Surgery:Eight Weeks Post Op

I was off to great start on my recovery from partial knee replacement surgery on July 9.  I used a walker for a day, and a cane for two days.  I was walking well within a week, taking 4X daily walks around the block, and in 12 days I was back at the Y.  Then things began to really slow down.

I was down to taking Norco 10 (vicadin and Tylenol) just a few times a day.  One reason for not wanting to take it was the drowsy, spacy feeling I had while on it.  I still needed mostly for night, as I simply could not get to sleep without it, and when I would wake up at 3am, the Norco would get me back to sleep.  The nighttime pain was the worse, and week after week when I thought it would improve, it didn't.

I went for my four week check up and Dr. Bugbee told me I was doing well.  When I complained that I still had pain, couldn't sleep and was tired most of the time, he told me to reduce my exercise and to remember what my body had been through.  I immediately cut back to five days at the Y, none of them terribly strenuous, although I was always tired after working out.  I would take a nice walk once a week with Fran that felt good, so I continued that.  The weeks rolled by.  I was definitely doing more, could walk faster, only iced when I felt like it (2X a day), had good flexibility, but tiredness and night pain continued. I decided it was time to call the doctor.

At exactly eight weeks, I called the doctor and told his wonderful nurse my story.  I still couldn't sleep, had night pain and was tired much of the time.  She told me everything was normal.  I have to be patient!  So that's what I'm trying to be.  I am taking Aleve now in the morning, and again at night if necessary.  I am off the Norco (five days now), so I'm not quite as tired, and the Aleve works great.  I was told by the nurse that at 12 weeks I should feel MUCH better. I hope so, as I know the long term effects of Aleve are not good.

I will report back to you again at 12 weeks and tell you how I feel.  Oh, how I'm looking forward to a good night's sleep.  I know everyone recovers differently, but I have heard from many knee replacement patients that three months is the beginning of feeling great.  I was with a woman who had her knee replaced six years ago.  She recalled that the recovery was very difficult, but after so many years couldn't give me any details.  She, like most people I talk to, are happy to have had the surgery, after all is said and done.  I hope I'll be saying that soon.

Surgery: 28 Days Post Op

As I write this, it's been a month since my partial knee replacement.  Tomorrow I go for my one month check up, but prior to hearing what the doctor has to say, I will tell you what I have to say about the first month with my new knee.

Some days are better than others.  I started out like gangbusters.  I was back at the Y in 10 days, off most of my meds in about the same amount of time, and from the looks of my knee, things were healing up nicely.  It was about the third week post op that I noticed I was not progressing as quickly as I thought I would.  In my effort to get off the pain meds in order to drive, play bridge, and read books, I was in quite a lot of pain.  I resisted the pain meds, which was a bad decision.  I have now returned to taking 1/2 a Norco twice a day.  Not much, but it's enough to take the edge off.  I feel much better.  Today I actually took 1 1/2 pills, and I plan to continue to do that as necessary.  Everyone told me, "Stay ahead of the pain,"  but did I listen?  No, not like I should have.  Actually, my physical activity has improved a lot, my range of flexibility is excellent, and my endurance is good.  But I'm so tired!  I go to the Y and workout in the morning, then come home and take a nap.  I have stabs of sharp pain from time to time, which is normal.  I don't sleep well at night, despite the fact that I am tired.

Tomorrow Dr. Bugbee will set me straight.  My guess is that he will tell me to take the pain meds before the pain and not have a constant gnawing pain all the time.  He will also most likely tell me to continue my exercise, and try to get more rest.  My hope is that in the next month I will have less pain, which will mean less pain meds, and less exhaustion.

We sometimes forget what we've been through when we have any type of surgery.  Surgery is a huge stress on the body, anesthesia in one's system can take weeks to flush out, and we're just not as young as we used to be.  Again I say that everyone is different, and that the healing process varies from patient to patient.  I'm glad to have the first month behind me, and look forward to month two being the month that I see big progress.  One more report, at the end of month two.

Post Op: Day 17

Today is Jul 26, 17 days since I received my partial knee replacement.  There have been ups and downs, but fortunately no real setbacks.  Norco 10 is the pain killer that was prescribed for me.  It's a combination of Vicadin and Tylenol.  Almost from the beginning I hated taking painkillers.  It inhibits your ability to think, to follow a conversation, it makes you so sleepy.  For me, the pain was better than the feeling I got from the painkillers, so I cut them out, except for one at night to help me get to sleep.  I can't lie.  I had quite a bit of pain on many days, but at least I could drive a car and go out for lunch without falling asleep.

