TO APPROACH OR NOT?

Those of you who have read my earlier posts, you may recall that I wrote about the patient across my room at the hospital after our TKR surgery.  After chatting with her, I found out that she was approached by a stranger at an airport.  The stranger observed that she was limping badly with her bowed legs and suspected that she may have a serious osteoarthritis (OA) condition.  So she recommended her to seek treatment from an orthopaedic surgeon and gave her a surgeon's contact.  She made an effort to see the surgeon, got diagnosed and went through a bilateral total knee replacement.  And there she was just across my room at the hospital except that she did her surgery one day earlier than me.  She was go glad that she took this step to end her misery.

From this experience, I became more observant of people when they walked.  I discovered that osteoarthritis is affecting more and more younger people.  For instance, there is this Indian clinic nurse who works at the clinic that I usually go to.  She is only 35 and one of her knee is in a bad condition and she walks with a limp.  I was happy to share my experience with her but due to financial constraints, she had a long waiting list at the government hospital to get her knee replaced.  I have two sisters, one aged 48 and the other is 55, both have quite bad OA and its a matter of time that they will go through TKR.

The other day, I saw another woman probably in her fifties walking with a bad limp in a local supermarket.  I could just feel her pain and was hesitating whether to approach her.  Somehow I did not gather the courage to do it.  At the back of my mind, I worry about how she would receive it if I approached her.  She might just ask me to mind my own business or maybe she would be grateful about it.  I really wouldn't know.

But I do know that while most people can see the benefits of doing TKR, the fear is too great for them to overcome.  Just like addicts, there is also a problem with denial for people suffering from OA.   I should know because I was there before.  That's why I had to force myself to hit rock bottom by continuing to be physically active to the point that I could not tolerate the pain anymore. Then I was ready to seek treatment. 

So coming back to the question of "to approach or not?", I think I will strive to do it if the environment is conducive enough.  If I am successful even with 10% of the people I approach, at least I have helped a few people.

DETAILED ACCOUNT OF TKR EXPERIENCE

THINGS TO PREPARE BEFORE SURGERY





X-ray post surgery

X-ray before surgery



                                             

Before I went through a bilateral total knee replacement (TKR) surgery, the condition of my joints were already serious, literally bone on bone like the x-ray above on the left.  The surgeon  tells me the brand and model of the artificial joint that he will be using which is obviously carried by the hospital.  So there really is no option for me to choose from.  However, I was told to google and read about the product from the internet.  I did and found that it was a reputable company/brand with lots of experience.  I felt reassured.

He also showed me a replica of the artificial joint and explained the type of material its made of, how it works and how they implant it.  I even googled youtube and saw some videos of TKR surgery.  Yes, it looked gross and I felt really nervous.  If you cannot stomach such visuals, then please do not do it.  For me, I controlled myself and viewed the whole video as I wanted to understand the whole process.  So it was enlightening for me.

I asked my surgeon questions such as;  what will happen if I fall?.  Well, he said that if you fall, it would be just like any other ordinary people.  It depends on whether it was a minor or major fall.  If its a minor fall, you will end up with cuts and bruises.  If it was a major fall, then an x-ray would be able to tell you the condition of the joints. 

My friend who also went through a bilateral total knee replacement a few years ago, told me that I would need a walker immediately after the surgery and she was kind enough to lend me hers.  It looked something like this one below on the left.  It is height adjustable and foldable. Subsequently, I progressed to a cane and the one I bought from a pharmacy looked like this one below on the right.  I chose this cane because the height is adjustable and this is important to ensure good posture.  Plus, it is foldable so it can easily fit anywhere.

For those of you considering or have already scheduled a TKR surgery, it would be good to find a suitable chair.  I wish I knew about this before the surgery so that I could be more prepared.  You know, everywhere I went after my TKR,  it was like I  was on a mission to look for the perfect chair.  I have never been so observant of chairs. I can tell you which mall have more suitable chairs/bench and which one sucks.  So based on my experience, I found that a solid chair with armrest is the best.  This would ensure that the chair is sturdy and the armrest is very useful for getting up.  Also, the higher the chair, the easier to sit down and get up.  Here are some examples of suitable chairs I obtained from the internet.

While my PT said that I should not sit on sofas but I found that if the sofas or recliners are high enough and the seat is firm, then they are appropriate.   It would be better if they come with armrest for the ease of getting up.

As for beds again, the higher the better.  I found that the hospital bed is the best as the height is adjustable.  Of course, we cant have hospital beds at home but we can just make do with whatever we have.  Try moving furniture around so that you can grab hold of it to get up.  I have seen videos in youtube where people have made lots of ingenious improvisation to turn their legs on the beds and also to get up from it.  Again, these are things that we do not know unless we did some research.  Rest assured, the doctor would not tell you any of such information.

Another challenge is sitting on a toilet bowl.  Most modern toilet bowls are too low.  I could not even push myself up with the walker.  So I improvised by holding on to something solid near the toilet bowl.  If I knew this earlier, I would have installed a metal bar/handle near the toilet bowl.  You can also consider getting portable toilet bowl raisers like the pictures below.  I did not know this until I saw my mother using one.  Its quite high and easy to sit and get up.  I was also obsessed with the height of toilet bowls when I go out after TKR.  I resorted to use public toilets for the handicapped hoping that they will have higher toilet bowls with metal bars for support.  Its disappointing to find that most of such toilets are not user friendly for people after TKR.

As part of preparation for surgery, its important to strengthen the muscles of your upper and lower body.  This is helpful especially after the surgery as you would need a lot of strength to be able to move about with the walker, crutches or canes.  You also need a lot of strength to push yourself  up from a sitting position as the muscles around the knees take some time to strengthen back even with regular physical therapy.