Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 101: Road Trips After Knee Replacement (How to Plan the Drive and Still Enjoy the Reason You’re Going)

Transcript

Episode 101: Road Trips After Knee Replacement (How to Plan the Drive and Still Enjoy the Reason You’re Going) · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

• 0:00
  For a hotel, Airbnb or VRBO, read the accessibility
• 0:03
  information and contact the property owner when
• 0:06
  the listing leaves questions. Ask about stairs,
• 0:09
  thresholds, toilet height, the shower or tub,
• 0:12
  parking, and the walking distance from the car.
• 0:16
  Are you ready to get back to what you love after
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  knee replacement? The Total Knee Success podcast
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  is your trusted guide with practical tips, evidence
• 0:24
  -based strategies, and no fluff. It's not personal
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  medical advice, just solid education to help
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  you manage pain, regain mobility, and get back
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  to living the life you love. Let's dive in. Welcome
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  back to the Total Knee Success podcast. I'm Michelle.
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  If a road trip is on your calendar after knee
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  replacement, you may be excited to get away and
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  a little concerned about how your knee will handle
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  the drive. That makes sense. A longer drive involves
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  much more sitting than a quick trip across town,
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  and thoughtful planning can help you arrive with
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  enough energy to enjoy the destination. This
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  episode begins our second Returning to Meaningful
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  Activities series, focused on travel and outdoor
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  activity. The next episodes will cover flying,
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  hiking, and returning to a bicycle. Today, we're
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  headed out on the road. By the end of this episode,
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  you'll know what to ask your healthcare team
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  before a long drive, what can help when your
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  knee feels stiff or swollen in the car, and how
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  to plan the vehicle stops, luggage, lodging,
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  and first evening of the trip. I'm going to tell
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  you about Dave. Dave is not a real person, but
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  his story is based on situations people face
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  after knee replacement. He had his left knee
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  replaced eight weeks ago and was planning a summer
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  road trip with his wife from Indiana. to several
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  national parks out west. This was a multi -day
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  drive, and Dave wanted to take his turn behind
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  the wheel of their automatic SUV. He had already
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  stopped taking prescription pain medication that
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  could impair driving several weeks earlier, and
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  his surgeon had cleared him to drive weeks ago.
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  He was comfortable on local trips of about 20
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  minutes. He was given the okay for this vacation.
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  But the longer trip added hours of sitting, repeated
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  stops, hotel stays, luggage. and several driving
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  days in a row. Dave and his wife gave themselves
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  more time than the navigation estimate and kept
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  the first day flexible. His left knee felt stiff
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  after sitting, so each stop took extra time.
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  He needed a little time to bend and straighten
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  his knee, stand, and walk before getting into
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  the SUV. By the end of the day, his knee and
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  ankle were more swollen and he had less energy
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  left when they arrived. A few choices they made
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  ahead of time helped the trip go well. There's
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  no single week after knee replacement when a
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  long car trip works for everyone. For Dave, traveling
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  in eight weeks was reasonable based on his medical
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  history, his progress, his driving ability, the
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  vehicle, and the plan he had discussed with his
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  surgeon. At eight weeks post -op, another person
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  may have a different medication plan, level of
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  mobility, health conditions, or blood clot risk.
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  So the timing of the long trip may be different.
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  Can I travel is a good question. Add the details
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  so your surgeon can answer it in a useful way.
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  Tell them where you're going, how many hours
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  you expect to travel each day, whether you'll
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  drive or ride, how remote the route will be,
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  and what kind of activity you hope to do when
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  you arrive. Ask how your personal risk factors
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  and current stage of healing might affect the
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  trip. Dave's local driving gave him a starting
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  point. A full travel day adds fatigue, changing
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  traffic, and much more time with your knee bent.
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  Safe driving requires enough motion and strength
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  to operate the vehicle, the ability to react
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  quickly, and the attention to respond when traffic
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  changes. Because Dave had a left knee replacement
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  and drove an automatic vehicle, his surgical
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  leg was not operating the gas and brake pedals.
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  He still needed to get in and out safely, sit
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  with his knee bent for some longer periods of
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  time, turn to check traffic, and stay comfortable
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  enough to control the vehicle. With a manual
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  transmission, Dave would have used his left leg
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  to operate the clutch every time he changed gears,
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  adding repeated work for his surgical leg throughout
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  the drive, and was happy he chose the automatic
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  transmission. Studies of brake response time
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  after knee replacement have focused heavily on
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  right -sided surgery because the right leg usually
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  controls the gas and brake in cars, trucks, and
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  SUVs. The studies show that braking ability changes
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  after surgery and improves over time. with considerable
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  variation among people and study methods. A study
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  average doesn't tell us when one person is ready.
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  The ability to drive safely also depends on the
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  individual's medication use, reaction time, strength,
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  motion, comfort, attention, and control of the
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  specific vehicle. Dave was already comfortable
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  with the SUV because he had been driving locally.
