What can I do to prepare for aftermath of knee surgery?

May 30, 2023 1:55 PM

I am having keyhole meniscus repair surgery in a couple of weeks, have never had a general anaesthetic or any kind of surgery before. I live on my own in a fairly inconvenient house and am quite solitary. Help me prepare to get through the recovery process and manage my anxiety.

I'm having the keyhole knee surgery in central London (UK), and will be in and out on the same day. The hospital is adjacent to the train station where I normally catch the train to my home which is well outside of London, about an hour away. I will be on my own on the day. I expect to be on crutches for 4 to 6 weeks.

My house has several steps from the street to my front door. Inside the house the kitchen is downstairs and the only bathroom is upstairs with an overbath shower - none of which is ideal.

I suspect the hospital staff will not be ok that I am going home alone. I have no other option. Can they keep me in? I don't think I'd deal very well with having to stay overnight. I am tempted to slightly gloss over this if/when they ask me - would that be terribly stupid and risky?

I'm trying to work out how to get home. Will I be in pain/ woozy / capable? If I have to take a taxi, I don't really know how to book a taxi that will be prepared to go so far out of London and it's hard to book in advance as I don't know when I'll be released. Might I be able to get to the train station, a one minute walk away, on crutches and then get a local taxi from the station to my house at the other end. Am I crazy to even consider it?

Assuming I manage to get home and inside, I've been preparing for life on crutches - so far I have:

- ordered a camping toilet to keep down stairs
- set up a mini kitchen upstairs:- mini fridge, microwave etc. I won't have to go downstairs for a few days at a time - particularly first few days
- bought a grabber thing to pick stuff up
- signed up for grocery deliveries and started stocking up on easily prepared foods
- done some de cluttering to make sure there isn't stuff I'll trip over
- bought a shower seat and waterproof cover for the dressings

Is there anything else I should do / buy to prepare?

Any advice / recommendations / reassurances gratefully received.

posted by ElasticParrot to Health & Fitness (21 answers total)

In the United States, they will not discharge you even after day surgery on your own, for safety reasons. Not even if you have a taxi or ride-share or similar. I don't know if that's the case in the UK. While it is a huge pain for those of us living on our own, I have to say it is probably a sensible rule.
posted by praemunire at 2:01 PM on May 30, 2023 [4 favorites]

You might consider cleaning service to come in a week or two after surgery. Try to plan it for about the time you will get annoyed with the mess and start thinking you are well enough to do some cleaning up. This will help prevent injuring yourself and setting back your recovery.
posted by CleverClover at 2:02 PM on May 30, 2023

Also this will sound silly but clip your toenails the day of surgery, you won't be able to bend your knee the right way to clip them for a while after.
posted by CleverClover at 2:04 PM on May 30, 2023 [8 favorites]

There is no way I could have gotten myself home after my knee surgery. I barely remember snippets of the ride home. I mostly remember the bumps where the pain was enough to startle me into some level of coherence before going back into fuzziness.

I didn't have laparoscopic/arthroscopic surgery though. Assuming your will be, so it might be different.

Set up all your meds and drinking water near by. You don't want to be getting up at all when the meds apart wearing off. Not even for a few steps to get water or reach a medicine bottle.

The first 2 or 3 days were the worst. It does get better. I was up and mobile on crutches pretty well after a couple days.

Will you get your painkillers ahead of time? Or at the hospital? Try to ask if they can fill them at the hospital pharmacy rather than needing to go to a pharmacy elsewhere.
posted by CleverClover at 2:11 PM on May 30, 2023 [6 favorites]

Will the NHS cover a home health aide for the first few hours of the day you come home? Might be a good idea if they will.
posted by nat at 2:15 PM on May 30, 2023 [4 favorites]

I had knee surgery on my own in Boston a couple of years ago. It wasn't fun but I survived. Note that I had had this particular surgery before, as well as many other orthopedic surgeries, so I was kind of an old pro.

Physical therapy will come to your hospital room and get you up on crutches. They just want to see that you won't harm yourself--it takes practice to get good at crutches. Accordingly, there is absolutely no way you can get to the train station on crutches postop, even if it were allowed.

