Saturday - much improved...

After Friday's unexpected pain, I was very relieved to wake up this morning to minimal discomfort and no additional swelling in my knee.  I forced myself to spend 7 hours in the knee machine today and got up to the magic number of 120!  

I broke down late afternoon and took a Percocet to help get me there, but figured that's what the doc gave me the pills for...  Don't think I'm in any danger of addiction...  In fact, I was a bit disappointed with that morphine last week!  Was looking forward to that great euphoric feeling it's supposed to give you, but I never want to see that stuff again!

And as a plus, I've had some moments without any discomfort when I was up walking around or standing, so that gives me some hope that I've turned a corner.  But I'm still having plenty of that nagging pulling sensation.  I was thinking earlier this week that pain comes in so many different varieties.  There's the sharp abrupt pointed pain like when I stubbed my toes in the bathroom this week.  If I had to give that a color, I'd paint it red.  The pain I feel would be just a dull, ugly brown.  It just wears on you.  You don't realize how much until it stops.  And oh, what a relief when it stops...

Enjoyed more daytime TV today, including two episodes of Property Ladder on The Learning Channel.  The people they featured made some really stupid decisions, but I figured in one case, the producers were salivating to get that woman on the air because she was such an incredible flake.  She wanted to spend $30K on renovations, and had this grand design in mind.  She had the sense to hire a general contractor, but when he told her that the grand design would be 40K, she got upset with him.  He suggested scaling back.  She didn't like that idea.In the end, she spent $72K, and after 4 months, still hadn't sold the house.  But she did make for compelling viewing.

Then Lifetime was having its "Love Gone Wrong" weekend, so I watched a couple of docudramas also about people who made some really bad decisions.   Now I'm sitting here watching the AKC Eukanuba dog show.  They're so beautiful!  Well, most of them.  There are still some funny-looking dogs out there.  

I also enjoy the sidebar videos on the difference dogs can make to a person's life, like a wheelchair-bound man and his Labrador assistance dog.    It showed him opening the front door for the dog to get the morning paper, and the dog looked so thrilled to pick it up off the sidewalk--just wagged his entire back end.  "Look!  I've got the paper!  Yippee!"  I try to bring some of that doggy enthusiasm to the things I do, but I'm not as cute as that Labrador.  

Superbowl tomorrow!

  

knee fears and other breakdowns...

I was in so much discomfort today and not managing my pain well.  I was trying not to take the Percocet anymore, but extra-strength tylenol just does absolutely nothing for me, and the doc doesn't want me to take ibuprofen due to its anti-inflammatory effects.  So I just tried to brave it out and by the time I got to the physical therapist was pretty close to tears and trying not to show it.

After torturing me in various ways, they put me on the stationary bike today for 4 minutes.  Four whole minutes!  It was so uncomfortable at first.  I whimpered a bit, thinking of my long bike rides in Germany, Australia, and Yorkshire, and how I could hardly push the pedal!  But I told myself to stop being silly, that before I knew it, I would be riding again, that I was progressing well, etc.  Then I heard BelleRuth's voice (star of healthjourneys.com and guided imagery) telling me there are times I will feel fearful, angry or sad, and I need to acknowledge that as my truth of the moment.  When I acknowledge my emotions, I allow myself to heal.  No denial with BelleRuth.  

So that's been my truth most of today's moments--in pain and sad over all the discomfort.  

This evening, sometime in hour 3-4 on the knee machine, my knee really started to hurt in weird ways that it hadn't before.  So I dialed the angle back a bit and soon just quit the machine all together.  The doc has emphasized how critical this machine is to my recovery, to regaining a fully functional knee, and part of me hated to stop for that reason!  But he's also told me to do what I can tolerate.  After toughing it out for several cycles, I decided that maybe I should just honor this unusual pain for the evening and try it again tomorrow.  So I've been just letting the ice bag sit on the knee and have turned off the motion machine.

