Wounded Knee Part 3 - Hospital Life

Following the operation, my stay in Ashford Hospital continued, and I maintained my diary...

6.00 a.m. Tuesday.  Surprisingly, I had slept reasonably well. The bed was comfortable and I was in very little pain (I don’t think the anaesthetic had fully worn off yet).  The night, however, was a bit disturbed, as John is a bit of a wanderer. Very confused, he was constantly trying to leave and go home, whilst the long-suffering nurse tried to fetch him back. He wasn’t being aggressive, but very argumentative and consequently rather disruptive. At one point he tried to climb out of the window by my bed, until I reminded him we were on the second floor.

As the morning progressed, I became concerned that I hadn’t passed water for 24 hours, and the nurses were keen that I did so. Feeling a bit dehydrated, I asked for a jug of water. The nurse drew my curtains round, and sat me on the side of the bed with a bottle to pee into. Still no success, although the nurse said it was quite common after a ‘spinal’. I resolved to drink lots more water. She took a blood test, I’m not sure why.

10.30 a.m. the physiotherapist came and put me through my paces in stretching and bending the new knee. I used a walking frame (taking with me the saline drip trolley and knee drain) for the short walk to the toilet (still nothing doing). The physio said she would try me on crutches in the afternoon. In the meantime I sat up in my chair in day clothes (shorts and T shirt). The physio told me to keep on doing the knee bending and stretching exercises at intervals during the day. The more I do now, she said, the more flexibility I will eventually have in the new knee.

Poor Terry was having problems, as his leg remains terribly swollen, which restricts his opportunities to exercise. He has been in hospital for 6 days now, and is getting fed up.

3.10 p.m.  I finally emptied my bladder, shouting ‘Eureka!’ as I came out of the toilet, to general applause. It had taken 24 hours for the epidural to wear off. Somebody came to collect me for an X-ray but couldn’t move me because of the blood drain still attached to my knee.

                                                   My knee with drain attached

3.30 p.m. It was nice to get a visit from Ken Howe, who had bought me several bars of chocolate and brought me up to date with Rotary gossip. I also had another  visit from the physio, who wanted to try me on crutches but couldn’t, because of my blood drain getting in the way. Altogether, I reckon I've lost a pint and a half of blood from the wound so far.

4.40 p.m. A nurse came and removed the drain from my knee and took me off the saline drip. However,  the  cannula remained in my wrist until they knew the result of this morning’s blood test.

Cannula in hand. Body double used here in case you were wondering...

8.00 p.m. John went home. He was given the go-ahead about 5 p.m. after his wife had made a bit of a fuss, then they had a long wait whilst medication was sorted out and a porter was organised to push John out in a wheelchair. For my part, I was having increasing trouble with pain. The spinal had  fully worn off, and now I was suffering. We had been told to ask for pain killers at the first sign of any pain as it is easier to manage at this point. I may have left it a bit late. The knee exercises, which were relatively pain free this morning, were now excruciating, and I seemed to have less movement in my knee than I had in the morning.

10 p.m. I was in constant pain at bed time, and the painkillers didn’t seem to be having any effect. I noticed  that Terry had been ‘using’ morphine during the day and I asked the nurse if I could have some. She gave me what she said was a full dose (normally they like to give you a half dose). Within 10 minutes I was fast asleep and didn’t wake up until 6 a.m. I understand now how people can get addicted to the stuff. When I woke I asked for more morphine in addition to painkiller tablets in an attempt to avoid pain happening rather than trying to deal with it after it occurs.

9.30 a.m. Wednesday. This is day 3 and the day I had been hoping to go home, but right now I feel  a long way from being able to cope at home.  I had a visit from the physio who once again got me bending and stretching the knee. I didn’t think I did as well as I had yesterday, but she seemed happy, blaming my reduced movement on increased swelling around the knee. She also brought me a pair of crutches and took me for a walk around the ward and down the corridor. I even went up and down a flight of stairs successfully. This is the test, I discovered, which determines whether a patient is fit to go home and consequently she was confident I would be leaving today.

10.15 a.m. I was taken for an X-Ray on the knee. A porter pushed me, in my bed, all the way there and back, even though I protested that I could manage on crutches. I was given to believe that  if the X-Ray proved satisfactory, I would be going home today. Incidentally, I still had a cannula attached to my wrist, even though yesterday’s blood tests were OK.  I spoke to a nurse about leaving today, as it’s looking increasingly likely that I will, but nobody has actually told me so yet.  I told her that my main fear about going home is pain management, because in hospital it is easy to ask for more painkillers, or morphine if pain is bad, but at home I can’t do that. She reassured me that I would be prescribed strong painkillers, although not morphine, which would deal with any pain.

