Another New Tin Lizzie Knee

Today is my daughter and son-in-law’s first wedding anniversary. They went to Chicago for the weekend and went to see a Chicago Cubs baseball game. Hope the Cubs won. Don’t want them in a bad mood on their special trip.

I now have my second tin lizzie knee. It’s been just a couple months since my right knee replacement surgery and my doc changed how he does things. The pain control protocol changed. Now he gives 3 pain meds before the anesthesiologist gives you the spinal block and sleepy stuff. The more numb the better in my book.

After the trip through the chop shop and a short tour through the recovery room, you wind up in your hospital room. Staying in a hospital room now is like a visit to the spa and hospitals are borrowing some concepts and terms from the land of hotels. First, you get a private room – at least in orthopedics. This is great – better rest and recovery and fewer germs. The hospital has WIFI and encourages you to bring your laptop and Blackberry. There are no defined visitor hours and the room has a couch that doubles as a bed, allowing for overnight guests.

On day one, my leg was immobilized. I had lots of padding from my toes to mid-thigh and was wrapped in an athletic wrap that might have been able to stretch to Cincinnati if unwound. Hey, who knows - the world’s biggest rubber band ball might have been started by an orthopedic surgeon. My new titanium parts and padding were in a big blue immobilizing sling held in place with lots of Velcro. I think back in the doctor’s lounge that orthopedic surgeons compare notes on how much Velcro and athletic wrap is used in a day, reminiscent of fishermen telling fish stories, or any kind of guy fest where power tools are discussed.

I wonder if the athletic wrap for the hospital is delivered in 18 wheeler trucks and comes on large rolls like carpeting. It’s possible that it comes on spools the size of water towers for small towns. Of course, another option is that it is delivered on flat bed trucks and comes in a giant ball that would fill the Hoover Dam Reservoir. All of these options would require several burly guys, a crane, or possibly a forklift to haul it in.

Day one is great. You are slightly groggy and very numb. The spinal block evaporates your memory of your body from the waist down. It’s a bit like being half invisible. Invisible is good since you are also wearing a hospital gown with a peek show in back.

On day two, the Velcro sling comes off and they put you on a continuous motion machine twice a day. This is to keep your leg moving and the new knee bending. This is the day that the spinal block wears off. As sensation returns, it’s a bit like landing on an alien planet with a familiar landscape. “Houston, we are being contacted by hostile forces. We are under siege by a tribe of nerve endings on Planet Knee Cap. Our shields are failing.” Body parts, it turns out have a long memory and hold a grudge.

During this stay, however, I had a couple of melt downs. My husband, Pat, came to visit after work and was sleeping on a couch. It was irritating. Don’t know why – just was. Also, I had zero appetitive and some well meaning tray toter from “host services” (which is basically a cart pushed by a worker who fills your water pitcher) would not shut up. She asked me if I had ordered dinner. I hadn’t. You see, they have ‘room service” in hospital rooms now and you can order food from 6:30 AM to 7 PM. It was only 5 and I wasn’t hungry. I also wasn’t feeling talkative.

So, rather than just leave me alone, the wonder woman of the water cart decided she had to convince me to order dinner. She did this by saying inane things like “I’m a good mom’ and “I love my job”. For my part, I thought I was pretty clear. I used body language. I put my hand over my eyes and said “I am not hungry and I don’t want to talk.” Simple yet to the point. When this didn’t work, I finally lost it. Since I couldn’t heave a bed pan or crutch at her I burst into tears and ordered her and Pat out of my room. This apparently led both of them to find my nurse and suggest that I was in too much pain. Yah think?

Knee surgery is followed by a whole regimen for controlling blood clots. First, they take you off all medication that thins your blood – like my hormone patch, the lack of which may have contributed to the melt downs, and one of my arthritis meds that really helps control the arthritis and pain.

After eliminating things that might thin your blood, they give you blood thinners. If this is making sense to anyone, you might be a great candidate for medical school. Start making a rubber band ball and save Velcro now. Blood thinners come in pill form but I was fortunate enough to get liquid stuff injected though wicked little needles into my stomach twice a day. The first shot left a palm size black and blue bruise on the left side of my tummy that is still looking mighty angry and very sensitive to touch.

