Keep on keeping on

I'm closing in on 6 weeks post surgery - a point where the surgeon and therapist says I should be 80% recovered. I have been feeling more and more "normal" and have gotten back into the routines of my life, but some things still elude me.

I have been going to the fitness indoor pool about every other day (when I don't have physical therapy) and walking back and forth, starting with 10 minutes my first few times and working my way up to 20 minutes today. I have also done toe and heel raises and squats (I've progressed from mini-squats to deeper squats) like the ones I do at therapy. Today, I did some step-ups that I also do in therapy now, only not as many. I thought that I would be through with therapy after six weeks (which ended Friday), but my therapist said two more weeks at least. I talked to a woman today at the pool who said she went for 16 weeks, but surely it won't take that long. Each time I go to therapy we seem to add exercises or machines to use, so I must be getting some strength back.  Just trying to be patient and enjoy the little steps I'm making toward recovery, like giving up the walker at night. I remind myself to be thankful that I don't have any pain when I walk - something that surely wasn't true six weeks ago.

I had a real treat for the 4th of July. I was able to get on a friend's sailboat with a little help and maneuvering which was parked directly across the water from the barge that shot off the fireworks for the 4th. It was a great front row seat and the fireworks were spectacular. Getting off the boat was lots easier than getting on, although the floating dock was a bit difficult to maneuver, still a little shaky, but I'm doing exercises at therapy that works on that.

Visited a friend today, who had surgery about 12 days ago. She's had home health care, but although she is doing really, really well, I am able to look at my progress and be glad I have 4 weeks ahead of her. I still have problems with my sleep patterns, and feel tired a good bit of the day. I don't know if that is due to lingering effects of surgery or whether there may be some other reason for the fatigue. I have an appointment with my regular internist this coming week, so maybe she can answer those questions. However, overall, I continue to improve and continue to be extremely happy I've had the surgery.

After one month

Today marks one month since I had my knee replacement. Hard to believe it - seems like a few days ago I was coming home from the hospital.  Then, again, considering all the changes that have taken place, it seems like a long time.

At this point I am becoming pretty self-sufficient. I no longer need the walker and never used a cane. I have started walking in the pool on the days I don't have physical therapy. I keep it to a minimum of 10-15 minutes right now, and that is enough to make me fairly tired. I still do the same minimal exercises as home, but the physical therapy has stepped it up a notch. At the last session, I used the recumbent bike for 5 minutes and then switched to a regular upright bike for the next 5 minutes warm up. It makes me think I'm not too far off from riding my own bike at home. The number of exercises I do has increased. In addition to my standard ones, I now do toe raises and mini-squats, balancing on a rocking board for 2 minutes, both back and forth and then side to side without holding on, using the leg press machine, another exercise using a machine with weights that is too hard for me to describe, and stepping up and down 18 inches leading with my knee-replaced leg (this goes against "up with the good, down with the bad" and took some adjustment) both forward and to the side. I continue to make progress with my range of motion which is now at 130 degrees and my straightening my leg is also improving though still not perfect. I have 3 more weeks of therapy to go. The good news is that I am now driving myself to therapy and also to the pool. This is great for my husband, because he was usually either early to pick me up and had to wait 10 or 15 minutes, or I finished up early, and I was waiting on him.

I still ice my knee 2-3 times a day, but I'm beginning to cut down on my pain medication and hope to be completely off that in the next week or two. I understand that I should make 80% of progress toward recovery in the first 6 weeks, with a year to reach 100%. I'll continue with this blog through the 6 weeks at least to record my progress. 

Sleep (or lack thereof)

I have had a significant problem with my sleep patterns since this surgery. It seems fairly easy to get days and nights mixed up with the hospital routine of waking up (or being woken up) at all hours and then, at home, waking up to take pain medication in the middle of the night.  I also found in the early weeks, even up to the present, if I have a particularly tiring day at PT or just from overdoing around the house, that sitting in bed icing my knee makes me so incredibly sleepy that I just have to nap. I've had naps that lasted two hours, and for me this is the kiss of death for a normal bedtime. Even though I feel very tired (I never seem to recover fully from a nap), I can lie awake for hours before sleep finally comes, and then it can be a fitful sleep with many wake-up times. This must be a problem for many knee replacement patients because the PA asked me if I had difficulty sleeping.

