I asked my friend Barbara to go with me to my pre-op appointment this morning because she listens better than I do and asks good questions -- things I may not necessarily think about. On a side note, I do know that according to classic grammar rules that should have read "things of about which I might not necessarily think," but that sounds so convoluted, especially for a blog! (I am forever the English teacher -- do not end a sentence in a preposition!).
Just as I thought, we weren't seeing anyone who could answer my questions about this particular surgery, only about the anesthesia and the medications I need to take and those I need to stop. I was reminded about the medications I need to stop using -- Advil and Aspirin -- as well as stopping my alcohol consumption. As most people know, I like a few glasses of wine as well as my cocktails. I am planning three months without imbibing; the warnings on the pain medication clearly states not to use alcohol while taking. Who knows? Perhaps three months might run into more. When searching for clip art I found some dramatic pictures of people before and after they stopped drinking, frightening enough to scare someone into not drinking!
One of the purposes of this blog is to help others prepare for an ankle replacement: unlike some of the more common replacements like the knee and the hip, there isn't as much available on the ankle. It turns out the pre-op visit for the ankle surgery is no different than any other surgery. They take your vitals -- weight, height, blood pressure, and oxygen. The next step is a long interview about your health history and medications, even though it is all written down. The pre-op specialist at Duke was great, listening closely to me, and making me feel very comfortable. She also was good at getting me to be honest: I don't always reveal all of my vices like a few drinks most nights. She made no judgements and, instead, explained why a change in behavior for the surgery was important. The last step was an examination and EKG.
The most important thing is that I passed all the pre-op tests with "flying colors," and my insurance company has approved the claim. Right now I am off my Advil and aspirin, so today, on a scale of 1-10 the pain is a good 5. I told them 7-8 at the doctor's office, but from what I am reading about the post-operative pain, it's probably more like a 4-5. Tomorrow I start with Celebrex, so I am hopeful that the pain will be reduced.
I sent my doctor 3 questions. First, if I had to keep the cast on for at least three weeks, yet they moved my post-op appointment up to just 12 days after the surgery. The doctor's team answered that the cast will be removed on the 11th for the post-op visit and they will put a new cast on. Depending on how it is healing, I might be able to start some weight bearing, although everything I have read has said absolutely no weight bearing until at least three weeks.
My second question had to do with pain management after the surgery. I am getting both general and a local anesthesia. The nerve block will help with the pain immediately following the surgery. The doctor's team answered that I will also be getting a catheter, which greatly confused me. How is a catheter going to help my pain? Isn't it to release urine? Rather than go send another email, I decided to do the research myself. It's called a popliteal catheter for pain management. It seems that ankle pain is particularly awful, and opioids don't work very well and can also lead to dependency, especially since one needs to take a lot. By administering a medication directly into the ankle, the pain is controlled better. A lot of the information I could find online was written for doctors rather than patients, but this link did a pretty good job of explaining in case you want more information:
Popliteal Catheter Infusion for Management of Protracted Postoperative Pain.
The important result is better sleep and less pain!
The third question was simply about getting a handicapped parking sticker, which he said would be no problem. I cannot drive for three months, but this will allow anyone driving me out and about to park where it will be easier for me to navigate.
It was interesting and encouraging to learn that people come from all over the United States and the world to have this surgery done at Duke University Hospital, especially with my orthopedic surgeons. I asked where the furthest someone traveled for the ankle replacement, and the intake nurse told me she had someone from Australia! They must be really good; at the risk of repeating myself, I am very lucky to have ended up here in the Research Triangle.
In the mean time the calls, the offers of help, the wishes and prayers of friends, family, and neighbors keep rolling in. I am overwhelmed with the generosity of others and know that after this is over, it will be my time to Pay It Forward.
Just as I thought, we weren't seeing anyone who could answer my questions about this particular surgery, only about the anesthesia and the medications I need to take and those I need to stop. I was reminded about the medications I need to stop using -- Advil and Aspirin -- as well as stopping my alcohol consumption. As most people know, I like a few glasses of wine as well as my cocktails. I am planning three months without imbibing; the warnings on the pain medication clearly states not to use alcohol while taking. Who knows? Perhaps three months might run into more. When searching for clip art I found some dramatic pictures of people before and after they stopped drinking, frightening enough to scare someone into not drinking!
One of the purposes of this blog is to help others prepare for an ankle replacement: unlike some of the more common replacements like the knee and the hip, there isn't as much available on the ankle. It turns out the pre-op visit for the ankle surgery is no different than any other surgery. They take your vitals -- weight, height, blood pressure, and oxygen. The next step is a long interview about your health history and medications, even though it is all written down. The pre-op specialist at Duke was great, listening closely to me, and making me feel very comfortable. She also was good at getting me to be honest: I don't always reveal all of my vices like a few drinks most nights. She made no judgements and, instead, explained why a change in behavior for the surgery was important. The last step was an examination and EKG.
The most important thing is that I passed all the pre-op tests with "flying colors," and my insurance company has approved the claim. Right now I am off my Advil and aspirin, so today, on a scale of 1-10 the pain is a good 5. I told them 7-8 at the doctor's office, but from what I am reading about the post-operative pain, it's probably more like a 4-5. Tomorrow I start with Celebrex, so I am hopeful that the pain will be reduced.
I sent my doctor 3 questions. First, if I had to keep the cast on for at least three weeks, yet they moved my post-op appointment up to just 12 days after the surgery. The doctor's team answered that the cast will be removed on the 11th for the post-op visit and they will put a new cast on. Depending on how it is healing, I might be able to start some weight bearing, although everything I have read has said absolutely no weight bearing until at least three weeks.
My second question had to do with pain management after the surgery. I am getting both general and a local anesthesia. The nerve block will help with the pain immediately following the surgery. The doctor's team answered that I will also be getting a catheter, which greatly confused me. How is a catheter going to help my pain? Isn't it to release urine? Rather than go send another email, I decided to do the research myself. It's called a popliteal catheter for pain management. It seems that ankle pain is particularly awful, and opioids don't work very well and can also lead to dependency, especially since one needs to take a lot. By administering a medication directly into the ankle, the pain is controlled better. A lot of the information I could find online was written for doctors rather than patients, but this link did a pretty good job of explaining in case you want more information:
Popliteal Catheter Infusion for Management of Protracted Postoperative Pain.
The important result is better sleep and less pain!
The third question was simply about getting a handicapped parking sticker, which he said would be no problem. I cannot drive for three months, but this will allow anyone driving me out and about to park where it will be easier for me to navigate.
It was interesting and encouraging to learn that people come from all over the United States and the world to have this surgery done at Duke University Hospital, especially with my orthopedic surgeons. I asked where the furthest someone traveled for the ankle replacement, and the intake nurse told me she had someone from Australia! They must be really good; at the risk of repeating myself, I am very lucky to have ended up here in the Research Triangle.
In the mean time the calls, the offers of help, the wishes and prayers of friends, family, and neighbors keep rolling in. I am overwhelmed with the generosity of others and know that after this is over, it will be my time to Pay It Forward.
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