Knee Repalcement, Part 4

I arrived at The Hyatt Residence (http://www.hyattclassic.com/go/palo-alto.html) on the Saturday following my surgery. I had a nicely decorated private room with TV, armoire, visitors chair, carpets and drapes and a lovely large bathroom (including an accessible shower). It was much more like a hotel room than any hospital room I’d even been in. The requisite adjustable bed was there with call button, reading light and that panel with connections for tubes and wires as a headboard. The whole place was carpeted and nicely decorated with pictures and real flowers. There was a TV room for meeting with visitors and a patio and garden that were beautifully planted. This facility was the ultimate level of a four level senior residence. Most of the other patients in this building needed fairly high levels of care. But there were also several like me who had just had a knee replaced and needed help for a week or so. One of my fellow victims had had BOTH done! That’s brave!
We got vitals monitored and medications delivered and mobility assistance and physical therapy and pretty good food delivered (until you can make it to the dining room). The first full day, Sunday, the OT got me into the shower which was a blessing even if it was strictly forbidden according to the doctor’s instructions (they are REALLY concerned about infection because it is the worst problem). We wrapped me up good and I shampooed and felt completely renewed. On Monday PT began and I was really surprised and pleased at how well it went and how fast I could progress. I used a walker most of the time because you really don’t feel confident about where that new knee thing is going at first. BTW, you don’t use a walker like a shopping cart with it pushed out in front of you as you see most of the time; it’s supposed to be right next to your hip so you can walk upright normally.
The hardest part of the rehab is trying to lift your new knee leg with the muscles of your thigh. It hurts and even if it doesn’t, it’s nearly impossible. Also, no heroics with the meds. Take the pills!!! People don’t get addicted to these things if they are just trying to keep the pain away. And pain relief is critical if you are going to work hard enough to make PT pay off. After my PT sessions I was strapped into an electric contraption that bent my knee for me for a couple of hours to keep it from stiffening up. And of course they ice the knee frequently to reduce the swelling.  I could go up and down stairs the first day and took a walk around the garden the second. I looked for a place to use my computer right away and found to my delight there was wireless in my room. I was urged and had no trouble taking a walk around the facility several times a day. People came to visit and I watched a lot of TV. (Italian TV is just gross so it was kinda nice to watch news and stuff without wiggling floozies.)
By the end of the week I was fully capable of fending for myself so my brother and his wife came to get me and I went north to stay at his house for the rest of my recovery. I used the walker to get in the door and except for a few trips to the bathroom, never used it again. Terry lent me a cane and I was able to walk three blocks home from the first session of PT in the clinic near their home.

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.