and it feels good!! Swept the entire apartment, wiped down counters, sorted laundry and started a load. whew!! I couldn't comprehend this kind of activity for the last few days. The only telltale sign is a slight queasiness in my stomach and that I am managing.
I had a good session with Jen, home health PT, yesterday. We went up to the gym and I got on the stationary bike for the 2nd time. This time I was able to spend about 5 minutes rotating forward and back without making a complete revolution. No cramps stopped the process this time. With each approach to the revolution, the knee is stretched and curled toward maximum extension and flexion. She measured me at 112 degrees of flexion without her help using my own muscle tone. I will go up this AM and see if I can make a full revolution.
Perhaps a slight mania has emerged...I interrupted this post to wipe down all the handles in the house with an antiseptic wipe. Motivated by the thought that this apartment has been like a sickroom to me as I've been confined and ailing here. Now I've purified it from the sick germs ;-)
Thursday, September 30, 2010
Wednesday, September 29, 2010
...the bowels of hell and then-some...
maybe I am getting better...I'm starting to find this funny...
Into my third day of withdrawal symptoms from the sudden stopping of my oxycodone. Here is one report on a website citing the symptoms and the results...
Into my third day of withdrawal symptoms from the sudden stopping of my oxycodone. Here is one report on a website citing the symptoms and the results...
Patient Betts describes her Oxycodone withdrawal as:
“…An indescribable torture that takes you to the bowels of hell and then-some. My body screamed for relief. The vomiting and diarrhea were inconsequential to how the body flails uncontrollably.”
She explains that just when she thought the withdrawal symptoms were subsiding, another wave came to wring her out and start all over again. Withdrawal from her addiction felt “like hell on earth had begun.” Her doctors, to her later dismay, only prescribed more painkillers for the symptoms and supposed ‘illness’!
My experience began with a deep pain in the pit of my stomach as I awoke on the day after taking the last of the RX. I felt listless and uncomfortable but did not really put it together with the drug withdrawal. Now into the third day of chills, headache, upset stomach, loss of appetite , all I am wondering is when will it end.
I am totally narc shy so even though I have a lesser pain pill with the norco, I am going to try to stick to the tylenol to get through the pain during physical therapy and avoid going anywhere near narcotics as long as I can.
Tuesday, September 28, 2010
2 weeks out
Many firsts have occurred in the last 5-7 days...
Figuring out the transition from narcotic to otc pain killer was not well specified. I was told to try to use tylenol (acetaminophen) for fill-in pain med. So in place of the evening oxy, I took 2 tylenol XS (650mg each). Sleep with the oxy, as I described to the nurse, was like a stone. The first night w/o oxy did not seem so different, perhaps not so sound. I woke up feeling a pain in my stomach and not very well. I took some breakfast to try to settle my stomach. I somehow got myself in the shower and dressed because I had two in-home appointments, nursing and PT, during the day. I felt on the verge of nausea and went back to bed with chills and weird sleep in and out. I emerged for my appointments but did not feel well. Rescheduled a phone appointment in which I wanted to be fresh.
Not through the transition yet. Hard to fall asleep with only the tylenol. Slept in several segments, got up once for an additional 650mg or tylenol. Woke still feeling sickish with headache.
Tylenol max. to protect the liver is 4000 mg/day. So now my pain med schedule is a math game. each XS (extended strength) tab is 650mg, each ES (extra strength) is 500mg, each norco contains 375mg acyt. The norco I will take an hour before I have physical therapy so that I can do the max range of motion.
- walking inside without crutches or cane
- walking outside on the arm of another, working on gait mechanics
- shopping with a friend (Nordstrom's fashion and makeup extravaganza Saturday)
- stairs: one footed up and down
- stairs: forgetting to one foot it down (and feeling the pull/pain)
- staples come out, steri-strips go on (steri-strips are showerable)
- oxy for pain is done, tylenol picks up the slack
Figuring out the transition from narcotic to otc pain killer was not well specified. I was told to try to use tylenol (acetaminophen) for fill-in pain med. So in place of the evening oxy, I took 2 tylenol XS (650mg each). Sleep with the oxy, as I described to the nurse, was like a stone. The first night w/o oxy did not seem so different, perhaps not so sound. I woke up feeling a pain in my stomach and not very well. I took some breakfast to try to settle my stomach. I somehow got myself in the shower and dressed because I had two in-home appointments, nursing and PT, during the day. I felt on the verge of nausea and went back to bed with chills and weird sleep in and out. I emerged for my appointments but did not feel well. Rescheduled a phone appointment in which I wanted to be fresh.
