End of the week check in…

Today started off being slow…well, that is ME being slow.  Getting out of bed is still pretty challenging since the surgery.  Nothing hurts as long as I just don’t move.  However, I have a dog that is not toilet trained and hasn’t learned how to cook yet (she’s only 11…I’m sure she will pick it up sometime soon).  🙂  I’ve been blessed as my mom has been coming over in the mornings before she goes to work to let my baby girl out.  That gives me time to figure out how to get out of bed and then make it to the facilities myself.

I finally got going and started work, and then I realized…CRAP!  I had a therapy session at 0700 this morning.  Why 0700??  Because my mom and nephew have been taking me to therapy and I’ve been scheduling my appointments around their availability.  Being it was 0815, I definitely missed that appointment.  I called them up, profusely apologized and asked if I could get in sometime today.  They said they had an appointment at 1300 (that’s 1pm for you civilians) so I took it.  That meant that I couldn’t take any pain meds as I was going to have to drive.

First day of driving after almost 3.5 weeks.  I had surgery on my right knee…I wasn’t sure if I was going to be able to move my foot from the gas to the brake fast enough if I had to.  The other thing I didn’t think about was the act of getting in my car.  I drive a Dodge Intrepid.  If you have ever seen one, you know they sit low to the ground.  Not the best car to have when you have bad knees (which is why I’m starting to look for a new mode of transportation).  I got downstairs and unlocked the car.  I opened the door and thought, ugh…how am I going to get in here!!??  Well, I did the sit and turn (no, silly, not sit and spin).  It did take me a while to get in, but I did it.  Whew!  I practiced in the parking spot moving my foot from the gas to the brake and back to make sure I could do it.  I definitely didn’t want to hurt anyone else during the process of driving to my appointment.

Needless to say I made it just fine to my appointment.   I was able to do a complete revolution in under 30 seconds.  Yay!!  I did 5 minutes on the stationary bike and then the therapist advised that we were going to work on stretching and stairs.  I haven’t done stairs since my surgery.  Well, I go up/down the stairs all the time as I live on the second floor, but it’s just one step at a time.  I was very nervous and pretty scared that it was going to hurt like the dickens.  We started with stretching.   She had me put my right foot up on the second step up and then had me do a forward lunge in as far as I could.  I would hold that for 15 seconds and then straighten completely out.  I did about 10 of those.

Then it was time to conquer the stairs.  We started with just one.  I would put my right foot up on the first step, just my leg as much as possible and allow my arms to help me get up.  Then I would bring my left foot up to the same step and relax.  I was surprised at how little it hurt.  The hardest part was getting the muscles to remember to do what they are supposed to do.  You would think that would be easy…but, believe me, it is very challenging.  Then I had to take a step down backwards leading with my good leg.  It took a lot of work to get that right knee to bend when it was supposed to.  Even my ankle was more stiff than I expected.  I did 10 of those.

The therapist then advised me it was time to go all the way up to the top step.  There are only 4 steps…but it may as well have been 4,000.  It looked too challenging.  However,  knowing that PT stands for Physical Torturer, I knew I had better get going.  It was slow, but I did all 4 steps!!  No pain, just extreme muscle tightness.  I did notice going back down that I was starting to get a charlie horse in my quad so we went back to stretching…and then she made me go up the stairs again, and again, and again.

I am soooo thankful that I had this surgery after my gastric bypass.  I could NOT imagine doing this with the extra 125 pounds on.  I was sweating just from going up/down 4 steps at a time.  If I was my original weight, I would have had a stroke…I’m sure of it.  After that we went to the hamstring curl machine to work on stretching and strength.  I am getting really good at the lengthening of my leg…I’m almost all the way straight.  The bend is MUCH more challenging.  I am still at about 111 degrees.  I really need to work on that some more this weekend, especially since I don’t have therapy again until Wednesday.

After therapy I decided to make a quick trip to the bank and then head home.  I thought I was doing pretty good.  I had a rough day yesterday and had gone waaaayyyyy too long without pain meds.  I had to go without pain meds this morning due to having to drive.  By the time I got home and settled down, I was one hurting unit.  I put the ice pack on first and then switched to the cryo-cuff.  I ate a little something and then took a pain pill.  I should have searched harder for a ride so I could have taken some meds prior to therapy.  I keep saying here that you should not go too long without taking your pain meds.  Why do I say this?  Because once you are hurting, it takes time and a lot of stress to get to non-hurting status.  Argh.  If only I would listen to what I say!!  So, please!  Learn from my mistakes.

