Monthly Archives: July 2014

Pottering On

Standard

Having written about unexpected loss a couple of days ago, I’d quite like my life back, and I am now a step closer to that on the mobility front anyway. The knee is extraordinarily painful. It is swollen to half the size of the other leg again from thigh to foot and bruised all over in purples and yellows – Cadbury purple and Coleman’s mustard yellow! From last year’s experience of the hips that will gradually change to Kermit green 😀 I was told a knee was more painful than hip replacements and it is true for the exercises certainly. Very much a cruel to be kind few minutes every hour where I work on pushing my new metal kneecap as far back as possible ( if I’d done this with my old arthritic knee it would have locked!) and try lifting my leg from my knee, which I have finally been able to do since yesterday, and also push and push painfully a centimetre at a time to get a 90 degree bend each time. I’m taking a massive amount of pain relief, even more than pre op, so I just want to sleep all the time |-) On the positive side though, I don’t know if it is because I have already been through this with the 2 hip replacements so recently, or whether I am just used to compensating for a rubbish knee, my ability to move around and manage things is much better than with the hips. There I had so many restrictions on movement because they could dislocate. This time the aim is to sit with my feet up with ice packs to get the swelling down so I am able to get the knee through the hourly exercise regime. It’ s a tough life lying here watching others work 😉 

Work wise I haven’t done a thing. I did feel guilty when I got home but have to try to remember I had major surgery less than a week ago. The major thing I learned last year, going back to work at 6 days post op each time, is online – just because you can, doesn’t mean you should. I’m planning to get back into things gently from tomorrow.

I’m getting into a routine with my husband home just now to help me – I certainly would be struggling to manage alone while still on 2 crutches. We get up and I do some exercises for my knee while he and my sone make breakfast. We go and rest it up with ice packs until coffee time when he leaves it to brew while he helps me in and out of the shower. My mother in law sent down the plastic covering she used for showering when she broke her leg, but actually it stops me washing the rest of my leg and it is only the dressing I need to keep dry, so cling film works just as well with a quick shower. I managed to wash my hair yesterday too.

I’m so exhausted by 6:00pm though I can hardly eat or keep my eyes open. I realised this afternoon I’m going to have to have an afternoon nap and, while I didn’t want to get up from it yesterday, I did feel a lot better and managed to stay awake long enough to watch a film with my husband before bed. I also find that the relaxation eases my back, which in turn eases my knee.

My dressing is yucky, but the hospital prefer you not to change it. It is not oozing anything like it was, but from the outside it looks a pretty disgusting colour. I also think it is contributing to me not being able to bend my knee as much as I need to.

However, the weather is lovely and I’ve been able to spend time outside this weekend lying on a lounger with my book – though mostly in the shade because it is so hot in the sun. I think the increasing tan on my legs may also be a bit of a giveaway that I haven’t been wearing my stockings when I go for my post op check! Summer

 

Unexpected Loss

Standard

I no longer have severe arthritis in my new metal joints! Having got used to something it has gone. 30 years of increasingly having my knee as an issue, in an hour and a half – and after a few months of recovery – it is a new knee. What a very strange feeling.

I wrote recently about the feeling of loss when you find you have a chronic condition – the life that you thought you would have is suddenly taken away. The future looks bleaker and you think of all the things you wish you had done while you still had the chance.

For years I have struggled, or groaned, or cut trips short and my husband and family have said ‘is your knee a problem?’. We decided we couldn’t go to Italy because we didn’t know if I could walk to visit anywhere.

… and it’s gone. I no longer have severe arthritis in either of my hips or my left knee. Ok – I still have arthritis – in my right knee, my spine, my shoulders and elbows, my feet and hands – but the bony spurs in my knee and hips have been cleaned out, the space where once just a short time ago bone was rubbing on bone is now filled with metal and new fluid. 

Admittedly it’s a bit tricky to consider just now while I am still sore and struggling with mobility post op. I have to say though, for all those people who say that having a knee done is worse than a hip, I’m not entirely sure I agree – it is just different and there are different pros and cons to each. Initially it was much more painful than my second hip, but probably not my first – I remember crying with pain then too in exactly the same time frame. While with my hips I had lots of restrictions to prevent me dislocating, I can’t dislocate this so mobility is considerably easier. It may be because I am used to compensating for my rubbish knee but I can bend and twist and reach for things, making managing afterwards much better. 