Scripps Home Health has been with me every step of the way.  They have been outstanding.  I have a case worker, who oversees my general health, PT, and Coumidin treatment.  Twice a week I have a nurse come to the house to check my health and take a blood sample.  Coumidin is a blood thinner which Dr. Bugbee prescribes for a month after surgery, to cut down on the possibility of blood clots.  Your blood levels are tested 2-3 times a week, and medication is modified depending upon your numbers.  I have been 2.1-2.4 which is perfect.  They want your numbers at 2.0-3.0.  Scripps Home Health also arranges for in home Pt.  My therapist is Nancie, and unfortunately Monday will be my last day with her.  She says I am free to go, get back to regular workouts (with modifications) and continue my stretching and strengthening.  As much as I've enjoyed seeing her 3x a week, I will be happy to end all the medical personnel comings and goings.

Pain.  There are times when I feel no pain (about an hour after the pain meds kick in), but for the rest of the time I feel constant "surgery pain."  It's not the pain I felt before surgery, but one I attribute to the trauma to my body.  I know that it's just a matter of time before it goes away, and my nighttime need for Norco 10 will go away too.

I never needed a walker or a cane.  Actually, I did use the cane for a few days, just to make sure I didn't get bumped.  My balance was good from the beginning, and I felt confident I would not fall.  I have been walking daily since I came home, probably the equivalent of about 4 times around the block, per day.  By the end of the day I'm tired, and Ron takes over walking Pepper.  I started back at the Y on day 10, and have been there everyday since.  I started with 5 minutes on the bicycle, adding a minute or two each day, and am now up to 18 minutes.  I can't wait to get back to my spin classes.  I do chair barre classes and aerobic and weight training with the help of a chair.  As soon as my incision is fully healed, I will get back in the pool.  Just kicking on a kickboard is great exercise.

Today I am meeting Fran at the Lumberyard for our first official Saturday morning walk since my surgery.  We are going to do a slow, very abbreviated version of what we used to do.  We plan to walk for just 20 minutes.  I will do what feels right, and will NOT overdo it.

Knee replacement has not been what I thought it would be.  I was prepared for the worst, as that seems to be what everyone told me about.  Everyone's experience is so different.  There is no NORMAL.  I hear stories everyday from the PT that surprise me.  A lady just had the surgery and it turns out she's allergic to the glue they used to close her incision.  They are going back in to redo it.  My roommate Kathy became allergic to one of the drugs she was taking and broke out in a terrible rash.  Another woman I know had extreme swelling in her knee, leg and ankle.  Oh, the things that can happen.  I consider myself very lucky to have come through this so easily (so far).  I think that my good physical condition before surgery had something to do with it.  There's no medical evidence that proves this, but I think it is true.  If you're having this, or any orthoaepedic surgery, get yourself in shape.  Your body will thank you.

Surgery: Seven Days Post Op

It is Tuesday afternoon, July 15.  It has been seven days since my partial knee replacement, and I'm doing very well.  One thing I have learned throughout this ordeal is that you can't compare yourself any other person.  Everyone heals differently and handles pain differently.  I am happy to report that most of the stories I heard before surgery did not apply to me.

Here's a brief update of my progress.  I came home on July 11.  On July 12 I put the walker away, finding it was in the way more than helping me.  I have a can that I take with me on walks for added stability, and to ward away anyone who might bump me.  When people see you coming with a cane, they take extra care to be nice.  Ron and I went to Starbucks this morning, and doors were held open for me, something that wouldn't happen without the cane.  I have kept the ice on my knee as much as possible, probably 6-7 times per day.  I always ice after PT or a long walk.  (around the block is a long walk).  I rest as often as I need to, which is pretty often.  I take a more nap and an afternoon nap (or rest), then go to sleep around 10pm.  I do find myself pretty tired, and I listen to my body and rest.  I am taking Norco 10 for pain.  It's a combination of vicadin and Tylenol, and was prescribed every 3-4 hours.  Since my goal is to get off the meds as soon as possible so I can drive, I only take Norco 10 when I really need it.  Everyone always says "Stay ahead of the pain,"  which means to keep taking the meds even if you don't have pain, because once you have it you will have difficulty getting rid of it.  I have not found this to be the case.  My last pain pill was at 10pm last night, and I plan to take another just before bed tonight.

I walk around the block several times each day, do all my PT exercises twice, and do almost everything around the house.  My philosophy is that the more I do, the faster my recovery will be.

