Carl had his total knee replacement 3 weeks ago. He walked into the physical therapy clinic accompanied by his wife, and with his cane in hand. Carl told his therapist that he was working on the backhoe over the weekend and helped out a bit with building fence. His wife wanted to know if it was really okay for Carl to be riding the stationary bike. No one had questions about Carl using the backhoe while on drugs ( I assume he's still on drugs if his wife is driving him to the therapy clinic).
I decide that as cute as Carl is with his wife and their matching outfits, that I don't like him.
Carl's outcome is what I expected from my own surgery. I'm young and driven. I planned on being released for work four weeks after my surgery. Instead I am still fighting to maintain the 70 degrees flexion that I've managed to gain. Carl had 90 degrees before he left the hospital. I had none. Somehow I failed before I even came home from the hospital.
It's looking more and more like I will have to go back for the manipulation under anesthesia. At this point I am both resigned and terrified. I don't want more pain. The pain I'm already in is more than I can handle with much grace or dignity some days. The idea of inflicting more pain is defeating. Worse, the idea of dealing with the nurses in the St. Luke's system is frightening. I simply don't want to do it. I would stomp my foot in defiance but I can't lift my leg to do so.
I don't know what to do. I do the exercises to the best of my abilities, but I know I'm failing. I work on the physical therapy exercises throughout the day and I work on the stationary bike two or more times a day to try and force my knee to bend. I go to physical therapy three times a week. And I'm still not progressing.
More and more often I want to accept that I've ruined my life and then go back to work where at least I am capable of doing something. I sit at home with my ice machine, needy and incapable of running my home. Maybe at work I could focus on something other than the fact that no matter how much I sweat, no matter how much I cry and no matter how much I bleed I am able to do something.
Blood, sweat and tears. That reminds me on Friday I split open a small part of my incision while at physical therapy. At nearly six weeks post-op, I shouldn't have that to worry about. I've been careful to follow all of the directions in caring for my knee replacement and the incision, but that didn't stop it from splitting.
Also on Friday, my leg stopped working altogether. It wouldn't bear weight. I was on my first outing with a friend and my leg simply stopped supporting me and stopped moving properly. Over the weekend, it remained swollen and difficult to move. Even now, four days later, my leg is swollen clear from above my knee to my foot.
So here I am, defeated by a knee replacement that was supposed to make my life better.
Tuesday, May 22, 2018
Wednesday, May 16, 2018
Progress report, Day 36
I've waited a while to post this because I needed time to deal with the information. I had my follow-up appointment on May 9. It was disappointing.
Because my pain and swelling wasn't well controlled, I haven't reached the flexion that I need in order to be released back to work. Instead I've been sent to intensive outpatient physical therapy in order to try and reach the 90-110 degree flexion. This means that I'm at physical therapy three times a week often for over an hour, and I'm working very hard at home on the exercises that build strength and flexion.
This shouldn't have happened. I complained to the doctor's office that my pain wasn't well controlled. The home health nurse and the home health physical therapist complained to the doctor's office that my pain wasn't well controlled. For some reason the doctor's office kept reducing my pain medication instead of finding an option that would help me. There wasn't a day that I didn't begin or end in tears from the pain of this knee replacement. For weeks I've been in agony. I was told that the pain would be less than I was experiencing before the surgery. Unfortunately this isn't true for me and I'm in so much more pain than before.
While the doctor agreed that this situation was bullshit (his word), I can't help but wonder why his nurses were allowed to continually reduce medication when the home health nurses, therapists, and I all called to report that I was suffering.
Its hard to remain confident in my doctor when I've been allowed to suffer so much for so long without reason. Even though he did give me a new medication with the instructions to take it right before physical therapy and when I exercise.
If I don't reach the 90-110 degree flexion by May 30, I'll be sent for a manipulation under anesthesia. this is where the doctor will put me under and then manipulate the leg until the scar tissue is stretched and broken and the leg can bend. The dangers include a broken leg.
