This is the morning of the 6th day after surgery. I have had no significant pain as yet. Some discomfort, but no real pain, nothing to warrant a Percocet, or oxycodone, though I have a plentiful supply if there should be need. I think part of the reason may be that the nerve block has not completely worn off yet, but that's only my feeling, no basis for it.
I'm on my usual medications of HCTZ 12.5 mg, which I've taken daily for several years, though admittedly not as faithfully as ordered. I've taken a full-strength aspirin a day for several years, mainly for the arthritis which had been haunting my knees, and then just because it seemed like a good idea. Doctors approved. My Ortho instructions have doubled the aspirin dose; it is prescribed now as a blood thinner, to prevent clots. I also take Pepcid as needed, same as before. I am prescribed Celebrex, but the pharmacy was unable to fill it without contacting the doctor, somebody from the hospital who I've neither seen nor heard of. I was going to use Tylenol instead, but the visiting nurse said Celebrex is very effective for swelling, so bring it on if it works out that way. I have 80 Oxycodone (Percocet) tablets, of which I can take "1 or 2 every 4 hours if needed for pain." That seems like a very wide discretionary margin, but what do I know? No wonder people become addicted. But maybe that's not such a bad thing.
This time, there was no passive motion machine which moved your operated leg for you. I guess the results didn't compensate for its expense and inconvenience. I didn't mind using it; you got the sense that something helpful might be occurring even during your inactive time. The gizmos at the foot of the bed were still there, some type of inflatable cuff attached to the equipment and to the splint-like cuffs that were on your legs. They were infrequently applied and never explained in any way. They felt kind of good though, for the brief time they were available. As before, they applied before the surgery, those white compression stockings, which are to be worn for weeks I understand, but can be removed twice a day or overnight or whatever. They're difficult to put on if you take them off, and they can be even harder to take off. I hope they're effective, because they're dreadful. They say proper sizing is key, but what if the upper part of your legs is larger than the lower part; not everybody has pipe stem legs the same diameter on top as on bottom. Oh, well. I've dealt with it before and I can do it again.
Something new was a large, heavy, black leg brace that was applied right after surgery; I think I woke up wearing it. They called it an IMMOBILIZER, which sounded to me like an Arnold Schwartzenegger movie. And it was just as uncomfortable to wear as the movies were to watch. It was heavy, dug into your skin when you sat in a chair, and put pressure on the incision. Somebody must have come up with it as a good way to stabilize the knee post surgery, but the entire focus is on having you move your leg. It must be all about that delicate balance that eludes us not privileged to know, but I would bet it's not going to last, not in its present format anyway. so that's pretty much it for meds and equipment.
The pain-----for 2 nights I woke up with pain in the area at the top of my foot, kind of sharp and demanding of attention. I got up and I think once I took a Tylenol, but the pain didn't last either time. I think they put your foot in some kind of vise during the surgery. No one will tell you that; they say the heavy bruising is due to blood flow. Well, maybe.
I'm feeling right now what seems like sciatic pain in my left hip and down the outside of my leg. I know the epidural and nerve block are put in the hip, and suppose that's why the pain now. Maybe the nerve block is finally wearing off. The top of the thigh muscle is a little sore at times, when I stretch it or do a lot of walking, especially outside. Once in a while, the stitches seem to be pulling a little under the bandage, but only minimal discomfort. I'll take a Tylenol, and I'm pretty sure that will be enough. I'm saving the big stuff for major knee pain, but so far all quiet on that front.
Monday, July 14, 2014
Sunday, July 13, 2014
Mind Lost in Time
When I started searching the internet for information on knee replacement, I came across a number of patient-authored, detailed journals. Some described the entire hospital stay, including the surgical experience and what happened afterward. I found it helpful and informative, and I thought I'd try to do the same. I can only assume that the authors of the articles had assistance because I failed miserably to write any consistent account. I'd written several notations on a notepad, but, while some entries are clear, others are not. The sequence is doubtful. Some events I would have recalled; others would have been completely forgotten if I hadn't read them, though in reading them, I do remember.
I had thought that I'd left the hospital the second morning after surgery without having seen the surgeon. But my "journal" entry reveals that at some point, I had been walking, using the walker I suppose, and accompanied by someone, I also have to suppose, when the surgeon asked how I was doing. I answered that the knee felt sideways. His reply, according to my notes, was, "I can assure you that one thing we do not do is install knees sideways." I told him that of course I didn't mean that the knee was sideways, but that I felt like I was veering sideways when I was walking on it. Ah, veering! Wouldn't you think doctors would know the effects of anesthesia?
