Post Op Day 2-3


Each day things got a little better and by Post-op day 2 I was allowed out of bed and able to use the bathroom with assistance.   I got more rest the second night although I still woke in pain I slept for longer.  Don’t ever let anyone tell you the hospital is a restful place.  They wake you at all hours of the day and night to take your vital signs, blood etc.  Of course, I expected that.

After breakfast physical therapy came and talked to me and explained that I would be able to get up and move later with assistance. I was allowed up in the chair for longer that day and had my friend Kathy come from Columbia and my friend Charlotte come visit.  I set all this up before hand and asked people to visit me since I knew John would be working and I would be alone most of the time.

Getting out of bed and walking for the first time was strange and scary.  I was taught how to get out of bed and rise to standing without putting weight on my left leg.  Then I was taught how to take steps forward with a walking while using it for support as I moved my left leg forward.  Next came moving backward and turning in order to sit in a chair, bed or toilet.  That day I walked a few dozen steps and was able to get to and from the bathroom with assistance.  I wasn’t allowed to get out of bed without waiting for assistance.  I also began some exercises in bed, moving my leg from side to side, lifting my leg up off the bed, sliding my heel up and down while bending my knee and kegel type exercises.  The more mobile I was the more the pain seemed to ease.

Later in the evening the Chaplain that I work with visited with me again for a little while again.

Overnight I slept better than I had the night before and in the early morning hours I moved, with help of course, to the chair and rested there for a few hours.  The following morning the doctor rounded as he had the other 2 days.  He commented that I must be an early riser since I was awake each time he came in.  I told him I am not but that I had to move frequently to be more comfortable.  I explained that I would rather re-position to relieve some of the pain than to take medication at such frequent intervals.

Things were progressing as expected and I was to be released from the hospital later that day.  Discharge planning had begun the day before and a walker for me to take home as well as a raised toilet seat were delivered.  The pharmacy came to ask who would be giving me the Lovenox injections that I had been receiving to prevent a blood clot and I told them I would be able to do them myself.  No on else was willing to do it for me and I was okay with doing it myself.

Physical Therapy worked with me on going up and down stairs to ensure that I would be able to get in the house once I arrived home.  Social work came to discuss my discharge plans and I told them I planned to go to my parent’s home for the first week or so since it is all one floor.  Referrals we also made to home health for PT after discharge.

That afternoon my parents  came to pick me up and I was given all of my prescriptions and instructions.  The dry bandage that had been in place since surgery was replaced with a waterproof bandage that could stay in place for  a week.

That evening one of my parent’s friends generously provided dinner for the entire family and John and the kids came over to eat and visit.  I was still very dependent on the walker but able to get to and from the bathroom and in and out of bed while using only oral medication to control my pain.  I was happy to be home!

After John and the kids left and I was ready for bed I noticed that I felt flushed and that my left leg had swollen to 2x the size it had been earlier in the day, red and warm to the touch.  I also noticed the incision was draining more than usual and that drainage was coming out from under the bandage.  Although it was late, I called the hospital orthopedic unit an asked what I should do.  They advised I go to the ER and said that they would call the ER and let them know to expect me.

I don’t know how long I waited to be seen, but when I was taken back they took the bandage off and the ER doctor examined me he said he was highly suspicious of infection.  He also ordered an ultrasound of my leg to rule out of blood clot.

I was taken to radiology where I met with the most unsympathetic ultrasound technician ever!  She didn’t really explain what she was going to do and began her exam.  She didn’t ask me how long it had been since surgery and didn’t seem at all concerned with my comfort.  She kept manipulating my leg and asking me to point my toes inward (which I told her I was neither allowed nor able to do).  Then when I told her that the position she had me in was painful and uncomfortable she simply said I would have to endure it so that she could do her job.  She offered to stop the exam a couple of times but obviously if she did that they couldn’t be sure that I didn’t have a blood clot!  Out of patience and in pain, I gritted my teeth and told her to just do what she had to do.  I was totally over it and pissed as hell.  After she finished the testing she asked me if I needed to sit up or change position.  I was so mad and in so much pain I was not nice.  I told her to “just leave me alone” and was in tears at this point.  The poor transport guy from the ER retrieved me and wheeled me back to the room.

As soon as I arrived back in the ER the nurse saw that I had my hands over my face and was extremely uncomfortable and the doctor, who had ordered morphine for pain, changed his mind and gave me Dilaudid(which is stronger) instead.  After that kicked in I was much better and felt a little bad as I could see the doctor was kicking himself for not giving me something for pain before sending me to radiology.

Next they removed the bandage and took a sample of the discharge to check it for infection.  The on call doctor with the surgery group saw me and agreed with the ER doctor and they started another infusion of Vancomycin.  The ER doctor seemed convinced I had an infection and wanted me admitted.  However, the on call surgeon did not want to admit me and really wanted my surgeon to see me before anything was decided.  I guess that’s what happens when you are operated on by the guy in the practice with the most experience.  The ER wasn’t pleased as they wanted to send me upstairs so they could fill that bed with someone else but they kept me for the 2 hours that it took for the Vancomycin to infuse and by then it was 6am and time for my surgeon to make his rounds anyhow.

When my doctor  came in he was great!  I found him to be compassionate throughout the entire process but especially so that morning.  He explained that he didn’t think this was infection but rather that the increased activity from the day before combined with the blood thinner I was receiving had caused the increased discharge.  To my relief he prescribed an oral antibiotic, just in case, and an anti fungal in case of yeast infection from all the antibiotics and sent me home.

I had sent my parents home a few hours before he came to get some rest and thinking they were going to admit me.  My dad came and got me and I was glad to go home though it had been a rough night.

 

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