"From the best to the worst and back again"

As one of the hundreds (?) of people who have joint replacement surgery each year at Forth Valley Royal Hospital, my experience went from great to horrendous and back again in the 3 days I was there. It’s likely the run-up unfolded in a fairly routine way: waiting many months (16) for surgery, going through pre-op assessment and arthroplasty class, etc., The hours after surgery was when things began to go from ‘normal’ to nightmare.

Completely unknown to me, one key bit of information was missed in pre-op assessment, which caused me considerable suffering. Hopefully my words here will reach the right people so no one else ever has to experience the preventable night of absolute agony I went through my first night in hospital. Knee replacement surgery with virtually no pain management is sheer hell.

But before I share what went wrong, I must first acknowledge my surgeon, Mr. Hendrix, and the entire surgical team, including anaesthetists through to recovery nurses, who were outstanding and have my utmost respect and gratitude for carrying out their tasks with the meticulous care and professionalism we all hope to receive from those in whose hands we place our lives. I can’t praise them highly enough.

My first awareness post-surgery was amazement at how alert and well I felt (spinal as opposed to general anaesthesia). Feeling came back slowly to my legs, as expected, and also as expected, post-op pain began to increase. I had been assured the nurses who would be looking after me were well advised on how painful knee replacement surgery is, and would keep me as comfortable as possible, I had only to ask.

As the pain increased, I asked for pain relief, but it had no effect, so I asked for more, and was given another medication. It also had no effect. As time passed and the intensity of pain increased, I asked yet again for relief. This became the nightmare cycle of that first night. No matter what pain medication I was given, nothing eased the agony which only grew worse throughout the night. 

My primary nurse did everything humanly possible, including paging the on-call surgeons, who tried different medications which continued to have no effect, and a pain specialist (who would not be in until 8 the following morning). I am exceedingly grateful for the dedication, care and the genuine concern my primary nurse had for me. They became my Night Angel. Two others I want to mention are the student nurses who were also part of the team that tried to help me that night.

The only ‘relief’ I had came in the precious moments they were able to spend in my room giving comfort by talking to me. I do not use the word precious lightly. The nurses, auxiliaries and care teams run their legs off during their 12 hour shifts. Those extra moments they took to comfort and try to ease my extreme pain during what felt an endless night, is something I will never forget. 

The following morning, the pain specialist was able to assess and correct what went wrong within minutes. Because I have suffered chronic pain for many years, the medications used to treat ‘normal’ patients after joint replacement surgery had no affect on me. The pain specialist ordered an appropriate medication regime, and within a few more hours I began to get some relief and feel human again. By late afternoon the day after surgery, I reckon I was experiencing the typical level of pain most people with joint replacement experience.

That said, that first post-op day was still very difficult because of the trauma from the night before, and I must give a grateful shout out to my primary day nurse, who became my Day Angel, and did their level best to make sure I didn’t have a repeat of the nightmare. My day nurse's ability to provide cheerful and competent care whilst almost running from patient to patient amazes me. And they have 12 hour shifts…

As the hours passed and bed pans came and went ( yeah ugh!), I grew to appreciate them all more and more, as well as gaining an understanding of just how hard they all work. Their dry wit and sense of humour, their quiet competence, and the food service main guy who tried to make sure I’d finally get a menu, all changed my 3-day hospital experience from the worst to the best. I simply couldn’t have asked for better care. For those of you who I didn’t interact with enough to learn your names or who quietly went about your work in the background, cleaning, food service, all and everyone, please know you are also much appreciated.

**To those who make up the pre-op assessment criteria: please, please, please include critical information linking people with pre-existing long term chronic pain with a pain specialist so they can be properly assessed prior to surgery.

**To those in admin who navigate the necessary paper trail requirements: give our hard working healthcare workers a break and provide each ward with a paper pusher specifically tasked to assist them with the endless paperwork, so they can get on with the important job of hands-on patient care. We are truly blessed to have such dedicated folk looking after us!