Thursday, September 30, 2004

Good coffee makes all the difference in the world

Knee-plus-one: Thursday, 30-Sep-2004:
I woke up with the 7 AM change in shift. My wife stopped in on her way to work, bringing me a go-cup with REAL coffee. Ahhh. We’ve been drinking fresh ground coffee for years, thanks to our children who bought us a grinder for Christmas once upon a time.

Pain control during the first night was fine. It was much much better control than I had following the meniscectomies in 1969 and 1973. In the pre-arthoscopy days, pain control was by nerve block, and when the block wore off post-surgery, the only pain control was by narcotic injection (demerol, in my case). PCA (“the button”) is a much, much better way to go.

Breakfast arrived relatively late for my normal schedule --- I was ravenous --- and most of the shift change actions had already occurred by the time breakfast came.

After breakfast, I was allowed to walk into the bathroom using a walker, and to sponge-bathe in private. Of course, I was accompanied by my IV tree, to which was attached my Foley bag. Of course, the nurse stayed within ear shot of the room. We clipped the blood drain bag to my boxer short-pajamas. The puls-ox monitor was disconnected during bath time, and reconnected when I got back to the bed.

I have kept my hair in a crewcut for years, and having a crewcut made a sponge bath very effective. It felt especially good after a relatively warm night, wearing TED stockings and plastic inflatable legs. Bathe. Brush teeth. Put on fresh clothes. Ahhh.

PT began at 10 AM, but only after the nurses were sure that my BP was stable upon sitting and standing. No light-headedness this AM. I went to PT in a wheelchair, wearing a robe over the hospital gown and shorts. Mostly, in-hospital PT consisted of assisted walking (get out of the wheelchair into a walker, and then motoring around the halls on the new knee). Plus, I did assisted flexion exercises by sitting in a wheelchair and rolling “over” the new knee so that it was bent >90 degrees. Because of my height and the length of my legs, I found this relatively easy, and was >90 on knee-plus-one day. Similarly, I was able to walk in the walker with relative ease. PT occurred at 10 AM and at 2 PM. After breakfast and before lunch.

Occupational therapy occurred after PT on Thursday. The therapist taught me how to go from a walker to a dining room chair; from walker to toilet; from walker into shower. Very simple, very practical and very functional. OT was an impressive operation, preparing the post-surgical patient for all of the things that they would face, from “Where do you put the walker when you are in front of the frig?” to “How do I get from the walker to the shower or toilet?”.

Getting out of bed was still a chore, thanks to all of the tubes and bags. But I could readily swing my legs over the side of the bed. I could also lift my leg-and-new-knee (straight leg lift) almost immediately after surgery.

Nurses and the surgeon’s PA indicated that I should expect to go home on Saturday (knee-plus-three days). On Thursday (knee-plus-one), this seems like it will be a stretch. Maybe Sunday.