This lack of progress is incredibly disappointing. The work that I've put into this knee through the years so far has contributed nothing to my recovery. I work to the point of nauseating agony every day only to be told its not enough. So far I've only achieved 70 degrees flexion.
Time is running out and I'm not sure how confident I am in my doctor if I do have to have a manipulation under anesthesia.
Because my pain and swelling wasn't well controlled, I haven't reached the flexion that I need in order to be released back to work. Instead I've been sent to intensive outpatient physical therapy in order to try and reach the 90-110 degree flexion. This means that I'm at physical therapy three times a week often for over an hour, and I'm working very hard at home on the exercises that build strength and flexion.
This shouldn't have happened. I complained to the doctor's office that my pain wasn't well controlled. The home health nurse and the home health physical therapist complained to the doctor's office that my pain wasn't well controlled. For some reason the doctor's office kept reducing my pain medication instead of finding an option that would help me. There wasn't a day that I didn't begin or end in tears from the pain of this knee replacement. For weeks I've been in agony. I was told that the pain would be less than I was experiencing before the surgery. Unfortunately this isn't true for me and I'm in so much more pain than before.
While the doctor agreed that this situation was bullshit (his word), I can't help but wonder why his nurses were allowed to continually reduce medication when the home health nurses, therapists, and I all called to report that I was suffering.
Its hard to remain confident in my doctor when I've been allowed to suffer so much for so long without reason. Even though he did give me a new medication with the instructions to take it right before physical therapy and when I exercise.
If I don't reach the 90-110 degree flexion by May 30, I'll be sent for a manipulation under anesthesia. this is where the doctor will put me under and then manipulate the leg until the scar tissue is stretched and broken and the leg can bend. The dangers include a broken leg.
This lack of progress is incredibly disappointing. The work that I've put into this knee through the years so far has contributed nothing to my recovery. I work to the point of nauseating agony every day only to be told its not enough. So far I've only achieved 70 degrees flexion.
Time is running out and I'm not sure how confident I am in my doctor if I do have to have a manipulation under anesthesia.
Sunday, May 6, 2018
Sweetness
Through all of the struggling with this knee replacement I have to point out that I've had amazing support from my husband.
There is sweetness as he helps me get to bed at night, setting up my ice cooler, helping me place my leg on the pile of pillows, making sure my cup is full of cold water, tucking in the tea towels and iceman pad on my knee, arranging my blankets in that particular way that I need in order to sleep, and setting up quiet music on a timer so I can fall asleep. He then waits another hour after I go to bed to make sure I'm asleep before he comes to bed. Or he sleeps on the sofa when he's worried about causing me more pain or waking me.
In the middle of his night his alarm rings and he gets up to give me my 3 a.m. medication. On weekdays he'll get up again at 6 to get our oldest out the door for school. Then his alarm goes off again at 9 to get me up for my morning medication. He makes sure that I'm taken care of and helps with those little things that make getting ready for the day so much easier. If I had to wander around the bedroom trying to figure out which teeshirt I wanted, I'd waste a lot of energy. He makes sure that throughout the day I have my medication and anything else I need.
In addition to all of this personal care, he makes sure the family runs as it should. He lines out the kids with their chores and schoolwork, and makes sure they get it done. He keeps the house clean, the family under control, plans meals and does the shopping.
He makes sure that he spends time with each kid here and there, and checks in on everyone to keep track of how they are doing.
In all of this taking care of us, he works from home, occasionally going to the office in order to take care of business. He's trying to plan for the next months in the field while taking care of everything else.
He makes it all look effortless. I know he's tired, and often worn out by taking care of me and doing all of the work that we'd usually split up. But he doesn't complain. He simply moves to his next task and takes care of whatever needs to be taken care of.
Having a husband who makes sure that I don't have to worry about anything is a blessing.
There is sweetness as he helps me get to bed at night, setting up my ice cooler, helping me place my leg on the pile of pillows, making sure my cup is full of cold water, tucking in the tea towels and iceman pad on my knee, arranging my blankets in that particular way that I need in order to sleep, and setting up quiet music on a timer so I can fall asleep. He then waits another hour after I go to bed to make sure I'm asleep before he comes to bed. Or he sleeps on the sofa when he's worried about causing me more pain or waking me.