My mom stopped by after her and my dad went out for dinner.  She took my lil girl outside for me and visited for a bit.  I had settled down by the time she came over, but it was still really nice for her to stop by.  This has been not only a physical challenge, but an emotional one.  I have a hard time reaching out for help.  I’m usually the strong one.  It is challenging to not be the strong one.  Sigh.

Ok, I’m going to bed and praying that tomorrow will be a better day.  Mom is going with me to look at cars (ugh…I hate this process).  I’m not buying anything yet (at least I don’t think I am), but I want to get an idea of what I really want and what I can really afford.  I do know that I definitely need something that does not sit on the ground like my current car.  🙂  I also don’t want something I have to climb up into.  Yea, I know..I’m picky.  LOL!

Have a wonderful night!

3 weeks + 1 day post op :) …

Today was a very long and a very emotional day.  I did not sleep much last night.  I started off by setting myself up in the CPM machine and was able to get to 110 degrees.  I just could not get comfortable.  After about 4 hours, I decided I’d had enough, and I put the machine on the floor and decided to try to sleep like a normal person.  Well, I’m a side sleeper.  Every time I rolled on to my right side, my left leg wanted to rest on my right leg.  Needless to say, the right knee did NOT like that, so that kept waking me up.  Finally I decided to just go sleep in the living room on the couch.  Again, I couldn’t get comfortable and even though I had taken some Percocet, I was still hurting.

I’m very blessed to have a family that helps me out.  My mom, sister, and nephew have all been fabulous!  However, I’m getting to the point where I want to have some independence.  If I want to go to Target just to go to Target…then I want to go…not have to call someone and ask them to come get me.  What a pain!  So, I’m definitely developing cabin fever.

To top everything off, my disability check from LAST week still has not arrived.  I called the company again to find out if maybe they mailed it to the wrong place.  They confirmed my address and said that it could take up to 10 business days to arrive at my house.  Why they are not doing direct deposit, I have NO idea!!!  I can get a letter to Afghanistan faster than 10 days.  I asked her where they were mailing it from…China??  She said, no, South Carolina.  Now, I live in Colorado…why does it take so long to get here???!!!  Argh.

Then this afternoon I was using the cryo-cuff and it felt like something was poking me in the knee.  I still have numbness on the right side of my knee so it was strange that I was feeling something poking over there.  I had to quit using the cryo-cuff because it was hurting more than helping.  I went to therapy this afternoon and chatted with my therapist.  He went and talked to the doc and then removed my steri-strips to make sure there was no infection or, heaven forbid, a staple they had missed.  Nope…neither one of those.  He found the two spots that were poking me:  it was from my scars from my surgery in December!!  The scar tissue was being moved and relocated due to the swelling from the new surgery and it was trying to readjust itself.  I was sooo flustered!  Now I have to massage those two previous scars to work them loose.  Next week we start working on the new scar.

My therapist is wonderful and he helped me realize that I am still going to have some crappy days for a while.  I mean, I knew this already, but it’s nice to have confirmation.  I’m not generally a very moody person, but between no sleep, pain, the stupid poking, and my disability check…it’s been a day.

I seriously hope tomorrow is a MUCH better day.  The emotional side of this surgery has taken a much harder toll on me than the physical side.  This is one of those time when I just need a hug.

Till next update…ciao!

Week 3 Post-op…

Hey!  I am now 3 weeks post-op!  Let me update you:

  1. I have graduated from the walker to a cane.  I do still need to use my crutches in the morning to just get up and get going until things “warm up”.
  2. I am now able to go to the little girl’s room without the toilet seat riser.  I’m using the big girl potty.  🙂  However, my recommendation is if you have to use a public bathroom, use the handicap stall.  I still have to use the bar to help pull myself up as the toilets are a lot lower than mine at home.
  3. I am able to walk around my house sometimes without the cane.  I can do about 5 minutes at a time before I start wobbling.  DON’T WOBBLE!  If you start to wobble, use the cane…don’t build bad habits.  This is very important.  If you have a full length mirror at the end of a hallway, watch yourself walk.  There are lots of things to watch for:  swinging your bad foot out to avoid bending your knee, limping, wobbling, not taking a full length step.  Also, something I learned at therapy yesterday…instead of walking slow (which seems appropriate), try to walk a normal speed…especially at this far out.  It is actually easier.  If you ski (I don’t…but I’ve heard), it’s kind of like that.  If you try to go slow because you are nervous, it is actually harder on you.  Going normal speed is easier on the system.
  4. I am back to work…with some restrictions.  I can’t drive yet or fly either.  I can’t stand for more than 20-30 minutes at a time.  I can’t sit for more than 30 minutes (need to take 15 minutes out to elevate my knee.  No crawling, bending, or kneeling.  Well, when I’m home, I work from home…not an office.  My boss has been fabulous about working with my restrictions.  I was going to take one more week off, but she said she has enough work to keep me busy so I don’t have to take any additional time off.
  5. I am still having post-op pain, but most of it is swelling related.  Remember to keep going with the cryo-cuff as much as you can.  If you are just sitting at home (or even in an office)…make sure you are using it.  It is hard to get the bend back in your knee if it is constantly swollen.  I make sure I alternate between the cryo-cuff and a large soft ice pack.  I use the ice pack on the back of my knee and the cryo-cuff for the front and sides of my knee.  I found that moving the cuff to different positions seems to help.
  6. Therapy is going really good.  Make sure you do all your “homework”.  This is the only way you will get stronger.  Yes, I know, sometimes it hurts and sometimes it is just play hard to do…but it will be worth it in the end.  I have a great therapist who explains the why of doing a particular exercise.  If I just think he is doing it to torture me, then I’m more reluctant and hard-headed.  He has figured that out.  🙂

