Saturday, October 1, 2011

Sent Home for Good Behavior

This picture of a fading Zinnia in our garden has been
added since I originally posted this on October 1, 2011 to
give you an opportunity to opt out of reading this piece.
The picture that follows is so graphic that I didn't
want to leave it as the first thing you see.
If you have a weak stomach,
you may want to skip this post about the
unwrapping of Beloved's knee after surgery.


Yesterday Beloved fulfilled all the requirements for hospitalization after surgery and was sent home.  I am still trying to wrap my brain around all that has happened this week.  His knee replacement surgery was on Wednesday morning, and slightly 48 hours after that, we were on our way home.  

This may not be an entirely pleasant post today because of one picture in particular that I am sharing.  But I do it because I sincerely want to be informational (not sensational) for those who may need to have this same surgery.  We had lots of questions beforehand and got lots of answers, largely based on what others have experienced, in addition to what the medical people said.  We have found the experience to be not as bad as expected.  There are a lot of factors that played into that, but overall, this has been a good thing.  

With that said, here are the last of the pictures taken at the hospital before he was discharged.  The first picture may be hard for some; if so, just skip on to the rest (which are not gory).

This was our first view of the stitches (25 staples) after the bandaging was removed.  You can see purple lines and his surgeon's initials on his thigh.  This was done prior to surgery to verify which leg needed the replacement.  Also before surgery a nurse shaved his knee and cleaned it well with soap and water.  Then after he was under anesthesia they scrubbed it more with [whatever they use, which makes the skin turn yellow].

The white stuff below the incision is quilt batting I loaned to the surgeon when he ran short of bandages. NO!  I'm kidding.  But the surgeon and his assistant were very liberal in covering the leg with a thick layer (truly about an inch!) of what looked much like quilt batting before wrapping the world's longest Ace bandage around the leg to hold it all on.

This picture (above) was taken just before Beloved got to take his first shower since surgery.  He is allowed to let water hit and run down the incision, but he is not supposed to soak it in a tub of water for 3 weeks.  Okay. On to more pleasant pictures.

After the shower, a fresh bandage was placed on the surgical site, and another pad was applied against the hole on the side of his knee where all that blood had been drained out, filtered and given back to him.    The combination of the drain tube and the heavy, tight bandaging made a big difference in the amount of swelling and bruising.  So far, he has virtually no bruising at all!  He was given white stockings called "teds" to wear to cut down on the formation of blood clots in the legs. They also serve to hold those bandages in place.  The teds go from his toes to the top of his thighs.  He is allowed to take them off when he goes to bed at night. While sleeping he wears a much shorter tube-stock kind of thing to hold the bandage in place.

This picture just amazes me.  He was walking down the hall at an amazing clip for being gimpy.  He and the walker have quickly become  friends, so to speak.  Everybody commented how well he was doing.  Even his range of motion is very good for this stage of the game.  They want his range of motion to go from 0 to 130 degrees.  Zero is when the leg is extended straight out in front.  His range now is 0 to 90.  It's great that he can already extend his leg out straight!  

His physical therapists were very helpful.  They instructed him about which leg to put out in front first  when he's trying to stand up, sit down, do stairs (going up you lead with the good leg; going down you lead with the bad leg), on crutches, and with the walker.  In this picture he was learning to navigate stairs with crutches, but he is doing so well that he and his therapist agreed the crutches are almost more of a bother  than a help.  He can do stairs with nothing more than the railing if he wants, or with the additional help of his cane.  This is all very good news because our bedrooms are not on the main floor of the house.

In my previous email I mentioned this instrument of torture, as some might think of it.  In recent years people would sit on a bed or a couch and lay the leg between the metal bars, with the heel of their foot in a cup-like thing. Then when turned on (electrical), the foot would be forced to move gently back and forth, extending and retracting the leg to reduce stiffness after surgery.  

They brought this into Beloved's room and it just sat there but never got used.  They said he had surpassed the need for it.  We hear some people liked the machine and some people did not.  I also hear that even surgeons are now backing off from using it as much as they did up until just recently, thinking that it may not be doing as much good as originally thought.  

So, we are home now.  Home physical therapy is to start as soon as today, and a home health care nurse will come on next week to examine the status of the incision.  In the meantime, Beloved has his exercises to do (isometric-type movements) and is taking prescriptions for the pain and to reduce blood clots.

He was given a walker to bring home and a stool to sit on while in the shower.  He is doing okay without a special toilet seat.  We already have crutches at home, so we declined to bring home more.  (I did take note of how they were adjusted to his height in case he decides he wants to use them.) We also have an extra pair of the teds hose, and a bunch of fresh pads for the incision area.   

All the hospital staff who worked with Beloved were in agreement his diligence to do the pre-surgery exercises made a big difference in his good range of motion after surgery.  

There will be more to come in the days ahead.  I hope our experience with total knee replacement is helpful for those who may be considering a similar procedure. 

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