I Finally Got My Knee Replacement

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 I finally got brave enough. I now have a new knee.

Hello Everyone! So many little things have been going on over the past year, and a few big ones, so please forgive me if I play a little catch-up on the blog over the next while. I am home recovering and have the time and, hopefully, the energy to start blogging again. I certainly have a lot of ideas and experiences to share, and I will start with my latest joint replacement.

 My knees have been bad for over 10 years, and I was scheduled to have my left knee replaced in January 2021. Unfortunately, I dislocated my hip under 3 weeks before I was to have the knee surgery, and then broke my other hip September 2021! 

On May 19th, 2023, after a two year delay I finally got my brand new left knee.

My pain management was complicated because of allergies and my poor medication tolerance. I was in the hospital for 4 days while all that got sorted out. I have been home for almost a month and working on recovering.

The surgeon warned me from the beginning that this would be a rough recovery and that it could be much more painful than hip replacements. He also was very frank in saying that a large percentage of people are dissatisfied with the outcome of the surgery. Yup. Not reassuring. The nurse doing the presurgical orientation at the hospital a couple days before surgery was a little more optimistic. She said I would spend the first two weeks post-surgery thinking the knee surgery was the worst decision I ever made. She said that within 6 months to a year, I shall be glad that I made the decision to go ahead with the surgery. 

I didn't feel like I didn't have much choice about going ahead with the surgery. My knee was very unstable and gave me pain daily. I reached a point where I was telling friends and family to go places and do things without me while I stayed home, which is not like me. My lower leg bowed out due to the knee collapsing inward. It was so severe that I started to have real trouble with my ankle. The doctor said I could eventually wind up needing an ankle repair.

The other consideration was that I had been on a shorter wait list with the physician because of the cancelled surgery. I was also on a health department priority list because my surgery that got cancelled when I dislocated my hip was also through the period of Covid when the hospital closed its surgical wings. I had postponed so long that I was about to get bumped to the end of the list, and it could be over two years before I got another chance. When talking to the surgeon, he said my knee was so severe and breaking down so fast that the surgery could get more complicated and result in a more difficult recovery.

Yes, this has been a pretty miserable recovery so far, and the exercises are more challenging than the hip ones were. The last two hip replacements were due to traumatic events, so the pain was probably worse than the average hip replacement. I am finding the pain level is not that different from what I experienced with the last surgeries and recoveries. Happily, this time, there was progress in finding workable solutions to pain management for me, so that helped at the beginning. In terms of managing my activities, it is a LOT better without restrictions about bending or living with the fear of another dislocation.

My life currently revolves around doing my physio exercises and icing my knee. More on that next time.

Home from the Hospital after Hip Replacement Surgery

 I have been home for a week now. The hip revision surgery went smoothly. The surgeon actually wound up changing the artificial hip parts and needed to repair tears in some of the supporting tissues of the joint that tore during the dislocation in December. It looks like there was no possible way the hip could have ever healed properly and stopped dislocating, so it was a good call to go forward with the surgery.

My new parts are a little more high-tech than the last ones and are much less likely to dislocate. I was concerned about the original plan to have a constraint liner in the socket limiting my mobility and how much I bend. Still, I knew something had to be done! The surgeon used a different version that won't constrain my hip movement any more than before.

 Hopefully, it won't have me living permanently with  Hip Restrictions, about not crossing legs ever, not bending from the waist more than 90 degrees, and so on. That doesn't mean I get to be stupid.. no fancy dance moves. I certainly need to watch out for falls, but I should be able to still have an active life... once we finally do a knee replacement and fix my left knee!

At the time of my surgery, we were still high in the third wave of covid in Manitoba, making for complications with our health care. The hospital my surgeon works from is one of the hospitals that has a covid ward and intensive care units, and it was beyond overwhelmed. They needed to send people out of the province to other hospitals because of a lack of equipment and staff. They closed down non-emergency surgery and admissions. Fortunately for me, my surgeon put in appeals and got permission to use the other large hospital with an orthopedic program for a few of his patients that he considered in need of the most immediate care.

