Archive for the ‘health’ Category

These are quotations from the medical team after my bi-lateral knee replacement.

Day of surgery “You’ll feel a lot better tomorrow”

Day after surgery “Today is the worst day, you’ll feel a lot better tomorrow”

Two days after surgery “You’ll feel a lot better when you go home”

Day I went home “You’ll feel a lot better in a week when you see the physio”

Day I saw the physio “You’ll feel a lot better at your 6 week consultation”

At 6 week consultation “We’ll see you in a year, you’ll feel the benefit by then”

The trick is to believe them implicitly every time.



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Some of the things I hadn’t thought about before the op and nobody told me were:

you have to get out of bed the day after surgery, and move around, you may faint but that is nothing to worry about apparently (I fainted 3 times in a row and I confess I did not enjoy the experience, turned out one of the painkillers was to blame);
my feet were in compression bootees which work on a pump to stimulate circulation, that meant I was tethered in my bed and couldn’t change position, a great incentive to get mobile so you can get rid of the darn things;
I had to wear compression socks all the time, except in the shower, for 4 weeks ;
you can’t just hop out of bed to go to the loo;
I was on a drip for antibiotics for the first day;
I can’t wee on command or if people are watching and waiting, but you have to wee to avoid infection etc.,
it gets lonely in hospital.

Before the operation I had very much taken the view that I didn’t want to know too much about the actual operation. What I believed I needed to concentrate on was recovery. Especially as every member of the medical profession I had spoken to before the operation had said “Bi-lateral, ooh, you’re brave”. Which I am not, but I had taken the hint that recovery would take some work on my part, and more than if I only had one done at a time.

The physio had also prepared me for this. Not only would both legs be hugely bruised, but I wouldn’t gave a good leg to stand on so to speak. This meant I would not be able to bend either leg initially so everything between prone and upright required arm power. To see what that’s like, try lying down on a bed, then get up without bending your legs at all. Even worse, try sitting down on the loo without bending your legs, then try standing up. Fun times. I perfected a technique of gently sliding my legs out in front of me as I lowered myself down, then levering myself up with my forearms. As the physio said “push your backside out and your nose up and forward, like a baby bird taking flight”. I don’t think I looked as cute as a baby bird but I did squawk occasionally! I also got stuck a couple of times and had to ask for help.

The second day after the operation (or Day 3 as they called it) I was using a walking frame. I had a sit down shower, (my bandages had come off and the new dressings were waterproof), washed my hair and cleaned my teeth. I even managed to dress myself. I was able to sit in a chair and felt much better for it. The physio came and gave me my first set of exercises, including bending my knees and raising my legs a few times each. I knew that I had to get as much bend as possible as soon as I could, because the movement you get in the first few weeks or so is what you keep,it is really hard to improve after that. As everybody told me “do what the physio tells you, exercise is more important than walking because walking will come back naturally”. Good advice. The most frightening part of the day was having to go and have x-rays of both knees, standing with my knees pressed flat to the plate as well as sitting with them bent. We managed it without any more fainting though. The funniest was hearing the nurses telling male patients who wouldn’t even try to walk to stop whinging because “the lady in the side ward has had both knees done and she’s walking” then seeing some bloke hobbling past my door in a determined way.

Day 4 I lost the bootees at last, my exercises were increased, I moved on to crutches, and was able to get myself up to go to the loo in the night. I had to drink so much water I felt I was going to burst. The pain was pretty bad, but actually less than I feared and no worse than a really bad day had been before the operation. A couple of nurses seemed to think I should be able to go home, but to do that I had to prove I could do stairs ok. That was a very daunting thought as yet again I had no “good leg to heaven bad leg to hell” option for up and down the stairs. The physio said we would try that the next day. As you can imagine, I didn’t sleep well.

The next day arrived, as did the physio. I had expected a short flight of test stairs in the exercise room. No chance! The test is on the stairs from the ground floor to the first floor. They looked like the ones in Labyrinth to me! I considered just throwing myself down them but I managed them, by dint of putting my weight on the banister and my crutch. The physio said she was happy for me to go home the next day (Day 6 ). I was over the moon.

On Day 6 I asked when I could go home. The nurse checked my wounds and one of them was leaking. She said she wasn’t happy for me to go. I could discharge myself, but that meant I was going against advice. So I stayed. That was my lowest day. I had tried so hard and I still might have got an infection. I cried a lot that day. I didn’t want to, I just couldn’t help it.

The next morning the same nurse collared the registrar to check my wounds. He was happy and let me go home. Now came the next surprise. How to get into the car without bending my legs? We considered sliding me in through the hatchback like a plank of wood, but eventually I worked it out. I had to back up to the passenger door, lower myself onto the seat sideways on, then use the grab handle to manoeuvre myself back until I could swing my legs in with minimal bend. At the other end I “just” had to reverse the process. I was home.

I had been given some aids to help me, including raised toilet seats which were great for me, but not so good for my husband as they are very high and can’t be lifted up. Fortunately we have 2 loos so we went for His and Hers. Stairs, showering, a normal bed and coping with the dog frightened me a bit, changing the dressings scared us both. All unnecessary worries when it came down to it.

Ten days after the operation I had to go to our GP surgery so the nurse could remove my staples. This stung a bit but was ok, she was brilliant and very calming. One dressing was removed at this point as the wound was doing really well. The problem wound was still leaking a bit, so she checked with one of the GPs who prescribed massive doses of antibiotics to be on the safe side. Within 2 days I had a horrible heat rash, or it could have been a reaction to the penicillin. I was prescribed a cream and antihistamine tablets which helped a lot.

