I fully confess that I am a coward and that I did everything to put off knee replacement surgery for over four years. It got to the inevitable point where I begged my doctor for the surgery. I needed to walk without pain. I needed the freedom to travel.
The short answer to the fundamental question is: Yes, I would do it again. And I would also recommend the surgery to anyone that is experiencing significant knee discomfort. It wasn’t easy surgery and it remains a focus of my current life (more on that later), but the results are well worth the efforts and the fear I felt pre-surgery and my avoidance techniques were unwarranted.
So here are some things to consider about knee replacement surgery:
1. You need to find the right doctor.
My doctor could probably have done this surgery in his sleep—he had performed so many of them. He had no bedside manner, but that was not important to me. I wanted the best technician. But his physician assistant was approachable and he had good office help that could answer questions.
Lots of my friends have interviewed many doctors before selecting the one that they could communicate with. Others (like former President Bush) traveled to other locations to have the “state of the art” surgery done by what they thought was the foremost expert. I instead wanted a local doctor and one who was recommended by other experts, including physical therapists and other local doctors—the one that, in their opinion, had the best results for their patients. I didn’t need hand holding.
2. Do physical therapy before the surgery.
I started physical therapy eight months before I had my surgery thinking that it would alleviate my discomfort. Although it helped, the relief it provided was short lived. In fact, my physical therapist was one of the people that encouraged me to get the surgery. The pre-surgery help I got made my recovery easier—I was stronger and had learned how to do many of the exercises.
Plus, it made me want to go back to outpatient therapy immediately following the surgery, rather than relying on the in-house services, which are generally provided by your insurance the first few weeks following surgery. Those that do outpatient therapy using the machines and expertise offered often recover faster. So, use Uber or have someone drive you to outpatient physical therapy as soon as you can.
3. Don’t let what others say control your actions and recovery.
Listen to your doctor (or, in my case, the PA). All doctors have different views of how best to recover following knee replacement. Some require you sleep on your back for 6 weeks, some require a continuous motion machine while you sleep, some hold back on the opioid drugs, while others encourage limited or controlled use, some say you can’t climb stairs for weeks while others make you walk stairs right after surgery.
So, what is right? For me, I did everything I was told to do. I stayed in the surgical center for two nights to make sure I had all the information I needed. I did get up myself to go to the bathroom and walk the floor immediately following the surgery. I did take my pain medication (including Hydrocodone for a couple of weeks) right on schedule so that I could keep moving.
Yes: I worried about taking too many drugs, but I worried more about being sedentary and not being able to get the knee to work. I used the ice machine and the calf massager at least twice a day. I slept in those awful compression hose. But all of it meant that I got my mobility back fairly quickly. I didn’t really need a cane or walker after the second week. I have been walking on my own since then—including up and down stairs.
4. Mobility isn’t the end of the story.
I got my mobility back quickly, but that did not stop the ache that you feel continually in your knee. It stiffens up. It gets hot. It feels wrong. And it tends to keep you awake at night. None of this goes away easily. I ice my knee, I still take medicine at night to sleep and I am constantly waking up and walking the floors (between my recliner and bed) at night.
Sitting at my desk at work is still hard. I got a standing desk so I could change my position, but if you sit too long in any place it doesn’t feel great. When will this end? I have been told that it gets better after three months and that in a year it will be great. But at 3:00 a.m. in the morning, that is little consolation.
5. The knee has to be your priority now.
I have to go the physical therapy three times a week and there is no excuse for not going. When my knee starts aching at work, I go home and ice it. I make sure that I do whatever I can to make it feel better. I am not travelling yet but plan to start this week (six weeks post-surgery).
Plane travel will require me to focus more on what is going on with my knee. I will need to watch for swelling and I will need to get up and walk. I have tried not to attend evening events for a while. Standing at a cocktail party is no fun right now and sitting at a long dinner can be very uncomfortable. If I am in a long meeting, I reach for an extra chair so I can put my foot up. Then I get up every half hour or so to walk around. It may be distracting to others, but it gets me through the meeting.
6. Give yourself a break.
This is surgery and your body needs time to recover. You can’t expect to feel great in two weeks. It takes time and you need to give your body and your knee some downtime. Enjoy the shows you haven’t seen on Netflix and recognize you will be back, even stronger, at some point in the future.