Sunday, 8 November 2015

Wounded Knee Part 2 - Operation

Eventually the morning of Monday  20th July dawned. I kept a diary of my stay in hospital, which may be of interest to anyone about to undergo a similar procedure.  My operation was scheduled for the afternoon, so they wanted me in at 10 a.m. I wasn’t allowed to eat anything at all after 7 a.m. apart from sips of water.

6.50 a.m. I eat a breakfast of Weetabix, not knowing when I will next get a square meal. My original intention was to get the IPDG to write on my good knee ‘Not this one’, to ensure they didn’t operate on the wrong knee by mistake. However I thought better of it, as the surgeon may not take kindly to me telling him his job, and I wanted to keep on the right side of him.


10.00 a.m. Exactly on time the IPDG drops me off at Ashford Hospital with my overnight bag and in I went, to find my allocated place in Dickens ward, which I understand is dedicated to orthopaedic  patients. The ward was divided into bays, and the one I was shown into had four beds in all. I was pleased to be shown to a bed by the window, thinking that at least I will have a view.  As I settled into my bedside chair, I looked around at my three room-mates, who were all in for replacement knees. To my left was a chap called John. He was being given exercises to do by a physiotherapist, and seemed to be expecting to leave that day. Opposite him was a chap called Terry, who looked a few years younger than me. He had been in since Thursday, and had hoped to be going home by now, but he had very little movement in the knee, which was seriously swollen, and also seemed to be having problems with blood seeping through the dressing on his operation scar.

Physiotherapy

Next to Terry and opposite me was a man called Mohamed. Like me he had arrived today, only he had been told to come in at 7 a.m. as he was due to be operated on  at 10 a.m.  It turned out he was a retired GP, having had a practice in Hounslow, so I presumed he was familiar with medical procedures. I was also encouraged that a retired GP trusted the NHS for his knee surgery when he could have gone private. However it was now gone 11 a.m. and he hadn’t been called.

Hounslow

11.15 a.m. The anaesthetist visits me and talks me through what would happen to me in the operating theatre. I would have a spinal injection (epidural) which would numb the lower half of my body. He said I could have a choice of staying awake during the operation or being given a sedative. Without hesitation I asked him to send me to sleep, as I didn’t want to know what they were doing to me in the theatre.

Epidural - long needle!

11.50 a.m. My surgeon, Mr Cameron-Smith comes to see me, and gets me to sign a consent form. I presume it was to absolve the hospital in case anything went wrong. I was pleased to see that he looked fresh and fit, as I would have worried if he looked tired, or had a hangover from the night before. He marked a big arrow on my right shin, pointing to the knee. This pleased me, as I was content now that they would operate on the correct knee. At around this time John in the bed next to me had some bad news – he was being kept in for another night. Also Mohamed was told his operation had been delayed which he was obviously unhappy about.

                                                                     Not my legs - but note arrow

2.00 p.m. a student nurse brings me a surgical gown to wear, which I put on the wrong way round to start with much to her amusement.  I have also been given a pair of paper knickers to wear. They were probably unisex, and a bit too small, but I supposed there was only one size.  The nurse goes through a long questionnaire with me and undertakes  various tests such as blood sugar, blood pressure, heart rate, blood oxygen and she seemed happy with them.  By now I am feeling hungry. All I have eaten today was a small bowl of cereal at 6.50 this morning, and I’m not allowed anything else before my operation. The lunch trolley has been and gone, and I had to refuse suet pudding and custard. That was the hardest part of the day so far.

Surgical gown

2.40 p.m. Mohamed is finally taken off for his operation, and I find myself alone in the ward. I turn on the communal TV and watch a bit of golf until 3.20 when a very little lady comes to fetch me for my operation. I was sitting in the chair, but she wanted me to lie on the bed so she could wheel me to the operation theatre. As she was half my size, I suggested that she lies on the bed and I push her. She wasn’t amused at my desperate attempt at humour and fetched a larger colleague to push me, in my bed, to the theatre.

3.25 p.m. We went down a few corridors and arrived in the anaesthetist area, where I met the chap who had spoken to me earlier, and a few others, including a student nurse. ‘Just my luck’ I thought, ‘An apprentice will be wielding the needle’. But no, she just watched whilst the experienced man did the deed. First I was connected, via a vein on the back of my hand, to a cannula, which dosed me with a mild sedative, designed to put me to sleep during the operation. The student nurse then attached  several  wires to various points of my body using sticking plaster.

