Preparing for Total Knee Surgery

My bilateral total knee surgery was planned for Sept. 8, 2009. I was given a folder at the doctor’s office with all kinds of information and what to do next, who to call, etc. I really wanted to continue working and enjoy the summer before all of this especially since my birthday falls in July. I had read quite a bit both on line and in a total knee book I had purchased. I had also talked with several women at my YMCA arthritis pool classes who had undergone total knee surgery (although not both at the same time). I started to keep “lists”, especially of questions to ask the doctor for  my upcoming pre-operative visits. This really helped me to process things in my mind and get some sense of peace going into surgery that I completely understood what would occur. For example, what if I have metal allergies?-would I be able to have a metal knee component?; How long will the knee implants last me?; what type of anesthesia will they give me?; what about pain management post op?; how many days in the hospital?; what type of prosthesis will be used in surgery?–I had heard of “mobile bearing” as women bear weight on their knees differently than men; how long will I be in acute rehab?; When will I be able to start outpatient physical therapy after home health therapy? and for how long will I need outpatient therapy?; when can I drive again?”; when can I go back into the pool again?; when can I ride my bike again?; when can I resume my medications?, i.e. vitamins, fish oils, arthritis medicine and pain pills. Dr. Goldstein told me most all of these meds are “blood thinning” so they want you off all of these from 2-6 weeks out before surgery.  Illinois Bone and Joint was very organized with all of the appointments and called me promptly to make all of my pre-operative and post op appts. through November once my surgery was scheduled. I had to call to arrange my autologous (self) donation of 2 units of blood with Lifesource as well as call to make a pre-op clearance visit with one of the Skokie medical physicians which was required for you to have surgery at their hospital. I also called Blue Cross, my insurance about my upcoming surgery to find out my coverage and out of pocket expenses, if acute rehab was covered as well as ambulance transport to the rehab facility and to inquire about coverage for outpatient physical therapy and which were “preferred” providers for better coverage under my plan. Luckily, I found out from Bl. Cross that there was an outpatient physical therapy center in my neighborhood under the plan and I called to inquire about scheduling my outpatient therapy visits.  I told them what my tentative start date would be not knowing ahead of time if all timing would go as planned and they were extremely helpful in tentatively setting up my first appts. and mailed out a questionnaire to complete ahead of time. Since I knew I would not be able to drive for a few weeks, I needed very early morning appts. which fill up fast, so that my husband could drive me to therapy and then home so he could go to work afterwards. These outpatient physical therapy appts. were three times per week initially. From the pre-op folder of info I was given at the doctor’s office, I also called to schedule the pre-op physical therapy class and the hospital pre-op class–both of which were very helpful in preparing you for the upcoming surgery and what to expect. Again, being an experienced orthopedic nurse, some folks asked why I would bother attending the classes but I found them a good review, as well as supportive, with an opportunity to ask questions. Class helped my husband too, attending with me, as to what he could expect with this surgery and what my needs would be once I got home from the hospital. The pre-op physical therapy class went over what exercises you could do to strengthen your muscles (and provided demonstrations and folder with pictures) to better condition yourself before the surgery (very important) to help with your post op recovery. They also provided a list of skilled nursing facilities you could call, tour, and reserve a bed ahead, for you to go to once you left the hospital (to complete therapy there until you were able to go home). The hospital pre-op class presented by nurses, a pharmacist, and a physical therapist, went over everything from what to expect from the time you arrive, where to go, what to expect in the 3 days you are in the hospital, pain management, nursing care, your stay in the hospital, Coumadin (oral blood thinner) therapy, discharge planning and rehab, physical therapy, and more. I made sure I updated my medical history and list of medications as well as made extra copies of my advanced directives to take to the hospital with me. So much to think about…

2 thoughts on “Preparing for Total Knee Surgery”

  1. My mom is having this at 68, if all cardio clearances pass. She suddenly got bell’s palsy to top in off. Needs the surgery b/c she really had so much pain. What can I do to help her prepare, in the diet/vitamin mode? They didn’t even ask for blood predonated and she’s O pos.

    1. I don’t know your mother and her medical history or what medicines she takes but I’ll try to give you some general suggestions. I also don’t know if your mom is having one vs. two knees done as the prep is slightly different. You usually don’t have to donate your own blood for one knee surgery as the blood loss tends to be less.. As far as diet and supplements go, iron supplements and a diet rich in iron 2 weeks ahead of time helps for the blood loss. My doctors told me to come off all my vitamins and supplements including fish oils in prep for the surgery as they felt most of those, especially the fish oils have blood thinning properties, and didn’t want the risk of me bleeding more with surgery. The hospital where she is having surgery usually prepares the patient and should advise her what she should be doing. I was given a packet of information from my surgeon’s office as well as offered the pre op class at the hospital which I think helped a lot. They also have you do some exercises in preparation to strengthen the muscles around the knee which is important too. Be sure to ask her doctor or call the hospital about this education if no one has offered it. Good luck to her!

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