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  Before the road trip, he and his wife made sure
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  his usual seat position left enough room to move
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  his left knee during a longer drive, and they
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  placed his cane within reach at the foot of the
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  back seat. Seat height, door width, legroom,
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  and a stable place to hold can change how easy
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  it is to enter and exit a vehicle. A very low
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  seat may require more knee bend and more effort
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  to stand. A high step into a truck can be challenging
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  to climb up into. If the vehicle you own is a
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  poor fit for a long trip, renting one with a
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  better seat height and easier access may be worth
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  considering. About an hour into the first day,
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  Dave's left knee began to feel stiff, so he made
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  sure to pump his ankle and move his knee during
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  the drive. After knee replacement, the healing
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  tissues around your knee may still be sensitive
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  to staying in one position. Sitting keeps your
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  knee bent, the muscles in your leg are less active,
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  and the normal movement that helps circulate
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  fluid throughout the joint and leg is reduced.
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  That combination can make your knee feel tight,
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  and the first few steps after getting out of
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  the car may feel stiff or less steady than usual.
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  Dave and his wife had identified several service
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  areas along the route and left room to stop sooner
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  when needed. This gave them choices without putting
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  the trip on a rigid timer. They looked for places
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  with paved parking, easy restroom access, and
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  enough space for Dave to get some walking in
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  and move around safely. At the first stop, Dave
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  turned in the seat, placed both feet securely,
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  and stood. He took a moment to adjust to standing,
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  bent and straightened his knee a few times, and
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  waited until his knee felt ready to move. Then
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  he walked to the restroom with his wife, and
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  they took their time getting back to the SUV.
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  Movement during a long travel day also connects
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  to blood clot prevention. A deep vein thrombosis,
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  or DVT, is a clot in a deep vein, usually in
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  the leg. Knee replacement temporarily raises
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  the risk, especially closer to surgery. Longer
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  periods of sitting add more time with the leg
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  relatively still, which reduces the muscle pumping
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  action that helps move blood back toward the
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  heart. Risk changes and generally decreases with
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  time after surgery and varies from person to
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  person. Your clinician may give you specific
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  instructions based on your history and risk factors.
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  Follow the plan you were given for medication,
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  compression garments, and activity. During stop,
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  spending and straightening your knee and spending
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  some time on your feet may help you avoid one
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  long stretch of sitting, as long as those activities
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  fit your current instruction and abilities. By
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  early afternoon, Dave noticed more fullness around
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  his knee and ankle. During a car ride, your foot
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  remains below your heart for long stretches.
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  Gravity pulls fluid toward the lower part of
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  your leg where your calf muscles are doing less
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  of the pumping that normally helps move blood
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  and fluid back toward your heart. That combination
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  can make swelling around your knee, lower leg,
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  and ankle more noticeable as the day goes on.
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  Look at when the swelling started, how quickly
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  it changed, and what other symptoms are present.
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  A gradual increase after hours in the car may
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  respond to the strategies you already use, like
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  elevation and ankle pumps or circles. Later in
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  the episode, I'll explain which changes warrant
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  prompt medical attention. If pain, tightness,
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  or changing symptoms are difficult to sort out,
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  my concise book, Making Sense of Pain After Knee
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  Replacement, explains how to look at the pattern,
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  timing, and context of symptoms after knee replacement.
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  It's for educational purposes only, and the link
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  is in the show notes if you'd like to take a
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  look. Compression garments are appropriate for
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  some people and unnecessary or unsuitable for
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  others. You may already have stockings provided
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  by the hospital or recommended by your clinician.
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  If you buy another pair, make sure you match
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  the type and millimeters of mercury or MMHG that
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  your clinician recommended. More pressure can
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  be inappropriate and fit is important. I'll link
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  a few compression sock options in the show notes.
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  So you can compare them if and only if compression
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  is already part of your plan and you've been
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  advised to use them by your clinician. Some show
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  note links are Amazon affiliate links. If you
• 9:01
  purchase through one of those links, I may earn
• 9:03
  a small commission at no additional cost to you.
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  Thank you. Medication use needs the same individual
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  approach. Know whether anything you take can
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  impair alertness, reaction time, or judgment.
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  Keep medications in their original containers.