I’m afraid the stockings are off. It is so warm and they are full length and incredibly uncomfortable. I do feel incredibly guilty. I am exercises and wiggling my ankles like mad. It’s unlikely I would get a DVT. I’m taking my anti coagulants and I only have to take them for 2 weeks as opposed to the 6 weeks expected for a hip – does the say that the knee is not so bad or difficult perhaps? I’m probably moving more than I would on a normal work day. Besides, there is no evidence that the things actually make a difference and I truly believe that insisting on them day and night over a summer for 6 weeks constitutes a form of torture. So they’re abandoned and sitting dolefully on my bedroom floor only to be put back on for physio and my post op appointment and my husband has strict instructions not to give me away. The exercises start again every time I get the slightest twinge in my left calf!

I also have a tummy upset. This is NOT fun.

I’m managing the pain with Tramadol and Diclofenac and ice packs and getting out and enjoying the sunshine. Just looking forward now to our holiday in a few weeks in, as my brother in law puts it – nice flat accessible Devon! – and great choice for someone with arthritis and a new joint 😀 climbing-128

 

 

Home again, Home again, Jiggidy Jig

Standard

I can go home.

I got myself comfortable last night. The physio doesn’t like it much. I found I could adjust the bed to lift my legs and produce the sort of astronaut position I use regularly at home to ease my spine. The last thing the physios want really is for me to be sitting or lying with knees bent because I have to be able to straighten my knee, but they appreciate the knee is not the only issue and I have promised to concentrate especially on the knee flattening exercises. I adjusted the bed to lie flat with my knees bent, took my pain relief and didn’t call the staff again all night – taking myself to the loo once. One of the most tricky bits of getting in and out of bed is doing it with a leg that doesn’t want to bend. The best way I have found to take control of this for myself is to hook my right toes under my left ankle. Then I have complete control over how far my knee moves and the speed at which I do it.

I spent the morning knitting and reading. I still feel pretty nauseous, but I’m not risking my chances of going home. The exercises went well and I reached – just about – the elusive 90 degree bend with some effort. I’m taking the yoga principle of move a bit, relax into the stretch then go a bit further. It takes some time to get the bend, but I guess it will come with time.

I knew I was going to be able to leave about 2:00 and my husband and son were off grocery shopping this morning. I gradually moved around packing my bag and getting myself washed and dressed, ate some lunch (and wished I hadn’t), saw occupational health, had my dressing changed again – the huge amount of bleeding and weeping I have forgotten to mention over the past couple of days is gradually reducing – and went through discharge with Alison, the nurse of particular note this year.

Nurses have not changed over the years. Just in these few days I have met the one who talks about her own stuff to another nurse over you as though you are not there while they make the bed around you, those who talk about themselves anyway and pay little heed to you, those who are bright and chirpy and call you ‘love’ and ‘sweetheart’ with condescension and ooze insincerity – and are usually considerably younger and as yet learned nothing about really being with and listening to their patients. There was one I took to actively avoiding, I was so uncomfortable with him! Nurses really should be made to do counselling and listening skills courses as part of their training. And those like Alison who are older, professional, know what they are doing, listen, understand and do what they can to solve the problems – what nurses should be but are few and far between.

Anyway, 2:00pm and time to go – I couldn’t get out of there fast enough. I had been really well looked after but there is no place like home! house_small

 

The Turning Point

Standard

I was a pain last night to the poor nurse on duty. She really had her patience tested with me. Every 2 hours I pushed my bell and asked for a bedpan and pain relief. At 10:00 two of them came and dosed me up with absolutely everything on my chart including my Tramadol IM again. It let me doze for a couple of hours until midnight when I was off again. There was nothing else they could give me, so the nurse got the doctor up to write up something else. Oromorph and the turning point. This was where finally we got the pain under some sort of control and 2 hourly pain relief following through the night kept it there.

Today was a very different day – and as I found last time, this is often the case. When you have a bad day, and you will, tomorrow will be completely different. The things you can do also increase and improve every day.

