July 24, 2014: Recovery day in the hospital

Slept off and on during the night. Blood pressure was very low at every measure but finally at 7:30 am, there are 3 digits to the upper number! I am no longer on an IV for fluids. The anesthesiologist came by to figure out best plan for pain management, and suggests oxycontin instead of oxycodone. The block started wearing off to where I could wiggle my toes about 4 am, or after 20 hours. As to how much pain will now arise we will see.

Night nurse was Dori Welch, daughter of famed avalanche investigator/forecaster Nick Logan, who lives in Breckenridge.

10 am: Moved to a chair for the rest of the morning. Learned the first set of exercises to do.

3 pm: just finished good PT session; able to walk 200 ft. with crutches. Got a “Game Ready” ice machine that we will rent for 2-3 weeks. My quad is not working: I cannot lift my leg even a paper width. It appears to be a consequence of the general invasion of the leg (as opposed to the adductor block not wearing off, as it would have worn off by now). Naturally I hope this improves tomorrow.

7 pm: A good day of PT and I walked 200 ft on crutches, so I will likely go home tomorrow. But the problem with the dead quadricep seems a bit more serious. Dr. JB was concerned this morning (I could tell from his manner), and many phone calls and discussions were made in the afternoon among the anesthetists and Dr C (traveling to New York). Dr DL ( a senior anesthesiologist) just came in to explain his view of what happened. The femoral block consists of a block of the saphenous nerve, but NOT the femoral nerve which controls motor function. This change is something they have been doing for three months. DL feels that the damage to the femoral nerve was caused by the tourniquet. Had they blocked the femoral nerve, they might not be certain, but because they do not do that, he has no doubt that the tourniquet is the culprit. Of course, it makes sense as he put it all very logically. Some people have nerves that are more sensitive or placed more sensitively to this procedure.

It affects only the quadricep. He says it will revive in a few weeks. Certainly this will slow down my recovery. There is nothing to be done but watch it and hope it slowly improves.

My evening session on the CPM (continuous passive motion) had lots of pain. Now using cooling machine (Game Ready); it helps a lot.

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