Not through the transition yet. Hard to fall asleep with only the tylenol. Slept in several segments, got up once for an additional 650mg or tylenol. Woke still feeling sickish with headache.
Tylenol max. to protect the liver is 4000 mg/day. So now my pain med schedule is a math game. each XS (extended strength) tab is 650mg, each ES (extra strength) is 500mg, each norco contains 375mg acyt. The norco I will take an hour before I have physical therapy so that I can do the max range of motion.
Wednesday, September 22, 2010
all the wonderful food...
I'm playing up my shut-in, invalid status pretty well and am reaping the rewards. People have brought amazing goodies and I am having fun savoring them all.
Early enough that my drugged memory has not stored the time, friend A brought chocolate ice cream milk shakes from M Burger. V.v.good!
The chicken white bean chili from M is delicious! and she brought enough to feed an army so we are enjoying it again and again. Plus she brought all the trimmings; the shredded sharp cheddar, the sour cream and the crispy oyster crackers to go on top. Yum! Also this good friend brought the sampler pac of 10 small Vosges bars; chocolate bacon bar, xxx, xxx, -- yum, yum, yum!!!
Then D came by with cupcakes from Sprinkles. And we taste tested four varieties: banana nut, carrot cake, red velvet and chocolate fudge with marshmallow filling. The first three had cream cheese frosting and the chocolate fudge, chocolate fudge.
A took me to the farmer's market for a lunch from Saigon Sisters. We both had the tofu spring rolls with peanut sauce. They were v.good.
Early enough that my drugged memory has not stored the time, friend A brought chocolate ice cream milk shakes from M Burger. V.v.good!
The chicken white bean chili from M is delicious! and she brought enough to feed an army so we are enjoying it again and again. Plus she brought all the trimmings; the shredded sharp cheddar, the sour cream and the crispy oyster crackers to go on top. Yum! Also this good friend brought the sampler pac of 10 small Vosges bars; chocolate bacon bar, xxx, xxx, -- yum, yum, yum!!!
Then D came by with cupcakes from Sprinkles. And we taste tested four varieties: banana nut, carrot cake, red velvet and chocolate fudge with marshmallow filling. The first three had cream cheese frosting and the chocolate fudge, chocolate fudge.
A took me to the farmer's market for a lunch from Saigon Sisters. We both had the tofu spring rolls with peanut sauce. They were v.good.
Tuesday, September 21, 2010
Marathon walk to the farmer's market
Let's see -- Ohio to Chicago & pretty much a straight shot. Perhaps doubling my previous PR outside, two crutches, distance.
A bit pooped, in need of water, shepherded by friend Andy. Sites & sounds are worth the effort. No PT to the house today; she said to do my PT exercises & walk in place of the session.
The market is bustling; the markets season may be drawing to a close.
I will look forward to my icing when I return.
Kay Burnett / 312.533.1227
Monday, September 20, 2010
You put your right crutch in, And you shake it all about...
The Hokey Pokey...the lyrics kept running through my head as I learned that I could walk using one crutch instead of two! I love the independence of having one hand free and I've been testing the strength of carrying with one hand. Out of range, possible but not recommended, is my laptop.
Another first on Sunday evening, taking a walk outside. My PT warned me that I should have my walking partner, in this first case, Eric, walk on the road side, kind of like chivalry, so that he could be the warrior and keep any flying bodies or vehicles away from me.
It felt good to know that I could walk outdoors without much trouble. Every curb becomes a step up or down -- higher degree of difficulty. Even sloping driveways can throw off the balance. But all this leads to a further range of motion and builds confidence in my mobility.
Another first on Sunday evening, taking a walk outside. My PT warned me that I should have my walking partner, in this first case, Eric, walk on the road side, kind of like chivalry, so that he could be the warrior and keep any flying bodies or vehicles away from me.
It felt good to know that I could walk outdoors without much trouble. Every curb becomes a step up or down -- higher degree of difficulty. Even sloping driveways can throw off the balance. But all this leads to a further range of motion and builds confidence in my mobility.
Saturday, September 18, 2010
Full-frontal knee
Friday, September 17, 2010
Home Day #2!!
waking up in my own bed was pretty nice!! I'm slowly getting re-acclimatized to my own house. Everything I do these days is done slowly, including composing and typing.
Suffice it to say for this evening, that I am on an upward tilt. Eric is helping out so much I could not get by on my own. I see why people on their own go to a care facility.
Suffice it to say for this evening, that I am on an upward tilt. Eric is helping out so much I could not get by on my own. I see why people on their own go to a care facility.
