A Cyclists Survival Guide to a Total Knee Replacement – Surgery Day (P-4)
I woke up in the morning. My mouth was horribly dry and I’m sure my breath was nasty. I barely slept all night anxious about the day. My bag was packed. Phone, e-reader, jammies, slippers, glasses, chapstick, wallet, keys, tooth brush, mouthwash. I’m ready to roll.
I was shuttled into the pre-op room where I garnered myself in a hospital robe, ass free, and sat and waited. It was so early, I was exhausted. Looking forward to anesthesia so I could sleep.
The nurse came in, installed my IV, took blood and said, “you’re gonna do great!”
My surgeon came in and smiled, “you ready?” I nodded. Looked at my two pretty legs and he drew the incision line.
My anesthesiologist came in next and she explained to me the procedure. “We’re not going to administer general anesthesia. Instead, I want to give you a local nerve block and a spinal. This should help you to wake up quicker and be more mobile. But, don’t worry, you will be sleeping throughout the procedure.”
Ugh! a spinal. Never had that before and it sounded scary. But, apparently it’s far safer than general anesthesia.
They laid me back and rolled me into the surgery room. The doctors looked like space aliens and the only way that I could tell they were smiling was to look into their eyes. The room was cold. The lights bright. It was very sterile, like a White Castle. Equipment, machines, bright lights surrounded me. The sounds of machines beeped. Cables strung out from me like tentacles. The IV hanging by my side dripping something into me to relieve anxiety. Shit. Awesome. Scary…
The anesthesiologist sat me up and explained that she was giving me a shot to numben key areas which included my back hip and knee. She started by applying the local nerve block and I felt my leg go dead. Weird. Then, a needle in my lower back, “you’ll feel some pressure.” Oh shit, that’s code for “pain!” Sure enough, deep breath, the needle penetrated and, mother of… And again. Owch! Finally, the pain stopped. They laid me back and said, “see ya on the flip side!” I went out.
Below is an actual knee replacement surgical video. This happens while your sleeping.
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Pau…
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Mr Gallas
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Mr Gallas
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Mr Gallas!
The room and nurse came into focus. The lights brightened. “You’re all done sweetie. How do you feel?” I’m pretty sure my answer was nonsensical, but, I was alive and awake. I shook my head, stretched and soon realized that I was dead below the waist. My feet, legs, nothing worked. “I can’t move my legs.” She explained that that was normal from the spinal and that I would recover those soon. More blood pressure, heart rate and blood tests. I was still out of it when a catheter was installed, then removed. “You have 6 hours before you will need to urinate on your own, or a new catheter will be used.” I was told. Cross my heart.
I was soon rolled to my room. TV with remote and speaker on the remote, I could order my meals and snacks right from the TV, how cool is that? I was hungry. An appetite was a good thing. I ate and fell asleep.
A few hours later I’d be woken. I think a 3 hour sleep is the most you’re allowed. Either they’re really connected to your safe recovery, or, they don’t want you to stay more than 2 nights. Each time I’d be woken to either blood pressure, heart rate, oxygen level tests, blood pricks, medication, more shots. I had to learn how to give myself a shot in my belly. The medication is called Lovenox, it’s a blood thinner to prevent blood clotting. As soon as I was drifting off, a new nurse or doctor would walk in and do something to me. After a day, you just kindof ignore it. Sleep through the visit from the vampire nurse. Watch cartoons on TV while another checked your blood pressure. After 3 or 4 hours from waking up, I was supposed to try to go pee. It was practice, really, I still wasnt able to move my feet, let alone walk. They fitted a brace onto my leg that kept it locked straight so I could get out of bed. With crutches, I got to the bathroom. I felt nothing. No sensation from my filling bladder. No feeling in my leg. Dead. I walked back to my bed and my cast was removed. My new leg was revealed. Ah shit! Let me take a picture. Click!
A couple more hours passed. I was drinking water and juice. I could hear it sloshing inside me, but, no feeling of needing to pee. I tried again. Nothing. 6 hours passed, my urethra regained feeling and I could feel the soreness from my initial catheter. It was do or die. I knew I had to pee, but, I just stood and waited and still nothing. Catheters are no fun. I took a walk about the hospital trying to encourage my bodily systems to move again. Stood over the toilet. Nothing. 7 hours passed. I laid in bed trying to compress my bladder by grabbing my good leg and hugging it. I did sit-ups and leg lifts. I drank lots of water. My nurse came in. He had his catheter gear and said that it was time. “Let me give it one more shot.” I asked. He nodded. I went to the toilet, relaxed. The sound of splashing water from a glorious urine stream echoed the bathroom. From outside the door, “that’s my boy!”
I was in the hospital for 2 nights. During that time I experimented with different pain killers. I settled on Tramadol, Tylenol and a muscle relaxer. I was asked what my pain was on a scale of 1 to 10. I gleefully explained that I had no pain. Zero. Nada! They said that was great and that the medication was doing its job. Throughout my first day, I was able to slowly regain movement and feeling starting at my foot and at my hip and slowly moved up and into my leg towards my knee. By the next morning, I was able to lift and straighten my leg and walk on crutches with no brace. I commenced with physical therapy and walked around the hospital with my PT. He instructed me how to ascend and descend stairs. I was shown how to shower. Once I passed all their tests, I was basically safe to go home. I would have one more night there and would be discharged the next morning.
In hindsight, I wished that I had stayed one more night. The fact of the matter was that simply, my pain was managed by the nerve block and not the pain meds. By day 3, at home, the nerve block wore off and all Hell broke loose!
Next – Post Surgery, what they won’t tell you