I hired a home health care company to get me from the hospital to home. Seconding praemunire--there is no way they will let you go home unescorted, but the home care employee was good enough for them.

I do not remember how I got my prescriptions--it could be that I got them before discharge, or I might have had them home-delivered.

I would highly recommend staying overnight even if you don't want to.

Don't worry about the stairs. You can go up and down on your butt, or, for me at least, up on crutches and down on your butt. It's possible to go down stairs on crutches, but kind of scary.

The shower isn't that bad, either. Just sit on the edge of the tub and swing your legs over the side.

Order some crutch pockets (example) to carry stuff around the house. For example, you can shove a travel mug of coffee in there.

This may be a sensitive topic--as a fat person myself, I tried to lose a couple of pounds pre-surgery to make crutches easier. A word to the wise.

I'll reply further once I think of other things.
posted by 8603 at 2:15 PM on May 30, 2023 [4 favorites]

Please be honest with your practitioners about their expectations for aftercare as well as your available resources. In my experience this is not the kind of thing like getting your tonsils removed where you go in, do it, then recover on your own. In addition to the household logistics (daunting - will you be able to sit down and get up off a camping toilet? can you climb stairs unaided at all?) there are (in the US at least) many time-sensitive follow-up tasks and appointments for therapy, medications, check-ins that will require some sort of travel.
posted by nkknkk at 2:16 PM on May 30, 2023 [3 favorites]

Having had knee surgery: you really can't get yourself home after a surgery like that, and I would not count on taking the train home, even with a companion. You will be woozy, tired, and also in pain. You'll be unsteady on your feet and pretty susceptible to falling and re-injuring your newly fixed knee, or hurting yourself in another way. If you can't get a friend to meet you at the hospital and bring you home, you can probably hire someone.

One thing that helped me a lot when I was in my initial recovery from knee surgery was having a tote bag I could bring things around the house in (because my hands were occupied with the crutches). I'd load up whatever I needed to bring from one part of the house in the tote, hang it off one shoulder, and then crutch my way around. Now that I think of it, a backpack would have worked even better.

Echoing nkknkk with the addition that you should ask them what they think your first week will be like after surgery. For me, it was my first surgery ever and I was completely unprepared for how limited my mobility would be, and how hard PT would be. I would have had a much easier time if I'd known and been able to set myself up better for the recovery.
posted by lunasol at 2:29 PM on May 30, 2023 [2 favorites]

Adjacent to a few knee replacements, next door neighbor, an incredibly stoic self-sufficient serious biker, needed lots of meds and a lot of help. Try to stock up on the serious stuff and all the ibuprofen, Tylenol and naproxin. Have food and everything in easy reach. But get help. After a few days or a week you'll be fine but I've never heard descriptions of incapacitating pain.
posted by sammyo at 2:46 PM on May 30, 2023

I woke up from laparoscopic surgery and anesthesia with some nausea, they gave me a few different meds to try to fix it but what helped in the end was benadryl, weirdly. You may want to ask for this if they don't offer it.
posted by LeeLanded at 3:00 PM on May 30, 2023

I had laparoscopic knee surgery (in the US) to remove some torn meniscus pieces in 2016 as an outpatient procedure. I was wheeled out of the hospital in a wheelchair, but I was alert and awake and able to crutch from the car into my house when we got home. Pain was higher the first couple of days (around 6 or 7 on the pain scale), but tolerable with acetaminophen and ibuprofen. My doctor insisted that I *not* use crutches starting about 72 hours after surgery to maintain strength and flexibility, which turned out to be easier and more pain-free than I expected. Stairs in my office building were hard for the first week, but got easier pretty quickly.

Thing to remember - if you're walking up or down something like a stair or a kerb, remember "down with the bad, up with the good". Step down with the bad, operated-on leg and up with good leg to minimize having to bend that knee and apply off-center pressure.

The answers to an AskMe I posted before my surgery might help here, too.
posted by hanov3r at 3:51 PM on May 30, 2023

You can hire non-emergency patient transport services to bring you home. Someone with the minimal medical training required should be available to be on standby to be called by the discharge nurse and then head over to pick you up when they receive the call.