                                                            X-Ray machine

10.30 There was a new arrival in the ward, Dave, who was occupying the bed previously belonging to John. Like me, he is in for a replacement knee. He is familiar with the hospital and its’ routines, having previously had both hips replaced. I assured him that knee surgery was much more painful than hips.

Replacement hip

2.00 p.m. Lunch had been and gone but still no official word about my departure. Terry was getting very restless.  He was determined to leave today although the physios were not happy with the flexibility in his leg, which remains very swollen. His argument was that if they gave him anti-inflammatories to take home he could manage fine. The physio said she would speak to the surgeon, who wouldn’t be available until 4.00 p.m. He reluctantly agreed to wait until then but pointed out that he was going home anyway.

3.00 p.m. Alfie, one of the male nurses, came to remove my bandages and change my dressing.  He  confirmed that I would be leaving today. They were just putting together my pack of medication.

                                                                              My knee with bandages removed

3.10 p.m. Dave went in for his operation. I wished him well and told him I may not be here when he gets back to the ward. I had a final visit from the physio. My knee can bend to a 90 degree angle, and  she said this was good after only two days.

4.30 p.m. Physio couldn’t get hold of Terry’s surgeon, so Terry decided to discharge himself, against the recommendation of all hospital staff. The problem with doing that is, if he later has a complaint to make about his treatment, he won’t have a leg to stand on (literally). I think he just got frustrated that all his fellow patients were going home in 3 days, and he was still there after 6 days.

6.15 p.m. I finally get the all clear, and am given a large bag full of medication. I asked if someone could help me carry my holdall and the bag of drugs downstairs, and a porter, with wheelchair, came to take me down.  I was very uncomfortable in the wheelchair because getting my feet onto the footplates meant bending my knee to a painful degree. When we got to the entrance I asked him to drop me off at a bench outside where I would wait for the IPDG to fetch me.

When the IPDG arrived, a tragi-comedy ensued. She parked alongside the pavement, about 5 yards from where I was sitting. I got up on my crutches, but couldn’t also carry the two bags, as they unbalanced me, so I hobbled over and after 5 minutes groaning managed to get into the car, leaving the IPDG to fetch the bags. She got out on her crutches, but couldn’t pick up the two bags either, however she did manage to kick them towards the kerb. Getting back into the car, she manoeuvred it alongside the bags, and I was able to lean out and haul them into the car using my crutches. If anyone had been watching, it must have been an entertaining spectacle.

The sort of car I should have been picked up in.

Our first call was to Tesco’s, just across the road from the hospital. Some of the drugs I needed weren’t supplied by the hospital, so they gave me a prescription to take to Tesco’s pharmacy. The one minute drive to Tesco’s car park was agony for me, as my knee was bent at a terribly painful angle, and I became aware that I had taken all the painkillers I was allowed. What I would have given for a dose of morphine at that point! I decided to get out of the car with the IPDG and hobble into the supermarket on my crutches, on the basis that it would be the lesser of two evils. However, the walk to the pharmacy counter (no more than 100 yards) was terribly painful, and the IPDG sent me back to the car, where I perched with my legs outside, until the IPDG returned with my drugs.

                                                     Tesco Ashford

Interestingly, I attracted the attention of people both going in and coming out of Tesco’s who noticed my plight and wanted to talk to me about their own knee operations. In fact, during the weeks since the operation, I have had dozens of conversations with complete strangers, who wanted to share their own experiences. Others wanted to know what the operation was like as they were thinking about having it done. I seem to have become introduced to a new fraternity, which I call the RKF (Replacement knee fellowship).

Eventually the IPDG got back to the car loaded with drugs, and we set off home. The drive home from Ashford Hospital is relatively short, but it must have been the longest 15 minutes of my life. It is difficult to describe what it’s like to be forced to bend your knee beyond what is comfortable just to get into the car, and remain that way for 15 minutes. The IPDG said I looked grey, and I’m not surprised, I don’t think I have ever suffered such pain before. When  we got home I went straight to bed where I finally found some relief, being able to lie on my back with my legs stretched out in front of me. I couldn’t turn over, either left or right, but I wasn’t bothered.  I was comfortable at last.