Bilateral Double Knee Replacement-Part 1: Surgery

A lot of you have been following me on facebook but I wanted to document my experience as a help and reference to others anticipating the same procedure. One thing that I am being told over and over and am learning the hard way is that everyone is different, each knee is different even if done at the same time by the same doctor. There is no standard, only guidelines which makes the law of averages. It is easy to overlook the stories of those who struggle and only hear the voices of those who got along exceptionally well and then set that bar for yourself.  Before surgery I asked lots of questions, talked to others in the “knee club” and it was very helpful but it also set my expectations very high and I assumed I would be one of the “wonder” persons. It  did give me an idea of what to expect but somehow I missed how hard and painful it would be. For me, my journey became filled with struggles and several setbacks as you will see as my story unfolds.

Day of surgery: Day 1 (Monday)

Prepped and ready for surgery.

Our pastor came, prayed for me and sat with Gene and Jill as I headed off to surgery.

My two and a half hour surgery went well. I awoke in recovery with my family standing around my bed laughing. They were laughing at me! I knew they were asking me questions and I knew they were laughing at my responses but I could not control my answers. At least I provided good entertainment for them and at that point I didn’t care!

Jill took a selfie with me during my silly spell!

After I was awake and settled in my room (5 p.m.), my family left. It had been a long day and they were tired and hungry and I was sleepy, in no pain and had the most wonderful nurse, Barbie Adams, as my night nurse. She is a neighbor and I have known the family for forty plus years.  They put foot pumps on my feet to prevent blood clots and ice-wraps on my knees for swelling. They had me wiggle my numb toes and brought me a light supper. In the middle of the night I craved party mix. I finally asked Mrs. Adams if they, by chance, had any crackers I could eat. She brought me orange juice, saltine crackers, peanut butter and two cups of Hershey’s Chocolate Ice-Cream. It was a feast and tasted so good. I had a good night and they let me sleep with almost no interruption.

Day after surgery: Day 2 (Tuesday)

I awoke at 3 a.m. and was wide awake. I decided it was a good time for my devotions as everything was quiet and dark in the hospital.  I still had no pain, my knees did not hurt, and I could now feel my toes.  A one point I pulled my knees up and said to the nurse, “look at what I can do!” I felt like wonder woman. Two different nurses said they had not seen anyone do what I could do at that point.

 

At 8 a.m. my doctor made his rounds and took the large band-aid looking bandages off my knees. Now I could see my battle scars. There were no stitches or staples on the outside, the wound was super glued together.

Because my surgery was in the middle of the day and it was late until I got to my room, they did not get me up to walk yesterday  I was still too numb. But by 9 a.m. this morning, physical therapy was in my room and it was time to get out of bed, take a few steps and learn to take care of my personal needs. They let me sit in a chair for half an hour. Jill was in early and stayed with me all day. We had a good morning with lots of laughter and conversation.

In the afternoon they decided to give me 5 mg of Oxycodone as my knees were starting to ache and to prepare me for the afternoon physical therapy session. The spinal and nerve blocks in my legs was wearing off. They wanted me to sit in a chair and have a sponge bath before therapy. I sat on the edge of the bed and they took my blood pressure.  The top number was 166.

They moved me to the chair and I immediately started feeling bad-really bad. I turned very pale, started sweating and became nauseated.  They said I yawned, asked to get back in bed and slumped over. They took my blood pressure and buzzed for help. The top number was 77. I was in and out of consciousness as they lifted me back in bed. Fortunately we don’t have a picture of this! They restarted my IV and put ice on my head until they could get my blood pressure settled. We finally decided I had reacted to the Oxycodone. They switched the pain medicine to Tramadol and that worked well for me.  During the afternoon my level of pain started increasing as my legs were starting to swell and became very, very tight. It was a rough night and I was not allowed to get up to go to the bathroom as I was still too woozy.

Day 3: (Wednesday)

Physical therapy couldn’t do much with me today as my blood pressure was still unstable and I felt dizzy. Later they did get me out of bed and I walked 20-30 feet down the hall and then sat in a chair for about 45 minutes. I was so sleepy and at one point went to sleep in mid-sentence. My ankles and knees were so tight and swollen and very tender to the touch. They had me do a few exercises but my knees were so painful. It was a rough day. Usually they keep their bilateral patients two nights but there will be no going home for me yet.

