Sunday, February 1, 2009
Sunday is a quiet day at the hospital. And from the casual amount of attention it's a light day for staffing as well. I had P.T. at 10:00 and it went well. I walked half way back to my room this time. The therapist and I discussed what kind of rehab I should get after I am released from the hospital. The therapist thinks it would be good for me to spend a week in a rehab facility to heal a bit more and to get some concentrated P.T.
By the way, I am getting used to the brace and it is not as uncomfortable as it looks. Also I am happy to report there's very little pain from the operation. The wound is sore of course but the new knee is no problem at all. The brace prevents any lateral movement of leg above and/or below my knee. This allows the Medial Collateral Ligament (MCL) to heal properly. I imagine that without the brace the ligament repair might be a tad touchy.
One of my surgeon's partners dropped by to see how I was doing. We chatted about my knee and he told me how tricky the ligament repair was.
Jack came by to have lunch. He and Billy had already spoken about some post-hospital rehab for me and agree it would be a good idea.
During my second P.T. session I mentioned that there was a sore place on my left heel. The therapist looked at it and told me I had a big bed sore, a "pressure ulcer," and he said the nurses should have been watching my pressure points better. I have noticed a bit of rivalry between the nurses and the physical therapy folks.
Because of the bed sore I now have to "float" my heel. This means putting a rolled up towel under my ankle whenever I'm in bed so the sore doesn't touch anything. Well, it will keep my mind off my knee.
Thursday, February 26, 2009
Wednesday, February 25, 2009
Two days after surgery
Saturday, January 31, 2009
Slept fairly well until somebody woke me at 3:45 for a blood test. Then at 4:20 A.M. the lights came on and the night nurse tells me she needs to change my dressing. There's another nurse on hand to help.
Before they can change the dressing on my knee they have to unwind lots of Ace bandages and break through the rigid foam cast. It breaks apart quite easily and soon they are down to the knee incision. It is surprisingly small -- a single, vertical cut about seven inches long -- and very clean. They count the staples and there are 26 of them. They also remove the drain from the wound and remove my catheter. Why couldn't they have done this at 10:00 A.M. instead of 4:20?
The nurse dresses the wound lightly with gauze pads and then she and her helper install the leg brace. It is much longer than I expected. The photo is my view of the brace. It was taken the day after the staples were removed.
At 11:15 the physical therapist shows me how to get in and out of bed with the brace on. We then go to the P.T. room and I learn to use a walker, how to stand up and sit down and, with the brace off, some range of motion exercises. I was told to take extra painkillers an hour before this one.
Back in the room my surgeon's P.A. stops by and explains the surgery (he was there) and why the ligament repair requires the brace. The knee replacement recovery is generally six weeks. But the ligament recovery is two to three months.
In the afternoon I had another light P.T. session and it went well. On the walker I walked a quarter of the way back to my room.
Lunch and dinner were both from the alternative menu -- deli sandwiches. Kim came by for a visit. I seem to remember I was very talkative from my drugs. Jack brought a Subway sandwich to eat while I had my hospital turkey sandwich.
I went to bed early and my neighbor had beeping problems through the night. The poor man has been in the hospital for something like 28 days. He has multiple problems. He came in after his feet were crushed in a car accident, then several pre-existing conditions got worse and now he has had prostate surgery, a hip replacement, several foot surgeries and a couple additional procedures. He has more surgery on Monday.
I learn all this because he has many family members visit for long periods of time. They are quiet and it's no problem for me but they stay and stay. He must be exhausted by them. At one point this evening there were eight of them in his room. OK, I'm nosy -- when they announced they were leaving I counted as they left.
Slept fairly well until somebody woke me at 3:45 for a blood test. Then at 4:20 A.M. the lights came on and the night nurse tells me she needs to change my dressing. There's another nurse on hand to help.
Before they can change the dressing on my knee they have to unwind lots of Ace bandages and break through the rigid foam cast. It breaks apart quite easily and soon they are down to the knee incision. It is surprisingly small -- a single, vertical cut about seven inches long -- and very clean. They count the staples and there are 26 of them. They also remove the drain from the wound and remove my catheter. Why couldn't they have done this at 10:00 A.M. instead of 4:20?
