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TKR My post-op blog!

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Josephine

NURSE DIRECTOR EMERITA
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Jun 8, 2007
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83
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The North
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Well, this is where you're going to get the entire story so just get yourselves comfortable for a nice long read!

Arrived in the hospital about 15 minutes early and got talking to a young lass whose mother has been disabled with bilateral O/A knees for almost six years and yet her doctor is still telling her that she is too young to have TKRs! She's also on double strength morphine and unable to do much more than sit and cry with the pain.

She is 58 years old!

So I gave her the name of my surgeon, told her she needed a second opinion and she should get herself referred to this chap. I also gave her the name of BS (of course!) and said we would all give her a good welcome! If I remember, her name is Margaret and she will, of course, be from the UK. I really think God was in that meeting!

Well, back to me! I got taken through to a special area where patients are prepared! It's called POD - PeriOperaative Department! I was put in a little room/cubicle, got into the ubiquitous op gown and checked out, had more blood taken for group and crossmatch and was prepared with (one) TED stocking. Later the surgeon came and went through some more routine stuff and got me to sign my life away!

Then the anaesthetist came and - joy of joys! - it was somebody I'd worked with before I retired! His name is Peter and he's a real doll! I loved working with him and if there was one person on this planet I would trust to do a spinal on me it's him! So I went into the anaesthetic room a moderately happy bunny!

Least I was till he pranged my right nerve root and almost made me kick the anaesthetic nurse in the 'never-mind'! Second time he got in there straight as an arrow and it was all done. He had asked me earlier if I had any 'final requests' (LOL!) and I had told him yes, I don't want to see anything once he was satisfied with the level of anaesthesia. To which he replied that he didn't believe in checking levels, that once I told him I had pins and needles
in my feet he would know the spinal had worked and would knock me out. He did and from the moment I had laid myself down on the table, I knew no more until I was being wheeled into recovery! It was blissful!

I also discovered that he had given me a very successful femoral block and a PCA plus oral meds if I should need them. I didn't! What I did need, about an hour after I got back to the ward, was to be catheterized as I had urinary retention and had to deal with the new information that UR hurts! Seems she had to phone a doctor for a single dose of prophylactic antibiotics before she could do that but it was tough finding one. In vain I begged her to do it anyway and eventually she agreed to but just as soon as she had opened all the packets and washed up, I began to urinate spontaneously! Oh joy! I didn't pass much but enough to be effective and everything was cleared away. She still gave me the antibiotics anyway!

Thereafter, I started keeping a record of everytime I used the PCA and what my pain score was! I had a relatively comfortable night.

Next morning, in a great flood of attention, the PCA and the drain were removed, I was given a bowl of water to wash and clean my teeth and cloths to get into and got out of bed. Unfortunately, along with the removal of the PCA I was given 60 mgs of codeine phosphate. Now 30 mgs will wipe me out big time. 60 is almost as good as a GA! Never the less, I was got out of bed and given a walker to help me get to the chair. Should have been warned as I tried to rise from the bed, my leg with the still working, very efficient femoral block, just gave way under me. I was feeling very wobbly and like a frail little old lady! I made a couple of steps to the chair but as I went to turn and sit, somehow I lost my co-ordination (what there was of it!), the leg that wasn't there crumpled and I kind of oozed not so gracefully to the floor!
The worst part was that I had my knee buckled under my chin! :hate-shocked: Just as well the block was still working, else I would have been screaming the place down! Instead I managed a kind of desperate "oh-oh!" amongst frantic cries to straighten my leg and eventually somebody realised and did it for me.

I was then told that I would have to get myself up off the floor as they weren't allowed to lift (health and safety rules! :DOH:) but I knew I was so spaced out with the morphine and pills there was no way I could lift a hankie much less me! But they still all stood round me watching and telling me to get myself up like I was sitting on a setter! Eventually they got a hoist and I was slung up in a most undignified manner and lowered into the chair. THAT was when I discovered the arm chair was about 6" too narrow so after some more somewhat vocal complaints from me, they finally got some common sense and decided to put me back on the bed but during all the kerfuffle, somebody had stripped it so it had to be made! I hung there while they got new sheets on it and was then gratefully lowered into a place of relative comfort! But the chair issue gave me a perfect excuse to stay in or on the bed for the next two days! :th_heehee:


There's one thing that has been referred to on here a couple of times but never elsewhere and that is the searing pain in the upper thigh and buttock. I was quite unprepared for that. What ever I did it seemed to affect my movements, getting into bed, walking, on and off the loo, SLRs. Oh my! It was horrendous! I despaired of ever being able to do SLRs though I could get a flexion of around 90/95 degrees which the surgeon was absolutely delighted with! I asked him about the other pain and he looked nonchalant and said "Of course - it's tourniquet pain!"
"You mean you know about? You even expect it?"
"Of course! Those muscles spend around 2-4 hours under some considerable compression, 350mgs mercury where blood pressure is often pumped up to a maximum of around 200 mgs. There's bound to be some consequences!"
Well, maybe, but I just never thought of it like that before! Anyway, by day 6 that pain magically dissipated and I could waggle that ol' leg around like a kid with a flag! I was sweeping it back and forth in bed like I was making snow angels!

