The Surgery and Hospital Stay

Pre-Surgery

As the day of surgery approached, I had several pre-op appointments to make sure that I was healthy enough to have the surgery. You will have these also. They included a basic physical, blood work, an EKG, and a meeting with the Physician's Assistant to review the procedure and answer any final questions.

You will probably have a lot of questions at this point. Keep a list and bring it with you, as this will most like be the last time prior to the day of surgery that you will get all your questions answered. If you're like me, you would much prefer knowing the answers before you start that drive to the hospital on the day of surgery.

I also attended a mandatory "Knee Replacement" class, where about 50 of us were given the scoop about what the surgery would entail and what would come next (the hospital stay, Home Health, PT, types of walkers, staple removal, etc.)

After all my pre-ops were over, I still had about a week until the surgery. It was a choice of staying home and worrying, or of one last ski trip. Which would you choose? We skied 5 out of 7 days, then drove home Monday for a Tuesday morning surgery. You might want to cut it a little less close. We probably should have come home on Sunday, but it all worked out OK.

When I arrived at the hospital, they checked my identity and had me change into one of those lovely hospital gowns. They took my pulse and blood pressure and put all my clothing into a bag with my name on it. You should not bring very much with you to the hospital - no jewelry, no watch, no cell phone, etc.  I can't function without my cell phone so my husband promised to bring it back, along with my charger, when he came to visit. As he did when I had my earlier surgery, he put my engagement and wedding rings onto his keyring, to be given back when I was ready to wear them.

Be careful about that charger. One of the nurses told me that chargers are the thing most left behind when patients are discharged from the hospital.

I also met with the anesthesiologist. In a perfect world he and I would have chatted the night before on the phone, but I had not yet gotten home when he called. He discussed the type of anesthesia I would receive, and why the surgeon has selected that type of anesthesia.

I then transferred from the hospital bed in reception to the one which would take me to the operating room.


Surgery (not much to tell)

My husband left and I was wheeled away to the prep room. I don't remember much after that, until waking up in the post op room. Franky, I don't remember much of that either. I wasn't in any pain and I just kept drifting in and out of sleep for a couple of hours. That is one of the nicer sensations, waking up, knowing you have a new knee, being very pleased and not being in any pain.

Then I was wheeled to my room, introduced to the nursing team, and went back to sleep.


Post-Surgery

I had the usual post-op meal of broth and Jello, very exciting but all I felt like eating at the time anyway.  Later that day they would actually ask me to mark a menu of solid food for the next day.  Randy (my husband, kudos if you remembered that from part 1!) showed up in the early evening, cell phone, charger, and all.  We chatted and we dozed in perfect harmony.  It turned out that the chair next to me opened up into a little bed, and the nurses offered him blankets and a pillow if he wanted to stay all night.  He left about midnight.

I was cold after the surgery and the nurses had covered me with several blankets.  I believed later that the blankets were made of lead because I could not lift my legs.  I learned later that my quads had shut down because they were cut during the surgery.  (This may not happen during your surgery if it is Minimally Invasive (MIS)).  I could not get MIS because I had hardware from my tibia plateau fracture that had to be removed.  When I got up to walk the first day, the nurses encased my thighs in a rigid support that resembled a black cardboard box with velcro fasteners.  This was to support me until my quads relearned how to fire.  Even after I got home, it was a couple of days before I could lift my legs very much.

Two words about a catheter: use it!  After my previous surgery, I did not have a cath.  Since I was continuously pumped full of fluids before, during, and after the operation, I had to call a nurse over to use a bedpan about every hour that first night.  I made sure I had a catheter this time.

About midnight, I began to experience some significant pain.  The nurse put dilaudid into my IV, and the pain disappeared and was replaced with a warm fuzzy feeling.  I felt much better.  Unfortunately the next time they came in to take my blood pressure it was really low.  No more dilaudid!  No more anything!  They had intended to get me up for my first PT, but cancelled it.

All night they kept on taking my blood pressure, and it remained very low.  I tried to stay awake.  It wasn't that hard because they kept coming in to check my blood pressure.  In my drug-induced fantasy I felt that if I fell asleep my blood pressure might drop even lower and I might never wake up.  In my saner moments I knew that wasn't going to happen.  I had faith in the doctors and nurses and did not even call Randy or ask him to come over.  I was fine.

Note:  Most likely you will need to use a front wheel aluminum walker, and will then graduate to a cane after a few days or a week or so.  Unless you already have one or both, why spend the money for a brand new walker which you will use for such a short period of time?  I only had to stop into 2 Goodwill stores to find a suitable walker for $4.  No one had  talked about my future need for a simple cane, so I did not look for one of those at the same time.  I ended up buying a new cane that I liked for under $20.

My blood pressure remained low, but I walked 3 times the next day with the walker.  I was still connected to all sorts of tubes and pumps which came with me as I walked.  The first time was just out of the room and up a small corridor, the second time was a little farther, the third time was to the end of the hallway.  The nurses showed me the spot to which I would have to walk the next day in order to be discharged, and it was about 1 1/2 times the distance I had already been able to walk.  I knew I could do it by the next morning.

Note:  You haven't lived until you've gone to the bathroom all connected to tubes and pumps, and then tried to clean yourself without disconnecting anything.  A real challenge, and despite myself I had to ask for help.  It's hard to maintain your dignity under those circumstances, and I guess you shouldn't even worry about it.

As a reward for my efforts I had filet mignon, mashed potatoes, mixed vegetables, chocolate cake and milk for dinner.  I figured I deserved it!

Time to Go Home

Although I would miss the salmon dinner I had ordered for my second night, I was determine to go home if I could.

My catheter was removed, and I was disconnected from all the tubes and pumps.  I was on my own.  I walked to the bathroom a couple of times (with a nurse) and made it down the hallway to the release point.  I called it the "Point of No Return" because getting there meant I would not have to return to my room for another night.

The discharge nurse showed me how to wrap my incision.  It could not get wet for 10 days, until the staples were removed.  In the meantime, I could shower, with help, after waterproofing my leg with plastic wrap.

I arrived home, made it up the 5 degree slope into our house, and collapsed into the recliner.  It would remain my home for a while.


Next:  Those first few days at home, and what I could have done differently (better)!



Please check back in 2 or 3 days for my third installment.