Saturday, July 9, 2016

At home after knee replacement

Post knee replace I had some minor complications with the anethstesia and hydromorphone. It came down to lots of nausea and vomiting. So not fun and very difficult to manage nutrition plans. 

There are three things to focus on for good recovery. Rest, rehab and nutrition. 

I wasn't sure if I could manage without the hydromorphone because the pain is is stunningly bad.  More on that later. 

Let's jump to rest. 
I opted for a ward room which has 4 beds. I thought that I didn't need to bother with a semi private room for 2 nights. Maybe not the right choice. 2 of my roommates were great. The third was a disaster for all of us. She was a little, fat, Persian lady, with a second new knee, who was all drama. She groaned and moaned, loudly, all the time. Wanted the bedpan, which was not allowed once physio got you up and walking, then wet the bed because you can't void properly with the bedpan. A trip to the bathroom or commode woke everyone and she'd go on and on about her pain. She moaned and grunted on the way to the bathroom, in the bathroom, on the way back and then once she got back into bed. 

The guy across from me was being evaluated for sleep apnea. I couldn't hear him snoring over her!! When the other 2 patients had visitors I couldn't hear their conversations. The Persian lady and her friends conducted their conversations very loudly. Rest, real rest, day and night was impossible. 

I was so glad to get home. My mom (84) picked me up. I was going to get a service to do it but she insisted. #mumisawesome  My nurses and physio were all awesome. They listened and helped and made me feel valued. The first thing I did when I got home was sleep. It's hard to describe how healing that felt. Every sleep has brought measurable improvement. So amazing! 

Part of what allows you to rest is pain management. 
This device is a big part of that. It's a cryo cuff. The physios recommend ice packs or a bag of peas. Having torn and sprained a few things over the years I have learned the value of icing. It's only really cold water but it makes a HUGE difference. So I got serious with the cryocuff. I checked online and there was a physio group that rented them. I was willing to buy one as they are about $170. Well worth it!!
It wraps the joint in icy water and keeps circulating the water so it stays cold. This is key to swelling and pain management. 
July 9 knee versus 
July 6 knee. Ok lighting is not helping. The swelling is less and despite  the visible bruising the swelling is less and the color is better in the July 9 knee. 

The other key is drugs. I mentioned problems with the hydromorphone. It did its job with the pain but I still needed Tylenol. The hydromorphone caused crazy itching, hot flashes, constipation, nausea and vomiting. The vomiting was a big problem because I wasn't keeping any food down. Rather than add a drug - an antiemetic to end the vomiting,  I contacted my Ex, a physician, about dropping the hydromorphone and adding Emtec (like T3s but no caffeine). His response was that hydromorphone is a more powerful drug than codiene and consequently has more side effects. Switching to the codiene was fine as long as pain was managed (allowing for 
the all important rest). So that's what I did and now I can make plans for nutrition including, importantly, my super nutritive Supermix.  


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