Here we go again!

Thu Feb 07, 2013 11:53 am

G was scheduled for knee replacement surgery Tuesday. Got to the hospital at 5:30 am. did all the pre-op stuff- put him in a "johnny", shaved his leg. EKG, blood work, IV started with a saline drip. Visit from RN, Anesthesiologist and other support staff. surgeon walks in at 8:40 and says the surgery is a "no go". G had arterial valve replacement in 08 and has a mechanical valve. He has been on Coumadin since. He took his last dose last Friday but his INR was still too high (blood too thin) for surgery. We have been eating brussel sprouts, broccoli and spinach 3 meals a day to reduce his INR (vitamin K).

He went to the Coumadin clinic this afternoon and his INR is down enough for surgery. So we show up at the hospital at 5 am tomorrow and try again.

The Coumadin make surgery a catch 22. His blood has to be thick enough to avoid bleeding but then there is the risk of a blood clot in the valve.

He will have to have some other mediation immediatly after surgery that will thin his blood enough to avoid a clot but not so much that he has bleeding in the surgery site.

We are both ready to get this over with.

Just needed to vent.

Thanks for being there.

Thu Feb 07, 2013 12:18 pm

Oh my! It seems like with any medication there is a catch 22 situation. I'm hoping everything goes perfect for him and recovery is swift.

Thu Feb 07, 2013 1:10 pm

Me too, Elizabeth: perfect procedure and swift recovery.

Modern medical science -- it is great that the health professionals can gear up fully, then stand down at the last moment because of patient risk. I can imagine that it is very stressful, however. But, what they can do with a little time and patience is phenomenal!

Here is Hoping that G is up and running in no time.

Steve

Thu Feb 07, 2013 4:29 pm

Thanks all. Your kind words of encouragement really cheer me on. I am not looking forward to this. The love of my my life is the WORST :twisted:

patient imaginable. When my dear man has the least ache or pain he is on line trying to figure out what fatal disease he has. That is when he is feeling good. When he had his valve replacement in 08 I had to get on anti anxiety meds just to deal with him.

He has no tolerance for morphine. He gets extremely anxious and sees things that are not there. So I have discussed this issue every time we see his doctor, NP, hospital staff whatever. Every time I bring the issue up he says "well maybe just a little bit" An eye roll to the health care provider is usually enough to get them to void morphine for my sake. I really do not need to deal with that kind of insanity.

Do I sound a little tense and stressed? Yeah - thats me. I think I need a small glass of wine.

Sigh - hospital at 5 am tomorrow.

Will post when I get a chance.

Keep us both in your prayers.

Thanks all.

Thu Feb 07, 2013 4:58 pm

I can understand him.

No question about it . . .

Steve

Fri Feb 08, 2013 7:53 pm

10:30 pm. Exhausted. Been up since 3 am. All is well. We have been stuffing our faces with broccoli, spinach and brussel sprouts three meals a day since Tuesday to get G's INR down. Yesterday afternoon it was down from 2.9 to 1.6. At the hospital at 5 am. G to OR at 7:30. Still no word on his INR. Anesthesiologist wants to do a spinal block but INR needs to be no more than 1.5. If higher he will do general anesthesia - not the best option but better than canceling again. Wait, wait, wait. 9:30 - surgery done, INR at 1.5 so spinal block. Good. all well. G's knee was really in terrible shape. Should have been replaed years ago. In a room by 10:30. G in good spirits. Walked this afternoon. PT which incldes manual manipulation and a machine that flexes his leg from 0 to 90 degrees - had that for 2 hours. Minimal pain today although he has been warned that tomorrow he will hurt like a bad bastard.

Sorry - too tired to spell check. Going to bed and will start over again tomorrow.

Later

Sat Feb 09, 2013 2:07 pm

I'm really glad to here that everything went smoothly. I hope he isn't in too much pain and recovery is speedy. My sis has had both her knees replace and our son, at 40, had his hip replaced and both are getting along really good. I hope G does as well.

Sat Feb 09, 2013 7:18 pm

Doctors, nurses, PT are all amazed at George's progress. 4 hours after surgery he was able to flex his knee to 90 degrees and walk. Today he is flexing at 100 degrees and taking long walks. He also has this crazy contraption that he uses twice a day. It flexes his knee for 2 hours. He is in good spirits (lots of good drugs). The issue now is to thin his blood out enough to avoid a clot in his valve without causing bleeding from his surgery. All is well. I have to say that the hospital staff is absolutely AWESOME :!:

His biggest complaint is that he wants a shower. No go on that until I get him home. Sigh! I am so proud of him. He is really trying to be good. Thanks for listening to me. Time for me to get a little rest.

Later

Sun Feb 10, 2013 6:28 am

Hope he has a fast recovery.