Here is the first hit I got searching for Central London, UK. I don't know how much it costs, but it seems to be a standard sort of service.
posted by Jane the Brown at 4:09 PM on May 30, 2023

First: You absolutely need to have some way to get home besides public transport! You're liable to get yourself in real trouble either falling or doing serious damage to your knee. Whatever you can do to get help with transport I strongly recommend it. Second: Don't fight staying overnight. Knee work is tough. Give yourself 24 hours of care in hospital. That may make a major difference in months of healing. Third: See if you can get someone to check on you the first week at home. Absolutely make sure you have your meds schedule worked out. You need to have alarms to remind you to take the meds, and you must keep a log of exactly when you take them and what you have taken. DH was absolutely useless at helping me to regulate my meds the first week of my knee surgery, and I had some serious repercussions because of it. The second week I was able to chart my meds on my own, but I was still pretty loopy. Bad things can happen if you don't take your meds as scheduled right after surgery. Bite the bullet and get some help. It's not worth screwing this up and having to do it over again or living with an unsatisfactory outcome that resulted from something avoidable that you did or didn't do.
posted by BlueHorse at 4:43 PM on May 30, 2023 [2 favorites]

When I had day surgery with general anaesthetic on the NHS, they would absolutely not let me leave alone, to the extent that they wanted to see the person meeting me, actually arrive on the ward, ask for me by name, and escort me off, there was no option to gloss over it. I've since seen the same approach on a different ward more recently with people who'd had twilight sedation - they just do. not. let people go wandering off alone after being heavily sedated/anaesthetised into unconsciousness, and that's without the leg/crutches unsteadiness. When you arrive, they take the name and phone number of the person collecting you, so that ward staff can call them when they deem you ready to be collected.

I don't know what they'd have done if I'd announced on the day of the procedure that I had nobody to collect me (the letter I got in advance made it clear that the only option was to be met and taken home), but I assume it would have been either cancellation of the procedure, or a lot of phone calls and stress for the nurses in trying to find me a bed on a ward somewhere at very short notice. Your appointment letter should have a phone number for questions ahead of the procedure, so I'd call them now and ask what your options are. That's with the proviso that if this is the NHS, they may not have a plan B apart from telling you they'll only do the procedure if you're going to be collected by a real life human that they can clap eyes on - but better to know that now while you still have time to work out a plan.

I don't know your circumstances, but I would say that if there is absolutely anybody you can think of who you can ask to meet you and accompany you home, and the same or another person to meet you and stay at your place until you hit the 24 hour mark: Now is the time to ask for help. Even if it means feeling incredibly uncomfortable asking for help from someone who's not much more than an acquaintance. I would absolutely want anybody I know, however faintly, to ask me this rather than attempt to do it themselves. I also live alone and my top tip is to ask someone else who lives alone - they get it. I asked a slightly random friend from a hobby group, who happened to live near the hospital, who is a man 20 years older than me, and arrived in his vest covered in dust, fresh from DIY, and got all kinds of odd looks from the nurses.

Attempting, fresh from anaesthetia and on new crutches, with a fresh wound (even if keyhole-sized), to get yourself onto a train, sounds like an absolutely terrible idea, I'm sorry to say. What if they release you just in time for the London rush hour, and your judgement is shot, and your memory affected by the anaesthetic, and you're either in pain or hopped up on pain relief? Don't do it to yourself!
posted by penguin pie at 5:15 PM on May 30, 2023 [9 favorites]

I had this surgery, but with an overnight stay before going home. Is it possible for you to stay overnight? Because as others observe, it's not great to go home straight away. Really not.

The last time I had surgery that required crutches (not the knee, I broke my leg a few years later) I got training from an occupational therapist on how to climb and descend stairs before I was discharged from hospital. It really helped. Again, stay overnight, get a proper discharge process.

For hygiene, shower seat is good, there are also boards that fit across the bath that you can sit on. Not sure how NHS works but perhaps the hospital can issue you with one (the public health system in NZ did).

Bathrobes with biiiig pockets are ideal for carrying things when you are on crutches.

