Post Surgery Week 6: Sometimes All You Need Is a Good Slap Upside the Head

Saturday, June 29

We live on one of the best blocks in the entire city of Denver, notwithstanding the occasional rowdy party crowds (who actually live a block over).  Since Ed and I moved here four years ago, we’ve gotten to know nearly everyone up and down the street.  Our street isn’t quite a dead end, but since there is a park at the north end of the block, it essentially functions as a cul de sac.  The traffic we get is mostly pedestrians, runners, dog walkers, parents (and grandparents) taking their kids to the park - or students and teachers walking the couple of blocks up to DU.

Our street is undergoing lots of changes this year.  That’s been one of the odd constants here:  with so many rentals, there is a steady rate of turnover.  But this year has been even more than normal.  A couple of our long-standing neighbors have reached retirement age, and chosen to move to greener - or flatter - pastures.

Our neighbors directly across the street have been wonderful neighbors.  Because they’re pretty private people, I’ll just call them Mr. and Mrs. N (for “Neighbor”;  I don’t think we’ve ever even learned their surname).  They told us a while back that when Mr. N retired, that they wanted to move to the Pacific Northwest so that they could have a more robust gardening environment.  Their yard, like ours, is all xeriscape and/or low water, native plants.  They’ve been longing to have the lushness you can only get with more rainfall.

A month or so ago, we heard, from other neighbors down the street, that Mr. and Mrs. N were moving.  They both usually spent a good deal of time out working in their yard, but they simply disappeared.  Our conversations were pretty much always casual conversations about plants, and neighbors, and a neighbor who had outdoor cats that wreaked havoc on the local bird population.  Although we invited Mr. and Mrs. N to our parties, they always politely thanked us, but never showed up.  When they disappeared from the block, we were concerned, but uncertain of what to do.  Had they moved and not said good-bye?  Would they welcome a knock on the door just to make sure things were alright?  Reading and watching too many murder mysteries got my overactive imagination cooking, but Ed always talked me out of my fantastical worries.  When we saw their car leave the garage and return again a few times in the past week, we were at least a little relieved.

Yesterday morning, I saw Mrs. N out working in their yard, and decided to take things into my own hands.  I crutched my way across the street, and started a conversation that completely changed my outlook on my woes.

It turns out that, over time, Mr. N has had both of his knees replaced, and both of his hips replaced.  And yes, Mr. N retired earlier this year, and they went to Washington and bought their retirement home in Olympia.  They were set to move in two weeks, but then Mr. N started having pain in one of his prosthetic hips.  It took a while before the problem was identified, and then it was bad:  he had an infection in the artificial hip.  This meant having yet another surgery to replace the prosthetic with a temporary antibiotic implant.  He now has IV antibiotics three times a day, and has to wait until the infection clears, and until the latest surgery heals, and then will require yet another surgery to implant his new and improved artificial hip.  The move is delayed by months and months and months;  they are working on getting a tenant for their brand-new (to them) Washington house for the short term.  Just when they were getting set to follow their dream, life got put on serious - and painful - hold.

It turns out that Mr. N’s surgeon is also my surgeon - Dr. Miner, which also means that his PA is Heather.  Mrs. N and I exchanged glowing remarks on how wonderful Heather is, and how you feel better just having her in your court (and how those butterflies just fly every time she opens her mouth).  Mrs. N also told me that Dr. Miner did the surgery on Mr. N’s hip on Father’s Day, just because it was that critical to get it done quickly.

When I told Mrs. N about my setbacks, and the pain, and the frustration, she just nodded, and said that Mr. N has gone through all of that - and not to worry, it does get better.  They love and trust Dr. Miner and his team.  And even with all the problems, they believe in the process and in the caretakers.  “You will be so happy that you had this done” said Mrs. N.  And in the face of all Mr. N’s problems, who am I to complain?

Later in the afternoon, I was preparing to go sit on our front porch with a book, and to soak in some of the warmth that has finally descended on Colorado.  I almost forgot my water bottle, and turned around to pick it up off the counter.  My leg ached a little, and - for a very brief moment - I wondered why.  Just a moment.  Just one little moment, and I had forgotten all about the surgery and the incision and my lack of mobility and the slow healing and the setbacks and the frustrations.  It was one glorious little moment.  Then I remembered that I have a bionic knee, and I took it - and the book and the water bottle - outside to sit on the front porch and enjoy the late afternoon warmth of a Colorado summer day.

Post Surgery Week 6: Living on Borrowed Goods

Friday, June 28

Doug's Walker

Back when I first told people I had knee replacement surgery scheduled, friends started coming out of the woodwork with medical equipment to lend me.  Lucky for me, too, since all of this stuff is expensive.  

First came a walker, courtesy of Doug, who has had his knee replaced - twice.  Ed picked up the walker from Doug.  And crutches.  And an ice machine.  We stored them in the garage while I awaited the fateful date of surgery.

Denise's Walker, with brand new tennis-ball feet

On the same day that these things appeared, my friend Denise, who broke her ankle in our early October 2017 blizzard, brought over her walker.  Denise’s walker had also seen double duty, since she used it first when she was recovering from the surgery to put pins/plates into her broken ankle, and then again a year later when she had surgery to have the metal removed.  She also had a scooter ready to lend me, but that just doesn’t work for a knee replacement, so it didn’t make the cut.  What did make the cut were the two new tennis balls that are designed specifically to go on the walker feet to keep the metal from scratching hard surfaces.  Denise had worn through her original tennis balls, and thoughtfully brought along a brand new package to adorn her walker.