Two weeks after the operation I had my first physio appointment. He couldn’t do anything because that dratted leaking hadn’t stopped. Swabs were taken just in case of infection, but they were clear. So I just had to wait. I did carry on with the exercises I was given in hospital though. After another four days the nurse and I held our breath as she removed my dressing. Then we both cheered because everything was healing at last.

This meant I could go back to physio. I had my crutches replaced by sticks and a new set of tougher exercises. After a week the physio assessed how I was doing. He said to reduce my reliance on the sticks gradually, to carry on with the exercises and go back in another week. That week saw the improvements really start. I could walk unaided in the house, including up and down stairs, I was sleeping better, and I was reducing my painkillers, and the rash had gone. At my next appointment the physio asked me to kick his hand. I did. It hurt him. He said “well! I asked for that” then sent me away to carry on as I had been until after my 6 week check up with the consultant.

I was very nervous before my 6 week appointment, and I didn’t know what to expect. As it turned out, I saw the registrar. He was really pleased, especially when he realised the bend in my knees through 125degrees. He told me I could start driving again, should wean myself off my stick, keep up the exercises, go for walks and consider a phased return to work after another week. Then he said he will see me in a year. By which time he said I will be feeling the benefit.

I know there is still a long way to go. I get aches, pains and twinges in muscles and tendons, I don’t sleep brilliantly, the outside of my knees will always be numb, and I don’t yet walk “fluidly”. But I can use the stairs now, stand up and sit down unaided, have got rid of that high loo seat and rarely take painkillers. So in some ways I am already feeling the benefit. I just have to get back on the motorbike ….

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This is not a medical post, it is just my experience and not necessarily the same as anybody else’s.

About 15 years ago I was diagnosed with severe osteoarthritis in my right knee. My excellent and caring GP referred me to a consultant who suggested an arthroscopy to tidy up the joint and assess the damage. The procedure was done as day surgery. I confess my confidence in the hospital and consultant was somewhat damaged because:

they forgot to call me through for my pre-med until I eventually asked why I was still in the waiting room after everybody else had gone, then I was rushed through as if it was my fault;
after surgery the consultant came to the ward, walked up to the lady in the next bed with a heavily bandaged elbow and said “I am sorry Mrs. Wrathall, there is nothing we can do for your knee”, she suggested he speak to me, the one with the heavily bandaged knee;
I was sent home with painkillers which are unsuitable for asthmatics, despite them being aware I had asthma and I had specifically asked if they were ok.

I went to my follow up appointment and was told I would have to have a full knee replacement. By then I had done research of my own and asked for a second opinion. The second consultant was great. He was frank, clear and interested. His advice was to wait as long as possible because replacements eventually need replacing, and techniques etc. were improving all the time. The fewer surgeries I had the better. He also said I would know when the time was right.

Then a few years ago my left knee started to deteriorate. I reached the stage where I couldn’t climb stairs, I needed a stick, I couldn’t stand for any length of time and, worst of all, I couldn’t get on the motorbike. I believed the time had come.

I now live in a completely different area, so a new hospital, consultants and GP. My GP was brilliant. He immediately asked which hospital I wanted. I had already done some research using http://njrsurgeonhospitalprofile.org.uk/ so I was able to make the choice. I was surprised to be referred and given an appointment there and then.

The first consultant I met discussed all the options with me, including having both knees done at the same time (bi-lateral knee replacement). I was very impressed when he said he thought that, as I might be suitable for bi-lateral, he wanted to refer me to a colleague who was more experienced in knee surgery. I got back onto http://njrsurgeonhospitalprofile.org.uk/ and found out the new consultant had his own website all about knee replacement. My librarian side took over and I found myself evaluating it for relevance, currency etc. It gave me more confidence going into my consultation.

Once again, he was very frank. He said bi-lateral was definitely an option because I am young and fit enough (much to my surprise) to do well, but it is not an easy option. I know how scared I am of hospital, so I doubted I would go back for a second surgery after the first. After discussing the pros and cons with myself and my husband the consultant said he was happy to go ahead. I asked him the best way to prepare and he suggested I have a physio appointment to discuss options.

I really recommend this, as he gave me a clear understanding of the difficulties I would face with no “good” leg to rely on. He gave me exercises to strengthen my legs and my upper body as I would rely on my arms to move around. I am very glad I listened to him and did my exercises twice a day.

I had two outpatient appointments prior to surgery. The first was to take bloods, swab for MRSA etc., take blood pressure readings and discuss any existing health problems. The second was to do final blood checks and type my blood “in case”. All the staff were happy to answer questions and talked me through what to expect. I was given literature as well so I could check anything I forgot. I was also told I could ring at any time if there was anything I wanted to ask.

The day of the surgery I was admitted at 07:30, and very quickly seen by the registrar and anaesthetist who again told me what to expect. I am terrified of hospitals and surgery so I was given a mild sedative to relax me. The surgery was done under sedative and spinal anaesthetic rather than a full anaesthetic. Be assured, this is not like it sounds, I had no idea of what was happening, or how much time was passing, just a lovely drowsy happy feeling. You know, unicorns, fairy dust and rainbows. After a short stay in recovery I was back on the ward being checked, given a drink and told to rest. The good thing about the spinal anaesthetic is that the effects wear off much more quickly and you very quickly feel better.

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