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  Follow the prescribed schedule and store them
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  where they remain accessible and at an appropriate
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  temperature. Do not drive after taking a medication
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  that impairs you. Make sure you ask the prescribing
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  clinician or pharmacist before changing the dose
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  or timing of any medication. Hydration was another
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  part of Dave's travel plan. He continued drinking
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  water throughout the day and the bathroom stops
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  gave him another chance to get out of the SUV
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  and move. If you have a condition that affects
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  how much fluid you should drink, such as a heart
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  or kidney condition, make sure you follow the
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  instructions from your health care provider while
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  traveling. Once fuel, meals, traffic, restrooms,
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  and time to move were included, each driving
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  day took longer than the MAP estimate. At eight
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  weeks post -op, that extra time reflected where
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  Dave was and his healing. As strength, endurance,
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  motion, and tolerance for longer days improve,
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  future trips may require fewer adjustments. For
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  this trip, Dave and his wife allowed enough flexibility
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  for a slower lunch or an extra stop so he could
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  move his leg more. They also changed how they
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  packed. Dave kept medication, water, a light
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  layer, and anything he might need during the
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  day in a small bag that was easy to reach. His
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  wife handled the heavier suitcase and they used
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  luggage carts at the hotels. If you handle a
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  bag, keep it close to you and avoid combining
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  a deep bend with a quick turn. Let someone else
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  take the heavy lifting early on after surgery
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  when help is available. The lodging deserved
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  as much attention as the drive. Dave and his
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  wife checked hotel listings for elevators, accessible
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  parking, bathroom features, and the distance
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  from the entrance to the room. For a hotel, Airbnb
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  or VRBO, read the accessibility information and
• 11:02
  contact the property owner when the listing leaves
• 11:04
  questions. Ask about stairs, thresholds, toilet
• 11:08
  height, the shower or tub. parking, and the walking
• 11:11
  distance from the car. In the United States,
• 11:13
  the Americans with Disabilities Act, or ADA,
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  was enacted in 1990 to prohibit discrimination
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  against people with disabilities and improve
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  access to public accommodations, including covered
• 11:24
  hotels and other places of lodging. Even with
• 11:27
  those requirements, the word accessible can refer
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  to different features. Short -term rentals vary
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  more, and the ADA does not cover owner -occupied
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  establishments renting five or fewer rooms. At
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  the end of their first day, Dave's knee felt
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  stiff and he was tired. They had kept the evening
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  open so his wife handled check -in while Dave
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  took a few minutes outside the car to stand and
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  move before going inside. They used a luggage
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  cart, chose dinner at the hotel, and saved sightseeing
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  for the next morning. He had time to settle in
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  and follow the swelling strategies already recommended
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  by his health care team. That first evening became
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  their pattern. On later days they chose shorter
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  driving stretches when they planned to walk more
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  at the next park. They used park shuttles when
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  available and picked overlooks and trails that
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  fit what Dave could comfortably do at eight weeks
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  post -op. One morning they reached an overlook
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  early before the parking area filled. Dave walked
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  from the car, took in the view and stayed long
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  enough to enjoy it without watching the clock.
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  Later that afternoon his knee felt fuller. so
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  they chose a scenic drive and stopped at two
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  overlooks rather than adding another trail. The
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  adjustment kept the day enjoyable and gave them
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  plenty to talk about over dinner. By the third
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  driving day, Dave knew what the first stop would
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  feel like. He allowed time for his knee to loosen
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  before walking away from the SUV and his wife
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  already had the water and snacks. Their routine
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  became easier because they had learned what his
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  knee needed during this particular trip. Dave
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  and his wife shared the driving and reached the
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  parks they had been looking forward to seeing.
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  He enjoyed the scenery and still had enough energy
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  for the experience as they had planned. Giving
• 13:06
  themselves extra time, choosing lodging with
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  the features Dave needed, having his wife handle
• 13:11
  the heavier bags, and keeping the first evenings
• 13:13
  flexible helped the trip go well. I'll link a
• 13:17
  list of optional travel items in the show notes
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  including small travel pillows, coolers for cold
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  packs, rolling luggage, and compression socks.
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  The list gives you one place to compare options.
• 13:28
  Choose only what fits the guidance you've received
• 13:30
  and the way you travel. A road trip after knee
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  replacement can be a wonderful way to get back
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  to the people, places, and activities you value.
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  Start with guidance that fits your health and
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  stage of healing. Test the vehicle, leave room
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  for stops, plan the lodging and arrival, and
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  give yourself enough time to really enjoy the
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  destination. Part of planning the trip is knowing
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  which symptoms need medical attention. Seek medical
• 13:55
  attention right away for new or one -sided calf
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  pain or swelling, unusual warmth or discoloration,
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  or a sudden worsening that concerns you. Chest
• 14:05
  pain and shortness of breath, among other worsening
• 14:08
  symptoms, require emergency evaluation. In episode
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  102, the second episode in this returning to
• 14:15
  menopause activity series, we'll cover flying
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  after knee replacement. We'll look at getting
• 14:20
  through the airport, security screening, seating,
• 14:23
  luggage. movement during the flight, and general
• 14:25
  information about prolonged sitting and blood
• 14:28
  clot risk during air travel. Remember that travel
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  after knee replacement is possible, but it requires
• 14:34
  some additional considerations, especially early
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  on. Thanks for joining me. I'm Michelle, and
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  this has been the Total Knee Success Podcast.
• 14:46
  This podcast is for educational purposes only.
• 14:50
  Discover more at TotalMeSuccess .com and be sure
• 14:53
  to subscribe and share because every step forward
• 14:56
  takes you closer to living the life you love.