Sunday, November 22, 2009

Knee Replacement, Part 3

Waking up was not fun. When you come out of the anesthetic, I think you aren’t fully medicated since you aren’t awake to let them know when it kicks in so they must wait until you are awake to apply enough to keep you pain free. Also they need you to wake up and make you breathe. Always important. I also tend to shake rather seriously after anesthesia. So I had a short time of really intense pain but I have no idea how long it was because soon after I was medicated quite heavily and stayed that way for the next two days. After a few hours in recovery, I was moved to a regular room. This is the Gulliver part: I had surgical pressure hose on both legs, a pair of inflated cuffs cradling both my lower legs, an inflatable bed pad under me, both of which inhaled and exhaled every time I moved, more IVs, an oxygen nasal tube, a drain from the incision, a urinary catheter and a giant dressing on my new knee. Felt a bit tied down. I was quite swollen with fluid but dry mouthed. Dilaudid was the main pain reliever I was given but there were others in the mix. Dilaudid makes me quite nauseous so I was in a quandary about using the self administering system to keep the pain down. I found if I didn’t move much and slept a lot, hardly difficult, I could use the button less often since I was really nauseated when I dosed myself. After a day’s worth of retching every time I took a dose, they switched me to oral medication to reduce the nausea. It worked. Thus I passed the first and second post op days.
I felt more alert and focused on the second day. I still was unable to eat much but didn’t miss it. I could sit up a bit and greeted the various gangs that came through: the catheter gang (not that one) took out the nerve block after about a day, the pain gang wanted numbers more than once (Is it a 3 or a 5 or a 7?), the doctor looked in with his fellas (fellows?) and I had hot and cold running nurses. I got flowers and phone calls. I was way too stoned to answer the phone which made my family a bit anxious. No phone calls before day three seems a good rule. Toward the end of the day, or first thing in the morning I had first my catheter and then my wound drain removed. Bled like crazy.
The morning of day three (Friday) I got my first visit from the physical therapist who got me to try to sit up straight and even move my legs toward (but NOT over!) the edge of the bed. She came back in the afternoon and got them over the edge and me standing, for a minute. Then when I needed to go to the bathroom I could use the walker she provided at the edge of the bed. By that evening, I could make it. Food seemed a reasonable concept by now, so I ate my first food on day three. The clouds began to clear and I could answer the phone and talk to people although I have no idea what I told them.
My next stop was arranged by an efficient woman who told me there might be a place in a skilled nursing facility nearby where I could stay for the next few days while I was unable to really care for myself. This is standard practice for many people who don’t have a good situation at home: no one able to be there all day, or not strong enough to pick you up if you fall down, or too grossed out by staples in your knee, or so on. Indeed there was and Medicare covered it and they would take me tomorrow!
So Saturday am, after a slow but resolute walk 30 feet down the hall of the hospital corridor, I took a special taxi to the Radisson Suites Healthcare facility attached to a senior housing complex less than 2 miles from Stanford Hospital. I told someone that the taxi was special because they need to tie you down. Then I saw a look of horror on her face and realized she saw me strapped to the floor of a van! No, they tie the wheelchair!! It cost $65. And that is the total amount this entire adventure has cost me. Medicare for everyone.

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