So basically today is my 7 day post-op and I am hurting. That's on one hand. On the other, did you read that I am up to 0-105 on my CPM machine? Started at 0-70 just 7 days ago, that's good :) Getting around somewhat better, that's good too :) and you know my PT says I'm doing phenomenal. Another good thing. I just need to keep looking at the good stuff. So what....I'm hurting today. There's going to be days like this. Tomorrow's another day :)
One Week Since Surgery 7/30/2014
Hard to believe it's been a week already since I've had my TKR. ( that's medical talk for total knee replacement) Am I glad I did it? Yes, of course I am. Only I want it to be 6 months from now. Since Monday I have been in a little bit of a funk. I feel good, I feel like I am making good progress, I am doing more and more exercises, I can run my CPM at 105, and I seem to be getting around (the bedroom, bathroom, family room) a lot better. BUT, you knew there would be a but, I feel like I should be doing more. And like I said Monday I think I am actually being too hard on myself. I am hurting today. Pretty much all day. Not sure if it's the addition of more new exercises, if it's from the way the new exercises hurt, or that I am trying to do too much cause I do overall feel good. Once again.... It's been a whole week from my surgery and i don't know why but I feel like I should be fixed. Where is this impatience coming from? I'm just really struggling with that.
Sock Tricks 7/29/2014
I had support hose put on my legs on my right leg, before surgery and then on my left leg when I was all done with my surgery. I was told that they are good for keeping your legs from getting blood clots as well as helping with overall circulation. I have had them on since my surgery. I did get them taken off when I took a shower before I came home but then they have been on since. At least til yesterday. I took another shower so I took my socks off and also had them washed since they were off. I had asked Kerry (my nurse sister in law) how long I should leave them on. She told me that I really should leave them on for about two weeks but could take them off at night. So I didn't put them back on yesterday cause I thought I'd wait til morning.
Once I got up and moving I asked Kev to put my socks on for me. I could probably manage my right left but would need help with the left so I just let him do both. Plus have you ever tried to get this type of sock on? It's not easy, they are super tight and take some work.
Kev learned this handy little trick at the hospital when they were putting them on me. Then today he tried it and it worked and I got my socks back on.
You put a small bag over your foot.
Then you gather up the stocking to get them ready to put on. You put the whole bundle over the bag on your foot and that helps them slide on.
Then all you have to do is get them adjusted and evened out and they are all set. You reach thru the little whole at the end and pull the bag out.
WA-LA....socks on the easy way!!! Well I may have had some help but it's easier this way for anyone :)
Feeling Tired 7/28/14
Not exactly sure why I felt tired all day, I had another good night of sleep. I left the CPM machine on and it worked out great. But thru the course of the morning and even this afternoon I felt tired. I even took like a 2 hour nap today. I guess I have to come back to the fact that I just had major surgery not even a week ago. I think I have been doing so good that I feel like I should just keep improving and doing more without any struggles. The other night my sister in law, who is a nurse, said that I needed to make sure I healed on the inside as well. And i don't think I'm letting it all come together, and it's all part of the outcome.
I had PT again today and was definitely sore when I was done. I have been doing the exercises that I was given on Saturday and then today I got some new ones and learned how to do the ones I'm already doing in a different way. This is one of those things that in one way is showing improvement and then in another I look at how far behind I am and how far I have to go to do simple tasks. Just weird for me. And I don't want to feel this way because this is going to be a long process especially if I am going to do all I need to do to have the best outcome. It's going to be small steps, small accomplishments and big results.
Again....I have to tell myself it's only been 5 days and stop being so hard on myself. Because really, I'm actually farther along then a lot of other people at this stage normally are. It shouldn't matter if I'm tired. Just go take a nap.
CPM Sleep 7/27/14
Last night I slept with my CPM machine running. The CPM machine is the contraption that hooks up to my leg and is electric. It bends and straightens my leg continuously once it's turned on.
