White water rafting as an aid to post-op recovery…..

Some seven months after my op, I was still quite sore and stiff but this may have been something to do with the fact that I had single-handedly landscaped the front garden.  I never was a good patient.  I didn’t hesitate, however, to accept an invite to the Chief Flying Instructor’s stag ‘do’.  There was some debate as to whether we should go white water rafting or go on a stupidly long zip wire but, as it turned out, the decision to go white water rafting had two surprising benefits.

It has to be said that I was still pulling the ‘knee replacement card’ at this stage and, when confronted with lugging a heavy rubber boat down a very steep hill, the card was played immediately.  This led to a lot of chuntering and muttering from one of the shorter members of the crew but, as it was delivered from near-ground height in an indecipherable Wilthsire accent, I ignored it.  In fact, I encouraged further mumblings by pointing out that, not only did I have a very sore knee, I was management, and therefore unused to manual labour, and he was not. Management, that is.

A completely unprovoked tumble backwards out of the boat in still water should have alerted me to the perils ahead.  A short while later, whilst paddling at the front of the boat, a particularly large ripple swept undeneath us, causing me to fall forward into the boat with my left leg bent under me and taking the full weight of my body.  My cries could be heard across the whole of North Wales.  The solicitousness of my fellow crew members did not last long, their concern soon being replaced by much jollity. One of the shorter members of the crew seemed to find it particularly amusing.

I had given myself the equivalent of an MUA: a manipulation under anaesthetic.  This manipulation takes place if you cannot bend your knee as much as you should be able to and involves grabbing your ankle and bending your leg back as far as it will go.  For that reason, it is done under general anaesthetic and, I am led to understand, sounds interesting.  I had just achieved the same thing (when I probably didn’t need to) but without the ‘Under Anaesthetic’ part. Make sure you do your physio!  I did manage to repeat the exercise ten days later, slipping over in the bathroom after a shower when in a hurry and taking shortcuts: walking over a wet floor to get my towel.  I must say that once the swelling died down, my knee felt remarkably good and pain free.  It is not a course of action that I would recommend, however, at least not without the ‘UA’ part of ‘MUA’.

The other benefit of our trip to Wales was seeing myself in profile in a full length mirror, wearing a body hugging wetsuit.  I do not need to tell you which of the crew members pointed out my rotundness to me but, on this occasion, his cruel remarks were probably justified: it was not pretty.  My subsequent loss of weight was also accompanied by a reduction in pain. Funny that…….

Kneedyman

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Make the pain go away!

As you will have gathered from my previous posts, I have a remarkably low pain threshold.  Indeed, one of my earlier memories is me, at the age of five, shouting ‘Hit him, Dad, he hurt me!’, just after a doctor gave me an injection in my bum.  It’s been downhill ever since.

Despite my low tolerance of pain, I have to be honest and say that, post-operatively, knee replacement hurts. A lot.  Indeed, surgeons have told me it is probably one of the most painful operations that you can have.  That is why pain relief is so important and you must not be shy about telling people that you need more if you need it.

When I had my last knee done, Consultants could not prescribe you the good stuff to take home and, after a few days, I was in the hands of my GP practice.  I could not get past the Practice Nurse. As a result, I found myself on Ibuprofen and Trammadol.  As a combination it was wholly inadequate and meant that physio was so painful I didn’t want to do it. As a result it was five weeks before I returned to work.  I work from home, in the main.  This time, I have been told to speak to the anaesthetist and agree what is needed and then tell the GP what I want to be prescribed.  In my experience,  Orthopaedic consultants can get quite animated when talking about GPs and pain relief.

No-one explained to me what Trammadol actually was.  Whilst the then Unfeeling One was monitoring what was being taken and when, she was not monitoring stock levels. Huge mistake.  I ran out of Trammadol and went into cold turkey which lasted for about four days.  She only became aware that there was an issue when she received a telephone call from my boss, suggesting that she get home as quickly as possible.  He had arranged  a conference call with the rest of the team to brief me back to work and they encountered a gibbering  idiot on the end of the phone who, to this day, has no recollection of the call.

Apologies, it has been really dry today but, it has to be said, there is not a lot of fun in pain. Unless it is someone else’s pain, of course. Next time, however, I will outline the benefits of a Manipulation Under Anaesthetic (MUA) and how to avoid having one, as I failed to do so, without the ‘UA’ bit.

