Saturday, October 02, 2004


Knee-plus-three days (2-Oct-2004, Saturday):
Saturday AM finally arrived. I bathed, packed and waited.

The surgeon’s PA and on-call partner came in; wrote me a handful of prescriptions (drugs, devices); and told me that a nurse would walk me through the remainder of the discharge process. However, I had to have one more PT session in the hospital before discharge. My leg had ballooned overnight, following removal of the Ace wrap. The doctor said that this was normal, and the swelling could take up to a month to go away. I needed to elevate my leg; keep it iced; and NOT put anything under my knee.

When I asked about follow-up appointments, PT, etc., I was given additional scrips and instructions to call the office on Monday.

Breakfast came. And then the PT person came by at 0900 to take me to PT. I was ready for release by 0930. The IV port was finally removed from my hand.

I was ready to go. So I called my college age daughter. And woke her up after she had just gone to bed.

My daughter and my mother (who now lives with us) came to pick me up at the hospital. A nurse took me in a wheelchair to the car, and we were off. We drove to a home health care supply store for a walker, a toilet riser, and TED stockings. Unfortunately, the TED stockings had to be ordered (I’ve got long legs), so I had to wear the same ones I used in the hospital until at least Monday. And the riser seat did not fit our toilet (my wife went to a building supplies store and replaced the entire seat). But the folding walker was great.

My daughter then went to the pharmacy to pick up the med prescriptions, only to discover that the warfarin scrip did not include dosage requirements. The pharmacist said “You’ll have to wait til Monday” and I panicked. Finally, after calling the pharmacy, the nurse’s station, and the physician’s answering service, the right connection was made, and all prescriptions were filled. Ta da.

Now, the problem was comfort at home. We live in a two-story house, but moved our bedroom to the first floor for the duration of my recovery. The “nest” we had made for me pre-surgery worked very well. However, the conflicting instructions that I was given by the surgeon (“elevate the leg”; “put nothing under the knee”) drove me crazy. We eventually hit upon building a ramp of pillows under the leg, from the thigh to the ankle, but with a gap under the knee. My knee and leg could then remain fully extended, yet be fully elevated. The “rule” stating “nothing under the knee” is intended to maximize the amount of time that the knee is in full extension. Yes, it will certainly feel better if you bend your knee and rest it on a pillow. However, this practice allows your knee to build up scar tissue (or muscle / ligament / tendon tightness) that keeps you from being able to attain full extension.

The remainder of the day was mostly spent with napping and trying to figure out how best to schedule pills and exercise. With both the percocet and the oxycontin, it took about 75 min from ingestion to noticeable reduction in pain. With both, I also tried to only take the minimum prescribed dose. I would later learn that this was an error in judgment.