In the middle of his night his alarm rings and he gets up to give me my 3 a.m. medication. On weekdays he'll get up again at 6 to get our oldest out the door for school. Then his alarm goes off again at 9 to get me up for my morning medication. He makes sure that I'm taken care of and helps with those little things that make getting ready for the day so much easier. If I had to wander around the bedroom trying to figure out which teeshirt I wanted, I'd waste a lot of energy. He makes sure that throughout the day I have my medication and anything else I need.
In addition to all of this personal care, he makes sure the family runs as it should. He lines out the kids with their chores and schoolwork, and makes sure they get it done. He keeps the house clean, the family under control, plans meals and does the shopping.
He makes sure that he spends time with each kid here and there, and checks in on everyone to keep track of how they are doing.
In all of this taking care of us, he works from home, occasionally going to the office in order to take care of business. He's trying to plan for the next months in the field while taking care of everything else.
He makes it all look effortless. I know he's tired, and often worn out by taking care of me and doing all of the work that we'd usually split up. But he doesn't complain. He simply moves to his next task and takes care of whatever needs to be taken care of.
Having a husband who makes sure that I don't have to worry about anything is a blessing.
Wednesday, May 2, 2018
Day 22
I'll be honest, I really want to write an upbeat progress report. But I can't. It's why I've put off blogging the past few days.
Over the last 22 days I've really struggled with pain control and with gaining flexibility in the new knee. Its been just over the past two days that I've started to see an improvement in the pain control, but the improvement may be too late for the flexibility in the knee.
I do feel like the stiffness and pain I have now is equivalent to the months following my injury in 2015. I'm choosing to see that as an improvement. I've been here before, I know I can live from this point on, whether or not its a great quality of life. Its not what I hoped for, but it may be what I get out of this.
The physical therapist is worried that since I did not get to the 90 degree flexion by two weeks that I won't get there and I'll end up with more problems than I had going into the surgery. Because I didn't meet that milestone, he fears I'll need additional surgery to break up the scar tissue that has formed.
In addition to this, I am walking better with a walking stick and weaning off the walker. I still use the walker when my knee is super sore or when I might be unsteady (waking up or after exercises). This too was supposed to be a milestone that was met at the end of week two.
So there we have it. Its not the best of progress reports, but its where I'm at.
Over the last 22 days I've really struggled with pain control and with gaining flexibility in the new knee. Its been just over the past two days that I've started to see an improvement in the pain control, but the improvement may be too late for the flexibility in the knee.
I do feel like the stiffness and pain I have now is equivalent to the months following my injury in 2015. I'm choosing to see that as an improvement. I've been here before, I know I can live from this point on, whether or not its a great quality of life. Its not what I hoped for, but it may be what I get out of this.
The physical therapist is worried that since I did not get to the 90 degree flexion by two weeks that I won't get there and I'll end up with more problems than I had going into the surgery. Because I didn't meet that milestone, he fears I'll need additional surgery to break up the scar tissue that has formed.
In addition to this, I am walking better with a walking stick and weaning off the walker. I still use the walker when my knee is super sore or when I might be unsteady (waking up or after exercises). This too was supposed to be a milestone that was met at the end of week two.
So there we have it. Its not the best of progress reports, but its where I'm at.
Monday, April 23, 2018
Day 13 post-op
Its been 13 days since I had my total knee replacement surgery. Here is how this is working out:
On April 10 I reported to the hospital at 7 a.m., which is too early for a person like me. I went into surgery around 10:15 and I don't know when I got out.
Surgery was a little different than I expected. In the past, for the arthroscopic procedures, I was put under with general anesthesia. With the knee replacement I was given a nerve block in my left thigh followed by a sedative. Once in the operating room I was given a spinal. Considering that I refused the spinal when I gave birth, that was a new experience for me. I wasn't prepared for the side effects of the spinal or how long they would last.
