New Knee!

 I'm very optimistic at the moment. Could drugs have something to do with that? Maybe? But drugs are part of the protocol, I'm supposed to be taking them!

Prep for the operation started well before Tuesday. I had a bunch of pre-op appointments to get cleared, and then there were elaborate instructions about cleaning myself the night before and morning of the operation, showers and special microbiome killing sponges to wipe everywhere. Surgery was scheduled for 8 am, but I had to be there two hours early. My BIL picked me up on the dot of 5 am, and followed me through the registration process. There became a standard call-and-response at every single stop - at least a dozen times that morning:  "What is your name?" "When were you born?" "Are you allergic to anything?". I had a qr code on my wristband that was scanned at every step.

In preop, (more wiping with special sponges), many people came by to introduce themselves. My surgeon came, (he signed my leg), a resident, a med student, and three or four members of the anesthesia team. ("What is your name?, etc., again!)

BIL stayed with me until they put the IV in, before starting the sedation. I gave up my phone, and they gave me a spinal block. By the time they wheeled me into the operating room, I was dead from the waist down. I couldn't feel a thing. The operating room was startling to me, not at all like Grey's Anatomy. Stark white, brilliant florescent lighting, almost shabby ceiling retrofitted with electrical mains and heating vents (my main view) and the room was really large - maybe they would have two patients in there at once? (BTW, they are opening a brand new surgical center next week, this was the swan song for the old side.) There seemed to be a lot of people in there! Shortly after arrival, they stuck my IV with sedation, and I was out.

I woke up still in the OR, still dead from the waist down. Whoever talked to me then said things went really well, and confirmed it was the partial (not a full) knee replacement, yay! I got wheeled down to recovery, where I stayed for a while, long enough to have two nurses because of a shift change. The goal for recovery, said the nurse, was to be able to bend both knees, raise both legs, and wiggle all my toes. Then they could move me on into a room, since I was going to be admitted. She raised my leg to demonstrate, and it was very disorienting to see my leg and feel nothing from its visible movements.

At first, recovery was AWFUL! I had the most awful shakes, shivering all over. Actually, the spinal block was still in effect so I have no idea if I was shivering below the waist. But above, my goodness! It came in waves, with a build-up, peak, and rapid fall-off. I tried to retreat to my mindfulness techniques, focused on my breathing, and that worked great in between the episodes, but when my body was uncontrollably shaking that was all I could think about. But then, sensation began to come back to my legs. First tingles, then the nurse said I was wiggling my toes. It was the weirdest thing - trying consciously to send a message to my toes to wiggle, and feeling no feedback that I was successful. But slowly, slowly, the feelings came back as the shivers abated. I got curious, and explored where I had feelings and what movements I could execute with my legs. It helped. All told, from shivers to feeling back in my legs, was about an hour. They had added a nerve block for the knee to take effect as the spinal block wore off, and so there was a magic moment when I felt great - zero pain! No shivers! And then they brought lunch, and I was hungry and scarfed down every bite. Then I realized I could have my stuff back and I got my kindle and phone and ipad, no boredom ever.

While still in recovery the PT folks came and got me up. It was good timing, I needed to pee, and really didn't want to use a bed pan. So I walked with a walker to the bathroom, and then to a stairwell, where I climbed two stairs - a hurdle I'd have to get into the house. When I got back to my bed, I was exhausted and in pain.

Finally I went up to the room. The nurses were really good at writing names down on the little white board in my room, I really appreciate that. Sadly, it was a very small double room and I had a fractious, noisy room-mate. We weren't allowed to close the door, so noise and light were constant. By the time dinner arrived, I had lost my appetite and "discomfort" had grown to pain. Over the course of the night, I had enormous heartburn pain, nausea, and stomach cramps. I had brought my noise-cancelling over-the-ear headphones, and a silk eyeshade, and that's the only reason I got any sleep at all. I listen to books, and all night I would tee up a chapter, close my eyes, and hope for sleep by the time the chapter was done. But I would open my eyes to realize my roommate was making a phone call (to Australia?) or complaining about something, or simply moaning. Of course, they came in to check vitals, give me drugs, and generally keep me from getting any rest. So I slept maybe twenty minutes at a time?

The following morning, I was awake at 5 and so was my roommate. But after the escorted trip to the bathroom and a new set of drugs, I actually got some deep sleep! An hour or two at least. All day, my knee hurt, but less than my stomach. They had added an anti-nausea med and also tums, and maybe that helped. I had PT and OT folks visiting, and they told me what to focus on for the next week, until I start PT. Two of my surgeon's residents stopped by, and they each emphasized how well the operation went. I mean, their eyes were glowing! I hope that bodes well for recovery. The hospital sent me home with twenty pages of discharge information and four pill bottles (to be supplemented with two OTC drugs at home). Helpfully, the medication instructions included the timing for the next dose of each. 

BIL, who had checked in on me many times, took me home. It was so nice to be swarmed by the doggos! He heated up some soup for me, but I couldn't manage more than a few swallows. I hurt all over. But I verified I could walk with the walker throughout the first floor, get into and out of bed, and go to the bathroom. BIL courageously stood by in case I needed him, but I didn't. Shortly, I took to my bed. In a few hours, my friend came over for the night, and it was comforting to have someone there, even if I didn't need them to do anything specific. Restless and uncomfortable all night, with intermittent books, but I took joy in the fact I could actually roll over to one side, off my back. (Other side not available yet.)

Another friend, who lives a ways away, came down later on Thursday. She made supper, and we watched a movie (NYAD! See it!). I was in bed by 7:30 pm (despite a couple of naps during the day). Again, a restless night, but at least five hours sleep (with ten hours in bed) according my tracking device.

Managing the medication is the hardest thing. I can take six different drugs, have to take at least three, and they all have different timings and limits. So of course I made a chart and I write it down. I am slightly addled from the pain meds, and I find I might not remember having taken a pill minutes after I did. So I am assiduous at checking them off. I am cautious on the strongest pain med, because it makes me woozy. I'm writing under its influence now, so please let me know if there is something here that's inappropriate. But by backing off some on the optional meds, I have got my stomach back under control, and my appetite is back. The fact is, the pain meds work, and if I don't take them there is a risk I'll do much less movement, which is bad in itself. So I'm taking less than the max, but not swearing them off completely. 

Today feels better than yesterday. I took a shower! (Hand wand and sitting on a stool.) No naps today, planning on a good night's sleep. Hopefully, tomorrow will feel better still.