Kneedyman

 

 

Ice, ice, and more ice

The one thing you will need is ice. And lots of it.  If the experimenting in leak-proof ice packs by the now Mrs Kneedyman are anything to go by, an iceberg the size of that encountered by the Titanic would probably be just about enough.  The ice is great for those moments at the mid-point between pain killers and for trying to get to sleep.  Bags of frozen peas are no use. You need four large bags, one for each side of the knee and two to go back in the freezer when the others have defrosted.  If you are on your own, as I was during the day, it entails a lot of travel to and from the freezer.  I did have some freezer packs recommended to me by a chiropractor but, being stiff as a board when frozen, they wouldn’t go around my knee.  They also warmed up very quickly and, like the peas, you need a lot of them.

The now Mrs Kneedyman decided that shopping bags full of supermarket ice were the way ahead and much experimentation took place to determine which supermarket provided the most water-tight bags.  Obviously, ice turns to very cold water, and leaks only tend to become apparent when the ice melts. The aim is to end up with a sealed bag of cold water, and not a wet leg.  On one very memorable night, I woke up to find myself in a very wet and extremely cold bed: it was the iciness of the wetness that led me to conclude that I had not had an accident of the embarrassing kind.  It was then that I realised that the now Mrs Kneedyman, having detected the failure of her latest experiment had decamped to the warm, dry bed in the spare room and no end of shouting could raise her.  It being November, I froze.

A bit of online research found the solution:  a cuff that fits around your knee, attached by a tube to an insulated flask in which you put a mix of ice and water.  Raise the flask and the cuffs fills up with deliciously refreshing and pain relieving icy water. Disconnect the tube and let the chill do its work.  When the water warms up (and the time it takes to lose it chill is about the length of time for which you should chill you knee in one session), re-connect the hose and drain the water back into the flask where it will chill again.  Instant relief with no mess, no chilly water everywhere, and no need to get up and down to go to the freezer.  It also considerably reduced the amount of ice that I was getting through.  I also left the cuff on at night with the tube connected and simply re-filled and drained the flask as required.  The now Mrs Kneedyman filled the flask when she left for work in the morning and it was still doing its stuff when she came home in the evening. A supermarket bag of ice lasted over 24 hours.  Indeed, it was so successful that the now Mrs Kneedyman briefly considered moving out of the spare room.

I don’t know what brands of cuff there are out there but the one I purchased was well worth the expense.  Needless to say, Mrs Kneedyman has been crawling around the loft (I have a bad knee, remember) to retrieve the cuff and flask: it is in her own interests, after all.

For those that are interested, the experiment involving two Sainsbury’s Bag for Life was the most successful

Kneedyman

Here we go again……

After a break of four years, I am back: the other knee needs doing now.  Sorry for not keeping you up to date with the recovery and progress following my first knee replacement or responding to comments: my dog died before I had a chance to take him on a first post-op walk. It rather knocked the stuffing out of me for a while and, combined with getting back to, and catching up with, work, I got out of the habit of blogging.  However……

My left knee is doing really well.  As I have remarked to a number of people, ‘You know you’re getting on a bit when your good knee is made out of metal’.  There was a bit of a rocky post-op period (more of which in a later blog) but I have managed to achieve a number of things since the op:

  • Have resumed hiking and climbed a few big hills in The Lakes and in Scotland. Long walks with the dog are a doddle.
  • Completed my interrupted gliding instructor’s course.
  • Managed a 300km flight in a glider. By myself.
  • Taken on two more Border Collies (both rescues).
  • Completed a photography course with the result that walks now take a lot longer, , much to the annoyance of The Unfeeling One, because it now takes me ages to take one picture.
  • Completed a major civil engineering and landscaping project in the front garden unassisted.  The Unfeeling One’s contribution to the endeavour was, having smelled gas, to report a leak in the gas main outside the house.  This was before telling me.  As I was in the front garden using an angle grinder to cut steel reinforcing bars at the time, I took this order of events personally.
  • Having made a grand job of the front garden, watched The Unfeeling One do the back garden.
  • So that the Unfeeling One could enjoy the fruit of her labours in the back garden, I asked her to marry me. She has now been Mrs Kneedyman for two years.

