Day 5: Codeine…

So codeine is a beautiful thing but it gives with one hand and takes with the other….

I only starting taking it on the second day and was taking 30mg up to six times a day.  It was working well and I was aware of the potential for constipation but had had it before and it had never been a problem (I didn’t realise that I’d only been taking 8mg previously).  On leaving the hospital the nurse advised me that it would be a good idea to get some lactulose to counteract the codeine and get me on an even keel.

After two days of codeine (Day 4) it was starting to be a bit of a struggle going to the toilet. I’m a pretty regular kind of guy so this was a big change so I started cracking on with the lactulose.  My wife had previously taken lactulose following  the birth of our children as she had to have one or two codeine tablets to get over the minor pain of child birth (nothing compared to a knee op supposedly).  At first it hadn’t worked and so she asked the nurse if she could up the dose to get things moving to which the nurse replied that it wouldn’t be a problem and advised to take what she needed.  On day 4 I decided to take a similar approach and took ‘what I needed’ with the hope it would get things moving.  This equated to taking approximately 5 doses as opposed to the recommended 3.  Everything was going ok until around 22.00ish when my stomach started to rumble, I thought this was a good thing. At first the movements were slow and steady but that was the calm before the storm.  The lactulose then took over and it and once it started it didn’t really stop and I was up every couple of hours all through the night!

I’ve continued to take the codeine and the side effects are still the same but I’ve now eased off the lactulose and taken enough to keep things moving at about the right rate.  I think the lesson I’ve learned is to stick to the recommended dose and I should have started as soon as I started taking the codeine rather than letting that it take control first.

Day 4: Hamstring Graft

I’d heard before the surgery that the area around where they take the hamstring graft can get quite painful. The area on my ‘good’ knee wasn’t a problem but my bad knee was giving me a lot of pain and especially when I was up and about on crutches.

Four days after the operation it finally started to improve and the pain was then just associated with the knee itself.  The weird thing is that your brain seems to tell you which bit hurts the most at any one time i.e. you know you have a lot of pain in your knee and in other parts of your body but the bit that you concentrate is whatever hurts most at the time.  I’d just say that don’t get bogged down or depressed about one particular bit of pain as it will improve but then no doubt something will then end up hurting more!

 

Day 3: Going Home

I was a bit apprehensive of how I’d sleep generally following the surgery as I wasn’t sure I’d cope with pretty much being in the same position all night. Thankfully it wasn’t too bad and although I woke up a few times I managed to get a reasonable nights sleep and it has pretty much been the same since.

Today was the day that I really needed to push on and get home. The physios came round about 11 and again I tackled the corridor and the stairs. It was better this time but far from easy and I was still in a lot of pain. Despite this the physios were confident enough in my ability to get around the house so said they were happy for me to go home. I was happy about that although a little disappointed as I was getting used to having people come to attend my every need at the click of a button…

After the physios had gone I attempted my first solo toilet trip (no more bed pans). It definitely makes you feel old when you have to ask someone to come and watch over you while you go to the toilet incase you hurt yourself… Never the less I made it to the toilet and back successfully although there was a lot of groaning and it took a long time – just something I was going to have to get used to.

The nurses then came round about lunch time and signed off all my forms and I was ready to go, just the small step of getting down the stairs and into the car! This was a bit of a struggle to be honest and was literally a sequence of baby steps getting from the ward to the lift and having rests along the way. I finally shuffled my way to the car and then was finally on my way home. I’m not sure if my wife was happy for me to be back as it then meant she had one more person to look after!

Day 2: One more night

I woke up in the morning feeling a lot better and finally started to feel hungry. After having some breakfast I was dosed up with some hard drugs ahead of my first physio therapy session. This involved starting on the codeine and liquid morphine.

The purpose of the physio session was to get me on my feet and teach me how to get up and down stairs so that I could hopefully be discharged that day.

The physio session started with the first time (hopefully not the last) that my underwear has been ‘wripped’ off and not just by one but two women! Thankfully I didn’t have to pay for this service but it wasn’t quite as it sounds as the underwear was made of paper and I’d had it on for over 24 hours so it was a case of needs must.  The purpose was so I could put some proper clothes on to hop up and down the corridor. In terms of clothes I’ve become accustomed to standard baggy shorts and a t-shirt due to my brace, thankfully being a basketball player I have lots of pairs of long baggy shorts which I had with me but if you don’t then it would be worth investing.

