Under the knife

The fact that I'm posting this tonight means that I'm in pretty decent shape as of right now. I'm still a little groggy and I'm starting to feel my leg again as the anesthesia continues to wear off, but so far, it seems like things have gone well.

I didn't sleep very well last night - a combination of anticipation (kind of like the night before you go to Disneyland when you're a kid, except in this instance, Mickey beats you up and sends you home with a big ice pack) and a lot of muscle soreness that has been building up in my shoulders and back over the past few weeks while I've been on the crutches. I woke up before my alarm and did a final set of pre-op leg exercises...may as well get my quads as strong as possible before-hand, right?

Anne took me over to the surgery center where we were the second ones in line. After some minimal paperwork (they had me fill out most of the stuff online earlier in the week), they took me back to the pre-op area and presented me with a very fashionable hospital gown, mesh cap, and non-slip socks to change into. Then, they got my IV started and the anesthesiologist came in to explain the sedation process and to offer me a "block" on my femoral nerve, which sounded like a good deal to me...

Meanwhile - and I should have figured out this was coming - a nurse got to work shaving my leg...only the way she did it, I now have a wide stripe of even-whiter-than-usual hairlessness running from the middle of my thigh to the middle of my calf on my right leg - nice! I might just decide to wear the brace a little longer until everything grows back...

Anne left at this point to go relieve her mom (who was headed out of town today) and get the kids taken to the various familes who had agreed to keep an eye on them today.

The anasthesiologist came in next to start the femoral block, which was a pretty interesting (and eerie) procedure. To find the femoral nerve, they inserted a small needle in the front of my hip just to the side of my femoral artery. The needle had an electrical stimulator on it which they fired to stimulate the nerve. They knew they were getting close to the nerve when my quadriceps muscle started to twitch with the electrical pulse. Then, they would reduce the stimulation to a lower level and repeat the process until they were close enough to the nerve to administer the block. Once that was in, it only took a few minutes before my leg was completely unresponsive to anything my brain told it to do...pretty freaky.

From there, they wheeled me in to the operating room and someone started to administer something to me via a breathing mask, but I never had a chance to ask what it was because within about 10 seconds, I was completely out. The next thing I knew, I was in the recovery room with people busy all around me checking numbers and writing stuff on charts. The pre-op documentation suggested bringing a book, but as soon as I opened my eyes in the recovery room, I realized that that would have been a collosal waste of time, since I couldn't seem to focus on anything for more than a second or two. Luckily, Anne had thought to suggest that since I would probably be able to hear sooner than I was able to read, I should bring my iPod, so I had one of the nurses help me get that set up. That turned out to be a good suggestion.

They let Anne come back and sit with me about this time since I was starting to feel a little more awake, but I don't remember a whole lot - just that I had a hard time completing sentences and for some reason, I kept wanting to crane my neck around and look at my pulse rate and blood pressure readings. I still couldn't feel my right leg, but apparently with a femoral block, that isn't uncommon and even now as I write this tonight, I'm just now starting to get feeling back in my leg...which is not an entirely good thing, but more on that in a minute...

At this point, the only evidence I could see of the surgery was that my leg was heavily bandaged underneath the leg brace that I've been wearing for several weeks now. They had wrapped an ice-water pad inside the dressing and it was connected to the "Iceman" pump circulating cold water through it. So as of right now, I have no idea what my leg looks like.

About the time I was able to complete some sentences, they started to get me ready to check out. It was about 10:30am by then, so the whole process from admissions to discharge had taken less than 5 hours and the surgery itself had probably been an hour or an hour and a half. When my surgeon talked with Anne after the surgery, he said that everything had gone very well and that we should have every reason to be optimistic for a good recovery. He sent me home with a bunch of pictures and a CD with a copy of the video taken through the scope during the procedure (maybe I'll post a few of the pictures later if people aren't too squeamish - they're really cool and you can really see the "before" and "after" effect).

When I got home, one of the things I noticed was that I was very light-headed, so I went up the stairs sliding backwards on my good leg. This of course meant that Anne had to bring all the "equipment" that they had sent me home with in from the car. And boy do I mean equipment - in addition to the leg brace, I have the "Iceman" ice machine that continuously circulates cold water through a special pad in my knee dressing, plus a great big contraption called a CPM (continuous passive motion) machine that keeps my knee moving by constantly flexing and extending it. Anne got me set up with all that and I think I promptly fell asleep for most of the afternoon - no wait - I ate some eggs and toast first because I was starving, then I fell asleep for the better part of the afternoon.

When I woke up, Isabelle & Chase were home, but they had friends over to play with, so they didn't feel like hanging out with dad and the giant contraption on his leg. Isabelle was playing with a friend from her preschool whose father had recently had almost the same surgery as mine, so Anne and Isabelle's friend's mom compared notes on our respective surgery experiences. Apparently, I've had a pretty good go of it so far. I guess his surgeon or anathesiologist did not give him the option of a femoral block and they did not use a CPM machine to immediately start the process of restoring his range of motion. He also had a really rough time with post-operative nausea, and (so far) I haven't had any such symptoms.

This afternoon, I felt well enough to sit up in bed. I looked through the pictures from my surgery and called my family to let them know how things had gone. It is especially helpful to have a brother that's a pharmacist to ask questions about medications and drug interactions.

By this evening, I was still unable to feel the top part of my leg, so the block must still be working, but I did finally manage to regain control of my quadriceps muscle after dinner, so I was able to do my leg lift exercises. The only problem was that I must not have had full use of the muscle, since I was unable to lock my knee on my own and had to rely on locking the brace in order to do my leg lifts. The other thing I noticed as the block began to wear off is that I am having gradually more and more pain. I've been taking the pain medication as directed though, such that so far it has been manageable.

Anne has been wonderful through this whole thing, from getting up at a crazy early hour to take me to the surgery center to schlepping all the surgical equipment up the stairs to bringing meals and various other requests as needed.

All in all, I feel very blessed tonight that things have so far gone well. I'm a little bit apprehensive about how things are going to be once this femoral block wears off, but I guess at this point, there's nothing I can do about that, is there?

I'll probably post again tomorrow and hopefully include some pictures...