FUDiabetes

Knee Replacement (TKR/TKA)

Hello FUD’ers! I am wondering if anyone here has undergone a TKR/TKA, and has pointers for pre/post surgery. I have the whole arthroscopic procedure down to a science for pain & insulin management but was wondering what I should prepare for as this is a much more invasive surgery.

Thank you to everyone in advance, and I hope everyone is having a great holiday season with family and friends!

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I’ve had lots of invasive surgeries but very little experience handling them as a responsible diabetic. So I’ve got nuthin. But I wanted to tell you good luck! When is it scheduled?

I had my endo request IV insulin for me during surgery (NOT knee replacement, but invasive), and communicated this to surgeon. It wasn’t communicated to hospital well (anesthesiologist), but in the end, I was able to have IV insulin and glucose though surgery and first 2 days after (i don’t remember much, mega pain meds). They did fingersticks frequently, and adjusted.

Then I had to sign papers to refuse insulin injections by staff, and that I would manage insulin with my pump the next 4 days in recovery, and they removed IV insulin. I also used dexcom during recovery.

For pain management, I made sure no Tylenol, due to interference with dexcom.

Ironically, 4 days after release, I was admitted again via ER visit, and received additional treatment (no surgery) and 3 day stay. Kept my pump and dexcom the whole time, and they completely ignored that I had diabetes, and I had full management.

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TY @Nickyghaleb! 1knee end of Jan, and the other end of Feb. Arthroscopic procedures I have dialed in because they are short. Starting to have 2nd thoughts…

Short and necessary? You’ve tapped into something I feel I can speak to, and that is just surgery in general. If it’s necessary and all other alternatives have been considered, then second thoughts are a waste of emotional energy. You do what you gotta do. However, if you’ve booked in because of the idea they’re short procedures, then I’ll say this: no surgery is cut and dry, and they rarely end up being as “short and convenient” as they were pitched. I’ve had six major operations and four… less major ones, I guess… and some of those smaller ones made for complicated recoveries and more unintended consequences.

My point, and there really is one, is to say if you need it, then that’s all there is to consider, but the more “elective” it is, the less I’d let the idea of it being convenient or small influence the decision.

I should’ve left you alone. My real intention was to wish you luck. :grin:

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This has nothing to do with diabetes, but having watched a number of people undergo TKR, are you sure you want two of them done that close together? I would rehab the first a little more before having the second if you are indeed having two TKR’s. After everything is said and done however, assuming you get the range of motion you are looking for, it should definitely be less pain.

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@Chris I was actually a candidate for simultaneous bilateral replacement. I chose to delay 1 by 30 days as I need MUA on the 1st knee (65 degree range of motion now) and might need it again in 30 days. I would prefer to have any additional MUA concurrently with the other knee if possible. I am prepared mentally for the pain that will ensue, and I will not have to take quite as much time off of work (2ish months). The 2nd knee surgery is completely contingent on the first - good bg control, range of motion, pain, etc. Might not even happen if everything goes sideways as sometimes happens.

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That sounds like a great plan. Sorry about the knee problems, those have to be a really frustrating thing. Of all the problems our extended family has had, the knees have caused more pain than just about anything else. It really is a booger of a problem. Good luck with your surgeries.

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TY. Been dealing with it for +20 years. Finally had enough. I still wonder though if I could put up with it for a little bit longer… is this really the right time?

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Just make sure you don’t make the mistake of waiting too long and not being able to properly do the rehab. That happened to one of my relatives.

Point taken, thank you

@elver Good luck! Hope it goes well.

Thank you @docslotnick! Still jumping through hoops to get it all approved. I think they make it difficult so you will either reconsider or not think about how difficult /painful it will be after surgery and reconsider.

I had a left total knee replacement done last March. I spent one night in the hospital (managed my own CGM, testing and pump) and all went well. For about three weeks I had quite a bit of discomfort and trouble sleeping. But then it got better. At six weeks I was walking on easy trails for up to 90 minutes without a cane. I’d do it again in a heartbeat! My advice for pre-op is to get your A1c in good shape (helps with healing) and work those quads! Strong quads really help with stability and a quick recovery.

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@mremmers Thanks for the tips! I hope my experience mirrors yours!

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@Nickyghaleb. I know my response is delayed, and I don’t disagree with you. For me it’s become a matter of being employed and having quality of life again or looking for a sedentary job that just isn’t me. Silicon Valley is insane. At my age it’s becoming a struggle to keep up, and I don’t feel that I am that old. That said, I had a number of work related accidents over the years that have never been comepletly rectified by 'scopes. I’m not a whiner type. I live hard, work hard, play hard. Sometimes too hard. At least I lived it and didn’t watch it. Not making excuses, and I have held out as long as my daily pain tolerance will allow. Im just tired. Tired of being in pain. Tired of squirming in my seat looking for the fleeting comfort others enjoy. Tired of 2 to. 3.hours a night sleep because my legs are screaming obscenities in the wee hours. As scared as I am of the permanence of a knee replacement, I’m almost more scared not too…

Sorry if that sounded like a rant. It’s not. I seriously value your input, and that of the members here at FUD. At FUD, I actually feel like I belong and am not a edge case.

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I genuinely hope I didn’t in any way make you feel like you were whining or jumping into something too fast. I have never once gotten anything from you that led me to believe you were a whiner. Now, there were a few jokes that made me question other parts of your personality, but… :grin: I’m kidding. I’m trying to make light of this because I hate reading all of that up there about the sleepless nights and fear and pain. If there’s somebody who should be trying out a surgical solution, it sounds like you’re the one. Pain sucks. 100% through and through, and I’m sorry you’ve got so much of it. I really have had a lot of surgeries, and I stand by what I said about being sure you need it before jumping in, but with that being said, the surgeries I’ve had have brought relief. I hope from the bottom of my heart that yours will, too.

So you can get back to playing hard… forget the working hard part. You might want to let up in that department. :heart:

@Nickyghaleb this is all me. You my dear lady are a genuine inspiration. I am just having a spectacularly bad month and having a case of the yips. In my heart of hearts I know the answer. My brain is still doing 80 mph on the hamster wheel. I don’t like to whine ( I would rather wine) but I do 2nd guess myself on occasion - most of the time to my own detriment.

Ms @Nickyghaleb you did not start or cause or state a thing that I have not already mentally dissected previously.

BTW… Congrats on your A1c!

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Fingers crossed that everything works out well, and you get that pain free life you are looking for.

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Thanks @chris. I hope so too.

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