The Rest of the Knee Story
As you know I had my knee replaced. For the two weeks prior to the surgery I was
a little apprehensive and quite frankly scared to have the surgery but I had
been yapping so much about it there was no way I could turn it down because
this was my last chance. Fortunately the
surgery was scheduled for 1:30 on May 2nd which gave us lots of time
to get to the hospital by 11:30 for all the pre-op stuff. The night before the surgery I had to have a
shower using an antibiotic sponge and on the morning of the surgery I had to
use an antibiotic sponge on my left leg.
What I remember now is being wheeled into the operating room and seeing
all the tools they were going to use on my knee. The resident physician was getting me
prepared and I had my spinal and they held up my leg and I asked them whose leg
that was because I felt absolutely nothing….”good thing.”
It seems I slept through most of the surgery and the only
thing I remember is waking up near the end and hearing them hammering on my
knee. It sounded like they were taking a
hammer and using a punch to hammer something into my leg, which they probably
were. According to the resident I hadn’t
done any talking during the whole procedure….”another good thing.” I was out of post-op recovery by about 5
o’clock and the surgeon told Darcy that the surgery went very well and he took
a little extra time to clean up some of the stuff that was in there. Darcy was so happy, she gave the surgeon a
big hug much to his surprise. He came
and saw me in my room on Wednesday night and explained that the surgery had
gone very well. You could not ask for a better surgeon.
I had a roommate on Thursday who was a professional baseball
player in the late 60’s and early 70’s.
For those of you who are baseball fans his name was Mike Kilkenny and he
pitched for the Detroit Tigers in the late 60’s and at the time of Denny
McLean, while McLean was making millions, Mike was very happy to get paid
$6,000 a year. He was a starting pitcher
with Detroit and then went to Oakland ,
San Francisco and finished off his career in Cleveland after spending
15 years in the majors. He and Ferguson Jenkins were the only two Canadians in
the league. He said Cleveland at the time was a place where you
knew the fans by name. The reason I am
talking about my roommate is because, it was a little upsetting, that he had
his surgery on Thursday, was walking on Friday and went home on Saturday. Meanwhile I had to stay until Monday. The same surgeon did both our knees and he
came in again and explained to Mike how his surgery went and then to me and
that is when I found out that he took extra time doing my knee. He says he usually does a knee in an hour
plus or minus a few minutes but he said mine was such a mess he took an extra ½
hour to fix it up. He said there was
lots of old injury stuff, arthritis, etc., and there was a lot of recent injury
from the crash. An interesting thing is he told me that when he was finished he
could straighten my leg out to under 5 degrees which he never expected
considering the condition of the knee……….yeehaw!!!!
Rehab in the hospital was interesting to say the least. Thursday wasn’t bad because, I still had some
of the effects of the hydromorphone that they used in the epidural, and the
physios bent my leg to approximately 55-60 degrees without too much pain. For
the rest of the weekend, Saturday, Sunday and Monday physios came in twice a
day to torture me and once to put ice on my knee. They eventually got it to bend to 70-75
degrees but in doing that there was a lot of whining and crying and all I can
say is “Yikes, it hurt.” It’s a good
thing they told me after the surgery that knee replacement was one of the most
painful operations that is done. If I
had known that there would have been a little more apprehension prior to the
event.
I knew there was going to be pain and I thought I could
handle pain very well and I wasn’t using my pain meds correctly because I
thought I was a tough guy. I would wait
until my knee was hurting and then take the pain medication to try and catch
up. The reason being I was afraid of
being addicted to hydromorphone. I have
since learned to use the medication prior to any activity to stay ahead of the
pain. I take a long lasting
hydromorphone of 9 mg in the morning and 6 in the evening and I have 2 mg of
breakthrough which means if I have pain I can take 2 mg every two hours and my
pain has decreased.
I started occupational therapy and physio on May 7that
Parkwood and they arranged it to have OT and PT on Mondays and Wednesdays at 10
and 11 which saves me a couple of trips
to London a
week. I assumed that in OT they would be
working on my left arm and in PT they would be looking at my left leg. Given the pain that I had when moving my knee
I was almost petrified to go to PT, instead of taking 2 mg every two hours, I
took 2 mg every hour prior to the therapy.
When I got to PT, the physio had told me that she had spoken to the OT
therapist and they had agreed since they were both using the same protocol on
my arm, that the physio would also do my arm until my knee healed and they were
able to work on that…..whew….. Physio
was also taking some time to get me to transfer from my wheelchair to a table
unassisted. Haven’t quite reached that
point yet as I need more leg strength in both my right and left legs and I’m
working on it. With OT and PT doing my arm the Physio from CCAC is working on
my leg. Under their licensing two physios cannot work on the same patient on
the same body part at the same time. Note: above one is a physiotherapist and
one is an occupational therapist.
Here’s just some ramblings about what’s been happening at
home. Had a couple of bouts of
constipation and I guess I have described that enough that you know what it’s
about. My pharmacist recommended an over
the counter laxative called RestoraLAX.
It acts by absorbing water from your blood stream and putting it into
your intestine thus eliminating constipation.