Knowing that there was a very good chance of needing a replacement on my other knee, the last, listed achievement was vital if I was to secure free, if brusque, post-operative care at home again.  No escaping back to her own house this time…….

So happy am I with the outcome from my first op, I am going back to the same surgeon, the same hospital, and having the same implant.  An eminent professor of orthopaedics did tell me I should not expect to get a ‘set of twins’ by having exactly the same implant: it was more of a ‘brother and sister’ relationship.  I do hope that they get on.

My only disappointment is that I have not have the opportunity to show off my scar to any airport security staff.  They are not interested in the least.  The first time I flew after the op, it was with a great deal of enthusiasm that I started to roll up my trouser leg after the security gentleman’s wand warned him of a potential improvised explosive device in the general area of my left knee:  I was told that I was holding up the queue and to get a move on.  On another occasion, at another airport far, far away (from here, that is), there was some confusion as it was believed that both of my knees should have been made of metal but, fortunately, this was resolved in a timely fashion and I did not miss my flight.  I had been attending a meeting and my conference badge grandly mis-titled me as ‘Dr Kneedyman – Faculty’.  A friend, or so I thought, mentioned that the ‘c’ in ‘Faculty’ was probably a typo).  For those that are interested (and we do get requests), implant cards as proof of implantation are of no interest to border authorities.

I had my pre-assessment yesterday and it is now less than three weeks until my operation.  Between now and then, I will let you know what I learned from the first replacement and what I am going to do differently this time.  The first pearl of wisdom is ‘Be patient’!  I was told that the first noticeable improvement would be about 6-8 weeks after surgery and the next big improvement would be at 8-12 month post-op.  That was my experience exactly.  Nine months after the operation, walking to the car, I suddenly realised that for the first time in twenty years I had absolutely no pain in my left knee joint.

Then the right knee started to feel left out…….

Kneedyman

 

Situation Vacant – Home Help and General Factotum

Owing to the resignation, at no notice, of the present incumbent, a situation for a General Factotum has become immediately available. The length of tenure is uncertain but the contract will be on a rolling weekly basis.  The role is to support me, Mr Kneedyman, as I recover from a very painful knee replacement operation by undertaking general domestic duties.  The duties required of the role can be undertaken outside normal working hours so it does not matter if the applicant is already in full time employment.  A typical day will be as follows:

  • 0600 – Reveille.  Don’t worry about setting the alarm, I will already have been awake for at least 2 hours and will rouse you by shouting down the landing.  It wouldn’t surprise me if my groaning and moaning hadn’t kept you awake for most of the night anyway.
  • 0610 – Brew.  A blend of Earl Grey and Darjeeling, leaf, brewed for exactly 4 minutes.  Measure out medication and ensure that it is taken as prescribed.
  • 0630 – 0715.  Exercise the hound.
  • 0720 – 0730.  Prepare Breakfast. You should also be prepared to assist should I have an accident in the shower (there is a an increased risk of slipping trying to keep one leg dry whilst soaping up and rinsing).
  • 0730 – Dressing.  Ensure that a full set of clean clothing (including TED stocking) are laid out and assist with dressing as required.
  • 0740 – Breakfast.  One bowlful of porridge made with water and organic oats, overlaying a single, peeled and diced kiwi fruit and 75g of blueberries, topped with lashings of agave nectar. Really.
  • 0745 – Hound Snack.  Feed the hound a single dental chew, accompanied by one large Bonio biscuit.  Ensure that water bowl has fresh water and is full.  Entertain him briefly.
  • 0750 – Physiotherapy Exercises.  Oversee my morning exercises ensuring that I complete the necessary number of exercises for the required amount of time.  This is not for the squeamish and you should be able to cope with the sight of someone in a significant amount of pain.
  • 0810 – First Settling In.  Ensure that I am settled in on the sofa with everything that I need until lunchtime.  As a minimum this should include medication, a reminder of when to take it, a plentiful supply of ice, plenty to drink and something for Tiffin mid-morning. You should also ensure that the TV is angled towards the sofa and that all remote controls are within arms’ reach. The house phone, mobile phone, and iPad should also be immediately available.  This will enable me to end calls immediately from annoying people trying to persuade me to let them, on my behalf, claim back PPI premiums for policies that I have never had and contact you by email, text, or voice as the need arises.
  • 0815 – Depart for your Place of Full Time Employment.  Should there not be enough time between Reveille and Departure to do the things that you need to do (showering, dressing, blow drying hair, straightening hair, applying makeup, etc), you may need to consider an earlier Reveille.   A male assistant should be able to manage the tight morning schedule more easily.
  • 1240 Approximately – Arrive Home for Lunch Break.  Enquiries after my general health should be made whilst ensuring that I have taken the correct medication at the correct time and nagging me if I have omitted to take them at the correct time or at all. You should also replenish the supply of ice whilst sympathising with my pain and general plight.
  • 1245 – Prepare Luncheon.  I am not in a fit enough state to make decisions regarding my diet and, although fresh chicken soup and dried toast are preferred, the daily menu choices will be left to you.  You should consider that I need to reduce my BMI and this will be challenging as I am largely immobile and inactive.
  • 1255 – Luncheon Served.  Having served luncheon, you should let the hound out to the rear of the house and clear up any doggie doo from lawns. Wash hands before collecting dirty luncheon dishes.
  • 1315 – Second Settling In.  As for First Settling In
  • 1320 – Return to Work.  It is recommended that you park outside your office and not in the town centre car park.  This will ensure that, in the event of an emergency, you are able to get home as quickly as possible.  You should ensure that your work colleagues understand the necessity of this and induce sufficient guilt in them that they will park elsewhere, leaving a space free for you at all times.  You could get to work earlier of course but this would mean that you would be unable to meet my needs.
  • 1730 – Leave Work.
  • 1740 – 1830 – Arrive Home.  This time may vary as I will, on occasion, require you to pick up a few things from the supermarket or pharmacy.  These will be in addition to the shopping lists that you will have already drawn up when designing the weekly menu. It is expected that you will do the main grocery shop during the weekend.
  • 1830 At the Very Latest.  Arrive home, enquire about my general state of health, ensure medication has been taken, replenish ice, offer soothing words to ease my discomfort.  This should take place at the same time as switching on the lights and drawing the curtains.
  • 1840 – 1930 – Prepare Dinner.  Whilst preparing dinner the hound should be let onto the rear lawns.  You should also aim to feed the hound by 1900.  His food consists of boiled rice, cooked egg, and fresh chicken, overlaying a small handful of kibble. This can be made in 3 day batches and sound planning is required to ensure that cooking the hound’s dinner does not delay my dinner.
  • 1930 – Serve Dinner.   This should be served on a tray in the lounge so I don’t have to suffer the pain of standing up and sitting at a table. Extra cushions will be required to prevent food spilling all down my front, creating additional washing for you. You may join me in the lounge for a full update on my condition and the progress of my recovery.
  • 2000 – 2200.  Administration.  This period of free time should be used for general administrative activities such as washing up, cleaning, washing laundry, ironing, preparing my clothes for the next day, menu planning, preparation of shopping lists, checking amount of remaining medication (it is in your own interests to ensure that I have an adequate supply of pain killers), and liaising with my mother to plan who is going to get me to and from my thrice weekly physiotherapy sessions. Mother only has Flower Club once a week, on Tuesday, so don’t believe her if she cites it as a reason for not being able to take me or pick me up.  Physio is on Mondays, Wednesdays, and Fridays.  She is retired and has nothing else to do except provide cover when absolutely essential. As the telephone is free to other land lines during this period, you will be permitted to call members of your family and whatever friends you have left.
  • 2200 – Preparation for Retirement.  You should ensure that the bedside lamp is illuminated, the bed covers are turned back in such a way as to allow the easy facilitation of getting my poorly knee into bed, my medication is easily to hand and I have a list of what to take and at what time throughout the night, that I have a fresh jug of water and a clean glass on the bedside table.  I will also require a plentiful supply of ice in a drip and leak proof format (the last incumbent had a problem in this regard) and my iPad must be fully charged and to hand so that I can do The Times Soduku puzzles and crosswords in the small hours before Reveille.
  • 2215 – Retirement.  I retire at 2215 each night and you will need to ensure that I am settled in bed and comfortable before:
  • 2220 – Exercise the Hound.  This is a shorter duration exercise than the morning exercise and the hound will need no longer than 30 minutes exercise.
  • 2300 – Hot Chocolate.  I will require a mug (250ml) of Green and Black’s Finest Drinking Chocolate before settling down to sleep.  You may join me before going to your own bedroom.
  • 2315 – Lights Out.  Prior to going to bed and before Lights Out you should ensure that the hound has a plentiful supply of water and is bedded down.  I will try to ensure that the clanking of my walking sticks does not wake you if I need to venture to the bathroom during the night but this cannot be guaranteed.

