Thursday, 3 April 2008

Tweaks, Pings, Pops Snaps and other Painful Sounds

Almost immediately I was transferred from POSU ready for return to the orthopaedic ward I realised that I would have to get used to ligaments being stretched, tendons cracking and other connecting tissue around my knee reacting to the slightest movement. Unfortunately all of these twinges were accompanied by peculiar feelings as things dropped into place for a while and announced the fact with the strangest of noises. Added to this was the readiness with which such muscle as remained would go into spasm at the slightest provocation.

Over the next 9 days I would gradually regain some muscle tone and as the swelling reduced was able to extend my limited range of movement. For most of that time however I had to support my right leg under the thigh as the dead weight of the leg being pulled down by gravity was a painful reminder of the extent of damage, to the soft tissue of my right leg, both before and during the operation.

Any transition from bed to chair or back again and standing up to plod short distances behind a zimmer frame with front mounted (alloy?) wheels was difficult for most of the time that I spent back in the orthopaedic ward.

Given time I could manage but unfortunately although there were a few exceptions most of the nursing staff had insufficient time to let me move at my own pace. As a result I would be pulled and dragged or encouraged to "get it over quickly". On one occasion the nurse who came to assist getting me out of bed came complaining that unlike her colleagues she had not had a cup of tea yet and that although one was waiting for her it was getting cold. I suggested she return after she had her tea, but she would not have it. This was even more galling because the morning before the hospital's coordinator for patient lifting and handling was attached to the ward and both skilfully and patiently assisted me getting out of bed. She adopted positions that allowed her to support the dead weight while I controlled the pace of movement from straight leg to bent and to from the middle to the end of the bed.

Movement around the hospital bed was difficult as the contact points (buttocks, elbows, heels, knuckles etc) sunk into the mattress and had to overcome the inertia of the less than slippery sheets. Perhaps this is why I was given a slippery red tube when I left POSU. ( I later discovered at home that when placed under the dead weight of my contorted right leg it could slide around with barely any effort. - so that's how it works , what a good idea, just a pity that advise about using this simple solution had not percolated down to the ward staff - no doubt in a few months it will have done).

Knowledge of appropriate patient lifting and handling techniques among nursing staff was very random. Sometimes without me needing to ask a nurse would automatically provide support without trying to force the pace of movement. I was very grateful for this whenever it happened. At times a nurse would need to be reminded to take it slowly and would oblige but this was not the hoped for and ideal automatic empathy that I just described. These nurses were sympathetic. Then there were the nurses who have seen it all before and believed in tough love. Funny whenever they "helped" I seemed to have more problems with involuntary muscle spasms as well as having to endure all those tweaks, pings, pops snaps and other painful sounds.

One day I came across an empathetic male radiographer who not only seemed to instinctively realise what a wimp I was but patiently and skillfully took the weight of my right leg while together we manoeuvred my body onto the x-ray table. During the process I experienced various twinges and popping sensations and what is more the radiographer felt them too! At last someone who was not only empathetic but could also experience the feelings even if only in a vicarious manner.

Despite my previous experience of 4 hip replacements I had not realised until I became a "one hip wonder" the importance of both skilful and empathetic handling and lifting by nursing and other staff. In the light of my recent experience I have therefore come to the conclusion that aditional attention needs to be given to patient handling and lifting during basic nurse training and updating courses.

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