On Monday morning I had a Robotic Arm Assisted Partial Knee Replacement of my left knee. I was discharged in the afternoon when the spinal and nerve blocks had worn off enough for my legs to move, allowing me to walk down the hall, and up and down a small stairway with the physical therapist.
This is what the nurses told me about pain and medication. On that famous scale of 1 to 10, 3-4 means you have pain that distracts you from what you are doing. (My interpretation: You are aware of hurting without the need to think about how you feel.) 5-6 means you are distracted away from what you are doing. (My interpretation: You hurt so much that you cannot concentrate on what you are trying to do.)
They told me not to let it get past 3-4, because once it gets to 5-6 it is difficult to get it under control. Being in the 3-4 realm means considering taking the pain medication. I did that on Monday when I got home from the hospital. I was careful to write down each time I took a pill.
The hospital had contacted a visiting nurse/physical therapy group who called late Monday afternoon to make arrangements for home visits. The first visit was scheduled for Tuesday afternoon.
Tuesday morning I felt quite good. I was able to negotiate the stairs to the ground floor, with my husband standing a couple of steps below me on guard for any problems. After breakfast in my recliner, during which I iced my swollen knee, I decided I would be able to sit at my desk and get some work done. Between sitting with the knee bent and walking back and forth to the bathroom, recliner, desk, I was quite tired by lunchtime. I elevated my knee, put on an icepack and fell asleep.
The therapist was delightful. The exercises were not. I was appalled at the movements I could not make, exhausted by those I could. I joked that it felt as if I had worked out for an hour at the gym, but it wasn’t really a joke. It felt as if I had been in a full force bodybuilding session when actually I had been slightly moving my front quadriceps muscle. I was able to feel the contractions with the fingers I had lightly resting on the top of my thigh, although there was little resultant visible movement in my leg.
We went through patterns of rising and lowering myself to the chair, a brief review of climbing up and down stairs. I demonstrated how I maneuvered myself into the bathroom on the ground floor. She left me a short list of exercises to repeat, and I, again, propped myself in the recliner to elevate, ice and nap.
Because I had spent the week before the operation with a house full of family, a couple of weeks before that doing deep cleaning in preparation for the family visit, and the weekend between their visit and my surgery away on a fishing trip, I had not prepared food for my recovery period. With all the extra step-and-fetch-it things Stan had been doing, I felt bad about adding all the meals.
I decided I would be able to prep supper. It was not horrendously difficult to use one crutch and bring the supplies and food to the counter between the stove and sink. I chopped vegetables and chicken breast. And, suddenly, I was exhausted. Really exhausted. Crying jag kind of exhausted.
I hobbled back to my recliner, Stan got me ice and a big glass of water. He cooked and delivered dinner. I sat.
Throughout Post-Op Day 1, I had deliberated about each 3-4 level of pain that occurred. Sometimes, I just needed to wait a few minutes. Other times ice did the trick. There had never been a time during the day that I felt the need for a pain pill. About 10 pm, when I was getting ready for bed, I decided that I should take one. I still had to climb the stairs and change. Each activity was sure to intensify the distress within my knee.
On Day 1, I was not able to bend my knee appreciably more than the slight bend it had after the operation. I could not reach my feet. Neither could I balance well to put pants on the good right leg. It hurt to get my left leg into bed.
At some point on the day of surgery, someone had told me that the third day was the hardest. That was on my mind on the night of Day 1. My leg hurt. A lot. I was only approaching Day 2 but knew I had that ‘worst day’ in the future. I had taken medication at 10 o’clock. Then I had gone through a lot of physical activity including the painful movement of my leg into bed.
The medication was supposed to be taken every 4 to 6 hours. The first hours were miserable. I couldn’t sleep. I couldn’t relieve the pain in my leg, and I was also uncomfortable sleeping only on my back. I had had an ice pack the night before but had not thought to ask Stan to get me one before he went to sleep. Finally, at 1230 I decided it was close enough to 4 hours (only one and a half away) and took another pill. I slept for a while. Then it was 130, and then 230. Finally, at 430 I took the last pill I would take for the day.
I woke about 730 on Post-Op Day 2. I felt good. I accepted help getting dressed. I had learned from the day before. I had everything I needed brought to my recliner area. I did not sit at my desk, but, rather, had my legs up throughout the day. I did not attempt to help with any meals. Therapy added massive bending of my leg at the stairs, and ‘marching’ using the kitchen counter as a balancing agent. Going from foot to foot was definitely full weight-bearing.
I had come home from the operation with an elastic stocking that goes from toe to groin (and folds at the top because I am short.) The stocking was finally removed and the bandage taken off (except the part that will be removed at the doctor’s office.) I showered and washed out my pressure stocking.
My leg was in the open. I was also able to sleep on either side and to have a pillow under my ankles which was much more comfortable when I slept on my back. I took a pain pill before bed, but, even though I woke during the night, did not need more medication. Day 3 was not a bad day! If I were not as superstitious as I am, I might be inclined to think that I went through the very worst on Tuesday night! (But I don’t dare do that.)