Journal of a Right Leg

with observations from

Master Organism, Right Knee

and possibly

Mr Brain

Part 1: waiting

needing replacement

For a long time this dark cloud has hung in the offing: hospital; knee replacement operation; what will it be like? Reading all the stuff on the web provides some enlightenment (and sounds less than totally pleasurable) but nothing can tell you what it is going to feel like, being there, experiencing that. The only possible strategy is to ignore it and divert one’s attention in shallow fantasy ...

Tuesday 1 April

R Leg: so here i am in Ward 9, Woodend, whither the Master Organism (MO) has brought me ... a day of utter scenic brightness, theatrically clear and flat, interspersed by blattering showers, a not bad day for saying goodbye to the dear familiarity of home and hello to the as-yet-unknown. i arose early, impelled by the MO’s long-standing desire to be Not Late For Register Class (MO is slow to adapt to non-working mode of life) - so early that not only had i time to take my Furry Friends for their statutory walklet but even arrived early at Woodend, where they drew an arrow on me, doubtless to ensure that the gaffer with the saw would not lose the place ...

cheering card

MO: ... although, had they tried to attack Mr Left Leg (currently the better one) they would of been met by a biro message on the kneecap:

G O   A W A Y

N O T

t h i s   o n e

which entertained the Kiwi admission doctor no end.

Dr Kiwi said that the actual op was easy - “anyone could do it” (well, in the same sense as anyone could read the Complete Works of Shakespeare -  if they were willing to put in the time and effort) - but that the hard part came afterwards, for the owner of the new knee, working at the exercises, getting mobile again. Bad news for a trained idler such as oneself.

With Dr Kiwi one explored the nastiest possibility, how much worse life could be if everything went as wrong as it could possibly go (Late Deep Infection (found on the net, aarrggh)), and also what a bundle of laughs it will be after everything has gone (as it surely will) right ...

R Knee: ... though not for moi, pardon me for interrupting you, MO, but from the point of view of moi, that bundle of laughs comes from me being carved into tiny slivers and likely enough chucked in the compost bin (NOT a pretty thought) ... (continues wittering & mumbling self-piteously)

MO: ... despite my hope (which proved physically impossible to realise) of retaining the former R Knee as a conversation-piece at the dining-table ...

R Leg: ... but in any case, Knee, by that time you will no longer be as it were a Together Entity, so you will hardly notice how much a bundle of non-laughs it will be for you; anyway, that aside, ‘tis not uncosy in here, and time wheechs past, what with people coming and going, wanting this, asking that ...

MO: like who is my next of kin - how do I know? They don't want all three luvvies, do they, how to decide? I am 120/80, might get a choice between general anaesthetic and spinal thingy, have to see what Mr Anaesthetist thinks (also Mr Brain).

R Leg: meantime R&V come with tall flowers and depart with alacrity, lunch happens, the MO does its homework (Information for Patients with Knee Replacement) and queries the many ambiguities therein, probably p-ing off a tall fluting staffie with nsoh (who however with luck will realise attitude only deriving from pre-traumatic stress nerves (ptsn)) ... well, basically, i is bored already and it’s still only Tuesday, might as well be festering in the tent on a wet weekend ...

MO: ... except peeing’s a lot easier here, and if you touch the roof it probably doesn’t let the rain in ...

Tutti: ... and just then, in came the Knee King, attended by Dr Kiwi and other anonymous acolytes, and we exchanged views. KK says 6 weeks of elastic stockings is “bollocks” and possibly driving ok earlier than 6 weeks, but DO NOT KNEEL because post-op numb patch would not feel tack in carpet, blimey, KK some sort of god, knowing of tacks in carpet? On the whole, vastly encouraging ...

R Knee: ... except of course for moi ... (snivel)

MO: ... as I was saying, encouraging, because these guys give off the unmistakable whiff of highly-competent good craftsmanship, together with a preference for telling the truth (though possibly not too much of it in advance) ... btw, severe arthritis was what I heard mentioned. Hah! must gloat to GP (who said surprisingly little).

