Surgery

One of my favorite sayings is, “The day begins the night before.” This statement is especially true pre-surgery when the patient must make every effort to minimize the presence of potentially harmful bacteria.

The night before surgery, I followed this hospital-recommended routine:

• Showered using a surgical scrub
• Dried off using a newly washed towel
• Slept in newly washed PJs using freshly laundered sheets

I repeated it again the next morning:
• Showered again with the surgical scrub
• Dried off with another newly washed towel
• Dressed in newly washed clothes.

Other instructions provided by the hospital at the pre-admission appointment included:
• Not eating any solid food after midnight
• Limiting drinking water and clear liquids, as approved by my surgeon, up to two hours before the scheduled arrival time at the hospital.
• Check with your doctor about taking other medications.

While hospitals generally advise bringing only necessities when you have surgery, it would be good to check with your hospital about their specific recommendations.
• In my case, I packed my small overnight bag with a change of clothes, including very loose-fitting pants and loose shoes, in anticipation of a swollen leg and foot.
• Brought a book and magazines—at least I could look at the pictures if I was too out-of-it to read.
• Included personal items such as my cell phone and charger, family photos, and a notepad and pencil to start my recovery journal.

Lastly, I left a list of friends’ email addresses with my husband to notify them of my progress.

At the hospital: I arrived, signed in, sat down, and waited to be called. After about 20 minutes, a nurse escorted me through a maze of hallways into the surgical area. She left me at the reception desk, where another nurse reconfirmed my identity and the type of surgery to be performed.

This was my last opportunity to use the bathroom. The pre-surgery preparation room was a purposeful place where medical personnel actively attended to patients in cubicles sectioned off by privacy curtains. Numerous electronic devices blinked and buzzed, either in use or ready to be moved to where needed.I was brought to my curtained space and given a hospital gown. I disrobed and placed my clothes in a bag with my name on it. I climbed onto the gurney and waited for the next act to begin.

Over the next hour, I was visited by numerous surgical team members, including nurses, the anesthesiologist, and the physician’s assistant, who completed last-minute paperwork. My surgeon stopped to ask how I was doing, confirmed my surgery’s side and site, and marked the leg. It was good to see him again and to know that he cared enough about me to answer any last-minute questions I might have. I then received my nerve block. One might imagine the time preceding surgery would be a period of anxiety or nervous anticipation; instead, the friendliness and confidence of my medical team helped me relax.

Having had this experience twice now, I do have some advice from the field:

1. Bring something to read in case your surgery is delayed.
2. Try to relax and think about the fun you’ll have a year from now.
3. Make sure you charge your cell phone before leaving home to stay in touch with loved ones, and bring your charger.
4. Ask for warm blankets if you start feeling cold.

Now is also a good time to say “Good-Bye” to your old knee. After all, it did serve you well for many years.

Left knee, pre-existing scar marked by surgeon

Left knee, healed, and right knee ready for surgery

Right knee marked by surgeon, before surgery

Finally, it was time for surgery. I was wheeled into a very bright and somewhat chilly operating room where surgical preparations, including shifting me from the gurney to the (very narrow) operating table and sitting me upright to give me a spinal injection, were performed with great speed and precision. I will never forget the nurse who comforted me with a most gratifying hug as the needle entered my back. I noticed another nurse standing apart from the activity, covered from head to toe in green. She was hooded and veiled and looked like a misplaced beekeeper. I later learned that hospital scrubs are green or blue for visual purposes. These colors, in theory, help refresh the doctors’ perception of red items and limit distracting after-effect illusions.

A nurse placed a sterile drape across my waist. On the other side of this barrier, the team coordinated a well-practiced pattern of pre-surgical responsibilities was being. The anesthesiologist reappeared, and just as I was about to tell him that I was getting cold…I woke up.

I wish I could have taken photographs in the operating room to share the perspective of lying on the table with what seemed a dozen hands and arms moving in a purposeful, synchronized dance over my head. That is the picture I’ve taken with me from my time there—the memory of what it felt like to be totally passive. The moment passed quickly, but it is worth remembering.