  

It was all kind of odd because I technically was still a patient of hospital A, where we had initially planned the surgery before Covid closures. I went to that hospital for covid screening the day before surgery and for X-rays. Then on surgery morning, I reported to hospital B for the actual surgery and 5 nights for recovery and my first physiotherapy and rehab sessions. I get my staples out this week, and that will occur at the cast clinic at hospital A.  

On arrival at the hospital, I had to have a security guard help me got from the entrance to the ward and helped carry my overnight bag, my walker, cane, a cold therapy machine! They started me off in the room I would be returning to after the surgical recovery room. That was kind of convenient. There was a bag for my clothes and the gown and housecoat right there waiting for me. 

They had an absolutely miserable time getting an IV into me but that is nothing new. I must say this location on my dominant hand was especially horrible once I needed to use my hands to push off and move around after the surgery and for the physiotherapy.

Next to the surgery cancellation, the hardest part for me about surgery during the Covid Pandemic was going into the hospital all by myself and not having visits from my loved ones.  The phone is just not the same and despite having a truly lovely roommate,  (Hi Pat) I was lonely and missing my family. I was so happy when I finally got home to my family and my own bed!

I am finding the recovery easier this time compared to my first hip replacement for various reasons. Since I dislocated it in December, I have been under a lot of restrictions and have been in pain and too some level gotten used to moving carefully.  I think we have gotten a better handle on my pain management too. I believe all that lying around in the brace has made my leg a lot less stressed physically. Still, the downside is I have most certainly lost a lot of overall strength in the past 6 months since I got hurt. 

I had been expecting to have knee surgery... and then it suddenly changed to hip revision, but the prehab exercises to prepare for those surgeries are very similar. I know the exercises well. Same as three years ago, and this time, I had lots of lead-up time, like it or not. Even though most of me feels like jello, I have tried to at least strengthen the muscles affected by surgery.

I have successfully lost some weight since my dislocation, so I am sure that has also made my recovery easier. I will eventually put up some posts about my weight loss experiences. It is a big part of my living health journey, and I rarely talk about it. I guess I am more than a little sensitive on the topic. I was a chubby kid that has also spent most of my adult life as an overweight person.  People, the struggle has been a hard one. I was not tempted to overeat with the hospital meals though.

I have an appointment set up with my new Physiotherapist in three weeks. Until then I will continue to do the hip exercises assigned by my hospital physiotherapist at least three times a day.

I am going to be editing my previous post Preparing for Hip Revision Surgery which included my plans about packing for the hospital. I had most of it correct but now I have even more helpful ideas and suggestions.   You do want to get your packing correct to make everything easier and as pleasant as possible during your stay at the hospital. So "stay tuned!"

Just in case you were wondering... I'm not really sure exactly what kind of hip replacement prosthetics I got, but it will be similar to what they discuss in the link below..

'Dual mobility' hip replacement reduces risk of dislocation (medicalxpress.com)

Surgery Tomorrow!

 I am having my Total Hip Revision tomorrow morning.

 Third hospital time is the charm for getting this hip functioning properly I hope.   I’m not looking forward to surgery or the recovery period but know that I need to do all I can to keep being mobile.

Cross your fingers and say a little prayer for me, please! 

Preparing for Hip Revision Surgery

 I am still waiting for Hip Revision surgery, and it looks like it is going to be a long wait after all. 

The city has a massive number of Covid cases, and our ICUs are beyond capacity, so non-emergency surgery is on hold yet again. I find it hard to deal with the uncertainty of the situation, but with the extremely high risk of covid in our community, I believe it is just what needs to happen. I have been struggling to move forward with anything, and I am very much in a holding pattern; I can't exercise much, I risk falling, I can't work, volunteer, or do much work around the house, and with Covid, there is no chance of going shopping or visiting with friends right now. I have had a hard time focussing on all the things I can do and tend to slip into thinking about the things I can't do. 

Hip Reversion surgery is what it is called when there is a problem with a hip replacement, and they do a second surgery to try and fix damage around the hip and its parts. Basically, the name says it all. They are revising the surgery that was done before. In my case, since I have had a serious dislocation and now it is still unstable, they intend to change the lining section in the hip socket to a different type that fits differently and restrains the amount of movement of the hip a little more. They will also check for things like damaged ligaments etc. In the meantime, I am at significant risk of it dislocating again, and I have some pain and mobility issues.