Thursday, September 16, 2010
Home! post #2
He stole my exit line!!
discharge about 1PM, home by 2:3oPM (after waiting for the taxi-it's a two block ride), and a hour nap (no interruptions, no beeping noises, serenity..).
great to be out of the hospital. not that it wasn't extremely pleasant and completely professional in every way, its just that nothing is under the patient's control, and the patient must ask for everything they want. I'm still asking for most everything I want. My rationale is that it is easier for a mobile Eric to get stuff than for me to require his attendance at my movements and put up with my turtle speed.
the best thing about today was that I got to take a shower - well not better than going home! showering, albeit on a chair bolted to the wall, was a wonderful break from the monotony of the hospital routine. and help wash away some of the adhesive residue, the bright orange beta dine and dust of the ordeal. even the poorly designed shower area with no wall holders for shampoo and a bar of ivory soap could spoil the joy of warm water running all over the body, soaped up body and hair and rinsing, rinsing, rinsing!!
Eric went to get the pain meds and other misc. drugs. Pain is at an okay level as long as I keep it under control. When I go over the drug limit, it's not that different from pre-surgery pain.
I must still be having some anesthesia effect; I have mini-hallucinations that are v.pleasant and then can't remember them ;-). I normally have floaters in my eyes that are small black spots briefly interfering with my vision. I now have larger gray clouds floating around; I can see through them for the most part but they do make things appear to move around and disappear. Maybe they will go away as my ADD lifts. Plus, I can't spell and everything takes forever. Rehab holds lots of opportunity for me!
discharge about 1PM, home by 2:3oPM (after waiting for the taxi-it's a two block ride), and a hour nap (no interruptions, no beeping noises, serenity..).
great to be out of the hospital. not that it wasn't extremely pleasant and completely professional in every way, its just that nothing is under the patient's control, and the patient must ask for everything they want. I'm still asking for most everything I want. My rationale is that it is easier for a mobile Eric to get stuff than for me to require his attendance at my movements and put up with my turtle speed.
the best thing about today was that I got to take a shower - well not better than going home! showering, albeit on a chair bolted to the wall, was a wonderful break from the monotony of the hospital routine. and help wash away some of the adhesive residue, the bright orange beta dine and dust of the ordeal. even the poorly designed shower area with no wall holders for shampoo and a bar of ivory soap could spoil the joy of warm water running all over the body, soaped up body and hair and rinsing, rinsing, rinsing!!
Eric went to get the pain meds and other misc. drugs. Pain is at an okay level as long as I keep it under control. When I go over the drug limit, it's not that different from pre-surgery pain.
I must still be having some anesthesia effect; I have mini-hallucinations that are v.pleasant and then can't remember them ;-). I normally have floaters in my eyes that are small black spots briefly interfering with my vision. I now have larger gray clouds floating around; I can see through them for the most part but they do make things appear to move around and disappear. Maybe they will go away as my ADD lifts. Plus, I can't spell and everything takes forever. Rehab holds lots of opportunity for me!
Getaway day?
An early start today - 4:45AM - to have the dressing changed (and the wound admired - "look how small that is!") and a walk down the hall under the nurse's supervision (Kay seems to have it down,with crutches or walker, but the head nurse was called in to scold her about freelancing out of bed to go to the bathroom; they don't want any falls on their watch).
We are pretty sure Kay will be checking out of the hospital this afternoon. At some point yesterday morning the mood shifted from warm "don't worry, you are welcome here forever" to the chillier "here's what needs to happen for you to get out of here on Thursday." Still very friendly, but good to have the encouragement though we weren't really thinking of staying... (Kay has a private room....private except for me sleeping on a pullout cot contraption under the window).
Kay says: "there's a lot I would describe if my brain wasn't so foggy." She'll be back online soon.
-Eric
We are pretty sure Kay will be checking out of the hospital this afternoon. At some point yesterday morning the mood shifted from warm "don't worry, you are welcome here forever" to the chillier "here's what needs to happen for you to get out of here on Thursday." Still very friendly, but good to have the encouragement though we weren't really thinking of staying... (Kay has a private room....private except for me sleeping on a pullout cot contraption under the window).
Kay says: "there's a lot I would describe if my brain wasn't so foggy." She'll be back online soon.
-Eric
Wednesday, September 15, 2010
"Breakfast?!"
"Breakfast?" Kay just said which is a good sign for the patient in recovery. She is wiped out by the pain medication and we are both daunted by what lies ahead. She still has to jump through some hoops or at least walk up and down the hall before she will be able to go home. Today will be a big day for physical therapy.