From what Dan said, the surgery went fine. The doctor did have to change the size of the prosthetics in the middle of the surgery. I'm wondering if the extra steps involved in changing that has contributed to my pain. If you've watched any videos of total knee replacement surgery then you know its pretty violent. If extra work had to be done, I can't imagine it made it any less painful.
As promised, it wasn't long after I was in a room before I was up and using the restroom. Here's where that spinal was annoying. It affected how I used the restroom for quite a while post surgery. Having to think about which muscles I needed and how much time I needed to plan in order to get to the restroom threw me off.
I only spent one night in the hospital and it was a rough one. I was pretty miserable with pain that wasn't well-controlled, nurses not listening when I asked to use the restroom and my regular medications being messed up. When the doctor offered to get me out of the hospital the day after surgery, I wasn't going to say no unless Dan had reservations. The hospital sent me home with plans for a St. Luke's home health nurse and physical therapist to visit.
It is a lot easier for me at home with my own corp of helpers. I think Dan has lost the most sleep since he's the one taking care of everything from getting me up and around, running errands, medication timing, keeping my ice machine running, making sure that the family is taken care of -- plus all of the regular household and homeschooling oversight.
The hospital expects you to have another adult with you at all times during the first two weeks after surgery but its nearly impossible unless you have extra support for that adult too. The second day home, Dan had to call a friend to babysit me while he took Becky to a doctor's appointment. For the most part, he's relied on our kids to make sure I'm ok when he needs to leave the house.
Physical therapy has been the hardest part of the general recovery. I have good days when I feel like I'm making real progress, but then I have days where I'm absolutely miserable. I've gotten to 70 degree flexion so far, but the aftermath of pushing that hard is pretty discouraging.
As for pain management, we strictly followed the doctor's orders which has gotten us into a weird position. The doctor told us to make sure I was taking two pain pills every four hours for the first week after leaving the hospital. When Dan told the surgeon's office triage nurse that we'd run out on a Sunday and asked for a prescription he could drop off and have filled on that Sunday, she told him that I wasn't supposed to be taking the two pain pills that frequently, and that the doctor didn't prescribe them that way (the prescription bottle said what the doctor told us, not what the nurse said). Later, when I called to ask the office triage nurse if I could add acetaminophen to the now reduced Norco prescription in order to get a better grip on the pain, I was told that she'd have to talk to the doctor. When the doctor's actual nurse called me back she seemed to think I had been asking for a higher dose of Norco instead of a higher dose of Tylenol. She was surprised when I explained that with the lower dose of Norco I wanted to add more Tylenol in order to get a better handle on the pain, and that I had never said I wanted more of the narcotics.
Looking forward to the rest of this week: I have physical therapy Tuesday and Thursday. Wednesday, I will have the home health nurse here to remove my giant band-aid, staples and sutures. The hope is that with the removal of the staples and band-aid, I'll be able to gain more function in my new knee.
On April 10 I reported to the hospital at 7 a.m., which is too early for a person like me. I went into surgery around 10:15 and I don't know when I got out.
Surgery was a little different than I expected. In the past, for the arthroscopic procedures, I was put under with general anesthesia. With the knee replacement I was given a nerve block in my left thigh followed by a sedative. Once in the operating room I was given a spinal. Considering that I refused the spinal when I gave birth, that was a new experience for me. I wasn't prepared for the side effects of the spinal or how long they would last.
From what Dan said, the surgery went fine. The doctor did have to change the size of the prosthetics in the middle of the surgery. I'm wondering if the extra steps involved in changing that has contributed to my pain. If you've watched any videos of total knee replacement surgery then you know its pretty violent. If extra work had to be done, I can't imagine it made it any less painful.
As promised, it wasn't long after I was in a room before I was up and using the restroom. Here's where that spinal was annoying. It affected how I used the restroom for quite a while post surgery. Having to think about which muscles I needed and how much time I needed to plan in order to get to the restroom threw me off.