It really isn't the pain that keeps me a wake, but the inability to find a comfortable sleeping position. For weeks after surgery, I was only able to sleep on my back, and I always slept in the same position with my left leg straight and my right one slightly bent. Now I am able to lie on my side if (and this is a big "if") I can find that one comfortable spot. Usually I can't, so I toss and turn (gingerly), and usually end up back on my back again. The PA gave me a prescription for something that isn't a sleeping pill or a muscle relaxer, but something that supposedly calms the nerve endings. That helps some, but I still continue to have problems falling asleep. This just might be me - I've always had difficulty with this, but now it is more pronounced.

Another problem is that when I have a very restless night, have a hard time falling asleep and wake up multiple times (usually every hour on the hour), when I finally get into that deep restful sleep, I sleep late into the morning. A few days I slept until 11:00 a.m., and had a hard time rising even at that hour. Of course, this exacerbates the problem - hard to go back to bed less than 12 hours since I woke up. My physical therapist suggested icing my knee for 30 minutes or so before I'm ready for sleep to see if that helps. I'll try that and let you know. But for now, this remains a problem.

If any of you reading this blog have some suggestions, I'd love to hear them.

A word about pain

I have looked at lots of sites on the internet about knee replacement, and found one where a woman who had knee replacement scheduled seemed overwhelmed worrying about the pain. Many people had responded to her to reassure her about pain management, but she still seemed so focused and fearful about the pain of surgery. That has prompted this post.

First of all, how many people do you know who undergo knee replacement surgery because they thought it would offer significant improvement in their minor knee pain? I'm sure your answer was "no one." The reason people schedule a knee replacement is because the pain and restriction of movement of the affected knee has greatly impacted their daily living to the point where they seek relief from this. I have talked with many friends and relatives who have delayed knee replacement and lived with constant pain because of this fear. One hundred per cent have said after knee replacement that they wished they had done it sooner. The longer you delay knee replacement because of fear of pain, the greater the chances are that you will have greater damage to your knee.

Does knee replacement surgery involve pain? Yes, it does. Does physical therapy involve pain? Yes, it does. Will this pain gradually decrease as you heal? Yes, it will. If you do not have knee replacement on a damaged knee, will it involve pain? Yes, it will. Will this pain gradually decrease? No, it won't. So, if you are one of many who are postponing surgery because of the fear of pain, you are probably just postponing the inevitable. At some point, you will undergo the surgery because you are unwilling to live with the pain. Why keep putting it off? If knee pain gets to a point where it impacts your lifestyle and you have one or more doctors' opinions that you would benefit from knee surgery, bite the bullet and go for it. I know I'm glad I did.

First doctor visit

Had a great visit at my doctor's office today. Can't believe it has been 3 weeks since my surgery, as the time has seemed to crawl by, but more and more I realize that it has been well worth it. My physical therapist had given me a note about my progress to give to him, and both the PA and doctor seemed pleased with it.

I had X-rays taken again, and everything looked good and in place.  The first thing the PA told me was that I could ditch the compression hose - what a relief. I was beginning to fear I would have permanent indentations on both legs. I forgot to ask the doctor why I had to have the hose on the good knee as well as the replaced one (not the bad knee anymore!) Maybe I'll remember on my next visit.  I do have to continue to wear the sleeve on my leg, but don't even have to wear that at night.

What a sad sight my leg is what with the glue residue, the extreme dryness, the long, ugly, discolored incision, and the exceedingly long hair that has avoided the razor for a month. The PA removed the adhesive strips that had held the incision closed and noted the new ones that the doctor had added when he re-glued me. There was only mild discomfort, hardly enough to mention. She did caution me not to pick at the glue residue (it is tempting, but I'll try to refrain.) She showed me how to massage the incision to help with the scarring. I am to use Vitamin E oil.

More good news, I can drive as long as I haven't had pain medication in 6 hours, I can go to the pool and walk in the water, maybe I can even putt a little bit, and I can jettison the walker if I want to. I think I will keep it for nighttime use, as I still need that security, but I'm walking around the house without it now.

I feel like today is a major milestone in my recovery and I will try to work even harder with physical therapy to get even better.

Pets?

It occurred to me that some of you reading this may have a pet just as I do. You may also have children in your home, but you can usually explain to children the necessity of being careful around someone who has just had a knee replacement. This is more difficult with pets.