I can adjust the angle that it bends and I have done some adjusting on it since I have used it in the hospital. When the company I rented it from came over and gave me a demo he said I would most likely start at 0-45. Well the first day they put it on me at the hospital the nurse said my order was written for 0-70. At first I was thinking there is no way that's right, but then again I'm the patient and what do I know. So the nurse put it on and the first couple bend and straightens hurt a little but then, like I've said in a previous post, it felt good. I liked the stretching. That same day when I was getting it put on again for another run of it, a different nurse looked at it and said, " you ran this thing to 70?" And I said yes and she said "you're a rock star!!" That was pretty cool, made me happy to think I was doing better then they thought I could.
I am suppose to be on it for 6 hours a day, and that can be in any combination that works. I have pretty much been doing it in 2 hour increments. I asked about sleeping with it on and was told it could only help if I felt ok with it on. So I told Kev I wanted to try it. He has to help me with it cause I can't lift it up on the bed and get strapped in. I was all ready and hoping for some good sleep. It actually felt more comfortable then just laying with my knee flat. And the good news is, I slept. I woke up around 2:00 to pee and was going to call Kev to come help me, but I managed to be able to reach the straps and could release them so I could get out. When I came back to bed I could get back in and strapped like I needed to be and I started running it again. Within a few minutes Kev came downstairs to see if I was ok, was I sleeping or needing any help. lol No problem, got it all worked out. So I fell back to sleep with the CPM running and didn't wake up again til almost 5:30. This was good news for me. I haven't been sleeping good and this was the most straight thru sleep I've had in a while. Plus when I actually was fully awake and unhooked the machine my leg felt great. My knee felt relaxed and flexible. Of course it tightened up and had some pain come back once I did some exercises and started working with it, but leaving it on and running was successful. I am going to try it again tonight to see how it goes again. I am still using it throughout the day, so I am definitely making it work. Oh and I am up to 0-85!!! Which I think means I'm making great progress.
Gold Star 7/26/14
I got a call last night about physical therapy and was told someone would call me to set it up. Within an hour a lady called and we made an appointment for her to come today about 9-9:30. For the first two weeks I am home I will have a home health care PT come to the house to give me physical therapy. After that I will go to a PT office for several weeks. The amount of weeks and how many times a week will depend on how well I am doing and my improvement etc.
I was up early cause I once again didn't sleep very well. I'm sure I just need to find a comfortable position, one that I can tolerate and not forget that my knee is sore. I ended up getting up three times to pee and I was ok with getting out of bed and using my walker to go the few steps to the bathroom. And I managed to get back in ok as well. Kev initially was sleeping in the downstairs bedroom with me but he couldn't take it that the bed is smaller then our usual one and the room is way hotter. I was joking with him that he took great care of me upstairs while I was downstairs. But so far he really is. I feel bad cause he has to do everything for me. I need some water, where's my phone charger, can you get me a snack? And he does it all. He's so awesome.
My PT, Karen came around 9:15. Kev answered the door and told her I was down in the dungeon, she didn't laugh. I'm sure in the next couple weeks she'll figure him out. So she came in and we did some paperwork, which she said was easier then usual because she didn't have to do any Medicare forms. Evidently I am one of her younger patients. After the paperwork she gave me a great massage. I was really worried when she started rubbing my leg that it was going to hurt, but it didn't, it felt great. I would have been happy just to have her do that the whole hour. But we moved on to other things. A couple of exercises are ones I have been doing since before my surgery and she was happy about that. One of them was to tighten my quad and then try to lift my leg off the bed. Try.....haha, well I lifted it. And a fairly good heighth. She was very impressed. And then I even did it a few more times. Yes I did it, but it hurt. Pretty much everything hurts to do, but the final outcome will be that nothing hurts and that will be awesome. After the exercises we did on the bed we went into the playroom so she could see how I walked and got around. Plus we did an exercise where I sat in a chair and had to stand up without using any armrests. Strictly the muscles in my legs. She said no one can so this after surgery but not to worry cause today was also an observation day of what I could do and then checking improvements from here on out. Well...not only did I get up, I did it 5 times!!! Again, she was really impressed. And I was feeling pretty good. We did a few more things and then the last one was to see how I do climbing the stairs. We walked over to them and I went up all three without any help from her or hanging on to the wall. I just went up one by one. Wow I was having a great day!! So then I went back down and she said she loved to see how far I already was and that I was going to have a great recovery. Normally the fist week after surgery she told me, a patient has PT every day and then they cut it back to 3-4 days the 2nd week. But Karen said I was already doing so well that she thinks I only need 3 days next week. Yippee!! I was on my way. When she left, Kev was upstairs with my sister and some friends and she said I did awesome, so good that I had earned a gold star!!!
