So you’ve just had your knee replaced, now what?

So you’ve just had your knee replaced, now what?

by | Sep 20, 2018 | Knee

A lot has led up to this. You’ve been hurting for months and more likely years. You’ve had a knee scope surgery as it was required by Medicare before your replacement. You’ve been limping along both dreading the procedure and filled with hope that you’ll be able to get around without the pain that’s been limiting you for so long. So what do you do now?

You’ll get to that point, but first you have to respect the surgery. Your recovery will be measured in months, not days or weeks. Knowing this will help you settle into a routine.

You must have equal time up and down. What I mean by this is if you’re not in bed with your leg elevated it counts as “up” time. “Up time” is walking, eating at the kitchen table, sitting on the couch, riding in the car for your post-op staple removal, going to your grand-daughters dance recital,…whatever… Any time your knee is lower than your heart it’s “up time”. The circulation in your operated leg is diminished following the surgery and when you’re “up” your leg is going to swell more and thereby hurt more. (More swelling = more pain… this can’t be emphasized enough!)

By “down,” I mean in bed or on the couch with your knee higher than your heart and your ankle higher than your knee. Recliners don’t count since your rear is the lowest point and your swelling won’t go down. The fluid will stop at the lowest point (your butt) and back up into the knee.

Equalize your “up” and “down” time and you’ll have a much happier and less swollen knee. I’ve had a lot of patients over the years that will be cruising along two weeks out of surgery, and will go on an outing. After being up for 6 hours they get home and they’re miserable for the next 24-48 hours because their knee is much more swollen. Respect the surgery and give your knee equal time.

You’ll need to do your exercises twice a day (or what ever your surgeon or therapist has recommended). If you haven’t been provided with exercises there will be a link for a sample set of home exercises at the end of this article. Please run these by your surgeon for his/her OK before attempting them. They are the standard exercises that are performed in the first week or two following replacement. Please keep in mind that these exercises aren’t designed to build strength, but rather “wake up” the muscles in and around your knee that are in shock and not working properly following the trauma of surgery.

You’ll need to ice your knee regularly (no less than six times a day, preferably more, and 20-30 minutes at a time). I recommend a cold pack here, but a couple of bags of frozen peas or corn works well too. One on top and one underneath. Just make sure that you protect your bare skin with a pillowcase or towel!

If your surgeon has ordered a CPM (continuous passive motion) machine please use this for 6 hours (or the surgeons protocol) per day. Most people I work with do a 2 hour session three times a day. Some surgeons don’t order CPM’s and that’s fine as I don’t think there are any studies that show long term benefit, but I think there’s a lot of short term benefit. It gets you in bed and elevates your leg (think “down time” my friends) . You can even throw a bag of frozen peas or a ColPac ice pack on your knee and the combination of elevation, gentle motion and cold can be a little slice of heaven.

Blood clots and preventing them. They are an uncommon side effect of the surgery, but blood clots can be a serious and fatal one. Most people are placed on a blood thinner such as a daily aspirin, a prescription medication like Eliquis or Pradaxa or at least wearing those white compression hose that seems like they were designed for a 20 pound toddler. Please use whatever your surgeon recommends and follow those recommendations to a fault.

Here’s link to a sample set of exercises that should be reviewed by your therapist or surgeon prior to attempting them.

Side note…If PT hasn’t been ordered, get on the phone and ask your surgeon to order PT. You need an ally in your recovery and a physical therapist is just what you need! These exercises are nothing crazy, just good movement and range of motion.

http://www.my-exercise-code.com then enter code Q9L9UBF

All of these recommendations and more including the newest advances in surgery as they become available, are in the book “Knee Replacement Surgery, A Patient’s Guide: Before, During & After“ available on amazon.com.

If you have any questions please feel free to reach out to me at www.chriseastonpt.com.

Thank you, and may God continue to bless you!
Chris

***This blog post is for informational purposes only and is not meant to replace the advice of a surgeon or your physical therapist. Please consult your surgeon re: all information included in this article.***

Your Knee Replacement Pre-Op/Before Surgery “To Do List”

Your Knee Replacement Pre-Op/Before Surgery “To Do List”

by | Sep 10, 2018 | Knee

You’ve made the decision to have your knee replaced. You’ve met with the surgeon. Your lab has been ordered. You have to go to the hospital (or your family doctor) next “Tuesday” to have your blood drawn for labs. Your surgeon might want you cleared by a cardiologist. All the OFFICIAL medical wheels are set into motion so that everyone else is prepared for your replacement.

What about you? Are you prepared? Physically? Mentally? Is your house ready? What about the dog?…

There’s a lot that goes into getting ready for a major surgery like this. There’s a lot to think about, but some pre-planning will make the process easier.

First off you have to realize that you’re going to essentially be out of commission for about 3-4 weeks. Ignore the stories of your neighbor who had it done 2 years ago and was out mowing the yard and golfing in a week. That’s simply not true, and if he did, you didn’t see him rolling around in bed for two days miserable from all the excess swelling. Respect the surgery. It IS a BIG deal and you need to honor that.

OK, so keeping that in mind make sure that:

  1. All your shopping is done and you’re stacked up on groceries. And yes, that also counts if you don’t do the shopping. I’ve heard many spouses over the years say “I didn’t know what I was getting into, and I didn’t even have the surgery.” Having shopping done for at least two weeks (and meals prepared in advance, think frozen casseroles) will be such a relief later on.
  2. All laundry is done and bed linens are clean and changed. You’re not going to be able to do laundry or change your sheets for at least 2-3 weeks and clean linens are always nice!
  3. You have ice packs at the ready. On my website I have a link to Amazon for a Col-Pac brand ice pack that I love, but you can also use a big bag of frozen corn or peas. If you’d like a recipe for a home-made icepack, message me and I’ll send you the recipe. Make sure your knee is protected by a towel and ice that baby no less than 6 times a day, yes 6! (20-30 minutes at a time).
  4. Make sure your house is clean and vacuumed. “I hate looking at all that stuff on the carpet and I can’t do anything about it, it’s driving me nuts!” I’ve heard that more times than I care to hear and have gotten out someone’s vacuum on more than one occasion.
  5. Please make sure all throw rugs are up, your bed comforter is up and off the floor at the foot of your bed and the floors are cleared. Trust me, you don’t want to fall after you undergo a knee replacement.
  6. I thought about leaving this out, but I’ll mention this anyway. You will be constipated following surgery. You know your normal rhythm, so plan accordingly. Don’t overdo it, but be aware that this will be a problem. Your surgeon will advise you on what steps to take if he/she hasn’t already.

Hopefully you’ve found this helpful. All of this information (and a lot more) is available in my book “Knee Replacement Surgery, A Patient’s Guide: Before, During & After” available on Amazon. If you have any questions please reach out to me either on FB or here on my website chriseastonpt.com/contact/. I’d love to answer any questions you have or help in any way I can.

God bless
Chris

P.S. I might have mentioned the dog earlier. Make sure Fido is stocked up on food as well. Those bags are heavy and having it on hand is nice. Dogs (and cats) can be fall hazards too, so please be careful!