Saturday, July 28, 2012

Caution: Knee surgery results, therapy not for squeamish

It's Day Five since my knee replacement. I've been to the grocery store (briefly), had lunch at a pizzeria and helped straighten up my home office.
I've also had some fitful nights when pain woke me up, an upset stomach from not eating enough while on pain medicine and frustration from being so darned bored. In other words, I'm recuperating about as planned, even better.
I'm one of the lucky ones. I had a knee replacement done about eight years ago and thought I knew what to expect. Truthfully, this one is going far better than the last. Sure, there is still pain, just not as severe; my hospital stay was short and while my range of motion is restricted, I'm able to walk with the aid of just a cane rather than a walker (the kind with neon yellow tennis balls stuck on the front legs) a lot sooner than before. Now that benefit is a little risky because it makes me cocky, feeling I can rush things along - which I can't.
I'm also lucky because I waited too long for the surgery. I was in such great pain before the surgery, the recovery is less painful and at least now I know this is an end.
And there's the real answer to when you should have your own knee replaced - when you don't have another choice. Now I will suggest you evaluate that situation very carefully.
In today's world of instant gratification, some people want the option of replacing a knee because they feel discomfort maybe because the cartilage is worn or you tore a meniscus. But brother, it's not like popping in a new battery into your iPhone and on you go. There is no "on you go."
In this case, you have to be marathoner not a sprinter
And you need to be less self-conscious about how your legs look in shorts (see photo above - that's going to leave a nasty scar.)
Replacing a knee is not for the squeamish. But pain is minimized, and therapy - if done right - is purposely long to ensure the recuperative effect lasts. But understand that, at least in my case, the end justifies the means. Contrary to what my wife believes, I am not a big fan of pain.
Some researchers have found four overarching themes why some people put off their decisions.
One conclusion was people needed more education and support about total knee replacement which is one of the reasons I am writing this blog.
You really can return to a normal life like walking the dog, gardening or doing housework with very few restrictions.
My goals are returning to snow shoeing this winter, bicycling to work in the spring and taking long walks with my wife at night. I'm more than halfway there now that I took that leap of faith.
I learned early on that delays and excuses will not make the situation better; only action can take care of that.
The next phase is therapy which will be tough because of the scar tissue and the massive swelling of the leg that will come down but only over time. See you on the back side.
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Thursday, July 26, 2012

With surgery completed, new lifestyle begins

In the parlance of restless sleepers, I'm a tosser. Just ask my wife. I'll find a comfortable spot on the bed with two pillows - one under my head and the other off to the side. I first lie on my right side, then on my left side, on my back and finally on my stomach which is where I usually end up. Then I settle in and wait to go deep. That lasts for about fifteen minutes before I get restless again. It's a routine I must follow or it takes much longer to fall asleep. It's almost like a cat that has to twist in a circle before it settles in.
I've tried going straight to the stomach and forsake the drama but that has yet to work. Colleen's not too happy with my nocturnal habit but most times she does get used to it.
Tonight it's going to get worse.
Following my knee replacement surgery Tuesday morning, I was released from the hospital this afternoon, nearly a day early. because there were no complications, the range of motion was improving and I was able to walk a long distance with my walker.
So we packed up and headed home.
Not the home I left, but rather an accommodating home that holds a temporarily handicapped resident for about three months. Furniture was pushed back to widen passageways, throw rugs were removed, a side table was brought into the TV room so I could continue my computer work and Colleen put together a shower stool for easier showering.
Those are the easy ones. But these past two nights at the hospital forced me to take a hard look at my sleep position alternatives. There is no way I will be able to toss and turn.
Hospital beds can be maneuvered electronically and mechanically in all sorts of positions. But the one at home just lies there, mocking me again to find my own mysterious comfort position. With my 31 metal staples in a perfect line, each twist brings a shot of pain. If I lie directly on my stomach with legs straight out, I'm also pressing my wounded knee to the mattress. Not a good choice.
Lying on my sides is out of the question because those previously mentioned muscles and tendons come alive. The least objectionable position may be lying on my back sandwiched between two large pillows to minimize my swaying and twisting. I will still feel the muscles underneath the knee - already sore from being held aside as my new metal joint was installed - stretch and complain quite bitterly for awhile. But that's just a prelude to my off-site physical therapy awaiting at 9:30 a.m. Friday.
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Wednesday, July 25, 2012