Day 3 Post-Op 7/25/14
A little bit of a rough morning. I got up out of bed to go for a walk with the PT lady. It was kind of early and my breakfast had just arrived but I decided I wanted to walk first. We were out walking the halls and were also going to conquer some stairs as well. We were just about to the hallway to do the stairs and I started to feel sick. I told the therapist I needed to go back to my room. When we got back I sat in the chair and then between her and the nurse they tried to make me feel better. I had a cool, wet cloth for my head and then some nausea pills to help get rid of that sick feeling I had. Not really sure where it came from but I was not happy about it. I had been doing so well not feeling sick because on other times I've had anesthesia I have gotten sick . This time I didn't, I didn't even feel sick once. And then this. But it worked it's way out. I sat for a while and ate a little bit of breakfast and then went back to bed. There was a chance that this was going to hinder whether I got to go home or not. I was hoping it wouldn't but if I was sick and not able to handle my pain meds or use the toilet it could happen. We think it was because I didn't get good sleep again , plus I had taken pain pills thru the night and hasn't eaten yet either. Who knows? The nurse asked if it was because I was feeling anxious about going home. One of the other people that clears me to go home also said I didn't have to if I wasn't ready. I was ready but I wanted to make sure I was going to be able to somewhat get around.
The rest of the morning got better. I was feeling better, the PT came back in and we went for a walk and I did awesome. Then we tried out the stairs and I didnt struggle at all. She said I was ready and she would be happy to release me. We talked about some other situations I may need to work on. One would be using the toilet and another getting in and out of the shower as well as a car. Also talked to the hospital doctor and let her know how my pain had been doing. She stressed to me what I had talked about yesterday which was to stay on top of any I was having and to also let my doctor know if I needed something stronger or different to take. I had a great nurse today and she was really helpful and wanted to make sure I was ok with going home. She told Kev and I what we needed to do once we got home and with follow ups etc. I got my drainage tube taken out as well as my catheter and then I got to take a shower. I had no idea I'd be able to take a shower so soon. The nurse had taken off my big bandage and padding and underneath that is a waterproof bandage. So I can shower and not worry about it. The stitches are self dissolving so I don't have to worry about doing anything with them either. Now the only thing left was to pack up and go. It was definite, I was ready to go.
I have to be honest I was a little worried about leaving. I think I just wasn't sure how everything would go and how I would do. At least at the hospital everyone is right there. But as the day had gone on and I saw and talked to more people they all assured me that I was going to be fine and was in great shape to work on what I needed to work on at home. Kev has a few weeks off and I know he is going to be very supportive and take great care of me.
We packed up, I signed forms and Kev got my prescriptions and we headed home. Once we got home I went down to my room and relaxed. I was now home and ready to work hard to get my new knee in great shape.
Day 2 Post-Op 7/24/14
The day did not start off too good. It actually all started in the middle of the night. I had a tough time sleeping. It was really broken up for short periods of time here and there. I did ask for my pain medication a few times and then had to ask for more to top it off. I felt bad cause Alicia had spent the night so she kept waking up to see what I needed etc. I finally just accepted the fact that I wasn't going to sleep. Around 4:00 am the nurse came in to put me on the CPM machine. The first couple of times it pulled back it hurt but then it started to feel good. It's a nice consistent movement that helps to keep my knee bending and stretching.
As the day went on I did more icing as well as more time on the CPM machine and some PT. The pain again has been good and bad. The key is to stay consistent with pain meds so it doesn't get real bad and then I'm trying to catch it up. Plus different things seem to take more out of me which will set it off as well. In all the things I read before my surgery everything really stressed that I do what they tell me. They, meaning the nurses, doctors, physical therapists, anyone that is involved with what I have gone through and has anything to do with my rehabilitation. Some of the important ones are 1) to take care of the pain. Like I just said, it's easier to stay on top instead of catching up. 2) keep doing the breathing exercises. These seem so simple but are really important. It's very easy after a major surgery to catch pneumonia because of fluids building up in your lungs due to not working on deep breathing.
