Update on dependence issue…

I want to start off by thanking my friends and family for helping me over the past few weeks.  Getting off of Norco (an opiode painkiller) has been much more challenging than even the things I’ve researched online.  I tried to go from 8 tablets a day down to 4 and had some bad side effects so I had to start over again.  I finally managed to get down to 2 tablets…and just taking those in the evening.  I noticed that my agitation levels increased the closer it got to the time to take my meds, but I pushed through it.

Last week I took a vacation with some friends and decided about half way through that it was time to cut back to just one pill.  I was worried about ruining my vacation, but I figured I could work through it without anyone noticing.  I had to add 1/2 of a Xanax pill to pull me through the rest of the evening, but I have now been on one Norco for the last 6 nights.  Tonight will be the last night I take Norco if everything goes well.  The only side effects, besides agitation, that I have noticed is severe itching on my head and face.  I tried taking a Benadryl, but that didn’t seem to help.  If the itching doesn’t stop soon, I will go see my doctor.  I’m guessing it is just another withdrawal affect, but it’s actually giving me a headache.  I will keep you posted on my progress.

As for my knee, things are going well.  I did a lot of walking on the beaches in Waikiki and I actually think it helped my knee.  When you walk on sand, especially wet sand, you really have to use a lot of muscles to stabilize yourself.  I would be tired by the end of the day, but not really hurting.  One of my friends with me noticed that I am still limping.  I don’t think it is from pain or range of motion limitations.  I believe it is from so many years of limping that I am going to have to learn how to walk the right way again.  So, I begin practicing.  I do notice that when I take my time and pay attention, my hip is sore.  I think it is from walking normally and the hip flexors aren’t used to working that way.

I still have some popping in the knee, but if I focus on the VMO muscles, I notice less popping.  I’m going to start going back to the gym and use the stationary bike.  I thought I would take a spinning class and just go at my own pace.  Biking is supposedly really good for your knees.  I will let you know how it goes.

I have no regrets doing this surgery.  I am pretty much pain free and almost off all the meds.  I can walk with my dog, go up/down the stairs, and I’m ready to start practicing for my first 5k (walking, not running).  I will keep this blog going for a while longer.  If you have any questions or comments, please feel free to leave them and I will respond as soon as I can.

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!

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!

First TKR PT…

My first night home was not too bad.  I was very excited, and also very nervous, to go home.  You always sleep better at home.  I mainly wanted to get home so I could get my dog to come back home and love on her.  My sister stayed with my Friday and Saturday night.  It was nice to have her there.  She is my reality check.  She helped me remember to take my meds and do my exercises and just go easy.  I am very interested in getting my life back to normal…well, minus the knee pain.  🙂  I tend to try to hurry things and push myself more than I should. So, she is good for me.

One of my friends, Theresa, offered to go and pick up Cricket for me on Saturday.  I was soooo excited to see Cricket, but didn’t want her to have to go all the way out there.  It is quite a ways out to the kennel where she stays.  I prayed about it and realized that I don’t have to do everything myself.  If my friends want to help me, I need to let them help.  I always try to be there for my friends for anything they need.  But I don’t want to be a bother to my friends.  It came to me that friends don’t “bother” each other.  They want to be there for their friends…and I need to learn how to let my friends be there for me.  Theresa brought Cricket home to me and visited for a while.  I’m sure I was pretty out of it, but I remember her hugging me and smiling to see me smile.

My sister and I went and rented a wheelchair on Saturday so we could go to the New West Fest on Sunday here in town.  I love going to the fest and seeing all the vendors and the new items that people design and bring each year.  However, the thought of trying to walk the fest only 5 days after TKR surgery and on a walker was not thrilling me.  So, we got a wheelchair that had a leg extension so I could elevate my knee and try to minimize the swelling.  The weather was really nice and the crowd was full of dogs and people.  First…it was great to see so many dogs out there.  Second, please don’t bring your dogs out in the hot weather on to a surface that is black top.  Leave them at home in the air conditioning or under their shade tree at home.  We spent a few hours out there and then I was done…and ready for ice and rest.

I have been doing the four exercises that I was assigned before I left.  Some are hard to do still, and some are getting easier.  After the fest and rest (hey, I’m a poet and didn’t know it), my sister had gone home and my mom had taken over watching me.  I can’t drive as long as I’m on pain meds and it might be another week before I get off of them.  I’m not going to over do it and I’m not going to try to take myself off the meds too soon.  Correction….I am not going to try to take myself off  the meds too soon AGAIN.  I took one pill at 1100 and went to the fest.  I came home and took a nap and by the time I got up it is almost 8 o’clock in the evening…and I was hurting.  A TKR is not just some simple procedure.  Basically, three parts of your leg bones are being amputated and a prosthesis is being implanted.  Be patient with yourself and give yourself time to heal.  As I mentioned before, the goals I set for myself were unrealistic and unattainable.  Please learn from my mistake…don’t do that to yourself.

I had my first physical therapy (PT) appointment this afternoon.  I also had to go in for blood work.  I’m on a blood thinner still so they want to keep tabs on my blood levels.  Mom took me to therapy and because I was early, I could go do my blood work prior to my therapy.  My therapy wasn’t too bad, but it reminded me of my rehab when I had lateral releases done.  They are no fun whatsoever.  The therapist had my sit on a stationary bike (good thing it’s not a real bike…I can’t ride one of those!).  She said to just move back and forth in a half circle to the extent of my range of motion.  She advised most people don’t get a full revolution until the 2nd or 3rd therapy appointment.  With only 1 minute left (out of 5), I got not just 1, but 5 full revolutions!!  I was so excited.  It felt good to achieve a goal…give me my  next goal.  🙂  The therapist then sat me down and went over my 5 new exercises.  The hardest one is lifting my leg that was operated on.  I can do it one or two times, but then the pain creeps up and the quad muscles shut down.  She said this was normal and that each time I worked on the exercises, it would get easier and easier.  I’m not very patient with myself, but I at least could understand once I made her explain to me WHY the quad was shutting down.  If I know the “why” to something, I can usually work with the upcoming results.  It doesn’t mean that I won’t at least TRY to prove the why wrong, but when I can’t, at least I know why. 

