Monthly Archives: February 2018

Knee replacement Italia – Part 3

I was told at the hospital upon release that I was set up at Prosperius, the therapy center in Umbertide and to go there the next day. The nurse at the hospital seemed puzzled I wanted to go home right away like I wanted to spend another night with them! So uncomfortable there. Anyway we got checked out and it turns out they had ordered an ambulance for me. They were not pleased when we said we didn’t need it. Luther drove us home in the glorious outside. Lovely fresh air. I managed to get up our 53 steps on my hand crutches. And basked in being Home and again with my cats. Home and cats have healing power beyond all else.

I had a welcome home glass of wine and Luther cooked our dinner with a bit of coaching. It was a lovely evening with English language TV for a change. Home!
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Well we found out you don’t know what you don’t know! We went to the local therapy center where I was told to go. And they told me they wanted to keep me for 2 weeks inpatient therapy(!) we had no idea. Gobsmacked. And this, after we SPECIFICALLY asked our GP and she assured us I would not be an in-patient candidate. We know the name of a therapist that a friend recommended who will come to me and we pay him privately. We asked if we could do that. They were fine with it. So we sent a text to him. Meanwhile I will continue to do the exercises I learned in the hospital four times a day. They are extremely painful to do so I have to force myself and remind myself it is important to work through them.
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The stairs are very difficult so I’m adamant I’m staying up here from now on. My doctor is supposed to arrange dressing changes and stitches removal but we are trying to do much of it up here in the house. So, through a friend, I’ve found the nicest nurse who comes here to change my dressing every 2 days. Distressing that she will take no compensation. She is an angel. So one less reason to go down stairs.
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I have also, through a friend, gotten someone to come and give me physical therapy. He is very nice but his job means he hurts me. I don’t think I’d like to do that for a living. But I’m very happy to have him. And he’s told me it’s crucial to do the exercises myself many times a day. I have been dealing with sciatica pain and I asked him about it. He said it’s a side effect of the epidural sometimes. He gave me a good massage which helped some. At least I know why. I want full function so I am going to do these exercises! I know it’s not forever.
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Maybe I was a bit foolish to not just check myself into Prosperius when I got out of the hospital. But at the time I couldn’t face being in another hospital for 2 weeks. So far we are managing here.
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I think my saga is done now except for the hard work of rehab. If there is anything new to add I will write about it as it occurs.

Knee replacement in Italia – Part 2

Musings
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Normal day.
5:45 am. Time for taking blood. 6:00 am blood pressure and temperature. 7:00 nurse arrives and scans your bracelet. Gets your medicines. Administers. 7:30 breakfast lady brings coffee and dry toast, like melba, with jam. Activity levels in halls ratchet up. 8:00 they come remake or change your bed and wash you some. Around 8:30 a gaggle of medical students comes and hears about the cases. PT person comes around this time too. Lunch arrives around 12 – 12:30. Afternoon is more random. More bracelet scans and meds. Coffee break in late afternoon. Dinner comes around 7pm. After dinner more scans and night meds. Ta da. Day is done.
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I contemplated the Italian word for pain, dolore. Or painful, dolorosso. I looked up an ache. Dolore. Hmmm. Seems like they should have that distinction. Fa male means it hurts. Male is the word for bad. Pronounced mah-lay.
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Some people who stood out. Dr. Pain, the first physical therapist. Nurse Ratchet, evil morning nurse who does meds. Sr. Huffinpuff – he does stuff like move beds, bring dinner, move trash bins out, stuff like that. He constantly sighs and pants while doing his work. One blond nurse who was kind and gave me a sleeping pill one night. The nurse who complained I peed too much. Dr. Trinchese, my surgeon. I call him the stealth surgeon. I saw him in the OR and then he did a drive by visit that lasted at most 15 seconds. “Come stai. Bend your leg. Lift your leg. Belissimo” and gone.
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Random thoughts and observations
Full time monks inhabit the hospital, gliding down the hallways.
Bringing your own coffee cup is key.
Bring cutlery.
Some hospitals do not provide toilet paper. I was told I was in a posh hospital because it did provide it.
They move you around in your bed for procedures.
Some nurses are tolerant of my bad Italian, many are not.
In my opinion the food is pretty bad. They try. You get three courses. Not sure if that’s a plus or minus. Bring salt, pepper, olive oil, lemon juice, Tabasco, anything to spice it up. Next time (hopefully a long time off!!) I would not order all the courses each meal. Breakfast is a cup of your favorite drink (not wine) and a packet of dry toast (like Melba) with a container of jam.
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Stay tuned for Part 3.

Knee replacement in Italia – Part 1

Much of the following posts about my hospital stay are musings of the experience as well as my documentation of what occurred. Most, I wrote while in the hospital.
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The surgery went well. The hospital is pretty modern. Not a young building but up to date. It is also enormous. A University Hospital. I saw very little of my surgeon. He showed up for the operation. Before surgery they take all your clothes and give you a completely transparent gown! I pulled my blanket up for the ride to the OR. As soon as I arrived they cut it off. What was the point?

Returned to my room. During the operation I had only an epidural. Could not move my legs when the tranqs ran out. The surgeon prescribed a bag of morphine for the first night. Since that there were no opiates to be seen. So my intell was correct. What they gave me was ok but my pain when I tried to exercise was through the roof. I was discussing this with one or Luther’s cousins who is a pharmacist. Opiates are properly used for recovery from surgery and for a short time afterward. As she said, “the pain actually increases the fight/flight hormones and delays healing. Also makes physical therapy a lot harder. I think they were giving prescriptions for too many pills at once and not scrutinizing refills [in the US]….” European mainland countries in general do not give pain meds. They do in the UK.

My PT started the day after surgery. It involved a machine that bent your knee over and over to the most painful angle you could stand. Then leg lifts, toe thrusts, tensing the muscles on the back of your thigh and more flexing. I kinda sat on the side of the bed and stood at a walker for a second. Unfortunately the next day was Sunday and then Monday a holiday so things slowed down. I was unable to lift my leg. It was like the signal wasn’t getting there but with a little help to start I could lift it with much pain. I think this is when some codeine would come in handy 😕 the leg was extremely swollen and I was convinced that had to be a part of the problem. I wanted to learn how to use the crutches. It would give me some freedom in the hospital. That was one of the hardest things, being unable to help myself with anything. I took great pains to keep things from falling on the floor. If they did, they were lost to me. The nursing staff are not there to help you. Sure, they would bring me a bedpan if I asked but one night, I had been instructed to drink water after a shot so I had to pee, three times in around a two hour span. She let me know she didn’t appreciate it and said it was not “normale”. I told her I had had 2 bottles of water. I was no longer trying to be nice.

The other thing was the total lack of privacy. I shared my room with another woman knee replacement patient…and her husband. He literally lived in the hospital with her. He brought a small chaise longue. With blankets and pillows and slept next to her. He was a nice man who occasionally helped me with an ice refill or cranked my bed up or down (no electric bed there!). I noticed other people walking up and down the hall with these beds. They expect family members to come care for the patients. I lived with just visits from Luther but they were invaluable.

I was not ready for the loneliness of not being able to speak to anyone, even to casually chat with the nurse or aide. I discouraged visitors so maybe I must take some blame for the loneliness. Luther visited every day and I know even HE was bored. And he hadn’t been there for 5 days
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Stay tuned for Part 2.