A doc was in here before dawn (Wednesday) to cut away the big bandage so we could all admire the scar.
Kay has been cheered by the many messages of support. Thanks so much for that!
-Eric
PS: I'm debating with myself about the propriety of putting the scar photo on the blog. I expect I'll lose my reserve as the day goes on.
A doc was in here before dawn (Wednesday) to cut away the big bandage so we could all admire the scar.
Kay has been cheered by the many messages of support. Thanks so much for that!
-Eric
PS: I'm debating with myself about the propriety of putting the scar photo on the blog. I expect I'll lose my reserve as the day goes on.
Tuesday, September 14, 2010
More firsts...
Kay had her first physical therapy session and her first bout with the Continuous Passive Motion (CPM) machine but low blood pressure has kept her bed-bound so far.
The leg exerciser, CPM, will be a twice a day treat during her hospital stay. This morning's setting was 55 degrees -- 130 is full -- and 75 degrees tonight. Tomorrow morning 90 degrees. We also hope she'll be standing tomorrow.
-Eric
-Eric
Day 2
Going nuts with itching from the tape on my back that is holding my epidural in place even though they turned off the meds going in hours ago the tape is my biggest problem at the moment i should be up & walking today! Can't wait!!!
Kay Burnett / 312.533.1227
Kay Burnett / 312.533.1227
Monday, September 13, 2010
Long day
Came thru surgery well. Doc says the knew was worse than he expected from X-rays & tests. More disease, more damage, more deterioration.
I am tired, loving the idea of water and
food, not ready to keep any of it down. Still wired up & pinned down. Tomorrow is another day. Looking forward to promised standing.
Kay Burnett / 312.533.1227
In room in time for US Open final!
Come visit! I'm in Room 1456 Feinberg Pavilion (telephone 312.926.1456)
Out of surgery
Dr. Ghate came to the waiting room at 11:40am to report that surgery went well and that I will be able to see Kay in the recovery room at approximately 2pm. He said the knee was worse that expected - Xrays didn't tell the whole story. He used terms like "bone on bone", "collapsed", "significant disease". So surgery was a good idea? Oh yes, he agreed.
The doctor said Kay will likely stand up today and start walking tomorrow. He said she would be in the hospital until Wednesday or Thursday - depending on how soon she is steady on her new knee.
(12:08pm - the waiting room receptionist said Kay just went to the recovery room).
-Eric
The doctor said Kay will likely stand up today and start walking tomorrow. He said she would be in the hospital until Wednesday or Thursday - depending on how soon she is steady on her new knee.
(12:08pm - the waiting room receptionist said Kay just went to the recovery room).
-Eric
Surgery
The "Surgery Family Waiting Area" receptionist just walked over to tell me that the surgery had begun (approximately 10:20AM). The procedure is supposed to take 2 hours.I'm occupying myself with work and one of the fancy Starbucks drinks Kay has promised herself tomorrow morning. Eric
"Show time!"
At least that's what the nurse said before wheeling Kay toward the operating room at 9:50. Frustrated by the pre-surgery fast (see the "no water" comment, earlier), the drugs and IV had Kay in a much better mood by the time she moved down the hall. Eric
Checking in pre-surgery
Sunday, September 12, 2010
Sunday
and surgery is tomorrow, Monday, first thing in the morning. I keep thinking in terms of my last...yoga, morning coffee, free day, etc. Probably not productive. I talked to a TKA survivor and exemplary yesterday and helped set my recovery timeframe a bit. He talked in terms of stairs in the first week; up-yes, down-no. His key advice was to get out of the hospital as quickly as possible. I have that in mind but, like his wife said, when you are there with your self-administered morphine pump, it may seem like a good idea to stay.
Today we have an afternoon play at Steppenwolf and a dinner following. At 10pm I must stop all intake of food and drink. The lack of water will be hard.
Today we have an afternoon play at Steppenwolf and a dinner following. At 10pm I must stop all intake of food and drink. The lack of water will be hard.
Friday, September 10, 2010
Monday Surgery
Got notice today that I am expected to arrive at NWH Galter Pavillion 5th floor at 6:30AM.
I hope this means early operating time, early finish, early recovery room, early and over.
I hope this means early operating time, early finish, early recovery room, early and over.
Thursday, September 9, 2010
Glucosamine & Chondroitin
I'm finding that I am really missing my Glocosamine & Chondroitin patch. Taking this combination as a supplement, either by caplet or by patch, has always been a bit suspect for me. I thought it helped me with basic aches and pains but then I wasn't sure because the effects were subtle and the pain was still there most of the time. For the past year or so I have been using the patch by Mendright shown in the link.
