Wednesday, November 29, 2006

Knee Surgery Is Done

SUMMARY: The last 24 hours--or less--

Tuesday evening, 7:00: Meet with my friend Karey, who is quite the knee-surgery veteran, to borrow her automated knee-icing machine (some inventions are truly mahvelous--and simple--and I'd have never imagined such a thing if she hadn't mentioned it earlier and offered to let me borrow it). She throws in a dinner of Thanksgiving "leftovers", which turn out to be a really lovely casserole made with layers of turkey and broccoli and potatos, smothered in cheese and baked. VERY tasty. Would never have known they were leftovers (which are supposed to be eaten out of tupperware containers and barely warmed over). Karey and Dan have lots of helpful hints.

My three dogs mingle with their three dogs with various levels of enthusiasm or antipathy. Inyo the retired Terv (well,OK, he hasn't retired from Tervhood) mostly hung out in the background, except when he came by periodically to show that he still remembers how to do the Shake and High 5 that I started teaching him while waiting for agility class Lo those many years ago. I just happen to have treats in my pocket for just such dog-behavior emergencies. He's not entirely convinced at first that a piece of puppy kibble is really what one would call a treat, but he eventually accepts it and periodically comes back for more.

The other dogs think this is a good idea and pretty soon I have thousands of dogs doing rights and lefts upon various commands (mostly rights and lefts but not guaranteed to match with what action the dogs actually take).

I am very stressed about the surgery although I know that there's no real reason to be. My knee, contrarily, is feeling absolutely wonderful and isn't swollen at all. Except for that catching thing that it started last week, which is happening more and more and more, to the point where I think that I don't even really want to walk, to avoid the chance that I might have to endure another of those sharp sudden spikes of pain. I will be very happy if the doctor can fix that. And whatever else needs fixing.

I head home after 10:00, picking up tons of ice for the ice machine on the way home. I decide that I'm too tired to start getting everything prepped for Surgery Day and crawl into bed with my security electric mattress pad (like a security blanket, only warmer) and then read for a while--everyone dies, makes me feel particularly encouraged), then fall asleep sometime after midnight.

Wednesday, 6:00 a.m.: I'm awake. Why why why? I lie in bed quietly for a while, checking to see whether maybe I have some sleep molecules left to take me away again. No such luck. Get up around 6:30.

I've had Boost back in her crate the last 2 nights, after not bothering most of the time for a few weeks. Of course she likes being on the bed because the other dogs are there, but she has to take the middle position to avoid the other 2 dogs, who hold down the two far corners of the bed. Which means that, as she adjusts her position or rolls over during the night, she always rolls over in my direction rather than towards the other dogs, which means that when *I* roll over, suddenly there's a dog where I want to be. So I jab my knees into where I want to put them, which makes Boost jump up, and then usually she jumps off the bed and wanders aimlessly around the room, which makes me nervous, so then I have to insist that she come back onto the bed and get her settled into position again in the middle of the bed. Repeat a couple of hours later.

So two nights ago I was just too tired and stressy to deal with that, so I suggested that she get into her crate (where she has slept most of the previous 18 months) and zipped her in. I think we both slept much better that way.

Wednesday, 7:00 a.m.: Boost fetches the newspaper for me from the end of the driveway. But--dang--I'm not allowed to have any food or drink, not even sips of water or mints or anything--after midnight before the surgery, so no reading the paper with breakfast! What ever shall I do?

I shall go through my to-do list to prep for my anticipated restrictions after surgery:
  • Finish laundry and haul most of it back upstairs to my bedroom.
  • Clear the boxes of xmas ornaments out of the hallway and off to one side in the living room. At least the tree is set up and has lights on it.
  • Put away all the random stuff sitting around in the kitchen and various other places that might be in the way.
  • Set up a "nest" in the living room, which is on the same level as the kitchen (bathroom & office are down 5 steps; bedroom is up 12), with laptop computer, books, crossword puzzles, lightweight down comforter, extra pillow, stuff like that.
  • Make sure I've moved plenty of cold drinks from the garage (down 5 steps) into the fridge.
Also assembled everything I need to take with me, or imagine I might need, if I end up having to wait a long time ahead of time in the waiting room or a long time afterwards in the recovery room. Plus I want to be prepared for blogging!
  • Notepad and paper, pens, digital snapshot camera.
  • Novel I'm in the process of reading; crossword puzzle book.
  • Kaiser card and photo ID, and $20 just in case--I don't know, but just in case anyway.
  • Glasses case for my glasses and inhaler for my occasional lightweight asthma, requested by Kaiser that I bring with me.
  • Crutches.
  • Icing machine.


Mom and Dad's Chauffeur Service dropping me off in the morning.
I'm now fully IDed.
Self-portrait with cute little surgical cap and gown.
9:15 a.m.: I am showered, packed, dressed "in loose-fitting, comfortable clothing, no jewelery", and parents are here to pick me up right on the dot. My check-in time is 9:45 and it's only a 15 minute drive there, usually.

9:30 a.m.: Mom and I go in while Dad parks the car. No line at the check-in, so I register and sit down. They call me in to get started before Dad has even reappeared from the parking lot. They go over a lot of the same questions that they asked me in pre-Op (hearing aid? diabetes? allergies to meds? screaming panic attacks at the sight of doctors in cute little surgical caps? etc.).