Time to get back to work.  Take it easy and let me know if you have any questions.

Staples are out!

I went in this morning and the first thing they did was draw blood to check my levels since I am still on a blood thinner.  That went well so I headed over to my surgeon’s office and there was a nice, young man ready and willing to take out my staples.  I was nervous as I have never had staples before so this would be my first time having staples removed.  He used an instrument that looked liked blunt scissors and went to the middle of the staple and pushed the “scissors” together and the two ends just popped up and then they were out.  The first one hurt a little; more so because I didn’t know what to expect I think.  The rest came out lickety-split…I think he had all 21 staples out in less than a minute.  He then placed steri-strips over the incision and said that they would stay on for about a week.  I can still shower, just no hot tub, swimming pool, or bath tubbing for another 2 weeks.

After that, Dr. Trumper came in and did an assessment on my knee.  He said my extension is really good and my bend is at about 112 degrees.  He said I am doing really good.  I have to keep up on my exercises and not to slack off just because the staples were out.  He advised me to keep using the cryo-cuff and the CPM machine as much as possible while I still have it.  Dr. Trumper said everything was looking great!  Yay!

I do have to keep going to physical therapy for at least 2 more weeks.  I also have to keep wearing the wonderful white compression stockings until about a week after I stop taking the blood thinners.

I still am in pain, but it is not the same pain as before the surgery.  I know I am getting better and can do almost all of my exercises without any help.  The hardest part right now is the bend.  My knee is still swollen so it is hard to get a good bend.  I have physical therapy this afternoon and my nephew is going to take me.  I am so blessed to have such a strong, supportive family.  I hate to have to rely on other people, but I know it is only temporary and soon I will be back behind the wheel driving myself wherever I want to go.  🙂

Getting Staples Removed Tomorrow…

Yay!  Tomorrow I get all 21 staples removed from my knee.  I will admit that I am nervous as I have never had staples removed before.  However, I talked with my physical therapist and she said that I will feel much better once they are out.  She said it doesn’t really hurt…feels like a pinch for each one they remove.  Yes, it doesn’t sound like fun, but it has to be done.  It is just another part of the journey to being able to walk a 5k again.  🙂

I am up to 115 degrees on the CPM.  I think I will be there for a few more days as I feel a good stretch at the top of my knee when I get to that point.  I can fully extend my knee now and even have a bit of a hyper-extension.  That is a good thing at this point.  I am doing my exercises about 4 times a day and icing and using the cryo-cuff during the rest of the day.

Oh!  Speaking of the cryo-cuff.  The one thing that I noticed yesterday was that even after using the cryo-cuff for about an hour, my knee still felt really warm. Yes, I know it is warm due to the swelling and all the healing going on, but I thought it would feel a bit cooler with all that ice water running over it.  So, last night I decided to pull down the compression stocking down below my knee and THEN put the cryo-cuff on. I don’t want to tell you to do this, but please talk to your surgeon or therapist and see if this is okay for your knee.  It has REALLY helped with the swelling.  I put a gauze pad over the staples just so the cuff doesn’t rub them as it inflates/deflates.  If I use the regular soft ice pack, I still keep the compression stocking up as I don’t want to damage my skin.  Just thought I would share that tid-bit with you.

I am taking off work next week as well.  I wasn’t going to, but I am still taking Percocet for the pain and really don’t want to be trying to do software testing under the influence.  😉  Yes, this also means that I still cannot drive….but that is okay as whenever I do go out to the store or go visit someone, my knee ends up swelling and then I’m hurting again.  So, being stuck in the house with my lil Cricket isn’t a bad thing.

