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Knee replacement surgery: my personal journey - the first 24 hours

27th July 2023 - 10.30 am

This was it. The day I'd been waiting for, anticipating, and if I am honest, apprehending for several months. I wasn't quite sure what to expect. I'd heard so many "horror" stories, even from friends about their own experience of arthroplasty of the knee (in other words, knee replacement). Most of their stories did nothing to reassure me, quite the opposite!

But here I was at the clinic, 30 minutes early (those of you who know me know how I hate being late!), suitcase, crutches and medical folder close to hand, waiting to be called up for admission into my room for the one night stay. I held the ticket with my number in my hand, gazing up at the screen in anticipation. My husband sat next to me, clearly even more nervous than me.

My knee problems had started many years earlier. In fact, the first signs of arthritis showed up on an x-ray when I was barely 20. Up until recently, I had managed to get by with hyarulonic acid injections every few years and continued to work out on a regular basis (with my surgeon's encouragement). But the last injections - the fourth series - hadn't given me much if any relief, and despite 20 or so physiotherapy sessions, my left knee was causing me grief. I could no longer do my daily fitness routine and climbing up and down the stairs had become very difficult. Sometimes I'd be caught unawares and my knee would "cave in" when I least expected it to. I still insisted on going on my daily walks with our dog, Tina, despite feeling unsteady on many occasions. There were days that I felt I had "aged" way before my time.

So to cut a long story short (this is a blog, not a biography after all!), my surgeon told me we had little alternative but to operate and that this was the logical outcome given that my joint was so severely damaged.

Back to the clinic: after completing the administrative and medical paperwork, I was led up to my room by a nurse and given a surgical gown, cap and slippers to change into, having already taken a shower at home and ensured that the body area in question was completely hair-free.

I was also asked to give a urine and blood sample.

As I sat in my special gear, I looked down at my knee and belovingly thanked it for all the years it had supported me (literally!) and bid it a last farewell. I was the first patient scheduled for surgery that afternoon. At 1.45 pm, the hospital porter knocked on the door. This was the point of no return.

Lying back on the trolley, I smiled and tried to look relaxed. As a matter of fact, I didn't feel that nervous. I trusted my surgeon 100% and was more excited than anxious.

I was wheeled down to the basement where the operating theatre was located and "parked" just outside in the corridor, where I was told I would be collected by a member of the team. It was freezing. I began shivering. Attempting to focus my mind on something else, I cast my eyes on the rows and rows of medical equipment and supplies stacked on the shelves around me. I was relieved when the nurse came to take me through.

The operating room was brightly lit up. I was greeted by who I presume was the nurse in charge, then moved on to the operating table and covered with a blanket. A special tube was placed under the blanket that emitted hot air for warmth. But as both my arms were exposed so that the necessary equipment could be attached, I was so cold by now that I simply couldn't stop shaking. I had a niggling feeling that the team would think my trembling was because I was so petrified!

My surgeon came by to say hello and I saw him discussing my case with a team of surgeons who were, in all likelihood, there to observe. My xrays were displayed on a light box not far from the table. I heard him speak in broken English to his colleagues, struggling to find the word for "spine" (rachis in French) - I wanted to shout it out to him, but thought that may be a bit inappropriate...

The anaesthetist explained that he would give me a regional anaesthetic in my upper leg first (called a saphenous nerve block) using ultrasound for guidance. This would last approximately 24 hours and would reduce post-surgical pain. I watched fascinated as the needle pierced my skin with such precision, the anaesthetist's eyes fixed on the screen.

I was then told that the anaesthetic agent would be administered to me via the IV line that had already been placed on the back of my hand. I was told that it would sting or burn a little bit, but that this was normal. I felt the tingling of the product for about 5 seconds, then everything went black.

My eyes opened and I looked around me, trying to find my bearings. I realised very quickly where I was: in the recovery room. It was over! That was quick I thought. My friendly surgeon walked over to me and put his hand on my shoulder, reassuring me that everything had gone well. To my utter surprise, he then took my leg into his hand and asked me to lift it. I was slightly taken aback. But I didn't argue and lifted the limb in question.

