almost two weeks into recovery

So much for my plan to blog regularly about my post-surgical recovery. The truth is, after my total knee replacement surgery on July 18, it took a long while for me to feel up to writing anything. I don’t mean that to sound scary or ominous; rather, surgery is a major trauma to the body, and joint replacement is a big deal. Time and patience are necessary for healing.

Even now on Day 12, I’m pretty tired and not completely confident in my cognitive faculties. But I am getting stronger and am making slow progress. Here’s a meandering look at what the surgery and immediate aftermath were like.

I was very anxious on the morning of the surgery. Knowing that everything would be fine didn’t help my body relax, and everyone on the pre-op team was so kind to me. Especially grueling was the 90-minute “block hold” after getting the IV started but before the nerve block and epidural were administered; there was a hold-up on getting all the required signatures on the surgical forms. Once that was remedied, however, things moved fast. After I was given a sedative via IV, I barely registered the administration of the nerve block. The epidural left more of an impression but was also fairly easy.

The last thing I remember prior to surgery was being brought into the OR, feeling my legs go increasingly numb, seeing the digital clock above the door (12:29 p.m.), and the anesthesiologist leaning over to reassure me that my nerves were entirely understandable. After that, there were post-op flashes of being moved onto a bed and being rolled away. It was shortly after 3 p.m. that I awoke in post-op recovery, being attended by the nurse who did my intake about six hours earlier. They gave me a dose of oxycodone as soon as I felt any discomfort, and the surgeon paid me a brief visit to see how I was doing.

Here’s something I discovered, first in the recovery area and later in my hospital room: at a certain point, I have no modesty anymore. An ultrasound of my bladder told the nurses I was too full for a catheter, and I apparently had no trouble shifting over to a bedside commode and peeing in front of everyone (and within earshot of others in recovery, as we were divided by mere curtains).

I’d previously wanted to go home the same day as my surgery. Even with the pre-op delay, that early discharge was still offered as a possibility, but I was comfortable in my hospital bed and happy to stay the night. I’m glad I made that decision, due to a medication issue that arose and an “incident” overnight. Mike visited with me for a while in my private room on the recovery floor and got to watch while I shuffled around on my walker when the physical therapist came to check on me. I pushed myself to walk more than twice as far as I was asked — basically out of my room and to the nurse’s desk immediately across the hall, and back — but deferred practice on stairs until the morning.

It’s no surprise that I reacted badly to the oxycodone. It’s not like I was hallucinating or bleeding out my eyeballs, but I was nauseated and very woozy. When I turned my head even a few degrees, the room spun. I couldn’t look at my phone without feeling sick. I had no appetite, either, which was a concern. I refused a second dose of oxy overnight and was switched to IV toradol for my stay, along with lots of tylenol, chewable aspirin, and antibiotics that came in both pill and IV form. Just before discharge, I was switched to Norco for pain relief; I still have trouble tolerating this combination of hydrocodone and acetaminophen, but the effects aren’t as bad. If I’d been sent home directly after surgery with a bunch of oxycodone, I would have been in for a miserable experience, with no immediate remedy available.

So, now, the “incident”: Somewhere around midnight, things got busy on the recovery floor. The nurses were all tending to other patients, and when I rang the call button, a non-orthopedics nurse responded. I needed help once an hour to get to the bathroom, but with everyone hitting their call buttons at once, it took three tries for the nurse to unhook me from the cryotherapy machine and the two pneumatic compression sleeves on my legs, because she kept having to dash out to answer another call. I was in the bathroom and standing by the toilet when another call rang. The nurse told me, “Be careful, because you’re at increased risk of falling so soon after surgery,” then left to answer the latest call.

My hindbrain must have interpreted her warning as a command, because two seconds later, I was on the floor.

I wouldn’t say that I fell — that language is too dramatic for what felt more like a slow surrender to gravity. I lost my balance — probably because of the oxycodone in my system and the fact that my right leg was still fully numb — and I grabbed my walker to ease my descent for a soft landing. But I was on the floor on my knees, and I was alone. Disoriented and determined, I didn’t call for help but somehow managed to get up and onto the toilet on my own. I was already back on my feet and headed toward the bed when the nurse returned. I felt silly, but I told her what happened, which set off a flurry of concern. There’s nothing like the overnight radiologist wheeling the portable x-ray behemoth into your room at 1:15 in the morning. The good news: no impact to the new knee. But from that point onward, every new person I encountered through shift changes and other protocols opened with, “I heard you fell.” I was also not allowed to be unsupervised in the bathroom. Again, if this had happened at home, it would have been much worse.

But the morning brought Day 1 of post-op, and I was feeling fine! Yes, I was learning how to shuffle around still, but the numbness in my right leg was easing. With the encouragement of the morning physical therapist, I walked a long corridor and practiced on some stairs. A member of my surgeon’s team visited to check my range of motion and was happily surprised by how well I was doing — and as she unwrapped the ACE bandage on my leg, a heart-shaped piece of blue-green foam fell out. She laughed, showed me the uneven edges in the foam, and told me that someone in the OR must have used surgical tools to shape this piece of padding. She swore she hadn’t seen anything like it before. Almost two weeks later, I’m still touched by that anonymous kindness.

There’s much more to share about the past two weeks, and some of it is grueling, but I’m tired (again) and I have more at-home physical therapy to do today. I hope to write more about my recovery experience in the days and weeks to come, in case these posts inform, encourage, or at least entertain someone else.

Posted in thoughts from the spiral.

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