Chat more later.  Hugs!

Let’s Review a Few Things…

I have had a hard week this week.  My knee is hurting (although different than pre-op pain).  I still can’t drive (still on pain meds).  I am feeling very alone in this process. Now I need to figure out what has brought on this whining and figure out where to go from here.

I didn’t sleep very well last night.  I got into bed about 0130 this morning and woke up around 0430.  I then went to go sleep on the couch.  I did something different last night thinking that it would help.  I put on my cryo-cuff prior to going to bed.  I thought that if I could keep the swelling down during the night, when I woke up in the morning, things wouldn’t be as sore.  Well, that proved to be an incorrect theory.  I got up at 4:30am this morning and brought my leg out of the CPM machine and off the edge of the bed.  Immediately the swelling returned as well as the pain.  I ended up going to sleep on the couch just to try a different position.  Sigh.

Going through a TKR surgery is not easy.  Nobody said it would be.  In fact, everyone said the exact opposite.  So why am I surprised at my results?  That is because I have set the bar at a super high level for myself and I have not learned how to give myself a break.  Let’s think about what has really happened here.  12 days ago I had surgery on my right knee.  Saying “surgery” does not really do what I had done justice.  What really happened is I had the bottom of my femur amputated, the top of my tibia amputated, and the backside of my patella shaved.  When I look at it as it really is, I believe I have every right to be in pain.

I did a lot of praying last night.  I need patience with myself and my progress.  Speaking of progress, let me lay it out so far:

  1. I am using the walker on a very limited basis.  I have moved to using a single crutch most of the time.
  2. I can get my leg to fully extend and even get it to hyper-extend slightly.
  3. I have a bend of about 105 degrees.
  4. It only takes me about 2 minutes to warm up on the stationary bicycle before I can do a complete revolution.  It took me 3.5 minutes at the beginning of the week.
  5. I can do my single leg raises without any assistance as of yesterday.  Prior to that, I had to have the therapist (or a towel if I was at home) to raise my leg.
  6. I can do toe raises with no problems and I am even able to do calf stretches on the edge of the stairs now.
  7. I am down from taking 2 Percocets every 4 hours to taking 1 Percocet every 4 hours.
  8. I can do my assigned exercises 4 times a day now.

I recommend this process to everyone who has a TKR surgery.  List out your progress so you can see it.  Looking at this list just now helped me realize that I am making progress.  Don’t let people tell you what you will and will not be able to do at any time.  Yes, having a surgery like this is a major event.  Do not go into it uninformed.  Set goals for yourself, but make sure you let yourself modify those goals as you move through the process.  I had to realign my goals several times and I am still in the process of evaluating future goals.  It is a never ending process.  Some things are going to come a bit easier for you than they did for me.  Some things will be easier for me than they are for you.  That does not mean that you are better than me or I am better than you.  We are all individuals and we all heal differently.  Do not judge your progress by my progress.  This is NOT a competition.  This is a healing process.  I made the decision to have this surgery because of the constant pain I was in.  Yes, I am in pain now.  The difference is that I know this pain will go away whereas the pain I had before was only getting worse.

I have a right to be sore and maybe even feel a little sorry for myself.  🙂  I even have the right to give up…if that is what I want to do.  However, I DO NOT GIVE UP.  So there.  Take that.  😉  I am going to continue to move forward.  I am going to continue to do my exercises and celebrate my achievements, no matter how small they may seem.  Most importantly, I have the right to heal at the rate my body deems necessary.  I am only 12 days post-op from major surgery.  I am doing well and I am going to keep getting better and better every day.

Now, I don’t know if anyone is reading this or if anyone ever will.  I would like to think someone does read this and that someone is getting ready to go through the same surgery.  So, I’d like to go over a few things that you will need or should consider getting prior to your surgery.  The first thing I recommend getting is a toilet seat riser with handle bars on the side.  What is a toilet seat riser?  It attaches to your toilet seat to give you an extra 3-6 inches of height on your toilet.  Why would you need this?  You are going to be very sore when you come home and the last thing you want to do is figure out how to get on/off the toilet when you have to go.  My toilet sits higher than most as I have had bad knees for years and bought a higher toilet to begin with.  However, getting into and up from a sitting position is not easy after all the work that was done  on your knee.  Trust me…get one…you will not regret it.