I did a lot today. It was my first full day off the crutches.  I took a shower, which is a bit of an ordeal (just my 2nd one since the operation).  I walked up and down the street for 10 minutes.     I had an hour of physical therapy with several new activities.  I walked another 5-10 minutes around the shopping center (got a Mocha Frap light as my after-PT treat).   And I'd done 3 hours successfully before that pain kicked in.  So I'm hoping it was just my new ligament's way of saying, "uh, enough for today, hon."  

And, since then, when I've been standing up and walking around, I haven't had the pain I'd experienced earlier in the day!  So perhaps it was a bit of a breakthrough in a positive way.  

Tomorrow will tell.  For now, I'll just try to enjoy "The Unsellables" on HGTV as Sophie tells these property owners the obvious - repair and clean up the place if you want to sell your house!  

Knee Machine

This is the knee machine.  The foot goes in the upright part and then you drape the rest of your leg down the middle of the gray fleecy stuff.  You use the remote control on the side to increase the angle.  It slides up and down the dark track in the middle

The dark blue blob on top is a fancy ice pack, and the blue/white thermos in the background is a container of ice and water that keeps the blue pack cold. I put the ice pack on top of my knee as it goes up and down in this machine.

I'm supposed to do 6 hrs a day, 2hrs on, 2 hrs off, but it actually hurts my back (lying on it) more than my knee.  I know this is critical to my recovery, but can't wait to be done with it..... 

I've started wiggling my good leg around in the air, crossing it over the bad leg, anything I can think of to move my back a bit, including "butt lifts."  Anything to give those back muscles something else to do.

Off the crutches!

Had my follow-up visit with doc yesterday and I am off the crutches!  I was going to compose a column on crutching techniques but will dispense with that now!  I am starting to take short therapeutic walks (5-10 min) in the neighborhood and am taking one crutch with me on those to help me feel more stable, but when I walk around the house, they're history.

I'm also out of the Ace bandage and just have surgical tape on the incisions in my knees.  A nurse re-glued me and taped me up at the doc's yesterday.  So no stitches or staples - just surgical glue...  My knee looks a little swollen, but looks like a knee and not a grapefruit.  

I'm having trouble bringing in multiple pictures so will just do this one for now.  

Thought I would close by telling y'all about some of the nifty new daytime shows I've discovered.  There's "Clean House" on the Style channel, where people with AMAZINGLY full houses of junk have the "Clean House" staff come in and get rid of all their stuff and get their space into something they can actually live in.  I thought it might help me get more organized but the last time I was this bad was in college.  I'm a neat freak compared to these people...

I've also been watching the Dog Whisperer a lot and Cash Cab.  My favorite missed question on Cash Cab so far - what island used in nuclear testing in the 50's gave its name to a piece of summer clothing?  The contestant's answer - Bermuda, in Bermuda shorts.  Yeah, there was a lot of nuclear testing on Bermuda....

And I've been a regular on the Comedy Channel and the Colbert Report.  Last night he interviewed a representative from the National Chicken Council about the shortage of wings for the Super Bowl.  I googled the NCC and the guy on the show and they both exist!  I even sent him a short e-mail and he replied that he preferred answering questions about chicken wings over questions about bird flu....

PT and leg machine

Today, went for my first day of PT, which turned out to be pretty much a non-event.  I was expecting all kinds of painful, torturous exercises, but they massaged my leg and gave it some electrical stimulation and measured it, and all in all, it was pretty pleasant, especially that leg massage.  

They also told me I didn't need the bandages on any more until I told them the doctor said to leave it on until I see him on Thursday.  Then they said, "oh."  They also didn't have my doctor's protocol for an ACL reconstruction, even though my info was faxed to them on Thursday.  

Later in the day, we picked up my CPM.  I can't remember what CPM stands for exactly, but it's the cradle-sized device that passively moves my leg around.  I wasn't terribly impressed with the guy who "fitted" the device, either, but I really like the machine and it's covered in this nice fake sheepskin stuff that feels good to my skin.  

