Thursday 5 November 2020



Photos of the clips below... (in case you're squeamish!)
I really want to thank all of you for your prayers. The surgery on my first knee took place as planned, and, fingers crossed, everything seems to be progressing satisfactorily.

My operation was scheduled for the Friday morning, and I was collected by ambulance at 4:45am in order to arrive in Hastings for admission at 7am. I drew the short straw, though, in finding myself having my operation after lunch - I know someone has to go last, but being nil by mouth all morning is a trial, especially for a coffee addict such as me.

I was expecting to have just the spinal anaesthetic, but actually had to have a general anaesthetic as well, which was a bit of a disappointment. I had been looking forward to hearing the operation progress even if I was unable to see anything. The anaesthetist thought he might have problems positioning the spinal block (due to my size) unless I was out cold, so I had to forego that little treat. Fortunately, given the advances in anaesthesia in the 28 years since my last major operation, the nausea, vomiting and (life-threatening) blood pressure problems I experienced back then were avoided, and I regained consciousness at about 5pm feeling reasonably chirpy.

Initially the pain in my left knee was more severe than it had been pre-operatively... that's not exactly earth-shattering news, and everyone had told me to expect that. But the liberal administration of painkillers post-operatively meant that my other leg was completely pain free for the first time in years, which was a blissful state of affairs. My first night was therefore restful, albeit short. Even with the drugs, it is difficult to sleep through all the monitoring of temperature, blood pressure, oxygen saturation and so on.

I was encouraged to take a few steps on the Saturday morning by the physiotherapists. Fortunately I'm adept at using crutches, and so was able to skip the zimmer frame. I proceeded to march off down the ward corridor, with the physios hovering at my side and telling me that I could stop as soon as I felt I'd done enough. The difference I could already feel inside the joint itself was staggering, and I was eager to see exactly how far I could go, so promptly practiced going up and down stairs as well (yes, dear reader, I was showing off!) After that, my non-operated-upon knee started to crunch and grind quite badly, and I realised that I still had one bad leg which needed to be treated carefully!! The physios declared that I was safe to go home as soon as I had been checked by the Occupational Health therapists.

Then the surgeon arrived, looking very pleased with himself. He told me that everything had gone really well, as far as he was concerned, and that he'd see me in six weeks or so. I commented on the difference I could feel already, and his reply was quite illuminating: he'd seen that I had absolutely no cartilage left in the knee joint, and the bones in my knee were grinding and crumbling away in a dreadful manner. His comment was that it wasn't surprising that I'd been in so much pain, nor that the post-op pain had been relatively mild in comparison. If I made good post-operative progress, he would be happy to discuss putting me on the waiting list for the second knee replacement at the follow-up.

All of this was ever so encouraging, and I rather expected to be seen by OT that morning as well, and possibly even to go home on Sunday. Ordinarily this would have been the case. However, due to Coronavirus-precautions in place in the hospital, and because my part of the ward was a secure Covid19-free area, staff who visited other parts of the hospital were not allowed to come on to the ward after doing anything else. I realised that I wouldn't be assessed until Monday morning, and so going home before then wasn't going to be possible.

On Monday, it seemed that there were problems. I had provided the measurements requested by OT two weeks earlier, but it seemed that the height of my bed was rather low. The hospital beds didn't go down to the required height, and so they couldn't check whether I could get up off the bed unaided. There was one bed in the whole hospital which was the correct height to allow me to have a go, but it was in a non-Covid-secure area. If I was taken off the ward, I wouldn't be allowed back in without having to be isolated in a side room and given another Covid swab test...

Eventually, by late afternoon, they worked out that, since no-one had used the room concerned that day, I was unlikely to contract Covid19 if they allowed me to go in. I was therefore quite hopeful that I could go home later in the evening. Alas, we all know what happens to the best-laid plans of mice and men... it turned out that I couldn't get up off the bed. I was able to walk around, stairs were no obstacle, and I was pretty nifty on my feet... only getting to my feet off the rather low bed I had at home was simply impossible with my newly-stitched-up and not-very-flexible knee joint!

I had had no idea that my bed was anything especially low when I'd purchased it, and it wasn't a futon or something like that. I had assumed most beds (excepting divans or orthopaedic beds) were a standard height. Apparently not. There I was, sitting on the edge of the bed, telling myself to stand up and absolutely nothing was happening.

The Occupational Therapists explained that they would normally get in touch with their works' department, and raisers could be installed to lift the bed (and an armchair, which was a similar height to the bed), however, given that I lived within a different Health Authority Trust, the mechanics of organising such alterations could get tricky. Fortunately I had a friend with a spare key who was willing to supervise any work done, but no-one had any idea when that would happen...

Finally, on Wednesday morning, I was told that the work had been done. Patient transport had been booked, and I was instructed to be ready to go from 1:30pm. I did so, but was extremely dubious about the ward matron's assurance that I'd be out just after lunch... since the booking had only been confirmed that morning, I was almost certain I'd be slotted in after people had been brought home from afternoon appointments. Sure enough, at 7:30pm, just when I was beginning to wonder if I might actually be in for a final night, the ambulance arrived. I finally arrived home at 10pm.

Miaowrini lived up to her name, and greeted me with much miaowing. I think she had missed me; she had certainly been upset by the strangers who'd invaded her territory and raised the height of the bed. Miaowrini has a slightly stiff back leg (following her own knee reconstruction surgery seven or so years ago) and she wasn't able to jump up onto the raised bed quite as easily as before. She proceeded to pace around me, yowling continuously, until I had completely unpacked my travel bag and returned it to its usual location. As soon as it was obvious that I was staying, the cat stopped yowling. She's been a bit clingy ever since, curling up on the bed next to me every night, and sometimes I've really had to shove her off my knee, because she's surprisingly heavy.

Gradually, my left knee is getting stronger. It aches, but this is a soft-tissue ache due to being cut open, ripped apart and clipped back together. The grinding, catching pain from the bones has completely gone, and, with exercise, the range of movement of my knee will definitely improve. It is therefore less painful than it was pre-operatively, and actually less painful than the other knee. A friend who popped around for coffee observed that my movements on getting up from the armchair were a lot smoother than they were before the operation, which I find encouraging. It's sometimes hard to recognise progress when you're living with something for a long time.

Today I went to my GP's surgery so that the nurse could remove the surgical clips. I assumed it would hurt (especially due to the nerve hypersensitivity I have in that leg, a condition which used to be called reflex sympathetic dystrophy but which is now classed as complex regional pain syndrome.) Once again, it wasn't as bad as I'd been led to believe, but it did feel distinctly odd. I'd taken a dose of liquid morphine from the supply I'd been given on leaving hospital (for breakthrough pain) and so had the edge taken off it, and I also decided that distraction might be a good move. So, for those of you who are interested, I took photos...

First of all, here are the clips in situ... (I took the photo with my foot on the floor, with the knee slightly bent, as this was the position the nurse was happiest working at - I'd assumed she'd have wanted me up on the couch, for ease of access! She told me the clips actually came out more easily this way. I wasn't going to argue.)

And, here I am once the clips (all 39 of them) were removed...

There was a little bleeding from the clips site, so I've got an adhesive dressing over the top for a few days, to let it all settle. 

If you could spare a prayer or two that I continue to make good progress, I'd be very grateful.
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