So it was about 24 hours after the surgery, and it was obvious that my pain was not anywhere near where it should be to go home. My life was still parsed into 6 minute intervals.
I was talking to one of the nurses and she told me that of the 12 ACI patients she had seen since Dr. Trice started bringing them to that wing to recover, only one had gone home the next day. She also observed that ACI seemed to be, on average, one of the most painful of the different types of joint surgeries admitted in that wing. Knee replacements even seemed easier on the patient, though they are far more intrusive. This is consistent with what I had read, but still interesting to hear from someone who sees it every day.
The goal was to take me off the morphine pump in the morning, but my pain level was still too high as the night progressed. Once more, they increased my pain meds during the night so I would have a chance at being ready in the morning. Then I finally fell asleep.
Friday, April 2, 2010
Thursday, April 1, 2010
Pictures and Tools
At this point, I have a few more pictures to share. First is the incision itself (GR 4), which is a lot easier for me to look at than others since I know it doesn't hurt that much. I haven't measured it, but this picture (GR 4) kind of shows the scale.
I have three significant tools to assist in my recovery. The first is the CPM machine that I mentioned earlier and will discuss extensively later. It occurs to me that others might benefit from guidance on proper positioning so they get off to a better start than I did.
The second tool is my Iceman (GR 1). This flat pad is connected to two tubes that then connect to a small cooler (GR 1). The cooler is full of ice water. The water is run from the cooler through one tube, through the pad, and then back through the other tube to the cooler. A dial (GR 1) on the tubes allows me to adjust the flow to make the pad cooler or warmer. A thermometer (GR 1) on the tube indicates the temperature of the pad. This thing is awesome because a cooler full of ice lasts about eight hours and because too cold is as bad on a joint as too warm. It makes the joint stiff.
The last significant tool is my brace (GR 1). The goal for the first 8 weeks is to increase range of motion and protect the knee, both goals that the brace helps with. It has to be locked whenever I am moving and also when I am sleeping. It unlocks and provides enough freedom of movement to comfortably use the CPM up to about 70 degrees.
Additionally, now that I am home, I also have my recovery cat (GR 1 - it's a cat!).
I have three significant tools to assist in my recovery. The first is the CPM machine that I mentioned earlier and will discuss extensively later. It occurs to me that others might benefit from guidance on proper positioning so they get off to a better start than I did.
The second tool is my Iceman (GR 1). This flat pad is connected to two tubes that then connect to a small cooler (GR 1). The cooler is full of ice water. The water is run from the cooler through one tube, through the pad, and then back through the other tube to the cooler. A dial (GR 1) on the tubes allows me to adjust the flow to make the pad cooler or warmer. A thermometer (GR 1) on the tube indicates the temperature of the pad. This thing is awesome because a cooler full of ice lasts about eight hours and because too cold is as bad on a joint as too warm. It makes the joint stiff.
The last significant tool is my brace (GR 1). The goal for the first 8 weeks is to increase range of motion and protect the knee, both goals that the brace helps with. It has to be locked whenever I am moving and also when I am sleeping. It unlocks and provides enough freedom of movement to comfortably use the CPM up to about 70 degrees.
Additionally, now that I am home, I also have my recovery cat (GR 1 - it's a cat!).
The Next Day
I continued on the CPM machine on a schedule of 2 hours on and 4 hours off. At 4:00 AM someone drew blood. At 9:00 AM a physical therapist and an occupational therapist came in and showed me how to use a leg lifter and get into a chair. Unfortunately I was too light-headed to crutch around. This was a disappointment in two ways. First, I was hoping to only have to spend one night in the hospital. Second, they had already removed the catheter that morning and I wasn't able to get to the bathroom. (By the way, I had no idea I had a catheter in until morning. I couldn't feel it.)
After several IV bags of fluid, I had to go! I tried the bedpan but that was unpleasant. When I protested that I didn't want to use it, they informed me that there was another option. Woohoo! The bedpan can be placed in a portable frame that can be placed next next to the bed. Getting to it is no harder than getting to a chair. I mention this because others should know they can ask for the portable commode.
I had a few more pain spikes during the day, but nothing as bad as the first night. My pain averaged about an 8 all day and I was very aware of how long six minutes took to pass so my morphine pump would work again. Clearly I was not going home that day.
After several IV bags of fluid, I had to go! I tried the bedpan but that was unpleasant. When I protested that I didn't want to use it, they informed me that there was another option. Woohoo! The bedpan can be placed in a portable frame that can be placed next next to the bed. Getting to it is no harder than getting to a chair. I mention this because others should know they can ask for the portable commode.