I have a cat, a Rag Doll cat, whose redeeming grace is that she is beautiful. However, her intelligence is in inverse proportion to her beauty. I could devote a whole blog to Cassie, but since this is about knee replacement, I'll only address dealing with her in regard to my surgery. I am Cassie's primary care giver. Up until this time, I have been the one to feed her, give her her medication, and clean out her litter box. The only interaction she has with my husband has been to snuggle up beside him on the sofa while he watches golf tournaments. Therefore, she has had a difficult time adjusting to having Bill as a primary care giver. When Bill gives her a morning treat of a spoonful of wet cat food as a reward for taking her medication, she will not follow him to the laundry room where her food bowl is, but stares at me and meows mournfully, before finally giving up and taking a nap. Eventually, when she goes to get a bit of dry cat food, she will discover the wet cat food has miraculously appeared and chows down.

Since my surgery, I have spent a fair amount of time in bed, a place that is forbidden to Cassie. I know many people allow pets, both canine and feline, into their bed, but my husband and I don't like sleeping with animals. So, Cassie knows that any attempt she has made to get on our bed is generally met with loud screams, and Cassie does not like that at all. So, Cassie sits beside my bed and meows, and meows, and meows - not a soft little mew, but a loud and indignent request to get up and pay her some attention. I have to admit that on a few occasions I have let her jump up on the bed, but she doesn't stay long. She is very nervous that the loud screams are imminent, so she quickly vacates the area.

Cassie likes to lie in the middle of any traffic pattern in our house and assumes that the humans will walk around her. It is not possible to navigate my walker around her, so I just plow ahead. The poor cat does not have enough sense to get out of the way, though since I've rolled over her tail a few times, she does appear to be getting the message.

Now while dealing with Cassie after my surgery has been somewhat annoying, I really can't imagine what it would be like with a dog, especially a rather large dog, especially a rather large dog who is used to sleeping in your bed. I have a friend who is having knee surgery next week. She has an English bulldog who sleeps in their bed. I seriously don't know what she's going to do. But, maybe she will read this blog and be somewhat prepared. I'm glad it isn't a problem I'll have to deal with.

Just remember that forewarned is forearmed, so if you have a pet, try to make some arrangements to deal with any situation that might arise.

A Reminder

I've been feeling pretty cocky lately - eschewing the walker and just walking from place to place, and I've been going longer and longer between pain pills. I think all that caught up to me today. Instead of my regular 10:00 a.m. PT, I went at 2:00 p.m. today. This was because I thought I had a doctor's appointment today, so I cancelled my regular time. When I found out I didn't have the appointment it was too late to secure my regular slot. (Remember what I wrote about scheduling your PT ahead of time to get the favored slots? This is why.)

My most recent regimen of pain pills has been one in the morning, one in mid-afternoon, and one before bed, which has kept most pain down to a dull ache or non-existent if I'm just sitting or lying around. This morning, I took my pill, spent about 20 minutes doing my at-home exercises (I'm supposed to do exercises twice a day - even if one time is PT), and then I iced my knee for about 30 minutes. I was doing fine, but as we pulled out of the driveway for my 2:00 appointment, I realized I had not taken my pain pill. At that time, my husband realized he had forgotten his grocery list (he's the shopper in the family now and he says it's scary that he's learning where everything is in the grocery store,) so he pulled back in the driveway, and ran in to get the list. Did I ask him to bring me a pain pill? No, of course not. I am tough, and really what difference could it make?

It turns out it actually did make a difference - a rather significant one. I confessed to my therapist about my forgetfulness, fully expecting a "that's o.k.," but he grimaced a bit and didn't respond. We started in on the bike, and the pain started, too. It was pretty much that way through the whole routine, and after I was finally released from the ice and electricity (which today of all days had a compression ice pack) I couldn't wait to get out of there. I doubt I will forget it again. I immediately took a pill when I got home, but remember what I said about not being able to catch up with the medicine? Well, it is true, but I'm hoping after my evening meds and a good night's sleep, I'll be much better in the morning.

Learning patience

Learning Patience

When recovering from knee surgery, you should have an abundance of patience, because recovery happens at what feels like a snail's pace, and a slow snail at that. I am about two weeks post surgery, and though I have been diligent with PT, at-home exercises, and icing, I can't help but think I should be back out on the tennis court by now, or at least on the golf course. Although I still use the walker, I frequently walk where I want to go, though I've been cautioned not to walk that much. I always thought that walking would be great for rehab, but for the first few weeks I've been cautioned both by the surgeon and the physical therapist not to stay on my feet for long periods of time and to keep the leg elevated as much as possible. You probably will hear the same thing, so don't be surprised. I have overdone it on a few occasions and have regretted it.