The above provides specific tasks but other duties include:  being on a moment’s notice to leave work (leaving your colleagues to do your work) in the event of a emergency or crisis (there have been two to date); being at my beck and call whether at work or at home; humouring me; toenail cutting (a high degree of affection for me is required for this task); endless nagging to ensure that I am managing my medication properly and doing my exercises (I have been a good boy to date and have only overdosed once, the latter leading to a brief state of euphoria and the best night’s sleep to date); driving me to and from physiotherapy sessions during the working day (your employer will probably require you to make up the lost time); driving around the countryside at my whim to collect things that I think I might need.

The applicant should demonstrate a sense of humour, the ability to plan , a high degree of initiative, endless patience, and boundless energy.

Renumeration:  None, just the satisfaction of looking after someone and knowing that you have helped them recover after major surgery. You can expect a pretty special and expensive Christmas pressie, however.

Assistance:  In addition to occasional support from my mother, the hound has been known to help. The picture below shows that his intention was well meant but that the execution was wanting. Not what you want to see at 5am when you can’t get up to go to the loo.  I can report that it was unused at the time the picture was taken.

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My recovery has not been plain sailing and I have had a couple of setbacks caused by pain killers but I will cover that in another blog. The drug in question is also the reason that I have not been blogging at all of late and, now that it is all out of my system, I shall be blogging more regularly.

I have no doubt that I would not have got through the last few weeks without The Unfeeling One’s care and ministrations: her stamina and patience have been severely tested and she has come through unscathed.  I may have appeared to have been giving her a bad press in my previous blogs, so I have decided to change her moniker to ‘The Very Feeling One’. I am older than the Very Feeling One and, as you know, I am very young: this means she is a mere babe in arms.  As a result, she is very fit and healthy and has been able to do all the everyday things for me that I couldn’t do and which we normally do without thinking.  How she has stuck it out, I am not sure.  Needless to say, she hasn’t resigned but she did move into the spare bedroom pretty smartly.  Her reward is a place reserved for her in heaven and, more materially, a very expensive Christmas present. She had better like it. It is a serious point however.  With the average age of a knee replacement patient being 70 years old, post operative care is something that needs to be carefully planned long before surgery takes place: you will be totally dependent on other people for at least 2 to 3 weeks and those people need to be fit and healthy.  I had totally unrealistic expectations about how quickly I would be up and about and, 3 weeks after discharge, I have yet to make it back to work.  Some of this is due to medication rather than my knee, but plans need to include some contingency.

Hopefully, another blog tomorrow in which I will describe the Very Feeling One’s attempts to achieve the perfect leak free ice pack (it took a few modifications from the original prototype to get there: patent pending) and my electric shock therapy at the hands of a physiotherapist.  They are not nice people.  Please spread the word that I am now up and about and blogging again.

Kneedyman

PS.  Just had a phone call from Number One son to let me know he is home from University tomorrow and can I come to Birmingham to pick him up. Do they ever listen to anything you say?  Now he has realised that I can’t cook and clean up after him, I suspect his enthusiasm for coming home has taken a severe dip.

Hold the traffic – I’m home!

Just a short post tonight so you know that I am still around and have not expired.  I went before the parole board last night and was released this morning. What had the potential to be a relaxing and peaceful time following the trauma of Monday night was spoiled.  By physiotherapists.  Day 2 after the operation, when I was in loads of pain, saw the arrival of a different physiotherapist who tortured me right up to the moment of my release, three times a day. Whilst she didn’t cause me any more massive blood loss, she was no less a smartly dressed sadist than the first one.  She had a nasty trick of helping me with my first leg raise and then suddenly whipping her hand away whilst bellowing ‘Don’t you put that leg down until I say so’!  She couldn’t count either. ‘Four or five repetitions’ became nine or ten by the time she had finished with the ‘just one more’ trick.

