Monday, November 02, 2009

Ooops - a little problem in the operating theatre!

Well, that was interesting!

On Saturday I went to the Orthopaedic Hospital in Oswestry to have minor arthroscopic surgery on my right knee.  I had a torn meniscus and my knee kept "locking up".  In addition, I couldn't straighten it completely and I couldn't bend it as far as the other one.

After a bit of discussion it was decided that I could have a spinal block, so I would be awake during the surgery.  If I had general anaesthesia they would keep me over-night in the high dependancy ward because of my sleep apnoea.  I was hoping they could do the 20 minute operation and there would be nothing to stop me going home later in the day.

Unfortunately, this didn't work out.  The block spread up my spine as well as down, so the paralysis and numbness first made me feel sick and then made me faint.  Apparently, my blood pressure fell and my pulse rate dropped to about 20.  I'm not sure but I think the block reached the nerves controlling my heart.  It got most of the thoracic nerves, but didn't get up into the cervical nerves, so it didn't stop my diaphragm and I kept breathing.  There's a good article on spinals at this web site.

They treated the problem with atropine and ephedrine and after a little while (I don't know how long it took, but the anaesthetist said it seemed like ages!) I came round to find the anaesthetis calling my name and looking very anxious.  Once my blood pressure started to go up they got on with the operation and since I was concious I was able to watch the action on a monitor.

So now I've seen the inside of my knee!  The surgeon found a tear in the meniscus and cut it off and then clipped off lots of rough bits of cartilage.  At the end he showed me the healthy bone (white) and the parts that have osteo-arthritis (pink).  There's not much can be done for that, but it isn't bothering me much yet, so we'll hope it doesn't progress much further.

When I got back to the recovery room, they tested to see how high the block had reached.  It was up to my armpits!  It shouldn't have gone above my waist! The aneasthetist stopped by to make sure I was all right and to explain what had happened. I was pleased to see him - he's very attractive! He came by to see me on the ward, too, twice(!) - a really nice guy!

Eventually, they wheeled me off to a ward and I was told I would stay the night.  I'd pretty much figured that out ahead of time ;-)  The anaesthetic slowly wore off.  I felt the numbness leave my chest and then found I could wiggle my toes.  As all this was happening I was making friends with the three other people in my bay.  They were all very nice and we had a good laugh.  But they are all in there for far worse stuff than me.  Two have had hip replacements and one a knee replacement.

After a while I was just able to lift my legs off the bed and sometime after supper they let me use a zimmer frame to walk to the loo!  I was glad about that as I didn't want to have to use a bottle or a bed-pan.

That first walk was very weird.  Not particularly painful, but my knee felt like it didn't belong to me.  Since then I've been exercising it and walking about on it and now 48 hours after the op I'm able to walk about the house, including up and down stairs, without the crutches they sent me home with. 

They also sent me home with painkillers that I haven't had to take, exercises which I am doing faithfully and letters for doctors and physios.  It appears that I will be doing some physio with a local practitioner and I'm glad of that for my knees need strengthening if I'm to tackle the hills and take my friend's dogs out for walks.

The bandages have come off and I'm left with two small dressings covering the places where the instruments went into my knee.  It's still a bit stiff and swollen but I made it to the neighbour's on crutches this afternoon and let them feed me with tea and cake!  I haven't tried the hill up the drive, yet.  I may leave that for a day or two!

Well, that's all the gory details - I'm glad it's over and really pleased at my progress so far.