On Tuesday morning I woke up feeling mostly calm and focused. My time was largely structured for me by my surgical team—two cups of black coffee and routine meds before 8 am; followed by a full-body shower at 9 a.m. At 9:45 I was to start the antiseptic scrub—first round was the whole leg, and then the area directly above and below each knee.
I made the last phone call at 10:30 a.m., to my friend and partner-in-crime, Susanne. She’s had every single joint replaced in her body at this point, and her last words were the only ones I really wanted to hear. She wished me luck, told me “TAKE THE PAIN MEDS,” and sent me on my way. We arrived at St. Joe’s at 11:22 for intake and pre-op.
It all gets pretty sketchy at this time. I don’t ever remember being nervous or having any pain. I was just on autopilot. I remember seeing my surgeon, who looked me in the eyes and said “It’s all going to be good.” I remember the epidural and my anesthesiologist, and talking about the good old days of natural childbirth. But mostly I remember a blur, a transfer onto the operating table, and then emerging from the darkness in recovery. I was still blocked from the spinal. My surgeon was telling me that the joints were terrible, far worse than he had anticipated, but he thought he has been able to straighten them nonetheless. He predicted that I would be happy with the results.
I was transferred to the 2nd floor of the old hospital, a general surgery unit, because my surgeon wanted me monitored. This was the biggest pain in the butt possible. Besides having every kind of wire and tube strung over and into every body part, the nurses were not informed or equipped to deal with orthopedic surgery patients. I had the required Foley catheter, a drain in each knee joint that were attached to two hemovac pumps that would filter and spin my drainage to produce a dense fluid of red blood cells that would be put back into my body (so, yes, Fluffy has been blood doping, notify the French press) two access IV’s, antibiotics, normal saline fluids, and a PCA pump to deliver pain meds directly into my spine via the surgical epidural lines. I was the Bionic Woman.
The rest of that evening was low key—I remember drinking broth and being left alone, mostly. Pain was not a problem because the spinal took another day to wear off.
Day 1, January 28 2009
At 12 hours postop, reality started to filter in. I was told that I would remain on floor two until I could manage my pain and the catheter was removed. Day 1 was also the day when the geniuses on the floor decided that I needed to walk. Bear in mind that nobody was quite sure why I was getting up, if there was a protocol for getting a bilateral joint recipient up on the first day, or the best way to accomplish it. But stand I did, and FAINT I nearly did—the world went black for a moment and I was bathed in cold sweat. To say the word “pain” and have it cover the entire spectrum of what I experienced somehow falls short. Let me say that the type of pain that comes to mind, several days later, is the pain you feel during a particularly bad root canal experience—when every tooth in your mouth is going through it at the same time, if you can imagine that. It’s simply too much pain for our little brains to process.
I am happy to report that cursing out a particularly inept nursing staff is still well within the scope of my skills set, irregardless of pain.
Day 2, January 29, 2009
Oh happy day, today I am transferring to the Ortho floor on level 5. The nursing staff on 5 GET IT. They understand pain control, why certain body parts need to be kept horizontal or vertical during forward motion, and why any any effort at this point has the capacity to exhaust me for hours on end. It’s not that I don’t appreciate the things that people do for me. It’s just that if you haven’t experienced this process you cannot understand what it means, and your feeble attempts to explain it to me just convince me that you are totally inept, and right now, because of how much every motion or activity hurts, I need to believe that you know what you are doing.
I am now transferring from the bed to the walker to the toilet and back, and spend a chunk of time every day in the chair in my room. I also spent 4 hours today in a continuous passive motion machine (CPM), which basically raises, rotates, and lowers my leg to attempt to loosen the muscles. It should reduce the freezing and stiffness. An after-the-fact observation is that the upper body arm and back muscle work I did several months pre-op has been well worth it. I have the strength to haul my body around on my arms, after all.
Day 3, January 30, 2009
I may or may not be moving to rehab today. My orthopedic surgeon and primary care doctor are having a disagreement over the seriousness of my anemia on the latest blood draw. My PC thinks I should stay an additional day and get a grip on things; my surgeon thinks we should let rehab deal with it. The staff on floor five are taking bets largely in favor of the surgeon.
After 3-1/2 hours strapped inside the CPM, the nurse came in to announce that I needed to be ready for discharge in about 2 hours. And this is when I realized that the whole concept of “rushing to get ready” really requires muscles that can respond completely when called upon to do so. Not to mention a person with a car who is there and ready to go. I’m not sure how all this fell through the cracks as it did, but I suspect it has something to do with the dim-wit social worker assigned to my case. Somehow we managed to get me and my stuff to the entrance to the hospital, then over to Glacier Hills, where my arrival was NOT anticipated, hence we got to watch them scramble for a while to find a bed and get me into it. But by the end of day 3, I was safely snuggled in my bed with plenty of tools that would help to get me back on my feet. I am so glad to be in rehab (although the Amy Whinehouse song keeps playing over and over in my mind, I say no no no). I think it gets better from here. I HOPE it gets better from here.
Day 4, January 31, 2009
Met with my physical therapist (Nikolina) and occupational therapist (Jean) who hooked me up with all kinds of cool tools, like the hand extender, the sock assistant (it is so cool, can pull up your socks for you) and a scrubby extended for getting my lower back. I love tools! I am such a primate!!!
I am able to bend my right knee by almost 90 degrees, a little less bend on the left. I am able to extend my right foot to nearly 180 degrees but can extend the left almost NOTHING—as in, start from no baseline at all. Talk about a humbling experience! My brain is screaming “lift these muscles” and my quad muscles are humming “nobody is home.”
More of the same tomorrow.
1 comments:
Wow. Just wow.
We are thinking of you!
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