I only spent one night in the hospital and it was a rough one. I was pretty miserable with pain that wasn't well-controlled, nurses not listening when I asked to use the restroom and my regular medications being messed up. When the doctor offered to get me out of the hospital the day after surgery, I wasn't going to say no unless Dan had reservations. The hospital sent me home with plans for a St. Luke's home health nurse and physical therapist to visit.
It is a lot easier for me at home with my own corp of helpers. I think Dan has lost the most sleep since he's the one taking care of everything from getting me up and around, running errands, medication timing, keeping my ice machine running, making sure that the family is taken care of -- plus all of the regular household and homeschooling oversight.
The hospital expects you to have another adult with you at all times during the first two weeks after surgery but its nearly impossible unless you have extra support for that adult too. The second day home, Dan had to call a friend to babysit me while he took Becky to a doctor's appointment. For the most part, he's relied on our kids to make sure I'm ok when he needs to leave the house.
Physical therapy has been the hardest part of the general recovery. I have good days when I feel like I'm making real progress, but then I have days where I'm absolutely miserable. I've gotten to 70 degree flexion so far, but the aftermath of pushing that hard is pretty discouraging.
As for pain management, we strictly followed the doctor's orders which has gotten us into a weird position. The doctor told us to make sure I was taking two pain pills every four hours for the first week after leaving the hospital. When Dan told the surgeon's office triage nurse that we'd run out on a Sunday and asked for a prescription he could drop off and have filled on that Sunday, she told him that I wasn't supposed to be taking the two pain pills that frequently, and that the doctor didn't prescribe them that way (the prescription bottle said what the doctor told us, not what the nurse said). Later, when I called to ask the office triage nurse if I could add acetaminophen to the now reduced Norco prescription in order to get a better grip on the pain, I was told that she'd have to talk to the doctor. When the doctor's actual nurse called me back she seemed to think I had been asking for a higher dose of Norco instead of a higher dose of Tylenol. She was surprised when I explained that with the lower dose of Norco I wanted to add more Tylenol in order to get a better handle on the pain, and that I had never said I wanted more of the narcotics.
Looking forward to the rest of this week: I have physical therapy Tuesday and Thursday. Wednesday, I will have the home health nurse here to remove my giant band-aid, staples and sutures. The hope is that with the removal of the staples and band-aid, I'll be able to gain more function in my new knee.
Monday, April 9, 2018
Day 1,010
Everything hinges on this surgery.
I'm not ready. With my husband having work trips scattered over the last six weeks, we didn't get everything done. The groceries are still not bought, the house not clean, the kids aren't ready. The equipment we should have bought haven't been made. I don't know what to do.
People say they feel everything is going to be just fine, but they aren't on this side of the situation. They don't hear the frustration of my younger children who always have to try so hard and do so much, vent about the oldest taking advantage of them. The people who think everything is going to be ok, don't worry that I won't get to come home if my house isn't ready. We're back to platitudes that offer nothing but thoughts and prayers.
So I sit here knowing that my family is just not ready for this.
This morning's first text was asking for accountability on why the newspaper was wrong. It was an oversight of many people, but I should have caught the problem. If I had been the first, second, third or fourth person to see the problem, I would have caught it. But I trusted someone who said she had it under control. People don't see the multitude of little things that just get done, because I do them.
So I sit here knowing that my work is just not ready for this.
Everything hinges on this surgery.
I'm not ready. I can't imagine a future where I continue to exist only in a very small circle, disabled and miserable. I don't want to consider not being able to enjoy my life. I imagine that I'll be back to walking my dogs, fishing with my kids and riding my bike. I imagine a life where I'll once again enjoy cooking in my kitchen. I imagine a life of standing in the back yard watching the stars in the middle of the night with my husband.
There is so much at stake.
Its easy for those who say "just ask if you need help," because they don't have to commit to helping. Because overwhelmed people never know how to ask for help. Because people who are scared and anxious can't even find the words to say everything is falling apart and we haven't even gotten to the hard part yet.
