout of it after a surgery about two years ago. The point of physical therapy is for the person to assist you with doing whatever exercise they are asking you to do. You mentioned that you have a hard time knowing how to implement their instructions – that’s what they are there to assist with! They’ll be able to answer some of your other questions too about kneeling, whether you can get back to short bursts of jogging, etc. Of the issues you have in front of you, I would put physical therapy entirely in the “already calming down about it” column.
So, here’s my very outdated memories of someone with no medical training but who spent two summers shadowing an orthopedic surgeon back in college, two decades ago. Ahem. So, legal disclaimer lol, this is not medical advice, not even remotely!
1. Is he planning a rotating-joint knee, or regular? This isn’t the actual terminology I’m sure, but basically there’s a fancier knee with a greater range of motion (?) that they would give younger, more active people. At 50, I’d be strongly pursuing that option. (I hesitate to say this because no one else has mentioned it, so maybe it’s not a thing anymore? Maybe they are all this way now? But I hate to not say it if it’s an option and might help!)
2. If your new knee eventually wears out, you can get a second new knee. It is a more involved procedure, but it is done.
3. I was present for a lot of cortisone shots, and was hugely needle-phobic myself at the time. No one ever screamed, that I can assure you. Maybe I remember some grimaces? TBH, I personally was intimidated by the idea, but impressed by how all these adults just handled themselves like adults. FWIW.
4. Absolutely tell the PT you do best w/written (or whatever) instructions – they should have handouts already, and certainly should be able to give you some. The healthcare system I used for fertility treatments and OB asked at the start of EVERY visit if I learn best through written, verbal, etc, etc, etc, (as though it would have changed since the previous few dozen visits), so this is NOT a weird thing to bring up in a healthcare setting!
5. From what I remember, the goal is to get up and get moving ASAP after surgery. And do all the PT. The more active you are, and more thorough w/PT, the better the outcome. From what I remember, young, active people do really well with knee replacements, and are able to live fuller lives than they did before the replacement.
6. I scrubbed in to dozens of knee replacements in my two summers. It was a very routine surgery, even in a small town. I say this in the spirit of encouragement – I know it is a huge deal, but be assured for the doctor and medical team, it’s just another Tuesday; they totally know what they are doing.
7. And for the record, this was all before robot surgery, so I’d have to think robot surgery would be less physically traumatic than what I observed!
ETA: I also don’t remember any complications in surgery. Not saying I remember perfectly or didn’t miss a follow-up issue, but the surgery themselves went smoothly, so far as I remember!
I consider this to be great news and I know it will be a success. You have gotten great advice and you are SO YOUNG for this kind of thing. I personally love it when I am YOUNG for something because it’s so rare! I do think the end of the year is a good idea, especially if you have a deductible to think about.
A couple things…
I have not had knee replacement but my mom (early 70s) has had both done and it seems like both the surgery and recovery went smoothly for her. She has no more pain and has no issues walking or doing farm chores. She seems to have lost a small amount of range of motion (she measures this by how much she can bend her knee in child’s pose) but not enough to effect daily life.
I had foot surgery a couple years ago and wasn’t supposed to get the incision wet for a couple weeks. I ‘showered’ by putting my foot in a plastic bag, sitting on a chair in the bathtub with my foot on a stool outside the tub, and spraying myself with a handheld shower attachment. Not satisfying but adequate.
I have had lots of physical therapy and PTs are my favorite health care professionals. They always seem kind and energetic and helpful, and I have enjoyed working with them. They also work a lot with elderly people so are probably used to repeating or rephrasing instructions. I think the suggestions for doing PT before surgery are good ones.
Good luck with all the decision-making and keep us posted.
Repeating/underscoring what many have said, but my mom (71) had both knees replaced in the past year and it was 1000% worth it. Her advice to others is do the PT religiously (I feel like tracking this will give you immense satisfaction). For her it was such a life improvement that the moment she got the all clear from PT for knee one she scheduled knee two!
