Total Knee Replacement - Surgery Plus Fourteen Days

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Total Knee Replacement

When I had my knee replacement surgery, they closed up the incision with staples. This was a first for me. Any incisions I’ve received in the past have been closed with stitches. I posted a picture of what the staples looked like in a previous entry.

Knee With Staples

Two weeks after the knee surgery I went to get the staples out.

Originally they were supposed to be removed at home by a nurse provided by the Health Care service. I was told, just before I left the hospital, that they were booked solid and I should arrange for my own doctor to do it. So that is what I did. Of course, my own doctor was not available for the removal, but the medical center where his office is located arranged for a resident to do the job.

I thought I was ready for anything. My daughter reassured me it was a simple procedure. “It was one of my favorite things to do when I was doing my placements. There’s nothing to it.” So I steeled myself a little. Thirty staples being released from their death grip on my flesh with some kind of pliers device didn’t seem like a “nothing to it” type of thing, but I’m a big, strong, brave guy. I could handle it. Until the resident walked in. He looked about 18 years old.

He seemed sure of himself during the introduction and I felt quite okay until we got to the point where he wanted to check out the staples. I hiked up my track pants and I swear his eyes actually bugged out a little. “Well,” he said. “You’ve got quite a few in there. The incision looks like it’s healing quite well. Could you excuse me a minute?” He got up and smiled at me as he left the room.

I looked up at Lynn. She had wanted to come along and see how staples are removed. “Do you get the feeling he just went to find a nurse and ask about staple removal,” I asked. She just laughed. “Maybe he’s gone to find the staple removal instructions.” Was I going to be his first? Was the young resident a staple removal virgin? Inquiring minds want to know.

I must admit that this was my first really queasy moment in the whole total knee replacement adventure. We watched him struggle to get his surgical gloves on. His hands were about two sizes to small for the gloves in the office, there was a lot of loose latex flopping around and he looked incredibly awkward as he slipped his fingers into the handle of the removal device. Check out the picture and imagine how it looked to me.




He was a little tentative as he approached his first staple, but he was trying hard to act confident as he slipped the tips of the device under the staples edge. One squeeze on the handles and the staple obediently let loose its clasp of my skin and came free.



You could tell he wanted to triumphantly look up at Lynn and I, but he restrained himself and acted as if this was just what he expected. By the time he got to staple number 15 it was old hat, and the last few almost came out by themselves.

The whole process went smoothly, with virtually no discomfort for me, and only a little for him, right at the beginning. I was pleased that I had been his first. He said his intention was to work as a GP, so I was doubly pleased to be helping a young one help fill the gap in family doctors that exist right now in Ontario.

I want to reassure anyone that may be looking at staple removal that there is no pain associated with it. I had been expecting some kind of local, but nothing of the sort, nor was it required. I remembered Dr. Blastorah telling me that my knee would feel a little funny, with some loss of sensation on the surface, after the operation. And that is true. Maybe that's one reason there was no discomfort.

All in all I would say it was an educational day, all the way around. Last but not least, here's a look at my stapleless knee.

Total Knee Replacement - Surgery Plus Two

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Total Knee Replacement

Friday night was restless. Not a great sleep. Having your leg wrapped in endless layers of gauze and cotton batting is a real pain. And not being able to move it very easily is also a hassle. But it is nice having the ability to adjust the bed controls to elevate your torso a little. I have to admit that even after what turned out to be 5 days in the hospital bed, I had no back problems. I would not be able to say the same about my bed at home.

I remember lots of periods of wakefulness between Friday night and Saturday morning. But the nurse managed to empty my little urinal three times between 12 AM and 6 AM without me noticing her, so I must have slept sometime.

Jeffrey is moving a little more slowly today, but he is up on his walker early, before breakfast. He likes his shave and wash. I am going to have to give serious consideration to whisker removal and shampoo today. This is a hospital, after all, not a canoe trip.

The nurse has already been around with a kind of warm wet nap, a very cool handy dandy clean-you-up-without-soap-and–water towel. A very heavy paper wipe, about 30 cm (or one foot) square that is slightly damp and impregnated with a little soap, glycerin, aloe etc. that can be warmed up in its own package in the microwave. I think there are 5 or 6 sheets to a package and the nurses hand them out and close your privacy curtains. (Hi Rachael, hi public corridor). Then you can give yourself a good rub down. The nurse comes a long a minute later to do your back and voila, country scented clean. Hey, I’ll take that, as opposed to standing over a drain somewhere, naked, hanging on to my walker while some helper hoses me down.