I've only taken two Percocet so far today.  Might just try ibuprofen tomorrow and see how I get on with that.  Also hope to take pictures of all my devices!  

Hospital and Beyond...

We were in the middle of rush hour traffic getting into Honolulu Friday morning and arrived about 20 minutes late.  But no one seemed to notice.  It's Hawaii and time is a casual thing... 

Since I'd done most of the admin stuff the day before, they just did an inventory of what I'd brought with me and sent me to the surgical admission center.  For the surgery, they put me in a thick purple paper gown (even had a partial lining) and matching purple socks.  Then they put me on a gurney and wheeled me into a waiting area where they hooked up an IV.  

Every hospital person who came back checked my wristband, asked my birthdate, and which knee was having the operation.  I told them I was expecting a lot of birthday cards after all this.  The surgeon came by and marked my leg and initialed it.  He was using the allograft technique, which means he was using cadaver tissue to reconstruct my ligament.  

After the IV was in, they allowed Chris to come back and we watched some CNN and talked a bit.  Because it was cold in the pre-op area, they had a hose (looked like a vacuum cleaner) that attached to a flap in the gown and it blew warm air on my tummy.  Very comfy!  Poor Chris had to just sit there and be cold.  

Then the anesthesiologist and nurse anesthetist came by and started to do their thing, and I didn't remember anything else until being wheeled into recovery.  The anesthesiologist had already told me she would give me a special shot after the operation into the right leg, and that was very welcome.  

There were also some pictures on my bed from the operation, with a CD attached.  I looked at them, holding them up right to my face, but they could have been pictures of Saturn.  Couldn't make a lot out of them.  At some point, they removed my pretty purple gown and put on one of those cloth ones.   But I got to keep the purple socks... 

Then I was wheeled up to my room.  All the rooms are private, but they leave the doors open with a curtain pulled for privacy.  So I might as well have been on a ward.  I could hear a man nearby groaning a lot.

The next few hours were pretty bad with nausea and a headache.  I was on a morphine drip, but it felt like I was having the mother of all migraines.  We (the nurse, Chris and I) finally decided it must be the morphine.  I could tell the nurse was nervous about removing the morphine, but he started me on Percocet, and the pain in my leg was fine.  And after that, the headache and nausea went away and my goodness, I felt SO much better after that.

They'd brought a liquid lunch that I'd been unable to get down.  Then they brought regular food for dinner.  It took me a couple of hours to get that down, and of course, it was quite cold by the end, but it felt so good to have food!  Around 11pm I asked for a snack, and they brought me chocolate pudding!  Mmmm.

Most of the afternoon my leg had been in a passive mobility device.  I think that's what they called it.  It looked like a cradle.  You put your leg in it and it starts to slowly move your leg up and down, getting your knee going.  I used that the whole time until I was discharged, which impressed the staff.  They said not everyone tolerated it that well, but I thought it felt good.  Very soothing.  The first half hour was a little painful, but after that, it just felt good.  On Monday, I get my own for two weeks.

They also had this ice machine thingy on my leg.  The ice pack is just a flat device that fastens around the knee with velcro, but it's attached to this tube which is attached to a little canister thing that looks like a small beer keg.  It plugs in and it's very noisy, and is filled with ice water, and keeps circulating ice water through the knee pack.  When I'm on the Percocet, I don't notice the noise.

I got through the night pretty well (thank goodness for my iPod!), and really looked forward to breakfast!  Though of course they took vital signs every few hours.  My BP had been high-ish with the morphine, but once I was off that, it was dropping into the 117/72 range, which was a relief to see.

They brought me an omelet with rice and some kind of little round patties which I suspect were Spam, very popular here in Hawaii.  Probably the first time I have had rice with breakfast, but again, I was hungry for it all.  Even drank the weak coffee.  I'm a growing girl - gotta get my ligament growing firmly around that graft!

