The First Week

One week ago I handed myself over to the competent people at Schenectady Regional Orthopaedics for my long overdue total knee replacement. With much trepidation I showed up at the appointed time and surrendered my clothing and cell phone for a hospital gown, funny hat and an IV line which was to be my constant companion for the next four days. Dr. D’Ascoli visited after I was prepped and autographed the suspect knee; ten minutes later I was off to the frigid operating room and I was grateful to the nurse for covering me with a heated blanket before heading in. I noted with some amusement that my knee was throbbing relentlessly and it occurred to me for the five millionth time that I was making a very good decision.

Awakening in the recovery room I was surprised at how little residual fuzziness I felt in my head; the anesthesiologist must have given me just the right amount of magic to do the trick. Immediately curious about the state of my leg, I peeled back the blanket to see an ace bandage wrapped from mid-thigh to toe and a mass of purple bruises on the exposed thigh above. Lovely. My leg was roughly half again its normal diameter and I was trying to imagine how much was bandage and how much was me. The pain was a dull ache and I knew the local anesthetics he used in place of a femoral block had not yet worn off.

Not long after being transferred to my room, I had my first physical therapy session which seems unthinkable, but I get the logic of it; why not do it before all the anesthesia wears off? This makes the first PT experience relatively pleasant because it is most assuredly less fun as time goes on. Susie did all of the same exercises they prescribed before the surgery and this time I really did feel like the little old person depicted in the booklet. In the space of a few hours my previously useful quadricep had been reduced to mush and I knew there was some serious work ahead of me. I took my first walk with the walker and it took intense concentration to navigate my giant throbbing thigh while coordinating the movement of the walker and dragging an IV drip.

One of my concerns had been pain management, but a white board visible from my bed ended up being the perfect tool for keeping track of a number of things. The three pain meds I was on, Oxycontin, Oxycodone and morphine were listed on the board with their ordered intervals, and every time one of them was administered the nurse would write the time down. This helped me keep track of things and take more ownership of my pain relief which in turn helped the overworked nursing staff. There was a pain scale printed on the board and that became my other tool for managing the daunting amount of discomfort native to this particular surgery and they would tick off the number I was feeling when meds were administered; this gave me a more logical way to assess and convey how much discomfort I was in. Other useful things that were included on the board were the name of the nurse, physical therapist, tech and housekeeper in charge of my room. Genius! There was only one night when a combination of dozing off and a nursing shift change caused me to awaken in unimaginable pain; I have never been so grateful for intravenous opiates in my life.

 

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