When I had the original hip replacement, I didn't really know what I should expect with surgery and the rehab part, and I was pretty scared. I learned a lot from Facebook groups, and internet sites and friends and the hospitals did have prehab classes where I spoke with their dietician, a physiotherapist and an occupational therapist who tried to prepare me for surgery and recovery and teach me ways to cope while living with arthritis and explain what they can.

I wound up needing a different car to come home in than when we had at the time and a different bed because we were sleeping in a low bed with a raised wood frame around it. I needed a bath seat, raised toilet seat and a handle around the toilet. I needed a walker and crutches to deal with stairs into our house. It was highly suggested that I get a recliner chair to sit and probably sleep in.

This will be my third time in hospital dealing with this hip, and I am starting to feel like quite the expert. At least this time, we don't have to buy any of the furniture or medical supplies! Been there, done that! I might not know "when," but I do have a better idea about the "what" and "how."

Packing lists

 

The last time was an ambulance ride with no jacket, no shoes, no phone, no nothing. My husband followed the ambulance to the hospital, and of course, they wouldn't let him in because of Covid 19, but they did take my phone from him and got it to me sometime the next morning. It was good to get in touch and tell him what was happening and eventually to Facetime on Christmas with my family. This time I plan on being prepared. I won't be having any company allowed, so no one to bring supplies.

Items I will Need to Pack

In the Hospital

• iPhone and earphones. Save some podcasts and music to my phone to keep me distracted.
• Charging cable and wall plug connector.
• glasses and a labelled case to put them in
• pen and notepad, maybe some activity book like colouring or crossword
• Slippers with good grips that you can easily step into.
• housecoat
• moisturizer and lip balm
• Hairbrush, elastics, hair clips.
• toothbrush and toothpaste in a case
• They do provide soap but if you have a particular kind, pack it along too.
• mini nail kit
• Pillow, comfort items or a small blanket if you want to. Things to keep you more comfortable.
• important papers your hospital might require like a list of medications and your health care numbers,
• Hard candies to suck on, or maybe breath mints
• Money is tricky. Loose change is usually a good idea, but with covid, nothing is open anyway.
• I would bring a garbage bag for dirty laundry.

Going HomeTime

• fresh underwear
• skirt and shirt or easy pull-on dress. (pants just don't work out well)
• I'm thinking about other slip-on shoes rather than my slippers for getting into the car.

Pickup Time

• Husband Bob is to bring a jacket or sweater if needed
• walker to get to the car
• crutches to get up a couple of stairs into our house.

When I get dropped off at home, Bob will go to the pharmacy to fill prescriptions from the hospital for pain killers and assorted other items.

I will update this post if I think of anything I forgot!

💚

I will stop whining about my hip for now and, like a good recreation person, move on to all the things that I can do until I actually have surgery. 

There are lots of things that don't involve much bending or stretching. And don't including all the things you can't do because your city is under severe constraints and risk due to Covid 19. 

💚

Difficult Health Decision

 I have some very disappointing news. I'm still broken.

After three months of wearing the hip brace, I was excited to finally get out of it and get back to my activities. I went to 2 pool exercise classes and one physiotherapy appointment. I was going to get a form filled so that I could get back to work with modified duties and eventually be back to normal hours. I was just starting to get a few things done around here that have needed doing, we went for a few car rides and a little walk in the park, and I was wearing pants other than leggings! Then it happened.

Last week, while I was seated, my hip had a partial dislocation. It popped out when I twisted sideways and kind of reached forward. I screamed, and my daughter called her dad and tried to figure out what to do. She was just starting to call 911, and I kind of arched my back with the pain and tada it clunked back in. Yes, I actually could hear the thunk as it relocated itself, and immediately the sharp, severe pain stopped. I cried and cried because, beyond the pain, I knew what this means. I put the miserable brace back on until I could check in with the doctor.

I called my surgeon's office and got an appointment for his next office day. He believes that we should do a revision surgery as soon as possible to go back in and change the style of the liner in the artificial socket and check things out. The protocol, if it had fully dislocated, would absolutely have been to do the surgery. There is no good guide for what to do with a partial dislocation, so the choice was up to me. I questioned why this dislocated at 2 and a half years out. It is very, very unusual - dislocations are usually very early in the game or after many, many years of wear. There is no answer to that one.

