Thursday, April 7, 2011

KNEE REPLACEMENT SURGERY: DISCHARGED–THE NEW REALITY

Catching up with well wishersGoodbye, friendly nursing staff and convenient call button.  Goodbye, tubes, endless noises, and every-two-hour nighttime checkups.  Goodbye, hospital food. 

Hello, steep motorhome steps.  Hello, narrow hallway spaces.  Hello, sunshine pouring in the windows.  Hello, fresh fruit whenever you want it.  Hello, woefully untrained nursing staff!

After two pain-free days of optimism, Odel awoke to a new reality on Wednesday morning.  The drain to remove fluid from his knee had been taken out Tuesday, and his knee was swollen, tight and painful.  During his morning stretching with Doug, his pain level moved towards the wrong end of the pain scale.  Very unhappy face!   The new reality has set in.

The incisionThe hospital stay for a full knee replacement is usually 3 nights; for a partial, it can be as few as 2 – and we were determined to get him out of there.  I arrived at the hospital mid-morning (with fresh pineapple and a banana) just in time to view the incision (I posted a small photo here; those of you with more interest can click on it if you’d like to see the gory details enlarged).

Once Brian was done changing the dressing, Odel had visitors (Sydney and Frank) and lunch arrived.  After that, we spent most of the afternoon waiting, and bird-dogging the various staff we needed to see prior to discharge. 

Doug the therapist wheeled Odel to the stairwell to practice going up and down stairs, then signed off on discharge.  The medical supply rep came by with Odel’s brand new wheeled walker, provided by Medicare (no more than 1 per 5 years, so we got a long lecture on keeping it).

Max bendThe hospital pharmacist came by to discuss Coumadin, the blood thinner every surgical patient takes before and after surgery, and the pain medication prescribed for Odel.  And, finally, late in the afternoon, RN Mindy signed the discharge papers, we loaded Odel into the car (ouch, ouch, ouch, that hurt!) and took off for home with a stop at the pharmacy along the way.

We pictured our biggest challenge as the narrow, steep steps into the motorhome, but they weren’t much of a problem.  The obvious immediate problem, once we got inside, was the uselessness of the walker in our confined space.  Only the main living room/kitchen is wide enough to accommodate it easily; it cannot maneuver well in the hallway, and doesn’t fit at all in the bathroom or bedroom.

Many fulltime RV’ers have an item or two that one spouse clings to while the other questions their logic.  Several years ago, I bought one of those little three-legged “seat canes” – works as a cane while walking and converts to a small seat when desired.  Who knows why I bought it?  The only thing I’ve ever used it for was a small cocktail table outdoors… and Odel complains periodically about carrying it around in our storage bays.

Stand back – it’s his new best friend!  Because Odel is able to put a reasonable amount of weight of his injured leg, using the cane and the always-close-by counters and tabletops, he can move reasonably freely everywhere he wants to go.  Problem solved; we’ll save the walker for outdoor use in a week or two.

Setting up for Odel’s homecoming required some rearranging.  He needed a chair with a firm seat and back, and arms, so I brought his lawn chair inside.  He can settle comfortable there or on the couch or in the bed, hobbling from place to place.   After the stress we’d put on his knee, it was ready for icing, so I settled him on the bed and went to get the ice packs (aka bags of frozen peas). 

The setupI pulled back the cover, settled the peas on his knee, asked “how’s that?” and he answered “wrong knee”!  Oops!  Guess the bandage should have been the clue!  It was our last hearty laugh of the evening, which went on to include a major puking event, an injection of another blood thinner, and other un-fun stuff.  By 7 pm, he was back in bed, took his pain pills, and settled in for what he hoped was a good night’s sleep.

And it was. 

As I write this, Anna, the home health nurse is here changing Odel’s dressing and drawing blood.  She will arrange for the physical therapist’s visits, and will return in a few days to remove the staples in Odel’s leg.  I’ve got a list of supplies to pickup to get Odel’s guts functioning again, and we’ll need a couple of days to work out our new routine.  It may not be as efficient as the hospital, but it is SO GOOD to have Odel back home!

23 comments:

  1. Laurie,
    We read your blog and like your writing style. Since so many full time RVers tend to have a few years on them and bodies do fall apart your description of what Odel is going through in a RV is quite interesting and informative. I have been thinking of getting my knees replaced and will read your postings with great interest.

    Keep up the great work and we hope Odel is up and back on his feet real soon.

    Larry

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  2. Welcome home Odel. Now you be a good boy and do what your 'nurse' tells you.
    Take care.

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  3. Another great post, Laurie. This whole procedure is so interesting and I am so happy you are reporting it in detail. It will be helpful to so many people who see this procedure happening to them in the future.

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  4. I'm glad to hear he's home even with the setbacks.

