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In a previous article I wrote about my experiences the day before and the day of my TKR surgery. In this article, I write about my first and only night in the hospital after knee replacement surgery.
I also share information about the day after TKR until I was discharged at noon. I was at the hospital for less than 30 total hours and had some interesting experiences.
Most of the experiences were good but my stay in the hospital wasn’t without challenges. Because this was my first TKR my frame of reference was limited.
If I had experienced TKR and knew what to expect I may have made some different decisions. I did do a lot of research prior to the operation but there’s no lesson like experience.
Even though I was “part” of my medical team, I put my trust in the hospital staff and hoped they knew what was best for me. I hope this provides valuable insight as you prepare for your knee replacement surgery.
My First Night In The Hospital
In my earlier article I left off after having dinner my first night in the hospital. After dinner, my day shift nurse brought in the night shift team and introduced them.
I had a new nurse that had two assistants and a nursing supervisor for the floor. They put the new team names on my whiteboard in front of my bed so I could remember and call them by name.
My new nurse informed me she was a “traveling nurse” and therefore she had limited knowledge of this particular hospital. She said she would do her best to meet my needs. She also told me that I was one of 5 patients assigned to her during this twelve-hour shift – that’s no easy task!
She went over my health information on the computer, scanned my wristband and made sure all the information she had received from the day shift was correct and up to date. When it was time for my pain medication she first asked me to tell her my name and date of birth (confirm the correct patient).
She asked me to rate my current pain level on a scale of one to ten (I was constantly asked about my pain level on a 0-10 scale and the staff tried their best to keep me below 5. She recorded my response, scanned my wristband then gave me the Percocet pill which I took orally.
The questions became a habit before receiving medication. They were always double-checking to avoid mistakes.
She returned in a few minutes with another pill (stool softener) that I was to begin taking regularly to help with bowel movements. Apparently, the pain medication has a tendency to back you up.
I chose not to use a catheter and I was allowed to walk with my walker to and from the bathroom. I’m glad I didn’t have a catheter but it was also a hassle to get up out of bed with a surgically repaired knee. I’d advise you weigh the pros and cons whether to use a catheter or not.
***Tip: Decide if you want a catheter and communicate it to your surgical team. If you don’t say something they’ll give you a catheter. I was adamant about not having one and my surgeon was fine with it.
Having gone to the bathroom with the Physical Therapist earlier, I learned that to go the bathroom I would have to unhook the air cuffs on my calves, remove the ice cuff, then roll my IV with me to the bathroom.
After the first experience walking to the bathroom, which was time-consuming, I decided to urinate in the bottle provided near the bed. I made good use of it that first night.
I was physically exhausted but sleeping wasn’t exactly easy. I was assigned to the bed nearest the hall that had more light and traffic. The hospital provided a dark mask and earplug package to make it easier to sleep.
***Tip: Ask if you’re sharing a hospital room or will have your own. If you’re sharing, ask for the bed farthest away from the door (if you want more privacy).
I soon learned that the hall lights would not be turned off or dimmed during the night – the blackout mask became very important. Without the blackout mask, I would have had little if any sleep.
Off to sleep I went expecting to be awake in 4 hours for my next pain medication and vital signs check.
Surprise 1
Unfortunately, I was awoken a few hours after falling asleep. A nurse assistant woke me up and said he was here to check my blood sugar. He cleaned off my right index finger so that he could prick it.
I was on pain medication and was a bit groggy, but I was alert enough to ask him why. He said my name and stated, ”aren’t you diabetic?”
When I replied “no”, he acted confused and said he needed to double check something. He returned shortly and apologized. Thankfully my finger wasn’t pricked and I didn’t receive an insulin shot.
***Tip: It’s always good to ask the nurses what they are doing. Asking questions helps avoid confusion and helps you learn the recovery process. I tried to learn the reasons for my IV, pain medication, compression, and ice pack. I also made an effort to remember my heart rate and blood pressure when they monitored it. The more you know about what’s happening to you the more you can help yourself.
Surprise 2
Back to sleep. I woke up frequently to urinate and I was very thirsty and drinking a good deal of water. Once when I filled the urine bottle I looked for my button to ring for assistance.
The call button had fallen down the side of the bed. Soon I had to urinate again but the bottle I used was full.
After hearing my roommate make some noise I asked if he would push his button to help me out. He did and the nurse arrived at my bed. She emptied my urine bottle and also gave me a second backup bottle.
While she was there I noticed the water circulating in my ice cuff was no longer cold. My roommate mentioned that he thought his no longer felt cold either.
I could not feel the water circulating through the tube and I knew it was not delivering cold water for my swelling. The nurse had her aide refill our ice buckets leading to the cuff and I tried to sleep. The next time I woke up to urinate I noticed that no cold water was circulating to my knee.
The night shift nurses and aides didn’t seem to know how the ice cuff operated. I was baffled that they didn’t know how to refill or operate the ice cuff.
Earlier in the day the physical therapists refilled both machines after our 4:00 pm workout and they would not reappear until tomorrow morning. Finally, the supervisor said she would have them get me a new machine from supply and see if that would work.