Back to the melt down. When the nurse came in to see me, her first line of interrogation was about ordering dinner. I tell you. These people are evil. I realized how helpless I was against them. About the only thing I could do was push the nurse call button. I wasn’t mobile. I couldn’t reach the walker or the crutches and I couldn’t get out of bed by myself. I decided that if I did order food, I would have something to throw. So I went through the menu and ordered stuff that was hot and liquid and would spatter, or came in large heavy bowls that would be good for discus throwing.

When the food came – what luck – the same tray toter brought it in, the pitcher pourer who pedals information about being a good mom and loving her job. I decided the next best thing was to fake sleep until their shift was over. After all, they all had to leave sometime. The next day was better although my doc did come in my room with a very serious look on his face – so who knows what they wrote in my chart. Good thing they didn’t know what I was thinking and that I never acted out any of my evil plans.

Another blood clot prevention thing they do is to slap your feet in the puffer booties. These things fit on your feet like Velcro sandals. They are hooked to a machine that fills them up with air every minute. The concept is a bit like a boa constrictor wrapped around its prey. As the air goes in, the puffer booties squeeze your feet. It helps keep blood circulating through your legs. It also makes it a little hard to sleep with a wheezing thing going off and squeezing your feet every minute. It does tend to push you up in the bed so it’s a bit like being rocked by an asthmatic robot.

I did have an IV in my hand. They put antibiotics in my IV and saline in my IV. I also got my shots in my IV, except for the ones in the stomach. The problem with IVs in your hand, when you need to use a walker or crutches, is that your hand bends and “compromises” the IV. The end result is that your hand swells up like a football. So, I had to have my IV changed. I started out with it in my left hand, since I’m right handed and I planned on doing some writing while in the hospital. But, they had to move the IV to my right hand. But no luck, the first poke went through my vein. I had Nurse very nice and I have pretty decent veins. But she wasn’t having success in the second spot. So, Nurse very nice called in another nurse. I was surrounded by women in white with needles. They went for a third unsuccessful spot in my right arm and then called in Nurse Janet.

Nurse Janet is Queen Mother of IVs. She still wears a nurse hat, which I thought was pretty cool. Nurse Janet went back to my left arm, talked to me and voila! The IV was placed. She put it half way between my wrist and my elbow – where getting in and out of bed and using a walker or crutches wasn’t going to affect it. I can’t even tell where Nurse Janet poked me. She left absolutely no trace. Having the IV in that location worked great. As a matter of fact, that’s where it should start out from the first poke back in the pre-operating area.

Most of the days I had Nurse Nimble. She is super nice, Asian and tiny. I don’t remember what she was doing, but I was sitting in a chair. She was helping me with something and wound up having to duck under my bedside tray. On day three I was able to lose the bulky bandages from surgery that were wrapped around my leg and knee. I graduated to some funky compression stockings that are basically an elastic tube. They are part of a pilot the hospital is doing to see if they work better at reducing swelling, etc., than other compression stockings.

The one for my non surgical leg went on peacefully. The one for my other leg was a bit of a bad boy. First, my surgical leg was puffy and stiff. It took 3 of us to get that thing on my leg. Nurse Nimble actually had to climb on my bed and tackle it at one point. I was holding bandages in place while Nurse Nimble and the surgical stocking swami wrestled with it. At that point, the pain pills were working just fine and I was copasetic.

Now that I’ve been wearing several days and am home, the stocking has been subdued but is still misbehaving. It is supposed to stay in place and keep my bandage over the staples that cover my new tin lizzie knee. But both ends of it like to roll. So, at one end I have a swollen foot with little fat sausage toes sticking out. At the other end my scar and staples peek out over the top of the non-cooperative and defiant flesh tube.

But, I did do well enough to get out of the hospital a day earlier than last time and I’m fairly mobile right now. I have less pain with this surgery and less swelling. So, all things considered, it was a success.