Surgery Day +1: Crash and Burn

Friday, May 24:  Crash and Burn

Oh. Holy. Mother. Of. God.  Somebody shoot me now.  Seriously.  Shoot me now.  Hang me.  Poison me.  Bring on the guillotine.  Anything to stop this pain.

Last night didn’t start off badly.  My night nurse, Marta, brought in pain meds around midnight, and cautioned me that I shouldn’t take them on an empty stomach.  She brought me a cup of applesauce, and I was soon back into la-la-land.  The CNA came in at four to take vitals, and then Marta was back around 5:30 or 6 with my next dose of pain meds.  No mention of needing food, so I swallowed some pills, and tried to get some more sleep.

Now, anyone who has spent time in a hospital knows that sleep is hard to come by.  Between nurses and CNAs bringing meds and taking vitals, and docs stopping by at random times, and food delivery at even more random times, and PT trying to get you up to walk, and the need to get help getting to and from the toilet:  it’s just a lousy place for sleep.  Add to that an increasing awareness that the nerve block and spinal deadening anesthetics are wearing off and the pain is just starting to ratchet up, sleep is a precious commodity.

This morning, I try to sleep, but my stomach is reeling.  I try deep breathing and positive visualizations, but I'm too far gone for any of that to work.  I yell at Ed that I’m going to throw up and he frantically tries to find a basin.  He calls my new day nurse, Kelly, in, and she slides the basin on my lap just in time.  Ugh.  There is not much in this world I like less than puking, but there you have it.  Now everyone tries to get food into me, but nothing at all appeals.  Finally I eat a few bites of yogurt;  it stays down, and there is celebration among the medical staff that I’m doing well again.  But I’m now spooked by this reaction to the pain meds, so I back off and try to get by with just Tylenol.

PT and OT come in to check me out:  the plan is for me to get through their lessons and tests, and get on my way home by ten a.m.  I get another stroll down the hall, and into the room where they’ll teach me how to navigate stairs, this time with crutches.  I manage my way up and down the stairs.  Ed and the PT are engaged in a fun small world conversation about people they know in common, and - standing at the foot of the stairs - the world starts to go bright around the edges of my eyes.  I say, “hey guys, I don’t feel so well” which is a massive understatement, but the most I can get out.  They plop me in a chair, but I’m still spiraling down, and finally it’s pretty much lights out.  Ed has, in the meantime, run frantically down to the nurses’s station and shouted to Kelly that I’m passing out, and she’s there in a flash.  Somehow they dump me in a wheelchair and hustle me back to my bed.  My blood pressure is 88/57, and that’s just not good enough to get released.

They call in the hospitalist, Dr. Hallmark, and he comes in, does his doctor thing, and pretty much scuttles my plans for going home today.  He explains that it’s the perfect storm of reaction to all the anesthesia even as it wears off, the pain meds on an empty stomach, and essentially the beating my body took in the surgery.  I have a giant bruise on the calf of my surgical leg, and it has me concerned about blood clots.  Dr. Hallmark takes a look and just says that the surgeons are pretty brutal when handling legs for knee replacements, and that I should expect bruises to continue to show up on that leg.

 The biggest complication about the plan to extend the hospital stay is that it’s Friday afternoon, and they close the Joint Replacement Floor at the hospital on weekends - especially this holiday weekend - because they don’t have enough patients to warrant the nursing staff.  So they unplug my medical paraphernalia, and take me up a floor to the orthopedic spine center floor.  My room is nearly identical, with a slightly better view, but really, who cares?  I pretty much want to curl up (something I can’t do - this damn new knee won’t bend that way yet) and die.  This may be the absolute worst physical day of my life.  It can’t be over soon enough.

All dreams of going home today:  dashed.  All those great measurement results from yesterday:  all so much fake news.  Rock star, indeed.  Crash and burn is more like it. So much for home sweet home today.