The nurse dresses the wound lightly with gauze pads and then she and her helper install the leg brace. It is much longer than I expected. The photo is my view of the brace. It was taken the day after the staples were removed.At 11:15 the physical therapist shows me how to get in and out of bed with the brace on. We then go to the P.T. room and I learn to use a walker, how to stand up and sit down and, with the brace off, some range of motion exercises. I was told to take extra painkillers an hour before this one.
Back in the room my surgeon's P.A. stops by and explains the surgery (he was there) and why the ligament repair requires the brace. The knee replacement recovery is generally six weeks. But the ligament recovery is two to three months.
In the afternoon I had another light P.T. session and it went well. On the walker I walked a quarter of the way back to my room.
Lunch and dinner were both from the alternative menu -- deli sandwiches. Kim came by for a visit. I seem to remember I was very talkative from my drugs. Jack brought a Subway sandwich to eat while I had my hospital turkey sandwich.
I went to bed early and my neighbor had beeping problems through the night. The poor man has been in the hospital for something like 28 days. He has multiple problems. He came in after his feet were crushed in a car accident, then several pre-existing conditions got worse and now he has had prostate surgery, a hip replacement, several foot surgeries and a couple additional procedures. He has more surgery on Monday.
I learn all this because he has many family members visit for long periods of time. They are quiet and it's no problem for me but they stay and stay. He must be exhausted by them. At one point this evening there were eight of them in his room. OK, I'm nosy -- when they announced they were leaving I counted as they left.
Tuesday, February 24, 2009
One day after surgery
Friday, January 30, 2009
I slept fairly well what with the drugs and the busy day I had on Thursday. The cast on my left leg has me pretty much stationary on my back. The trapeze hanging over the bed is very handy and I use it a lot to change my position. And the bed itself changes into 10,000 positions, too.
It's hard to stay asleep because there's a nurse every hour or so to check blood pressure or to take blood. But they need to do it. I also wake up when the man in the next room has various alarms go off. These don't appear to be noticed at the nurses desk and they can go on for many minutes. Last night I listened to one beeper go for 20 minutes before I called the nurse to come and shut it off.
Pain hasn't been a major problem. Once I slept too long and hadn't pressed the magic button for a couple of hours, but I took care of that soon enough. One nurse said I could press it every 20 minutes; another said every five minutes.
At 5:30 A.M., yes, 5:30 A.M., the night nurse and her assistant woke me and said it was their job to get me to sit up, get out of bed and sit in a chair. By the time we were done I was very much awake. The chair was comfortable and had a foot/leg rest in just the right place for me. I stayed in the chair until breakfast at 7:00 A.M. Lots of prunes with breakfast. All this morphine is constipating.
At 7:30 the day nurse came in and he took many of my tubes away. Gone were the IVs for fluids, and the one for antibiotics, and the morphine pump. In the brochure I was given last night it said this would happen 24 hours after surgery but I hadn't read it yet.
Most of the nurses work 12-hour shifts, three per week. There appears to be a separate staff for weekend nurses.
At lunchtime Jack came by and we had lunch. He brought a chicken sandwich from Wendy's, one of the fast food outlets located in the hospital. I had the official hospital lunch. Again the food here is surprisingly good. And if you don't want the meal of the day you can order other items, including deli sandwiches.
After lunch a new physical therapist arrived to take me to my afternoon session. We practiced how to stand up and how to sit down. The session was brief because there's so little I can do with the cast on my leg. It comes off tomorrow.
Back in the room I decided to sit in the chair until dinner. The therapist said this would be a good thing to do. About 30 minutes after physical therapy I was getting some serious pain and the nurse gave me some Vicodin tablets. Half an hour later the pain was worse and he said I would bring me "something to take the edge off the pain." He arrived with a large dose of something in a syringe and the pain was going away before he got it all into me.
A few minutes later the house doctor came by to see if the pain was better. He was the person who authorized the shot.
I don't remember much more that happened that Friday. Except that before bedtime I got my first shot of the blood thinner -- Lovenox, I'm to get it every 12 hours. It's the one I have to inject myself after I get home.
I slept fairly well what with the drugs and the busy day I had on Thursday. The cast on my left leg has me pretty much stationary on my back. The trapeze hanging over the bed is very handy and I use it a lot to change my position. And the bed itself changes into 10,000 positions, too.
It's hard to stay asleep because there's a nurse every hour or so to check blood pressure or to take blood. But they need to do it. I also wake up when the man in the next room has various alarms go off. These don't appear to be noticed at the nurses desk and they can go on for many minutes. Last night I listened to one beeper go for 20 minutes before I called the nurse to come and shut it off.
