Lessons for Those Facing a Total Knee Replacement - Part Two

10. There are various names for it, but learn to use and value the strap or belt that you use as a leg-mover. I call mine “Isadora” after Isadora Duncan and her scarf since I wear my leg-mover around my neck and use it for everything, even snaring the most valuable “Get Well” gift I received: an omnibus volume of NY Times Crossword Puzzles. Great for that hour from 2 to 3 in the morning when you can’t sleep anyway.

11. If you always wanted to get a laptop, get it before the operation and learn how to use it. It, like the crossword puzzles, turned out to be invaluable during those long, empty morning hours. Mah-Jong solitaire is particularly habit-forming.

12. Don’t worry too much about pulled muscles in your back, sides, wrists, etc. They come from walking differently and using crutches and canes. They’ll heal before your knee does anyway.

13. You’ll be amazed at how quickly you’ll be able to sense when you’ve increased flexing by a degree or two and the same for extension. As you get closer to the end of rehab and establishing full Range of Motion, each degree becomes more and more precious. Celebrate every one of them!

14. They say it’s possible but if you have your left knee done, it’s impossible to sleep on your right side for very long and vice versa. Pillows between the knees? Under the knee? Doesn’t work for me. Good luck.

15. Be VERY NICE to your Significant Other. They will have to take on extra duties that make you impatient to even ask for but that you simply cannot do yourself for a while. At the same time, try to do more and more for yourself each day to remind yourself that this rehab stuff is temporary and has the goal of returning you to a normal, independent life, assuming you had one before the operation!

16. Get out to dinner, a movie or something fun as soon as you can stand sitting in one place for more than an hour. (That may take a few weeks.) You’ll have earned it and your Significant Other will want the fun as well.

17. Set goals for performance: pick a date for the resumption of your golfing hobby; set a goal for walking up and down the stairs foot-over-foot again; set a date for walking to the corner and back, around the block, etc.; make a date with your physical therapist for dinner so you can tell them you didn’t mean all those nasty things you called them when they were stretching you.

18. Don’t worry if the next thing that goes is a hip. They say the rehab is nowhere near as bad as for a knee!!!

Lessons for Those Facing a Total Knee Replacement

I am undoubtedly not typical of a knee replacement patient but, having gone through the procedure twice in the past five years, I feel qualified to offer some advice. At least, these are some of the changes in your life you might look out for as you go through the process of the replacement. Yes, it is not merely an operation; it is a process, the most important part of which starts in the recovery room.

1. Rehab is everything. The operation takes a couple of hours; the rehab takes months and months so plan to start rehab as soon as possible.

2. Learn to manage your pain in the hospital and don’t be macho or Amazonian about managing it at home. Pain wrecks rehab, destroys sleep and exhausts you. The professionals tell us that not managing pain also slows recovery drastically. My rule of thumb: when my pain goes over 6 and is clearly headed higher toward 10, I take the Percocet and track the time so as to not take any more than two in four hours. (Sometimes each dosage will last longer than four hours, but it’s amazing how often at the four-hour mark you can feel the pain start to return!)

3. Rehab hurts. Once home and started with a therapist or by yourself or at an outpatient rehab facility upon discharge from the hospital, learn to manage your pain meds. I take 2 Percocets an hour before every therapy session. Without the pain meds, the therapy is limited by pain and not as productive. The goal is to regain “Range of Motion” in the joint and to do that you have to take your knee beyond where pain would stop you. BUT—see #4

4. When your pain meds kick in, be careful not to over-stretch because the pain won’t be there to stop you. Learn to exercise to a stretch that you can feel even with pain meds. To go any further asks for pulled muscles that turn up only after the pain meds fade away.

5. Have the operation in the summer months, during re-runs on TV. You won’t want to watch much anyway and the only sports on during the summer, baseball, can help you get to sleep anyway.

6. Do not plan to read War and Peace during recuperation. I find my attention span the first few weeks was limited to a few pages of Dr. Seuss at a time. Similarly, don’t plan to write anything meaningful. Many pages of my journal have these odd dribbles of ink off the page where my pen went when I fell asleep during a short entry.

7. Welcome visitors but don’t be afraid to let them know when you can’t remember their names any more from fatigue.

8. Plan to start a diet. I lost twenty pounds in less than a month because I didn’t want to eat much at all and didn’t need to. I have suggested that my orthopedic surgeon market his “Joint Replacement and Weight Loss System.”

9. Sleep whenever you feel sleepy. Usual sleep patterns are destroyed anyway so take it when you can get it. You’re not going to be going anywhere during the day and, if you followed suggestion #5, there’s going to be nothing you’ll miss on TV anyway. The best nap is the one after PT!!

After writing that, I made myself so sleepy that I followed my own advice and nodded off. Next blog, nine more tips on handling a knee replacement, including the value of Mah-Jongg on your computer and the care and treatment of your Significant Other.