Total Knee Replacement (TKR) Part 2 – What to expect in the hospital

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Ever watch The Texas Chainsaw Massacre?

Remember the part where the protagonists can hear the buzzing of a chainsaw behind sheets of plastic and they don’t know what’s happening but they know it’s nothing good?

Well let’s just say you should probably opt for the pre-med.  The pre-med is a drug or combination of drugs given prior to anaesthetic which also takes the edge off panic long enough to get you to your surgery.  Nobody wants a patient in a hospital gown, bare bum exposed to the breeze, running out of the building.

I opted for the pre-med and was wheeled to the waiting area outside theatre where my anaesthetic was delivered. I couldn’t wait. Beam me up pretty please Scotty.  Then I was wheeled into theatre on a trolley.  This meant I never got to see what lay beyond the rubber curtain where I could see hear the sound of a buzzsaw and banging.  A – lot – of  -banging.

What happens in theatre stays in theatre and I didn’t want to know.  I already knew that the knee would be pulled off and thrown into the bin. That the top of my tibia and bottom of my femur would be sawn off to rid it of the disease (Grade IV Osteoarthritis) and the fresh cut bone would accommodate the titanium knee.  The knee would be hammered into place on said tibia and femur and over time it would become part of the body.  My surgeon had told me that he would leave me the patella.  That was nice of him.

I didn’t watch any versions of the surgery on Youtube because I felt I would psych myself out.  All I remember was the sound of banging and then being woken up in the recovery room. There was no pain.  An anaesthetic injection is generally delivered to the knee during the procedure and it will last some time. The knee will covered with an ice pack to reduce swelling. Even though I was groggy it felt good to be alive. I had just survived a major procedure.

The physiotherapists came round shortly after surgery and within two hours I was walking with a zimmer frame.  This was to keep the blood pumping through the legs and to avoid any potential issues such as clotting and the related danger of blood clots breaking off and travelling to the lungs. This had happened to me when I’d had my meniscus removed and can be life threatening.

I can honestly say that except for a few fleeting minutes on the first night, I felt no pain. Discomfort yes, tension in the knee yes, difficulty going to the loo yes, but actual pain no. A cocktail of drugs is provided including the slow release Targin and the fast release Endone – both are narcotics and you will be taking them for about 3 weeks to a month post op.  After three weeks I ditched all drugs and went on to Panadol.  I felt I could manage on my own.

Scar tissue is not your friend and doctors will want  you to stay on the drugs to quickly get into your rehab program so as to prevent the buildup of scar tissue. Like the very next day. This is not a recovery that allows for passengers.  Not understanding the swift buildup of scar tissue was my first big mistake.  I will cover this in the next few posts.

I’d packed my computer, colouring books, and reading books and was settling in for a long stay. I enjoyed being waited on hand and foot and the free wine at dinner (yes even on Endone) and I was in no rush to get back to my life where my shattered business and related financial problems were waiting for me.

In the end I only stayed one night.  After showing off by walking down the passage with one crutch instead of two and climbing up and down their small flight of fake stairs (the litmus test before they will release you back into the wild) the surgeon thought I was old and ugly enough to cope on my own and discharged me.

Goodbye nice snuggly bed.  Goodbye not having to think about anything.  Goodbye to narcotic induced oblivion.  Back to the real world.

Hello rehab!

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