 I was supposed to have that cancelled knee replacement finally happen in July. He is highly concerned that if we don't have my hip stable at the time of the knee surgery and it dislocated again, it would be catastrophic for the recovery of both joints. He suggested that if the hip wasn't 100 % by then, we should do the hip instead of the knee at that time or just cancel the knee surgery.

 I asked if serious strengthening exercises would be a possibility instead. Our decision was that since I already had an appointment in a couple days with the physiotherapist, I should get her opinion. 

I saw the physiotherapist three days later. She really didn't think it was likely that we could get it strong enough once I was having repeat injuries like this, and the unfixed knee was not helping the situation. She said she would just go with the surgery rather than waiting in fear for another dislocation. Don't put so much work into strengthening that hip just to have the muscle cut in an emergency situation. Made sense. 

I called the doctor's office, and now I have surgery scheduled for May 19th.

Three weeks is actually a nice amount of time to get organized for life after surgery and to talk myself into accepting that this is really happening. On May 25th, it will be 3 years since I was in the hospital having the replacement and 13 years since I was in the hospital due to the pulmonary embolism and the subsequent brain injury. May is apparently not an easy month for my health. I am pretty discouraged at this point. I feel like I have done all I can, but then I question what I might have done wrong that I am having trouble with my hip like this. Unwarranted Self-blame is an issue for me sometimes.

The new Physiotherapist, Janine, said something helpful. I hadn't actually said anything about blaming myself out loud, but I guess she picked up on my emotional state. She looked at me kind of sharply and said, "You do know this isn't your fault, don't you?  This isn't you, failing here... it's your hip. No, actually, it is not your hip .. it is the prosthesis (artificial hip) that is failing. Maybe a problem with it. Maybe not the right fit or orientation for you and your life, but for sure, it is NOT you!" I didn't realize how upset I was feeling about that until I felt such a wave of relief go over me with her words.

I'm going to try and get some fun into the next 3 weeks while I still can. Life has already been so restrictive in this Covid Time. Unfortunately, we are in another wave in Winnipeg and experiencing increasing restrictions related to rapidly increasing case numbers. Another bunch of limitations because of the hip and now continuing for 4 more months is just adding to the isolation and feelings of being restricted. Even though I am in quite a bit of discomfort and pain, I want to go for some car ride adventures, take some photos, have a picnic, get some takeout food and enjoy our yard. I don't want to miss this lovely warm spring weather.

It has Been a Difficult Summer

I am not totally sure why I haven't posted. I think I just got overwhelmed and rather depressed post surgery and through the recovery.

I had a set back in my recovery from the hip replacement a day or so after my last post.
It would be considered a soft tissue injury but basically I had a lot of swelling in my leg and probably tore internal stitches but I really didn't do anything to over-stretch or move in an inappropriate way. I had a huge lump form below the incision with a lot of swelling followed by massive bruising. Worst was my leg hurt a lot and really just would not work. My hamstring and my glute were both involved so it was a huge step backward with me back on bed rest and using a walker. I never did get back to the hip rehab programs but instead when to a physiotherapist for the muscle problems.

My knee is still a huge problem and I talked to the surgeon about that. I qualify for a knee replacement and could have been placed on a waiting list, but he suggested we again try all the other methods for pain control that I have done in the past, but that with the hip realigned I might have some better success and treatments might last a little longer. He suggested that the surgery and recovery are much harder for a knee replacement and it would be a good idea to not rush from one surgery on top of another and give lots of time to fully recuperate.
My back is pretty sore too. I guess I have been compensating when I walk for so long (for one reason or another)r that suddenly having the hip fixed forces everything else to change yet again.

Summer has been pretty boring for the most part. I tried to do bits of activities but did not last very long.  I did not get out to the lake until basically the last weekend in July and it turned into a pretty hard to manage weekend but I do love being at the lake.

I am supposed to be returning to work this coming week and I am not sure how I feel about it. In some ways I am delighted because I do love my job and miss the residents and my coworkers and all the fun we have. At the same time I want to be physically able to do a good job and not be in pain myself. For the next month I will be returning with shorter work days and with some movement restrictions such as not standing for more than half an hour and not lifting or pushing items over 10 pounds.

