Wednesday, April 10, 2024

Knee Joint Replacement Surgery--one week later

Bruising the day after surgery
WARNING: This is a non sewing, quilting post.

Almost ten years ago while on a walk with the dog, I tore the meniscus in one knee. About six weeks later, I tore the meniscus in the other knee doing the same activity. In 2013, I had arthroscopic surgery on one knee and a few months later, I had it on the other knee. At no time, was I ever able to recoup my range of motion or strength that I had before the tears. 

Over the years, I tried acupuncture, chiropractic treatments, physical therapy, cortisone shots, synvisc shots and massage to manage the pain and loss of functionality. Some treatments helped; but, nothing got me anywhere near where I was before the initial tears. 

Support stocking marks day three
Fast forward to Spring vacation 2023 when we took our granddaughter on a trip to London and it was obvious that I needed more intervention regarding my knees. The family trip to Greece summer 2023 confirmed that I had exhausted all coping strategies.

COVID caused a backlog of people needing orthopedic surgeries. COVID also caused a lot of medical staff to retire. In our area, anesthesiologists are in short supply. I waited six months for an appointment with an orthopedic clinic. I waited another six weeks for a reply to some of my pre surgery tests. 

Day three--
Wound under water proof bandage 
At that point, I researched and chose a different orthopedic clinic. Again, I had to wait about six months for the initial appointment which was scheduled early December. The day of my initial appointment, my knee had swollen so much that I was unable to bend it. The surgeon prescribed PT until I had surgery which wouldn't be until June. 

I started PT in January. While I didn't think it would help much, I was wrong! I was able to strengthen some muscles and improve my gait which did help combat the pain. I also called the surgery scheduler early March and asked to be placed on the waiting list if someone canceled. I figured, I'd be at least a month earlier than scheduled. 

Leg sleeve for the Nice ice machine
The scheduler returned my call the next day and let me know that there were no openings until June. Bummer, I thought. But, I told her that we were going to become fast buddies because I was going to call her every Monday until I had a surgery date. She laughed and said she appreciated what I was trying to do; but, June was going to be my month.

Imagine my surprise when she called me the following day to say that an extra day had opened on the schedule and would I like it. I called back and said whenever it was, I'd take it. It was for April first!!! I took a breath and said I liked her style of humor. She replied . . .What??? April first is April Fool's Day, I said no fooling??? She replied that she was dead serious although she did chuckle!!!

ROM Tech machine

It was a whirlwind to complete the tests needed for the surgery to take place. At every appointment, I asked to be able to go home the same day as surgery. Again the clinic staff let me know, it wasn't an option with this surgeon. Although the physician's assistant said if I had good results from the hospital pre-exam there might be a chance. I asked to use the ice machine which insurance does not cover and to use the ROM Tech machine which insurance does cover.

At the hospital pre exam that I was told to plan on being there for three hours, I was out in about 45 minutes. The nurse practitioner who examined me said I was a great candidate for home same day as surgery. . .I hadn't even asked!!! Other than being overweight and having arthritic knees and a neck fusion, my body was in better shape than I gave it credit!

Then it was on to the twice daily showers. To lessen the chance of infection, I got to shower morning and night with five minutes spent gently washing the surgical area. I used a special liquid soap the hospital supplied. I found that soap challenge to rinse off!! Late afternoon on the day before my scheduled surgery, I received a call that my surgery was canceled. 

Five days post surgery

My surgeon's flight had been canceled and he wasn't able to return in time. Turns out my surgeon was in Cancun, Mexico. They had confirmed their flight; gone to the airport and was told there that there flight was canceled. No worries. . .they could fly out on two days later!!! I'm sure he had a lot of calls to make for rescheduling and then he also had to figure out where to stay!

I had my surgery on Wednesday, April 3 instead of Monday, April 1. The reason that he was able to reschedule with relatively few days between is that it was Spring Vacation in Washington and many doctors were out of town.

We checked in for the surgery at 5:30am. This meant I was up at 2:40am to drink 16 ounces of apple juice that is recommended. I took yet another full body shower, dried with a fresh towel and put on freshly laundered clothing. I did pack a bag in case I wasn't able to go home on the same day. We left home at 4:30am. 

Ankle five days post surgery
At 6:00am, I met the pre surgery nurse who confirmed I was being admitted. I said I hoped that I could go home the same day. She said not likely; but, possible if I was able to get the okay from all the medical entities. When I said the nurse practitioner had said I was a candidate at my pre surgery appointment, she said we would try! 

I donned the warming gown. By 6:40, the IV nurse had inserted an IV line into my hand. The CNA placed a thigh high support stocking on my left leg. The right leg stocking was placed in my bed to go to the operating room. Support stockings are used to prevent blood clots. At 7:10, I made one final trip to the bathroom. The pre-surgery nurse kept me and my husband informed at every step of the process.

