The big day and after

March 17th 2009

Central heating

Been having some trouble with the central heating these past few weeks. Can only get hot water when the central heating is running. Boiler engineers have been out numerous times and changed numerous parts, some several times! They came out on Friday and promised it was sorted. Sunday night - this time it's packed in altogether so my shower is reduced to a bucket of water filled from the kettle and a cup to pour it over myself! Yikes! I ring on Monday, they come straight away but need a part he doesn't have with him. They'll be back the next afternoon. Er, no you won't! I need that back on before then. In the end, they come about 9am on Tuesday and fix it by 11am! So I have about 30 mins to shower and wash my hair before the taxi arrives. Phew!



Arrived at hospital

Arrived about 15 minutes early at the hospital which looks more like an hotel reception! Very posh (of course, it's new) and the receptionist gets me up on the computer, finds my notes and then fits me with an identity tag. First hotel I've been in where the receptionist does that!!

In the waiting area, 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 is 58 years old! She's also on double strength morphine and unable to do much more than sit and cry with the pain.

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 BoneSmart (of course!) and said we would all give her a good welcome!



Pre-operative prep

Well, back to me! I got taken through to a special area where patients are prepared! It's called POD - PeriOperative 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 arrived and went through some more routine stuff, marked my leg 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! 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 tingling in my feet he would know the spinal had worked and knock me out. He was as good as his word 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!



First night

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 the nurse 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 even what my pain score was! I had a relatively comfortable night.



First day and not so sure footed

Next morning, in a great flood of attention, I was given a bowl of water to wash and clean my teeth, the PCA and the drain were removed, and I had to dress so they could get me out of bed. Unfortunately, along with the removal of the PCA earlier (which I had just used) 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, at 10.30am 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 ended up with my knee buckled right under my chin! Just as well the block was still working, else I would have been screaming the place down! Instead I managed a kind of desperate and somewhat pathetic cries until somebody realised and helped me straighten it.




Health and Safety - but for whom?!

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!) but I knew I was so spaced out with the pills there was no way I could even lift a hankie much less me! 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 4" too narrow so they decided to put me back on the bed but it had to be made! I was left hanging there until they got new sheets on it and I was gratefully lowered into a place of relative comfort!



Tourniquet pain .. not to be underestimated

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 with which the surgeon was absolutely delighted! 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 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!