It is a natural product and you take it as much as you want, however if
you take too much, it may go from hard to too soft very quickly. The natural
ingredient is polyethylene glycol which sounds like plastic or antifreeze to
me. I take ½ teaspoon with my breakfast
and it seems to do okay. Of course I am
still taking my other laxatives, Milk of Magnesia, Senekot and Soflax. You get the picture.
The knee created some problems at home as I was in ‘pain’ when
anybody even thought about moving my knee.
Note this was before I learned how to use my medication. The PSWs who came in to shower and do bowel
care became almost afraid to touch me as I can yell quite loudly. We made arrangements
with the agency to send two PSWs, one to hold my leg and one to move me. I was having trouble moving and sitting up in
bed because I had so much muscle tone (spasms).
We looked at my medications and the resident physician had decreased my
Baclofen (antispasmodic) after the surgery from 50 mg daily to 15 mg
daily. I couldn’t sit up and when I
moved my legs my arms would spasm and tighten up and I had difficulty moving
anything. After some time and a doctors’
visit I got my Baclofen increased to 60 mg daily and I am able to sit up and
move much better…….jeeez who would have thought that one drug would have that
much of an affect.
Now back to the two PSWs at every visit…….after taking the
Baclofen and being able to take my pain meds correctly, I could sit up by
myself and move my leg around very easily. One worker does most of the work and
the other assists or does other things around the house like making my bed etc.
I felt embarrassed having two people and
the money that is being wasted on me but I was told that it is a safety issue
and the cost to repair me after a fall
far outweighs the cost of a PSW, that’s the system I guess.
Darcy was having problems moving me around. When I get in and out of bed she has to lift
my legs in and this is more weight she can handle. And when there was one PSW, Darcy would
assist in getting me to sit up which meant she would have to assist lifting my
body weight of 170 lbs or help moving my leg and she got very upset when I
would say, very loudly, well ok, yell ‘NO…NO…NO…NO…PLEASE...STOP’ and I was not even on the commode
yet. Needless to say, Darcy was at her
breaking point and on Wednesday, May 9th, she was having some
problems and I asked her to check her blood pressure which is usually around
118/84; this time it was 173/104. She
was afraid she was having a heart attack or stroke because she was having pains
in her chest on the left side and her fingers were feeling numb and
tingly. She was also afraid of what
would to me if she was not here. We called a friend who came over immediately
and took her to the hospital and his wife came over to look after me. To complicate matters I was very constipated
at the time and while removing the stool my hemorrhoid started to bleed. This
frightened me a little bit because I am on blood thinners. More friends came over and one went and
bought some Depends as we didn’t know if I would be bleeding through the night
or not. A friend who is a nurse came
over and checked my Depends before I went to sleep and there was no blood….worry
ended. Now the problem was Darcy was in
the hospital and I needed another friend to sleep over night and she slept on
the sofa.
Darcy was released from the hospital in the morning her pain
in the chest was gone, her BP was down and the ECG was good and the blood work
showed nothing. Since she has been home, we have tried to limit her lifting.
Having 2 PSWs coming twice a day helps alleviate some of that. One reason for a
lot of lifting was that I was told that I should not keep my leg in the same
position for more than an hour. I was in and out of my chair several times a
day which meant that Darcy had to lift my legs and spin me into bed several
times a day which contributed to her back pain and stress.
My knee is getting better and now it bends almost 90 degrees
without any pain and it seems to have happened overnight. On Tuesday I was at a friend’s place and my
knee was bending 60-70 degrees and I couldn’t get my foot on the foot plate of
the wheelchair….today, Thursday it bends almost 90 degrees and I can put almost
half my foot on the foot plate…hmmmm…good progress.
In physio on Wednesday, I had acupuncture in my left leg for
an additional 20 minutes. Acupuncture
takes some time to have an affect, I’m just hoping it’s a good one as I had when
I was in the hospital. The other good news is I tried to ride my bicycle today
but I didn’t have the courage to spin the pedal all the way around due to
anticipated pain. I spent about 20
minutes doing half pedal strokes without turning the pedals all the way
around…a workout nonetheless. After my
pedaling session Darcy suggested that I put my both feet on the ground to see
if my left foot would sit flat on the ground……it did. I tried to do some
standup launches which means I hang onto the handlebar with one hand and try to
get my butt off the saddle. I tried
several little launches which I got my butt off the saddle about two inches and
then I tried the big one and I almost stood up……..yeehaw. I tried several more and it felt really good,
however I really needed my right arm in pulling and holding myself up. I couldn’t do it without my right arm. I will
be doing it many times in the future hopefully after half an hour of proper
cycling.
As mentioned the lack of Baclofen causes a lot of spasms
plus the sore knee didn’t’ help either and last Saturday, May 12th I
was on 15mg of Baclofen and was very stiff and sore. I could not move very well
and was very disappointed in myself that I missed my Karate Club’s Shai-club
tournament – after the club has been sooooooooooooo supportive of me. However
some friends came over and got me out of bed at about 2 and took me for a
coffee.
