A link to my medical blog

There's a separate blog for my medical notes and the daily log of my recent knee surgery. Just click here.

I am back home and blogging again

Two weeks ago today I had surgery on my left knee -- the Total Knee Replacement. I am doing fine after four nights in the hospital followed by five more at a rehab facility. I have been home since last Saturday.

I can get around using a walker, ride in the car and do some physical therapy. And I rest a lot. Because there was also some ligament repair necessary I am wearing a rather large leg brace for the next six weeks or so.

Despite being addled by drugs most of the time, I managed to keep a daily journal of this medical adventure. I will start posting it soon.

The Pre-Op Procedures

Last Friday I arrived at Sacred Heart Health System headquarters, AKA "The Hospital", for my 10:00 A.M. appointment. They were busy, but that's no surprise. And running late.

The first step began at 10:20 when I was called in to have my blood pressure taken by nurse #1. Then we went into her rather nice office and she said, "Let's see, you're going to come in next Thursday for a left hip replacement."

I was ready to leave. We then looked at all the paperwork and the computer screen. She had mis-read the malady. Yes, all the documents say I'll be having a left knee replacement. She was sorry to have made such a mistake.

She took my medical history. I have done this several times before in recent weeks. When she was finished I asked her about all the things my surgeon said would be explained at this interview. She knew nothing about any of them and asked me, "Weren't these questions all covered in your joint replacement class?" That was the first I had heard of the class.

I am to arrive at the surgery check-in office at 5:00 A.M. on Thursday.

Next I went back to the waiting room to wait. Then nurse #2 took blood (lots of it) and urine and gave me an EKG. I passed that one nicely she said. Then back to the waiting room.

Then nurse #3 explained my anaesthesiology to me and mentioned, for the very first time, that I would have some nerve blocker surgery before my knee operation. I'll be asleep for it but they will wake me up after -- just in time to put me under for the knee surgery. She gave me several sheets of paper telling me what to do and what not to do the day before.

Then I left the Pre-Op waiting area to visit another waiting room for a couple of chest x-rays. I got out of there at 12:00 noon exactly.

Apparently all the things the surgeon said would be explained to me will be explained when I go to physical therapy after the operation. I do have a booklet from the surgeon telling me, along with many other instructions, to scrub the knee area the night before with the special soap provided. But nobody gave me any special soap. Or knows anything about the special soap. I'll use Dial.

All I can say right now is, "Just do it."

Research Study of Blood Thinners

When I met the orthopedic surgeon last Tuesday he mentioned I could take part in a double-blind research study of a new drug, a blood thinner. He added that this drug is, "not approved by the United States Food and Drug Administration." Not yet, at least. It will be compared with a drug that is approved by the FDA for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE) after knee replacement surgery.

He gave me a 14 page contract-like legal document -- an Informed Consent Form -- and asked me to read it and decide, by the time of my pre-op interview at the hospital, if I would take part.

I have decided not to participate. The study appears to require a lot of followup visits and some tests that sound intrusive and stressful. Lots of visits to medical offices.

Am I expected to participate? I feel awkward turning it down, but I really don't want to be part of it. Deciding on having the knee surgery itself was a huge step for me. Now this question comes up. I am sure the surgery and recovery will be quite stressful enough without adding any more stress factors.

My Left Knee Has Been Acting Up

I Meet the New Surgeon

Last fall I told my regular M.D. that I really wanted a referral to a different orthopedic specialist. I had trouble communicating with the one I had been seeing for the past couple of years. And frankly, I didn't want him "working" on me. In November I got an appointment to meet a new joint specialist.

Well, I didn't actually meet him but I was examined and interviewed by his Physician Assistant. He looked at the x-rays and told me that I need a knee replacement. I asked, "How soon?" And he said, "Can you be here tomorrow morning?" But seriously folks, he said it needs to be in the next two or three months. "Call us when you are ready."

In the middle of December I was ready and called to start the process. By then I was having lots of problems walking and used a cane all the time. A few days later the date for the surgery was set -- late January -- and I went in to meet the new orthopedic doctor.

I don't know why I was dreading this appointment so. Maybe I shouldn't have fired the previous specialist? What if I dislike this one as much as the former one? Does this appointment mean I am really going to have the surgery in three weeks?

An hour and fifteen minutes after my appointment time, in walks the doctor. He's friendly, soft-spoken and very reassuring. He immediately answered my first five questions before asking me what questions I had. I didn't have any other questions.

Yes, I need Total Knee Replacement (TKR) surgery for the left knee. Apparently it is the same thing as a Total Knee Arthroplasty (TKA).

The exam confirmed what his assistant had found: my knee needs replacing soon. Strangely when he was twisting my leg around to see how much play was in the joint (a lot) it didn't hurt much. For the past several weeks there has been less pain in the left knee. The right heel has been much more painful, especially at night. Either I have gotten used to the left knee or the pain transmitters have ground away along with some of my bone and cartilage. Maybe a little of both.

He told me I would be in the hospital three to five days and might need a few more days, perhaps a week, in a rehab facility. Rehab is unlikely as we live in a single story house and there are no stairs to deal with. And Jack will be here to help me and drive me to physical therapy for the weeks I can't drive.

The next step for me is the pre-op interview at the hospital next week. Then I'll find out everything I'll have to do before the surgery. And after.

If you really want to know more about the procedure, here's a link to the University of Iowa's TKR information.