Today I had two visitors and went out for lunch.  I was tired at 2pm and took a one hour nap.  I find my mind wandering right now as I try to write this, so I know the anesthesia and pain meds are still in my system.

If you're having a total or partial knee replacement, listen to your body.  Everyone handles pain differently.  Pain to you may not be pain to me.  Some people are on walkers for months after surgery, others just a few days or weeks.  There is no "average" amount of time your recovery will take.  I just hope that you listen to your body and do what you can.  Don't use this time to get sympathy, although a little TLC is nice.  I hope you have as positive an experience as I had.  I've got visitors for the next few days, and by Saturday I plan to be driving.  If you're on the 5 on Saturday morning, look for me.  I'll be on my way to the Y to meet friends for coffee.

Surgery: Two Days Post

It is Friday, July, 11, and I've been home for nine hours.  I feel fantastic.  I wanted to get down a few thoughts about the surgery before I forget, so here goes.

I arrived Wednesday morning at Scripps Green at 8am, check in time for 10am surgery.  Ron dropped me off, then went to breakfast with a friend, and waited for the call from the doctor saying I was in recovery.  Dr. Bugbee called Ron around 1pm telling him that all went well, and to come over to the hospital.  From  9:30am-12:45 I remember nothing.  The staff at Scripps Green were WONDERFUL.  I met the anthestheisiologst at 9:45 and he told me about the nerve block he was getting ready to administer.  I was a little worried about that shot in the groin, but he assured me I would be in la la land and feel nothing.  He was right.  I was gone in an instant, and don't remember anything until recovery and trying to read the clock.

I arrived in my room, 414B, at 1pm.  I had the most beautiful view you could imagine.  I looked out on Torrey Pines Golf Course, Pacific Ocean in the background and hang gliders everywhere.  If you have to be in a hospital, this is where you want to be. At this point, I was feeling no pain.  Ron arrived and visited with me for about 2 hours.  I finally kicked him out, telling him I couldn't follow the conversation and just wanted to sleep.  He left me alone, to try to get some rest.

It's hard to rest in a hospital.  The staff arrives like clockwork every 2-4 hours to check your vitals and see how you're feeling.  Just when you doze off, in comes a rattling cart ready to take BP, temperature and straighten out your bed.  Don't ever go to the hospital and expect to rest.  At about 5pm my roommate arrived.  Her husband, mother in law and daughter where there too.  They stayed about an hour, and then left, giving us a chance to meet one another and then rest.

My roommate was Kathy.  We had actually met about 10 days prior at our surgery education class.  A sign in sheet was going around the room, and she noticed that she and I had the same doctor on the same day, so she introduced herself.  My surgery was at 10am, hers was at 2pm.  We ended up  sharing a room, and had two wonderful days getting to know each other and sharing our post op experience together.  It turns out we have many friends in common.  Such a small world.

Kathy had a full knee replacement, and I had a partial, and there definitely is a difference in recovery.  Of course that makes perfect sense.  We were both feeling great initially, as the nerve block takes 24-48 hours to wear off.  You know the block is gone when you can lift your straight leg off the bed.  It took 36 hours for both of our blocks to wear off.  I had very little pain at this point, whereas Kathy had more significant pain.  I was ready to go home early Friday morning, and Kathy opted for another day.

PT is started on the afternoon of surgery.  At first I was simply standing with a brace on my leg (to prevent my rubbery leg from collapsing), taking a few steps, and doing a few simple leg lifts in bed.  The real PT started the next day, again consisting of warm up exercises in bed, then a brace on my leg for protection, finally walking down the hall.  Once I got going I felt great.  By the time I left on Friday morning I was walking without the brace, around the nurses station, and practicing walking up and down steps.

Kathy and I became fast friends.  Our husbands enjoyed meeting each other, and we will definitely get together soon to compare notes.  We had so many common friendships, and in just 36 hours we knew so much about each other.  It made the time go fast.  She met my visiting friends, I met hers, and our time together was one big party.

Just two things were not to our liking:  anti inflammatory injections that went right into the IV burned like hell.  Whoa.  I can feel that sting now.  Also, we wore little booties that pumped up constantly, to prevent blood clots.  Just when you felt yourself dozing off, the bootie would pump up and wake me up.  All in all, it was a wonderful hospital experience, not like I was expecting at all.  I'm home and on my way to recovery, and I'll write one more surgery blog about what comes next.  I can tell that for me, this is going to be a quick recovery.  I have to believe that all that exercise at the Y has made my recovery faster.  More later.