It was a relief to get out of my room and practice with the sticks in the corridor, showing off my new boxers and blood-stained slippers. It was on one of my early solo expeditions that I found a room with a vending machine that dispensed excellent free hot chocolate. Indeed, one of the reasons that the Unfeeling One had chosen that hospital for me was because of the quality of its free hot chocolate which she drank in copious amounts whilst waiting around for me.  I also befriended a lady who had also undergone a knee replacement on the same day as me but it was to be a short-lived friendship.  I noticed that, as she became more familiar, she started asking me quite detailed questions about how my exercises were going and I finally twigged as to who she was when she started passing comments on my technique with the walking sticks:  she was a retired physiotherapist!  I had to abandon my hot chocolate (I needed both sticks) and flee back to my room.  She may have been criticising my technique but she couldn’t keep up with me.

The Unfeeling One turned up nice and early this morning, did my packing for me, and then had to sit there as we waited for the pharmacist to come and give me all the pain killers I am going to need.  Whilst we were waiting, I took her to the room with the vending machine and the foot tapping stopped for a while.  Eventually, the pharmacist arrived and handed over endless packages of drugs accompanied by even lengthier explanations.  I managed to stay with her but, just as panic was starting to set in and I was worried about over-dosing myself, I noticed that the Unfeeling One had her notebook out: what a relief. With a brief stop at the x-ray department to collect some piccies, and at reception to hand in my release chit, I was free!  This was what it was all for: a Smith and Nephew Genesis II Total Knee Replacement System as fitted into my leg.  Note the patella button on my newly resurfaced knee cap and the row of clips holding the wound together.

Image

The Unfeeling One had brought Lyle with her which would have been great had he not simply barked at me, had a pee, and jumped back into the car.  Clearly he has had a great time with Mother of Unfeeling One and was not particularly impressed by my return.  I am glad no-one has told him he is ill because I was really worried that something would happen to him whilst I was away.  His ‘3 weeks to live’ has now extended to 11 weeks. The drive home was fairly uneventful, apart from the Unfeeling One experimenting to see how I would cope with an emergency stop:  not very well as it turned out.  She claimed that it was not her fault but, as I was dozing, I will never know.

Having pulled up outside the house, on the other side of the road, the Unfeeling One leapt out of the car, grabbed Lyle and took him inside.  She appeared very quickly again when she heard the squealing of tyres as traffic came to an abrupt halt in the road outside. Yours truly had decided that he couldn’t wait and set out across the road without the aid of a Lollipop Lady or any other form of traffic control.  My explanation to the Unfeeling One that there was nothing coming when I set out at my snail’s pace was swept aside as she felt obliged to apologise to the queues of traffic trying to get though the village.

No sooner had we got inside the house, then my mother arrived and she and the Unfeeling One started laying down the law and telling me what I could do and couldn’t do and when I could and couldn’t do it.  Tiredness starting sweeping over me at this point. It transpired that neither of them had any intention of staying with me in the afternoon (work and flower club preparation, obviously) and they were just ensuring that their consciences were clear in the event that I tried, for example, to come down the stairs, fell, and broke my neck. They had, after all, told me that I was not to go up or down the stairs under any circumstances.  Whilst at hospital, I got really fed up with an endless succession of people asking me if my bowels had moved and when asked the same question by the Unfeeling One, I started to react with increasing petulance.  When I was instructed that I was not to go to the toilet unless either one of them was around I told them that I would call out ‘Ive fiiiiiniiished’ when I needed their help.  That shut them up. With that, I went up the stairs, all by myself, and went to sleep in my own bed.

The picture below shows Lyle, totally unimpressed with my lack of mobility and speed, recognising the potential of my walking sticks.

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Now I know what all the fuss was about – my knee hurts

Apologies for the gap between blogs but no-one warned me about Day 2.  It is the most painful post-op day, apparently.  It had better be.

if I recall, the last instalment of my saga ended at the point where, after a completely sleepless night, I was checking out the results of my online Christmas shopping.  I shall continue.  Shortly after realising that I had paid a fortune for some flowers for The Unfeeling One (loads of Brownie points in the bank) my breakfast appeared. I had a pot of natural yoghurt, a bowl of fresh fruit salad and a pot of black tea. I would not recommend having a full English as your first meal after major surgery. My neighbour did and the wailing and groaning kept me awake all morning. Very inconsiderate. It will also cost you a couple of intra-muscular jabs into your thigh so you aren’t sick.