Wired up (body double used here)

3.40 p.m.  I am transferred from my bed to an operating bed and told to sit on the side of  it, hunched forward. The anaesthetist then said to me that although he is warning me that I was about to be sprayed with a very cold spray, I would still be shocked by just how cold it was. And so it proved, as he sprayed my lower back it felt like a block of ice had been placed there.  I nearly jumped through the ceiling. The spray temporarily numbed my lower back, whilst I was given the epidural, which is a strong anaesthetic injected into the spine. Within a minute my body was completely numb from the waist down, and it would take some 24 hours to fully wear off. Whilst I was receiving this injection, Mr Cameron-Smith appeared and shaved the area around my right knee to prepare it for being operated on. When he finished he jokingly asked for £5 for the haircut.


4 p.m.  Finally I am wheeled into the operating theatre and positioned under some large overhead lamps. I was aware of 6 or 7 people bustling around me, including the anaesthetist, who sat alongside me, observing information being provided to a monitor by the various wires attached to me. I saw one of the surgeons applying a tourniquet to my right leg, well above the knee, then a screen was raised at waist level, so I could no longer see what they were doing to my leg.

An operating theatre

The strange thing was that although I felt like I was in a sort of twilight zone, I wasn’t asleep, so was awake for the entire operation. Normally this would have freaked me out, but in my half-asleep state, I was quite relaxed and interested in what was going on. I could hear the team talking to each other as they worked, including Mr Cameron-Smith, who was clearly in charge, and I could hear all sorts of scraping, sawing and banging, which sometimes would reverberate through my body, although I felt no pain.


 I was concentrating on the conversation between the surgeons, listening for someone to say something like  ‘Oops’ or ‘s**t, that shouldn’t have happened!’  Happily everything I heard was positive and they seemed happy with the outcome of their work. At one point the anaesthetist noticed I was awake and sought to reassure me by telling me that I was in hospital, having a knee operation. Fortunately I knew that already.


5.20 p.m. The operation lasted an hour and 20 minutes, and seemed to be quite hard work physically for the team, as they were constantly lifting my leg and manipulating it to check the new joint.  Eventually it was all over and I was  transferred  back to my ward bed and wheeled down to the recovery room, still connected to all my wires. Removing the tapes that held the various wires to my chest and arms was the most painful part of the proceedings. I was the only patient in the recovery room, which clearly had space for several others, and I sensed the staff were waiting for me to go back to my ward so that they could go home.

A recovery room

6.05 p.m. I am in the recovery room, where I will stay for 30 minutes, having my heartbeat, blood oxygen levels and blood pressure monitored throughout, before a porter came and wheeled me back to Dickens ward. Mohamed was already back, but wearing an oxygen mask. This was later removed.

The disappointing thing for me was that I had missed dinner, and was now starving, having eaten nothing for 12 hours. I was brought a cup of tea and a cake, then texted the IPDG that I was back in the ward. She came through the door very shortly afterwards looking very relieved to find me alive. The problem had been that although she phoned the ward, they didn’t know what was happening in the theatre. I felt for her. She had been visiting her Mum that afternoon at St Peters Hospital, and now me at Ashford. At least she knew I was OK. She brought some welcome snacks for me, and a porter also brought me a cheese sandwich off the trolley, so my hunger was sated.



7.30 p.m. I could feel the numbness slowly leaving my lower body, and by the time the IPDG left I could move my feet, although not my toes. I was also aware of some pain in my leg. Before I went in, I had been advised by others who had this operation that I should ensure I take pain killers at the first sign of any pain. If you catch it early, it is easier to control. I actually went one better than that. At 9.15 p.m. the nurse came round with a trolley of drugs. She gave me some paracetamol even though I hadn’t yet felt any twinges.

A drugs trolley


10.00  As I settled down for the night I reviewed my situation. Both my legs had pumps attached at the calf. These are connected to a power supply and alternately constrict, then release the leg. This causes blood to flow, which will hopefully prevent DVT, or blood clots. Additionally there was a tube, attached to my (heavily bandaged) right knee, which was draining blood from the wounded area. It looked as if a pint or so had been collected so far. I also had a saline drip attached to my left wrist via a cannula. So I was therefore pretty immobile, even if I wanted to move. I would have liked to change into nightwear (purchased specially for the occasion last weekend) but this seemed impossible so I resolved to try and sleep in the half-reclining position I had been left in, wearing  my surgical gown and paper knickers. If I had been given the opportunity at this point to turn the clocks back 24 hours, I probably would have cancelled the whole damn thing.

My knee post op

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