No pain - thank God!

"Now bend it" he continued. I slowly acquiesced, slightly concerned, but still confident.

"A little bit more, come on, you can do it!"

And sure enough, the knee flexed, from what I recall, to approximately 90°.

A nurse asked me if I felt any pain. I told her that I had no real pain, just a very mild discomfort. She explained that she would give me something less potent than morphine so that I would be comfortable for the following hours.

I had no idea what time it was, but learnt later that the procedure had taken longer than anticipated. On the way back from theatre, my porter made a stop off at radiology so that an x-ray could be taken to check everything was in place. By the time I reached my room, it was 7 pm. I had been gone for over 5 hours!

Back in my room, the nurse helped me change in to my own nightgown and settle down in my bed. I was feeling quite peckish by now - luckily I didn't experience any nausea from the anaesthetic which I also put down to having followed a pre-surgery protocol, including an acupuncture session with my TCM practitioner the day before - so was delighted when my meal arrived!

I finished everything on my plate, then closed my eyes. I felt pleasantly tired. Before I knew it, it was the following morning.

The nurse knocked on the door and told me it was time for a shower!

I must admit I wasn't expecting to be taking a shower so soon. Nor was I expecting for the nurse to be "Calamity Jane 2023"!

As she placed a plastic protection over my dressing so it would not get wet, she involuntarily "stabbed" the area around my wound with her nails.

"Oh I'm so sorry - did I hurt you?"

I shook my head and smiled.

Then she helped me get out of bed, inadvertently stepping on my "good" foot in the process. I chuckled to myself. This was stuff for the movies.

Handing me my crutches, I stood up and made my way to the bathroom, nurse in tow. As I reached the shower, she pulled out a stool for me to sit on and placed my towel within reach. Easing myself down carefully, she moved my crutches to the side and... wait for it.... accidentally hitting my leg in the process. You couldn't make this up!

By this time, I was struggling to keep the laughter at bay. Luckily she didn't actually hurt me, but I did think to myself that this was getting more and more like a farce.

All in all, my first visit to the bathroom was much easier than I could ever have imagined. I had been rather apprehensive about being able to go to the toilet and sit down on the seat prior to the operation, but in reality it was no big deal.

Washed, dressed and refreshed, I walked slowly back to the bed. Calamity Jane told me she was going to put on the support stockings I'd been prescribed by the surgeon. The good leg first. The stocking went on relatively easy. Then the bad leg. Stretching the stocking over my toes, she carefully pulled it over the rest of my foot, trying not to put any pressure on my knee. I thought we'd managed to get this done without any more mishaps, but just as she was tugging on the stocking to pull it over my calf, her left hand suddenly slipped away, hitting my good leg, whilst the stocking was released down directly onto my wound like an elastic rebound!

I gasped, more out of surpise than pain.

"Oh my God - I am sooo sorry. Are you OK?"

I refrained from any sarcastic remarks.

Despite these minor mishaps, I was very well looked after and the whole medical team should be commended.

After breakfast, a succession of medical professionals walked through my door:

  • the anaesthetist came to see if everything was all right and to explain that the nerve block would gradually wear off after 24 hours. He also told me that I did not require a blood transfusion and that my red blood cell count was still at an acceptable level. I would be given anti-coagulant injections as from that evening.

  • my surgeon also came to check on me. I was told that my knee was very badly damaged and that the operation had taken longer than anticipated.

  • the physiotherapist arrived to take me on my first walk around the corridors. I honestly believed it would be more difficult, but other than tiring quite quickly, I completed my little stroll from and back to my room with flying colours.

  • the lab nurse took another blood test to ensure my haemoglobin levels were within range, amongst other things.

  • and finally, the ambulance driver and his colleague (I have purposely not used the term "paramedic" which doesn't actually exist in France) who were to take me to the rehabilitation centre a few miles away.

As the ambulance slowly moved away from the clinic, I was thankful that the surgical procedure and everything surrounding it were over. I also knew that the battle was far from being won and that the hard work would begin once I arrived at rehab.

I'll be recounting how the first few days at the rehabilitation centre panned out in a future blog, so stay tuned!

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