I thought I’d post a little running diary of my progress since my knee replacement surgery. I know I was forever looking online for the experiences of others who had gone through the operation to see if my recovery was on par with everyone elses. Hopefully this may help someone else.
First up what is a Bilateral total knee replacement you may ask. Well basically it is when you have both your knee joints replaced with artificial ones. I had my operations done simultaneously, one orthopedic surgeon on each knee done at the same time. While this is a longer surgery with recovery being more difficult (as you don’t have a good leg to stand on, literally) in the immediate post surgery period; it’s all over and done with at once. Some people have their operations staged, meaning they have one knee replaced and go back in weeks or months later to have the second knee done when they have recovered. There are some valid reasons for doing it like this, especially if you are older or have cardiac issues. Your orthopedic surgeon will decide with you on the best method for you. As I was young, a virtual spring chicken at 42 compared to their usual clientele, had no cardiac issues and very severe damage in both knees I was a great candidate for having both surgeries at the same time… though I was most avidly regretting it the first few days afterward, oh the pain.
This video shows the the knee replacement procedure, one of the less graphic ones around but tells the story accurately enough.
Operation Day
I was to arrive at the hospital at 7:15 am (ouch) and was immediately gowned up and met with the anesthesiologist, who was rather dishy I might add. I had no time to stress or worry, I was wheeled down to theater where I met with my wonderful surgeons in the receiving bay and just went over a few of my forms. Adding a few more signatures here and there. After a brief period of wakefulness in the theater where everyone was super nice and did their utmost to calm my nerves I drifted off to sleep.
The operation took about 5 hours, I had some pretty bad knees, my left one in particular had no cartilage left at all and had become quite deformed, it required some work. I was moved up to the ward mid afternoon and while not in a great deal of pain due to the drugs I was very immobile and mentally in lala land. My legs were in cradles, little hammock devices to keep my knees elevated and bent and I was attached to drips, had O2 and a catheter in.
I was hooked up on a PCA pump, patient controlled anesthesia, where I would press a little button any time I felt I needed more pain relief and I’d get a small hit of fentanyl. I think I could press this once every 5 minutes up to so many times in the hour then I’d get locked out until the hour was up. I locked myself out a lot. I became quite fond of that little machine.
I had no appetite but did try to have a bit of soup that evening for dinner. By this stage nausea from the pain meds was my overwhelming discomfort. I had a variety of injected and oral antiemtics to combat this but it never really went away until I significantly reduced my pain medication days later.
Day 2
I was told I’d be helped to stand on this day prior to the operation. In reality there was no way that was going to happen. I was quite violently ill with nausea and my legs were not responding to any signals from my brain at all. I had a lot of swelling and was losing a fair bit of blood from my drains still. I was transfused 2 units and had some very flash cryoderm ice packs strapped around my knees that recycled and chilled the water inside themselves and then inflated and pumped themselves up to keep pressure on my knees. Don’t ask me how they worked, science, it’s clever. I couldn’t feel these at all as I was still numb but I was assured they were cold by others. The heat and swelling came down and the blood loss eased up by the next day.
Bed exercises were commenced, bending and straightening basically. Trying for full extension and getting my leg straight, back of knee into the bed. Bending each leg up to 90 degrees.
Day 3
My surgeon liked clear bandages so he could see what was going on, I actually liked this. I liked seeing the wound and assuring myself all was well. My wounds were sealed with staples and while I don’t think these leave the nicest scar aesthetically I appreciate the the knees take a lot of stress and probably need something more industrial than nylon sutures.
I had my drains removed and came off my PCA.
I had fairly extensive bruising, especially on the left leg where my surgeon had made sure to completely straighten my leg while I was under anesthesia. My leg hadn’t been straight in years so you can imagine the soft tissues did not much like that. I also had bruising that went right down the shins that was more latent to develop but stayed for a lot longer. I imagine this was from the hole they drilled down into my bone to attach the prosthesis.
The physiotherapist managed to get me standing of the gutter frame walker. This was fairly monumental, I was wondering if I’d ever stand again let alone walk.
Bed exercises continued with some leg raises added.
Day 4
My last day of antibiotics and with that I had my IV removed.
MY first steps! The physio had me walking, very tentatively, around the ward on a walking frame. Adjusting to being vertical after four days of horizontal was challenging let alone getting my legs to respond to my brains commands to walk. It didn’t help that I was still feeling quite vile and threw up on the physiotherapist.
I had my catheter removed and my first shower. Hooray for waterproof dressings.
I had a huge panic attack that evening. I was done. I was sore. I was never going to walk again, and I was fairly certain I was going to die. I think I asked someone to give me an EKG as I was sure I was having a heart attack. Worst patient ever.
The food did nothing to cheer me up. Between what was served up each meal and my ever present nausea I am surprised I didn’t lose screeds of weight in there.
I started easing back on the morphine based pain meds and just using panadol. This improved my nausea greatly. My panic attacks seemed to pick up in frequency though and were helped by some anti anxiety pills.
I graduated to crutches and was given the okay to walk to the bathroom without assistance. Freedom was mine.
The weather was lovely and I had a wonderful view from my room but I wanted out. I was getting antsy to go home and had quite the crying jag that night.
Bored. Bored. Bored.
No nausea but still having panic attacks, especially in the evenings. I was experiencing some pain now I was just on panadol, mainly related to the soft muscle and ligaments around the knees which hadn’t been in certain positions for years.
I kept myself entertained with Angry Birds and with some Nora Roberts books on my Kobo.
My bed exercises were getting intense, I would actually be left breathless and sweating… just from leg raises. I was ridiculously unfit. I was also a bit anaemic, I looked very pale and it didn’t take much exertion to exhaust me. Excuse the no make up, it wasn’t high on my priority list.
The physio had me climb her mini stair frame with my crutches. I climbed the mountain.
Day 7
I continued to get stronger, walking further on my crutches and walked up a stairwell of 15 steps… and back down again.
The state of my knee wounds 1 week after the operations.
Day 8
I walked up a flight of 30 steps and back down again.
I had my staples removed. 38 in the left knee, 30 in the right. It feels much like getting waxed, sharp and a little ouchy but not exactly painful.
Over all my experience was a positive one, I had excellent nursing care, skilled doctors who visited everyday. Pain specialists on the ward who were constantly helping me find the right balance to combat nausea and achieve pain relief. Physiotherapists working with me daily. Lovely room companions (4 bed ward that only had 2 of us in it, and an ever revolving third lady at times) the food left a lot to be desired but I’m not expecting hotel service, the whole thing was on the tab of the government after all.
The lady who was in with me had her hip replaced and said she had the same operation a few years ago privately and the care was no different, in fact she found the public hospital care just as good if not better and wasn’t out of pocket 22k.
Viva public health. Never been happier to pay taxes.