STOP THE PRESSES!

A few years ago, my mother had back surgery.  I had read that satin sheets would make moving around in bed easier following surgery, so I purchased a set for her.  Before my surgery, I thought about borrowing them, but I didn't.  I used them last night, and oh how I wish I had been using them the whole time!!  Impossible and near impossible moves were totally possible--even without all the grunting and groaning.  They are expensive, but it will be well worth the expense.

Another small advance

Yesterday I returned my Continuous Passive Motion machine. (CPM)  It's a nifty machine that sits on your bed and bends your knee slowly and for the most part without pain.  I began at around a 75 degree bend and gradually increased it every day.  Yesterday I had reached 110-115 degrees on the left knee and 125 on the right.  The amount of bend with the machine measures about 15 degrees less when bending on your own, but still, it feels great to see the progress.  I was supposed to spend 4 hours in the machine with each leg.  That's a lot of time on your back watching TV!    I am a bit apprehensive knowing that now all the bending is up to me.  Today the PT worked on my knees, tugging on them and bending them for me, and I felt better that it was probably not all up to me after all.  After her stretching and tugging, I measured 107 on the left and 117 on the right!


I'm thinking I'm going to spend some of my new found time doing some walking now.   The notes I got from the St. Francis class said by 5 weeks I should be walking 8 blocks--not even close!!  One half block, maybe?  I also plan to use the walking path at church since I am a bit leary of twigs and leaves and pine cones and other such items that could cause me to end up on the ground.  Besides the pain that would cause, I truly don't think I could get up!

4 weeks

Yesterday I had my first post-op visit at 4 weeks.  I was taken for X-rays which was ok until the tech repeated the right knee 4 times.  OK, I'm beginning to get nervous because this is my good knee, the one that bothers me the least.  Is is not so bad because it doesn't even work correctly?  She goes and gets the doctor.  He says, "She's too relaxed.""  That does not sound good.  What pain is he going to inflict on me to decrease my relaxation??!!  He comes in and positions me in an awkward position, they get the X-ray, and all is good.  I was given the freedom to do anything I feel like doing.  He felt safe saying that--heaven knows I won't be doing anything daring.  I also started learning to walk at PT.  At home I am giving up my walker and using a cane.  This has really slowed me down. (My door frames and floor moldings will be happy; I have really beat them up with the walker.)  Prior to surgery, I used my cane in my left hand for 2 years.  Now I have to use my right hand because my left knee is the weaker knee.  So every step is an effort of concentration and exaggerated motion.  When I think about what I was like 4 weeks ago, I realize I have come a long way.  Four weeks ago I was literally dragging my left foot.  I could not move it from side to side or pick it up in any way.  Two days ago I threw my left leg up on the bed, and my husband and I both dropped our jaws at my feat. At the end of each day, I write down any minor improvement I noticed that day.  Most of them have been miniscule, but at the end of the week, they add up to something noticeable.  On the days that I feel discouraged, which is more often now--I think I am getting weary-- I can look at my lists and see the remarkable progress that I have made.  You may remember that my 2 month goal was to be without assistance in the house.  I'm feeling pretty sure I can accomplish that in one month now that I have graduated to the cane already. Now my doctor wants me to work on giving up pain meds.  Since I am now off blood thinner, I can take NSAIDS.  I started out with 2 after breakfast and will take 2 with dinner, then save my narcotics for the break out pain.  Let's just say that the pain broke out sooner than I was hoping.  I am to keep records of how many pills I take over 3 days.  If I took 11 pills over 3 days, then the next 3 days, I am to take 10 or less. Sounds reasonable, but scary, too.

One Word (3 weeks)

CONSTIPATION.  I guess this goes in the ugly category.  This single word will forever strike fear in my heart.  Of course, my southern upbringing and the fact that my mother will be horrified that I am even bringing this subject up will temper what I have to say, but since I am a nurse, there are no topics that are off limits to me.


What a miserable day I had yesterday.  ALL DAY.  I knew that constipation was something that could happen because of the narcotics I am taking.  But I really didn't think it would be a problem for me.  I am so regular, you could practically tell time by my regularity.  I knew to drink lots of fluids.  But drinking fluids in the hospital required getting out of bed, and that was painful, it required calling someone every time I needed to use the commode chair and losing all privacy.  I knew to eat fresh fruits.  In the hospital, I rarely got fresh fruit, but I always made an effort to eat all fruit I was brought --even the nasty, gritty canned pears.


After I got home, I ate and drank even less than I did in the hospital.  I started taking Colace as a preventative. The bottle said 1-3/day.  I took one.  I am now taking THREE.  Yesterday required 2 enemas, and I still was contemplating the ER because I knew I was in serious trouble.  Today I am reminded of the momentos from my first delivery--painful hemmorhoids.


