Recovering From Second Surgery

The left knee operation on March 22nd has been successful. It is a different experience than the first knee. I guess that no procedure is identical even though the Doctor and the patient are the same.

The operation started at 8:00 a.m. and was quite a bit longer though I don't know the exact time. The relaxation medication was either stronger or a bigger dose because I don't really remember any of the procedure nor the conversation that took place between Doctor and staff. About all I remember is the hammering of steel on steel at the end just as in the first operation. I might even have commented that there was more hammering this time.

The Recovery Room was great. The nurses really pay attention to you and monitor the heart rate, oxygen levels, blood pressure and temperature very thoroughly. I remembered my breathing exercises and was able to keep the oxygen level close to 98% until there was a bit of nausea just before being moved to the ward. The self administered pain injections are wonderful. I was even more keen to avoid discomfort so took a shot whenever I began to feel a twinge. All staff made me feel great by complimenting me on how little a dosage I actually took. Over the recovery period in the hospital, I don't think I took more than 2 or possibly 3 shots in an hour and the machine was set up to allow a dosage every 6 minutes if I so desired.

I arrived in the ward shortly after noon and the ward staff were very helpful. The toughest procedure was the insertion of the catheter but the young male nurse was very sympathetic and very gentle. I guess there is nothing like close identification with the procedure to ensure a steady, soft hand. The night nurse was very professional and visited every few hours to make sure I was OK. I appreciated her no nonsense approach. As before, there was one nurse that was a bit 'ditzy.' Just as with the last experience, she gossiped outside the room, came to undertake procedures but would have to make three trips back for the tools, materials, etc. Then complained about being so busy and behind. No wonder! I guess no amount of training can instill an orderly, systematic practice over a strong personality. No harm, I wasn't in great need and found it amusing.

The physio and occupational therapists arrived on Wednesday morning and as before, the pole with all the intervenus fluids hadn't been removed. We went for our walk and with a bit of organization on their part I was able to demonstrate I could navigate the stairs and passed the crucial test for release.

As I said, the experience was quite different. Even the incision is on a different part of my knee, more central and perhaps a bit longer. Pictures for comparison which follow soon will help to figure that out. I must say that there was more discomfort after release from hospital and the different narcotic for pain control doesn't seem to work as well. It still has the same constipation effect but I have taken larger quantities of the stool softener which has helped a lot. This narcotic doesn't have the Tylenol built in so I'm taking a couple of Tylenol each time - abou every 5 hours.

The knee is much more stiff this time. Bending it is difficult. There will be a bigger challenge for the physiotherapist when I start increased exercises this Wednesday. I have more bruising this time; on my stomach for a blood thinner shot which was new, as well as on my calf and ankle. My ankle has been quite sore espcially after my first walk outside. It is swollen an feels like it has been almost sprained.

During the hospital recovery period, I had some significant bleeding from the incision. It seeped through the bandage and the nurse wrapped over the initial bandage on the first night. I still left a large blood stain on the sheets. The second night, after a new dressing, it bled through again but not as much. The gentle and kind student nurse bandaged me just before release and there was still some blood on the gauze but not enough to seep through. There was a touch of red each time we changed the dressing until yesterday afternoon. Today I'm expecting that we should not have to re-dress the knee.

I learned from the last recovery period and am getting more bed rest. The night nurse insisted that sleep was the best curative and each morning I do feel that there has been overnight recovery. The same can be said after morning and afternoon naps. Curious how sleep helps everthing improve.

I have an appointment on April 7th to have the stitches removed. Hope all goes well for the next week and a half.

Left Knee Operation

It has been a busy time back to work so blogging has been set aside. The operation was scheduled for February 26th but cancelled because of the bed shortage in Ottawa hospitals. I was one of the 150 elective surgeries to be postponed.

It was not a long wait, however, as the rescheduled opertion is March 22nd. That is Monday! I'm first on the table at 8:00 a.m. so we have to be on hand by 6:15. Another early morning! My body will think we are going to the airport.

With the extra time, I am guilty of having eased up on the exercises. Went back at it with a vegeance on Thursday and am still paying the price today. It is amazing how much my legs have stiffened up without the exercises. Note to file: Don't Do This With the Second Knee. I feel as though I have as much flexibility in the operated knee, but the strength isn't there. Still, it is much the stronger knee and is already the "prime." The left knee is very sore and aches even with a full dose of Advil each day. I'm hoping that it hasn't deteriorated to the point were a hemi isn't feasible.

It is amazing how blaze (Blog doesn't accept keyboard accents!) one becomes with the second operation. I haven't spent any time preparing mentally until last night. It seems that in the middle of the night it became time to review! Today I'm getting out all my papers to make sure I follow all the instructions: Stop some of the medications on the day before, wash knee with special disinfectant soap Sunday night and again Monday morning, no food after 12 midnight, only a sip of water on Monday mornng. The early operation will mean that I shouldn't be into coffee deprivation but will probably want some in the afternoon. Hope my stomach can take it, my head will need it.

