How an Anxiety Expert Prepared for Knee Replacement Surgery

Recently, we spoke with Mani, a hypnotherapist and author. Mani has written an award-winning memoir as well as a book entitled “Journey from Anxiety to Freedom”. Mani describes this book as a “self-revelation” and “how-to-guide” for overcoming anxiety.

Anyone who has faced the unknown of surgery knows that the journey leading up to “due day” is emotionally taxing at best and debilitating at worst. We thought it’d be fascinating to hear from Mani, an anxiety expert and practicing therapist, on how she overcame her own pre-surgery stress and to learn what advice she’d share with others preparing for a hip or knee replacement.

Journey to a New Knee

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“I started having joint pain in my thirties,” explains Mani. In other words, like a lot of you, Mani knew for many years that a knee replacement was on the horizon. She adds, “It’s been a gradual, eroding of my physical activity.” For Mani, this eroding of her physical activity started with no longer being able to take real hikes and led to avoiding getting on her bike, not being able to do yoga or run after her grandkids.

“In the last few years, I noticed myself withdrawing from activities…I just couldn’t do a lot of things I liked to do.”

Mani said that although she ignored the issue as long as she could. It was on her 71st birthday in April of 2016 when she finally decided, “okay, this thing is in the way of my life”. That is when she made an appointment to see an orthopedist. Mani explains the visit, “My doctor looked at some x-rays that I had gotten and said, ‘I think you might need one or both knees replaced’”. With this, Mani began getting hyaluronic acid shots for relief.

In order to be ready for her right total knee replacement (RTKR), Mani would have to improve her left knee function by undergoing arthroscopic surgery. In November 2016, Mani had left knee arthroscopy surgery and began physical therapy soon after.

“I had an arthroscopy on my left knee, my better knee, so that it’d be good enough to support my right knee.”

For Mani, a large part of getting mentally prepared and working with her own fears, was searching for the right doctor for her total knee replacement.

Getting Things “Right” (or should we say, RKTR)

“I went through a 3 or 4 month period of calling up and making doctors appointments and then cancelling them. I was feeling very indecisive, often thinking, ‘Do I trust that doctor to be the best choice for me?’”, Mani shared.

“I was depressed about feeling such indecision because the need to take action was looming over me”, she explains. For Mani, her struggle with finding “the right” joint replacement surgeon was what she found most frustrating about the whole joint replacement process. Mani adds, “In hindsight, I was waiting for my head-heart-gut to be in alignment”. In other words, Mani was waiting for something to “click” and for everything to just feel right before scheduling surgery. “Before trusting a doctor, I had to trust myself.”

“I know you don’t look for a surgeon to have the best personality because you want skills, but I also wanted to feel a connection to the person. I needed some level of comfort and confidence in the doctor to reduce my own anxiety,” explained Mani.

Mani researched a half dozen possible surgeons. She asked fellow knee replacement patients for recommendations, perused online forums, and talked to her physical therapist. Eventually, one doctor’s name kept popping up: Dr. Sah of Washington Hospital in Fremont, California.

Mani explains, “ I liked the surgeon [Dr. Sah] and he connected with me. I first saw his name on a women’s referral website and then I asked my Physical Therapist, who commented on his great recovery times.” With her head-heart-gut all saying “yes”, Mani scheduled her surgery with Dr. Sah.

On April 20th, 2017 Mani had in her own words, “life-giving” surgery.

Surgery Prep: A Fateful Run-In

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With confidence in her choice of surgeon, Mani focused on staying active until surgery day. This meant keeping up with stationary biking at her local gym. It was here that Mani overheard a woman talking about her own knee replacement surgery. Mani explains, “I went over to her and she told me about the PeerWell program.” That day, Mani downloaded the PeerWell PreHab app and reached out to us for a registration code. Mani would carry out a daily PreHab plan on her smartphone for the final month before her knee operation.

“Every day I played the PeerWell program at home or while I rode the bike...I loved the countdown it gave me. I had a booklet from my doctor with exercises but it was on a page, and it wasn’t as pro-active. For me, I was excited to open the PeerWell app every day to see “28 days until surgery, 27 days, and so on”, Mani illustrates.

“The PeerWell program made it really easy to do something each day and feel emotionally prepared. It gave me confidence. I felt empowered. It played a wonderful role in my psychological preparation,” explains Mani.

With PeerWell in her back pocket, Mani was excited by her progress and became increasingly confident in her own preparedness. Mani was not just physically ready for her “life-saving” procedure, but psychologically ready as well.

“I thought, ‘Of course I’ll be anxious’…but I wasn’t. I had confidence in my choice of doctor, and the PeerWell program played a role in my confidence on a deep level. I was at peace with myself and my choices."

Time for Some Healing

So, how did Mani’s surgery go? With all of her physical and emotional preparation, you guessed it: Mani’s knee replacement was textbook. She was out of the hospital in 1 day. She also surprised herself at her ability to manage post-op pain. Mani explains, “I began to realize that my pain level was manageable and that I didn’t need to stay on regular opioids. I switched to ibuprofen and acetaminophen. And used the narcotics occasionally.” Her minimal use of opioids is something that Mani said “made recovery easier”.

In addition, Mani shared, “I was very pleased to discover that my capacity to handle minimum functioning came back quickly. Getting on my feet and doing the exercises was a lot easier than anticipated. I was very lucky. I think the preparation helped.”

However, what Mani didn’t expect, and something we think is extremely important to mention, was the post-op “mental healing” process. “You don’t hear as much about the fact that it took a month before I began feeling like myself. Some people say, “Well, you’re on narcotics” but this was not the case for me.” Regaining her mental footing and clarity was a longer and more challenging process than Mani had anticipated. “It really does take some time to re-integrate yourself after surgery. Now I know that it affects not just my knee, but my whole being.”

As of this writing, Mani is 8 weeks out from surgery. Mani said that she “still has a ways to go” but can’t help but feeling amazed by what modern medicine can do. Her words of wisdom for those considering a replacement: “Pay attention if your life and activities are beginning to erode. Don’t wait too long. Woman wait longer than men do for knee surgery. Get a support system going.”

Rapid Fire Questions

In this section, we ask our interviewees to answer with the first thought that comes to mind. Their questions are transcribed exactly. Here’s what Mani had to say about her knee replacement...under fire!

1. What advice do you give people preparing for a replacement?

M: Definitely have a daily program that prepares you emotionally, spiritually and physically. It doesn’t have to be much but do something daily.

2. What is something that caught you off-guard about knee replacement surgery?

M: What I mentioned earlier: the physical part has its own timeline but there’s an internal orienting that takes time.

3. Describe your replacement in one word.

M: Amazing.

4. Rate your entire joint replacement experience on a scale from 1-10 (1 being the worst thing ever and 10 being the best thing ever).

M: Well, it sounds funny but I really want to give it a 10. Although I was getting around before the replacement, about 1 year ago is when I looked in the mirror, I realized my knee had become crooked. It’s a miracle what modern medicine can do. It’s a miracle that I have a straight leg.

5. If you could tell yourself something at the beginning of your journey, what would it be?

M: Pay attention. Speak up. Ask questions. Be at peace.


Facing a knee or hip replacement? Sign-up for PeerWell and start a Prehab program that will combat anxiety and get you mentally and physically ready for your new joint and new life!

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Hi, I'm Grace. I write all things surgery for the PeerWell blog. You may remember me from such titles as: "Diabetes & Joint Replacement 101" & "Sex After a Joint Replacement".

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