My friends Dianne and Tom also had lots and lots of stuff to drop off, a day or two before surgery.  Tom had his knee replaced in January, and I think he was happy to be rid of all the equipment.  They arrived bearing scads of “gifts”:  another set of crutches, a toilet seat raiser, a cane, a grabber-thingy (the gadget that allows you to pick up stuff without having to bend to the floor), and - wait for it - walker number three!  When I tried to gracefully decline the walker (who needs three walkers anyway?), Dianne was there to demonstrate what a Cadillac of a walker it was, complete with a seat and a storage pocket and super-duper brakes.  How could I pass that up?

Tom and Dianne's Cadillac Walker

When I got home from the hospital, Doug was back with more stuff:  a soft wedge to elevate my leg, and a contraption that would allow us to set up the wedge in our bed.  The wedge itself was a Godsend during all those weeks when I needed to keep my knee 18 inches above my heart;  we never did set up the contraption on our bed since I spent most of my true sleeping time on the sofa anyway.

I had thought that three walkers was, well, overkill, but oddly enough, it turned out that three was just the right number.  Doug’s walker went upstairs, where we have more carpet than hardwood.  Denise’s walker - with the new blue tennis balls - stayed downstairs where the floors are almost all hardwoods (that scratch way too easily, but don’t get me started on that, or we’ll be here all day).  And Dianne’s walker, the Cadillac?  Well, it was the perfect thing for when we took those walks outside in the early weeks.  Without question we would run into neighbors, and would stop to chat.  The seat on that walker saved me over and over again.  When I quit using it to walk down the street, I would take it out on the front porch and use it for my foot rest:  the brakes made it perfectly adjustable.  It truly is a Cadillac.

A few weeks ago, when things were looking up and I was walking without any aid (except for the cane that I used mostly to make sure people gave me some space, and maybe for a bit of balance), Ed suggested that we start to return the borrowed goods.  Certainly, he argued (and reasonably so), we don’t need all these walkers and all this other equipment sitting around.  My superstition told me - wisely, it turns out - that it might invite trouble to give all the stuff back so early.

And so it’s happened over the last couple of weeks: I’ve gone backwards.  Doug’s walker is by my bed at night now (again), since my stability has suffered with the inflamed soft tissues.  I use it to help steady me when pain wakes me up in the middle of the night, and I get up to walk around and go in search of another ice pack.  Orders from PA and PT this week were that I need to use crutches, even for short walks outside;  good thing that they are still right here, next to the door.  The cane is still my go-to weapon of choice when we make short car trips.  The wedge is on the floor near the couch, ready to come back into service should it be needed - otherwise the sofa pillows are serving well to allow me to elevate my knee some.  That ice machine?  Still in use, almost 24x7.

There’s an old saying “don’t look a gift horse in the mouth”.  It’s an admonition that one shouldn’t question the value of gifts.  In this case, the “gifts” are all loaners, and I think the advice is just plain wrong.  I’m so very lucky to have friends who have helped out by loaning me all this stuff.  I’ll feel oh so very much luckier when I can finally return it all to its rightful owners.

Post Surgery Week 6: The Scorpion and the Frog

Thursday, June 27

There’s an old fable about a scorpion and a frog.  The scorpion asks the frog to give him a ride across the river.  The frog is suspicious, and afraid that the scorpion will sting him.  But the scorpion makes an argument that seems reasonable, saying, “if I sting you, we would both die”, so the frog agrees.  Halfway across the river, the scorpion stings the frog, dooming them both.  The frog asks the scorpion, “why did you do that, for surely, now we will both die?”  The scorpion answers, “I couldn’t help it, it is in my nature”.

What is not in my nature is the latest advice from Lindsey, the PT, yesterday, which was this:  do nothing.  Do nothing?  Do nothing!  Do nothing?  It’s just not - NOT - in my nature.

When I saw Heather on Monday, she acknowledged, “some people like this recovery period, since they love to just sit in front of the TV”.  Somebody kill me now.  I can binge watch stuff with the best of them, but just mindless hours in front of the tube make me crazy.  In fact, I am so weary of binge watching the stuff I’m binge watching (The Great British Baking Show, Outlander, Victoria, Castle, Mash, and heaven knows how many bad movies with just a few gems thrown in), I couldn’t force myself to watch the debates last night.

Many years ago, a New Yorker author mentioned, in a piece in the Talk of the Town, the somewhat idyllic idea of wishing to go to prison so that he could catch up on his reading.  That was followed up a couple of years ago by a similar cartoon.  https://condenaststore.com/featured/new-yorker-march-13th-2017-lars-kenseth.html

I’ve often thought that it would be perfect to have an excuse to do nothing but catch up on my reading, but after five full weeks, I’m starting to wonder how great that whole thought was anyway.  I’ve finished six books, started yet another, and have dabbled in a few more, and still have a stack in front of me.  Good Lord.  Can’t I just take a walk between chapters?  Well, according to all my medical experts the answer is:  no.

I’ve spent much of the last several years dreaming about retirement:  the ability to sleep in, spend my days doing whatever I want, reading, watching movies in the middle of the day - in the middle of the week!  But those dreams of retirement also include activity!  Running, travel, hikes, skiing, gardening, birding, boating:  you name it, there’s little I don’t want to do.  But after five full weeks on my backside (courtesy, at least financially, of the wonderful short term disability insurance I’m blessed with), I’m ready to be done with this pretend retirement.  It’s not so much that I’m longing to work again, I’m just longing to do ANYthing that is not nothing.