The therapist recommended that I go home, ice, and rest for the remainder of the day.  Mom and I stopped by Wal-Mart first to pick up a few things and then headed home.  I tried to take a nap, but couldn’t stay asleep. I did use my CPM machine and I get a lot of relief from that.  I am also able to move around the house some without my walker.  I have something to hold on to (usually a wall or counter) and that helps.  Heaven forbid if I fall…I’m not getting up.  I will have to call my friends at the 911 center and say, “Help, I’ve fallen and I can’t get up.”.  How embarrassing!  So, I will continue to be careful. 

Tonight is tentatively the last night I will have someone with me 24/7.  I am going to try to go solo and see what happens.  The biggest challenge will be walking my dog a couple of times per day.  I just need to take one step at a time and she will do good and not pull…at least I hope so. 

Keep you posted!

Post-op Day 4…Part II

My sister called and said that she was running late getting out of the office, but she would still be there to pick me up soon.  Part of me was excited to go home; but the other side was very nervous…especially after waking up in so much pain last night.  However, I have been saying a lot of prayers and know that I won’t be alone.  So many people have offered to help me out and that means so much to me. 

I had a nice lunch and then did another lap around the floor.  I’m actually getting pretty good at it now. The knee does a lot of popping/clicking, but that is because it is so swollen and full of fluid.  It doesn’t hurt…just makes my skin crawl like fingernails on a chalkboard.  When I’m not up walking the floor, I’m laying down with the cryocuff around my knee and my leg in the CPM machine.  I also am taking time to work on my exercises.  The extension is still the hardest, but it is getting easier.  Oh, yea, I still have pain in my thigh area from the tourniquet.  I am going to put ice on it tonight to see if that helps.  It feels like i did 500 squats the previous night…just achey.

As I was doing one of my walks last night before bed, I walked by the nurses station and thought I saw someone I recognized.  No, I’m not like my Grandma who literally knows EVERYONE and their complete families. 🙂  I made it back to my room still wondering how I knew this nurse.  She came into my room a short time later advising that the original nurse assigned to me had to leave on a family medical issue.  I figured now would be the perfect time to ask her.  I just had drugs and I could easily blame it on them.  JUST KIDDING!.maybe.  I just said..”I know I know you from somewhere but I can’t place it.  Did you go to FRCC?” FRCC is Front Range Community College.  Her eyes lit up and she said she had been wondering the same thing.  We both went to FRCC and did workstudy jobs  for the time we were there.  We spent some time catching up and it really made my day.

Back to this afternoon…I took my time getting my stuff together so I had no need to ever come back here.  Then I started coming back to reality and thought I should just donate enough money so I could have my own wing whenever needed.  Still not realistic enough?  Sigh.  Ok.  It’s not that I don’t like the people or the place, I just want to be able to get to my place and start healing.  It took quite a bit of persuading to let my sister and my mom stay with me over the weekend.  It took THEM persuading ME.  I just wanted to be home alone and take care of me.  However, sometimes you have to accept help…and there is nothing wrong with that.  I see this now.  I am always there for my family for whatever they need.  It might seem weird to say, but a friend told me that it is time to let them help me.  I get a sense of purpose from helping my friends and family and it is only fair to allow them that same feeling.

My sister came to pick me up and I am positive I left the surgery center with more stuff than I came with.  🙂  Oh, yes, the CPM machine came home with me.  I have that for the next two weeks to use.  This machine really works on my flexing and extension.  I can get up to 90 degrees but I usually start around 50 degrees and add 5 degrees every other 5 minutes.  After we dropped my stuff off at home, we went to the pharmacy to drop off my scripts and pick up a few things for snacks later.  Thank goodness the pharmacy has a place to sit.  I will admit it was a good feeling to walk around in a direction other than a circle.  Hahah!  However, I don’t want to push it on my first day out. 

So, my sis and I sat and waited for my scripts to be ready.  My sis was looking at some of the clearance items by the pharmacy and when she came and sat down, something fell behind her.  It was one of those HUGE golf umbrellas.  It was on sale for only ten bucks.  I told her that it was a sign that we needed that umbrella so she picked it up and I bought it.  🙂  Ok, so it maybe wasn’t a sign, but it was a way cool umbrella.  Christel reminded me that it would be perfect for taking Cricket out for walks in the rain.  Cricket loves to chase the bubbles in the water as the rain water runs down the gutters on the edge of the streets.  So, at least the next time I won’t be as wet as she does.  🙂

We got my prescriptions and headed home.  My mom and nephew were there to help us bring up stuff.  Well, not “us”…help my sister.  My job was just to get up the stairs without falling back down the stairs.  After they got everything inside and me safely inside and sitting down, we decided it was time to order dinner.  There was NO way I was going to cook.  For those of you that know me, you know I’m not a great cook anyways.  I out-bake people, but cooking….not my thing.  We ordered pizza and wings and had a nice little smorgasbord.  It was fun to just sit there and eat and visit.

I am keeping up on my pain meds for the first few days and will try to ween myself off of them during this first week.  The surgeon suggested that I take them before my therapy for the first week.  I want to be able to move and use my therapy sessions as completely as I can, so I will take his advice.

For now, I am going to try to get some sleep and start out tomorrow in my own place and see what adventures await.