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.

Wednesday, November 18, 2009

Knee Repalcement, Part 2

I arrived in SF on 1st July to spend a few days with my brother who will put me up during my recovery. But since he and his wife both work every day, I rented a car and a hotel room and took myself to Palo Alto for my surgery. I had a preliminary appointment with my surgeon and another with anesthesiologists and still another with my personal physician who cleared me for my surgery.
On the night before surgery, I did not sleep well despite the elegant hotel room in Palo Alto. Woke about 5 and being NPO, no eating or drinking, I read and paced until 6, then showered again with the special soap. Completely germ free for at least 30 seconds. Began to see all surfaces as crawling with bugs! Paid my bill and exited just as my cab arrived.
As I strolled into the main entrance of the Stanford Hospital, I had the strange sensation of not really being there. I walked comfortably, no pain, no problems. What am I doing here? I don’t need this! This is for OLD PEOPLE! But I moved obediently toward the check-in desk where I had been only a few days before. Smart to get you oriented in advance. I was checked in and tagged (both wrists this time) and led, still obediently, to the surgery prep. I undressed and donned the famous backless gown. They’re bigger and more complicated now. And then was settled into a corner to wait to be prepared for surgery.
At least 3 nurses attended me: one added two bright red allergy tags to my wrist d├ęcor and the others asked me the same 10 questions I had answered for the last 10 days. A pretty child doctor from anesthesiology came with questions about previous surgeries. Another pretty one came in as the lead of the “catheter team”. Catheter team? It takes a team? God. It seems they will install a catheter in the femoral nerve bundle that numbs the whole leg from upper thigh to mid calf. More team mates arrived pushing an ultrasound machine which was used to locate the appropriate nerve. In a bunch they install the catheter without even a stick. Go team! In 10 or 15 minutes it feels as if someone has left a large dog in my lap. My leg has departed me.
More visitors: my doctor signed my leg; anesthesia angel again; vampire brigade (lab techs seeking blood); porters to take my goods away to my future room.
Finally, around 11.30am (original time was 10.15) I am laid flat and rolled into the OR. It is seriously cold!! Seems the surgeons must wear a lot of protective gear (they look like the boy in the bubble of TV fame) so they like it cold. It’s ultra bright. The room is crammed with shelves of tools. It looks like a clean bright hardware store. I avoid looking at the scary stuff. There’s a traffic jam of people: several nurses, three or more greened up doctors, orderlies. I am shifted like luggage to the table and set upon. Egg crate foam under the other leg, arm supports, more wires, another stick, wrap this, cover that, and then a mask and orders to “breathe deeply, it’s only oxygen.” I am bid sweet dreams, arms wide, eyes clenched, shaky and cold.

Sunday, November 15, 2009



Well, I’m back. I have been gone for three months and then here for 6 weeks just in time for a whole passel of visitors: sister Melinda, cousins Fred and Takaya, friends Bob and Kate. Each visit was charming in a different way with hiking, eating and culture leading the list. But now I’m nearly back to normal with only one of me to manage. So of course, I came down with something! A sore throat at the moment and I hope that this is all I get given the horror stories about flu all over the US. No one here is as crazy as the anti-government “Don’t get your flu shot from those commie/fascist/totalitarians” wing nuts in the US. The media here are urging everyone to get shots and stay home if you are sick, but then they have this socialized thing called sick leave, so they might just do it.


Since returning I have traveled to Spoleto, Assisi, Feltre in the Dolomites and Venice with Melinda, Siena, Orvieto and Rome with Fred and Takayo and roamed the back streets with Kate and Bob. Had a big dinner party and went to eat big meat with Paolo and friends. Looked at naked men at the Accademia (that would be David and the Mapplethorpe photos). Reappeared at the Uffizi to continue my data job in the best work space in Europe. Ran off to Pisa to look at clearly the best Chagall exhibit in Europe. Had a happy reunion with Angelika and dinners and lunches with all my lovely friends. But first I need to fulfill my promise to document the most amazing knee replacement experience ever. Next post.