Surgery Day – April 1, 2019

This is the day I undergo total hip replacement surgery. This is a long post, reflective of a long day.

Before bed, the previous night, I drank, as instructed, 800 ml of apple juice over 90 minutes. I was told no food after midnight but I was well asleep by then.

I went to bed at 10pm and woke up at 3.45am in order to shower before going to the hospital. I drank the rest of the apple juice, 400 ml as instructed, before 5am, along with a small cup of black tea. Clear liquids are allowed up to one hour before hospital arrival time. This is 3 hours before surgery.

Arrival at the hospital was 6am. My husband dropped me at the front door while I went to register and get my wristbands. One was my name and date of birth with hospital number and the other one was a red wrist band stating Allergy Alert. In my case it was an allergy to nickel.

This is a photo of my wristbands along with the IV that was attached to me for more than 24 hours.

He parked the car and came to meet me. There is a waiting room as you first arrive in the Admissions Department where everyone initially waits. Have things with you to pass the time.

Surgery was due for 8am and around 7.15am I had a consultation with the nurse. Vitals were taken, temperature, blood oxygen and blood pressure. My temperature was 36c which I knew was fine. 36C – 38C is normal for an adult. I have heard of patients being turned away at this stage due to running a high temperature. I have spent the past several weeks avoiding anyone and everyone who had the slightest sniffle.

Preparation

We were told that the operation would start at 8am and the surgeon would come into the waiting room at 9.30am to let my husband know how it went. The nurse gave my husband an idea of the timeline and when to disappear for a coffee etc.

The nurse explained that we would move to the pre-op waiting room once I had changed into a gown. At this stage I was told to wear a robe over the top and put slippers on. I wore Crocs to allow for any potential swelling. The hospital gowns themselves were a new design that did not gape at the back. The hospital volunteer gave me a personal demonstration. It seemed to flummox the rest of the hospital employees throughout the day because the tie wrapped from the front around the back of your body to the left where it tied to a shorter tie. No more gaping open backs to the gowns!

15 to 20 minutes before 8am I saw another nurse who was setting everyone up with an IV. The IV was on a stand with wheels but in my case because I was not walking well she gave me one with a wheel half way down the pole to hold onto and steer. I’m really not sure if it was easier or not.

Not long after the IV was placed I was called to talk to the anaesthetist who would be administering the spinal block for my surgery. I did make her aware that I knew someone who had been aware during knee surgery of being able to hear noises and that freaked me out.

She did confirm that it should not happen but if  I was to hear anything my brain would not associate it with the operation.

Here we go……..

Just before 8am I was asked to follow through the door into the operating room. I walked in to what surprised me, was a much smaller room than I expected. I really had no expectations but this was my first thought. I was given a step stool in order to help me sit on the operating table sideways with my feet still on the step stool. The Surgeon greeted me and I told him no fooling around due to the fact it was April Fools Day. They gave me a pillow to hold with both arms draped forwards over it and asked me to relax my shoulders and lean a little more forwards as the anaesthetist gave me the spinal block.

Recovery room

That was the last I remember until I was in the recovery room with several other patients. Once again, a close check was made on vitals and I could see the monitors. The arm band cuff for blood pressure checks must have been on some kind of automatic set-up because I worked out it took my pressure every 20 minutes.

Initially on waking up I was asked if I felt drowsy, nauseous, light headed etc. The fact was in that way I felt totally fine. I had no feeling of pain and really only felt discomfort at the incision site and around that area. I had no feeling in either of my legs from the waist down. The feeling gradually started to come back NOT as I was told from the bottom up but from the waist down. I pumped my ankles once I could and got feeling back in my left (non-operated leg) first, although  the toes stayed numb on my right foot for a long time. The surgeon came to see me to tell me that the operation went well and I had got the “best of the best” equipment inside me.

Move to hospital room

A couple of hours later when my semi private room was ready I was moved onto the musculoskeletal (MSK) ward room 3530-bed 1. It is really level 3, room 530 bed 1. The last time 30 years ago in England hospital rooms had solid walls between them. In this case there was a gap and a curtain around each bed.