This is one of the supplements that is "off limits" for the 10 days before surgery and so I have had no patch for about 6 days now. I find that my knuckle joints of my hands are achy and in general I have been feeling different, more crotchety.
I have discovered that The Body Knows! My body has been telling me things as I lead up to this surgery that my mind perhaps is slow to grasp. I have recently become allergic to my underwear! The elastic on it itches and chafes my skin and leaves an imprint after I've taken it off. I've had this happen before, I can't remember the exact circumstances but I take it now as a sign of the agitation and anxiousness I feel approaching the surgery.
This is one of the supplements that is "off limits" for the 10 days before surgery and so I have had no patch for about 6 days now. I find that my knuckle joints of my hands are achy and in general I have been feeling different, more crotchety.
I have discovered that The Body Knows! My body has been telling me things as I lead up to this surgery that my mind perhaps is slow to grasp. I have recently become allergic to my underwear! The elastic on it itches and chafes my skin and leaves an imprint after I've taken it off. I've had this happen before, I can't remember the exact circumstances but I take it now as a sign of the agitation and anxiousness I feel approaching the surgery.
Wednesday, September 8, 2010
Pain management is a b#!&%!
Picked up a bottle of Tylenol Arthritis Pain caplets (650mg acetaminophen). Docs say I can take up to 4000mg of acetaminophen a day safely and for a limited period of time. I am weighing taking 2 of these at bedtime vs. taking one Tylenol PM (500mg acetaminophen + 25mg diphenhydramine HCI). The effect of the TAP caps was not entirely what I had hoped. At first they did dull the knee pain but then another layer of pain emerged as though revealed by the lack of the first.
I had switched from the Aleve (220mg naproxen) on doctors orders. The things they had me stop at 10 days before surgery in addition to the Aleve; Fish Oil, Flaxseed Oil and the Glucosamine patch. Vitamins, minerals and RX drugs are okay up until the day before.
I don't know if there is a break-in period for a new pain killer...I had more or less successfully been managing the pain with generic extra strength acetaminophen (500mg) three times per day.
Moving around pain control is always different from the quiet time of going to sleep. I had experimented with using Tylenol PM on alternate nights because the pain makes me continually move my legs around to find a comfortable position and I was getting little sleep (not to mention keeping my husband unsettled all night).
An ongoing experiment for now. Next week I'll have the heavy drugs and I'll probably be sleeping all the time.
I had switched from the Aleve (220mg naproxen) on doctors orders. The things they had me stop at 10 days before surgery in addition to the Aleve; Fish Oil, Flaxseed Oil and the Glucosamine patch. Vitamins, minerals and RX drugs are okay up until the day before.
I don't know if there is a break-in period for a new pain killer...I had more or less successfully been managing the pain with generic extra strength acetaminophen (500mg) three times per day.
Moving around pain control is always different from the quiet time of going to sleep. I had experimented with using Tylenol PM on alternate nights because the pain makes me continually move my legs around to find a comfortable position and I was getting little sleep (not to mention keeping my husband unsettled all night).
An ongoing experiment for now. Next week I'll have the heavy drugs and I'll probably be sleeping all the time.
Tuesday, September 7, 2010
Knee alignment
This is a set-up designed by Gabriel Halpern at Yoga Circle to equalize the alignment of the legs and in my case, particularly to stretch out the left leg which would not straighten because of the compromised knee.The set-up consists of a long pillow between the legs, straps at the hip crease, just above the knee and at the ankles and a 50# weight on top of the thighs. The weight stays in place for no more than 10 minutes and is repeated on a regular basis.
how do I know this is the best option?
I think about this question from time to time. Why am I willing to undergo this major procedure and invasion of my body when I can still walk around?
Friends who know my plans for the knee replacement immediately want to help me, push me in a wheelchair, sit down with me or stay home. There is surprise among some that I am not showing outward signs of the pain or the crippled up stature of a person with a failed knee.
I have been tending to this knee and modifying my life around it for the last 3 years, 5 years, even 10 years when I gave up running. I'm ready to plan around another priority.
This is what I've been doing to keep the knee functioning: the first thing was a knee arthroscopy about 10 years ago. The doctor trimmed the cartilage which had gotten torn by my arthritic knee. His mantra was "motion is lotion" so I returned to my spin class about 1 week after that procedure. It was not a big deal. I think I used a cane for a few days and then was good. I had the procedure repeated several years later when I could not run for the bus. I never run for the bus now. I don't run to cross a street in front of a turning car. I don't run for anything because I know the payment will be high in terms of pain.