Physical therapy

Physical Therapy

When you have a damaged knee that prevents you from participating in the normal activities of your life, surgery for a knee replacement is only 50% of the battle to return to normal. Physical therapy and your efforts in therapy comprise the other 50%. There are, unfortunately, many people who think only the surgery is necessary, so they continue to live their lives quite unhappily with less than full range of motion in their knee. Therefore, physical therapy and your wholehearted participation in it are vital to your recovery. 

Some doctors will begin your therapy at home with a home health service. My doctor did not, so my experience is in outpatient PT. Some doctors send their patients to therapy the day after getting home from the hospital, but you can expect to begin therapy within the week after your dismissal from the hospital, if not the next day.  On my first visit I had an initial assessment to determine where I was beginning which included measuring the extent of my swelling and how much I could bend and straighten my knee. This determines where you will begin in your exercises.  I was fortunate to be able to bend my knee to 105 degrees, but you may be anywhere between 90 and 110 when you start. You may start some minimal exercises, but the real work begins on your second visit.

Let me share what my physical therapist told me about PT for knee replacement. "Ordinarily, in all physical therapy we tell patients if a certain move hurts, they shouldn't do it. However, for a knee replacement it almost has to hurt to make any progress." He was right - it does hurt to do the therapy, sometimes it hurts a lot. Since I had a fairly good degree of knee bend, I started on a recumbent bike. I could not at first make the pedal go all the way around because bending my knee that much caused intensive pain in my kneecap, so I just went back and forth and back and forth until my knee loosened up enough (near the end of the five minute time set) to go around, and that was going backwards (which is easier) than going forwards. I then did some leg lifts both lying on my back and then on my side, a couple of hamstring stretch exercises, an excercise where you use a strap to pull your foot toward your derriere as close as possible, and a few others that are just too difficult to describe adequately. At the end of which, my knee bend degree was once again measured. The session ended with some electrical stimulation and an ice pack on my knee for about 15 minutes. I have done physical therapy for my neck, for my back, and for my shoulder, (that should tell you something about my joint health) and I always looked forward to this part because it felt so good. This, for my knee, did not feel good. My ankle was propped on a rolled up towel and the heavy ice pack was placed over my knee. This is intended to help you straighten your knee, and it is painful. While I exceeded the average on the knee bending measurement, I am below average on straightening my knee, possibly because I've always had tight hamstrings. In any case, I was more than ready to get rid of the ice by the time the buzzer went off.

Here is a link that will give you a visual of the exercises that I've done and some additional ones, including the ones I couldn't describe:  http://www.healthline.com/health-slideshow/total-knee-replacement-surgery-excercises-after#1

At Home

At Home

Here are some good, if not essential, items to have at home by the time you arrive: (1) a toilet seat that sits on top of yours to raise it up to a height that allows you to settle down without undue bending of the knee. One that has handles is even better for helping you get up again. (2) an adjustable walker - a plain Jane one is perfectly acceptable, but some have pockets for carrying items, or even have a seat that allows you to "rest" on long journeys (which you hopefully won't be taking for awhile) - just depends on how much you want to spend. If you have Medicare, one will be provided for you. I borrowed one from a friend - my contribution to saving Medicare from bankruptcy. I think some people prefer crutches, but I think a walker is easier; (3) a shower seat, preferably one that also has handles to help you get up and down. Even though showers take a little effort, it is worth it to get that "clean" feeling. Have someone help you in and out of the shower - this is not the time to prove how self-sufficient you are; (4) an ice machine or some apparatus to help you ice your knee on a regular basis. I have the one I used in the hospital, but I think that will depend on your doctor whether you come home with one or not. My husband brought home some suction grip handles that we had on our boat to attach to the shower walls. These work just like the handicap rails, but not nearly as bulky, and can easily be removed.

Remove any rugs that are not permanently affixed to the floor. Your walker will catch on the edges of the rug and you'll end up falling, which could have disastrous results. Rearrange furniture so you can get to the places you'll need to frequent without having to dodge around chairs or tables. You'll be scooting around with your walker in no time, so you don't want anything in your way that slows you down.