I had a few more pain spikes during the day, but nothing as bad as the first night. My pain averaged about an 8 all day and I was very aware of how long six minutes took to pass so my morphine pump would work again. Clearly I was not going home that day.
Wednesday, March 31, 2010
First Night
Before blissfully allowing me alone to sleep, I was informed that I had to start using the CPM machine at 11:00 that night. Just before 11:00, my husband rejoined me in the private room to help me through that first night. He brought movies. :)
Getting into the CPM was okay, but it was somewhat painful. I kept pushing it away from me to try to get more comfortable but that only made the position worse. It especially hurt when fully straightened. As wonderful as the nurses were, I don't think they were confident in CPM positioning so they kept letting me make it worse. I finally found a fairly comfortable position, though it was very incorrect, and got through those first two hours.
This is where the night got interesting. The nurse and technician got me out of the CPM machine and allowed my leg to rest straight in the bed. I don't know if was the bad positioning of the CPM or if was just the effect of movement, but I was quickly overwhelmed by a level of pain which I had never experienced nor imagined. The best way I can describe it is that my brain whited out. I wasn't aware of anything but the pain and when I did remember to breathe, it came out as hyperventilating. The worst was that writhing made me move my leg which started fresh waves of pain. I didn't know that level of pain existed.
At any rate, they increased my pain medication and eventually I was able to regain myself and rest.
Getting into the CPM was okay, but it was somewhat painful. I kept pushing it away from me to try to get more comfortable but that only made the position worse. It especially hurt when fully straightened. As wonderful as the nurses were, I don't think they were confident in CPM positioning so they kept letting me make it worse. I finally found a fairly comfortable position, though it was very incorrect, and got through those first two hours.
This is where the night got interesting. The nurse and technician got me out of the CPM machine and allowed my leg to rest straight in the bed. I don't know if was the bad positioning of the CPM or if was just the effect of movement, but I was quickly overwhelmed by a level of pain which I had never experienced nor imagined. The best way I can describe it is that my brain whited out. I wasn't aware of anything but the pain and when I did remember to breathe, it came out as hyperventilating. The worst was that writhing made me move my leg which started fresh waves of pain. I didn't know that level of pain existed.
At any rate, they increased my pain medication and eventually I was able to regain myself and rest.
Another Perspective
Writing about the day of the surgery is strange. I read back over it and don't feel like I have actually said anything. I slept through most of the major events! In that spirit, I asked my husband to relay part of the day himself. Here is his account of a highlight: meeting with Dr. Trice after the waiting was over.
Family Waiting Room
Although Dr. Trice, Allison’s surgeon, had scheduled for eight hours, the surgery ‘only’ took about four and a half. At around 3:30, Dr. Trice came into the waiting room and found our two families (Allison’s mother and both my parents had come to visit) waiting for any news. Even through one of the many assistant nurses had called a few times during the procedure to keep me informed of her progress, I was looking forward to hearing from him. He looked understandably tired, and even though I expected it, my attention kept getting drawn to the small splatters of red that stood out against the green surgical scrubs.
After meeting the family, he explained how he found the condition of the cartilage and generally what the gist of the procedure was. He produced two pages of pictures, the first a series of four images (1 2 3 4 Warning: GR 5 for all of them) outlining the current damaged area. In these he pointed out that the surgical probe was able to easily puncture the cartilage; it looked like the consistency of curdled milk. The second page was a series of four images (1 2 3 4 Warning: GR 5) outlining the steps taken in the procedure. These pictures were the most striking, and he explained that he was able to clean out the impacted area, and implant the cultured cartilage under a thin membrane of organic material. From my obviously untrained eye, the remaining tissue looked a great deal healthier than the damaged cartilage.
Additionally, Dr. Trice shared with us a series of images from what I assumed was a successful procedure. In these, a picture stunningly similar to Allison’s damaged area was compared to the same knee after the patch had dissolved. The new cartilage was silky smooth, like an overly polished piece of pure white marble. He reminded me again that this procedure had a 70 percent chance of success, so nothing is guaranteed. Although, when compared to the option of having done nothing, I will take a 70 percent increased chance of getting a result like that. Dr. Trice wrapped up by saying Allison was coming out of the anesthetic well, and that it would be a few hours until they moved her into her room.
Monday, March 29, 2010
Details
So obviously it has been a few crazy days. I will try to relay as much as I can, but it will take several entries.
Surgery Day
My husband and I got up early and got to the hospital on time. I had to wait for about an hour as they had a full schedule and there was more than enough time allotted for my preparation. I cooled my heels in the family waiting room and got to see where my husband and mother would be waiting. It was a nice room with a monitor that provided updates on patients by their numbers. The room had a view of the Baltimore harbor and you could actually see the USS Comfort docked out there.
