Knee Surgery Day Two

Well, I’m back from the hospital following my knee surgery. It was a “Total knee arthroplasty (TKA), also known as total knee replacement,” described as a “surgical procedure that involves replacing the damaged surfaces of the knee joint with artificial components made of metal and plastic.” I am now the bionic man. First time I’ve had artificial bits embedded in me, but it’s common with my age cohort who get their knees and hips done.* 

I came home just after 5 p.m. yesterday. I could have stayed in the hospital overnight, but I’m sure the hospital staff preferred to see me go home, and besides, I like the company of my cats and dog, and, of course, Susan. It’s going to be rough for a few weeks, and a challenge to the limits of her patience, too.**

The long road to recovery starts today, with my first set of exercises this morning. Every movement, every turn, twist, shuffle and bend hurts. My leg doesn’t yet bend well, so getting up or down from bed or chair is a burst of pain. Using the toilet is simply awful. I have a rented walker, but it hurts my hands and arms, too, as well as my operated leg. Susan has to help me sit up, rise, sit down, use the toilet, put on my slippers, get dressed (yes, and underpants, too). She also has to do everything in the house for the next few weeks: feed the pets, walk the dog, make tea, make meals, bring me my laptop, help me exercise, drive and shop… I love her for her stamina and strength. Sigh. I feel so inadequate and will try to make it up to her when I am more mobile.

Six weeks is the estimated recovery time. Some folks do it in less; others take longer. Over the course of a few subsequent posts I’ll let you know how mine is going. I suspect, at least based on the first 24 hours, I will be in the average length.

I cannot do one of the exercise sets yet: I cannot put my knee on a coffee can and raise my leg. No way: my muscles just won’t do it. I cannot lift my left at all from any position using just its own muscles. And trying to force it hurts. A lot. The rest of the exercises hurt, of course, but I can do them even if slowly and without much motion. I can only hope they get easier and less painful. My leg, too, is still quite swollen, and my foot, too: getting a slipper on it is difficult.

I was surprised at the level of constant pain. I have a reasonably good pain tolerance, and recovered from my previous surgery and treatment (prostate; covered the under the Cancer Diaries posts here) without too much distress. But this is different: the knee is called on for everything we do and, of course, I have a scar stapled together that protests any stretching. I’m taking 1000 mg Tylenol and a baby aspirin; the former for pain, the latter as a blood thinner. But Tylenol doesn’t do much for me in terms of pain management. I have a prescription for narcotics, but I didn’t use them after the prostate surgery, and don’t want to get into them now. I’ll stick to the Acetaminophen for now.

I did my first set of exercises starting today. Three sets a day, every day. Agony. But I am told it will get better, get easier, less painful. I hope so because it’s Spanish Inquisition torture right now. At the time of writing, I have done two sets; at least as many as I can.

Bit of personal history first: I damaged my left knee in the mid-1990s playing paintball. When I dove into a sandy trench on the speedball field,  my left leg went the wrong way. It swelled up for a while and caused me problems walking, and never recovered. It hurt, it stayed swollen (albeit not as much). I limped, and I have been progressively feeling the discomfort. The last few X-rays showed progressive bone-on-bone arthritis. I didn’t want elective surgery, but in the last two years, walking has become more painful. We love to walk around town, but if it is painful, I stop enjoying it. And a stumble or sudden twist at home caused me more pain.

Susan and I were in a scheduled appointment with the orthopedic surgeon last week and we were discussing a schedule for my operation. Sometime in the winter was the best guess, maybe December if we were far enough up the list; maybe February if not. However, he had had a last-minute cancellation just before we arrived, and asked, “How about next week?” I took the opportunity and said yes. That meant I had to attend a physio education class, read about 40 pages of instructions and advice, and attend a pre-op session all within a few days. But the local hospital (Collingwood General and Marine or CGMH) arranged it. Pre-op involved X-rays again, blood work, and meetings with nurses and an anesthesiologist. All very friendly, helpful, and supportive.

I needed to buy a cane and rent a walker, too, also done locally. I should have bought a versa frame to help me get up from the toilet, but I didn’t. You can’t rent them, and I didn’t want to spend the money. We’re already on a tight budget. But I’m not sure it was a wise decision: getting up and down from the toilet is one of the harder things I have to do. Stairs are the worst, though.

I went into hospital to prepare for surgery at 8 a.m. Wednesday morning. I  got changed, then was hooked up to an IV and answered the usual battery of questions, met the nurses and anesthesiologist.  Surgery itself was at 10. I took an overnight bag just in case, but also to carry my books (four this time: I expected at least four hours waiting or in recovery where I would have time to read; I generally judge the number of books required at one per hour). Yes, I actually read some from all four (one in particular, about the discovery of early hominids in Africa, kept me interested to read more). Books also provide an incentive for staff to talk with me about what I am reading, and there’s little I like more than to talk with others about books.

The surgery was done following a spinal anesthetic. I could have asked for a general, but never having had a spinal, I was curious how it differed. The young woman who gave it was a resident just learning and she did a good job, with no pain to me. I was a bit surprised at how quickly my legs went numb and even more surprised to see them hoisted in the air on supports while I felt nothing. Then they gave me a sedative to sleep through the procedure.

Next thing I knew, the recovery room nurses were calling my name and waking me up. It took about an hour for feeling to return to my legs — and the pain to set in. I was given Tylenol and a small dose of narcotic to help alleviate it, but as I said before, Tylenol has little effect for me on pain. I can’t say what, if anything, the narcotic did to help, but so far, there and at home, Tylenol has not been much help.

I was assessed by staff, including physio staff (I had to pass some basic milestones like climbing up and down five stairs, which I did with difficulty but well enough for them to let me go home). I have since been given a date for my first physio session, too.

I’ll have more in future posts.

One last note: during this recovery, I say “Fuck!” a lot. Every time I get a sudden or surprise pain. Be warned: that may spread into the texts.

Notes:

From the Cleveland Clinic:

Arthroplasty is joint replacement surgery. People may undergo arthroplasty to treat arthritis or other joint problems if nonsurgical treatments have not worked.
During an arthroplasty, surgeons remove damaged areas of a joint and replace them with an artificial joint made of metal, plastic, or ceramic. A surgeon may replace part of the joint or all of it. The new joint will move in the same way as a natural joint.

** I wrote this on social media yesterday after I came home:

A poem for coming home from knee surgery the same day

Ow.
Ow. Ow. Ow. Ow. Ow.
Ow. Ow. Ow. Ow. Ow. Ow. Ow.
Ow. Ow. Ow. Ow. Ow. Ow. Ow. Ow.
Ow. Ow. Ow. Ow. Ow. Ow. Ow. Ow.  Ow. Ow. Ow.
Ow. Ow. Ow. Ow. Ow. Ow. Ow. Ow. Ow. Ow. Ow.  Ow.
Ow. Ow. Ow. Ow. Ow. Ow.
Ow.
Fuck.

And today I took liberties with a pop song:

Every breath you take
And every move you make
Every toilet break, every step you take
I’ll be hurting you

Every time you sit
And every time you rise
Even when you rest, every move’s a test
I’ll be hurting you

[Chorus]
Oh, can’t you see?
I’m your brand new knee
I make your poor leg ache
With every step you take

[Post-Chorus]
Every move you make
And every step you take
Every stair and chair, you will find me there
I’ll be hurting you

[Bridge]
Since you came home, I’ve been making you so sore
You toss at night, and I ache for you some more
You turn around, but your knee screams when it’s bent
You cry and curse as your feelings loudly vent
I keep aching, hurting… please don’t bend.

(with apologies to the Police)

Words: 1,647