The PT came in with my initial set of exercises.  They weren't too bad.  Again, the staff seemed surprised I wasn't showing more pain.  Soreness is the best way to describe it.  I had also gone through the night (almost 7 hours) on only 2 Percocet.  I don't think of myself as being particularly brave about pain.  But I had been listening to BelleRuth Naperstek's guided imagery on successful surgery, where she tells me I will have minimal discomfort, and it appears she was right!

Finally the doctor came and said how great everything was and discharged me.  Chris made a trip to the car with the ice / beer keg and other stuff and then a wheel chair guy wheeled me out to the car.  I came home to two beautiful sets of flowers - a dozen red roses from Chris and a very cheerful bouquet of yellow flowers from colleagues in Texas.  

I start physical therapy and my passive motion machine tomorrow and am looking forward to that and to getting rid of crutches.  The doc says I can drive as soon as I'm off the Percocet, so that's motivating!  But I think I'll use those a few more days...  Man, can those things put you to sleep.  And I have such vivid dreams!  

So for the past 24 hours here at home, I've been drinking liquids, taking drugs, watching a little TV, and crutching to the bathroom and back.  Thank goodness I can do that by myself.  In the hospital, it took one-two helpers due to the IV lines and getting my leg in and out of the passive device.  And I really want to wash my hair.  But maybe will save that adventure for tomorrow...

The Pre-Op process

I had my pre-op appointment today for tomorrow's surgery.  First, it gave me a chance to find the hospital here in downtown Honolulu.  It was a rainy morning and there were several traffic issues, so the 15 miles took 80 minutes to get there.  The irony is that driving in heavy traffic is one of the things that really makes my knee feel like it's getting pulled apart...

When  I got there, they gave me a 2-page questionnaire that no one showed any interest again, at least not until I asked several people, "do you want this?"  I discovered my pre-op appointment was actually a series of appointments.

First, the nurse took me back to an examining room so I could sit for a bit.  Never sure why they do that...  I told her I needed a snack after that trip, and she just laughed...  Anyway, I took the time to relax from the drive and then play with the rubber joints all orthopedic surgeons seems to have around. 

Then she had me change into a pair of big baggy shorts, and the knee brace guy came in.  My nifty Robo-Cop brace has a hinge in it, and a lock on the hinge to really keep that leg straight.  He showed me how to adjust all the straps and how to put it on properly.  He said I'll be wearing that thing pretty much 24 hours a day.  "How long?"  I asked.  "It depends," he says.

They say that a lot around here.  "It depends."  

The doctor came in and we discussed the procedure a bit.  Of course, I have a good dozen questions swirling in my head now and none then.  It will be 3 months before I can start jogging.  Not that I ever did a lot of jogging before.  But definitely none for 3 months.  Nine months before I can do any cutting actions with the knee, like an NFL running back or basketball player.  Well, never did those either...  I can swim after about a month.  The first 4-6 weeks are the crucial part, where the risk is greatest that the new ligament might be stretched.  

He's going to use an allograft, a graft from a cadaver.  This is less painful than shaving part of my patellar tendon.  Less pain sounds good to me.  He gives me a pain medication, Percocet, and recommends I fill it today so I'll have it when I need it.  He talks some more about pain and how they manage it.  I haven't really thought much about the pain.  I'm hoping it's a good thing that I'm not dwelling on that topic much.  

We discuss the physical therapy a bit.  I know that is critical to my recovery.  He recommends renting a passive motion machine for the first two weeks to help me regain my full range of motion.  Happy to do that.  There is a good PT place near where I live, and he already has me signed up there.

Then a nurse comes in and goes through a lot of paperwork.  I sign it all.  She gives me some body wipes I'm supposed to use (right after I finish writing this).  She finally tells me what time to show up on Friday - 6:45am.  Yikes!  I will be spending one night, and she gives me a pamphlet on what to bring with me.  The answer - not much...  (They recommend you leave all jewelry at home and I've already taken off my rings.  My left hand looks funny without them.)