Pain hasn't been a major problem. Once I slept too long and hadn't pressed the magic button for a couple of hours, but I took care of that soon enough. One nurse said I could press it every 20 minutes; another said every five minutes.
At 5:30 A.M., yes, 5:30 A.M., the night nurse and her assistant woke me and said it was their job to get me to sit up, get out of bed and sit in a chair. By the time we were done I was very much awake. The chair was comfortable and had a foot/leg rest in just the right place for me. I stayed in the chair until breakfast at 7:00 A.M. Lots of prunes with breakfast. All this morphine is constipating.
At 7:30 the day nurse came in and he took many of my tubes away. Gone were the IVs for fluids, and the one for antibiotics, and the morphine pump. In the brochure I was given last night it said this would happen 24 hours after surgery but I hadn't read it yet.
Most of the nurses work 12-hour shifts, three per week. There appears to be a separate staff for weekend nurses.
At lunchtime Jack came by and we had lunch. He brought a chicken sandwich from Wendy's, one of the fast food outlets located in the hospital. I had the official hospital lunch. Again the food here is surprisingly good. And if you don't want the meal of the day you can order other items, including deli sandwiches.
After lunch a new physical therapist arrived to take me to my afternoon session. We practiced how to stand up and how to sit down. The session was brief because there's so little I can do with the cast on my leg. It comes off tomorrow.
Back in the room I decided to sit in the chair until dinner. The therapist said this would be a good thing to do. About 30 minutes after physical therapy I was getting some serious pain and the nurse gave me some Vicodin tablets. Half an hour later the pain was worse and he said I would bring me "something to take the edge off the pain." He arrived with a large dose of something in a syringe and the pain was going away before he got it all into me.
A few minutes later the house doctor came by to see if the pain was better. He was the person who authorized the shot.
I don't remember much more that happened that Friday. Except that before bedtime I got my first shot of the blood thinner -- Lovenox, I'm to get it every 12 hours. It's the one I have to inject myself after I get home.
Monday, February 23, 2009
Day 0 -- The Knee Is Replaced, Part 3
Thursday, January 29
About 1:30 Jack came by for a visit. While he was there various people came in the room every few minutes to take blood or check vital signs. I even got a phone call from my "hostess" to find out what I wanted for dinner.
He agreed that the room was very nice and I was getting a lot of attention. A couple of years ago he had a less-than-wonderful experience in this same hospital but a different department was involved.
At 2:45 I got my first visit from the Physical Therapy department -- two people. They said I needed to sit up on the edge of the bed and try to stand. They helped me sit up and turn to the side of the bed. Then they put a wide belt around my waist and told me to stand up. The belt was to catch me when I fell over. Which I did.
I was told to bend my knee a little and I told them I couldn't. They thought I was worried it would hurt. What I meant was I was in a cast and my knee didn't bend right now. One of them tried to bend the knee a little bit and discovered why I couldn't move it. Shouldn't they have known this?
After the therapists left I looked at my left leg. I expected a bulky dressing around the knee. What I saw was a huge, tree trunk sized cast going from my upper thigh to my ankle, wrapped in a wide ace bandage. It is light weight and sounds hollow when you tap it. It's some kind of foam that hardens in place.
Just before 4:00 a lady from the Admission Office came in with a clipboard full of questions for me. These were the same questions I answered last Friday at my Pre-Op interview. While she was there a woman from the surgeon's office dropped off a leg brace "for Saturday."
I was asked my full name and date of birth every time anyone from the staff came in my room. And then they checked my wrist band to see if I was really me. Hospital policy.
My policy, which I decided upon before I checked in, was to be unrelentingly cheerful and full of good attitude. It paid off. The nurses are bored with complaints.
I napped off and on between visits from nurses and aides who kept telling me to breathe better. I got a plastic device to blow into to improve my breathing and oxygen levels. The painkillers were working well for me and my memories of the afternoon and evening are hazy. Dinner seemed very good, turkey, etc. with great pumpkin pie.
The nurse brought me a brochure about the day-by-day recovery from the surgery and valuable tips for knee rehabilitation.
Jack visited in the evening and told me how cold the weather was getting.