Ah well, you'll have to excuse me:  it’s time to close this post.  I really, really must get back to doing nothing.  Even if it’s not in my nature.

Post Surgery Week 5: Monday Morning Meltdown

Monday, June 24

Yesterday’s Sunday New York Times crossword had a single word clue for 85-Across:  Fortitude.  

This should have been easy for me.  I’ve always thought of myself as someone with plenty of fortitude; as someone who is something of a stud.  After all, I ran 66 marathons!  One of those marathons was a 50-miler, with the first 15 miles or so on the Appalachian Trail which is, for anyone who hasn't experienced it, a bear to hike let alone to run.  Years ago, I broke my thumb skiing and stayed on the slopes until the bitter end of the day.  Years after that, I broke a rib or two skiing on a Saturday, and still skied again on Sunday.  This was a couple of months before my first Boston Marathon, and (if you’re catching the theme), I still managed to train for and run that 26.2 miler.  I got a stress fracture in my foot in one marathon and still finished.  In another trail race - my Kentucky marathon - I did a serious face plant somewhere around mile 14, breaking my nose and leaving a trail of blood a mile long, and still finished the race.  One time, I wasn’t feeling so great going into the Boston Marathon, but I still finished it.  It wasn’t until the next day that I was diagnosed with appendicitis and had to have emergency surgery.  I was the stud of the ER.

I’ve survived major bike wrecks and some minor car wrecks and a wrecked marriage and a bunch of crappy jobs before I found the right career.  I’ve survived more surgeries than I can count, and broken bones up the wazoo.  I've suffered from personal losses (too many to count) and failures, bad decisions and bad luck.  I've always found a way to get through them.

This is not to say I have not had joys in my life - way, way too many to mention here - so many loved ones and so many wonderful experiences and so many special people and places and times.  But those are not the things that make up fortitude.

And I thought I had it.  Fortitude.  But nothing I tried fit the space in the puzzle.  Strength?  Too long.  Stamina?  Ditto.  Grit?  Too short.  I struggled.

It was not a good day, yesterday, anyway;  I spent the weekend backsliding and experiencing major pain.  Again.  It started in earnest Saturday afternoon - just like the week before - and got just as intense just as quickly.  I cried.  I swore.  I swore more.  Ed helped me get around, but good heavens:  it’s one of the most helpless feelings in the world to not be able to stand up by yourself.  Especially when you think you’re a stud.

Sunday morning, the pain woke me up at 4 a.m.  I fought it until 4:30, and got up and walked around a little - something that has helped in the past.  This time, I was barely able to limp around, and I thought that it was smart that I have not returned the walkers I’ve borrowed to their owners, since it felt that the way things were going, I’d be using one again at any moment.  By 5 a.m., I decided to take all of my morning meds, even though it was four hours ahead of schedule.  I threw in an extra Valium for good measure.  At least that way I was able to sleep, even though it meant I was a groggy mess when I finally woke up several hours later.  And all that just meant that when the pain returned later in the afternoon, I was already at my max on the most helpful of the meds, and pretty much had no recourse.  (I walked across the street to ask our new neighbor, who is an anesthesiologist, if I could take more meloxicam than I already had.  His answer:  no.  So much for free medical advice.)

So by the time I got up and showered and got ready to go see Lindsey this morning, I was pretty much a basket case.  I yelled at Ed, who was only trying to help, and made him sad, and then I sat down and sobbed.  I’d become so scared of any movement, and how much pain it would bring, but mostly I was afraid that my knee, my leg, was totally screwed up.  I wanted more than anything in the world to go back five weeks and change my life.  I’ve been thinking:  how much do I need to ski anyway?  Do I really need to go for those big hikes?  Could I live a life without being the active person I once was?  Those thoughts terrify me.

Ed got me to my appointment just on time, and when Lindsey said, “how are you doing?” I just started to cry again.  That’s when she said:  it’s time for you to see the doctor - I’m calling them right now to get you in.

Dr. Miner has two PAs, Jason and Heather, and I’ve seen them both in the past.  Both are good.  This morning, the person I drew was Heather, and how perfect was that?  Heather exudes happiness and optimism and butterflies and pretty flowers and everything that is good in the world.  There is a happy rainbow over her head.  She was the perfect person for where I was when I walked into that office.

And she gets it:  how hard this is for someone who is usually active.  She worked on my knee, bending it this way and that; she took x-rays; she reviewed my activities and meds.  She assured us that my implant is healing perfectly, and showed us in detail on the x-rays.  Her overall assessment:  all the pain is in the soft tissue which is, in her words, “pissed off”.  There are no magic solutions, no silver bullets, but there are things we can change up.  Stop the drugs that don’t seem to be helping (especially the narcotic Tramadol, since its major side effect is depression), change up some others (since I’ve had luck with Aleve in the past, I’ll try that instead of the meloxicam).  If the CBD oil is helping:  great.  If I want to see my chiropractor who does the laser stuff:  great.  No need to elevate my knee any longer since the swelling is minimal.  I can back off on the icing.  I can start massaging the scar and working on minimizing it.  I can massage my quads.  In fact, she encouraged me to get a good gentle massage.  She gave me permission to walk farther than I have been - with the caveat that I need to go back to crutches in order to do that.  

And best of all, she said, “if it makes you feel better, have a glass of wine!”  Ed made her repeat that about seven times;  I was ready to take her on her word the first time she said it.

By the time I walked out of the appointment with Heather, I felt some hope again.  I felt a tiny bit of optimism.  I felt a tiny bit of my fortitude (or is it “spine”, which fits into 85-Across quite nicely) return.