Then she sends me to a basement to have an interview with nurse who finally shows interest, excitement even, in that 2-page questionnaire.  She seems surprised to see that I don't have any daily prescriptions yet.  After going through my health history, which makes me feel pretty healthy, she describes the next day and warns me that a lot of people will ask me questions before the surgery, and that is by design.  "To make sure you don't take out a kidney?"  She sort of laughs at that as she says, "right."

Next I go to the Physical Therapy department where I get fitted for crutches.  Brace!  Crutches!  No, no, I'm going to be one of those people who rises, takes up my bed and walks.  But I don't tell her that.  I practice with the crutches.  

Before leaving the hospital, I check out the gift shop, coffee shop and cafeteria.  Not too exciting.   The hospital is near Honolulu's big fancy Ala Moana Mall, so I go there for lunch and treat myself to a little retail therapy at the Vera Bradley store.  Buying a couple of small items for my brief hospital stay somehow makes me feel better, a little more settled.

I've packed a little backpack with my few belongings they recommend.  The one place I'm going off script is by bringing my iPod.  I'm downloading a couple of movies to it now.  I'll have a private room (all rooms are private in this hospital), and I'm sure there will be a TV, but I want more entertainment options.  I'm anticipating a long night...

Well, time for those body wipes.  It's almost 9pm, and in abt 8 hours, I'll be up and body wiping again...  But it's the first step to getting my life back.  I keep telling myself that...

Regaining my life under the knife...

For the next few weeks, lucky readers, this blog will chronicle my knee surgery and recovery.  As some of you know, in 2002, I ruptured my ACL on a ski trip.  My knee actually did really well until our move to England, where two slips on ice resulted in a much looser knee and some damaged cartilage.  A surgeon there recommended the reconstructive operation and one here in Honolulu concurred.  So tomorrow is the Big Day.

I vacillate between being really excited about getting my life back and really dreading the process.  On the one hand, the knee has increasingly limited my activities.  In London on one trip, it just collapsed on me one night.  We'd left a show and were in the tube getting to our train and it just stopped holding my weight.  I had to drag myself up the steps by the handrail.  Didn't hurt, didn't give any warning, just stopped holding me up.

Here in Hawaii, getting out of the ocean surf was always a nail biter.  The fear I felt was so strong that I was almost ashamed of it.  And after walking that 10K, I've had a heavy, swollen sensation in it.  So I'm ready.  I'm ready to be active without fear.

But on the other hand, the next 4 weeks are going to be hard, and the entire recovery process is about 9 months.  That's just a reality I have to face, though I'm doing pretty good with the denial...  I had a pre-op appointment today and was genuinely surprised when the doctor gave me a pain prescription and said "better get that filled today."  AAAAAAAGH

Ready or not, denial or not, here I come!  Join me in these next few weeks for a blow-by-blow description of recovering from an ACL reconstruction!  What a trip it will be!  

2009 Catch Up

Right after my last post on 26 December, we had the Big Oahu Blackout, which made news especially since Obama was still vacationing here. 12 hrs of no power for most of the island, and they're still trying to figure out exactly what happened. It appeared to be a series of freak lightning strikes. Today's paper included one article that said based on the cost to prevent this very unusual occurrence from happening again, we might just prefer to live with the risk...

This year, 2009, is the 50th anniversary of statehood for both Alaska and Hawaii! Apparently statehood day is in March, so anticipating more celebrations for that.

Speaking of celebrations, after enduring a New Year's Eve here, we both have firmly stated that wherever we will be next year, it will NOT be here. Our neighbors started with the fireworks around 6:30pm and continued until about 1am. It was like being shelled all night long.

Supposedly parts of the island looked like they were on fire from all the smoke. The smoke was so thick on our street that we shut our front windows. Really don't get the point. It reminded me of those countries where they shoot guns in the air after a wedding and half the time end up wounding the bride or groom...

Getting ready for life without football. Don't know what I will do...