*   *   *

(NB tea = supper (apparently))

*   *   *

(later, after tea=supper)

MO + Mr Brain: we were reading some Primo Levi but many interruptions and besides ptsn (see above) impede concentration, so got a Ben Elton out of books in tea=supper-room; begins with rat eating chap’s rotted leg, chap (to get rid of rat) cuts off leg with blunt knife : “flesh ... falls apart before the blade, as if it has been braised. In a moment, man and leg are parted.” Hey Ben, what about bone, you ever try cutting through braised bone with blunt knife, eh? ... Memo: question Dr Kiwi about feasibility ... (or maybe not, perhaps best shut up, not put ideas in people’s minds?)

R Knee: (peenge, whimper, gulp)

(evening comes and goes, and so does a night of restlessness and longing for the heat and noise of machinery to stop and for furry people to be in bed purring beside one - viz for normality)

MO: people keep coming and wondering if one is All Right, all by oneself. Yes, all by oneself is just fine: after all who wants to chat about the basic what-ifness of the current situation?

Wednesday 2 April

R Leg: (yawns) porridge, rice krispies, anotherthing, prunes ... gimme prunes, cos that is how i feels, black-souled and wizened

R Knee: moi aussi, and barely surfaced as we are, here comes KK with his attendant phalanx, their eyes bright, their tails bushy, seeking whom they may chop up in little bits for the compost-bin (peenge) - no, not me! not yet! i have surely another 24 hours here in this mortal pain, sorry, plane ... ochone, ochone, ‘twas difficult to find repose, accustomed as one is to the surround of fur and growls and the wheech of the cold night air and the whoo of the owl and the cats’ song of hate and the far-off cry of the semi-mythical pumas in the forest to the north ...

R Leg: ach belt up, we all get right scunnered when you go all bardic ...

(a great white bird passes the window carrying folk from maybe Schipol to ABZ)

MO: Last time I was this bored-&-apprehensive was in Final Hons year, having just realised I’d done the wrong lot of set books ...

(another great white bird)

... we must be on the landing flight path, so the wind could well be in the NW, could it? ... wish I had a compass with me

R Leg: MO, don’t you think you’re forgetting the purpose of this Journal?

R Knee: Yes. Forgetting. Not thinking of moi (whimper)

MO: Shuddup. So, what is the Journal’s purpose then, R Leg? Enlighten me.

R Leg: Well ... er ... hmh ...

MO: Yesss? We haven’t all day ...

R Leg: Oh? Haven’t we? ...well then, would you not agree that the purpose is to divert us all to some extent in this comfortable and well-attended yet stimulus-free zone of mounting tension, by enabling us to rabbit on free-associatively, in between tiny bouts of book and radio, to neither of which we are able to attend?

R Knee: corblimeymate

R Leg: ... the night was long, was it not?

MO: It was. I attribute its length to (a) heat; (b) no fur; (c) incessant machinery noise; (d) remorseless eye of light beaming through door; (e) bardic stuff R Knee was on about earlier ..

R Knee: ... yes! yes! ...

MO: shuddup ... and (f) at a tentative guess I’d say we might be lying E-W here, while N-S is what we are used to, and who knows how that might affect the psyche?

Messrs Bowels: quick! quick!!

(time passes)

* * *

MO: ... ahhhh! Powerful guys, those prunes.

R Leg: and still only 9.35, usually we’re still at breakfast, feet up, knees covered with fur ...

All: We must do our exercises; we must get home asap

R Knee: ... at any rate, whatever tiny piteous fragments of moi...

(a time of blank non-reflection ensues; in the corridor, people pass and re-pass; the distant chatter and mindless music-bites of a TV drift around; you could, I suppose, get used to this; if you had to; would you come to look back on it with nostalgia, even? Who can say? time passes, punctuated by peenges from R Knee)

MO: ... lunch... not hungry ... coffee... ‘tis like the dentist waiting-room: keep hearing intermittent whine of drill (saw?) - seems unlikely as op theatre some little distance away ... here comes the physio bearing chart of exercises for tomorrow and tomorrow and tomorrow ...

R Knee: here comes the anaesthetist to talk to moi

R Leg: don’t be silly; you are a basically quite unfeeling dude, it is me that he is interested in

MO: actually it is all of us, but principally me ...