Hopefully, you will fill your prescription for pain medication on the way home from the hospital. You need to take it on a regular basis, at least at first. Now is not the time to try to forego the drugs - the doctor gives you the prescription for a reason. Knee replacement hurts - it is major surgery and a lot of muscle and tissue is cut to fit that new knee in place. There is also precedence that if you get behind on your pain medication, it is hard to catch up. If you wait until the pain is too severe, a dose that would have been sufficient if taken on time, will be not be enough to make you comfortable. I'm not sure why this is, but it is true.

In the hospital you were probably given compression stockings - wear them, even though they make indentations in your leg. These are much more preferable than blood clots. Pretend you are on vacation in Bermuda. You also may have been given a sleeve to go over the stocking on your replacement leg. Wear that, too, even though it makes even deeper ridges in your skin. You may have noticed that your leg with the knee replacement is slightly larger than your other leg, like maybe twice as big. The compression stocking and sleeve will help with this. More importantly for swelling is icing your leg - a practice begun in the hospital but one that definitely should be continued at home, a number of times during the day.

The latest in stylish knee replacement attire

If you are scheduled to go home from the hospital and not to a rehab facility, it is because you were asked and replied in the affirmative that you had someone to help you at home. Again, there is a reason you were asked if there would be someone at home to help you. If you are the type of person that I am - one that feels self-sufficient and reluctant to rely on someone else - this is going to be difficult. I know I try to do things for myself that I really shouldn't, and my husband reminds me often that I needn't be so stubborn, so this is a "Do as I say, not as I do, though I know better." I think I've finally realized that my husband wants to help me because he cares about me, and I don't think he feels unduly burdened (though if he does he hides it well most of the time).

Knee replacement is sort of like giving birth. Everything you read on the subject discusses the preparation for it, perhaps describing the events itself, but there is not much on the aftermath. That is the subject of this blog - not what happens before and during knee replacement, but what happens after that new knee is in place. This then is my own personal journey - but as all the doctors and physical therapists will tell you - everyone's experience is different - so that is my disclaimer.

A couple of things you should take care of before surgery, but which concern the aftermath of surgery are: (1) Schedule your physical therapy in advance of your surgery. Your doctor will normally let you choose your own therapist, so do your homework, ask around, and then take the therapy order to them so you can obtain times that suit your schedule. If you don't do this, you may have to take a piecemeal schedule where you go at different times on different days of the week. I have six weeks worth of therapy scheduled at the prime time of 10:00 a.m. every Monday, Wednesday, and Friday.
(2) Ask your doctor to approve and give you an application for a handicap placard. Usually you can get one for 6 months and this will be very helpful in limiting the distance you have to walk to get somewhere. I plan to be able to walk really well in 6 months, but it might be nice to have that placard in the glove compartment. I'll try not to abuse it, but, well, you know.

Before I begin describing my experience, I'd like to acknowledge that my doctor used computer assistance during my surgery and I heard he operated in a space suit. It was apparent he was obsessive-compulsive about avoiding infection, including instructions to not shave my leg a week before surgery, use an antiseptic wipe after showering the night before surgery, wear clean pjs and sleep on clean sheets. Now I'll proceed with my tale.

Day 1
I had called the office in the morning the day before my surgery and was told I was scheduled at 6:30. I was euphoric because the instructions to not eat or drink anything after midnight the night before surgery always makes me so incredibly thirsty upon awakening. Now I could just tumble out of bed and would only be dehydrated for 30 minutes or so. That afternoon I received a call from the hospital telling me the schedule had to be arranged because there were two patients scheduled at 6:30. Guess who was moved from #1 to #5.  I had to be at the hospital at 8:30 so I would have plenty of time to put on a hospital gown, have an IV in place and spend hours yearning for a glass of water. My husband was allowed to join me after I was settled in. At least we had a TV in our little cubicle, but it froze during the Today show, and none of the attendants who came in and out had a clue why ours did this when everyone else's had moved on to the next show. My doctor's PA dropped by to check on me and to autograph my right leg to make sure they replaced the correct knee. My doctor dropped by between his #3 and #4 surgery to tell me I would go to get my anesthesia "very soon," and to also autograph my leg to make doubly sure they operated on the correct leg. Finally, I kissed my husband and travelled the maze of corridors to the anesthesia holding area. The anesthesiologist popped in to tell me he would be giving me my nerve block and to also autograph my leg - I guess three's the charm! I never felt the nerve block because the mild sedative they gave me through my IV knocked me out completely, probably because I was so dehydrated! It was late afternoon when I came back from "la-la" land. When I woke from the anesthesia my first observation was my right leg was swathed mummy-like in yards of gauze. There was a tube (a drain) leading from beneath the gauze to some unknown and unseeable destination, and some sort of machine was attached to my leg which moved my lower leg back and forth at a miniscule pace bending my new knee back and forth. Actually, all that was the second thing I noticed. The first was actually my husband's relieved face showing he was glad the surgery was complete and successful. I really didn't experience much pain as the nerve block I had was still continuing to work. I was hooked up to an IV with an antibiotic drip which probably lasted into the evening hours.  The therapist stopped by, unhooked me (with the help of the nurse) and escorted me into the hall with a walker where I strolled (well, maybe limped) up and down the corridor, but applauded as though I had just run a marathon. I did take this opportunity to use the bathroom. I learned very quickly that one should not bend the replaced knee to settle on the toilet, but rather bend the un-replaced knee and straighten the replaced one to lower yourself. Back in bed with my knee machine, IV, and an knee-icing contraption, I settled in for the evening. Still under the influence of the nerve block and with an IV pain killer, I spent a fairly restful night in spite of the comings and goings of the nursing staff.

