Tuesday, November 16, 2010

So, just another scar!

Last Tuesday, the 9th, Lizzie drove me into University Medical Center for my knee replacement surgery. Thankfully, they didn't want me there by 6am, as threatened. We arrived about 8:30 for a 9:45 date with the table - most reasonable!!

Met with the anesthesiologist, and was most disappointed that he would not be using my port-a-cath (inserted directly into my vein for my breast cancer surgery itself and the follow-up chemo and whatnot), saying that he felt the port didn't allow enough volume of meds or whatever, should an emergency arise. Drat - more holes in my hand and arm veins.

He did surprise me by saying that he would be using a femoral nerve block as part of the sedation and pain management. That had been mentioned casually as a possibility, but in such an off-hand manner that I didn't even feel it was worth researching. I wish I had!

The doc suggested that he could knock me out prior to the procedure, but you know me - I wanted to watch. The team uses an ultrasound image to find the femoral nerve in the groin area. The link I highlighted above s
hows the exact image I saw on the ultrasound! Once they've identified the spot they want, they take a horse needle and jab it in and poke it around until they find the nerve. They did use some lidocaine prior to that assault, but if it helped much, you could have fooled me! That was a painful procedure!

Once the needle is in place, a tiny catheter is threaded through the needle into the nerve itself, for about 20 feet (actually probably only about 20-24 inches), so that pain meds can be delivered directly to the area that needs it most.

I don't respond to pain medication like most people, and this instance was no different. They kept asking if my foot was numb, my leg was numb, if my toes were tingling. No, no and no. They all felt perfectly normal. But they thought the block must be working anyway, so we went ahead with the surgery.

Of course, while setting the block, the IV into my hand popped out - as they always do, so I was spraying blood everywhere, and they had to stick yet another hole into my poor over-used veins. No one ever listens, or believe
s, when I tell them this will happen.

A couple minutes later, the surgery was complete, I was wide awake and ready to be moved from Recovery into my room. Except my room wasn't ready.

Which was probably just as well, because part of the knee replacement includes leaving a drain in place (I've been there before!) to get rid of the anticipated overflow of blood after carving me up. And I was filling and re-filling the drain bag. And re-filling it and re-filling it. They were beginning to think they'd have to go back in to find out why I didn't stop with the blood flow.

In the meantime, my room, a private room yet!!, was cleared for me, so we started getting me ready to move. And, surprise, my IV popped out
again, and sprayed more blood around. This is getting old!

There wasn't a bed available to shift me onto for the move, so rather than make me wait around any longer, we all decided to just leave me on the Recovery Room bed and get me to my room. I think they were tired of me bleeding on everything!

By then, of course, I was STARVING! But they wouldn't let me have a regular meal, because I was still bleeding from my leg like a running faucet. So I had a cup of beef broth and a glass of cranberry juice and some jello. Did not do much for my hunger!

But my room was very nice - had a great little flat screen TV with 27 good channels, one of which was some terrific soft instrumental sounds with photos of Hawaii and surf and birdies and nature and it was Wonderful!

Finally, about 7:30, my bleeding had slowed enough that they decided I was going to live - and could eat real food!! Unfortunately the kitchen was closed.

Now, this is one of the many 'bests' that this hospital offers. They have room service!! Patients receive a menu, and can order whatever they wan
t, whenever they want it, as often as they want! Up until 7:30 at night. Oh well.

But my nurses and PCTs (patient care technicians) were terrific - all of them were terrific!! - and came up with a sandwich and other munchies to hold me until morning!

Wednesday morning - breakfast! Yummy breakfast - had a bowl of strawberries, a glass of cranberry juice, an omelet with bacon, tomatoes and onions, and a side of salsa, plus a side of bacon and a side of sausage. Nice, nice!!

All the docs dropped by - the pain management guy, who looked darling with my wig on over his surgical cap, was still baffled that my toes still f
elt normal, no tingling or numbness. The surgeons were very happy with their handiwork, and I found that I'm stapled together - I guess no one uses stitches anymore.

And my ankle, my right ankle under my new knee, hurt like an SOB! Obviously the femoral nerve block didn't go that far! That ankle is the one that
was crushed in that car accident so very long ago - and is still totally worthless, except as a weather forecasting tool. As I described it to the doc, it felt like acid was being poured on it, then a truck was driving back and forth across it. They acknowledged that they had used the foot to move the leg around as necessary for the surgery. That's WAY more movement than the foot can tolerate! But my surgeon knew just what to do - she wrote me a prescription for some stuff called Gabapentin. This is the only drug that has ever helped my severe chronic pain in that ankle! Of course when I read the small print, I realize I need to check it out a little further, since I already take a prescription to control a seizure disorder, and that is this little pills main role in life.

Beyond that, I felt great! I could move my leg without too much pain, and everyone seemed impressed with how well I was doing. Again, I can't say enough how very special all the staff in this hospital is - every person I met is caring and thoughtful and helpful and kind - almost all the PCTs are studying to be RNs. Great people!

Thursday, I had my first PT - physical therapy. I was able to lift my leg on and off the bed without assistance, walked up and down the halls with my walker, and learned how to walk the stairs - and received the OK to go home the next day. Hurray!!

But, in typical fashion, I over-did it! I felt so good, and could move without pain - wrong. They pulled the nerve block, which felt really weird, since I could feel the thing being sucked out of my leg. The leg which never felt the block as I was expected to, suddenly felt pain! My leg said 'screw you' - I'm never moving again. Drugs, give me some drugs!! Now!!

I'm back to being somewhat human - I hurt and can't move like I was. Oh well - I get to go home! That's what counts!

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