For some reason, riding my bike has been an activity that I have been able to continue to do. I think it has something to do with being clipped into pedals which keep my knee aligned directly over my foot. This is one accommodation I have made when doing any exercise. It seems keeping the alignment keeps the range of motion open. When alignment is not there, I hear the clunk, clunk, clunk of the bone on bone when I bend into a yoga pose for instance. I learned on a recent week in Wisconsin that this does not work when putting the knee under resistance. I was resigned to riding the flat roads in beautiful, hilly, southern WI to keep the pain to a manageable level and this was especially important when we had plays to sit through in the evening. Any activity that puts any extra stress on the knee requires significant icing when the activity is over.
Over the last few years I have been working on building strength in the leg so that it can support the faulty knee. I think of all the things I've done, this has been the most helpful. Walking can be painful and Eric told me I was starting to walk with a limp. I worked hard to walk without the limp, not sure if I succeeded but he didn't mention it again, and this had to do with hip and glut strength, quad strength, hip flexibility, focus on balance and stride. Much of this work has been done with yoga (thanks to my wonderful instructors) which I love for its ability to work with a body where it is and help it extend into areas that are less accessible. My most recent foray into strengthening is a concerted effort to be in the best possible shape as I approach this surgery with the assumption that I will come through it strong if I go in strong. I am working with a fabulous personal trainer on using my body weight resistance through pilates and other methods to strengthen core, upper body and legs where I can without putting the knee under pressure
This post is going on too long because this is a passionate topic for me.
Friends who know my plans for the knee replacement immediately want to help me, push me in a wheelchair, sit down with me or stay home. There is surprise among some that I am not showing outward signs of the pain or the crippled up stature of a person with a failed knee.
I have been tending to this knee and modifying my life around it for the last 3 years, 5 years, even 10 years when I gave up running. I'm ready to plan around another priority.
This is what I've been doing to keep the knee functioning: the first thing was a knee arthroscopy about 10 years ago. The doctor trimmed the cartilage which had gotten torn by my arthritic knee. His mantra was "motion is lotion" so I returned to my spin class about 1 week after that procedure. It was not a big deal. I think I used a cane for a few days and then was good. I had the procedure repeated several years later when I could not run for the bus. I never run for the bus now. I don't run to cross a street in front of a turning car. I don't run for anything because I know the payment will be high in terms of pain.
For some reason, riding my bike has been an activity that I have been able to continue to do. I think it has something to do with being clipped into pedals which keep my knee aligned directly over my foot. This is one accommodation I have made when doing any exercise. It seems keeping the alignment keeps the range of motion open. When alignment is not there, I hear the clunk, clunk, clunk of the bone on bone when I bend into a yoga pose for instance. I learned on a recent week in Wisconsin that this does not work when putting the knee under resistance. I was resigned to riding the flat roads in beautiful, hilly, southern WI to keep the pain to a manageable level and this was especially important when we had plays to sit through in the evening. Any activity that puts any extra stress on the knee requires significant icing when the activity is over.
Over the last few years I have been working on building strength in the leg so that it can support the faulty knee. I think of all the things I've done, this has been the most helpful. Walking can be painful and Eric told me I was starting to walk with a limp. I worked hard to walk without the limp, not sure if I succeeded but he didn't mention it again, and this had to do with hip and glut strength, quad strength, hip flexibility, focus on balance and stride. Much of this work has been done with yoga (thanks to my wonderful instructors) which I love for its ability to work with a body where it is and help it extend into areas that are less accessible. My most recent foray into strengthening is a concerted effort to be in the best possible shape as I approach this surgery with the assumption that I will come through it strong if I go in strong. I am working with a fabulous personal trainer on using my body weight resistance through pilates and other methods to strengthen core, upper body and legs where I can without putting the knee under pressure
This post is going on too long because this is a passionate topic for me.
Monday, September 6, 2010
one week and now I'm counting...
One week from today I will under go my total knee replacement. I don't watch a lot of hospital dramas but I do think of House and the certain progression from a small hangnail to a life threatening condition, all escalating because the staff is just experimenting on the patient.
My main concern for this type of surgery is that they operate on the correct leg. It is my LEFT knee. On my shoulder, I believe, they wrote on each side: "NO" on the good side and cryptic messages on the one they were to cut.