My surgeon came and said that my knee had been really bad. The knee cap apparently was the worst bit – there was nothing there – and the cavity behind was pretty much empty. Not surprising it had been so painful for so long – although compared to the pain yesterday I would still have gone back to that if I’d had a choice. The pain I still have is aggravated by my spine, which seems more apparent now. I can feel the nerve jolts and twitches from my back and trough my left hip and down the inside of my leg through my knee to my foot. When I can relax some of this is eased fortunately.

Today I was able to do some of my exercises, though I am a little alarmed not to be able to lift my own leg, but I bent my knee to about 80 degrees. I have to reach 90 degrees to be ‘released’. I can straighten my knee and push my knee cap back – something that would have locked just a few days ago. I had a wheelchair to the stairs but went up and down with little problem, other than an overly long dressing gown, and then walked back with 2 crutches to my room. No walker for me! I spent the whole day up to bedtime in my chair knitting and reading, taking myself to the loo as necessary. This was what I was doing when the nurse who had been driven dotty by me last night came on duty and saw me – a completely different me to the one she had met last night.

I do feel incredibly sick though. The nausea is preventing me from wanting to eat. I’d liked the idea of chocolate – being world chocolate day – but when I husband bought it for me I couldn’t eat any. He also bought a packet of mints, which were much more welcome to take the awful metallic taste from my mouth. Whether this is the morphine, which they fortunately have kept up pretty regularly, or something else is concerned I am not sure. This afternoon and evening’s nurse lives on a canal boat, which gave my husband plenty to chat about when he came in this evening. I even managed to sit up and watch some television – Coast Australia – before taking myself off to bed.

The Pain Day

Standard

I had a comfortable night. I was looked after by the lovebird nurse who had looked after me the first night after my first hip last year. Hourly observations and a drip running kept me awake a great deal with dozing between. I was gradually aware of feeling returning to my legs and feet, but I had a good dose of diamorphine and then morphine inside me. Trying to use a bedpan in bed with numb everything is quite an experience.

Enjoy it while you can! As the feeling returned so did the pain – and it really hurts – not helped by the pain in my back and being in the same position in the bed for such a long time. By the time my husband came to see me late morning I was sobbing with pain. One of the nurses came past and came to see what was up. She told me that even if I had been told there was nothing else I could have, there was always something they could pull out of the bag – this time it was a full dose of Tramadol IM to get a bigger impact. It did take the edge off, until the physio arrived. Getting out of bed was something I really wanted to do as invariably being up and moving and doing the exercises does relieve some of the tension and consequently the pain, but had me sobbing again as the pain darted through my leg and new joint when I put weight on it. I managed to move to the chair, but this is certainly far from fun, and quite a shock to the system after the spinal.

My surgeon came round and assured me that the x rays I’d had taken this morning were good and show everything to be in the correct place. Apparently, other than the joint he has realigned my knee to its correct position. The bandages coming off 24 hours post op gave some indication as to why it was so painful – my leg is so swollen, my thigh and calf could be played like a drum if it were not so sore, with the skin stretched and shiny around them and pulled so tight that there can hardly be any give left.

My husband and son came back to see me in the evening. I was concerned about my son seeing me like this but he was so caring and thoughtful, coming and taking my shoulder as I cried and telling me he was there for me – absolute evidence to me that those having autism have no empathy is a ridiculous myth concocted by people who have not paid enough attention. My husband stroked my head and arm until I was sleepy and pain relief took the edge off again before they left.

If I could cut my own leg off just now I would – although as the nurse pointed out, the stump would just hurt instead.

A very very bad day 😦 

Cyber upgrade 3

Standard

Well today was the day – again. I’ve felt pretty sick all weekend wondering if I was doing the right thing and considering backing out. A sort of settling for better the devil you know situation. I’ve put up with this dodgy knee on and off for 30 years now. Trouble is, if I chicken out I’ll regret it and end up with weeks to wait again. Now we’re finally here I might as well just get on with it. I have been noticing increasing problems over the past few weeks after all and it certainly restricts everything I do. Though sometimes it is tempting to give in, retire to a wheelchair permanently and forget the whole thing. But this is THE knee – the one that everything else has been leading up to – everything else was basically foundation for this.