At 9:30 they called me back and I changed into a hospital gown. Soon a series of people started streaming in asking the standard questions about any complicating factors. Dr. Trice came by and signed the correct leg for surgery. He asked if I had any questions, but the way he looked at me I could tell he knew we had been through everything and there was just nothing left to discuss. This was it.
The operating room had been booked for eight hours. While we knew it would be a while, that was still a shockingly long time. My husband and mother would be given updates from inside the operating room every few hours and they could leave the waiting room (or hospital) and still get updates as long as they left cell phone numbers.
The surgery was scheduled for 11:00 and we headed back there just a few minutes after. When the operating room doors opened the first thing I saw was the smile of Holly, Dr. Trice’s surgical nurse who I had spoken with at every appointment leading up to this. She knew how glad I was to finally be there. I am not sure how often patients are that happy about surgery.
They moved me over from the pre-op bed to the operating table, which was very narrow. They swung in arm rests with foam egg crate padding and began strapping me down. They put a mask over my face and told me to breathe deep. I went out like a light.
After
Things went smoothly and they were able to finish in 4 ½ hours. I woke up in the recovery room in a more comfortable bed and in some pain. I actually came out of the anesthesia much smoother than I expected. I read a lot about others having nerve blocks, but I don’t think they did that with me. My painkiller was in my IV and I had a morphine pump that I could use once every six minutes.
The recovery room is basically where they take you to wake up. Family isn’t allowed in there and I don’t really remember much, so this part is hard to write about. About all I remember is that the recovery nurse did notice my pretty toes and got a kick out of them. :)
When I was clearly stable they took me to my room in the Wenz Orthopedic Wing and brought my husband and mother up to join me. The room was gorgeous! It was big, had hard wood floors, a few chairs, and a sofa that folded out into a bed. It looked like they hired the same designers that Westin uses. I saw all this in the morning though, because my eyes were closed. I was alert, but just had no interest in opening my eyes. After seeing me get settled in, my family left since all I wanted to do was sleep. I got right to that.
Surgery Day
My husband and I got up early and got to the hospital on time. I had to wait for about an hour as they had a full schedule and there was more than enough time allotted for my preparation. I cooled my heels in the family waiting room and got to see where my husband and mother would be waiting. It was a nice room with a monitor that provided updates on patients by their numbers. The room had a view of the Baltimore harbor and you could actually see the USS Comfort docked out there.
At 9:30 they called me back and I changed into a hospital gown. Soon a series of people started streaming in asking the standard questions about any complicating factors. Dr. Trice came by and signed the correct leg for surgery. He asked if I had any questions, but the way he looked at me I could tell he knew we had been through everything and there was just nothing left to discuss. This was it.
The operating room had been booked for eight hours. While we knew it would be a while, that was still a shockingly long time. My husband and mother would be given updates from inside the operating room every few hours and they could leave the waiting room (or hospital) and still get updates as long as they left cell phone numbers.
The surgery was scheduled for 11:00 and we headed back there just a few minutes after. When the operating room doors opened the first thing I saw was the smile of Holly, Dr. Trice’s surgical nurse who I had spoken with at every appointment leading up to this. She knew how glad I was to finally be there. I am not sure how often patients are that happy about surgery.
They moved me over from the pre-op bed to the operating table, which was very narrow. They swung in arm rests with foam egg crate padding and began strapping me down. They put a mask over my face and told me to breathe deep. I went out like a light.
After
Things went smoothly and they were able to finish in 4 ½ hours. I woke up in the recovery room in a more comfortable bed and in some pain. I actually came out of the anesthesia much smoother than I expected. I read a lot about others having nerve blocks, but I don’t think they did that with me. My painkiller was in my IV and I had a morphine pump that I could use once every six minutes.
The recovery room is basically where they take you to wake up. Family isn’t allowed in there and I don’t really remember much, so this part is hard to write about. About all I remember is that the recovery nurse did notice my pretty toes and got a kick out of them. :)
When I was clearly stable they took me to my room in the Wenz Orthopedic Wing and brought my husband and mother up to join me. The room was gorgeous! It was big, had hard wood floors, a few chairs, and a sofa that folded out into a bed. It looked like they hired the same designers that Westin uses. I saw all this in the morning though, because my eyes were closed. I was alert, but just had no interest in opening my eyes. After seeing me get settled in, my family left since all I wanted to do was sleep. I got right to that.
Saturday, March 27, 2010
Home again, home again, jiggity-jig!
I just came home this afternoon and wanted to let everyone know I am doing fine! I will post more details tomorrow once I get some rest. Thanks for all your support!
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