Day 2
Days in the hospital begin early, and as the nurse told me, try to be awake by 6:00 because that's when the surgeon comes by, and he'll only be there 2 minutes, and he was right. I told the doctor that I wanted to exercise my option to stay in the hospital a second night - his response was that hospitals were for sick people and I wasn't sick, so I could go home that afternoon. You should be aware that insurance companies put pressure on doctors to "move 'em out," but you should exercise your rights, and spending a second night in the hospital if possible. If you stay, you have an additional day of PT, which in my case was an extended walk around the floor corridors, you have access to the machine that exercises your knee, and the nursing staff who if you are lucky to have a good one as I was, will refill the ice for your machine that helps with swelling, and will assist you in getting to the bathroom (or possibly help with the bed pan). Staying another day will also enable you to get IV pain reliever in case you need it after that 36-hour nerve block finally wears off, which is definitely preferable than waiting for an hour for pills to take effect. My surgeon told me he foresees knee replacement done as outpatient surgery within five years, but until that comes to pass, stay in the hospital a second night if you can.

Leaving the hospital
Before you leave the hospital, you will probably have a final visit from the doctor who will check your incision, and you'll be unhooked from the IV (if you're still connected) or have your port removed, your drain will be taken out and all that gauze that hides your leg will be unrolled and discarded. This takes awhile. Likely you'll be visited again by the PT for another stroll around the corridors who holds on to you by grasping the gaping ends of your hospital gown, performing two essential tasks at once. You'll be given some exercises to do at home. You'll also receive a visit from the Occupational Therapist, who, as far as I could tell, was responsible for showing you how to take a shower and helping you do that. If you have stairs that you have to negotiate at home, he/she will instruct you "up with good, and down with the bad." When you get your shower, you get your first look at your incision. Mine was not a "minimally invasive" surgery, so I had a six inch scar running down the middle of my knee cap. There will likely be lines marked on either side of your knee, which my husband figured out was to line up the skin when the incision was closed. Most incisions now are glued instead of stapled, and after the bandage was removed I found I had become "unglued" at one juncture and was leaking blood in a steady stream. Fortunately for me (not fortunately for my friend), I had a friend who had experienced this same thing, but he had left the hospital without completely stopping the blood flow. He ended up in the emergency room at 11:00 that night to be "re-glued" and had to go back to the surgeon the next day to again be "re-glued." I remarked to my OT that his surgeon (also mine) was extremely unhappy that he hadn't been contacted by the hospital staff about my friend's condition, so, of course, my surgeon was contacted. I was able to go by his office before I left for home to get a professional glue job. So, if this happens to you, be pro-active and get any thing taken care of correctly before you leave the hospital. Make sure you have all prescriptions in hand along with at-home instructions and exercises to perform prior to going to PT. It is always good to have this information in writing because no matter your mental abilities, it is helpful to have it in black and white and not just stored in one's memory. Most knee replacements are performed on people who have worn out the knee over the years, which means your mental abilities may have declined also, albeit at a slower rate than your knee. Anesthesia still probably lingers in your system, too, which can play havoc with your memory, too. 

This is just the first post of my blog - click on the titles to the right if you want to view more.