Sunday I did the stairs and very well too, even if I do say so myself! So despite the missmanagement of the aids deliveries, I offered to come home on Tuesday and did so! My brother and his wife kindly arranged to come up and stay with me a few days and see me settled in but to be honest, I'm already pretty independant. I can walk with one crutch though I'm not going to, and I can get up and down off the loo without any help. I can also walk quite freely around the house though slowly. I can bend down to feed the cats and put my slippers and panties on.

When the taxi dropped me off at the door, he left my two suitcases standing there and a basket of flowers and a bag of all my meds from hospital and scooted! So first thing I had to do was to pull them indoors!

My next task was to feed the cats and the third to get my laptop opened up. That was when I realised I had come up with this absoutely marvellous idea of unplugging things when I went away. One of these was my Gateway router which is upstairs in the study! So - only 10 mins home and I have to go upstairs (and down of course!) to switch it on.That accomplished, I start to read my emails (all 214!) and try to check the forums. But I fell asleep and then my brother arrived so one way and another, you're getting this first insallment at 11.30 pm and not earlier as planned!

Section 2 will be later - meaning tomorrow sometime! Till then G'night!
 
Hi Josephine So pleased your back and well. Sounds like nothing will hold you back. God your going up and down stairs already. I found that fairly hard. Yes I remember the spinal block, not feeling your leg. Wonder if you will get the muscle spasms later. You take it easy as you tell all of us to. I will be logging on to see how you are doing. Take care. Lizzie.
 
Welcome home Jo, we missed you.

Glad things went well with the actual surgery, not sure about some of the care. Interesting differences between health care systems. Here antibiotics are started 1 hour before the operation starts and go for 24 hours. They also do the catherization in the OR as they assume that will be a problem. I really understand the urinary retention pain. I had that on my very first operation and they kept the water running in the room to see if that would work, it didn't. The 2nd surgery I had I went almost 20 hours before they did the cath. After that I never used general anesthesia or sedation again. That did help that problem.

Hard to believe they did not hold onto you when you took those first steps especially given the pain killers. In the hospital I was at, the first time out of bed was with the PT and they put a belt on you to catch you if you start to wobble after that the nurse or PT was always to the side and just slightly behind you to make sure you did not fall. The hoist sounds awful, sounds like they need training in how to assist people without hurting themself

Glad even though my surgery went long did not have the tourniquet pain problem, glad it is gone.

Hope you did not tip that taxi driver. How did he think you were going to get that stuff inside. I see you were inventive but sure wish there was someone around to help you.


I did the same thing with the electronics when I left home and when I finally made it downstairs found the TV would not work at all and the company had to come out and replace the satellite receiver. Good thing the downstairs TV is not connected to the upstairs ones.


Well rest up and enjoy being home.

Simon
 
Welcome back Josephine, Though I can't relate to knees, I am so glad you are back and doing so well. As a hippie, I remember feeling so bad for the kneesys in the rehab center. They seemed to be having a harder time of it--no matter what the age. But you sound so well. Such good news.

Take real good care,
Laurie
 
YAY!!!! You're home! Welcome back Jo - we've missed you dreadfully! I can't believe you're already hiking up and down stairs - and the bit where you were suspended in the hoist while they made up your bed made mxe wince in sympathy! I hope your recovery is smooth and uneventful!
IT'S GOOD TO HAVE YOU BACK! :)

Peta xx
 
Oh, Josephine....what a story so far!!! I'm amazed at some of the things you endured in the hospital. But I guess it's more important to focus on the outcome and how well you're doing now. And it sounds like you REALLY are doing well.

What kind of pain meds are you on now? You sound really good!!
 
Welcome home Jo. While reading your post, I felt I was right there with you.

I can believe they didn't pick you up. After my husband had his 1st TKR, he needed to be on a CPM machine... but there was no one on the floor who was allowed to lift it onto his bed. After we waited 30 minutes for the right person to come and hoist it up, the type A personality I am, I did it. From that point on, I was the designated person to handle the CPM machine... up on the bed, down to the floor, several times a day, for 4 days. I think all that lifting made me have my TKR sooner than later.

Don't overdo it, remember to ice, take your pain meds, take your stool softeners and keep giving us updates... Sandy
 
Jo--welcome back & thanks for your story.

I am amazed at the regional differences in the practice of medicine...I had the femoral block and they posted signs all over the room reminding me NOT to try to move without one or two nurses/aides there to assist me....when I did fall, they picked me up promptly...there is no way they would have told me to get in the chair myself. Guess here in the states they are more afraid of a lawsuit from a patient than from a hospital employee :)

Don't know why but I didn't have the tourniquet pain problem with either knee.

