Knee Surgery – The Big Day Fast Approaches

It’s almost here. I have my right knee replaced this Wednesday (January 26, 2011). The left one follows one week later, February 2, 2011.

Suspected Scenerio

Tomorrow, Tuesday, I have to start my preparations for surgery. Actually, I began about a week ago when they had me stop taking NSAID anti-inflamitory medicines. These include aspirin, my arthritis tablets (Etodolac), and in the event of a gout attack, Indomethacin. They said it was ok to replace the etodolac with Arthritis-pain Tylenol.

On Tuesday I also stop taking my high-blood pressure medicines but continue to take Omeprazole for acid-reflux. In fact, they said that was probably something that was good to take because surgery can often lead to upset stomachs.

In the evening I’m not supposed to have anything salty or spicy to eat, which eliminates about 90% of our diet.

I have to wash my knee with Betadine soap. I think that’s that reddish orange stuff they put on to disinfect the area. Then I have to do it a second time the next morning. Both times I have to be extra careful to wash it all off because it can cause the skin to tighten up and itch.

The day of surgery I can take an Omeprazole but only with a very small sip of water. I can brush my teeth as long as I don’t swallow. Other than that, nothing to eat or drink.

I report to the Surgical Center at 9:00 in the morning. There are about three hours of preparations, much of which I suspect involves sitting around. Then at 12:00 Noon I go under the knife. The work will be done by Dr Jeffrey Nassif and his physician’s assistant, Patti Recker. You may remember Patti as the one who gave me the Synvisc injections in my knees over the last couple of years. The surgery itself takes about 2 hours with another hour in the recovery room. So I ought to be in my regular room sometime about 3:00 in the afternoon. I suspect I won’t be good for anything the rest of that night. They have threatened to have me out of bed, testing my new bionic knee later on the day of surgery. Thursday and Friday I start my therapy. I get out of the hospital on Friday afternoon if I meet all the criteria on my “Discharge Steps to Home” checklist.

Those requirements include:

– Eating regular food
– Making sure my digestive track is functioning normally (that’s the nice way to say it)
– Having normal vital signs
– Understanding my blood thinning medication
– Knowing how to take care of my incision
– Being done with the IV treatments
– Showing that I know what can and cannot be done after surgery
– Completing my “In-hospital occupational and physical therapy”
– Understanding my post-hospital therapy exercises and guidelines
– Having a caregiver for the first 2 or 3 days (this would be my own sweet Karen)
– Having my pain treatable by oral medication
– Making my follow-up appointments (doctor/lab/therapy)
– Getting the doctor’s discharge order
– Having discharge instructions reviewed and signed

I return one week later to have the other knee done. Once home, I have to continue therapy, both formally at the clinic and informally at home. I also have to self-administer blood thinners and as of now, it looks like it will involve hypodermic injections in my stomach. Ugh!

Recent Events

Once I decided to have the surgery done, it was a long time before anything happened. About 3 or 4 weeks ago, they sent me a packet of forms and informational materials to fill out and review.

Then a couple of weeks ago it was off to the surgeon’s. They started off by taking blood samples and a range of x-rays; both knees, from the front, back, side, and a curious one that was straight up my femur from the bottom. While they were being developed, Patti (see above) came into the exam room and reviewed all the forms with me. She put the x-rays up on the light board, all 8 of them and she had a devil of a time making them fit in the limited space. She was taking measurements with a fancy protractor type instrument and explaining what I was seeing. I am bone on bone on the inside of my knee but still have quite a bit of cartilage on the outsides. She said she suspected I was a little bow-legged because of it. I have never noticed that but the rest of you are probably saying, “Oh, that explains everything!” behind a chuckle into the back of your hand. It turns out one leg is 3 degrees out of plumb and the other one is 6 degrees.

She left to get the doctor and when she did, I jumped up quick as a bunny, whipped out my cell phone camera and took pictures of the x-rays. See here…

The doctor came in and said, “Hi. How are you doing? Do you have any questions?” Which I didn’t because Patti had answered all of them before he got there. Then said he would see me on the 26th and left.

Then it was off to the chest x-ray unit. The knee x-rays were the old film style that had to be developed but the chest x-ray was all digital and came up on a computer monitor. I wanted to get a picture of that too, but the technician was not co-operating so I missed out there.

My last stop was with the St Lukes “STAR” nurse, whatever that means. She went over the forms again but in a lot more depth and told me a whole lot of stuff about what was going to happen.

There was so much information you couldn’t keep track of it all and your eyes started rolling in the sockets. This whole business took 2 or 3 hours.

The next week I had two appointments. The first was in the morning with my family doctor, Paul Lottes. He gave me a quick physical exam to guarantee I was healthy enough to have the surgery.

In the afternoon I had to go to the St Lukes Surgery Center for a class and a slide show about my stay in the hospital. On the way out I passed a huge aquarium they had in the waiting room. One of the fish was a plecostomus, a bottom feeder that looks like it came straight from some prehistoric ocean. That reminded me of a time when Lance was just a little feller, maybe 5 or 6 years old. We had an aquarium too back then. We used to go to Hawkeye Seed all the time because of their huge tropical fish department. As Karen and I were looking at this fish and that fish, Lance was making his own way around the store and at one point from a couple of aisles away he yelled at the top of his lungs, “Jesus Christ, Dad, look at the size of this plecostomus!”

So, Jesus Christ, Lance, look at the size of THIS plecostomus!”