As promised in my last post, this one is going to
concentrate on my first week home after surgery..
I arrived home a week ago and, after a cup of tea,
faced the first challenge of my non-weight-bearing spell (which is scheduled to
be two weeks, until my first check up).
We are fortunate to have a smallish spare bedroom,
which we decided to allocate to me to sleep in initially after my
operation - I was pretty sure I would sleep fitfully, and didn't want to
unnecessarily disturb my wife's sleep, and it has also meant that we have
been able to arrange it solely focused on the needs of the "patient".
The room in question is upstairs, and so the
challenge was to navigate quite steep stairs. Despite my practice on, and
comfort with crutches, and the presence of my fit and strong brother, I still
decided that the safest way of mounting the stairs would be, inelegantly
and slowly, on my bottom. That's fine until you get to the top and wonder how
you're going to get upright - I could have managed with crutches, but my
brother and the handrail seemed the surer option.
For reasons that will become apparent later,
that one-way trip up the stairs has been the only encounter with
the stairs to date!
In the days before my operation, I installed a
small TV in the designated room, and I also decided to purchase
an overbed table, which has really been an absolute godsend; with the
table, and a "reaching stick", I really do have most things to hand,
saving my wife from running up and down stairs all the time.
In order to help with the essential elevation of my
ankle above heart level for two weeks (to minimise wound swelling), I had
also procured a shaped wedge of soft foam, with a cotton cover, which has
been excellent in helping me ensure the leg remains elevated, especially when
sleeping, and has also been very comfortable.
I actually got a good first night's sleep, despite
the efforts of the dawn chorus outside my open window. After tea and some
juice (I'm back on my juice diet), I manoeuvred myself on my crutches to the
bathroom for a constitutional (unsuccessful), and a shower.
In preparation for showering in relative comfort
and safety, I had bought an adjustable-height shower stool, and a waterproof
cast cover. The latter pulls on from your foot up to mid thigh, where there is
an elasticated collar to provide a seal - this works really well, and ensured
my cast remained totally dry during a lengthy shower.
What didn't work as anticipated was the
(adjustable-height) shower stool - even on its highest setting, it felt too low
to me to safely lower myself on to it from my crutches, especially in a shower,
and I was even more daunted by the prospect of getting up from the stool at the
end of the shower, especially with only my slight wife around to assist.
However, a bit of improvisation sorted
the problem.
I had acquired an adjustable frame and seat to
assist in using the toilet, and fortunately this fit within the shower cubicle.
With a higher seat and arms, this was much easier and safer, so I was able to
have the first real shower and hair wash for three days.
With the aid of my wife, and my crutches, we moved
the toilet frame next to the sink so I was able to shave quite
comfortably, brush my teeth, spray on some deodorant etc., before heading back
to bed on my crutches.
My second night's sleep was not quite as good as
the first at home, mainly because I was finding pressure on the bottom of my
spine and my bottom from essentially being in one position most of the time,
with little opportunity to move around because of my elevated leg. I was also
concerned about ensuring that I had no problems with pressure sores.
Back to good old Amazon, and I found a pump-driven
air mattress, which has about two hundred air pockets, and where the
pressure on each pocket is varied every few minutes. In combination with a
quiet motor/pump, I have found this has almost completely removed the pressure
issue, thank goodness.
I/we settled into this pattern, interspersed with
TV/email/meals, for a couple of more days, and I thought ' "this is going
to be easier than I thought",
WRONG ................ things started to go amiss
last Sunday.
I had felt a twinge in my right
(i.e. non-operated leg) knee on Saturday night; to be fair, I have had
problems with this knee previously (probably also arthritis-related). Well, on
Sunday morning when I got onto my crutches in preparation for a trip to
the bathroom, it was immediately clear to me that my "good" leg would
not support my weight. Dosed up on Paracetamol and tried later, but same result.
So, no way to make even the short journey from
bedroom to bathroom, which also exacerbated another burgeoning problem - the
desire but inability to "take a weight off my mind" (more of this
later).
My wife gave me a bed bath, and I settled back
into bed somewhat frustrated and grumpy to watch more TV.
When I woke the following morning with no
improvement, I decided I needed some physio work on my dicky knee. Spoke to my
local GP surgery, who agreed on the basis of a phone conversation, but
then said it would take at least two weeks to arrange through the NHS.
Contacted a private physio firm, and they agree to make a house visit on
Wednesday. The physio took history, examined the knee, manipulated it and did
some ultrasound, and said she thought that an anti-inflammatory (which had been
discontinued after surgery) would help the process. She undertook to speak to
my GP, who understandably wanted to see me before prescribing more medicine,
but the fact that I could not get to the surgery meant another day's wait for a
home visit. (I'm in no way being critical of my GP partnership here - it's just
the way things are, and they're actually very responsive and helpful within the
limit of their resources).
A GP came to see me on the Thursday and agreed an anti-inflammatory
was appropriate, so finally on Friday I was able to add that to my daily intake
of medicines. Clearly had the desired effect (together with the exercises the
physio had given me) because today, for the first time for almost a week, I have
been able to take myself off to the bathroom, much to my relief (and that
of my wife I suspect, though she said nothing and has been remarkably stoic, as
I'm not exactly a model patient!).
In the interim, we'd had to improvise toilet
arrangements in the bedroom using the toilet stand and a bucket, which
although regularly deployed had not been successfully "initiated"
until a couple of days ago (those of you who are squeamish please skip to the
next paragraph). It's a fact of life that opiate-based medicines tend to result
in constipation (exacerbated by general inactivity), which is why my bag of
medicines included both laxatives and stool softener. Despite these I had
not had any success for more than a week, and started to get concerned about solid
build-up (impaction). I was becoming very uncomfortable, and so I decided
that I had to take matters into my own hands (or fingers rather!) and so
undertook a bit of manual unblocking; not pleasant, but absolutely had the
desired effect, opening the floodgates and, touchwood, no further problems in
that department. I make no apologies for including this last paragraph -
it is these sort of issues that seem to make (the aftermath of) surgery often
more difficult than it should be, and impact on one's sense of dignity, which
then has the potential to make one feel "down", and yet are very
rarely written or even talked about.
So, at the time of writing, I'm feeling
comfortable, the sun is shining in Norwich, and I've been enjoying watching the
Open Golf from St. Andrews. Plus, the ankle itself seems fine, in-so-far
as I can tell - toes get wriggled regularly, are a nice rosy-red colour, and
respond to a daily "touch-test".
Day after tomorrow, I'm back to RNOH for removal of
stitches, new cast (probably, though possibly a boot), and - if all going
according to plan - a big change from non-weight-bearing to
fully-weight-bearing on my operated ankle.
Most likely I will update you on return from that
visit, so talk to you soon!
David