I had thought that I'd left the hospital the second morning after surgery without having seen the surgeon. But my "journal" entry reveals that at some point, I had been walking, using the walker I suppose, and accompanied by someone, I also have to suppose, when the surgeon asked how I was doing. I answered that the knee felt sideways. His reply, according to my notes, was, "I can assure you that one thing we do not do is install knees sideways." I told him that of course I didn't mean that the knee was sideways, but that I felt like I was veering sideways when I was walking on it. Ah, veering! Wouldn't you think doctors would know the effects of anesthesia?
July 13, 2014 4;43.A.M.
I'm sitting here, assessing my situation. I can't sleep, don't feel like eating, but have no actual pain. Last year, for the right knee surgery, I left the hospital on the morning of the 5th day, so in a few hours that much time will have elapsed, though I've now been home for 3 days. My left leg looks a mess. It is swollen from thigh to foot, with so much bruising and discoloration that it looks like a tractor ran over it. The stitches beneath the wonderfully smooth bandage are pulling a little, but certainly not enough to warrant a Percocet. I may be coming paranoid, as I'm more concerned right now that I may have a kidney infection and that my retina, lasered the day before surgery, is going to tear again. I'm reminded that when our washing machine malfunctioned a few days ago, we didn't call a repairman. We ordered a new one. When one of the parts goes, the others can't be far behind.
Saturday, July 12, 2014
Bright spot----Fernando
He entered the hospital and signed in on the board in the room, under either Nurse or Tech. I believe he was Tech. "My name is Fernando," he told us, and then, "Fernando. How many people do you know who are called Fernando? It is different, my name. You can go downstairs to the kitchen, the garage, anywhere in the hospital and how many are named John. But Fernando, I am the only one." He than told us he was feeling a little sad because he was turning 50 on Oct. 23. I told him he didn't look that age, closer to 37 or so, true I think. He was grateful and said he used to be a model. I asked what he modeled and I thought he said toys, but then he took a picture of himself out of his wallet and showed it to me. He, shirtless and muscled at age 19, and wearing what looked like a sailor hat. I asked if he was a dancer, and he said yes, how did I know. I didn't want to mention Chippendale's so I just said he looked like a dancer. He added that for 15 years he had danced in almost all the shows in NYC, off-Broadway, naming Cats and several others. I wondered if my nephew's wife would have known him, but then again she has probably come across more than one Fernando in her career.
I think I get it....July 12, 2014
Christine, from the Eddy Visiting Nurse Program, came here today to assess my status. She asked how I liked St.. Peter's new Orthopedic Wing, with private rooms, special beds and all that is needed to make orthopedic recovery ideal. It was scheduled to open June 30, but unfortunately, I missed out on that as the move is 2 weeks behind schedule. I related to her the more than several instances of subpar treatment, and she was appalled. She wants me to write a letter, and said she herself may do the same. Since I'm expecting as good a surgical result as last year at Samaritan, I told her I was reluctant to complain, now that it's in the past. But she insisted that the surgeons should know. I think they're already looking ahead to the new facility, and are just ready to forget the old. I don't know how many surgeries are scheduled by Ortho NY in the next 2 weeks, but I would think it's a considerable number.
Since I'm feeling a little blurry, though I haven't even yet touched the Percocet, I'll list only Christine's major concern: the risk of infection, ironically enough.
The emphasis on joint replacement surgery is to avoid infection at all costs. For 4 days before surgery, the patient is ordered to shower and shampoo as usual, and then wash and shower again using a prescription antibiotic cleanser. Then for 2 or 3 days to apply the prescription ointment to the nostrils twice a day. Sheets are to be clean the night before surgery as well as all clothing items after each shower. It's kind of a pain, but I did it faithfully, wanting to avoid any prospect of infection.
I'm a little vague about what happened after the surgery, knowing only that it must have ended around noon,(11:01, I'm told) and that the surgeon reportedly said the knee was in bad shape. I can't remember whether I was alone when I was moved to what was to have been my room for the night. But after my visitors had left, a woman was moved into the bed on the other side of the room, which was definitely neither a private room nor one exclusively for orthopedic patients, even for the first night. She was murmuring, probably post surgically, and there was no problem until the "visitor" arrived. He was obviously impaired, probably about 10 years younger than she, and to put it mildly, not well groomed. Not that there's anything wrong with that. What bothered me to some degree is that he walked into my side of the room and greeted me by name. I returned his greeting, wondering how he knew my name. I had no idea who the other patient was and I must say I was becoming uneasy. Men in their 40's normally are not interested in befriending older women, and ulterior motive entered my mind.