My night nurse was not very helpful and acted like she didn’t want to be there. The rule is you have to ask for pain meds. If you don’t ask, you don’t get. I was on four different pain medications; one was twice a day, one every six hours, two I could have in between. My brain absolutely could not keep it straight. I could not remember the names of the meds, what I could have when or when I took what. I quickly learned the value of a family caregiver who watches out for your needs.

I asked the night nurse to please give me my meds during the night whenever I was allowed to have them. She was a follower of “the letter of the law”, insisting I had to ask, in spite of my pleading. It was very frustrating. I had ice packs on my legs around the clock and the ice packs needed to be changed every 2-3 hours. I had to ask for them to be changed regularly also. Sometimes I would sleep through the time when I could have meds and then would hurt so bad as it took a while for the meds to catch up. When the night nurse would come in, she would call someone else to come help me to the bathroom, take off the foot pumps, change my ice. She did only the basic. I was very glad when the night shift change and I did not see her again.

Day 4: (Thursday)

Therapy got me up and we walked down the hall and then I sat in a chair again for about 45 minutes. My blood pressure is still fluctuating but not as bad. I felt a little more encouraged today and walking with the walker is going better. My knees hurt and because they are so swollen and tight, they do not want to bend. It is hard to stay focused on the anticipated goal and stay upbeat when you hurt. However, today I began to think about going home and when Dr. Kerr came in for the night rounds he said that in the morning, I could go home.

Day 5: (Friday)

Today is the day and it is time to go home. It feels a little bit overwhelming and intimidating. In the hospital they are set up to handle me and there are medical people to answer my questions. I wondered, can I really do this? Am I ready? Can I handle my home set up? I know I can walk with the walker but I haven’t had a shower yet. How will I handle that?

In preparation for going home, therapy consisted of learning to do a 4″ and 6″ step so that I can get into the house. Oh the little things we take for granted!!! The therapist had not been able to do all that she wanted to do with me in the hospital because of my blood pressure episode and asked if I wanted In-Home Care therapy. That sounded like a wonderful idea and she signed me up for two weeks.  This soon proved to be a mistake-it will be written about in part 2. By 11:30 the paperwork was signed, I was released, and ready to go home.

The night nurse did not do a good job keeping my legs iced and by morning my knees were extra swollen and so tight they could hardly bend. The first issue in getting me home started when they brought a transport chair to take me down to our vehicle.  The seat on a transport chair tilts slightly backwards which means your knees have to bend more than normal to reach the very narrow rests for your feet. It hurt so bad I could not stand it. They insisted that was my only option. I reminded them that they had me in a wheelchair earlier and I knew that would work, to please let me use that. They finally consented and even provided pillows to help support my legs. The second issue was that I was now signed out of the hospital and no longer were they allowed to help me.  The strapping young transport fella that was to wheel me down to the main entrance to our vehicle could do only that-wheel me down.  He was not allowed to help get me into the vehicle.

Our daughter, Jill, came in to get me as we decided her vehicle had more leg room in the front to get my legs in and out. Getting me in the vehicle proved to be very difficult. I could not bend my legs enough to get in regardless of how I tried twisting and turning. The young fella just stood there and stared. Finally, we decided to have me sit on the edge of the back seat and scoot across with my legs straight out in front of me on the seat. Without a finger lifted from the strapping young fella, Jill finally maneuvered me into place and off we went on the twenty minute ride home.

By the time we got home, I was really hurting and exhausted.  I went straight to bed. While I slept, Jill got my prescriptions filled and organized. Now we began the process of figuring out how to function at home. The white wicker chair seemed to be my best sitting chair (arm rests on a chair are very useful in getting up!) and I instantly knew I had to have a high rise seat for the potty. Our bathroom is narrow but fortunately we had remodeled it several years ago making it more functional.  I had to go in the door with the walker sideways, park my chariot by the sink and hold onto the sink to shuffle to the toilet.

Gene and Jill took turns getting up during the night to give me my meds and change my ice. The long awaited surgery week was over. It was good to be home.

Other blog posts about my surgery:

Bilateral Knee Replacement-Part 2: Recovery and Therapy

Rahab and Ruth

Ready or Not, Here I Go

Domino Effect

Highly Motivated

I Can Help You!

 

1 Comment »

  1. […] first week in the hospital is detailed in Part 1. When I left the hospital on Friday, four days after surgery, they asked if I wanted Home Health to […]


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