 Do everything you know to avoid this condition. Being more active would help, but doing 8 hours/day in the CPM limits that for me.  I have since learned there are abdominal exercises to do. I don't mind telling you that I have been affected by this physically, emotionally, and psychologically.

Pain, pain go away! (2 weeks)

This is for the 2 people I know who are following me in this journey later this month:


Here is what I have done for the past 2 days.  When I woke up, I  had mild pain, and I took one pain pill anyway.  I can take 1-2 pills every 4-6 hours.  So, every 4 hours, the pain was just beginning to creep up, and I would take one pill. I had 2 pretty good days because my pain was never uncomfortable, and I didn't mind moving around as much because it was not as painful as it has been.  I guess everyone has to figure this out for himself, but moving more freely because I was not guarding against the pain was so liberating.  So all day the past 2 days, I basically took one pill every 4 hours, then 2 at bedtime.


This morning when I woke up, I felt really good.  I had slept like a rock, I had no pain, and getting out of bed was miraculous compared to the past 2 weeks.  I thought this was going to be a really good day.  Did I immediately take my pain medicine? Nooooo.  Did I let the pain get ahead of me?  Yesssssss.  So I spent the rest of the day feeling sorry for myself and  being weepy because of my pain.  My new regimen for the duration will be one pill upon awakening, and paying attention to the clock and my pain level as the day progresses. Paying attention to the clock is more important than to the pain level. I figure eventually 4 hours will turn into 5, then into 6 hours.  

The Grass is not Greener on the Other Side

I've been home almost 3 days.  Coming home was difficult.  While in the hospital, I fantasized about how easier some things would be, and how happy I would be to be home.  It's a whole lot harder;  I've had more pain.  The actual trip-- preparation, leaving, and getting into the house were hard. I was thoroughly exhausted and having more pain than I had expected.  Even though I have great help at home, I am doing a bit more for myself and covering more territory than I did in the hospital.  I figure that contributes to my increased pain. It is hard to make myself do my exercises, but I can plan for my coordinating my pain pills and exercises better.  The day after going home, I went to physical therapy.  I was a bit apprehensive since this would be my first male therapist.  But after Slayer, this guy was quite manageable.  He even massaged my knees, which helped loosen things up in there so much!  After therapy, I was focused on how much time had to pass before I could take more pain medicine, and totally forgot that ice would have given me much relief.  I may have to resort to posting notes around to remind me about pain relief.  Things that I know just don't come to mind when I am in pain! 


Since I have to be on the CPM machine to bend my knees for so many hours, I spend a lot of time in my bed, rather isolated. Last night I went TV shopping online to buy a small TV to help pass the time while on CPM.  It was a planned purchase to be done before my surgery, but it just didn't happen.  I decided that I did not have to thoroughly research this purchase--it was not like I was spending a ton of money for a decision that I might regret.  So I made the purchase at Best Buy, and because of Christmas, they were open until 11PM,  and I sent my guys out to pick it up.  Easy as that.


Before leaving the hospital, the doctor told me that getting back in the water would be the best thing I could do, and it would speed up my progress.  I've decided to continue to be recovering from 2 major surgeries the remainder of the week-end, then go back to the pool and machines next week.  Just getting there will require more energy than I have now, much less exerting energy to do the work.  I may just be talking big.

WOO HOO!!!! I'm going home tomorrow!

I am surprising everyone by going home tomorrow.  This is not to brag one bit, but it has become very clear to me that I was more than prepared physically for this surgery.  Not one person I encountered did not not comment on how well I was doing, especially since I had had 2 knees done.  I kept hearing it over and over, and it made no sense to me.  It was very painful to stand,  it was very painful to walk, I felt like my mother-in-law in her last days, crouched over a walker.  It was very difficult to get out of bed, so I could not imagine that I was doing better than anyone else. As the days passed and the staff and I got more familiar with each other, the stories about others became more animated.  I told them that the pain is very real; maybe I was just more proud.  I had someone at 5:00 in the morning tell me that she had been watching me, and she could not figure out what was different about me.  I proceeded to tell her that I could tell her what was different--about how I spent the last year getting ready for this and what all that involved. Next thing I know, I'm having to talk about it with everyone else working that shift because she has gone back and told them about it.  If I have truly been the star that this staff has led me to believe, it's just wrong that everyone is not required to do prehab prior to surgery.  This has not been easy by any means, but according to everyone who has worked with me, I have made it look that way.  (By the way, I have always considered myself a baby when it comes to pain, so I don't think it's because I had a high pain threshold.)