WBAT means weight bearing as tolerated. I am allowed to put full weight on my right hip.

The told me they really like to get to know you, which was her way of telling me they need to take 2 swabs, one oral and one rectal, to check for viruses. Barely takes a minute and not invasive.

My husband was allowed to see me in my room as soon as I was settled. It was just after 12pm. The nurse came to see me and introduce herself. She also pointed out the board and who my physiotherapist was. He did come to visit me later that same day.

The surgeon came to visit me again later that afternoon. He did not seem concerned my toes were still numb on my right foot although he did say it was a little strange. The  nurse told me that I had been given a heavy dose of spinal block, which may be another reason for not having been given a numbing injection into my thigh. I was told that different anaesthetists have different ways of doing things also. I mentioned that I once had sciatica so bad about 25 years ago that my little toe (also right side) stayed numb for 3 months.

Room with a view

The other view

Pain management

At 12.45pm I asked for pain killers because I was now in severe pain. They ask you to rate your pain and I rated it 7-8. Asked again at 1pm and told if I wasn’t feeling better in 45 minutes (1.45pm) to ask for another. They would not give me anything. At 2.45pm I was given 2 Tylenol. For anyone who knows me Tylenol is a waste of time but I accepted them over nothing, but can’t really say they helped any. They referred to them as Tylenol extenders which I have discovered are Tylenol Arthritis.

I was also in severe bad stomach ache but something told me it was pressure on my bladder. It seemed to take them a long while from telling me they would scan my bladder to me asking again and them actually doing that. They told me I had over a litre in my bladder. They soon got the commode! At this stage it took 3 people to help me on the commode because my right foot was still numb. I had to move myself (as difficult as it was) onto the edge of the bed to put my feet to the floor. Then they all helped hold me while I moved my feet slowly to sit on the commode at the side of the bed. I have never felt more relief at emptying my bladder than I did then. I saw the nurse measuring the urine and she told me that amazingly I had just peed one and a half litres! That fact followed me through all day, I was the talk of the ward. Each different nurse, technician or physiotherapist all commented on how impressive it was!

Lunch

This arrived around 2.30pm time and was mushroom soup, egg salad sandwich on brown bread, a small dish of mandarins and a cup of tea. It was not too bad and I did feel like eating something. It went down slower than normal but was welcome. It isn’t the easiest to eat half laid down but it’s surprising what you can accomplish with a little bit of determination. You are supplied with iced water all the time, just ask if you drink it quicker than they bring it. It is very important to keep hydrated. It is an important step in avoiding blood clots.

Resting after surgery

For the rest of the day the best thing was to stay in bed and rest. I was not overly tired and made notes on my phone on important issues. I sent texts to friends and family to let them know I was OK!

After using the commode it was suggested I sat on the chair until dinner was brought round. This was about 3 hours and felt a little long, but I pushed myself. It all hurts whether sitting or lying.

I was given 2 small orange painkillers (last time I was given 1) along with an anti-inflammatory at 4.18pm. At this time an antibiotic was also added into the drip. The canula for the IV is placed on the back of your hand but made it difficult to move on and off the bed. It was re-taped to my hand 4 times throughout my stay.

Dinner

Chicken in mushroom sauce, peas, carrots and wild rice. Along with that was a carrot muffin and a cup of tea. Not overly tasty but absolutely edible.

Evening

The nurse who had looked after me checked my vitals just before 6.30pm and told me she would see me the following morning.

The night nurse introduced herself when she came on shift and she too did a great job as did all the staff.

As you lie in bed you have control of the light (which no-one told me initially)  and a button to call for help. It was when I called to turn out the light it was shown to me. I also had my husband wrap my phone charger around the bed rail so I was constantly charged! I took headphones which I only used early morning to listen to music.

Throughout the night

The routine was to be woken up for pain meds and vitals every 4 hours. Despite having ear plugs with me I personally did not need to use them but it was a little noisy so it is advisable. I think I’m more unusual in that I slept.

Goodnight and onto day 2…..