He made a quick trip into the PATIENTS ONLY BATHROOM, and returned more antic than before. There is no way to describe his speech other than ranting. He must have repeated at least a dozen times that he didn't know where her cane was, resorting to increasing degrees of profanity to make his point . Not that there's anything wrong with that either, I guess. He was mumbling by now, and saying something about going out to return bottles and buying something.
I had written 2 comments on a slip of paper and showed it to the nurse (Karen?) when she came into the room. I wrote that the visitor was impaired, and she readily agreed, saying she could tell by his eyes. My other written question was as to when visiting hours ended, and she said that unfortunately visiting hours never end, as per federal law. I didn't know this, remembering those announcements over the PA system ordering visitors out at 8:30 or so, doesn't seem so long ago, actually. She said that at a certain time, they lock all doors but the front entrance. (I guess they haven't had enough hospital shootings yet because it's been years since you could walk into unlocked doors at schools, federal buildings, etc.) I told her that I didn't want to stay in this room if that was the case, if he could leave, return and be there all night. She said she'd relay my concern and that's when things escalated. TBC
Part II
The nice young nurse reported back that unfortunately there were no other rooms available so I would have to stay there. I said I wouldn't and would go sleep in the lounge. I don't really know how this would come about because I had no idea where the lounge might be, or even if one existed, and also was just hours out from surgery and not quite able to even feel where my legs were. But I found out from the Eddy rep today that I had inadvertently used the magic phrase----that I didn't feel safe there. I said it because it happened to be true and I'd remembered that was one of the admission questions. The visiting nurse said it's a prime responsibility of hospitals to insure the safety of patients and if anyone ever wants to make a point, just use the words, "I don't feel safe."
Anyway, word came back that they had found another room, and so I was moved there. I've no idea of the room number, but there was another patient already there. Seems like a victory, but hold on.
After a time, I needed to have whatever help was needed to go to the bathroom, so I pressed the beeper. No response. I'm attached to an IV line, not yet even cleared to get out of bed. I pressed several more times. I remember counting up to 7 but continued on well beyond that number. No one responded. The woman in the next bed spoke up: "Would you try to be more considerate; I'm having serious surgery in the morning and am trying to rest." I apologized for disturbing her, but said I needed to get a nurse, and asked if she would ring her buzzer. She did and within 15 seconds, the nurse, Ann, appeared. She was directed over to me . I asked her why she had not responded to my 7-8 calls. (Actually more like 10-13 calls, but I didn't want to seem extreme.) Ann was one of the few remaining old school nurses, 40+ years of nursing she let me know, and she took that tone. The tone that makes me see red, even half sedated. "You're not my only patient, you know." "But yet you responded to the other patient's beep. That seems like discrimination to me." She goes deeper: "You're smarter than that, " she says, and then digging herself a bigger hole, said that she'd "already fulfilled one request for me." Grrr. ""Who are you to assess my intelligence, and is there a quota on requests a patient makes?" She tried to maintain her position for a while, but all of a sudden she seemed to deflate, and said she agreed with me, that she'd been wrong. So I got to go to the bathroom, or the nearest thing to it. Another nurse came in later and said Ann had gone home, that she wasn't feeling well. Too bad. I didn't feel so hot myself.
Since I'm feeling a little blurry, though I haven't even yet touched the Percocet, I'll list only Christine's major concern: the risk of infection, ironically enough.
The emphasis on joint replacement surgery is to avoid infection at all costs. For 4 days before surgery, the patient is ordered to shower and shampoo as usual, and then wash and shower again using a prescription antibiotic cleanser. Then for 2 or 3 days to apply the prescription ointment to the nostrils twice a day. Sheets are to be clean the night before surgery as well as all clothing items after each shower. It's kind of a pain, but I did it faithfully, wanting to avoid any prospect of infection.
I'm a little vague about what happened after the surgery, knowing only that it must have ended around noon,(11:01, I'm told) and that the surgeon reportedly said the knee was in bad shape. I can't remember whether I was alone when I was moved to what was to have been my room for the night. But after my visitors had left, a woman was moved into the bed on the other side of the room, which was definitely neither a private room nor one exclusively for orthopedic patients, even for the first night. She was murmuring, probably post surgically, and there was no problem until the "visitor" arrived. He was obviously impaired, probably about 10 years younger than she, and to put it mildly, not well groomed. Not that there's anything wrong with that. What bothered me to some degree is that he walked into my side of the room and greeted me by name. I returned his greeting, wondering how he knew my name. I had no idea who the other patient was and I must say I was becoming uneasy. Men in their 40's normally are not interested in befriending older women, and ulterior motive entered my mind.
