From Skiing in Austria to a bed in the Hospital (Twice) in 6 months …!

So, if any of you have read my page on my love of snowboarding you will no doubt be fully aware of my trials and tribulations as a Snowboarder with fractured Coccyx and painful recovery. Well, you will also no doubt be kind of familiar with my most recent situation having visited Austria for a week of Winter Sports, where I decided to leave the board in its bag and take to the skis instead? This is a post based on my path to recovery having been through keyhole surgery to have the torn meniscus repaired to only then find out that the knee cap was shot and required replacement and I continue with the events from attending hospital on day 1 in the hope that anyone who is perhaps going through similar either now or at some point in the future will have an ideas of what to expect. Although the medical staff provide you with leaflets and oral information to enable you to understand as much as possible, it is not until after the event and on reflection that you realise there were aspects that they either chose not to tell you because to them it perhaps paled into insignificance or they genuinely forgot. So, I thought I would take this opportunity here to add in an account of my experience to possibly support others.

24 hours or so following the actual op and sat upright in my bed on the ward is when I actually wrote most of this and decided to log onto a Facebook Group for knee surgery that was set up in America to support others with the similar situations that like-minded people found themselves in. In all honesty, as good and as supportive I found the group I also found it somewhat troublesome in that there was a lot of jargon from “across the pond” that I was not familiar with, there was reference to procedures and medicines that just didn’t make any sense so on coming out of hospital I set up my own support group for knee surgery, recovery and other issues based and aimed at people in the UK.

18/8/15 – Day 1:
Admitted to hospital for elective surgery to replace left knee patella and fit plate to femur. A procedure known as Patellofemoral Joint Replacement or PKR Partial Knee Replacement.
Admitted at 08:00, taken to theatre at 10:30, prepped with spinal block and rolled in at 11:00.
Had surgery, awake but sedated throughout until final closure and the last thing I remember was the Anaesthetist shouting “Paul, Paul you need to breathe” “Wake up and breathe for me, 1 breath, 2 breath, 3 ….”
Knee Bandage Post OpI then came round on the ward with the usual checks, tea and toast. Came back from theatre with a morphine pump, I now believe to be known as a PCA or Patient Controlled Analgesia, which was doing its best to keep the pain at bay. Managed to sit up and have tea and then the excruciating onset of pain whereby I felt as though my whole left leg from the thigh down below the knee was going to explode under severe pressure as everything inside seemed to be bursting to get outside and run for the hills.
First morphine pump expended, second set up as well as a second drip of saline and constant oxygen to try and raise the SATS that were being depleted by the morphine.
Got through the night – somehow! Although it was very painful and consisted of a lot of moaning and groaning and quite possibly annoying my three fellow sufferers in the same room.

19/8/15 – Day 2:
Pain still as bad and on a level of 6/10 at best and 10/10 at worst. Pump taken down and replaced with morphine based tablets known as Oxycontin. Pain continued all day as did the sickness feeling and the expectation any time soon that my leg was going to explode into a million pieces. Surgeon came to see me and said that he is very surprised that I am in so much pain after this time and that normally people stop having pain after 24hours. He got me out of bed to sit in the chair and asked me to bend my leg to 90 degrees. This was extremely painful and I could only manage about 20 degrees until the pain was too great to bare. He took hold of my leg and pushed it to a 90 degree bend, which, let me tell you was far from fun and he came close to being “forcibly removed from my personal space quite quickly2. Not that I am an aggressive person or that I disrespect anyone in the medical profession, especially one so gifted as to replace my knee cap and hopefully allow me to walk properly again but I defy anyone who is subjected to that much pain so soon after surgery not to feel a little “put out”! In hindsight it was the right thing he had done as I was being afraid to bend my leg due to the fact that it was painful and also because I did not know if I would be doing more harm or good by pushing it. He confirmed in his “manipulation” and demonstration of what he was expecting from me that there was indeed no further damage I could do.

20/8/15 – Day 3:
And the pain in my leg was increasing. I had been put on to stronger morphine and although I was happy to expect and work through pain whilst exercising I was struggling to accept the excruciating pain whilst at rest in bed. This pain had me climbing the walls, I was crying with the level of pain it was so severe. They called for a Duty Nurse Practitioner as there are no Drs about due to it now having gone past midnight. The Nurse Practitioner came and due to my pain levels my body had started to shiver as I started a fever with a body temp of 38.8. She wrote me up for 2 x bags of saline IV and 2.5ml of morphine. No sooner had they taken all the blankets off me (I apparently had EIGHT on me by this point to try and keep warm. The truth was that I was too warm and the body had gone in to a state of shiver to try and regulate my temp to a more normal condition. I of course knew all of this with my First Aid training but in all honesty I wasn’t interested, I wanted to stop shivering and I wanted the pain to stop plain and simple! They put a fan on me, placed the first drip up and gave me the shot of morphine I was spaced out, in no pain at all and slept all through the night and only woke up to the sound of clattering trolleys and plates as the breakfast was being served. But there was a problem; the pain was back with a vengeance. I asked for another shot and also if my bloods results were back to see if I had an infection they need to treat me for. My bloods weren’t yet back, I wasn’t allowed another injection and my pain and fever was back to haunt me. I was given the tablet form of morphine and told to rest.
Bruise 122/8/15 – Day 5:
Still in pain from 2 days previous but determined to beat it. Today (Friday) is the day I was meant to be getting out. The surgeon came to see me during his rounds, I had been doing all the exercises he showed me and I could now bend the leg to around 80 degrees by myself. He was happy for me to go home if I was happy. My concern as voiced to him was that should I go home and have the same level of pain can they give me morphine tablets to take with me? “No”, was the reply which did not come as a surprise as I knew that protocol here in the UK is NOT to discharge with any form of morphine unless in extreme circumstances and a plan of action has been drawn up and agreed with a pain management specialist. So I said that I would like to stay another night to get off the Oxycontin gradually and just rely on Co-codamol only.

23/8/15 – Day 6:
I managed to “make do” with only one Oxycontin last night but topped up with Co-Codamol every 6 hours and today I am ready to head home, some 6 days after coming in. I was initially meant to come in on Day 1 and leave on Day 4 so all in all not too bad. The surgeon has still not advised why the pain was so severe, he has still not advised why my recovery has been longer than any other but I suppose it is just the way. Some will be text book recovery and others won’t.

Hopsital ViewMy fear upon leaving the hospital was not only about having ample pain relief but also whether I will have to have the right knee done at some point given the amount of crepitus I have on bending and straightening this knee. I also understand that this procedure and the prosthetic parts of the repair only last 15 years so by the time I reach 71 it will be time to start all over again on this knee.

Oh the joys!

I have done some follow up on this with a video log on my YouTube channel showing the progress and exercises etc so please feel free to take a look and as always I am happy to take any feedback on any aspect.

I will also be looking to add in a little more to this blog as I progress along the way. I am starting to build up a great network of people who are having similar procedures to me through various groups on Facebook. I think that being off work, which has probably been the most difficult for me so far as I am struggling not being active, this social aspect of my progress has very much helped and I would like to think, as I say that it may help others along the way as they find surgery on their knees an upcoming and somewhat daunting task.

Thank you.