It has been an entire week since my knee replacement surgery and while many of the experiences and observations I had last time are the same there are quite a few differences. In spite of the fact that I had some serious reservations about opting to do the surgery as an out-patient I’m glad I did.
Same day service meant rethinking my choice of anaesthesia and instead of undergoing general anaesthesia I opted for a spinal instead. I was completely asleep during the cutting and drilling but waking up from a spinal was free of the usual nausea and debilitating loopiness that just seems to hang on for days. A friend who had a spinal for some arthroscopic surgery said it was like waking up from a nap, a claim I regarded suspiciously but she was absolutely correct. In Recovery, rather than waiting for me to hurl a nurse cheerfully gave me a cup of ice chips. Bliss!
The other item of great concern was managing the inevitable pain. Total knee replacements hurt. A lot. With the last knee I spent four days in the hospital having my pain managed for me; oxycontin, oxycodone and morphine were administered by nurses and unless I was feeling especially awful I didn’t have to pay much attention. In preparation for going home the excellent staff at OrthoNY prescribed Celebrex, Tramadol and oxycodone ahead of time so I had everything ready and no one had to make a frantic trip to the pharmacy. I was given a very specific sheet on what to take when and the meds were treated a bit like a ladder with oxycodone being on the top. Celebrex was a given as it was used to control the swelling, followed by extra strength Tylenol and Tramadol; oxycodone was for any pain the lower rungs on the ladder didn’t take care of and after three days I was able to eliminate the top rung completely. I’m pretty sure I will never understand the recreational appeal of opiates.
The bandage covering my staples is the same Aquacel bandage I had last time, a high-tech affair that allows me to shower but there seems to be vastly less bruising this time around and remarkably less numbness. I’m hoping this will result in fewer “phantom pains” caused by reprogramming nerve endings which can be powerful enough to blast through any pain meds and awaken me from a deep sleep.
My health insurance coverage changed a couple years ago and did not include in-home physical therapy for the first two weeks so I used the little exercise sheet I was sent home with and an app for my phone called Orthophysical which actually has the ability to measure my extension and flexion. Eager to map the challenge, my torture started in earnest and by the time I went to outside physical therapy on day five my new PT Don pronounced that I was already half way there.
One thing the two surgeries have in common is the immediate relief from the horrendous, limiting knee pain I was experiencing. In both cases the very first time I stood on my new titanium parts I knew I had been given a wonderful new opportunity to use my body the way it was meant to be used making all the post-surgical pain worth it.
Color me grateful.
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