After taking it out of the box and hooking it up it worked. This was the only time I was frustrated during my hospital stay.
***Tip: I’m glad I remembered that I was a “part” of my medical team and that I was encouraged to speak up. I’m also glad I asked about the various devices hooked up to my legs. Asking questions will help you know if something is wrong – don’t be afraid to speak up!
Morning Consultation with the Surgeon After TKR Surgery
My roommate and I were woken up by our surgeon at 6:00 am. He told us he was here for a quick check up and he would remove the drain tube in our leg.
He would also remove the outer ace bandage. He jokingly said that this would be the last time he hurt us (removing the drainage tube didn’t feel good however I was still taking strong pain medication).
He reminded us that although we were in pain now he’d be our best friend in 10 days. After taking out the drain plug (a quick, sharp, momentary pain) he talked to us privately about how the surgery went.
He shared that the inside of my knee was ugly. He was surprised I could walk at all prior to surgery. He thought I should have had the surgery several years ago and reminded me the surgery went smoothly. He believed I would experience a much better functioning and pain-free knee.
After the surgeon left, the day shift nursing staff took over. These nurses were familiar faces from the first day of surgery.
I started out with an “advanced liquid diet” breakfast. They unhooked all my monitors and IV’s and asked me if I wanted to walk to the bathroom then sit in a chair for breakfast.
I did both and was served a breakfast of cream of wheat, yogurt, apple juice, a carton of milk and a cup of coffee. They also gave me a copy of the small local newspaper that I was able to read.
My wife came in for a visit just as the Physical Therapists came into the room. My therapist wanted me to take a short walk down the hall using my walker.
I walked about four rooms down and returned to the room where she had me review the standing exercises that they had given me the day before. She told me she would be back in 20 minutes to give me the stair test and that if I “passed” I would be cleared to go home.
During my wait, the nurse gave me a shot of Hebron in my stomach to thin my blood and help prevent any clotting.
A hospital administrator came in to see how I was doing. She asked me about the care I had received so far.
I was very positive about the pre-op and the surgery teams as well as the day shift but less positive about the night shift.
2nd Physical Therapist Session After TKR Surgery
The Physical Therapist returned with a wheelchair and told me I could walk or ride in the chair to the stair test. I opted to walk which turned out to be a much longer walk than before.
When I reached the Physical Therapist’s center I was given a brief tutorial on how to go up and down stairs. Even though I had no stairs in my home this test was still required.
I went up and down about five steps. Good leg first on the way up and surgical knee first on the way down.
I was reminded to always have a tight grip on the rail. I was told that I passed and was set to go home and that the nursing staff would begin the process for discharge.
Discharged After Knee Replacement Surgery
My wife left and my son visited to take me home. The nurse and I decided on the pain medication I would be using at home.
At her suggestion, I elected to take “Percocet”. My prescription was to be filled by my local pharmacy and was for 50 pills. I was to take one every four hours.
Another hospital worker came by and gave me a choice of several home Physical Therapists that would visit my home. She also asked if I could choose an off site Physical Therapist after my 7 visits at home were over.
My family called a few friends and neighbors who had recently had surgery and they asked them for suggestions. When the hospital worker returned I made my decision, signed papers, and was told I would receive a phone call to set up my first physical therapy appointment.
The nurse returned and had me sign discharge papers and gave me a bathing kit and a bag of some hospital issue items (dark mask, ear plugs, urinating bottle etc.) that I could take home. I was given my change of clothing and again signed a paper saying all my belongings were in the bag.
It took some effort to change from my hospital gown into my regular clothes and was told to wait for the hospital volunteer that would drive me to my car in a wheelchair. After goodbyes to the staff and my roommate, a volunteer named Joseph wheeled me out to my car.
Joseph had had the same surgery 10 weeks before and encouraged me not to be a tough guy and to take the pain medication. He said he switched to Tylenol the 3rd day after surgery and had a difficult time doing the physical therapy. Once in the car, I was home in 20 minutes.
Observations From My TKR Stay In The Hospital
Several people remarked that my second knee would be much easier. They seemed to assume I would have my other knee replaced at some date.
My knee replacement was the result of a previous sports injury and my “other” knee is in great shape. The doctor was impressed after seeing the X-ray and said it was unlikely the other knee would need to be replaced.
Conclusion
In this article I shared my personal experience during my first and only night in the hospital and the second day (morning) after my TKR surgery. I was surprised my stay went by so fast.
Granted, I was unconscious for a portion of the time. The rest of the time I felt I was aware of what was going on. I made notes each evening so that I would have a good memory of my experience.
It was nice that the hospital provided a mini notebook and pencil by my bedside. This was my first TKR surgery and I knew only what to expect from reading and talking with friends who previously had the procedure.
The reading and instruction from friends wasn’t specific and I was unsure what to expect in the hospital. I hope my article helps to give you an understanding of what to expect during your stay in the hospital.
If you develop an infection or other complications your stay may be longer and your care might be different than mine. Remember that you are part of your medical team.
Speak up and ask questions if you do not understand something. The more you know, the more comfortable you will be.