Sun Feb 10, 2013 4:29 pm

Best wishes

Sun Feb 10, 2013 4:40 pm

Progress - knee flex to 110 degrees! Walks morning and afternoon and 2 hours morning and afternoon on the flex machine. He had a shower today which made him feel so much better. His aid is great. She told him that she was only supposed to give him a sponge bath but since he was walking so well she wrapped his leg in plastic and gave him a shower. The big bulky bandage was changed this morning. What he has now looks like a giant Band Aid. It looks good for discharge tomorrow. His blood work will be the deciding factor. His spirits are good - of course he is loaded up on happy pills. I have to say that the staff at Lafayette General is awesome. From housekeeping to Doctors and everyone in between has been wonderful. I appreciate the fact that they show concern for me as well as George knowing that I will be his caretaker 24/7 for the next 6 weeks. When George decided to have the surgery done his son started badgering him to have it done in Houston. I am glad we had it done here. It is easier on both of us and my family is here to provide support once I get him home.

Sigh - the first hurdle is almost over. G has been getting PT in the hospital but it is not an aggressive PT. He starts at the clinic Wednesday morning. Every day for 2 weeks then 3 times a day for 4 weeks. He has been warned that this will be a much more aggressive PT as in make a grown man cry.

One day at a time.

Mon Feb 11, 2013 5:14 am

Yup! My partner has had both knees replaced. She swears that being a sadist is one of the qualifications for becoming a physical therapist. But working obsessively at the PT, with the therapist and at home is key to good recovery. Best wishes!

Mon Feb 11, 2013 5:24 pm

Crap - George is still in the hospital. His blood work was not right. We could have gone home and had his blood monitored daily at a coumadin clinic but tomorrow is Mardi Gras and the clinics are closed.
The alternataive is going to an emergency room for blood work. No way are we going to an emergency room this soon after surgery. Just beg for an infection. G will be discharged in the a.m. unless something drastic goes wrong with his blood work. He has been in good spirits until this afternoon. Not knowing what was going on stressed him out and he got real pissy. As soon as a decission was made he chilled out.

So home tomorrow.

Thu Feb 14, 2013 5:44 am

I hope the blood test showed everything was fine and he is is home now. Please let us know how things are going.

Sat Feb 16, 2013 6:02 pm

All is good. George was discharged Tuesday afternoon. He started PT Wednesday morning. He also had blood work done at the coumadin clinic. His INR was at 2.5 which is the minimum safty level for his mechanical valve. Wednesday and Thursday his PT was a little more aggressive than in the hospital but still on the easy side. The were gauging his flexability and strength. Friday he had a "big boy" work out. Ankle weights were used for 2 of his exercises and he was put on a stationary bike. He was only able to do 2 complete revolurions and spent the rest of the time rocking his knee. We usually stop for lunch after PT. Friday he needed cheese to go with his whine. He was down on the therapist saying thay did not know what they were doing because he was in too much pain. We got back to the house and I see his pain meds sitting on the table next to his chair. I have his meds scheduled so he takes them an hour before PT. He was yacking on the phone and forgot to take his meds. That won't happen again. He has exercises that he is to do every evening when he has PT and twice a day when he does not.

I was looking forward to a quiet day at home today but G was bored and wanted to go to Cabelas in Gonzales. Over an hour drive. They had some scope on sale that he could not live without. So we drove there, had lunch, shopped. Now in the stage of convincing me we REALLY needed to go G tells me "you know there is a boot store near Cabelas we can stop at and shop for boots for you and we can stop at La Berge on the way home and play for a while." My inner self laughed. Do I need to tell you that after the drive there then walking around Cabelas G was exhausted and his leg was cramping.

Ow well. The man is very lucky that I love him as much as I do. I post daily family updates and his sisters e-mail back "Thank you so much for taking such good care of our brother". I am enough of a b**** to think Yeah - you sure don't to deal with him. His son calls and offers advice but has no clue what is involved in caring for his father. When G had his valve replacement in 08 we had it done at Baylor in Grapevine, Tx. Brad was there for the surgery and stayed until G moved from ICU to a room (5 days). A couple of years later I was talking to Heather (daughter-in-law) about the nitty gritty, down and dirty of caring for George after his surgery. Heather was appalled. She told me flat out that there was no way she or Brad could have done that for him. They would have had to put him in a rehab facility or extended care facility until he could care for himself. So much for family caring for family. I am blessed. My family provides me with help and support in caring for George. At this point it is bringing food so I don't have to cook and daily calls of support and encouragement.

Ouch - I really do sound b****y.

Oh well. George is really behaving better than I expected. If I want him to do something I just tell him not to do it. If I do not want him to do something I tell him to do it. That works.

Wow - thanks all for the opportunity to rant. I can't do that with family because there will always be judgement good or bad. With people I don't really know judgement is not an issue.

You guys and gals are the best.