Cleaning Frenzy Before Surgery

It's just about 10 days before my surgery, and I seem to be on a bit of a cleaning frenzy.  This is VERY unlike me.  Housework is my least favorite activity, as I don't do it well or get much enjoyment from it.  However, in the past week or so I have started cleaning the house in nooks and crannies that haven't been touched in months.  Is this normal behavior?

I researched this a little, and found that cleaning is a stress reliever for many people.  Others I have talked to have felt the need to clean before they go in for surgery.  Expectant moms often find themselves cleaning their houses more than usual.  Also, people getting ready to go on a trip will get everything in order before they leave.  My conclusion is that cleaning to relieve stress is normal.

I started polishing all the silver trophies we have displayed in the house, from our horse racing days.  I HATE polishing silver, but feel compelled to do it (once I did the first one), and will finish that task today.  I also plan to dust my paperweight collection and crystal animals that have been gathering dust for way too long. The house should be spotless by the time Marcos and his wife, my occasional cleaning crew come on Thursday.  They will clean showers, floors and all the tasks I really hate.

So, if you come over to see me after my surgery, you'll be coming into a nice, clean house.  The carpets are clean, the house if spotless, and even Pepper has had a bath.  How long will it stay that way?  Not long, but at least it's kept me occupied for the two weeks before surgery.  I've got to keep busy!

Getting Ready For Surgery 2

The date of my surgery, July 9, is fast approaching. This coming week I have a lot of pre-op things to take care of, some surgery related and some personal. First, I have my pre-op appointments with doctors, nurses and support staff, which is scheduled over a period of four hours. A meeting with the surgical nurse and assistant surgeon will be an opportunity for me to ask all my questions. I have a list, so I don't forget anything. Then I have blood work and an EKG, in addition to financial information arrangements. They won't do any surgery on you until they're sure they're getting paid.

Another morning will be spent going to the joint replacement class. Here an orthopedic nurse will explain the entire procedure to us, with another chance to ask questions. I'll probably find out more than I want to know.

Next, I've got to collect all the things I will need after surgery: walker, cane, toilet booster, shower chair and ice packs. Thanks to Charlene, I have most of the items I need. She's got an Abbey Rents store in her garage!

Finally, although I have nurse Ron to help with ice packs, walking and general care, I felt I needed more. I was lucky to find a woman who I feel will be perfect. She is personal trainer, lives in my neighborhood, and has a very flexible schedule. She will come for several hours each day to help with my exercises, straighten up the house and do laundry, and take Pepper for a walk. I'm excited to have her available, and it will give Ron a chance to get out of the house for a few hours. Oh, the planning that goes into surgery.

I'm excited and a bit anxious, which I think is normal. My concern is how long my recovery will take. I've never been one to spend days at home, so this will be new to me. I've got lots of books to read and I've got my IPad to play with. I can play bridge on that, which should help pass the time. I'll get back to you on my blog as soon after surgery as I feel like writing.

Getting Ready For Surgery

Elective surgery is a big decision. Sometimes I think the more you know about the surgery, the less likely you are to have it. After suffering with a torn meniscus and arthritis in my left knee for over five years, and eventually finding out that I have no cartilage left in that knee, I have made the decision to get a new knee.

My pain began about five years ago. It kept me from doing many of the activities I had done before, or doing my favorite things, like walking, yoga and boogie boarding, at a less intense level. I turned over in bed one night, and it seemed that my knee went one way, and the rest of my leg went the other way. I've never been the same since. I have had two arthroscopic repairs to this knee to clean up the meniscus and arthritis, but over the past six months, my knee has deteriorated.

I have been to six orthopedic surgeons over the past five years. I decided last December I was going to have my knee replaced, so I started in earnest to find a doctor with whom I felt comfortable. I met with several and am finally scheduled for surgery with Dr. Bugbee at Scripps Green on July 9.

Next, I began asking everyone I knew who had had this surgery in the past few years about their experience. The more you ask, the more you learn, and you even get some information that you'd rather not have, like the fact that you need to take Coumadin for a month after surgery to prevent blood clots. I did not know that. Infection is also a possibility, so getting out of the hospital as soon as possible is recommended. Constipation! I never thought about that problem until it was brought to my attention. You must take Vicadin for the pain, and that can cause serious constipation, or even blockage, in some cases.

These are just a few of the things I have discovered in my quest to be ready for surgery and to have a quick recovery. Getting my house ready, and having some help are other issues that I have researched, and will write about at another time. Oh! And calling Blue Cross to understand my benefits before the surgery was very important. All that next week. Until then, I'm counting the days until July 9, and hope that shortly thereafter I will be pain free.