About 1:30 Jack came by for a visit. While he was there various people came in the room every few minutes to take blood or check vital signs. I even got a phone call from my "hostess" to find out what I wanted for dinner.
He agreed that the room was very nice and I was getting a lot of attention. A couple of years ago he had a less-than-wonderful experience in this same hospital but a different department was involved.
At 2:45 I got my first visit from the Physical Therapy department -- two people. They said I needed to sit up on the edge of the bed and try to stand. They helped me sit up and turn to the side of the bed. Then they put a wide belt around my waist and told me to stand up. The belt was to catch me when I fell over. Which I did.
I was told to bend my knee a little and I told them I couldn't. They thought I was worried it would hurt. What I meant was I was in a cast and my knee didn't bend right now. One of them tried to bend the knee a little bit and discovered why I couldn't move it. Shouldn't they have known this?
After the therapists left I looked at my left leg. I expected a bulky dressing around the knee. What I saw was a huge, tree trunk sized cast going from my upper thigh to my ankle, wrapped in a wide ace bandage. It is light weight and sounds hollow when you tap it. It's some kind of foam that hardens in place.
Just before 4:00 a lady from the Admission Office came in with a clipboard full of questions for me. These were the same questions I answered last Friday at my Pre-Op interview. While she was there a woman from the surgeon's office dropped off a leg brace "for Saturday."
I was asked my full name and date of birth every time anyone from the staff came in my room. And then they checked my wrist band to see if I was really me. Hospital policy.
My policy, which I decided upon before I checked in, was to be unrelentingly cheerful and full of good attitude. It paid off. The nurses are bored with complaints.
I napped off and on between visits from nurses and aides who kept telling me to breathe better. I got a plastic device to blow into to improve my breathing and oxygen levels. The painkillers were working well for me and my memories of the afternoon and evening are hazy. Dinner seemed very good, turkey, etc. with great pumpkin pie.
The nurse brought me a brochure about the day-by-day recovery from the surgery and valuable tips for knee rehabilitation.
Jack visited in the evening and told me how cold the weather was getting.
Sunday, February 22, 2009
Day 0 -- The Knee Is Replaced, Part 2
Thursday, January 29
I am coming to in the recovery room and most of all I am thirsty. And my throat is scratchy from the breathing tube. The nurse says I can have some ice chips in a few minutes. Right now apparently the worry is that I will get an upset stomach if I eat or drink anything. It's a little after 10:00 A.M.
Soon I get a cup of ice chips to eat with a spoon. When I didn't throw up they bring me another cup of ice.
The anesthesiologist visited and said it all went well. Then I saw the surgeon and he said the knee replacement went fine but there was a ligament attached to a bone spur that had to be repaired. I'll be in a cast for a few days then I'll need to wear a brace for a while.
They kept me in the recovery room longer than planned. My room wasn't ready yet in the hip and knee joint wing. Just before noon they took me to my room, very nice, a suite of two private rooms sharing a bathroom.
Once I am settled in my bed I am awake enough to count all the tubes and catheters connected to me. I have an IV for fluids, another for antibiotics, two small hoses connecting the nerve blocker, a drain at the wound, a catheter for urine, a connector for taking blood and a morphine pump. I also have an automatic blood pressure cuff and a red L.E.D. taped to a finger to check my oxygen level. The L.E.D. is on all the time and glows in a very E.T. way.
The room is bright and cheery, on the ground floor with a view of a busy courtyard. My nurse asked if I wanted a special meal for lunch. I told her I didn't need anything special and ten minutes later I got a very nice lunch -- pot roast, veggies and dessert. And endless Cokes all afternoon. And I can press the painkiller pump whenever I need to. Or even want to.
I am coming to in the recovery room and most of all I am thirsty. And my throat is scratchy from the breathing tube. The nurse says I can have some ice chips in a few minutes. Right now apparently the worry is that I will get an upset stomach if I eat or drink anything. It's a little after 10:00 A.M.
Soon I get a cup of ice chips to eat with a spoon. When I didn't throw up they bring me another cup of ice.
The anesthesiologist visited and said it all went well. Then I saw the surgeon and he said the knee replacement went fine but there was a ligament attached to a bone spur that had to be repaired. I'll be in a cast for a few days then I'll need to wear a brace for a while.
They kept me in the recovery room longer than planned. My room wasn't ready yet in the hip and knee joint wing. Just before noon they took me to my room, very nice, a suite of two private rooms sharing a bathroom.
