Working with knee arthritis/Knee Replacement as a nurse?

Nurses General Nursing

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Hello all

I've been working as an ER nurse for 13 years and the last year I've been working as a Vascular access nurse doing PICCs and IVs.  I really like the work, it's sort of my dream job.  I walk a lot for the job, like 13k steps per shift. Right now I'm 2 days a week, 2 twelves.

I also make guitars in my spare time and I'm on my feet a lot with that.

I've had intermittent knee issues, fairly minor, for years.  In the last 1.5 years they have gotten significantly worse.  I went to an orthopedic doctor and he told me I have bone on bone arthritis.  I feel like that term is not helpful...seems to describe a lot of things.  I got fitted for an expensive custom knee brace which he said might help.  I am going to get that today.  He suggested I would need a knee replacement at some point.

I've done some physical therapy and starting with a new one this week.  I use Voltaren gel, and I'm taking supplements, etc.  I can't tell if anything is specifically helping.

I can do kettlebell exercises and ride on a bike with zero pain.  But walking really exacerbates it.

I have not had to take any time off work thus far, sometimes though after a shift I'm really feeling it.   I've had a couple weeks off, in general my knee feels better, I think it was pretty inflamed, but I'm definitely not out of the woods.

Anyway, I was just wondering if anyone is working as a bedside nurse with a knee replacement and/or battling arthritis in their knees and how is it going?  I really like this job, it suits me in a lot of ways, and I don't really want to do something different, but it definitely is a lot of walking around. 

Thanks!

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Specializes in CRNA, Finally retired.

I have rotten knees from an accident. I have the same experience as you re:  walking vs. riding a bike.  You will have a better idea of what you can tolerate after you use the brace.  The brace will probably be too uncomfortable to wear for a full shift.  I've found that a smaller brace or knee sleeves to be helpful and you can wear them all day.  You will know when you are ready for a knee replacement.  For most patients not being able to sleep at night becomes intolerable.   But pay attention to your stride.  Once you start limping it throws off you back and you neck so make sure you keep your shoulders level.  You sound pretty busy already but Tai Chi taught by a physical therapist has been extremely helpful to me even though I must do it in knee braces:(  if you can, learn to do any skill sitting down that you can.  

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Specializes in orthopedic/trauma, Informatics, diabetes.

I am going through something similar! last July, I went to sit on my porch steps and when I bent my knee, I heard and felt a pop. Didn't really hurt that much but something was def off. Went to my ortho doc, did the cortisone shot and PT, didn't get better. Next in the protocol is the MRI. He was 99% sure I had a meniscus tear. It ended up being arthritis behind my knee cap with a Baker's cyst. Got a brace and more PT. Then I got a hyaluronic gel injection and it felt so much better. That was November. Around April, it started hurting again. I had been able to work my 3-12s OK. I work weekends and one weekday. No more 3 in a row. Worked with the insurance lady at the doctor's office and she was able to get another round of injections approved (once a week for 3 weeks) for May. It didn't feel great right away and if it didn't help, the next step is a knee replacement. I just got back from going to Vegas to see Grateful Dead iteration at the Sphere for 3 nights. My knee did surprisingly well! I think I need to be more active. 

The plan is to see how I do from now to November, when I would be eligible for the gel injections again. If they don't work, then I have to think about joint replacement. 

I just don't know how I will know when it's time. Everyone I meet says that they waited too long, they feel great and should have done it sooner. Ironically, I am an orthopedic nurse 😂 which actually makes me nervous because I have watched the videos.

Where I work, they have added a virtual admission/discharge nurse who does remote charting for admission and discharges. A few nurses I know have done that after surgeries (we had a float nurse who had back surgery and walking was still too much, but they could sit and do the virtual thing) I was thinking about looking into it if I need my knee done sooner than later. I just turned 60 this year and would like to stay where I am for the last few years.

Definitely look into the gel treatment! No side effects like from the cortisone (which I am now intolerant too-I was up for 2 days with high HR and insomnia from the injection. 

Best of luck!! I feel your pain. 💜

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How was the gel? My mother is currently having this issue, and I am trying to convince her to get the gel. I am not sure how else I could assist my mother. She tried the steroid, and it was painful. It burned her days never again. I want to get the surgery and recover slowly, but she is refusing. I am not sure what to do, to be honest. 

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Specializes in Psych, Addictions, SOL (Student of Life).
luv2 said:

How was the gel? My mother is currently having this issue, and I am trying to convince her to get the gel. I am not sure how else I could assist my mother. She tried the steroid, and it was painful. It burned her days never again. I want to get the surgery and recover slowly, but she is refusing. I am not sure what to do, to be honest. 

Well the good news is that Voltaren topical is now available OTC/ I buy mine at Costo and it works pretty good. I also use topical CBD and a home made muscle rub.

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Thank you very much. She is on Voltaren topical, and it works a little. I will go at her pace when she is comfortable, and I pray it will not be too late.

 

 

 

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Specializes in orthopedic/trauma, Informatics, diabetes.
luv2 said:

How was the gel?

It's actually very good!! I have developed a pretty good sensitivity to cortisone (in a bad way). When they injected my R knee with cortisone, not only did it not help, it gave me heart palpitations and I didn't sleep for 2 days. I cannot tolerate PO steroids either. 

I got my first gel injection in Nov 23. It really helped. About month 4, I started having pain again and it was a fight to get it approved for another dose at 6 months (the person that is in charge of getting this procedure/medication approved is fabulous at her job). I got another injection in May (3rd week-ish). At first I was bummed because it didn't seem to help much. The PA said give it a month. 

I just got back from Las Vegas, I bought myself a bday present of going to see Dead and Company at the Sphere. There was a LOT of walking, up and down ramps and stairs and then the 3 shows in a row where I danced for 3 hours. Didn't need my brace at all. I am SO relieved!!  If I am able to get these done every 6 months for a little while, I will be ecstatic! I am not ready mentally for a replacement. 

I used to be a large animal vet tech for over 10 years and we used hyaluronic acid on horses for at least 40 years (I'm 60). There are no long term adverse effects like there is with cortisone. They don't hurt anymore than any other joint injection. I highly recommend them!

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Specializes in orthopedic/trauma, Informatics, diabetes.
hppygr8ful said:

How was the gel?

I think I need to clarify, are you talking about hyaluronic gel injections or the topical NSAID, Voltaren?

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