So I have 3 more hours of therapy in the morning after a real shower.  Then I'm planning on pizza for dinner!

A taste of rehab (1 week)

 (Just read my last post and got tickled at all the mistakes.  Will try to remember to correct them.  I have so many postings in my head-- just hope that I can remember them.  Obviously they will perhaps be out of order.


I have had a good hospital experience thus far.  I spent Monday--Thursday in luxury accommodations.  Wood floors, flat screen TV, wifi, 4 month old bed, and Rick had spacious accommodations in the suite side.  It was impressive and definitely a selling point for the hospital.  The nurses were serious about pain control, so all calls were answered promptly.  Nursing care was efficient and professional. I did have one humiliating day, and I'm still thinking about reporting on that.  Then Thursday, I was transferred to the inpatient rehab unit.  Ugly, dark, and depressing.  It really affected me emotionally.  But the staff has been fantastic and more than made up for the dreary surroundings.


Friday I had an hour and an half of occupational therapy, an hour and an hour and an half of physical therapy.  Thoroughly exhausted me.  Saturday was unbelievable.  Same 3 hours of therapy, but intense.  I cannot go home until my knees bend to 90 degrees, plus I have to master some stairs, and walk a required distance.  The physical therapist proudly told me her nickname was Slayer.  Masochist would be better.  She inflicted great pain, all the while smiling, and asking if we were having fun!  She bent my best knee, the right knee, to 95 degrees, so I guess the right side of my body can go home.  The left knee which is the most painful, sorest, and stiffest, she managed to bend to 82 degrees.  It was truly awful.  I was convinced that my stitches would be busting any minute! Then in OT I had to pedal bike pedals with my arms for 20 minutes, lift 10# weights on a pulley for 180 times, work a rickshaw for 140 times, biceps curls (60), and several other exercises.  Then back to the room to bend each knee for 4 hours on the machine.  When I moved to this unit I was depressed about having Sunday off.  By noon Saturday, I was THRILLED that Sunday was a day of rest.  They let me eat breakfast before bathing, let me snooze before bathing, and the best thing-- put pj's back on instead of dressing!!!  Basically spent 8 hours in the bed on my machine bending my knees.  I would like to tell you that I am ready to get back to work tomorrow after my day of rest, but that would be a lie.  But I know that the work will get me closer to home, and I'm ready for that.

Last month I had surgery

Here it is the first day of December.  Doesn't seem that long ago that I had surgery.  Actually it's been 2 1/2 days.  Surgery went without a hitch as far as I know.  I had a spinal which was interesting in itself.  I was also sedated, but after the first knee the nurse anesthetist brought me back to consciousness, so I was in and out hearing what was going on, even talking some, not sure I made any sense. Recovery was a blur, but once I went back to the room I didn't have to deal with the wooziness of general anesthesia.  There was some concern since it was unknown if I were having partials or total knee replacements, and the time involved was different.  So I got a "super" spinal that kept my lower body numb for about 10 or 12 hours.  I also got femoral nerve blocks to help with the pain following surgery.  The right one worked GREAT, and I have not had one bit of surgical pain in my right knee.  The left knee worked some, but I had had 2 really bad episodes of pain.  My left leg was hurting in the OR and continued all day.  By 6 PM, I finally had the wherewithal to realize that this was not normal, and that this block was not working.  I had been using my pump all day, but it continued to get worse.  I let them know that I had to have more help, so I got Toradol and percocet.  It took a few hours to get the pain under control after that episode.  Then the next night, the back of my left knee was uncomfortable, so I stuck my ice pack under my knee.  Well, my knee pain was getting worse, and I'm thinking maybe I shouldn't have put the ice on it.  The moral of this story is don't wait until you figure out that this is a different kind of pain episode than you've ever experienced, that you must get on top of the pain.  As a migraineur, I should have known that.  Pain will not win over me again--there is no virtue in not taking pain medicine.  You must stay on top of the pain.  Today I learned that if you can take 2 pills, you should.  I don't like the woozy feeling it gives me, so I was just taking one because I was going to physical therapy and was not really in  pain at the time.  Then after a rather grueling physical therapy session, I needed that pain medicine, and they would not give it to me "because that is not the way they do it."  Some people just can't think out of the box.  Lucky for me my doctor called the floor at that time , and they talked to him, and I got a shot of morphine.  (Great, the hospital just lost power. Wonder what kind of experiences that will bring?)


Oh, the biggest shocker came yesterday when someone from rehab came to talk to me about 1-2 weeks of inpatient rehab.  I must admit, Rick looked pretty excited at the prospect.  I will find out tomorrow or Friday if my insurance will pay for it. The doctor in charge today said that almost all double knees qualify for rehab, but it's not a given.