After my total knee replacement, I took this photo from my hospital bed at 4am the morning after surgery. I had been wide awake all night and the new dawn felt symbolic.
The philosophy in the unit was that patients in the unit
- were not ill
- needed inpatient care and rehabilitation
- would then continue the process with the appropriate support at home.
- would get dressed each day
- would regain independence gradually until ready for discharge
The average length of stay at the hospital is reported to be two days for a total knee replacement. In the end, I was in hospital for three nights.
My prime objective was to become well enough to be discharged safely to go home as soon as possible because -:
- everyone is happier back in their own bed
- there’s less risk of post operative infection at home than in hospital
- there’s evidence of quicker and more efficient recovery in most cases.
I needed to
- to be medically fit,
- to have the pain from the surgery well controlled
- to have met the physiotherapist’s targets of being able to walk with crutches or sticks and to go up and down the stairs
This is a brief diary of how that happened
DAY 1
- Had a bandage round my leg with a drain from the wound.
- was given shots of oral morphine to control the pain as well as taking the painkillers I had been having before the operation
- was also given laxatives and a laxative drink as the anaesthetics can make you constipated
- was shown how to do exercises in bed
- was shown how to use a special holster with ice gel packs on either side to ice my knee.
- was helped into a chair with arms by the bed and tried to bend my knee.
- In the afternoon, the physiotherapist taught me how to use a walker.
- I could then go to the bathroom instead of using a bedpan
DAY 2
- The bandage was taken off and I could see the plaster over the wound which had self dissolving stitches underneath.
- Had an X-ray of my knee. The mark on the dressing is where the radiographer lined up the machine
- Had a setback as I nearly fainted when I sat in the chair by the bed. (This is quite common after a major operation and it meant that my length of stay was extended by a day.)
- In the morning, physiotherapist taught me to go up and down a fake step with crutches
- In the afternoon, she taught me how to go up and down stairs with crutches.
DAY 3
- Physiotherapist checked that I was competent going up and down the stairs.
- I had a shower and washed my hair in the ward shower room which made me feel a lot better.
- I had to wait for the paperwork, discharge summary and prescription before I could finally go home at 3.20pm.
DISCHARGE PLAN
- Everyone needs a definitive discharge plan including a plan for transport ‘Home’
- This was discussed with every patient at the Pre-Assessment appointment and again at the Preparing for Surgery afternoon.
- I was fortunate in that my husband could collect me in his car and had taken two days’ annual leave from work