Lea and I completed a busy day yesterday with a sigh of relief. We first went to the Riverview Hospital surgical center to meet with the surgical nurse who is coordinating Lea’s upcoming knee surgery. Nurse Jane was gathering information on Lea’s medical history, and appeared a little miffed that I kept responding for Lea. So, I let Lea answer questions and then I corrected her answer or supplemented with additional information.

I was eventually able to help Jane understand what Lea has been through and the ordeal she is continuing to experience.  She was quite surprised when I handed her a packet including the 30+ page discharge report from Hartford Hospital along with the X-rays and hip surgery information from Kona Community Hospital last November. Then she was ready to talk about Lea’s medicines, her physical and mental limitations, and her general state of health.

Jane began to understand that Lea is an unusual case, and she began to take more interest in her predicament. She was  ready to hurriedly order an EKG test, blood chemistry workup, and other information that would be needed to do a complete review of Lea’s health. She was further surprised to learn that Dr Miller just had all that testing completed within the previous few days, and that it was available on the hospital’s network.

After completing all the necessary paperwork, she took us an adjoining office where we met with an anesthesiologist who was greatly interested in the information from Hartford Hospital, and particularly from Kona Hospital, where Lea received hip surgery. After talking about several options for her pain management during the knee surgery we agreed that she will receive a twilight medication prior to the procedure, a general anesthesia during the procedure, and a spinal block that will deaden the pain in her right leg for about 12 hours after the surgery is completed.

We felt much more comfortable about the surgery after talking to him and seeing that he was taking into consideration all the complications that affect her today, what she has experienced in the past, and what procedures would be gentler on her overall system. She will come out of the general anesthesia within a few minutes of the dressing being applied, so she can regulate her breathing as quickly as possible. That will minimize the chance that she will need ventilation support. The spinal block will cover the pain in the leg, and will replace the narcotic pain killer she is currently taking. She will also have a “Pain Control Analgesic” button she can press to deliver herself more medication as needed.

She will be in the hospital at least four days; the day of the surgery, and three post-operative days. She may be released at that time, or, if there are complications, she may be transferred into a rehabilitation center at the hospital for further treatment. We have requested a private room for her so I can stay with her and help her through the recovery process. She is in a very delicate mental state in that she can tolerate day to day activities as long as they don’t create any stress. The least little bit of anxiety tips her over into an angry depression. I’m hoping to help her through recovery by protecting her from the stress as much as possible.

We attended a Joint Replacement class yesterday afternoon presented by a surgical center nurse and one of the Rehabilitative Therapists that we know from our previous Occupational Therapy workouts. They presented an extensive volume of information on “What’s Going to Happen?” Therapist Andy explained that the hospital’s goals for the day of the operation is to get the patient recovered enough from the anesthesia to sit up on the side of the bed. The next day the goal is to walk a little, and perhaps sit in a bedside chair for a few minutes while a machine flexes the new knee. The following day the patient will go through the prescribed exercises that will be used at home.

Typically “a knee,” which is a patient that has a knee replacement (there was also “a hip” in the class) will be on a walker for two to three weeks and then graduate to a cane, which they will use until comfortable enough to get around without it. One of the restrictions is that Lea won’t be able to take a shower until the stitches are removed about two weeks after the procedure. She also is supposed to try to limit the amount of walking she does to exercise her knee and try to do other things like riding a stationary bicycle or swimming. Those don’t cause impacts on the bones, and helps the knee last longer.

The surgeon will draw blood during the procedure to prepare platelet gel to be applied back into the wounds created during the surgery. The practice of utilizing the gel is quickly becoming the fastest growing new technique in surgical procedures because it promotes quicker healing and faster recovery. The platelet gel is created in the operating theater by harvesting stem cells and other natural healing agents from your own blood, mixed with other agents and applied back onto the wound. 

She will come out of surgery with a huge compression bandage on her right leg, an apparatus that circulates chilled water through a membrane placed over the operative area to prevent swelling, surgical socks, and those cuffs for both lower legs that inflate and deflate repleatedly to prevent blood clots. Those are the devices that were left on Lea too long at Hartford Hospital and gave her such horrific blisters that she could no longer use the boots to prevent drop foot. She still suffers from that careless mistake, and it is sure to be a consideration in her recovery.

She will also have a Foley installed during surgery, since she won’t be getting on a stool for a few days, and she will be on oxygen to ensure that she can maintain proper oxygenation in the blood to avoid any complications. I will be working with her to make sure she breathes deeply enough to avoid fluid collections in the lung cavities. We had enough of those in Hartford. I can’t say that I care to go through that again if I can help her avoid it.

So, we are feeling better about the upcoming surgery and recovery, and hope that she will get through the six to eight weeks of initial recovery without any more problems than most patients incur. I can’t say that I am looking forward to being in a hospital room for four more days, but it is necessary. We can only pray that God’s plan is for a complete and speedy recovery. Meanwhile, we’ll do whatever we can to make her as comfortable as possible. She is, after all, one of His favorites!