So this was pretty much the first time I’d walked on crutches. I was given them the first time I injured my knee but I didn’t really use them as I found it easier and quicker to just hobble around. Getting around on crutches is not difficult but one thing I would suggest ahead of the surgery is to watch a few videos on the internet on getting up and down stairs on crutches so you have a basic idea on what to do. Following the surgery the pain was generally manageable but the first time I got up the pain was excruciating and especially at the back of the knee where I had the work done around the hamstring; as soon as I had my leg hanging under its own weight on the crutches the knee and hamstring were extremely painful and I found it very hard to take instructions and get around. I managed to get about 10 yards down the corridor but that was about all I could manage before the pain got too much so it was back to my bed for a rest and another try in the afternoon.

Once back on the bed the two women set about me again (the physio’s). It was time to go through the exercises that I was going to be doing to get me on the road to recovery. I was given three basic exercises to do:

  1. Leg raises
  2. Platella massaging
  3. Knee ‘crunches’

I was told to do reps of 10 every two hours (when awake) for the first 48 hours and then reps of 30 four times a day after that. The first time I did the exercises it was really hard work and it felt pointless even trying but I’ve stuck with it and have felt the benefits and improved every time I have done them.

Following the exercises was the first time I iced my knee. Despite really complex surgery RICE (Rest Ice Compression Elevation) is still the best formula for recovery. The ice was very painful the first time I applied it but I’ve now got used to it and it has really helped to get the swelling down.

The physios came back in the afternoon (largely uneventful this time) and I had another try getting up and down the corridor and tackled the stairs for the first time. This was ok but again the pain was pretty horrific and I was only slightly more in control than Bambi on ice. On getting back to my bed the executive decision was made that I’d be staying in for another night. I didn’t complain, another night of food, free internet and not having to leave the bed suited me fine; better than going home and having to try and referee a 3 year old and a 10 month old from the sofa!

For the first 24 hours Inhad bandages around my knees so didn’t really have a feeling for the extent of the work they’d done to my knee. On the next round of visits by the nurses they decided to take the bandages off as the physios wanted to get the ice directly onto the skin to get the greatest benefit. It was at this point that the extent of the operation really started to sink in. On taking the bandages off I could see the incisions in both knees and the extent of the one for the MCL. They also changed the dressing so I got my first sight of the wound itself. Although it was tidy I am pretty quesy and again it just brought it home the extent of the injury and I was happy once it was covered up again.

The rest of the day was pretty uneventful and mainly involved drugs (liquid morphine, blood thinner injected straight into my stomach, codeine, paracetamol and ibruprofen) and watching the night manager (all 8 episodes in a day).

Post Surgery: Day 1

Following surgery I was in the recovery room for about 30 mins. Generally I felt ok although a bit sick.  The surgeon came round and said the surgery went well and ‘needed to be done’, reassuring now that I had a 12 inch incisision to me knee. I was in a bit of a daze post surgery but can still remember everything and was then taken back up to the ward.

The next 12 hours I felt absolutely drained and really struggled to keep my eyes open so was just drifting in and out of consciousness. Ahead of the op one of my concerns was the initial pain in the immediate hours after it was complete; this wasn’t too bad thankfully and with just paracetamol and ibruprofen the first day I was reasonably comfortable but I suspect a lot of the drugs administered during the op were still in my system.

I had hamstring grafts taken from both knees and one of my fears was that my ‘good’ leg would be incapacitated nearly as severely as the ‘bad one’ in the short term. Thankfully this wasn’t the case and my ‘good’ knee was uncomfortable but nothing more than a twinge of the hamstring. There was still an incisision, staples and bruising but I think it is a case of all things being relative and compared to the other knee it was like a paper cut!

The first 24 hours I never left my bed and didn’t really move at all as I had a bed pan to go to the toilet and had food and drink brought to me.

Ultimately day 1 wasn’t as bad as I expected   . A combination of drugs and tiredness meant it passed relatively quickly.