I dont have personal experience, but I have an (alarming?) number of friends who have had knee replacements young. All of them have bounced back pretty quickly and ALL of them say they wish they had done it sooner. When you’re able to get it wet again and are worried about excercise, you could see if there are any communuty center water aerobics classes nearby. Those always look fun and sociable, and it would definitely be easier on your new knee than any running!
For a change I read all the comments before commenting, and what an education! I would like to assure you that not being able to shower for two weeks (if that is indeed that case) would be a primary Primary Concern for me as well, but it sounds like there are workarounds. I would also have the same concerns about work, but again, it can be managed, and (as someone who has had to manage it basically alone) generally people will be happy to manage it if it means a valued co-worker will come back happier and healthier. Just from following you here for years, I feel like you have a really good personality for following all the necessary steps to recover well (and then eventually writing a really useful blog post about it). I’ve only had bad knee pain a couple of times, and it was always able to be helped by physio, but it is a miserable thing, and I’m sorry you’ve experienced it for so long. I hope if you do it that the results are life-changing.
My mom had her knee replaced last year, at 73. She was able to go upstairs within a day or two – it was going down them that was trickier, but she was able to manage by taking them slowly.
I’d advise you to at least try something like this for recovery, and you’re pretty likely to find a used one near you on FB or the like:
https://supplycoldtherapy.com/products/breg-polar-care-kodiak
These are good for showers:
https://www.walmart.com/ip/Waterproof-Knee-Cover-Shower-Adult-After-Surgery-Upgraded-Surgery-Watertight-Cast-Protector-Replacement-Wound-Burns-Broken-Soft-Stretchy-Reusable/8968164055?wmlspartner=wlpa&selectedSellerId=101645357
A shower chair might be nice at first, too. I’m sorry you have to go through this but glad for how much better you’re going to feel afterward!
I have no idea about the knee surgery, but can give some input about hair washing.
There are special shower caps that you can buy, that have washing agents and moisture in them, that you put on (yourself or someone else) and massage your head, and it cleans your head. I’m not 100% sure how that works, but it’s something that’s used for hair washing for bedbound people.
Otherwise, I think Paul can give you a little home salon treatment with a small tub and some warm water and shampoo every now and then, and do some relaxing scalp massages, no?
In any case, I wouldn’t regard the operation as reason to get a short hair cut, particularly not if you’ve just made it to successful-messy-bun stadium, and are liking it!
Not exactly the same, but my dad has just (like, in August) had a hip replacement. He’s 71, he’s a marathon runner, and like you his hip was down to bone grinding on bone.
I was worried (he’s fit and healthy but lousy with pain). And for the first week he was a little taken aback by the pain levels and said morphine wasn’t really cutting it. But by week 2 he was so much more mobile and more himself and now, almost 6 weeks out, he’s walking almost normally and very perky. Unlike you, he’s been told he can run again, but until next year. He’s actually really enjoying the physio because it helps him feel like he can influence his way back to full health.
I think he’s been allowed to shower? But he has to sit on a special commode thing on top of the toilet because he couldn’t bend well. Overall, it’s been a really positive experience! Hope that’s some reassurance.
Also, I nearly forgot! I have not had a knee replacement, but I *have*, at the ripe old age of 30, had an MFPL reconstruction after multiple dislocated knees. Basically they replaced all the ligaments in my knee with ones that weren’t like linguine, using ligaments from my hamstring if I remember correctly.
I was allowed to shower! But I was so out of it on tramadol I have no idea whether I did or not in the first week or two… it was painful for sure but not unbearable, the hardest part was having my knee locked in a brace sticking straight out for 2 weeks, then regaining 10 degrees each week. Again, physio was really important, but you start it much later with that surgery. I just googled to see if the two op recoveries are comparable but I guess they’re for for different things so 🤷♀️.