3) do the suggested exercises. I looked up on line what I was going to need to be doing right away after surgery and actually started doing them before I went it. Then when the PT came in, I knew what she was talking about and the importance of what exercises are needed for what. One exercise that is really important is not really for the rehab of my knee but it is to keep good circulation in my legs to keep blood clots from forming. 4) stay hydrated. Drink water, water, water. All day yesterday and today my mouth has been so dry. That's mainly from the anestisia and the pain meds, but to help that I have been drinking a ton of water. Plus. It helps to flush all that stuff out of your body as well. 5) rest. Whether it be resting to go to sleep or just resting because I just had major surgery, there has to be time to let my body adapt to my new joint and basically breaking it in. Overall those are some of the things I have learned not only from previous surgeries but also from the information I have read and heard in order for my surgery to be successful.
I'm supposed to go home tomorrow so we'll see how tonight and the morning go. I still have a drainage tube in as well as a catheter so I have to get those removed before that can happen as well. Now that I am trying to move around a little more the catheter is bugging me. Although on the other hand it's been nice not having to try to get up and use the bathroom. It's hard work getting in and out if bed.
New Knee for Me Day 7/23/14
The day started bright and early by leaving the house at 4:30 am. I had to sign in at 5 am for my 7 am surgery. I wasn't feeling too nervous which was surprising to me. Usually in a situation like this I am extremely nervous, sweaty, emotional, you name it. But today I was good. I was ready. Kev and I got to the hospital and checked in and Alicia met us there. We waited in the waiting room for a few minutes and then I was called in to finish up my registration, get my wristbands and of course pay my co-pay. It was just a short time after that that a nurse came out to get me and we all went back to the pre-op area for more preparations. I had to change out of my clothes and put on the lovely gown which was now going to be my outfit for the nest couple days. Different nurses came in and asked different questions, verified what I was doing there and basically did more preparations. The anestisologist came in and talked about what she would be doing to take care of me in the surgery room as well as how I would be getting a spinal block and light anesthesia so that I would not have any pain or be awake. This was now about the time I started to get nervous. I think she could tell because she was very reassuring that I wouldn't feel anything and would have the surgery and then wake up in the recovery room. The nurse told me I was the doctors first surgery that morning so we were just about ready to get started. I had an IV put in and then I had my spinal block put in. Although it was not as easy as I just made it sound. I had to swing my legs over the side of the bed while I hugged a pillow and the nurse held me. This was the preferred method of getting the block in. Try # 1 fail. Try # 2 fail. Try # 3 fail again. Finally try # 4 was a success. There were times this hurt, a lot. I remember the nurse getting a tissue and wiping the tears from my eyes. The anestisologist couldn't get it in. My body was not cooperating. Evidently I have arthritis in my back and she could not get the needle to go in past it. I felt sharp pains here and there and that is what brought on the tears. Plus I think I was just getting super nervous. So she tried again and again still with no luck. By the end of the third try she decided she would wait for the head of the department who was right across hall with a different patient. He came over and got it right in.
I don't remember too much from here but I do know I saw the doctor and introduced him to Kev and Alicia and then told Alicia to take our picture.
Later in the afternoon one of the physical therapists from the hospital came in and got me up.
I had a walker to use and wasn't really sure how to use it. I was trying to use it like crutches and was picking it up and then scooting it and was just doing it all wrong. You really are just supposed to slide it and stay in between it. It is good to keep as a guide as well as a stabilizer. We walked two doors down the hall turned around and came back. I was exhausted. This hurt quite a bit but was definitely tolerable. It was shocking to me and everyone else that I got up and walked on my new knee right away. But for it to be successful you need to put it to work right away. The PT gave me some exercises to do while I was just sitting in bed and assured me that although they may hurt they are necessary for recovery. Honestly I figured anything from here on out that I did was going to hurt.