I'm not ready. With my husband having work trips scattered over the last six weeks, we didn't get everything done. The groceries are still not bought, the house not clean, the kids aren't ready. The equipment we should have bought haven't been made. I don't know what to do.
People say they feel everything is going to be just fine, but they aren't on this side of the situation. They don't hear the frustration of my younger children who always have to try so hard and do so much, vent about the oldest taking advantage of them. The people who think everything is going to be ok, don't worry that I won't get to come home if my house isn't ready. We're back to platitudes that offer nothing but thoughts and prayers.
So I sit here knowing that my family is just not ready for this.
This morning's first text was asking for accountability on why the newspaper was wrong. It was an oversight of many people, but I should have caught the problem. If I had been the first, second, third or fourth person to see the problem, I would have caught it. But I trusted someone who said she had it under control. People don't see the multitude of little things that just get done, because I do them.
So I sit here knowing that my work is just not ready for this.
Everything hinges on this surgery.
I'm not ready. I can't imagine a future where I continue to exist only in a very small circle, disabled and miserable. I don't want to consider not being able to enjoy my life. I imagine that I'll be back to walking my dogs, fishing with my kids and riding my bike. I imagine a life where I'll once again enjoy cooking in my kitchen. I imagine a life of standing in the back yard watching the stars in the middle of the night with my husband.
There is so much at stake.
Its easy for those who say "just ask if you need help," because they don't have to commit to helping. Because overwhelmed people never know how to ask for help. Because people who are scared and anxious can't even find the words to say everything is falling apart and we haven't even gotten to the hard part yet.
Friday, March 30, 2018
Getting ready and seeking peace
We aren't ready for this. And still to this day, with less than two weeks to go, I am waffling. But for every day where I have medium pain there are days where I have serious pain. The medium pain I can live with until it becomes serious again. Its then that I know I'm making the right decision.
That's the crazy part of chronic pain, it's always there, but it's not always the same. This is also one of the hardest parts of explaining that today is OK, but yesterday I had to stop myself from screaming in agony with every step I took.
So we get ready. We've bought things we think we need, and we've bought things we know we need. In the end they may or may not work out.
I barely waver on the spiritual peace in the decision to have this major joint replaced while I'm young and the kids are young. When doubts arise on the big questions with this, I'm at peace.
It's the everyday stuff that I'm seeking peace with. There is a definite goal in my head to create a peaceful, quiet background to come home from the hospital to. Clutter and chaos have always bothered me, but now I feel the anxiety of it even more as I get closer to a time when my house will need to be sterile but comfortable. My level of comfort with clutter is significantly less than the rest of the family. This is where I can't find the peace I'm desperately seeking.
How do you explain to children that don't see the mess that the mess is too much? I'm exhausted from morning to midnight with living, and I can't find it in me to clean up once again. I don't know how to get them to see that they need to care that the house isn't good enough. It's stressful and it worries me.
So with a little more than a week before I change my life in one way or another, I am still struggling to figure everything out.
That's the crazy part of chronic pain, it's always there, but it's not always the same. This is also one of the hardest parts of explaining that today is OK, but yesterday I had to stop myself from screaming in agony with every step I took.
So we get ready. We've bought things we think we need, and we've bought things we know we need. In the end they may or may not work out.
I barely waver on the spiritual peace in the decision to have this major joint replaced while I'm young and the kids are young. When doubts arise on the big questions with this, I'm at peace.
It's the everyday stuff that I'm seeking peace with. There is a definite goal in my head to create a peaceful, quiet background to come home from the hospital to. Clutter and chaos have always bothered me, but now I feel the anxiety of it even more as I get closer to a time when my house will need to be sterile but comfortable. My level of comfort with clutter is significantly less than the rest of the family. This is where I can't find the peace I'm desperately seeking.
How do you explain to children that don't see the mess that the mess is too much? I'm exhausted from morning to midnight with living, and I can't find it in me to clean up once again. I don't know how to get them to see that they need to care that the house isn't good enough. It's stressful and it worries me.
So with a little more than a week before I change my life in one way or another, I am still struggling to figure everything out.
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