10 years later and I can run 10k and barely feel any pain, except when the weather is damp and it aches a little. It was worth it for sure!
My dad has had two knee replacements. The first, he waited way too long, until he was in so much pain he could hardly walk. The recovery for that one was awful, because all the muscles in that leg had gotten so weak. The second knee replacement, he got much sooner, because he knew how much better he’d feel. His recovery from that was easy-peasy (at 82!) He was going up and down a couple stairs and getting into the passenger seat in a car within 4 days. Also, the in-home PT guy was quite handsome. I rather enjoyed his visits.
My 80 year old mom had god-awful arthritis in her knees which has been described to me by the specialist as bone on bone. She’s also terribly sick in other ways, so no one has ever suggested a knee replacement – she very clearly couldn’t handle any degree of surgery. So I don’t have anything to add about surgery, but I will say cortisone shots have been massively helpful for her, and they last for a very long time.
Wow, a whole knee replacement! Well, no wonder you’ve been having so much pain for so long. My SIL just had her knee done last year but I don’t remember what her recovery was. I just know that she had so much pain, and then after the surgery the pain was all gone.
I stayed with my Grandmother for a week when she was 75 and had her knee replaced. I was there for week 2 and at that point we were already driving to physical therapy and she was up and walking around the house – she was a little slow and cautious, but she was walking. She could go up and down a few stairs and get in and out of the car. She did have a walker, but only for the short term, maybe 3-4 weeks. I think you might want to camp out downstairs the first few days, and then move upstairs when you are ready. I think having the kids around could be nice – at least for the first 2 weeks. You’re going to do great!
I cannot weigh in on knee replacements specifically, but I have had both a cortisone shot and physical therapy – for frozen shoulder (thanks much, perimenopause!). For the cortisone, they gave me a numbing shot (tiny needle) prior to the bigger cortisone needle, and so it was only mildly uncomfortable (I was braced for much worse!). The shot was seriously life changing – at the time, my pain was so bad that I couldn’t find ANY comfortable positions in bed and couldn’t do the physical therapy that was supposed to help me get better. I instantaneously felt better, could actually get some sleep (some of the time – the shot didn’t cure my hormonal anxiety or snoring husband, unfortunately!), and was able to progress with my physical therapy. If you are going to wait a few months to schedule your replacement, perhaps the shot is a good option just to get you through the wait (assuming your doc agrees/recommends). If you are getting some swelling and tenderness in your knee, the cortisone may help, even if little cartilage is left.
I did see a lot of fellow patients at PT who were recovering from knee replacement surgery, many of them just a few days after the surgery. The therapists were great at working with them, and it was all very low stress. I would imagine that PT in your own home would be even less stress, so it’s fantastic that your doc is getting that set for you. I love the idea some of the commenters have suggested about getting PT ahead of the surgery to strengthen your joint and establish a baseline, too.
Best of luck with whatever timing you end up choosing – I hope the process and recovery goes smoothly. It’s a bit aggravating that you’ve had to wait so long to be taken seriously by your primary care doc about this, but sadly this seems to be the standard for how the medical community treats women with pain.
Re PT – the last time I did it, the physio had an app with videos and she could email links to video demos of the exercises as well. This was VERY helpful and could be something to ask about.
Swistle, this is a gift article from the Washington Post: “Not ready for a knee replacement? You might be able to fix your cartilage instead.”
https://wapo.st/3MOkr0E
Get or do a pedicure right before, because it can be a while until you can manage it. Unruly toenails are a mental nuisance that no one needs. Meal plan hard ahead of time so you don’t have that stress for the first couple of weeks. Slippers that slip on the easiest post op. Walkers are adjustable for taller people like yourself. Make yourself some recovery zones outfitted with what you like at hand: tissues, lip balm, hand cream, phone charger, etc. Possibly a heating pad, too; moving and sleeping differently can bring on back pain. You can do this!!!