Post #2 Day of surgery/Hospital stay

March 20th, 21st, 22nd 2013
Surgery Day/ My two night stay in the hospital

Well it's surgery day. Today I will be having two surgeries on my right knee. The MPFL reconstruction, which is where I have a cadaver ligament placed on the inside of my knee. My own ligament has been stretched from all the numerous dislocations and honestly does not hold my knee cap in place at all anymore. Its basically just hanging out in my body, not doing its job! And the second surgery I am having is the Tibial tubercle fulkerson osteotomy. This is where they will break my shin bone (tibia) and slide it over so that the ligament attached to that bone is straight and not being pulled to one side. Right now my ligament is not straight and it is pulling my patella to the outside, so any slight twisting to my knee causes my patella to pop right out. Stupid knees, everything else in my body is doing it's job.

 The anesthesiologist gave me the option of having a nerve block or not. Heck I didn't know. I've never had a surgery like this before. I figured if my doctor ordered it he had good reason. So I got the nerve block. When i hear nerve block i think: CRAP THIS IS GOING TO HURT GOING IN. Talk about a piece of cake. My nerves slightly "fluttered" a couple times but that was it. The needle was so tiny i didn't even feel it going in.

After the nerve block was placed i was on my way to surgery. My surgery took about three hours and i woke up in the surgery room. They wheeled me into the recovery room and pain was pretty bearable.  Although i was still pretty doped up, a couple fentanyl hits fixed any pain i had. The pain was more related to pressure.  It felt like there was a lot of pressure on my kneecap and every now and then there was a sharp pain in my inner knee (hence where the fentanyl came in).

After sitting in the recovery room for almost three hours (they didn't have a room for me, i only needed to be there for an hour), they wheeled me away to my room.  Funny side story, the person who wheeled me up to my hospital room was someone i had a couple college classes with.  It was nice to catch up, although i was still pretty loopy.

When i got to my room my parents were there to meet me.  I was amazed by how little pain i felt.  Heck if this is all there is to it, I'm kicking myself for not doing it years before (little did i know PAIN was soon to come).  I took a small amount of pain meds every four hours but for the most part due to the block, my thigh and knee were both numb completely.  I could feel my foot and move it, however it felt like my foot was just asleep.  You know that tingling feeling you get after sleeping on your arm or leg wrong?  The anethesiologist warned me that a large part of the nerve block would start to wear off by that night.  When they said "wear off" i assumed they meant as the nerve block wore off my pain would slowly start to increase.  Boy was i wrong.  At 1AM my nerve block started to wear off, and my pain rocketed from a 5 to a 12 on the pain scale.  I've never felt that kind of pain before.  I woke up crying, and once at that pain level it took about two hours to come back down.  I was not expecting that.  I honestly thought my pain would slowly increase from 5 to maybe 8, then 8 to maybe 10; but not from 5 to 12 almost instantly.

The nurse i had that night was not very helpful either, so maybe if i'd had someone better, it would have been more manageable.  Either way that was a bad, bad night.  I finally fell asleep around 5AM and woke up again at 7AM with a lot of pain.  Not nearly as bad as the night befor,e but i would say maybe an 8 on the pain scale.  I asked the CNA to help me to the bedside commode.  I instructed her to lift my leg a certain way and that she could not drop my leg down.  She however did not follow through with instructions well, and by the time i got back into bed i was in severe pain again.  She had dropped my leg twice, and by the second time i lost it; tears just poured from my eyes.  I spent the majority of that morning trying to catch up on my pain.  Anyone who has dealt with extreme pain might know that catching up to and overcoming pain is MUCH harder than maintaining pain.  By afternoon i was doing better, but i decided to stay one more night just to make sure my pain was under control.  And boy am i glad i did...again that evening i found myself going from a pain level of 7 to well over 10...again.  My leg muscles spasmed so bad my leg almost levitated off the bed.  The good thing was that the RN i had that night was amazing!  He explained to me that my pain medicine would not take effect until my muscles stopped spasming.  Understanding this helped- I believed him since my muscles were so tight, my foot/toes were tingling.  After several hours of pain, thankfully we finally started to get the pain back under control.

I don't like taking more medicine than i have to since I tend to get sick with pain medicine.  However after my two experiences with extreme pain i learned that it's better to stay on top of your medicine (at least for the first couple days/first week), than to bravely try and take the bare minimum meds. Once you get to that pain level it takes an hour or two to get back down to a tolerable level.  A hard lesson learned!

Pain was my biggest obstacle in the hospital.  The physical therapist worked with me only a couple hours after surgery.  He bent my knee and i took two steps with the walker.  By the next day i was using crutches and trying the stairs.  It was a very slow walk, but it was a walk, i was so excited!  I'm only allowed to do toe touches/ten pounds of weight on my right leg.  So with crutches i basically just touch the ground with my right foot to gain a slight amount of balance.

Well this is a long post, so i think i'll jot down key points (don't laugh) of this post so people who are reading my blog for insight on their future surgery don't have to read this WHOLE blog, HA!

Key Points:

• Placement of nerve block was a piece of cake, didn't hurt at all
• Directly after surgery = very little pain...or maybe i should say pain was tolerable
• Once nerve block STARTS to wear off pain level will jump to extreme pain (if you do not "stay up" on pain pills- literally- watch the clock!)
• If you do get a nerve block, i suggest taking all the pain medicine you are allowed, even if you are not in much pain, so once it wears off pain will not hit as hard as it hit me
• Physical therapy worked with me just hours after surgery, he bent my knee and i took two steps with a walker
• I ended up staying two nights in the hospital due to pain control, if you stay absolutely current with your pain meds i would expect one night in the hospital might be enough for you