Through out the rest of the day I was monitored to see where my pain level was at and given what I needed to help get it under control. I was getting morphin shots in my IV but that was something that they did not want to keep doing. It's very strong and very addictive. I liked it cause it works very well. They started to just give me some pain pills which worked at times and other times had to be backed up with an IV shot.
Surgery was a success so far. Overall the day went well. They do say that day two can sometimes be harder because everything is now wearing off. But we'll see. Right now I just need to make it thru the night.
Through out the rest of the day I was monitored to see where my pain level was at and given what I needed to help get it under control. I was getting morphin shots in my IV but that was something that they did not want to keep doing. It's very strong and very addictive. I liked it cause it works very well. They started to just give me some pain pills which worked at times and other times had to be backed up with an IV shot.
Surgery was a success so far. Overall the day went well. They do say that day two can sometimes be harder because everything is now wearing off. But we'll see. Right now I just need to make it thru the night.
Tomorrow is the Big Day 7/22/14
Wow....I am having my knee replacement surgery in the morning. I can't believe it's finally time. I did work today and since I was going to be home bound for a while Kev wanted to take me out to eat. After dinner we went home and then I decided I needed a haircut. I've been wanting one, but for some reason I had to get one tonight. The salon at the mall was open and a girl took me right away. I think I got 6 inches cut off. It feels great and is going to be way easier to deal with in the hospital and at home since I can't shower for a while.
After I got home from work and before we went to dinner, a guy came by to drop off and show me how to use my electric ice pump and CPM machine. (continual passive motion) The pump is a wrap that goes all the way around my leg, it is attached to an ice chest filled with ice and water. You turn the pump on and it pushes cold water into the wrap and automatically ices my knee. How cool is that?
The motion machine will be hooked up to my knee and just keep bending it. It starts at a certain angle and then through time at the hospital and at home the angle will get better and better. The guy that brought it over measured it for my leg and then showed me how to use it. I even got to test it out.
No eating or drinking for the rest of the night. Have to be at the hospital at 5 am for my 7am surgery.
Two Days to Go 7/21/14
Here it is Monday and surgery is Wednesday!!! I went to a preoperative class at the hospital this afternoon. It had a lot of good information. To start the class off the Chief Nursing Officer told us all about the hospital, how it came to be, it's mission and values. And he joked how a lot of people had the same reaction when their surgeon said they were going to have their surgey at Oasis Hospital, Oasis what??? It was too funny cause that is exactly what I thought. My doctor did explain to me the type of hospital it was etc so I did know some of the information.
Oasis Hospital is strictly an orthopedic hospital. All patients are there because they are choosing to have surgery to improve their quality of life, not because they are sick. It is a well hospital that was constructed by surgeons that wanted to be able to use their own procedures and practices not the ones that are regulated by group hospitals. They do only orthopedic surgeries so the hospital is specialized in patient care and recovery. As well as the information about the hospital, each of the different departments that anyone deals with came and talked to us. From the time we walk thru the door and sign in until we are picked up on the curb at discharge, we were told step by step what to expect. Alicia went with me because they encourage you to bring someone that will be helping in your care. They are all about patients having a "coach" that will help them to do what they need to do to have a successful recovery. I got a great handbook that has all the information as well. I really had only one complaint about the whole class, and that was that it would have been nice to have gone to it a few weeks earlier, just to be able to have known some things in advance. I did talk to the women running the class and she agreed, but I also did tell her that I did some research online so I knew about some of the things that I would be dealing with before and after.
I also had been given a list of stuff I would need to do before surgery from the doctor. I am talking about different tests and lab work, that kind of stuff. Did you know you need to get a clearance from your dentist to have surgery? I found this so odd. But then the nurse from the doctor's office explained it to me when she called, as well as a friend in my bunco group who is a dental hygienist. They told me that since this is a surgery involving a joint replacement they have to be sure I have no infections of any type. Your mouth is a big bacteria, germ and infection carrier. So to keep any infections to possibly travel to your new joint, this is something that needs to be checked before surgery. Other tests included blood work to check all kinds of different counts, an EKG, urinalysis, chest x-rays, and I'm sure a few others I can't remember. The week before surgery and up until surgery you cannot take any aspirin, vitamins, fish oil or anything along those lines, only prescribed medications. Plus you also have to wash with a specific anti bacterial soap. I did run into some glitches with getting some of my tests done, but completed them and now have two days to go.
