A Cyclists Survival Guide to a Total Knee Replacement – Pre Surgery (P-3)
Pre-Surgery
So, you’re gonna bite the bullet and get it done. Pre-surgery is a series of doctors visits and planning for the surgery and planning for how you will live your life when you’re discharged. There are several things that need to be accomplished. A doctors visit to describe the surgical procedures where they will walk you through what to expect. They will go over what you’ll need to do prior to surgery. My doctor was very proactive to prevent infection. I was prescribed antibiotics that I took prior to the surgery, an antibiotic ointment that I needed to apply to the inside of my nostrils, and anti biotic wipes to clean my legs twice a day. Once I began the antibiotic treatments (about 1 week prior to surgery), I needed to suspend shaving my legs. Nicks and cuts could lead to infection.
This is a good time to consult with your doctor about pain treatment plans. This is really important. You need to understand what pain medication you will be on. Learn everything that you can. The surgeon, for the most part, will simply prescribe medication for the pain. This is pretty much mandatory. No matter how tough you think you are, the pain will break you down and you will need something to alleviate it. With pain, your recovery is hampered. You will not be able to push as hard as you will need to to get your range of motion back. Pain will demotivate you and exercise and rehabilitation will be the last thought on your mind. So, a pain management plan is a must. However, the surgeon only knows what works to relieve pain and will throw a bunch of narcotics your way without much description on how to effectively apply them, or, an explanation of the side effects. Most likely, you will be prescribed Oxycodone, (perhaps Tramodol), Morphine pills, and muscle relaxers. Find out what your doctor likes to prescribe and do some research on that medication. Talk with your physical therapist about pain management and how to apply the prescription. The surgeon doesn’t get to see you screaming in agony while your in physical therapy. Use your pt. Additionally, learn about how to discontinue the drugs. These are narcotics and are highly addictive, including Tramodol. The withdrawal from these is equivalent to heroine withdrawal. You absolutely must have a plan of action! I’ll go into more detail below.
I needed to get another MRI. The second MRI provided a more detailed scan in order to allow the surgeon to prepare cutting templates.
Take a week or two to design your living arrangement. Post surgery you will either utilize crutches or a walker, so, you need to make sure that you can move around your home comfortably. This may be a good opportunity to call or visit a home heath agency and allow them into your home. They will tell you where to expect trouble and how to mediate it.
Things to think about include, showering and using the toilet. You will not want to stand during either operation for a while. Slipping in the shower is compounded by the weakness and instability you will have on your surgical leg. Additionally, you will have very little range of motion and bending your leg is minimal. Make sure that you can sit on the toilet with one leg fully extended. A shower stool will be required and a hand held shower head is very useful. Most home heath PT and OT clinics will provide you with the apparatuses needed for this, otherwise, run into Walgreens and grab a shower chair. A helpful device may also be a toilet seat height extender. If you intend to do any cooking in the kitchen, add a couple of chairs or stools. Make sure that your bed is close to the bathroom, for the first few weeks, you’ll need to run to it every 3 hours. If your potty is up a flight of stairs, you will be cursing at 3AM.
Being a very active cyclists, I used this time to ride my ass off. You’re not going to do it again for 8-12 weeks after surgery even with the most aggressive treatment. I even rode my bike to my pre-surgery physical. The buzz of the waiting room stopped as I clomped through with cleats and the clickity clack of my hub filled the marble floored echo chamber of a waiting room. The nurse said, “I love Colorado! Only here a guy will show up in spandex in the middle of December and come to his pre-op appointment in socks.” They drew blood, took an EKG, tested my urine, and gave me a chest x-ray. Enjoy your 2 legs!
Remember, no food or water 12 hours prior to surgery. You’ll need a ride home from the hospital, so, plan that.
Thank you so much for sharing your story. I am an avid cyclist and had my knee replaced eight weeks ago .. you are right I was not prepared for the teething but I am now riding my indoor bike 30 minutes and can’t wait to get outside
Great thread you have written – thank you
What manufacturer device did you have implanted? Did you research all the available manufacturers? Did this influence your choice of surgeon or did you pick a guy/gal who you liked.
I know a surgeon is going to use the device that (s)he uses. He or she is not going to use a new or different device just because you want it.
thanks
Hey Patrick. I had some good referrals to the doctor I went with. He he gave me a couple of options with respect to the hardware, but, insisted the newest option had the best longevity. I probably should have researched it, but, didn’t.
Such a great post. I would offer that it is now possible for them to give you a local drug that lasts about 72 hours that kills the bone and the off the chart pains. This drug simply gets one past the first couple of days and makes pain management much easier. Another handy device that I have used before during my ACL work is the “ice machine”. I have found this a tremendous asset in managing pain. Simply astounding! I got the Polar device that has a timer on it and would run in cycles till you turn it off. The first three weeks we went through 300 pounds of ice. I took blood thinners the first three weeks and could not take Ibuprofen or Voltarin but when I stopped the thinners and could get back onto NSAIDS the relief was almost immediate. Within 2 hours. Pain meds only work on nerve pain and would do almost nothing for the pain caused by weight of the blood draining into my calf… Just thought I would drop a line. Thanks!