Surgery day

 As promised, here is my recap and thoughts about my knee replacement surgery day. As noted in previous blog, contracting Covid changed my surgery date from September 8th to September 28th. Although only 20 additional days it felt like a very long time. My "head" and my knee was ready for the 8th. My knee was not happy!

I continued to work full-time as a case manager for formerly homeless individuals and also taught my cycle and dynamic strength classes. Teaching the classes truly made me happy and also reinforced the need for this surgery. Bike was great; however, my exercise form in dynamic strength illustrated how bad was knee was. It also showed that I am still recovering from my hip replacement (same side) that was done in April. I wondered how this might affect my knee recovery but put this out of  my mind....for now.

Surgery day was finally here! I was scheduled for "Swift" (one day surgery). My husband and I arrived at the hospital at 7AM and there was no looking back! I was prepped and when the IV was placed my husband was able to come back and sit with me. We saw my surgeon, Dr. Sherman, together and having been through 3 other surgeries with him the "drill" was simple. Soon it would be show time. My husband left shortly after my surgeon, which was fine as it was time for the femoral block. I had this for the first knee replacement in 2015 and also had nerve blocks for both hip replacements so I was familiar with the process. It is more unsettling than painful. Made it through, no issues. It was explained, as in my other surgeries, that we would be doing spinal with sedation as long as there were no challenges. I was fine with this as I never had any issues previously and actually feel good when in recovery.

When I had my knee replaced in 2015, I do remember being in the OR and also sitting up for the spinal...then nothing! Well, nothing until I woke up and asked what I was hearing..."the saw"...and out like a light again😂

For my left hip I truly do not remember going to the OR. Nothing.

For my second hip, I do remember getting to the OR ...then...nothing.

Interesting....

This surgery.....

I was totally awake for the ride to the OR. I was awake and alert for the bed transfer. I saw the VERY long table with lots of hardware and equipment. The robot was not in the room yet...

I was awake as they positioned me for the spinal and commented that I was not sure if I liked being "this awake" 😒

I do remember the injections for the spinal and then.....nothing😊

Next...I wake up in the recovery suite. I felt very good. My nurse, Paul, was wonderful. I was given diet ginger ale and water. Soon he brought me lunch which was a turkey sandwich, lorna doone cookies, apple and chips. I have a sweet tooth so I went for the cookies first - LOL! As I was eating, my husband came in and brought me my Pepsi Zero and also one of my favorite chocolate chip cookies. Soon, the pain was coming in and Paul brought me some medications. All going well.

As I was scheduled to go home, PT came in to get me waling. It was about 1:30PM and I had not urinated since the morning. PT walked me and I was doing well with this. I was taken to the rest room but nada. Despite turning on the water I just could not "go". PT waled me back to my cubby and I was able to sit in a chair rather than back to the bed. MY husband and I chatted and I continued to drink water - lots of water. We tried the bathroom again and again...nada. As I sat in the chair following this attempt I expressed to Paul that I had significant pain in my lower abdomen. He went to get the bladder scan to see what was happening.

As he did the scan, he got a look in his face. He showed me the bladder and reported that the scan was indicating 1500CC which was most likely less than what was present. He left and quickly returned with the Orthopedic PA right behind him. I was told that I was not going home and that they were placing an in-dwelling catheter due to the amount in my bladder. After the placement of the catheter my bladder was relived of 1700cc's. Holy crap!

Luckily, there was a room on the ortho floor for me and I was transferred to it. And double lucky, it was a negative pressure room so it was at the end of the hall, quiet and had and entry area to the actual room. SO quiet! My husband left so I could get settled in the room and have nursing do all the intake work. This went without incident. PT came and took me for a walk. They also provided me with some exercises to do in the bed.

I was staying ahead of the pain for the most part. I spoke to the nurse and we decided that she would bring oxy (5mg) and then a few hours later, Tylenol (650mg); this way we could stay ahead without waiting for me to call for meds. This worked well.

I was connected to HR and BP monitoring. I warned them to lower the HR bottom line as I tend to have a low resting HR. They set the alarm for 47. Well....very soon the alarm was ringing...46/45, etc. My BP was low as well. This was monitored throughout the night. A number of times my HR went into the higher 30's.  The night nurse took the BP cuff off during the night but not the HR one as the doctor wanted it continuously monitored.

At 6AM the catheter was removed. It was around this time that my knee screamed. WOW....the nerve block was wearing off and the pain was real. Of course this is normal. This is major surgery. For some reason I did not remember this pain from my first replacement. Funny how the mind works😮

I was able to use the bathroom within about 2.5 hours, which was good news. Now I just had to "time" future bathroom visit as I was not allowed to walk solo. The morning was going by quickly. The day PA came in and reported that she was not "happy" with how low my HR went. We talked about my fitness level and she still had concerns. A little while later the nurse came in with an IV bag and stated that the PA wanted to see if my HR would increase following this. After the bag there was a reading of 50 and the decision was made that I could go home. I have to say...I am pretty fit...however I also feel that a HR in the 30's is a bit too low. I will monitor this using my Active 4 watch and talk to my PCP in a future visit.

PT visit for another walk and using stairs and I was able to get dressed and ready to go.

Coming soon - Previous surgery memory loss and first days at home.....