I keep thinking "What the heck happened to summer?" however I have been enjoying a beautiful early fall at the lake and doing the odd crafty thing during the past couple of weeks.  I have signed up for Arthritis water therapy classes at the public pool for the fall and Girl Guides starts up next week.

Life continues.

Physiotherapy for Hip Replacement

I went to an assessment for Physiotherapy at the Reh-Fit Center in Winnipeg last week. It was a good experience and I will be going for my first group session on Tuesday. She took a thorough history and is aware that I do have asthma,  high blood pressure issues and that I do not have equal strength on both sides. I have a bit of a wonky gait from "before" but apparently everyone with severe enough issues to need a joint replacement has gait issues, so that is something else that will automatically be addressed! Yipee😊! She checked my incision which is not fully healed and said we will continue to keep an eye on it too. She sent me home with a new and improved list of exercises.

About a year ago the government started doing an overhaul of health care services. One of the cuts was the post-hip and knee surgery outpatient aftercare. The departments were closed. The physio departments remained in the hospitals for inpatient care but staff layoffs occurred.

Since that time the health authority has continued to support the pre-hab clinic. They are giving education prior to surgery to have people as ready as possible for surgery and have the best outcomes. I will post a link at the bottom of this post for more information about the hip/ knee clinic. They have a lot of very good videos about joint replacement but I would draw your attention to a video of the exercises they recommend doing during for the time you are waiting for surgery. I think it would have benefited me to have started them years ago!

http://www.wrha.mb.ca/prog/hipknee/index.php



The physiotherapy and occupational therapists in the hospital assess if you are safe to leave for home before discharge and they review a few of the exercises that were to have been practiced before the surgery. You are to exercise at home but the set they give you is not looking at your specific needs nor does it show how to increase and changes the exercises as you grow stronger.
They give you a prescription for further private physiotherapy but then it is in your hands.

Many people do not have a insurance beyond that of our Canadian public health care system. I have very minimal work-related health insurance.  Physio for me is largely an out of pocket expense.

Many others have been in the same situations. I am youngish for a hip replacement and many seniors older than me live on limited incomes and will not have as much help as they need to get as full a recovery as possible.

The Reh-Fit center is very conveniently located about a mile from my home and is a lovely space with great resources and highly trained staff. I have known several people who have been referred there post heart attacks and they can't say enough good things about the services. It has a charitable status and a fantastic reputation but is at a higher cost than many other places around the city.

The Reh-Fit Centre is more than a fitness centre. We provide an environment to help individuals achieve and maintain health and wellness. We offer individual and group options for exercise, nutrition, and education through a team of certified health and fitness professionals. Expert guidance from professional personnel, innovative health enhancement programs, and the integration of medical, rehabilitative, and fitness services all are delivered in a clean, service-oriented environment.

                                                                                     http://www.reh-fit.com/about-us/

The Reh-Fit Centre has been offering post hip and knee replacement programming for members who are 6 months or more post surgery for a few years now. I noticed several months ago, after the withdrawal of our hospital-based rehab, that they were offering a knee replacement program for the immediate post-surgery period but not for hips. After I got home from the hospital an ad popped up in my social media feed about the new hip program so I called them up.

They launched the new program in mid-May!  They do not require membership and they enroll people between 1 and 2 weeks post surgery. I just plain old got lucky with this one! They do an initial assessment by a physiotherapist for about $70 (possibly covered by your private medical coverage) and then you can continue with weekly group sessions with a physiotherapist, a kinesiologist and possibly a volunteer. The groups can be up to 10 people, last an hour and all this for only $20 a visit.
After they feel you are no longer benefitting from this program they will encourage you toward other programs to help with your continued improvement.

We will see how this all goes tomorrow!

My Hip Replacement Surgery

The surgery was 19 days ago and I have had a chance to relax and reflect on the experience. I am home and my new hip is amazing and working very well. The pain is so much less than before the surgery and I am feeling better all the time.

I was pretty tense beforehand.. let's call it panicked.
I  had bad, life-threatening experiences in the hospital as a kid.
It was also very much on my mind that my hip surgery was occurring at 10 years to the day from when I was admitted to the hospital, hemorrhaging and with a pulmonary embolism in my lungs - and my life changed forever.

