I arrived to inpatient check in at Hospital da Luz Guimarães, which is separate from the standard appointment check in desk, just before 9:00 the morning of January 31st. I felt a bit disembodied, floating around in a near dream like state. I had been struggling with my knee for such a long time that it was hard to believe surgery day had actually arrived. After reading through informational paperwork, which the hospital thoughtfully provided in English, and paying my 10% copay, Andrew and I were escorted to my room. The room had a nice view, 2 beds, and a private bathroom with a shower. I was instructed to take a shower, use a specific sponge for everything below my face, and change into hospital garb.

The shower nozzle was set at tsunami power level and I was not prepared, so I managed to soak the entire bathroom and part of my hallway with water. I had barely finished my shower when the flurry of activity started with cleanup on aisle #5 – described by a hilarious nurse as a “sea of water”. I apologized profusely for my incompetence in the shower. Staff hooked me up to equipment, and started an IV in my hand. I was ready, but extremely stressed, which very clearly showed in my elevated blood pressure readings. The nurses were finalizing paperwork and said that they were missing some test results, particularly bloodwork and a list of my medications.

I was fairly certain I had completed all of the required tests because my surgeon had explicitly covered this topic. Prerequisites included a bloodwork panel and an EKG which I had completed 3 months earlier at my GP’s request. I had also completed a coagulation test specifically for ACL surgery. Fortunately I had brought paper copies of my medication prescriptions, bloodwork panels, and any other possibly pertinent paperwork I could think of, with me on surgery day. Carting around paper copies of medical tests and information with you is another difference between Portugal and the United States. Although you can find exam results on the hospital app, staff seem to prefer the simplicity of looking at a paper copy. Worst case scenario is sometimes I bring extra paperwork to appointments that isn’t needed.

Shortly after providing the paperwork, I was rolled through hallways and an elevator into a room adjacent to the surgical unit. The nurses that handled intake handed me off to surgical staff and thoughtfully briefed the new nurses that I understood Portuguese but speaking slowly was helpful for me. I was asked some more questions about medication and my low thyroid, and the anesthesiologist introduced herself. Staff was great about explaining what was happening and eventually I was ready to go under the knife. My surgeon arrived and asked if I was ready and motivated. After transferring to the surgical table, the next thing I remember was waking up in the recovery room. The first thing I did was wiggle my toes. TOTAL SUCCESS! I was freezing and my blood pressure was still elevated. The recovery nurse noticed I was shivering and pumped warm air under my blankets. I was told several times that I would have to stay in recovery until my BP lowered, and eventually it did.

During the check in process the clerk had confirmed Andrew’s phone number and the hospital sent him updates via text. He received two texts: the first was that I was entering the operating room at 10:56, the second was that I was in post-op/recovery at 12:03. I rejoined him in my room within an hour of surgery completion. Andrew was a trooper and kept me company all day until he left at about 7:30 pm to pick up a few groceries and return home to take care of our fuzzy kids. He could have stayed overnight, but because we live within miles of the hospital, it seemed unnecessary.

I was only allowed tiny sips of water for several hours, which was difficult since I had been fasting prior to surgery. Staff stopped by and asked about food preferences for meals during my stay. A colleague of my surgeon stopped by to see how I was doing and gave instructions about exercises I should start doing right away. The most shocking information was that I was allowed to bear partial weight on my leg right away (as much as pain level would allow).

I felt attended to throughout the day and night with regular BP checks, IV meds, and ice packs for my knee. I opted for assistance the first time I went to the restroom since I wasn’t sure about my mobility on a leg that had been nerve blocked. After I received very nice compliments about my crutch skills from a nurse, and confirmation from another nurse that I could walk on my own, I felt confident enough to go it alone. I was happily surprised that I was indeed able to bear light weight right away. Those YouTube tutorials and practice really seemed to pay off. Hospital food was generous, and there was even a nighttime tea and snack delivery at 10:30 pm.

Sleep was fitful at best, I managed about 6 hours total in 2 hour segments. I experienced some pain, but nothing unmanageable with the meds that I was given. The worst pain came from small involuntary movements like those leg twitches that happen right before you fall asleep, also my caffeine deprivation caused one doozy of a headache that wasn’t resolved until coffee arrived at 8:30 the next morning. One of the nighttime/early morning nurses was very concerned that I hadn’t called for help to the bathroom during the night. I reassured her that I had been going by myself and hadn’t experienced any problems.

I wasn’t sure when I would be discharged, so Andrew brought some light pajamas, slippers, and shorts when he returned. I had been so preoccupied with the surgery itself, that I didn’t pack very well. By the time he arrived just before noon, I had been cleared for departure. I was allowed to choose when I wanted to leave and after lunch a nurse gave me a final briefing. I received scads of paperwork including serial numbers for the orthopedic hardware implanted in my leg, information about wound care, reminders about partial weight bearing on crutches, and a follow up appointment with my surgeon.

During the explanation of my prescriptions, both Andrew and I thought our Portuguese was failing us when the nurse described shots in my abdomen that would need to be administered at home if possible. I clarified, “we have to do this for 2 days”? The nurse: “NO 12 days”. We looked at each other in shock – WTF, can you believe this? Andrew has a severe needle phobia, he has even gone to hypnotherapy to minimize the terror. The nurse gave a demonstration and Andrew was like “I don’t think I can do it”. The nurse replied that if we weren’t brave enough to do this at home (she mentioned that diabetics have to do this all the time and it is not that big of a deal) we could go to our local pharmacy and they would give the shots. Ugh, that meant more Uber rides and more trips up and down our outdoor stairs on crutches in order to access the street. Our pharmacy is only half a mile from our house, but that would be a serious challenge on crutches. I just might have to give myself these shots.

We took an Uber home and I seamlessly scaled the stairs outside our house for the first time. I had been exceptionally preoccupied about this. We made our way to the cinema/recovery room and then Andrew headed to the pharmacy. Prescriptions included a 1000mg Tylenol equivalent, 500 mg naproxen, and those pesky blood thinner injections. I couldn’t help but think that in the States I would have been given some kind of narcotic. I wondered how bad the pain would be over the following weeks. Next stop on my ACL journey is rehab and recovery.