My feeling of contentment was further enhanced when another lovely lady came to help me wash myself (something which, you may remember, The Unfeeling One swore she would never do) and, almost magically, changed the bed sheets without me noticing.  The moment she left there was a gentle knock at the door and another lovely lady, with much apologising, asked if it was okay to clean my room.  Within 10 minutes, it was gleaming.  Throughout all of this, one question was asked continually: ‘Have the physiotherapists been to see you yet?’ After the 3rd time I was asked this I began to suspect that the arrival of the physiotherapist would be a Bad Thing. I was right.  Having managed all the exercises with the greatest of ease (little realising that Day 1 was a day of false hope) I announced that I needed to go to the loo.  With 3 ladies in the room, my natural shyness precluded me from using a cardboard pee bottle so I grabbed my walking frame and, with a certain degree of nimbleness, shot into the en suite.  As I was standing there I looked down, only to see a huge pool of blood spreading out from around my feet.  I was bleeding and it was going all over my brand new John Lewis slippers! It was the first time I had worn them. My shrieks alerted those outside to my plight: ‘Don’t worry, you’ve just got a bit of leakage around one of the bottom clips’. What? Leakage? I’m bleeding to death here! It was everywhere.  My room looked like the site of an especially gruesome murder by the time they had finished cleaning me up and had re-dressed the wound. Fortunately, the blood stains on my slippers were limited to the inside so won’t be noticeable when I’m wearing  them. Thus ended my first physiotherapy session.

One of my many followers had warned me that the drain which would be put in during the op would be painful but I hadn’t noticed anything hanging out in the brief moments that my wound had been visible (I did manage to snap a quick picture of the wound with my phone but it is a bit too gruesome to display in a family show). In researching this mysterious drain that I didn’t appear to have, I found an article in the Journal of Bone and Joint Surgery entitled  ‘The use of a closed-suction drain in total knee arthroplasty’.  It concluded that, whilst 94% of consultant orthopaedic surgeons in the UK routinely used a closed-suction drain, there was no evidence to support its use.  One to ask my surgeon, I think.  He must so look forward to that part of his ward round when he gets to me.  When asked, he very patiently explained that there had, recently, been a very positive move away from the use of drains.  in short, there is now a very good chance that you won’t have a drain put in.  I have to say, that the amount and type of numbers used in the article was very impressive.  For a trade whose tools appear to be hammers and saws, I am beginning to realise that there may be some real science behind it all.

Day 2 kicked in mid-afternoon with no warning.  Come 7 o’clock in the evening, if I had had a saw I would have taken the whole leg off myself. If you are offered pain relief, take all you can get. Don’t be heroical or stoical, get as much as you can, as often as you can.  My whole night was just a cycle of sleeping, pain, and pill popping. There really is no need to be in pain and don’t feel that you are disturbing someone by asking them for help. It took me a while to overcome my natural unwillingness to summon someone by pushing a button (I’ve seen them on Downton) but there’s no stopping me now. Both my surgeon and anaesthetist have told me that a knee replacement is the most painful operation you can have, and it is worse the younger you are. As you all know, I am very young.  Man flu doesn’t even come close. Hip replacement? A stroll in the park by comparison.

Another reason for ensuring that you get loads of pain relief is so that you can manage to do your physiotherapy. If you don’t do the physiotherapy properly, you will have wasted the whole procedure.  As the more perceptive amongst you will have realised, I have a pretty low pain threshold and, without the physios there to push you, it is all too easy not to bother.  I am lucky, I will have The Unfeeling One at home who will, I have no doubt, bully me into doing the exercises.  My physio is going quite well and I graduated onto sticks today. Stairs tomorrow and, hopefully, home on Friday.

Two other side effects to be aware of.  The anaesthetic and the opiate based pain killers have made me very itchy.  I didn’t think I had got fleas, but Piriton started appearing with all the other pills.  My continual scratching had been noticed by others. Apparently, one in five patients react this way. The other side effect hasn’t resolved itself yet, despite having had prunes for breakfast two days in a row with further supplements of Senokot. ‘Nuff said.  Kneedyman.