Post Surgery Week 5: Patience Is a Virtue

Friday, June 21

Patience is a virtue…..and one that I am sorely lacking.

I was absolutely certain that by the end of Week 4, I would be in fine mettle, eager to get back to the routines of life:  work, increasing exercise, and, well, imbibing whatever food and drink that I normally do.

But life has a way of playing to your weakness, and the setback that I suffered this past week is just the latest of the Jokester’s tricks.  I’m working on taking the setback in stride (although Lindsey and company will barely allow me any strides), but it’s a challenge.  Today’s clouds and rain help a bit.  After all, I can pretend that it’s just one of those rainy days I look forward to in order to slow down, read a book, watch a movie, and enjoy life in the slow lane for a few hours.  Never mind that everything I do right now is in the slow lane….

This morning after I got dressed, Ed looked at how my shorts were hanging on my body and said, “you’re losing weight”.  Well, yeah, and how weird is that?  I’m burning exactly zero calories;  you can’t count the tiny amount of PT that I do right now as true exercise.  I *do* work up a sweat on a regular basis, but that’s brought on by doing my morning ablutions:  PT, shower, reload the ice machine, make coffee and toast half a bagel, and prepare my morning meds.  All of that leaves me so exhausted that I need serious couch time to recover.  If I have reason to walk up and down the stairs in the same five minutes:  that’s a workout.

Morning Cocktail (and this is the reduced drugs version!)

But that morning cocktail of drugs is killing my appetite, and I find myself eating a fraction of my regular diet.  And more to the point is the fact that I’m missing my alcohol!  I’ve been dry since a day before surgery, which is a much longer stretch than I expected, but then again, I never expected to be on narcotics nearly this long.  A friend whispered in my ear that a little glass of wine wouldn’t hurt, but it seems to me that I’m already loading up my liver and kidneys with a bunch of toxins, and why take a chance?  Besides, I also fear that the drugs would probably screw up my taste buds, and who wants to ruin the taste of a nice glass of wine or a nice Scotch?

All of that doesn’t stop me from dreaming of what my first drink will be once I get shed of the worst of these drugs.  Our friend Rick mentioned the other day that he has a bottle of Prosecco chilling for just the occasion.  That sounds yummy.  And there’s some good dark beer that’s been in our fridge far too long:  it’s just shouting to be consumed.  And, oh, I keep hearing Dr. Betts - the anesthesiologist who told me, on the morning of surgery, to think of his drug cocktail as my morning margarita - oh, what I wouldn’t give for a good marg, and soon!  And there’s always my old standby:  red wine.  I practically owe it to my local wine shop to start there.  After all, I worry that my long abstinence may be causing them existential problems.

Ah, dreams.  For now, it’s time to pour my new favorite drink:  Whole Foods grapefruit flavored Italian soda.  Why don’t you join me in a Friday afternoon drink?  Cheers!

Post Surgery Week 4: The Doldrums

Wednesday, June 19

Time passes slowly while you’re flat on your back, waiting for the pain to pass so you can get back to the business of recovery.  I read a little, check the news for new Trump-isms, look at Facebook in the hopes that somebody posts something interesting, text with a few friends, and binge watch some Great British Baking.  My knee is elevated, and iced must of the time, and now I’ve added a heating pad to try to relax my IT band.  I’m learning to take great care before I move my leg, in an effort to minimize the number of stabs I have to withstand in a day.

Not much has changed since Monday.  The stabbing pains are less frequent (see above:  learning how to move to avoid them), but no less severe.  I’m loopy and shaky from the increased dosage of meds.  I had another PT session with Lindsey this morning, and it turned into just another massage session with a recommendation that I go see the doc, and that means I’m in another holding pattern waiting for them to call back to schedule the visit.  Lindsey didn’t allow me to put any activities back into my schedule, but she thought that maybe taping my knee would help stabilize it, so I’ve got that look going for me now, too.

The good news is that my IT Band pain has lessened, at least a little.  Who knows why:  it could be the PT massages, or it could be the increased pain meds, or it could be the heating pad, or it could be the CBD salve.  Whatever.  I’ll take it.  Not perfect yet, but “a little better” sure beats going backwards.

And the other good news:  I’ve had two of the best sleep nights since surgery.  Is this due to the CBD?  After all, our budtender (how funny to write that word!) said that even without psychoactive effects of THC, that the CBD would help have a calming effect.  If that’s actually the cause, I’ll take two containers of the stuff next time we go to the dispensary!  I’m already sorry that I won’t be able to travel out of state with the stuff.

In the meantime, I get my jollies by communing with the birds in our yard.  This summer we have a pair of House Wrens with a nest in our front ash tree.  The male sits outside the bird house (a hollowed out gourd that our friend Deb made for us) and perches on the same branch and sings his heart out.  I walk out there and stand in my stocking feet, wearing a fleece even when it’s in the 80s, carrying a cane, and talk to the birds.  “Do you have babies yet?” I ask, and he just sings some more.  Every once in a while the bird sitting on the nest will peek out of the gourd.  Blue Jays will loudly announce their arrival, and I’ll encourage them to help themselves to peanuts that we put on a tray for them.  I yell at the squirrels, and coo at the Mourning Doves.  I can only imagine that people walking down the street - and we get a lot of pedestrians, because of our closeness to DU plus the fact that there is a park at the end of our block - think I’m a crazy lady.  What the heck.  Life could be worse.