The other thing to think about getting is a tub transfer bench.  Now, if you don’t have a tub and just have a shower, then I recommend getting a chair for your shower.  Standing up is a challenge during your first week at home…even the 2nd and the 3rd weeks.  You will notice that your knee starts to swell almost immediately.  So, having something safe to sit on in the shower is a relief.  I have a tub.  I could have just gotten a regular tub chair, but there is one downside to that.  Getting into and out of the tub is challenging at first.  Lifting your leg over the edge of the tub is sometimes painful.  If you get a transfer bench, half of the bench is inside the tub, the other half is outside the tub.  You can then sit on the edge of the bench and slowly scoot around and use a towel or your other leg to help move your sore leg over the edge of the tub.  I have a small bathroom so I have been using my left foot to lift my right foot up to toilet set and then I can slide it from there to the edge of the tub.  After that it is pretty easy.  I had a lateral release done on both knees years ago and I learned my lesson from there.  Please learn this lesson from me and get you a transfer bench.  You can ask your surgeon to write you a prescription for it and hopefully your insurance or your FSA/HSA will help take care of the cost.  If not, it is still worth it.

I’d like to also recommend that you keep a towel by your bed where you can easily reach it.  No, that for sweating, but to help you lift your leg from the floor to the top of your mattress.  This is no easy feat to begin with.  You will get stronger over time, but give yourself some help in the beginning.  Now, if you have a big dog that can help, I suppose that would work, but that takes a lot of training.  The only thing my little dog likes to do with my feet is do the “butt dance” and that doesn’t make me feel very good.  🙂  If you don’t know what the butt dance is, just go love on a dog and scratch their back.  Their hind legs start doing a little dance of their own as the scratching feels good to them and they get a little happy.  LOL!  The towel…yes, the towel.  Fold it in half and put it around the bottom of your foot.   Then use your arms to lift your leg to the bed.  It really does help.  If you want a good core work out, just use your good leg to do the same thing.  Put your good foot under the foot of your sore knee and left.  Great for the abs.  🙂

Please do your exercises as often as you can.  The more you can do them, the stronger your knee will get and the more independent you will become.  They are not fun and they are not easy, but they are definitely worth it.

If you have any questions, please let me know.  I don’t have all the answers, but sometimes it helps to talk to someone who knows what you are going through (or about to go through).

Hugs!

End of first week post-op…

I made it!!!   The first week has now passed!  I am very happy with my progress so far.  I had some outrageous goals set for myself prior to surgery.  After doing research and talking with my surgical staff, I reset my goals.  So, let’s see where I’m at:

  • I am still using the walker, but mainly just first thing in the morning until I get moving.
  • The swelling is decreasing more and more every day.
  • The incision looks great and I don’t have any seepage.
  • I am working on my exercises 3 times a day.
  • I can go up/down the steps one at a time with just one of my crutches.
  • I can actually use my “modified” leg to go up two stairs!  Yay!
  • I can make a complete revolution on the stationary bike.
  • I am walking with just a crutch when I take my puppy out for her walks.

Tonight will be my first night solo.  It is nice to know I have family and friends close by just in case, but I’m looking forward to a night with just me and my lil love bug.  🙂 

Tomorrow I have another therapy appointment and I’m ready to see what new torture techniques, er, uh, I mean exercises, they have in store for me.  I still have issues with the straight leg raises.  I can get my quads to engage but as soon as I attempt to lift the leg, the pain sets it and the quad shuts down.  Don’t worry, I’m not giving up.  I will continue to “help” my leg perform the exercise until it decides it can do it on its own.  The other exercises are getting easier.  When doing the CPM, I can get a 95 degree bend after a few minutes of warming up. 

Nutrition is important during your recovery.  I feel an extra level of importance is set upon me as I am also a gastric bypass patient.  Due to some pain and just recovering from my surgery, my appetite has decreased.  I have increased my fluids and my fiber supplements just to keep things moving.  I am also drinking my protein drinks to make sure I get enough protein in.  Isopure Grape Frost and Alpine Punch are my two favorites. 

I’m still wearing the wonderful white pressure stockings on both legs.  I’m hoping tomorrow the therapist will approve me taking off the one on the good leg.  They are definitely making a fashion statement…but I’m not sure it’s one I want anyone to listen to.  😉  If you are still swelling, you are up too much and need to continue icing.  Let the Cryo-cuff become your new best friend.  It circulates ice-cold water around your knee.  It really helps the swelling and relieves some of the pain.

I have not decided whether or not I will return to work next week.  I am still grounded from flying and driving, but my boss has work I can do remotely.  If I’m still on pain meds, I think I will wait an extra week.  I don’t want to mess up anything due to the meds…so we will see how I do the remainder of the week.

Take care of your knees!