I woke just before 6:00 and my husband went down to make hot chocolate for us both and bought it back to bed. I really couldn’t face breakfast, although by the time they were downstairs making toast I certainly could. Too late though! I got in the shower and packed my bag while they ate. I spent the morning working as it gave me something to occupy my mind. The 2 hours away I started with suddenly turned into half an hour and a risk of being late. Silly photographs in the garden of my husband and son to take with me on my i pad – the cat vanished this year – and big hugs and off we went to the hospital for 12:00. I was seen one at a time by the usual suspects – admissions nurse, surgeon, physio, anaesthetist – he wants to do a spinal with sedation; I want to know nothing about this at all! The spinal is a little iffy with my newly diagnosed spine problems, but we’ll see when he reads through the notes. Nice gown and paper knickers and a walk to theatre with my husband, who gives me a hug before I walk away.

The trolley is still in theatre so I sit on a stool while the anaesthetist puts in a venflon and we talk. He did his medical training in Newcastle. When the trolley comes in I sit on the side and he elects to do a spinal – he puts it in above the problem area and it is no problem this time. I feel my right leg go warm but not the one being operated on, so we spend some time waiting with periodic testing with cold spray to check. The sedation stings going into my venflon and is very slow to work. The clock in front of me says 3:00pm. 

I woke up in theatre. I was behind a green sheet and I could hear my surgeon talking about his wife although I can’t recall what he said. He lifted my leg up for me to see – quite bizarre as I knew it was my leg but couldn’t feel it. It was wrapped in bandages, everything was cleared away and I was taken off to recovery. What is it about recovery that every time you just want to close your eyes they wake you up again! 😀 I was feeling pretty good, although with a dose of diamorphine in a spinal that’s not entirely surprising.

I got back to the ward about 6:00pm and dozed until my husband and son came to see me. They were surprised to see me looking so bright and cheerful – the difference between a spinal and sedation and a general anaesthetic – I’d even had tea and a sandwich.

Here we go again!

 

Knee rly there!

Standard

Oh dear – a terrible title 😦

Three days to go. I had blood taken this morning. That always makes it more real! It shows you are having too much done when it is the same phlebotomist every time and, not only does he recognise me, again, but remembers that incident last time when I left his room without a sticky plaster and bled down the corridor.

I’m having days where I think ‘what’s the point’ and other days where I can barely touch my knee, never mind get comfortable, and think ‘well it can’t be any worse’. Of course for the first few weeks that’s exactly what it will be!

I’m just at the point where I can walk up (though not always down) the stairs with alternate legs, although I admit there’s still quite a bit of leverage on the banister rail, and can get onto my right side in bed and sometimes fall asleep there, though not my left. It’ll be on my back again from Monday. Just as well I’ve had a year of that now and I’m used to it, but I also have pillows under my knees to help my back, and I won’t be doing that with a knee kept straight.

I’m not sure what to wear either. Thank goodness it is summer again or I could be getting very cold. I’m reading that people are not able to tolerate jeans against their scar for a very long time and even a skirt brushing it can be sore, so a long summer in shorts I think. Not a pretty sight!

I had wanted to get my legs tanned pre op to compensate for the long surgical stockings for the rest of the summer, but it’s rainy and going to stay that way all weekend I believe, so the tan I have is all that I will have, unless I ignore my surgeon and leave the stockings off. There’s a reasonable chance of that. I’m reading that there is little evidence to say they help with reducing DVT, especially as I will also be on anti coagulants for weeks, but they do apparently, and I can see this, help to reduce swelling and therefore presumably pain. I have 3 ice packs at the ready to help there too.

The rest of the weekend will be spent planning what to take with me again. Not much has changed from last time, though the laptop may go with me this time with DVDs. Having said that, if it is with me there is the temptation to work since I will be able to receive and send e mail and get on with my seriously tedious essay – must do something about that! I really should take the opportunity to rest, read non work books and do my knitting! Last weekend I started to put together the hippy blanket – 38 squares. I think just a bit bigger – 49 for a square or 48 perhaps if I make it rectangular. Oh decisions decisions! 🙂 It’s quite bright though – reds, purples and had green with some coloured mix wool in there too. I don’t think my husband is impressed 😀 But it is certainly Hippy!! 

 

rainbow-heart