Post surgery and the infamous pain day

Midnight is here. Time for a pain pill (Percocet) and a much needed sleeping pill. Despite bringing earplugs to block hospital noise, I was only able to catch cat naps from 9 am on.
My next scheduled check-in came thankfully a little at 420 am. That gave me a good four-hour sleep from which I was awakened for another pain pill; stripping off the big bandage, and disconnecting tubes including the drainage from the wound site. Getting more freedom today to really push therapy which everyone is telling me will be tough, rough and worth it.
During my 8 am med routine something new was introduced. I get to shoot myself up - an anticoagulant called Lovenox. Even though I was a child of the '60s, I've never injected anything in my body so I was not sure about this one. Then I thought about my son, Michael who recently discovered he has Type One diabetes. Even though he had a strong almost panic aversion to needles, he does this all time. So it looks I'll be the block off the old chip. I did it today with no problems and will continue to do this every day for a week and a half.
After dressing in street clothes and eating a healthy breakfast we traveled slowly with my walker, Colleen following behind with my recliner to morning therapy session. Most all therapy will be done in this chair the comfort of which belied what I was going to experience.
I was joined by four others, two of whom had knee replacements. The therapy was not for strength but rather to gain confidence and range of motion. It proved to be easier on some while others weren't as comfortable with the pain.
An aside for the moment about Mayo Health Clinic System personnel. I've been in my fair share of hospitals in my life so this observation is qualitative in nature. Not only are personnel here helpful but very friendly, familial friendly as though I'd always been here. Very open, communicating all things you should need to know and even a welcoming "town square" conversation even about family life. They all end their discussions with something you rarely hear in a hospital "Is there anything else I can get you? They have that "improve the patient experience" down pat.
11am and I've earned my "green feet" designation meaning I can travel the halls unaided except for the mandatory walker. If I'm caught walking without the walker, I'm back to red feet and have to sit in the corner with no TV for two hours.
The afternoon therapy session is just a repeat of the morning so it already seemed like a routine.
Tomorrow - barring any surprises - the highlight will be taking a shower. And hopefully learn what time on Friday I can go home. Who knows? Maybe a Dino's Pizza is calling my name by then.
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Tuesday, July 24, 2012

Knee Replacement day: Not bad ... So far

Even though I've had many surgeries before this one, my anxiety level was embarrassingly high this morning and even the night before.
The nurse said waves of heat were coming from my body. BP was 154 over 125. I was assured "we have meds for that." It is a hospital after all. Deep breathing, distraction, talking with my wife - nothing calmed me. What's with this? Wife Colleen chalked it up to old age; I thought it was related to having too many experiences. Been down this road before and all went well. What are the chances I keep escaping complications.
Then there was the filling out of the Living Will. Did I just awaken a subconscious fear of mortality? I'm 62. People my age read the obit section; there but for the grace of God, etc.
But the medical staff was reassuring, confident and very thorough. Knee area shaved, tubes put in and information collected all mixed in with cheerful small talk.
The gurney journey to the OR was bright, cold and busy with everyone readying their respective stations. Lots if talk, instrument alignment and one warm blanket. Did I mention it was cold?
Then when all was ready I sat up on the table, legs dangling off the side. I leaned forward with my forehead resting on the chest of a staffer and stared at the floor.
Behind me, hands were searching out the right spot using the telemetry of the hip bones and then a finger selected the right spot and stopped.
"You'll feel something cold on your back for a minute." it was the numbing medicine prior to the epidural. If something happened after that I don't remember. No counting back from 100. No spinning OpArt. Just "zonk." It was 6:50 a.m.
At 8:20 I woke up in the OR feeling absolutely relaxed and in no pain ... And numb from the waist down. How long this is going to last no one could be sure. But it eventually will be the last comfort I get and most of the day I enjoyed it.
It was a short visit in recovery. I was pretty clear and lucid so they sent me up to my room on the second floor, a short walk to physical therapy the next day.
At about 1245pm, I got my first taste of exercise - moving from the bed to chair. "That's it? I'm raring to go and I merely hop one step?"
They want to ensure I don't get dizzy, faint and crash to the floor. At my 240 lbs., who can blame them?
Meals so far have consisted of coffee (decaf), broth, Jello and juice. Later I can graduate to a solid piece of toast. Oh joy.
All in all, this is a much better experience than eight years ago when i had my first replacement. A lot has changed since then.
Now therapy will be the true test.
That's tomorrow. Later
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