When I was at the doctor last week, they xrayed both knees. He found that one of the images had been mis-labeled as "right" when it was the "left". He said that the xray person would be responsible for relabeling and they would have to file an incident. This prompted me to phone the surgeon's nurse to remind her that this had happened and needed to be corrected. I should follow up with an email so that I have it in writing. The discovery was prompted by my mentioning that I had broken the femur on the left leg when I was 10 years old. He could see the scar tissue on the xray but the image was labeled "right".
This led me to thinking that once I became aware that an error had occurred, it was my responsibility to ensure that it was corrected. I see this as a karma kind of thing. Too often we want to say "everything will be all right" but once we become aware, I believe good karma puts us in charge of following through the situation. Karma may be the wrong word but it is a kind of non-logical, non-intellectual thing that I have no other word for at the moment.
My main concern for this type of surgery is that they operate on the correct leg. It is my LEFT knee. On my shoulder, I believe, they wrote on each side: "NO" on the good side and cryptic messages on the one they were to cut.
When I was at the doctor last week, they xrayed both knees. He found that one of the images had been mis-labeled as "right" when it was the "left". He said that the xray person would be responsible for relabeling and they would have to file an incident. This prompted me to phone the surgeon's nurse to remind her that this had happened and needed to be corrected. I should follow up with an email so that I have it in writing. The discovery was prompted by my mentioning that I had broken the femur on the left leg when I was 10 years old. He could see the scar tissue on the xray but the image was labeled "right".
This led me to thinking that once I became aware that an error had occurred, it was my responsibility to ensure that it was corrected. I see this as a karma kind of thing. Too often we want to say "everything will be all right" but once we become aware, I believe good karma puts us in charge of following through the situation. Karma may be the wrong word but it is a kind of non-logical, non-intellectual thing that I have no other word for at the moment.
Sunday, September 5, 2010
anticipation grows...
...and turns to anxiety and nervousness. I'm still able to have enthusiasm for the outcome but the reality of the cutting and the discomfort and the scariness are coming to the fore. I guess that's unavoidable and I do know what I'm getting into so there is no hiding from that. My other surgery experiences have set me up nicely for this one -- none have been bad but I am familiar with the turmoil and the uncertainty of the march up to the merciful oblivion.
I am understanding that my oblivion will be controlled differently this time. My mental numbness will occur with something (not sure exactly what) that will make me sleepy. The body numbness will occur through an epidural and then a femoral block. I need to look them up. In this way, the area undergoing surgery will be singled out for numbing and the rest of the body should be free from the heavy drugs. Respiratory anesthesia has caused me intense nausea in the past so I'm hoping to avoid that this time. The shoulder surgeries I had used a nerve block that made the entire shoulder and arm seem to be removed from the body and lasted a full 24 hours.
I am somewhat disturbed that I will stay overnight in the hospital. The doctors say the average stay is three days and I am hoping that I will get out before that. I will be in an orthopedic ward at Northwestern where Eric will have guest privileges overnight! I'm not sure how they make that out to sound like a good thing but they do.
I am understanding that my oblivion will be controlled differently this time. My mental numbness will occur with something (not sure exactly what) that will make me sleepy. The body numbness will occur through an epidural and then a femoral block. I need to look them up. In this way, the area undergoing surgery will be singled out for numbing and the rest of the body should be free from the heavy drugs. Respiratory anesthesia has caused me intense nausea in the past so I'm hoping to avoid that this time. The shoulder surgeries I had used a nerve block that made the entire shoulder and arm seem to be removed from the body and lasted a full 24 hours.
I am somewhat disturbed that I will stay overnight in the hospital. The doctors say the average stay is three days and I am hoping that I will get out before that. I will be in an orthopedic ward at Northwestern where Eric will have guest privileges overnight! I'm not sure how they make that out to sound like a good thing but they do.
Friday, September 3, 2010
strengthening for surgery
I know from past surgery experiences that the condition and attitude that you take into the procedure can affect the outcome and recovery time. I decided to do some focused strengthening of my legs and core to get into the best shape I could before going into the surgery and was something I would want to continue once I had finished my knee rehab and started to get back to regular activities and workouts.
I signed up for a Personal Training program offered by my health club. The best deal was to go for 30 sessions (bringing the per session price down around $60) and paying up front. I was glad I had been paid for my summer consulting work as it was a good sized chunk of cash.
I was very impressed with the knowledge and enthusiasm of the trainer to whom I was introduced during my special introductory session. We began scheduling two weekly sessions together.