He made a quick trip into the PATIENTS ONLY BATHROOM, and returned more antic than before. There is no way to describe his speech other than ranting. He must have repeated at least a dozen times that he didn't know where her cane was, resorting to increasing degrees of profanity to make his point . Not that there's anything wrong with that either, I guess. He was mumbling by now, and saying something about going out to return bottles and buying something.
I had written 2 comments on a slip of paper and showed it to the nurse (Karen?) when she came into the room. I wrote that the visitor was impaired, and she readily agreed, saying she could tell by his eyes. My other written question was as to when visiting hours ended, and she said that unfortunately visiting hours never end, as per federal law. I didn't know this, remembering those announcements over the PA system ordering visitors out at 8:30 or so, doesn't seem so long ago, actually. She said that at a certain time, they lock all doors but the front entrance. (I guess they haven't had enough hospital shootings yet because it's been years since you could walk into unlocked doors at schools, federal buildings, etc.) I told her that I didn't want to stay in this room if that was the case, if he could leave, return and be there all night. She said she'd relay my concern and that's when things escalated. TBC
Part II
The nice young nurse reported back that unfortunately there were no other rooms available so I would have to stay there. I said I wouldn't and would go sleep in the lounge. I don't really know how this would come about because I had no idea where the lounge might be, or even if one existed, and also was just hours out from surgery and not quite able to even feel where my legs were. But I found out from the Eddy rep today that I had inadvertently used the magic phrase----that I didn't feel safe there. I said it because it happened to be true and I'd remembered that was one of the admission questions. The visiting nurse said it's a prime responsibility of hospitals to insure the safety of patients and if anyone ever wants to make a point, just use the words, "I don't feel safe."
Anyway, word came back that they had found another room, and so I was moved there. I've no idea of the room number, but there was another patient already there. Seems like a victory, but hold on.
After a time, I needed to have whatever help was needed to go to the bathroom, so I pressed the beeper. No response. I'm attached to an IV line, not yet even cleared to get out of bed. I pressed several more times. I remember counting up to 7 but continued on well beyond that number. No one responded. The woman in the next bed spoke up: "Would you try to be more considerate; I'm having serious surgery in the morning and am trying to rest." I apologized for disturbing her, but said I needed to get a nurse, and asked if she would ring her buzzer. She did and within 15 seconds, the nurse, Ann, appeared. She was directed over to me . I asked her why she had not responded to my 7-8 calls. (Actually more like 10-13 calls, but I didn't want to seem extreme.) Ann was one of the few remaining old school nurses, 40+ years of nursing she let me know, and she took that tone. The tone that makes me see red, even half sedated. "You're not my only patient, you know." "But yet you responded to the other patient's beep. That seems like discrimination to me." She goes deeper: "You're smarter than that, " she says, and then digging herself a bigger hole, said that she'd "already fulfilled one request for me." Grrr. ""Who are you to assess my intelligence, and is there a quota on requests a patient makes?" She tried to maintain her position for a while, but all of a sudden she seemed to deflate, and said she agreed with me, that she'd been wrong. So I got to go to the bathroom, or the nearest thing to it. Another nurse came in later and said Ann had gone home, that she wasn't feeling well. Too bad. I didn't feel so hot myself.
Monday, July 7, 2014
Still July 7
Surgery is scheduled tomorrow for 9:30 a.m. I'm to be there at 6:30. The "Patient's Guide" explains that it is necessary to arrive 2 hours before surgery because "sometimes there are cancellations and your surgery may be earlier. It allows for the nurses to accommodate all of your needs in preparing you for your surgery. But if the surgery is scheduled for 7:30 , you may report at 5:45 a.m." The scheduler told me to arrive not 2, but 3, hours before surgery, so I guess all my needs will be well met. *I later learned that while all other patients are to report 2 hours before surgery, it's 3 hours for orthopedic patients.
July 7, 2014
I have to wait until at least 1:00 p.m. before calling to find out what time surgery is scheduled. I'm not anxious to call, am in fact dreading it. I kept my appointment this morning with Dr. Sax. Everything seemed good since last Wednesday's episode, so I was somewhat surprised to find there was a "small retinal tear" which the good doctor lasered. The procedure was uncomfortable, even painful, and I drove home relying on one eye only. The doctor said to return in 3-4 weeks, but to call right away if I have any more floaters or flashers. If so, I suppose I'll have to alert the hospital staff so it won't seem I'm hallucinating. Overall, I just feel lower than the proverbial snake's belly. There must be a snake in Proverbs, mustn't there?
Subscribe to:
Posts (Atom)