So anyway, after some discussion, it seems best to stay awake (though numb) during the procedure, so as not to miss out on a possibly-not-to-be-repeated experience, and also to be able to write it all up for Posterity; and having established that, during the procedure, chat, far from a distraction, will actually be helpful, we have fixed on a mutually agreeable subject, viz: Small Sailing Dinghies (like e.g. OKs and Hornets)

R Knee: you guys actually propose to not talk about MOI? In my LAST MOMENTS?

R Leg: get real, Knee, you will be being ensliverated and thus in no fit state - and besides the droning/rasping/whine of the saw will blot out all chat for you ... but to choose not to talk about ME? When i am the prima ballerina in the whole enterprise ...

MO: guys, guys, we’re all in this together; after all, you will feel no pain: if there is pain to be felt, ‘twill be in the head, thus I shall be the one to feel it ... I shall be the one needing diversion.

Mr Brain: actually, pain is perceived in the Brain, without me, you would feel nothing ...

(enter L with Grauniad, Private Eye and newsie)

(tea=supper (nice fish): last food for yonks; got to be up at 6, shower etc. arrggh ... night; heat; noise)

***

During these two days, bloods have been taken, pee analysed, BP measured, an ECG done, pee analysed again because of tiny bit of nitra/ites first time round (meaning? - who knows); the body is seemingly ok enough ...

Part 2: op day (and after)

Thursday 3 April

MO: Sparrowfart (6 a.m.), up, questions, shower, inadequate gown with tiny flowers, more questions, tummy pill, “mild” sedative offered and declined (might put one to sleep - miss all excitement), op-time approaches, bored, restless, aarrggh ...

R Leg: stop twitching, Knee

R Knee: can’t help it, condemned knee didn’t even get hearty breakfast, let alone Last Wish

R Leg: your voice has gone all tiny and wobbly, cheer up, things could be a lot worse

R Knee: easy for you to say, b*st*rd MO sold me down the river, never a thankyou, all these years carrying it about uncomplaining, and now to be tossed aside like a

R Leg: shuddUP ... wot about ME, doomed to sawing and hammering and bandaging and monster exercising for who knows how long, arrrgh

MO: you are - both of you - extremely valued members of our little microcosm, we value your input, press 1 if you want to pay a bill, 2 to speak to an actual person, 3 to hear the menu again ... oh, oh, sorry, sorry, wrong mode, flipped slightly there ... Knee, I love and appreciate you and want to stop hurting you when we walk about, this is why we are here

R Knee: so stay sitting down, don’t walk about, leave me alone, b*st*rd

MO: can’t manage that, Knee, need food, drink, toys; think it through: no food > fading energies > death > dissolution ... and that includes you as well, inextricably bound to your loving Master Organism ...

***

The black cloud is upon us - a flurry of action supervenes, and the various bits fall silent, legs and their components being numb, MO being too interested in the action to speak except with Mr Anaesthetist, which it does at some length. It is some little time before one can resume this Journal

***

(much later, around 2.15 p.m.)

Well, we got wheeled to the workplace and it all happened ...the spinal thingy (legs went all warm and cosy and stopped belonging); smell of meth (reminiscent of lighting the primus in the tent in days gone by); extra jab to block R Leg for longer: already hooked up to oxygen and tube(s?); R Leg is raised and ceases to be a part of one (no feedback arrives from it, hence old lizard brain knows real leg is lying flat and what happens to raised leg is of no importance - it’s just a simulation - even though logic suggests that (since they said the leg would be raised) the raised leg must be the real one); cloth barrier prevents view of action but can see big inflatable(?) collar travelling up R Leg to stop bleeding; sad to miss view but heard discussion of properties of bone cement (e.g. desired temperature - not unlike building glassfibre dinghy), enjoyed the song of the saw, less horrid than dentist’s drill and no pain or smell of burning bone.

But the interesting and gripping bit was long chat (as previously arranged) with Anaesthetist, who comes from Edinburgh, sailed at Lochearn Sailing Club (as did I), got his spouse there (as did I), did elective at mission hospital in Africa where instead of chatting with Zulu women during caesarian (not being able to speak Zulu) got them to sing, whereupon the rest of the theatre joined in, marvellous. We discussed Hornets, OKs, Lasers; the funky kite-sailed experimental proa built by late spouse; how much more difficult two children are than one (less than you might think); and so the time passed, and one was far less apprehensive than otherwise one might have been.