    My major puking event turned out to be from morphine. Once they changed my medicine I was OK.

    Odel's fingers might fit the scalloped handle of your chair/cane. Mine don't. I put a crutch handle cushion on mine which I love.

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  5. Home is always the best place to be. Looks like you have everything set as best you can, including the three legged cane!! Get well soon Odel.

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  6. Gee, Laurie...whew. So glad you are writing about this in such detail. Glad the photo of the knee was small, ick. Then wondering about the major puking event. I can't do pain killers, since they initiate just such an event, wondering if this is happening to Odel too. I sure hope not. It's why I hope I never have to have elective surgery. Welcome home to Odel, I know it's good to be in your own home in spite of the realities.

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  7. Great post with wonderful info...most fulltimers at some point will be confined following an illness, surgery, etc. You are doing a great job helping everyone realize the reality of being confined in a small place -- thank goodness for the three-legged cane. Praying Odel will heal quickly -- he has a great caregiver:)

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  8. See, I told you about putting a big colorful X on Odels knee to show which was the correct leg. Bandages can be unreliable & deceiving but a big X marks the correct spot every time. Lucky for you Odel did not have a knee jerk reaction to the peas on the knee caper:))

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  9. Having broken my leg bad enough to warrant 4 months with no weight bearing last year, I think it's awesome to see such great recovery from a knee replacement! I can't imagine recovering in an RV (but we will be FT by the end of the year) so I look forward to reading about how everyone does. Best wishes to a quick recovery!

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  10. Oh my...poor Odel and the pain he is now going through...I'm sure it will get better with time, and they say the 3rd and 4th days after a surgery are the worst...Dennis broke his knee cap in 1971....and was casted from toe to groin, and in the hospital for 10days..Boy have things changed..Hang in there and have Odel repeat this phrase, "Better living through science!"..take the pain meds!!!

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  11. Best wishes for recovery without much pain. I enjoy your writing style and look forward to your Blog every day. Thanks.

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  12. Watching you make adjustments is helpful for anyone who might have to go thru this in the future.

    Hope he can manage his pain without the ones that make him barf.

    Just remember, no Tylenol if you drink wine or any other alcohol. It's easy to forget.

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  13. It's always great to get out of the hospital! I imagine Odel's knee will be sore for a few days yet. Hope it doesn't hurt too much.

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  14. It's great to have the patient home...I think?? :)

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  15. Laurie, you are a trooper. Its hard to be the chief, cook and bottle washer, as well as nurse and concerned comforter. Odell you have a keeper there as I am sure know!! Knee surgery is patience in progress, every day better and better, that is my prayer for both of you.

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  16. what a great 'nurse' you are Laurie!..hang in there!..hope Odel has a better day tomorrow!..great writing of the 'blow by blow' description of the first day at 'home'!!

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  17. Yes space is a problem in the motorhomes, and especially in the bathroom when you have limited mobility. But we too have one of those chair canes, and it comes in handy a lot of the time. With my bad back, the cane can turn the cramped space into a workable arrangement.

    Odel will get better every day, and perhaps he can store the cane back underneath more quickly than you can imagine right now.

    Best wishes for a speedy recovery!

    Rod and Loyce

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  18. Awesome news! So glad to hear that Odel is home and hopefully each day will get easier. It will certainly be nice for you to not have to travel back and forth to the hospital. You're both in our thoughts!

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  19. Thank you for all the detail and tips - I'm sure it will be helpful to everyone at some time. Hope Odel feels better soon!

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  20. Welcome home, Odel! Been there, done that, different details, of course. Nice thing about a motorhome -- the narrow hallways, the ever-present counters to lean on. No handicapped person should be without a motorhome! And for those with serious mobility problems, there are lift chairs to mount outside the entry door to make getting in and our of the rig very easy -- time consuming (two minute ride either way) but easy.

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  21. Laurie... my aunt had knee replacement last summer. The replacement went amazingly well, but she reacted to the pain meds and was horribly sick for days. She went into a rehab center for PT, but was so sick she couldn't exercise and they sent her home. It took multiple tries before they finally found a combination of pain meds and anti-nausea medicine that helped. I can find out what it was if you need for me to. BUT... even with the setbacks and problems she had, her new knee is doing GREAT and she is so glad that she had it done!
    Thank you for taking the time to keep your readers posted on Odel's progress. With everything else you have to do, it is very thoughtful of you to write about the experience. I pray that you both get plenty of rest and that you see healing progress every day!
    Take care...

    Kerri in AL :-)

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  22. Welcome home, Odel ... take it easy and don't overdo it.

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  23. Sending healing thoughts your way! The knee replacements take a while, but if you're diligent about the rehab they are well worth it. Paul's dad had one a few years ago and the replaced knee actually has better mobility than his other one. Nina

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