They just took the bandages off and unwound about 20 feet of gauze wrapped around enough cotton batting to outfit three Santa Claus imitators. They took off the bandage put in after surgery. Ouch. What…, no time to shave the leg? I remember after my original cartilage removal it looked like they shaved everything from ankle to groin. Here they barely took out a half inch (12 cm) wide strip. The cut is about 8-10 inches (20 -25 cm) long. There’s a little drainage tube that just disappears into the side of the knee and leads to a little liquid collection container that sits on the bed at my left side. That tube comes out now as well.

When they remove the drainage tube it doesn’t so much hurt as send a little jolt though my knee. Very similar to getting a shot of electrical current. Weird. There’s a little bleeding from the drainage hole, but not much weeping from the main incision. And speaking of the main incision, it looks like some mad, serial stapler got a hold of me and just had his way. There must be thirty staples. I’ve seen model railroad tracks with fewer cross ties. I wonder what they will feel like coming out.

A few minutes of work with a damp clothe, a little rubbing away of cotton batting residue, application of a new bandage (over the unshaved hair on my leg – how often are we going to change that bandage now) the disconnection of some fluid IV lines and I am a free man. Except for this wonky knee that doesn’t want to bend and leg that hurts too much to lift without support. Still, a new threshold has been crossed.

Today’s breakfast is special. A piece of toast with three slices of bacon, cream of wheat, juice…whoa. What are they trying to do, make me stay forever?

Physio is a little more interesting without having to fight through all the bandaging. I sense the therapist isn’t that pleased with my progress. I try and explain to her the greater difficulty in lifting and straightening a long leg like mine, as compared to the little short legs she mostly deals with. It’s a simple matter of leverage. We all studied this stuff in school. She is not that impressed with the argument.

In Jeffrey’s conversation with his doctor this morning the possibility is raised, of him going home today. The doctor says, sure, why not, as long as the physiotherapist agrees. Jeffrey’s wife says “what am I going to do with you at home.”

Suddenly Jeffrey is an over-achiever again for the therapist. Last nights sweats and chills are banished from his mind. He meets all requirements and is gone by lunch time.

The therapist and I got up for a little scoot around the hallways. She is just a small thing. Maybe 5 foot high, maybe 90 pounds. But mean. Like an agitated rattler. During the rehab exercises, I go to assist my injured leg with the toe of my good one and her hand lashes out, giving me a smart little slap on the ankle. “There’ll be none of that,” is all she says. She obviously knows her stuff.

My hallway scoot is exhilarating, except for the fact that I am barefoot. I didn’t think to pack slippers or sandals for my stay. Of course, I didn’t expect Lynn to take the clothes I arrived in home with her on Thursday. They go in a separate plastic bag labeled “Personal Belongings” when you gown up for surgery. Lynn thought I would have no need for them until check out time Monday, so why leave them lying around in the hospital? Good thinking except for the no shoes dilemma I now find myself in.

Of course, I can’t catch her by phone before she leaves to come visit. It’s going to be an early visit today because there is another horse to see afterwards. So the visit winds up being a little broken. After the initial chit chat, Lynn takes off to find me a pair of cheap flip flops or equivalent at the closest store. Naturally, nothing has my size (13) so it takes a while. She finally gets back with what we used to call “bedroom slippers” in the old days. You know, the ones with the sponge rubber sole, plaid uppers over the toe and black stretchy material around the heel. Comfy. They really were a good fit, and felt secure under foot with the rubber sole, but anything with a back on it is a problem for straight legged people (like recent knee surgery patients). It’s a good thing I was able to touch my toes before the operation, so I can just barely bend enough to put the things on and slip the heel of my left foot comfortably into them. Sandals would have been handier. But now I have a pair of “bedroom slippers” that are the foot equivalent of comfort food.

Today was another stretch in the chair. Two hours today. It got cut short because I asked for help to get up and into my walker so I could travel across the hall to the handicapped “patients only” washroom. A lot more room in there and it is possible to sit on the toilet with your leg extended. My first bowel movement. I normally wouldn’t be so forward with this kind of information, but let me reveal a little secret. If you don’t manage on your own, then the nurses will provide medication to assist. My philosophy re: BMs shifted when I got that bit of info. Laxatives work differently for different people. They tend to work really well for me, so I preferred doing without.

Of course, I needed no assistance using the walker, and once I was done my business, I just walkered my way back to my bed (already made up) and got in. No need to be stuck in the damn chair for 4 hours again like yesterday.

Total Knee Replacement