An assistive trolley is also handy for transporting things (eg you can put a plate and a glass etc on the trolley and push it). Again, look into whether one can be issued to you.
posted by i_am_joe's_spleen at 5:59 PM on May 30, 2023

Get yourself some N95 masks and wear them the entire time you're in hospital - at the moment ~1/3 of covid infections in the UK are healthcare acquired ie people go into hospital for something unrelated and end up with covid. And get out as fast as you can!

You can do this! When I was on crutches I lived alone in a 4th floor walk-up. I had to crutch up and down 2 flights of stairs to get to the laundry room - almost fell backwards down the stairs once with a backpack full of heavy wet laundry; not advised.

I used a tote bag with straps long enough to go around my neck (similar to the musette feed bags used in the Tour de France) to carry things around the house ie thermos of coffee + mug + book from kitchen to sofa.
posted by lulu68 at 7:47 PM on May 30, 2023 [2 favorites]

To go downstairs safely, sit on the top step and then using your one good leg, move down to the next step. Basically you are walking down using your hands on either side of your butt, and your good foot and your butt taking all your weight.

To go upstairs do it in reverse. Sit down on the second or third step from the bottom and walk yourself up on your butt backwards. You are facing the wrong direction when you climb the stairs.

Practice this with a few things to carry before you have your surgery. Get a capacious bag, such as a shopping bag, and go up and down with it loaded with stuff you need to transfer up and down. You can either sling it on your shoulder, or lower it by the handles step by step in front of you.

Going down is hardest, because of having to sit on the top step without risking a fall. You can always sit on the floor and then walk yourself forward on your butt, hands and foot until you reach the stairs and can start down them.

Going down sitting significantly reduces the chances of a fall and since your hands, butt and good foot can all take some of your weight you don't have to put any weight on the bad leg at all. The hard part is getting the crutches up and down. It's undignified but so, so much safer than trying to get up and down on your feet.


If you have an office chair on wheels put that into service as a wheelchair. Try it out before surgery to make sure you have enough room to maneuver.
posted by Jane the Brown at 8:24 PM on May 30, 2023

Broke my knee years ago and had a bunch of hardware installed. Your surgery seems less intrusive, but -- I would not count on being able to go home on your own. It's not a question of willpower, it's a question of maintaining consciousness.

General tips:
-- have plenty of painkillers. Remember to take the next painkiller before the first one expires.
-- have extra pillows on the bed. Sleeping will be AWFUL. Your regular sleep movements will be totally disrupted. Have the pillows there to keep your leg immobile.
-- sleep as much as you can. Don't be embarrassed by how much sleep you will need. It's the best thing for you right away, and you will be exhausted all the time.
-- try to do whatever physio they suggest. It's difficult, and often more pain than the injury or surgery.

Your world will totally collapse and shrink. The mental struggle is as much a challenge as the physical one. NGL, it's tough. Good luck.
posted by Capt. Renault at 8:00 AM on May 31, 2023

I benefited a lot from using an ice machine, AKA cold machine, after knee surgery. It has a tank for water and ice, and a double hose that circulates cold water through a pad strapped around the knee. The machine made it possible not to get up for ice packs for several hours at a time. I think you can get a new one for $150-200; I bought a used one. It’s even more convenient to load the tank with frozen water bottles and swap them out when the time comes.
posted by wryly at 12:49 PM on May 31, 2023

In addition to the camping toilet, you may want to get a plastic urinal bottle (assuming you're a man) to keep by your bedside. Every morning after emptying, just put in a drop of dishwasher fluid, add water, shake a few times, and re-empty. That will keep it from getting disgusting after a period of multiple uses.
posted by Leontine at 6:24 PM on May 31, 2023

Response by poster: Quick update:

Told hospital last week I’d have to leave alone in a taxi, we agreed I’d be admitted overnight. All went ok apart from waiting three hours on prescription from pharmacy before I could leave. Decided against getting the train, got taxi the whole way, took nearly 2 hours and £170. But, am safely home, on sofa and feeling ok.

Thanks to everyone who answered.
posted by ElasticParrot at 8:55 AM on June 17, 2023 [5 favorites]