Well, really more like Surgery Plus 17 hours and counting.
Mom didn't get out of recovery and into a room until 5:30 on Tuesday, so by the time I arrived at the hospital about 10:30 AM (I'd had fasting lab work and a doctor's appointment), I was shocked to see her already up and in a chair. The physical therapist had had her take about 3 steps to the chair, and later, about five steps back. When her surgeon came by later, she was saying she was surprised to be doing so well in less than 24 hours.
The physical therapist had her up by 9 AM, just 16 hours after surgery. He showed her how to get up to the walker, then take a few steps to the chair, turn and sit correctly so her knee would bend correctly. Later, he moved the bed further away and made her walk further to get back. She was exhausted but amazed that she managed it so soon. She said the doctor had been right. Her only pain was from the incision, not the knee pain she had been living with for so long.
EQUIPMENT -
First, as soon as she reached her room after surgery, plastic legging are placed on each leg. I didn't learn what they are called but they are similar to an air cast and a machine pumps air in and out in a messaging motion to keep the blood circulating.
She was also put on a very scary looking contraption that was nicely padded but looked like something that belonged under a car with metal and gears. It is called a CPM (Continual Positional Motion). The machine is set to gently flex and relax the knee automatically. If you don't see one, ask your nurse or doctor about it. Every therapist I talked to before surgery said the CPM was essential in getting the knee moving right after surgery. I think it helped.
NOTE: Your patient may not remember using it. Seriously. As the nurse explained, the CPM machine is placed in the bed with the knee strapped into it just before the patient goes to sleep and removed about 4-5 in the morning. Because of this, and the residual medication affects, mom didn't even remember seeing it, but I knew it had been used. Still, it doesn't hurt to check with the night nurse to be sure.
SUGGESTIONS -
* If at all possible, be with your loved one the day after surgery. Speak to the surgeon after surgery to know what time he/she will be making morning rounds, so you can be there. Mom was still on the pain medications and residual anesthesia, so she really doesn't remember that day very well. According to the nurses, it is at least 48 hours before a patient is really themselves again. Chances are, the patient won't remember much of what was said or who visited them.
In the 2 hours I was there, the surgeon, the internist, two nutritionists, the case manager, one physical therapy tech, a lab tech, and a representative from the rehab facility came into her room. You need a score card. LOL If you can, ask for a business card or at least have a notebook handy, so you can write their name and what they do. Over the first 3 days in the hospital, she had several visitors that either didn't give her their name, spoke too softly or with two much of an accent for her to hear and understand, or worked with one of her doctors but didn't identify themselves. She wasn't sure who told her what and when.
* You also need to be sure things promised are done. She was nauseous from the pain medication and one person from the kitchen said they would send up soup and crackers for lunch but she got a regular meal. I had to tell the person delivering the tray that it was wrong so they would bring something she could eat. When I told the second nutritionist, she left for awhile and returned with a bag of crackers, granola bars and Boost pudding so mom could nibble as she felt like it. Nothing would have been done it I hadn't insisted.
* Be sure that the doctors have your name and cell phone number. Since mom can't hear well, I made sure that everyone who needed my number had it so they could contact me if there were any problems. I left several of my business cards in her bedside table drawer.
Day Two had a couple set backs. See Part 8 for the details.
Kathy
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