I kept thinking I can still change my mind - this is an elective procedure. The fact is that  I can not imagine living the rest of my life in the kind of pain and disability that I have been experiencing. I have fought too hard to regain my independence to have it slowly disappear on me once again.

They try to have patients well prepared for hip surgery. Patients have gone to these Regional health authority hip and knee clinic orientation meeting, met with appropriate therapists from the center and have an appointment with their surgeon. We received a 50 something page booklet to read that should answer most questions.

The week before surgery patients went to the hospital where they are having your surgery and have meetings with the anesthesiologist, physiotherapist, occupational therapist and a nurse. Blood pressure is checked and they do one last x-ray of the knee or hip. You get another booklet outlining what time you personally need to be at the hospital when you are last allowed to eat or take medications, a map of the place and a list of what you should or should not pack for your stay. There is a caregiver pamphlet with where to park and what the person accompanying the patient needs to do.

I have a LOT of allergies and because of past experience, I was concerned about that aspect of the surgery and was not feeling as prepared as we could be.  It did indeed turn into a problem with me trying to convince people of the severity of the reactions I can have to medication. Fortunately, the pain management nurse at the hospital actually contacted my allergists' office and got a written report about what medications I can have. I can say without a doubt that woman made a huge difference in the safe and successful management of my care.
There were still a lot of problems with pain management and even greater problems with finding a way to send me home with something for pain relief.

Lilacs and early summer flowers are not my friends. I have severe allergy-induced asthma,  I have wound up at the doctor or in the emergency at least 5 times during that last two weeks of May  This is a bad time for surgery. I wound up having three asthma attacks while in the hospital and one of them was probably the scariest close call I can remember. I am sure that besides the seasonal allergies I was reacting to some of the sanitation chemicals used to clean in the hospital and I suspect just the effect of the surgery on a body as well as the effects of the pain medication on breathing added up to a horrible mix of conditions.

The days blurred together with pain, narcotics, sponge baths and nurses coming in and out. Meals were ummm nourishing. The staff was all very kind and nice to me.

My family were there for me and kept me company and helped in any way they could.

I got along well with my roommate who had a knee replacement and I feel lucky to have shared this experience with her and shared her company.

Physiotherapists came each day to make sure I was starting to move a bit and getting me standing as soon as possible. They have to make sure you can get in and out of bed safely, stand up and use a bathroom and if needed make sure you can safely go up the number of stairs required so you can get into your home upon discharge.

My hospital bed.

The Walker.

My poor leg.

I just have to share the view from my second-floor hospital window. Talk about patriotic!

It was actually very soothing and meditative to lie in bed and watch the flag moving in the breeze.

My recovery now continues at home. I am doing the hospital based exercises and trying to move around the best I can.  Next, I will be starting a brand new post-surgery rehab program at a facility called the Reh-Fit Center.

My goal is to be Leading a Healthy Life!

One Week to Hip Surgery

I haven't written because I have been avoiding talking about how I am feeling while I am getting ready for my upcoming hip replacement surgery.

There has been a lot to do to get ready. I have gone to a lot of appointments, bought a lot of things to make life easier and I learned a lot in the process.  I do want to journal my experiences with this surgery on Leading A Healthy Life so I thought I better just sit down and start to type!

I had expected that my surgery would be in Fall 2018 but there was a cancellation and they gave me a May 25th date. I know I am lucky to be seen so soon but I am perpetually feeling like I am playing catch-up, both physically and emotionally and financially. I took short-term disability from work and have pulled out of my art group and Girl Guides for the now so there have been a lot of changes in my life. I am rapidly going between be ecstatic at the thought that soon I will soon be able to walk and drive and do all those wonderful things in life------- to feeling absolute panic as I imagine all the worse case scenarios.

I am in a lot of pain and walking is horrible, sleeping is difficult and my allergies knock out the use of most effective painkillers. I have been dealing with this for a long time now and have done medication, physio, water programs, hot and cold treatment, cortisone shots and so on and now I am out of options other than surgery.

If the hip goes well I will get on a waiting list to deal with my knees which are in horrible shape too.

I am going to work on being POSITIVE about the outcome!

Please keep cheering me on!

Photo from 

Ashim D’Silva