So - looking forward to the second operation and hoping it goes just like the first. Then we can really start the rehab and be ready for the gardening season.

Phase 2: Left Knee Operation Scheduled

With all of the exercises and back to work on a regular, if shortened hours, basis it takes time to post new blogs.

The big news is that my right knee has recovered sufficiently that the operation on the left knee has been scheduled for February 26, 2010. So much for long waits and huge delays! Unfortunately this news won't receive nearly as much USA press as the Newfoundland premier's heart operation in the USA. My experience is a good rebuttal against the charges that Canadian medical care is slow and inferior.

The ongoing process of healing does take time. Two weeks ago I was feeling great and decided to shovel a little bit of snow that had accumulated on the front walk. It was only about 10 shovel fulls and I didn't feel anything at the time. However, late that night my legs were aching and I couldn't sleep. The ache continued for about two days. The physiotherapist advised that there was no damage to the knee replacement but that I had just worked the leg muscles too hard. It is shocking that there has been that much loss of strength. I don't think it is entirely due to the operation. I have been increasingly less active because of the arthritis so the deterioration is likely a longer term phenomenon than just the operation.

We are now working on strengthening the left leg. Some tests at physiotherapy reveal that it is much weaker and less flexible than the right knee now. That is good news for the recovery but bad news for the next operation. So now there are even more excercises to do as I build up the left leg. Hopefully the knee can withstand the increased work without too much aggravation.

That has proven to be one of the most surprising elements of the recovery process. Another observation has been that I am not able to exercise the right knee as strenuously as is needed because the left leg won't take the increased strain. Many of the exercises require use of both legs even though it is the right one that is being developped. I find that the number of repetitions and the level of exercise are limited by the pain in the left knee. I now have a couple of exercises which focus on just the right knee.

All is very surprising, even though quite logical when you think about it.

Staples Removed

Great news! The staples are out. They weren't bothering me except for a little tightness when bending the knee but it is good to have them removed. It is a sign that recovery is well underway.

The surgeon has given the implant his full inspection and I've passed! The knee feels strong and dependable. Still a bit of stiffness and some aching but that requires exercise and time I'm told.

It's not a surprise (to me) but I'm cleared to drive again. Walking easily without a cane except on the stairs and for steadiness outside on the ice and snow, I quite capable of making the shift from accelerator to brake.

The really great news is that the surgeon is willing to undertake the left knee replacement in a couple of months if all goes as well as it has so far. I'm to see him in 4-5 weeks for a check-up.

Now it's time to exercise and lose some of that weight that didn't happen before the last surgery when it happened so quickly!

The Evidence in Pictures

It is now well into 2010 and I promised to post a photo of my knees. There is also a diagram of what has been implanted inside the skin. The picture was taken a few weeks ago between Christmas and New Years and still shows the bit of bruising at the beginning of the incision.

The healing process has gone well and I hope to have the stiches removed tomorrow when I see the surgeon. The physiotherapist gives me hope that there is no apparent reason to keep them in any longer.

Yesterday there was a bit of a setback. I walked for nearly an hour at the plaza without either cane or walker. It seems that having the smallest bit of support helps the balance on the knee and we want to return to a state of no walking aids. After the walk I was fatigued but it felt pretty good. At home, the leg began to ache and there was more swelling. We had been warned that this could happen and the recommended treatment is to alternate heat and cold to improve the circulation.

I was plugging the heating pad in and without thinking put my knee down on the padded recliner to reach the plug. Immediately I felt I had done something I should not have. No real pain but there was a different feeling. Thi morning the knee was stiffer and I had lost some of the flexibility. There was also a return of the numbness I had felt earlier around the knee cap.

The physiotherapist suggests that there is no real damage. I have pressured the healing at the point where the appliance has been inserted in the bone. Some of the healing may have been lost but it will recover shortly and there hasn't been any shifting of the implant.

A good work out with the therapist, 5 minutes of cycling and standing on a balance pad have brought the flexibility back to the 120 degrees and more of bend that I had achieved last week.

It's amazing how one forgets to be careful when you feel good and are getting back to normal. Earlier this week my daughter noticed that I was leading with the operated leg when going up the stairs. I'm right footed and I hadn't even realized I was doing it. Although no one has told me to start going up stairs in the normal fashion, it appears that I'm ready!

The best part is that the right leg feels stronger, more reliable and generally has less pain than the left leg - already. Hopefully the recovery continues to speed along and we can look forward to having the operation on the left leg as soon as it is feasible.