Once I am settled in my bed I am awake enough to count all the tubes and catheters connected to me. I have an IV for fluids, another for antibiotics, two small hoses connecting the nerve blocker, a drain at the wound, a catheter for urine, a connector for taking blood and a morphine pump. I also have an automatic blood pressure cuff and a red L.E.D. taped to a finger to check my oxygen level. The L.E.D. is on all the time and glows in a very E.T. way.
The room is bright and cheery, on the ground floor with a view of a busy courtyard. My nurse asked if I wanted a special meal for lunch. I told her I didn't need anything special and ten minutes later I got a very nice lunch -- pot roast, veggies and dessert. And endless Cokes all afternoon. And I can press the painkiller pump whenever I need to. Or even want to.
Saturday, February 21, 2009
Day 0 -- The Knee Is Replaced, Part 1
Thursday, January 29
Up at 4:20 A.M. and no coffee for me, or even any water. Jack had time for one cup of coffee. We got to the waiting room at 5:00 and sat with other people having surgery today. When I checked in the receptionist said, "Your doctor says you'll need a wheelchair to get to Pre-Op. Be sure to tell the attendant." I told her I could probably make it using my cane but she said it's a long walk. It turns out it's close to a quarter of a mile.
At about 5:20 we all leave the first waiting room and head for the surgery waiting area -- led by me getting pushed in the wheelchair. There are about 9 or 10 patients and another dozen friends and family. The receptionist was right, it's a long walk.
The surgery waiting room is busy and cheery. Lots of nurses and technical people come to me with questions and forms to sign. After I got changed into my gown they paged Jack and he came in to sit with me.
A lady from the chaplain's office appeared to see if I was Catholic and wanted a priest; if not then perhaps a representative from some other religion? The anesthesiologist, an Osteopath, (why are there M.D.s and D.O.s and what's the difference?, that's something to Wiki about someday) stops by to explain what's going to happen. He's the tenth person this morning to ask me when I last had anything to eat or drink.
The anesthesiologist's P.A. came by with a student/intern around 6:45 and they prepped me for the nerve blocker. I would get a light dose of sedation while they found some nerves in the front and back of my upper thigh. These nerves -- serving the area around the knee -- would get flooded with pain killer during surgery and for the next three or four days. This reduces the amount of morphine I'll need after the operation. At this point Jack headed for home and a nap I hope.
As I started to fall asleep somebody told me my surgery was scheduled for 8:00 and I would just stay under after the nerve block installation. When I woke up the surgery was over. I was in the recovery room being told to take deep breaths. I was thirsty, hungry and high as a kite.
Up at 4:20 A.M. and no coffee for me, or even any water. Jack had time for one cup of coffee. We got to the waiting room at 5:00 and sat with other people having surgery today. When I checked in the receptionist said, "Your doctor says you'll need a wheelchair to get to Pre-Op. Be sure to tell the attendant." I told her I could probably make it using my cane but she said it's a long walk. It turns out it's close to a quarter of a mile.
At about 5:20 we all leave the first waiting room and head for the surgery waiting area -- led by me getting pushed in the wheelchair. There are about 9 or 10 patients and another dozen friends and family. The receptionist was right, it's a long walk.
The surgery waiting room is busy and cheery. Lots of nurses and technical people come to me with questions and forms to sign. After I got changed into my gown they paged Jack and he came in to sit with me.
A lady from the chaplain's office appeared to see if I was Catholic and wanted a priest; if not then perhaps a representative from some other religion? The anesthesiologist, an Osteopath, (why are there M.D.s and D.O.s and what's the difference?, that's something to Wiki about someday) stops by to explain what's going to happen. He's the tenth person this morning to ask me when I last had anything to eat or drink.
The anesthesiologist's P.A. came by with a student/intern around 6:45 and they prepped me for the nerve blocker. I would get a light dose of sedation while they found some nerves in the front and back of my upper thigh. These nerves -- serving the area around the knee -- would get flooded with pain killer during surgery and for the next three or four days. This reduces the amount of morphine I'll need after the operation. At this point Jack headed for home and a nap I hope.
As I started to fall asleep somebody told me my surgery was scheduled for 8:00 and I would just stay under after the nerve block installation. When I woke up the surgery was over. I was in the recovery room being told to take deep breaths. I was thirsty, hungry and high as a kite.
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