Leg and ankle eight days 
post surgery
At 7:15, the anesthesiologist had a conference with me. He recommended a spinal block as I would require less drugs and would have an easier time waking up. I went with his recommendation. At 7:25, the surgeon signed the knee joint to be replaced and asked if I had any other questions. At 7:30, I was on my way to the operating room.

I saw the operating room and moved myself to the table. I had the spinal block. I felt the anesthesia medication going in through my IV. I noted it was 7:35. I next noted it was 9:25 and I was in the recovery room. I had no headache, no nausea and felt fully awake. My husband said that I was out of surgery at 9:07 and that the surgeon had stated it went well.

My first questions were about the anesthesia. I learned I handled it well and that it was a good option for me. My second set of questions were about the knee joint. Did the surgeon test it before he stitched me up for maximum flexibility and extension? Did the surgeon test it after he

Comparison of legs for swelling eight days post surgery

had stitched me up? The nurse said yes, lots of testing was done before I was stitched up and after I was stitched up. She also said these were not questions she often received! I told her it was a quality check. I wanted to be sure the part was installed well and correctly!

She asked if I could handle ice chips, I gave it a try and said that it was too bad they weren't lime flavored. She asked if I would like a popsicle which was lemon flavored. It tasted great and by the time I had eaten it, I was back in my short stay room. I lucked out in that I had the same nurse post op that I had pre op. I ate a container of jello and a cup of broth. All stayed down.

What I didn't realize was the spinal block takes time to wear off. Sometimes, the brain can't detect full bladder symptoms. . . enough written. Once I could wiggle my toes, PT came and ran me through the exercise program. I had a visit from the nurse practitioner who again quizzed me and my husband about our home situation. Then a member of the orthopedic team came by to test me. They all gave me a thumbs up on going home the same day. All that remained was the surgeon's sign off. I was in the bathroom, when he came by; but, he signed me out and a little before 2pm, we were headed home.

It was wonderful to be home. My husband, Bob, is and continues to be an excellent caregiver. He had to deal with the support stocking which wouldn't stay up around my thigh. It ended up rolling down and acted like an elastic band around my thigh. It gave me a rash and a bruise. By the third day, I couldn't stand the pressure and took them off. The clinic nurse sent me knee high stockings in the mail which arrived today. She would have preferred my husband drive to the clinic and pick them up. The clinic is 40 minutes away with light traffic. I feel okay being on my own for an hour; but, not more than that!  

The materials regarding the surgery state someone is needed to stay with the patient for a minimum of three days post surgery. I can't imagine being on my own for meals, bathing etc after three days. I still need a watchful eye getting in and out of the shower. I can make a sandwich; but, can't carry it with the walker so end up eating it standing. My husband fixes me a plate and serve me. I have eaten at the table; but, most often it is more comfortable to eat with my feet up. I'm still working on the muscles to raise my leg. . .so far those muscles are on vacation!!!

I've ridden the ROM Tech five times every day---that is the prescribed amount of sessions. Each session has a passive and an active movement phase which helps with the range of motion of the knee. You can adjust the pedals to keep the 12-15 minute time manageable for pain. I use the ice machine 30 minutes of almost every hour that I'm awake. At night, I leave a gel pack on the area that feels the warmest or aches the most. 

I believe the coolness along with the extra strength Tylenol has helped manage my pain. Moving and stretching also helps. I've taken two narcotic pain tablets which I split into four dosages over the second and third day. I also take aspirin twice a day to prevent blood clots and Celebrex twice a day to reduce swelling.

I've taken photos of my leg and the pretty colors it is turning. If I had been able to stand wearing the support hose, the bruising would have been less. It looks awful; but, it doesn't hurt. A waterproof bandage covers the incision. It will come off on April 18 when the stitches come out.

The second, third and four days were when my leg was the sorest. I felt like I'd been in a car accident! I am appreciative of the flowers a couple sent me as well as a the paper bouquet my friend Sharron sent. My in town daughter and her two daughters dropped by for a visit on Saturday. My quilters friends have sent me healing wishes, A number of them also have sent me photos of the quilt show so I could view some of the entries! I'm appreciative of the multiple calls my London daughter has sent! 

Life is good and getting better every day!



Janice Smith said...

Wow! This post was fascinating to read. I have a friend who had knee replacements, but I never realized how much went into the surgery and recovery phase. Thank you for sharing this experience. It sounds as if you are making steady progress and hopefully, you will soon be pain free in your daily life and on your future travels. Your husband gets extra kudos as well for taking such good care of you.
Stay strong :-)

Jocelyn is Canadian Needle Nana said...

Like Janice, I also found this post a fascinating read. Thank you for writing and journaling online about will be a record of how it all went. It sounds like you are on track for healing well and think of the joy you will have when you can move about without pain. I'm convinced this will all have been worth once you move through it and out the other side. Also what a great hubby by your side for all of this...a keeper for sure!