5 Days and Counting 718/14
It's been a long time coming, at least I think it has been. I started having knee issues when I was in high school. I remember my dad taking me to the doctor to have my knee drained, the old "water on the knee." The doctor poked me with a syringe needle and pulled out this blob of gel. It was the weirdest thing. And just the beginning of many visits to a knee doctor. Through the years and up to date I have had four surgeries on my left knee and one on my right. The left one for reasons you can guess is the one that gives me pretty much all of my problems. I have had 3 cortisone shots, countless doses of ibuprofen, ice packs, and prescribed pain relievers. At one time I even got weekly shots of a medicine called Supartz which basically is a joint fluid therapy. It was a shot I got directly into my knee to help with pain and swelling and overall just masking the problem. They worked for a while, everything worked for a while. I have no cartilage left in my knee and I am pretty much sick of trying to work around it. My knee doctor continued to tell me every time I saw him for a new Vicodin prescription that I was too young for a knee replacement. It has been years that I have been asking him to just get it over with and give me a new one. Yet he continued to say no. Finally in April when I saw him, I think he just wanted to shut me up, he told me he was going to send me to see another Orthopedic Surgeon. He said if Dr Wilmink thinks you should have a replacement then you should have it done, because he is one of the best and he'll take care of it.
So on May 15th I had an appointment to see him. I took the MRI I had had done in March from my previous doctor with me and was ready to beg for a new knee. Dr Wilmink came in, we talked about what was going on and why I was there. He looked at my MRI and said I was a perfect candidate for a knee replacement, my left knee is bone on bone. He then sent me down the hall to have an x-ray which shows some different details to what the MRI shows. The medical term for all that's going on in there is Osteoarthritis. I have no cartilage and my knee cap is crooked as a result. I started to say I wanted to be able to rehab my knee and continue to be active and not wait til I was 65 etc etc and he was like, I completely agree. I barely got to plead my case. We talked a little more about everything that was entailed with a knee replacement and the procedure that he uses and how it works etc. And to be honest I kind of forget what else he was saying cause all I wanted to do was give him a hug cause he was going to give me a new knee. I left the office with some paperwork of everything I needed if I decided that this was the route I was going to take. I really just wanted to say, "I'm in, what date can he do it?" But in all the paperwork it explained what I needed to do to proceed as far as getting different tests done, authorizations, blood work etc. Within a couple of days I got a call from Dr Wilmink's office verifying that I was going to have the surgery and then I started making appointments to get it all going.
Here is an article I found about my doctor and the procedure that he uses for knee replacement surgery. It's really interesting.
Dr. Michael Wilmink, an Arizona Orthopedics Associates surgeon, said Baby Boomers and others with weak knees are seeking knee replacement surgery to maintain an active lifestyle.
"My patients want to run and tee off at the golf course for the next 15 years," Wilmink said. "Things have changed and people want replacements now."
Wilmink and the other doctors at their new hospital, Oasis on Van Buren and 40th streets, have adopted a new type of knee replacement surgery: the Signature Knee.
The Signature Knee technology still uses the same metal-on-metal replacement joint, but it customizes the procedure to the patient's bone structure.
"We're not making a replacement for the bell curve of average measurements," Wilmink said. "We're doing personal, accurate replacements that match."
With the Signature Knee technology, an orthopedic surgeon looks at a patient's MRI or CT scan digitally. Then with the assistance of an engineer, the two detail a precise measure of each bone cut and the best angles to drill into the femur and tibia in order to secure a replacement joint.
These plans then go to a mold manufacturer in Belgium, where a laser model of the knee joint and the placeholder for drill holes is created.
The mold must be used within about six months because a patient's knee joint may shift or wear down further.
The Signature Knee advertises a more accurate surgery, shorter surgery time, less blood loss and less chance of infection.
So here it is 5 days before the date my surgery is scheduled for, which is next Wednesday, July 23rd at 7:00 am. I am still at the point where I am really excited to get it done. I am sure on Tuesday I will be freaking out, and then on Thursday be wondering why I did it. LOL
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