I have tried to keep my fitness level steady as I age and hurt from the knee. On my own I do a cardio routine several times per week and yoga as many as four times per week. I was swimming once per week and trying to bump that up to twice. Although it is not weight bearing, swimming is a great workout for me. I love being in the water, I love working on streamlining my stroke. I do primarily drills and change up the strokes, all but the butterfly.
As with all workouts these days, I need to pay close attention to keep from overworking my shoulders and my arthritic knee and avoid injury.
The first several sessions of PT were great. We talked about my upcoming surgery, my limitations, strengths and weaknesses. I got some good work for my shoulders and chest, core and arms and light work with legs. As we went on, the leg work climbed in resistance, repetition and rigor. I was interested in having strength in the muscles surrounding the knee.
Today I must declare "NO LEGS". The leg work recently has been extremely painful. Not necessarily at the time of the workout and that throws me off. When I can do it and not feel too much pain, I get the sense that it will be okay. But it is after the activity that the pain begins. This last workout on Monday left pain lurking through Thursday when I had some if it massaged out of my glut, my quad, my calf and my ankle. I cannot afford to be in pain for so many days following an activity.
I signed up for a Personal Training program offered by my health club. The best deal was to go for 30 sessions (bringing the per session price down around $60) and paying up front. I was glad I had been paid for my summer consulting work as it was a good sized chunk of cash.
I was very impressed with the knowledge and enthusiasm of the trainer to whom I was introduced during my special introductory session. We began scheduling two weekly sessions together.
I have tried to keep my fitness level steady as I age and hurt from the knee. On my own I do a cardio routine several times per week and yoga as many as four times per week. I was swimming once per week and trying to bump that up to twice. Although it is not weight bearing, swimming is a great workout for me. I love being in the water, I love working on streamlining my stroke. I do primarily drills and change up the strokes, all but the butterfly.
As with all workouts these days, I need to pay close attention to keep from overworking my shoulders and my arthritic knee and avoid injury.
The first several sessions of PT were great. We talked about my upcoming surgery, my limitations, strengths and weaknesses. I got some good work for my shoulders and chest, core and arms and light work with legs. As we went on, the leg work climbed in resistance, repetition and rigor. I was interested in having strength in the muscles surrounding the knee.
Today I must declare "NO LEGS". The leg work recently has been extremely painful. Not necessarily at the time of the workout and that throws me off. When I can do it and not feel too much pain, I get the sense that it will be okay. But it is after the activity that the pain begins. This last workout on Monday left pain lurking through Thursday when I had some if it massaged out of my glut, my quad, my calf and my ankle. I cannot afford to be in pain for so many days following an activity.
Thursday, September 2, 2010
anticipation
This week I have seen my hospitalist and my surgeon, had my blood drawn, changed my medications and started thinking very seriously about this upcoming event.
People are starting to ask me about the surgery because they know it is coming up soon. I am trying to provide enough info so that people will think to visit or get in touch but not the gory details.
I am quite enthusiastic about the outcome, to have a fully functioning knee. We took our bikes to our favorite biking place in Wisconsin last week and I (we) were confined to riding on the flat lands. The hill climbing was just too much strain on the knee and therefore too much pain and too much time icing afterward.
I told the doc this week that I wanted to be able to bicycle up hills and walk around for an hour or more. He said I could do all that and more. He advised not to jump out of airplanes and I stated that I was not planning to run again. I didn't really have any plans to jump out of an airplane and I never enjoyed running enough to continue that punishment. Biking is something that I love to do and want to do more of with a healthy knee.
I will be getting the Zimmer women's knee installed in my left leg replacing my arthritic knee joint that has no cartilage remaining on the lateral side. The bone grinding against bone is not only noisy but painful and really annoying.
People are starting to ask me about the surgery because they know it is coming up soon. I am trying to provide enough info so that people will think to visit or get in touch but not the gory details.
I am quite enthusiastic about the outcome, to have a fully functioning knee. We took our bikes to our favorite biking place in Wisconsin last week and I (we) were confined to riding on the flat lands. The hill climbing was just too much strain on the knee and therefore too much pain and too much time icing afterward.
I told the doc this week that I wanted to be able to bicycle up hills and walk around for an hour or more. He said I could do all that and more. He advised not to jump out of airplanes and I stated that I was not planning to run again. I didn't really have any plans to jump out of an airplane and I never enjoyed running enough to continue that punishment. Biking is something that I love to do and want to do more of with a healthy knee.
I will be getting the Zimmer women's knee installed in my left leg replacing my arthritic knee joint that has no cartilage remaining on the lateral side. The bone grinding against bone is not only noisy but painful and really annoying.
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