I cannot believe the cabbie left you with all that to cope with!

I'm feeling more and more spoiled.

Anyway, take advantage of the help while you have it. And rest, take the pain meds, and of course, the stool softeners!

We're so happy to have you back!
 
Jo, that's quite the story. What do you mean they aren't allowed to get you up off the floor? What the heck do nurses do now besides pen pushing? There should have been someone to help you in the first place, bloody lazy nurses, sorry...OK I will calm down now and count to ten!!

Glad you are doing so well though besides the fall. Now just you let your brother and his wife pamper you for a few days, plenty if time for you to look after yourself when they go. Remeber REST helps you heal too!!

Anyway, take care. Look forward to seeing your updates. You are now officially a Kneesal Buddie too. ((((HUGS))))) Sue xoxoxoxo
 
Wow - Jo -- what an experience! As others have said there is a big difference with the post operation care in the UK and here in the NorthEast US at least. I had some drug that totally blocked the pain for the first 24 hours or so -- dripped through the epidural which was left in place until the day after the surgery. At which time they switch to intravenous Dilaudin (sp) which was awful. Both meds were on PCA.Then Percs. But all the numbness wore off from both legs before I was let out of the recovery room . So it couldn't have been a femoral block. And there was no thigh and butt pain and your post is the first I've even heard of that....
You are very courageous to come home alone and struggle with your suitcases etc. What an *** that taxi guy was!!!! And then feed the cats and then deal with the wireless router upstairs. I didn't have the guts to go upstairs to my bedroom for maybe 10 days. I slept on a futon in the living room. You sound like you're doing amazingly well -- especially with all those early issues like falling (can't believe they let that happen; I too had PT people around me like flies when I first stood up and started walking. for 2 days until they were sure I was OK on my own with the walker. And yes they do the catheter in the operating room here while you're still out. That was the worst of my pain. It was always uncomfortable and sometimes blocked up and when they finally pulled it out on the 3rd morning so I could go home -- it hurt like hell and hurt down there for weeks and weeks!!! No one told me about that!!!.
You must be so happy to be home and the cats must be happy too. Since it is almost a week now -- I would say the worst is over. But as I recall you get only 3 PT sessions which is so strange and leaves it all to you. So you have to be really determined and focused and work that leg and bend!!!! And if you didn't do it before you went into the hospital -- you might want to try to get down on the floor and figure out how to get back up while your brother and sister in law are still there to help you if you need it. Just in case. Anyhow welcome back and let the good times roll!!! They will -- sooner than you can imagine!
Stephani
 
Welcome home, Jo! Sounds like the hospital staff is first in line for the Good Samaritan Award--NOT! But your delightful sense of humor was evident between the lines, so I know you'll forgive me for laughing aloud when I read your "sling" adventure!

We're all delighted you're back, of course, but understand you need your recovery sleep, so don't push it! Jamie's kept the chicks fed and the barnyard quite warm & comfy while Mother's been away, so just knowing you're back in the henhouse will do for another day or two!
 
Yay! Jo!!! You DID,,,its finally OVER, & now the real
Healing can begin!
0xan't wait to hear about the second part of
Your journey to recovery! So proud of you!
Boy did we ALL miss you! Rest up. Elevate ice &compress,,,,
& enjoy being HOME again: You are doing great!
Jo,,,,did you need the earplugs???? X0X0
 
Ahhh Jo-Jo,
What a great sory so far!!! You are something thats is for sure. I am glad that the thigh and tush pain is gone. (Now if mine would just go away! Riding in a car is the hardest thing to do with the thigh pain.) I am so happy you are home!!! Can hardly wait for the next part of your story.

[Bonesmart.org] My post-op blog!



^i^
 
Jo
I am so glad you are home. I so remember the wonderful feeling of getting home after my hip replacement.
It is all uphill from here.
Rest and rest some more
judy
 
Dear Josephine
So pleased to hear that you are on the way to recovery. You are one amazing lady - no hint in your answer to my questions that you were just a day or so away from surgery yourself. I hope you are feeling OK and not in too much pain. We are all rooting for you - from all around the world!
Love and best wishes
Jeanne
 
Hi Jo...so glad you are back with us and I must say I thought our health system here in Canada was bad but I think your treatment was worse. At least here the nurses did help me a bit....I say bit!!
Lord what we go through and a few months down the road are able to laugh about but at the time it is pure HELL!!!
So like you told all of us...hang in there and it will get better...
Lots of hugs to you...Carolxx
 
Dear Jo
It's wonderful to hear from you that you are OK and on the road to recovery! Your sister has been great about keeping us posted about you but it's always better to hear from the source. As always you are a goldmine of helpful info and your humerous telling of the tale puts a smile on all our faces.
Welcome home, Mother Hen. Thank you for being YOU!
Blessings, Irene
 
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