10:00 a.m. (est; I'm not wearing my watch): I'm on a bed in the pre-op area, dressed only in my undies, one of those nice cloth gowns that tie in back, a cute little surgical cap for my hair, two disposable surgical booties, and one sock. They bring in all my stuff and send my parents home. They guess that I'll be done and ready to go home probably before 1:00.

Nurse has trouble getting the vein in the back of my hand to straighten out for the IV connector. She explains kindly what she's doing and why, apologizing repeatedly for the pain. I ask her whether most patients eventually give in to the torture and tell where the treasure is buried. She laughs and says she's never heard that line before. Maybe she's just being polite.

My doctor, Mr. Automata in our intial meeting, breezes in with a cheery and human-looking smile. We converse briefly about the right knee being the right knee, or the correct knee being the correct knee. He sent me email yesterday in response to a question of mine, saying "I'm looking forward to tomorrow." All of this is confirming that people go to medical school primarily for the joy of being able to legally poke other people repeatedly with sharp objects. When I mention his message, he says he always looks forward to the chance to make people's pain go away. It's a good line. Would probably hold up in court.

The nurse finishes pinning both the back and the front of my left handage and brisks herself away in search of substances to inject into the tubes and thereby into my circulatory system.

The anaesthesiologist, a very nice man, comes by and we have a brief discussion about the right leg being the right leg, etc., and then progress to a longer discussion about epidural (spinal) numbing or general anaesthesia. I really don't want to do the latter. It's scary, because you lose control of your body and your ability to respond to what it's telling you and so on. The doctor tells me that he has the same reaction, hates losing that mental control, but when he's had surgery, he had general, and he strongly recommends that for a variety of reasons. Epidural has small but slight risk of damaging nerves. More painful before and after. Recovery can take hours. More side effects likely. Sure, it's a commonly used procedure where they want the patient to be aware, as in birth deliveries, but they don't often use it there for knee surgery. General has its risks, too, but I'm a very low risk patient and he has no reservations at all about recommending the general for me. He gradually convinces me. He says that it's a bit of a phobia, wanting to avoid that general anaesthesia, and he'll give me something nice IV (valium-equivalent) to help me feel better about the decision. And about the surgery. And about life, the universe, and everything.

They are kind enough to have me read and sign all the various releases and disclaimers BEFORE they give me the "what-the-heck-life-is-beautiful" drug. I've had no time at all in which I needed to have novels or crossword puzzle books, although I do manage to snap a couple of photos (and nurse takes photo of me in the bed).

10:30 a.m., more or less: I feel great! A little distanced from the world, but just hunky-dory happy, calm, and peaceful. Everything's going to be just fine, yessirree. They wheel me into the operating room and I wiggle myself from the card onto the table with a little guidance. Dozens of people are bustling around doing whatever it is that people bustle around doing in operating rooms. Maybe if I ever watched TV (ER?) I'd know.
In the recovery room. With cap off.
Recovery room. Is it me or the camera that's a little wee bit skewed at the moment?
Apparently one of the things they do while bustling around is wrap my leg in surgical gauze and ace bandages, because I'm now lying there in the recovery room, opening my eyes (when did they close?), with my knee all bundled up. I suppose that some of the bustling also involved surgery, but you couldn't tell by me. I feel just the same as I did 30 subjective seconds ago while I was moving onto the table in the operating room--awake, comfortable, calm. The clock says, I think--

Blood-oxygen monitor. No sharp pointy things involved.

Post-surgery meal: Bread and water.
Noon-ish? Various very nice people ask how I'm doing, feed me some Vicodin, water, and graham crackers, call my parents, check my various status indicators, read me my instructions for the next few days, have me sign a release stating that I acknowledge still being alive after the surgery, and so on. Dad is there before they're even done with all that, and I get into my clothing and take a couple of steps into the wheelchair (so I didn't need the snacks I packed, the novel, the crutches, or the ice machine--I'll put that on at home). They wheel me out to the curb, dad drives me home and settles me in.


At home now--my view from my sofa nest. Finished putting lights on yesterday. Decorations are still in boxes.
You can see my three loving guard dogs hanging around my sofa nest (Jake left, Tika bottom, Boost by tree), and some boxes of tree decor, just waiting.
The icing machine. Looks like a cooler--well, I guess it is, with a motor and a hose and a thing that wraps around my leg and conveys ice-cold water automagically.
My sofa nest.

1:45ish Dad is gone, I'm here in my couch nest, the ice machine running. The surgical dressing is so thick that I can barely feel any coolness, but I'll just leave it on, letting it do its job. Leg feels fine, but the instruction sheet says "marcaine (a type of pain medication) was placed in your knee after the surgery, which will significantly reduce your discomfort during he first night. When this wears off, you may feel increased discomfort." Something to look forward to. And to discover whether "increased discomfort" is a euphemism for "bring on the morphine now, by the truckload please."

I feel no nausea, maybe a teeny bit of light headedness when standing (but that could've been from lack of food, too), and right now I'm feeling a teeny bit headachey (could be from lack of food, lack of sleep, aftereffects of anaesthesia, or just random headachability.

I think I'll have more food, see whether I can xfer this to my real computer to post on my blog, and maybe take a nap.

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