Post Surgery Week 4 - Finding Joy Under House Arrest

Monday, June 17

My pain in the knee had improved only slightly by this morning, no doubt due to the massive amounts of drugs I’ve started imbibing again.  I started the day tired, depressed, a bit surly, and in a fair amount of pain.  I was scared witless of going to PT, since I was certain it was going to hurt like hell.

But Lindsey listened to my story of woe, and then spent pretty much the entire appointment time massaging my IT Band.  Her theory was that because it’s extremely tight (and it has been for decades), it’s causing the sharp pain.  But, really, she admitted that she wasn’t quite sure - and if things don’t improve in a couple of days, I should go see the surgeon.  My knee behaved itself while she did the massaging, but when I leaned over to slip on my shoe, it stabbed me again and I thought I was going to pass out.  So much for the massage helping.

The net-net of the appointment was that I was essentially placed under house arrest.  All the progress that I’ve made in the past three plus weeks?   Gone in a poof.  No more walks to the corner and back.  No more stationary bike.  No more reciprocal stair climbing.  All of the PT exercises?  Stopped, except for the two she feels are essential.  Twice a week PT appointments are now thrice a week again.  The allowable?  Keeping my knee and ankle elevated while flat on my back on the couch, icing my knee, and keeping a heating pad on my IT Band.

The whole thing left me feeling helpless, and yet, I had a couple of ideas that I thought might be worth giving a try.  The first is a low power laser treatment that my chiropractor has done on my knee in the past, and that has always helped reduce inflammation.  How could it hurt to try it on the IT Band?  And the second is the thing that people have been whispering in my ear - shouting in my ear, really - for months:  CBD oil.  I proposed these to Lindsey.  She found no fault with either option, but told me to not do anything without Dr. Miner’s approval.

So I called his office and waited for the next few hours for someone to call me back.  I’ve noted before that one of the things I highly value in this medical practice is that they *always* call back on the same day.  As the afternoon hours whiled away, and I binge watched more of the Great British Baking Show, I started to fear that this might be the one time without a callback.

It was unfounded fear:  Jason, one of Dr. Miner’s PAs, called.  We talked about the pain, and he theorized that I have popliteal tendonitis.  It is not entirely common after total knee replacement, but the symptoms of extreme pain make it the likely culprit.  He increased the dosage of my anti-inflammatory med.  I asked:  how about laser?  Jason:  let’s wait on that.  I asked:  CBD oil?  Jason:  I’m good with it.

That’s how Ed and I found ourselves in a pot shop for the first time since marijuana became legal in Colorado, getting educated about the various forms of CBD oil.  Something about doing something new - and violating that house arrest - made it a fun experience.  And a hopeful one.  We celebrated our purchase by stopping at our favorite ice cream joint on the way home.  We hadn’t even broken into the (non-high-inducing) CBD salve, and already we had the munchies!

Then, as if that wasn’t enough joy for the universe to give us in one day (really, it would have been quite enough for me, any hope is still hope), Ed’s sister Janice called.  You could hear the smile in her voice, all the way from Bar Harbor, Maine.  “I have news!” she said, and in the moment, I knew.  Our niece Nikki just gave birth a few hours ago to our newest grand-nephew, and everyone is happy, healthy, and glowing.  This brings the number of great-nephews and nieces that Ed and I share to an even ten.  Another baby to hold; another rugrat to play with on holidays;  another reason to get this knee healed so I can get down on the floor with them all.

Oh - and then my email sounded, and I looked:  our friend Tom just sent me a pdf of the latest book he has written.  I read the first chapter a few months ago and provided input, and had been eager to get the full thing.  Now I have something new to break up my TV-binging.  Who said house arrest is a bad thing?

Post Surgery - Week 4 and Dark Days

Sunday, June 16

It’s been another round of tough days here in Lake Woe-Be-Me.

Thursday promised to be a better day:  between feeling a wee bit better, I had my first big outing post-surgery.  Ed, who works in the film business, also has ties to the local theatre scene, and a friend of his had written a play that is in production at a local theatre.  The tickets were bought long before we knew how long this recovery would take, and I was determined to make it work.  It felt weird to take car drive longer than a mile, which is the distance to all my health care providers:  the hospital where I had surgery, the surgeon’s offices, and - most importantly these days - the PT practice.  I felt like I was seeing an entirely new world!

The play was good - very thought-provoking, some good laughs, and lots to talk about afterwards.  Ed had called the theatre ahead of time and moved our seats to an aisle location so I could stretch my leg when I needed to, so it all worked out well.  We were home and headed to bed by ten p.m., and I was looking forward to - needing desperately - a good night of sleep at long last.

Our neighbors had other ideas.

We live a couple of blocks from the University of Denver, and as a result, our residential neighborhood is very mixed.  We (mostly) like that:  we get a nice cross-section of young families, young couples or roomies just starting out who rent houses here, empty-nesters, professionals who have the McMansions that have sprung up between the bungalows, the confirmed bachelor at the end of the block who has been here for forty years or more.  We also get a fair number of college students who are renters.

For the most part, the renters are decent and respectful.  But there are always exceptions to that rule, and for the last year, the problem house has been directly across the alley from ours.  These young folks held a hum-dinger of a party Thursday night that was just getting started at ten p.m., and only got louder through 2 a.m. and beyond.  Over the years, we’ve pretty much learned that calling the police with noise complaints is a waste of time:   the police always tell us that they have to come out for us to swear out a complaint, and even when we agree, they are always (ALWAYS!) no-shows.  (When we call back to find out the status of their arrival, they are always handling “higher priority calls”.)  That means that we are essentially SOL when there is a loud party.