Another source of surprising comfort was the intermittent squeeze on the arm of a cuff (monitoring BP?) which felt like a reassuring hand. Nevertheless, towards the end of perhaps (unsure because no watch) an hour and a half sawing and hammering (feeling like a tent-peg), one was beginning to feel just a tad flaky, and it was a relief when the monster bandage went on, leg was lowered and one was wheeled into recovery, where people kept looking and checking, and one actually had to make quite an effort not to blub. Could have murdered a big juicy fillet steak. And a nice long sleep, nobody asking questions.

replacement

Back in bed, time passed without pain (lovely on-demand morphine) but nastily: nastiest of all was not being able to feel/control legs; second nastiest was having to lie on back, which gets v. stiff and sore if it can’t change position. Toes were checked frequently for sensation and warmth; presently there was a prickling, and by around 2.30 p.m. the legs came back to life and things improved a bit.

So no pain, some discomfort from back but not unbearable, no hunger/thirst, it’s ok here travelling through the black cloud, but it’s being a very long day and I wish there was a fast-forward device.

S visits at night briefly.

Friday 4 April

Tired, tired, tired, want to sleep for ever. Tubes out, except for drain, in course of day, replaced by various pain-killer and anti-inflammatory pills, plus aspirin to protect against clots. BP way down. Sensation of doing tight turn in glider, things nearly, but not quite, greying out. Shuffle partly on one side, exquisite comfort for back, but not for long - the Knee King and his minions come by, he turns me on my back again with the words “Life’s a bitch sometimes”, an oddly comforting comment because true.

Lunch (fried fish, wondrous good), more pills, negotiate for fewer because think possibly don’t need so many. Keep falling asleep. BP wheechs about. 88/44 or thereabouts.

L comes with Grauniad and new postage stamps of fruits with hats and legs of choice to stick on separately - doubt if I’ll ever have the energy for that much creativity. More bloods. Going to be shifted to another room, with People in it. Ochone.

Down inside that huge fat dressing there is no chat at all from leg or knee.

Visit and newsie from young A: they are cutting the trees to the south, aha! More sun in the winter, can’t be bad.

Saturday 5 April

Sparrowfart. Big fat dressing away, drain out (weirdest sensation), all lovely. New thin stick-on dressing. Great. Tube thing out of hand. Use zimmer supervised (easy), do exercises (murder). Lots of pills, keep falling asleep.

Visit from R&V with email from K and grapes. Difficult to stay awake long enough to speak.

Exercises (4 batches / day, 10 exercises / batch) give grief, but different grief from previous knee grief, and even in this short time getting less grievous. Reduce number of pills again, fear total zonkment.

People in the room are fine enough. No-one wants TV on (good), can hear continuous canned gameshow laughter from blokes’ room across the corridor.

Sunday 6 April

Get a row for falling out of bed (retrieving watch from floor). No pain-relievers, just aspirin and anti-inflammatories.

Unattended bog and shower, hurrah, zimmer to phone (hurrah), no-one in.

Finally managed a crap (fourth day since last one) - enormous, solid cement, phew!

Visit and newsie from L.

Lots of twitching in leg. Been zooming to and fro, now quite swollen and bruised. Been refusing pain-relievers, maybe rethink and have some paracetamol - sore through the night, though not unduly so; but lots of disturbance, massively hot (open window without permission, how stroppy), screams at 2.15 a.m. from Queen Edna (“two husbands, lovely people, did everything for me” and “I’m 81 so I am the senior person in the ward”). In the corner Ann the Fan (she needs a fan running all night because she’s too hot) thrashes about, calling nurse to get more water, to find her special wee green facecloth. Which nurse very patiently does. Two others are quiet, they are due to leave today.

Monday 7 April

Visit from Knee King who is pleased with progress. Give him Going Home propaganda.

Busy, busy: physio; more exercises; can do 85° bend (need 90° for getting home); get sticks instead of zimmer, walk to dining-room with them. Tire v. quickly, back on painkillers, otherwise exercises too sore. To x-ray, see pix of new knee, formidable, wonder if I can get copy.

Visits from R&V and M&M. Exercises take a long time. V. tired.

