Today is Wednesday August 31. I traveled from Seattle two days ago (Monday). As you, the reader, know, I chose to have my knee done, as an outpatient, by a close friend and colleague in Seattle. Aside from the inherent trust I had in Dr. McAllister, I also am a firm believer in his enhanced recovery protocols. So much a believer, these protocols are mine in my own practice. No matter how modern these techniques are- this is still a major operation. Mobility, and safety in transferring do not necessary come quickly. I was still quite concerned navigating through the airport, spending hours on the plane, and then getting back to my house. It all turned out just fine but I learned quite a lot.
After the surgery I went to his home as i noted in a previous post. My room was on the main floor and did not need to navigate steps to get to the bathroom or food. My wife stayed with me as caregiver extraordinaire- a critical role I will expand on in a future post. After a week we all felt it was safe for me to travel back to New York. One thing that all surgeons are concerned about in joint replacement surgery is the development of blood clots in the legs first few weeks after surgery. These blood clots can travel from the legs to the lung and can serious health problems. The issues of air travel and that 5-6 hours of possible immobility need to be mitigated. Right from the beginning, I had early mobility on day one, sequential compression devices for over 12 hours a day on my legs and chemical prophylaxis with Coumadin for 3 days followed by Lovenox injections (self-injected) each day. Lovenox is heparin which aggressively thins the blood. I put the picture of its chemical structure above just in case you see it walking down the street. Sitting in my seat on the plane, fully anti-coagulated, with my leg pumps, and getting up every half hour gave great piece of mind.
Space & Time
In traveling using public transportation (airplane) I had a sense that the world was moving at 78 RPM and I was at 16 RPM. If you don’t get that reference look it up on Wikipedia. I don’t think that people really see it that way until you are moving slow. Where you place your knee in space and the time it takes to do so is not even average after a knee replacement. Careful and safe positioning are critical. I have to admit to a new found respect for the need for modifications for patients with disabilities. I always knew quite a bit about this as a provider but as a patient it is an eye opener.