This week, it meant another sleepless night for me.  Between knee pain and general discomfort and loud noises, it just wasn’t happening for me.  

Friday morning was yet another outpatient PT experience, and I walked in feeling like a zombie.  It was frustrating to have gone a few degrees backwards on my flexion, but really, I was too tired and too depressed to care much.  The good news was that I had some stationary bike time, and a lesson in how to walk downstairs reciprocally - in other words, somewhat like a normal person, just with a cane.  Lindsey gave me permission to do this once a day at home, and that was a day brightener.  We reviewed all of my PT exercises, did a bit of tweaking (Lindsey:  “these are non-negotiable!” and “do these if you feel like doing a bit more”).  Finally, Friday night came and I (finally) slept through much of the night.  It was glorious.

Until late Saturday afternoon.  I was elevating and icing on the couch, as usual, and turned my knee just ever so slightly, and the world turned upside down.  SO MUCH FREAKING PAIN!  This was the kind of pain that I had prior to surgery - the very thing that made me decide to go through with it - and that I had hoped I would never have again in my life.  There was just no making it better.  It continued through the evening and night - just the slightest movement of my knee could set it off.  It was back to barely sleeping:  I was trying to protect against moving my knee in the way that set off the knife-stabbing pains, and I never really slept deeply.

By this morning, I was pretty much done in.  Ed helped me get out of bed, and I still screamed.  He helped me get settled on the couch, and when I got up the first time, I still screamed.  I sat on the couch and sobbed until I was out of breath.  Ed brought me a plateful of meds - all the stuff I had been cutting back on, now I’ve taken maximum dosages of each again, and am getting a bit loopy as a result.  Ed’s helping me keep on a schedule of ice for 20 minutes, then get up and move about for a little while, then back to ice.  As long as he moves my leg for me, I don’t have to bend it much to stand up, and that helps.

I’ve been reading all the literature I can find about post-surgery pain:  all the stuff my surgeon provided, plus everything the great internets has to offer.  The pain thing seems to vary greatly, and to last anywhere up to 4 to 6 weeks post-surgery, with most people getting relief after 3-4 weeks.  It appears that I’m not falling into that lucky 3-week group.  The only thing I can figure out to do is to keep doing all of the above:  ice and elevate, move when I can (especially with Ed’s help - thank heavens he is able to stay home with me all day today), take as much pain meds as I can tolerate.

It’s easy to understand how animals in pain just chew off their offending joint.  If things don’t get better soon, I may resort to that strategy.

Post Surgery: End of Week 3 and Good Riddance!

Thursday, June 13

Here it is, the end of week 3, and, oh, week 3?  Don’t let the door hit you in the ass on the way out.

This was a hard one.  In fact, for the last few days, I’ve been hearing Bob Dylan singing:

And it’s a hard, and it’s a hard, it’s a hard, and it’s a hard

And it’s a hard rain’s a-gonna fall

The first couple of weeks were hard, too, but at least there were mileposts along the way.  Getting the surgery done.  Walking for the first time on my new bionic knee.  Getting the first hospital PT done.  Getting out of the hospital and home to my own comforts, albeit a day later than planned.  Getting started with the outpatient PT, every other day.  Friends visiting, calls, and all those positive vibes.  Looking forward to that ever-so-important two-week post-surgery checkup, getting rid of the super-annoying TED stockings, replacing the waterproof wound covering with eight little steri-strips.  Getting into the routine of icing, elevating, doing the PT, getting in several short little walks every day.

But after week two, then what?  This past week has been a major downer.  It’s a hard, lonely business, this recovering business.  It feels like it’s always time for the next round of PT, and, well, parts of the PT are just freaking painful, and it’s just hard to do that multiple times a day.  I’ve been doing so well in the outpatient PT that Lindsey (remember, the Gestapo?) told me I don’t need to come three times a week any longer;  two times is fine, thank you very much.  So that’s a relief from a scheduling standpoint, but, well, jeez, that was one of my few social interactions.  I’m tired from not sleeping, and I’m tired of not sleeping.  Those Sleep Intervals (actually more like waking intervals) are wearing on me.  I’ve lost the ability to nap during the day, so I am a walking zombie.  I’m tired of being so totally dependent, even though everyone (especially Ed) has been so generous with doing stuff, bringing stuff, picking up prescriptions, offers of help.  I’m tired of being dependent on drugs, and tired of the Catch-22 of the pain meds:  you can’t really heal if you are in immense pain and if you aren’t getting proper rest, but the pain meds make it impossible to get good rest.

It’s all a bit like marathon training.  At first, you sign up for the race, and you’re excited.  Woohoo - I’m finally gonna do this thing!  And the first few weeks of the training schedule are very manageable, and you celebrate every time you run a new, longest distance.  People ask how it’s going, and by gum, you’re doing great.  Haven’t missed a workout yet, and you’re sleeping well because of all the exercise.  But then the runs get longer, and it takes longer to recover.  Sleep gets harder, because your muscles just ache.  And you have to follow the freaking run schedule every freaking day, or you won’t be ready on time.  That means running in the rain, and the cold, and the heat, and on days when you’d rather just go out for a beer after work than to go slog out another nine miles on that same old route you just ran a day ago.  The race is still a ways off, and it feels like it is going to take a monumental effort to just get to the starting line intact.  But the only way to get through it is to just get through it.  In the world of marathoning, there are no doubt countless folks who have given up because this phase is just so very tough, and have never made it to the starting line.  In the case of this new knee, there are few choices.  Either I do the PT and get through the pain and get out of this with the best bionic knee possible, or I do a half-assed job and end up with a stiff, unbending knee that never really approaches the potential.  That’s pretty much missing the starting line.