Can’t sleep. Ann the Fan blowing a gale. At 2, go walkies far far along darkened corridor into well-lit stretch where nurses playing cards in dining-room, and way beyond that. What is to stop a person escaping? ... and going where exactly, in pyjamas, on two sticks, with no car, hmm? Oh well, just a thought, but I’m needing out of here ...

Tuesday 8 April

Knee King. Feed him the Going Home propaganda again. He decides 90° bend ok, knee flat on bed ok, if physio passes ability on stairs then ok. Later do bar exercises ok and 10 stairs, up and down, with 2 sticks, and one-stick-plus-rail, twice, ok (easy-peasy, actually, far easier than knee bend), so can Go Home. Hah!

Phone L: come and get me, L.

Get stacks of pills, info sheets, lots of paperwork, negotiate for copies of x-rays, manage to get socks and lace-up shoes on, wait impatiently ...

L comes, walk out to her car, try to get in, one way, another way, impossible ... panic, must I go back to the heat in the night, aarrggh, no no, big effort, finally get in. 

Part 3: home

Arrive. Out of car (difficult), call cats, out they come, purring like anything, straight past me, to L - oh well, I expect I smell all wrong. While L unlocks house, walk along road, to hide tears of thankful relief running down face, because everything is so beautiful. Get to first gate and have to come back, totally wiped.

lots of fur

Night. Cool, quiet, window open, owl in woods, lots of fur (they’ve decided to recognise me since I gave them treats).

Later ... can’t get up off WC, mighty effort, hear ligament snap at R knee, burst of pure agony, like bad sprain. Aarggh. Find old zimmer (which came with the house, what luck!) and set up a tottery mechanism to aid future attempts; but do not dare try to get in bath/shower. Oh well, a bit of dirt doesn’t matter.

Later ... Occupational Therapy come and install disabled WC seat, bath board, kitchen stool, making life a heap easier.

L sees I can manage ok and goes home. She claims she’s had a lovely holiday (cooking! weeding!) Don’t know how I can ever repay debt of gratitude to her; I’d have coped if she hadn’t been here, but it would’ve been much less easy.

Edginess, twitching, total blockage of bowels. Stop Voltarol. Stop Tramadol. Lots better; calmer; bowels gradually sort themselves out, with a bit of help of unparalleled grossness (no, you don’t want to know).

gross

Day 10 or so, post-op: staples out. Middle daughter visiting, so make her film it on videocam, wish I’d got film of actual op. Much better without staples, though not a pretty sight. Take photos and email them here and there. Replies say “Gross”, and so it is.

Walk a little farther each day.

Later, at about 5 weeks post-op, get in car (not easy) drive round the parking space a couple of times, feels ok. Drive down to the smithy at the corner, turn and come back, doesn’t feel ok, vibration hurts.

Staircase dream. A repeat dream of a large factory-like interior, with an iron staircase twisting upwards to a metal balcony high up near the roof of the building. In previous dreams the metal was rusting, treads broken, gaps in the handrail, pieces missing from the balcony, difficult and frightening to negotiate, a little worse each time the dream came round. This time, someone had repaired all the gaps, replaced the treads, added a bonny new highly-polished brass handrail, everything easy and safe to negotiate. How metaphorical can you get?

6 weeks: driving is now ok, though I go cautiously, by quiet roads, prudent/cowardly.

8 weeks: to Woodend for checkup, all ok. Drive there with no problems, but still don’t want to go through middle of town.

Later ... scar is growing fur. Left knee is as bald as an egg, always has been, so has right knee always been, but now it’s FURRY. Take its photo and email to K. Her reply: “gross”.

card from middle daughter

August: 4 months: don’t need sticks around house, mostly one stick in garden (which is big and rough), 2 sticks for distance and/or rough ground, otherwise bad limp develops. Walking down the road, experiment, count paces with no sticks until limp becomes bad. Gradually extend this till one day 200 paces, chuffed as anything, get out strimmer and attack jungle for 3 hours. Big mistake, can hardly walk for next two weeks.

September: middle daughter’s wedding in Orkney; long drive, lots of stairs, late nights, have super time, v.v. tired.

Late Sept: left knee has become iffy like right knee used to be 3 years or so ago; it’s the reason I still need one stick walking down the road. Go see GP and we agree that best to get left knee done, so ...

... all this is going to have to happen again ...

Aarrrgggghhhh!