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The Pre-Op Appointment

Last Friday I arrived at the huge, regional, not-for-profit, medical center, known hereafter as "the hospital", for my 10:00 A.M. appointment. They were busy, but that's no surprise. And running late.

The first step began at 10:20 when I was called in to have my blood pressure taken by nurse #1. Then we went into her rather nice office and she said, "Let's see, you're going to come in next Thursday for a left hip replacement."

I was ready to leave. We then looked at all the paperwork and the computer screen. She had mis-read the malady. Yes, all the documents say I'll be having a left knee replacement. She was sorry to have made such a mistake.

She took my medical history. I have done this several times before in recent weeks. When she was finished I asked her about all the things my surgeon said would be explained at this interview. She knew nothing about any of them and asked me, "Weren't these questions all covered in your joint replacement class?" That was the first I had heard of the class.

I am to arrive at the surgery check-in office at 5:00 A.M. on Thursday.

Next I went back to the waiting room to wait. Then nurse #2 took blood (lots of it) and urine and gave me an EKG. I passed that one nicely she said. Then back to the waiting room.

Then nurse #3 explained my anaesthesiology to me and mentioned, for the very first time, that I would have some nerve blocker surgery before my knee operation. I'll be asleep for it but they will wake me up after -- just in time to put me under for the knee surgery. She gave me several sheets of paper telling me what to do and what not to do the day before.

Then I left the Pre-Op waiting area to visit another waiting room for a couple of chest x-rays. I got out of there at 12:00 noon exactly.

Apparently all the things the surgeon said would be explained to me will be explained when I go to physical therapy after the operation. I do have a booklet from the surgeon telling me, along with many other instructions, to scrub the knee area the night before with the special soap provided. But no body gave me any special soap. Or knows anything about the special soap. I'll use Dial.

All I can say right now is, "Just do it."

"Preparing For Joint Replacement Surgery"

Go to this link, for an excellent article by Jonathan Cluett, M.D., from about.com's website. It has some good tips for anyone planning to have total knee replacement surgery.

Follow-up phone call

I got a call from LaQuanna at the hospital. She was checking some of the facts in my file. And making sure I was planning to show up Friday for my appointment for a pre-op interview.

Research Study of Blood Thinners

When I met the orthopedic surgeon last Tuesday he mentioned a double-blind research study of an investigational drug, a blood thinner. He added that this drug is, "not approved by the United States Food and Drug Administration." Not yet, at least. It will be compared to a drug that is approved by the FDA for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE) after knee replacement surgery.

He gave me a 14 page contract-like legal document -- an Informed Consent Form -- and asked me to read it and decide, by the time of my pre-op interview at the hospital, if I would take part.

I have decided not to participate. The study appears to require a lot of followup and some tests that sound intrusive and stressful.

Am I expected to participate? I feel awkward turning it down, but I really don't want to be part of it. Deciding on having the knee surgery itself was a huge step for me. Now this question comes up. And by the surgeon himself.

I am sure the surgery and recovery will be quite stressful enough without adding any more stress factors.

Last dentist visit for a while

The bridge is installed and fits fine. What a relief to have the sharp, nasty temporary out of my mouth. My tongue can now finish healing.

It's been nine weeks since the problem there began. That's been a long time. Made longer by the dentist's office being closed now and then because of Christmas and New Year's. I will never have any dental work done just before the holidays again.

Meet the Surgeon

I don't know why I was dreading this appointment so. Maybe I shouldn't have fired the previous specialist? What if I dislike this one as much as the former one? Does this appointment mean I am really going to have the surgery in three weeks?

An hour and fifteen minutes after my appointment time, in walks the doctor. He's friendly, soft-spoken and very reassuring. He immediately answered my first five questions before asking me what questions I had. I didn't have any other questions.

Yes, I need Total Knee Replacement (TKR) surgery of the left knee. Apparently it is the same thing as a Total Knee Arthroplasty (TKA).

The exam confirmed what his assistant had found: my knee needs replacing and soon. Strangely when he was twisting my leg around to see how much play was in the joint (a lot) it didn't hurt at all. For the past several weeks there has been less pain in the left knee. The right heel has been much more painful, especially at night.

Either I have gotten used to the left knee or the pain transmitters have ground away along with my bone and cartilage. Maybe a little of both.

He told me I would be in the hospital three to five days and might need a few more days, perhaps a week, in a rehab facility. Everybody I know who has gone to rehab has had an alcohol problem. If I'm in rehab for knee therapy can I have a drink before dinner?

The next step for me is the pre-op interview at the hospital. Then I'll find out everything I'll have to do before the surgery. And after.

Dental update

The broken temporary crown has smoothed out and isn't as sharp against my tongue (I found a new use for an emery board). The sore spot is less inflamed and doesn't hurt nearly as much. Three more days until the new bridge is installed.

Orthopaedic Surgeon Links

American Academy of Orthopaedic Surgeons
Here are some links to the American Academy of Orthopaedic Surgeons, their information about total knee replacement and some frequently asked questions.

American Association of Hip and Knee Surgeons
The AAHKS also has a lot of information. Start with their Patient Information links.

Pre-Op Appointment

In today's mail came a form from the orthopedic surgeon telling me to be at Sacred Heart Medical Mall Suite 107 for surgery instructions at 10:00 A.M. on Friday, January 23. To reschedule call (850) 416-7830.

I find it strange that yesterday's caller from the orthopedic doctor's office didn't tell me about the pre-op appointment. It was mailed to me from their office on December 31 and must be in my file. Another of their "lost" appointments for me?

Knee Doctor Appointment Confusion

At 3:00 P.M. today I got a call from the orthopedic surgeon's scheduler. She needed to make an appointment for me to see the surgeon.

I told her that the surgeon's nurse had already done that on December 18 -- scheduled me to meet the doctor on January 14. And scheduled me for knee replacement surgery for Thursday, January 29. And told me she would send me a packet of info about the operation and what I need to do to prepare for it. I have received nothing in the mail.

The caller said, "There's no appointment for you to meet the surgeon, just the knee surgery on the 26th." I asked her to check on the date and she corrected it to the 29th.

I now will see the doctor on Tuesday, January 6.

Continued Dental Problem

My tongue very sore again from sharp edges on the broken temporary bridge.