So on it goes.  Here’s to starting Week 4 with a new resolve and better attitude.  I’m going to work on getting Warren Zevon and “Poor Poor Pitiful Me” out of my head.  One of the things I’m most tired of is the fact that all of the police in my life (Ed, PT Lindsey, PA Heather) have limited my walking to what is, IMHO, a pittance.  No more than two walks a day that are hardly a block and a half long.  But Doug just stopped by to remind me that I should listen to these cops.  And Doug knows:  he had a total knee replacement five or six years ago.  He did not have the guidance I do, and he totally overdid his activities, and then had to have the same knee revised a few years later.  When he says, “Don’t Overdo It!”, he speaks with authority.  No way do I ever want to have to go through this process again.

Plus, Doug brought a book that he promises will have me laughing out loud.  If that doesn’t work, I’ll go back to binge watching the Great British Baking Show, and having a laugh whenever I tell Siri to turn on the ice machine and she responds with stuff like “Gotcha!”  And when all else fails, I’ll look at my recovering scar, and work on generating the grace to appreciate how far I’ve come in the last three weeks.

Post Surgery Week 3: Gold Star PT

Monday, June 10

Yesterday turned out to be a tough day.  I’m not sure if it was the cold weather, or the fact that perhaps staying an hour at Keith’s Coffee House for the wonderful music was too much, or if I just tried to wean myself off the Tramadol too quickly.  In any case, I felt pretty lousy most of the day, and resigned myself to the sofa with leg attached to the ice machine while binge watching multiple series on TV.

Somehow, though, the night - that I was dreading - was better.  Just a couple of Sleep Intervals.  I was already out of bed and back downstairs on the couch before midnight, but then I slept hard until 3 a.m.  Another round of icing to be safe, along with more pain meds, and I was back in bed at 3:30 and slept soundly until 8.  That’s a lousy way to get a partial night’s sleep, but it’s the best I’ve had in weeks, so I’ll take it.

But never mind all that;  today was a Gold Star day at PT.  Lindsey (no longer to be called Gestapo Lindsey after today!) put me on a stationary bike and let me pedal for five or six minutes.  Heaven!  I wasn’t sure I could make a full rotation (remember, just a week ago, I could barely get 2/3rds of the way around), but today it was pretty much easy-peasy.  I’m cleared to do 5-10 minutes of spinning a day at home now.  Yippee!

The six week goals for range of motion were set early on by Dr. Miner and team:  they want extension of zero degrees and flexion of 120 degrees.  Today, I was at (drum roll, please!) three degrees of extension and my flexion was at 125 degrees.  Hallelujah!  There’s still work to be done, but it feels wonderful to know that all this effort I put into the PT exercises at home (three times a day, every day, for thirty minutes each session, and plenty of pain in the mix) is paying off.

Still, it’s amazing how just a simple outing to go to PT can wipe me out.  Really, it’s a five minute drive from home, a couple minutes walk into the building, thirty minutes with Lindsey, and home again a few minutes later.  Just that little bit of activity has me on my back on the couch with ice on my knee, ready to go back to binge watching the British Baking Show.  I realized far, far too late that I blew the timing of my surgery:  five or six weeks later, and I could be watching the Tour de France every day!

Bonus Days: Post Surgery Week 3: Welcome to My World

Bonus Days: Post Surgery Week 3: Welcome to My World: Sunday, June 9 When I got home from the hospital, Ed and Doug rearranged our living room to make it most convenient for all my...

Post Surgery Week 3: Welcome to My World

Sunday, June 9

When I got home from the hospital, Ed and Doug rearranged our living room to make it most convenient for all my needs.  In this time of recovery, that means that my world has become reduced to a six-foot wide circle.  Most everything I need to get through the day, with just a few exceptions, is found in this span.  Take a tour with me.

Here’s the coffee table, and I find it impressive how much stuff it can hold.  There are my reading glasses (two prescription pairs, one for books, one for laptop;  there are also a couple of drug-store variety readers, too) ), and the laptop charger.  There’s my water bottle (best to keep all liquids in sealed containers after what happened with the kicking-of-the-juice experience in the hospital), and normally there’s also a coffee or tea travel mug as well.  There’s a physical therapy stretchy band.  You’ll see that there’s a small pharmacy of drugs, along with a pill cutter that the last nurse I had in the hospital deeded to us.  You might notice the package of pitted prunes:  directly related to all those meds.  ‘Nuff said.  Plenty of remotes for the TV and stereo and fireplace (and yes, it’s June, but it’s also Colorado, and between the fact that it’s only 53 degrees outside today and I spend a bunch of my time with ice surrounding much of my left leg, I’m always cold).

There are piles of books and magazines.  I haven’t yet had time to file away the books I’ve finished here on the couch.  Those include “Old Man on a Bicycle” (wouldn’t recommend it), “The Storm on Our Shores” (a book about the battle for Attu during WWII by Mark Obmascik, one of my favorite authors, who just happens to be local and just happened to write “The Big Year” and just happens to also be a birder), “The Feather Thief” (oh Good Lord, this book pissed me off royally), and “Come Rain or Come Shine” (the latest in my reading of the Jan Karon Father Tim books).  I have next possibilities stacked up, also:  too many to mention.  There are New Yorkers I’m working to catch up on, and a Yoga magazine that was a gift and is definitely necessary but I just haven’t gotten around to exploring it yet.

