Ankle surgery here we come - 49 days to surgery (S-49)


Amazing how the time has flown since I was first given a date for my surgery - now only seven weeks to surgery, and counting!

As I mentioned in my post yesterday, the big event for me over the last week was my pre-op assessment at RNOH, including the "randomisation" process which decided that I would be undergoing a Total Ankle Replacement (TAR) in seven weeks' time.

In this post, as promised, I'm going to tell you more about the pre-op assessment, and also talk some more about the various aids I've been looking at to assist me during the period after surgery when I need to ensure nil or only partial weight bearing on my post-operative left ankle.

First the pre-op assessment. The challenges of the M25 on a Friday afternoon, and of securing a parking place at RNOH, should not be underestimated by anyone attending a consultation at the site, so please make sure you allow plenty of time. I failed to do so, and thus instead of arriving calm and composed for my pre-op assessment, I was rushing and even then was five minutes late.

My appointment for my pre-op assessment was at the Patient Centre, which is on your right when you are looking up the hill at the Outpatients Department.

Partly as a result of too much time on the M25, the first thing I needed to do when I arrived was to "use the facilities". The staff in the pre-op unit are smart - as soon as you ask - "where's the loo" - they just pop a little plastic bottle into your hand and let you draw the obvious conclusion.

So, that's the urine sample taken care of. Next was a (self-managed) swab of nostrils and groin to check for the dreaded MRSA (Methicillin-resistant Staphylococcus Aureus) which has been a major concern for hospitals over recent years. This was followed by an ECG, though clearly my skin was not in co-operative mood, as the nurse had to move the electrodes around a couple of times before the machine would provide a decent output.

Blood pressure to follow and (I think because I had a slightly elevated BP), some blood was to be taken for analysis. There then ensued a rather interesting little conversation between me and the nurse -

Nurse - "How good are you with needles?"
Me - "Normally pretty good"
Nurse - "Great, that will be fine then"
Me - "Probably, but isn't the real question how good YOU are with needles?!"

This seemed to amuse both the nurse taking my blood, and her colleague in the room - I told her that, based on my previous experience, I would only know how good she was a day later, based on the degree, if any, of bruising (and I'm happy to report there was none).

Her colleague then took over and went through a quite detailed history, including a list of current medications (in my case to control high blood pressure) - remember to have a list of your medications with you as and when you attend a pre-op).

That was the end of the main pre-op session, so I was collected by Deirdre Brooking and we then did the much-anticipated "randomisation" (see second paragraph and previous posts).

I then met Mr. Goldberg's Registrar (Dr. Najefi) who reconfirmed some points on my history, and then answered a couple of questions I had related to the actual TAR device, and the reason for a CT scan of the lower left leg which was scheduled for later (this is only done if you have been selected for a TAR).

Deirdre Brooking then took me up to the scanning area, where we checked in with the receptionist, and I was offered and accepted a much-appreciated cup of tea.

I then spent some time with Deirdre going through a series of questionnaires, which I guess are a key component of the actual TARVA trial. One questionnaire is to measure, pre-operatively, your degree of discomfort/immobility, and the impact of your ankle arthritis on you day-to-day life, obviously as a basis for post-operative comparison - the so-called patient outcome. Another looked at the degree to which you were able to care for yourself, and also some questions around the personal costs incurred as a result of the condition.

That just left the final process - a CT scan, which was the only glitch in what had otherwise been a very smooth afternoon. Unfortunately the scanning department was running quite late. They did keep us informed of the likely delay, but it meant that I was just over an hour late for my scan (but every cloud has a silver lining - the delay meant that the M25 was a little less rammed then it would otherwise have been had I left earlier, so I had a reasonably comfortable and speedy return journey).

I think this is already quite a lengthy post, so I'll save my comments on walking aids until the next one, but I would like to thank all the staff I met during the pre-op asessment for their professional yet personal and cheerful approach - very much appreciated.

Post on walking aids to follow shortly.

Regards

David

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