Not past my use by date and total knee replacement surgery

I was scanning the list of documents in my writing file when I saw this piece I wrote a few years back after the first total knee replacement I endured. While I have had a couple more such replacements since then, this experience, both the post surgery health experience and specialist aftercare, rather lack of, still annoy me. 

 Belatedly I thought that I should have reported him to the appropriate authorities for his opioid advice. What would you have done? Here's my account of that experience and some cautionary information that a specialist probably won't alert you to. 

 74 years old and past my use by date ? 

 I’m not passed my used by date but that was the message I received from the orthopaedic surgeon during my first post operative check up after having a knee replacement. While he was delighted with the success of his technical expertise, I had questions relating to the issue of taking opioid based painkillers for an indefinite time. This concerned me because in the 1980s I was prescribed an opioid painkiller long term for spinal pain and ended up becoming addicted to it. I was alerted to that fact only after hearing some doctor friends discussing drugs at a social gathering and I heard the drug I was taking mentioned. The withdrawal period from that opioid was no fun. 

My question:

 “Approximately how long can you take 150mg twice daily without becoming addicted?” that gave me the message my life was now inconsequential, not worth much at all. 

His response? 

“Who cares if you become addicted? You are 74 years old. Take it for the rest of your life if you need to and be happy.”

Whoa! What was I hearing? 

A doctor, and an esteemed Surgeon at that, saying that it is OK to become a prescription drug addict? Does he not know the effects of drug addiction on a person’s health, both physical and mental, the effects on the addict’s family members and the cost to the country’s health system? 

 Of course, being me, while controlling my impulse to blast him for his disdain for the life of what he described as an elderly person [I’m not!] I pointed out that I had a lot of clear headed living to do and that I regarded myself as being essential to humanity for the care and support I give others in my family and as an advocate for justice and human rights, locally and worldwide plus I enjoy life and have a lot more of the world to experience, even if only in Australia at the moment. 

 I also had questions relating to the period immediately after the surgery when I suffered both pneumonia and hyponatremia. His advice about the pneumonia and hyponatremia was that at my age the body often goes into shock, resulting in “all kinds of things.” 

This was not explained to me during my pre operation consultation when he explained the procedure. Although I had asked questions I didn’t know to ask about low blood sodium and pneumonia. I now know that hyponatremia is quite common after knee surgery and can be very dangerous to one’s survival as it is often not recognised until the patient is in a bad way. 

 So, if you are climbing up the numbers of life and need surgery. this is what you’ll probably not be told by your surgeon:

 

1. Surgery shocks your body which can result in hyponatremia – low sodium concentration in your blood. This is problematic because if not identified leads to a coma and possible death and cognitive impairment after recovery.

Fortunately I realised that I was seeing crazy things, saying crazy things, had crazy fingers and feeling nauseous and asked for a General Practitioner Specialist to see me. She ordered an immediate blood test and came back two hours later to do an infusion and restrict my fluid intake until sodium levels reached a normal level. 

 2. For someone described as elderly, senior etc, pneumonia is also quite common after surgery. Get your family – support crew to look out for this. 

 3. The longer you stay in hospital the more you are likely to suffer mental deterioration – depression, confusion and the like – and decreased physical condition. I ended up staying almost four weeks instead of one week. [Thank goodness I had health insurance.]

My lovely young GP said he’d never seen me so “flat” and attributed that to my hospital experience. 

In addition, the longer you are in hospital the easier it is to pick up another infection. Yep! Got that too. 

 4. Knee Surgery. Muscles and nerves are, to say the least, disturbed. That means after surgery your leg may[will] be hard, sensitive to touch, internally bruised, resulting in long term swelling. 

I’m also experiencing a lot of skin sensitivity and lack of feeling more than six weeks after surgery. How long will it be for the swelling, sensitivity and hot feeling around my knee to be resolved? 

My esteemed surgeon’s response? “In about a year it will be as good as it gets for a 74 year old.”