There’s a pair of binoculars;  who doesn’t keep a pair at their side at all times?  Sadly, the view from my couch doesn’t afford me a wide variety of birds, as the feeders are all in the wrong position from here.  There are place mats (we eat many of our meals here) and, of course, serviettes (we may be barbarians when it comes to where we eat, but at least we’re semi-civilized about it).  There’s a get well card (with chickadees on it, what else?) and a few pieces of mail and catalogs hidden in the stacks of books and magazines.

There’s also a single harmonica in its case;  the rest of my set and all my harmonica music is in a pouch under the coffee table.  Lest you think this too pretentious, keep in mind that I just started harmonica lessons at the beginning of the year and I’m still struggling to play clean, clear single notes.  Ed has progressed far more rapidly than I have, and is bending notes reliably while my attempts to bend sound like sick squirrels.  Also under the coffee table:  my laptop is normally stored here, alongside the cardboard scratching pad that Tookie (my faithful 11-year old kitty) likes to tear up.  Tookie likes to bring me his brush (that’s the purple thing that we call “the purple hand of love”), so it’s here, too.  Seriously:  this cat picks up the brush upstairs and carries it all the way down here (meowing all the way) and drops it at my feet when he’s determined to get brushed.

On the other side of the couch - just barely within my reach - is the ice machine.  We borrowed this from Doug, which was a good deal for us and generous on his part, but it’s been a challenge.  It sprang a leak after a day or two, hence the fact that it now sits in a plastic tub as a preventive measure.  Ed and Andrew fixed the cause of the leak, and it worked like a champ for the next two days.  Ed even got a smart plug, hooked it into our smart speaker so I could tell Siri to turn on the ice machine, which she would graciously do, and then she would automatically turn it off after twenty minutes.  That was a sweet advance until, after just another day, the power pack on the thing died.  Ed’s at Best Buy right now working on getting a replacement power pack.  In the meantime, in the photo you’ll also see one of the old-fashioned ice packs that we cycle through the freezer.  There’s a flour sack dish towel also hanging on the back of the couch:  used to protect my leg from frostbite when I don’t have on long pants.  The photos don't show well some of the most critical of my necessities:  the wedge to elevate my knee, all my pillows, and the fleece blanket that is my constant companion.

What else?  Oh, well duh!  There's my iPhone, but it's always in my pocket or in my hand.  How else can I keep up with NY Times crossword puzzles?  Pretty much the only necessity missing from my reach is the bowl of chocolates.  That’s okay:  it’s a great motivator for me to get up and move outside of my circle.  But for all that, there’s very little I need that I can’t reach from the center of my world.

Post Surgery Week 3: Dr. Jekyll and Mr. Hyde

Saturday, June 8

The last couple of days have been, if I may be so bold, pretty darn awesome.  No more TED stockings, no more walker, a little reduction in my meds, and a few other freedoms like being able to increase the length of my multiple-times-daily walks.  These are good things, all to be celebrated.

But combined with the good stuff is a dark and ugly side of my knee replacement saga:  the emergence of Dr. Jekyll and Mr. Hyde in the form of one bionic knee.

Now, Dr. Jekyll hangs around most of the day. He’s a pretty well-behaved knee, although he gets a bit cranky from time to time.  I keep him elevated and iced, stretched and strengthened, walked on and rested, medicated as directed:  in other words, all the things I have been prescribed to do.  I’m even at the point where I am able to drop my daytime dosage of my narcotic pain reliever.  Dr. Jekyll is the guy who gets gold stars at PT and at doctor appointments.

But Mr. Hyde?  Oh, he is one bad character!  He starts coming out in the evening hours, and by the time I crawl into bed, he’s taken full control of that &^%$# left leg.  Somehow he finds a way to ignore any and all pain relievers.  He wakes me up incessantly.  Well, actually, more to the point:  he doesn’t let me sleep at all.  There is no position that I can get into for more than say ten seconds that doesn’t end up hurting like hell.  This is the stuff that keeps me awake from two a.m. until six a.m. when exhaustion finally wins over pain for control of my body - but then it’s only a short-term victory.

Heather, the PA, was sympathetic when I saw her Thursday, but she also said this is a pattern that’s not going away in the next day or two.  She says that the pain is largely because of how much things stiffen and tighten up when I’m not up and moving, so her suggestion is to intentionally set timers to wake up in the night and to move as much as possible.

So now I’m working on what I’m calling Interval Sleeping, since it seems a bit like the intervals that my coach Benji Durden used to assign when I was marathon training.  I go to bed at 10 or 11, and pain wakes me up by 1 or 1:30.  I grab my trusty down pillow, go downstairs to the couch where the wedge that I use to elevate my leg is set up, turn on the ice machine, and settle in.  I fall asleep.  But then I have to wake up to take the ice off - too many warnings about frostbite suffered by people who sleep with the ice on too long - and pretty soon I’m massively uncomfortable again.  So I go upstairs and get an hour or so of sleep on the bed, until the pain wakes me up again.  Downstairs I go, pillow, wedge, ice machine.  I’ve been adjusting my pain meds so I have an extra dose available to me in the middle of the night, but I’m not sure that’s doing much good.  Sometimes I think that just taking a shot of whisky or tequila might be the better solution.

I’m praying that Mr. Hyde will (sometime soon!) recede into his dark and nasty shadows, and I can get in some nice LSDs (in running: long slow distance, in sleeping:  long slow dreams) instead of those exhausting Sleep Intervals.