A Desultory Day

Just because I'm committed to writing every day, I'll tell you briefly about my activities (or rather, lack of activities) for the day. Oh, well, it's Sunday, so everyone deserves a day off, right?

Sleeping in the basement was nice last night in the sense that it was so dark and chilly, and sleeping on a nice, pillow-top mattress seemed more comfortable although I woke up feeling somewhat stiffer than usual. I also woke up feeling tired, so who knows what I did all night. Maybe I tossed and turned and didn't sleep as well as I thought I did.

The morning was comprised of the usual: breakfast, exercises, showering, resting in my bedroom, watching a bit of TV, and getting dressed. By the time that was done, I was so tired that I came downstairs and dozed for a bit before eating a few crackers and cheese. After lunchtime I was feeling decidedly washed out and lacking in energy. Stan needed to go to the grocery for dinner ingredients, so I went along with him but felt like I was about to collapse by the time we got home--not because of my knee which is doing fine, but because of the heat (which is unrelenting) and my general feeling of malaise.

I fell into the bed in the office/bedroom and slept from 1:00 until 4:00. After talking on the phone with my mother, I lay on the couch and read in a rather desultory manner until Stan fixed dinner at 6:00. Even though his sloppy joes were tasty, I could only manage a few bites--just not feeling very perky. Now, at 7:00, I'm ready for bed again.

Tomorrow must be a better day. I start out-patient physical therapy tomorrow and, although I don't know what to expect, I know I'll need more energy than I had today, so I'm going to bed, then will try to eat a breakfast that will give me enough energy to do whatever I need to do for my therapy. I'll take Percocet tomorrow for that, but have taken none since yesterday, so I'm trying hard to live "au naturel" and do without pain killers.

Well, yawn....and good night.

Lunch and Shopping

Beginning Monday, there will be more TKR-specific news because that's when I begin out-patient physical therapy. I have very little idea about what to expect from this, so we'll all be enlightened after my first session on Monday. For now, however, I will report on daily life, 18 days after TKR surgery.

Is life back to normal? No....but almost. It has been (aside from the incredible, awful heat) a lovely day. Stan and I had a normal morning: breakfast, email and web browsing, exercise. While I went upstairs to shower, do laundry, and watch TV, Stan went out in the yard to do some prep work for a short walkway he's installing. At 11:00, we left to drive to Manassas where we went to one of our favorite restaurants for an early lunch (Red, Hot, and Blue) and then we went to Kohl's to shop. You know, it's not a big deal to wander around a store, pick out a few items, try them on, and then purchase some of them. At least, it's not a big deal until you've had knee surgery and you weren't sure if you'd even be able to walk more than a few steps just 18 days later. I'm delighted to say that I did just fine, didn't get particularly tired, had a good time, and bought three cute new blouses. What a nice, normal outing! Although I feel confident I could have gone elsewhere and done more, Stan and I decided not to push our luck, so we drove home. Before I leave this topic, I'll mention that, after much internal debate, I took one Percocet before leaving home so that I would be able to walk around and enjoy the day. I wasn't in any pain or feeling particularly stiff or sore before we left, and I almost didn't take it, but in the end, I did. Would I have done just as well without the Percocet? I sort of think I would, but I don't know, of course. It's the only Percocet I'd taken in over 24 hours, the Bufferin and ibuprofen having been sufficient around the house. Just thought I'd mention this.....

After getting home and trying on my clothes, Stan persuaded me to go downstairs to the basement to take a nap. It's really cold down there which, on this miserably hot day, seemed like a very good idea, so down I went. After watching TV and then reading for about 45 minutes, I fell asleep in the nice, big, soft bed and enjoyed the feeling of snuggling under covers. What a treat in the middle of summer!

Stan has been working outside, but the heat finally drove even him inside, so now it's almost evening. It's the time of day when we start looking forward to the sun going down so that the world can start to cool off a little. Another round of exercises still to come, but that's about all that we have planned for the rest of the day. But how nice to have a normal Saturday!

Too Hot for Anything

Oh, my! Will it ever be cool again? It doesn't have a lot to do with my recovery, but I must comment again on the oppressive heat. We set a record for this date with a reading of 103 this afternoon. In a way, it does have something to do with my recovery because I would very much have enjoyed going somewhere today or I would have enjoyed taking a walk outside. With this heat, however, there's no way I'm going to go anywhere. Even in perfect health I don't do well in the heat, and feeling a little less-than-perfect, there's no way I'm going to go tromping around outside in this hot weather.

Since I started this blog with the intention of giving insights/advice about daily life after TKR surgery, I will not dwell too much on the medical aspects. I will say briefly, however, that I took it easy today because this was the first day after my stitches had been removed. My incision looks fine but I wanted to be careful not to harm it now that there are no stitches and no steri-strips to hold it together. For that reason, I did all my strengthening exercises but skipped the exercises that would have stretched my knee cap, thus endangering the incision. Because of not exercising quite so much, and because of the heat, I tried to walk a lot inside the house--around and around and around the family room to kitchen to dining room down the hall, and then all over again.

So what did I do on this 17th day since surgery? I had my bran flakes breakfast, checked email and browsed the news on the internet, then did my exercises at the urging of Coach Stan. After going upstairs for a shower and a little TV, I came back down and sort of wasted time until lunch. Stan ate an early lunch, then left to go run errands and go swimming. I ate a light lunch (the chickpea salad I made two days ago), then retired to the cool office/bedroom to read (Charles Dickens' "Sketches of Young Couples") and eventually to nap for a VERY long time. I shouldn't have slept so long because I suspect that I'll have a hard time sleeping through the night but that's what I did. Unlike the first week to 10 days after surgery when I slept off and on all day and then slept all night, I'm returning to more normal sleep patterns now. But, once school starts in three weeks, how will I ever get through a day without a nap?

The last bit of information I'll record is that I tried an experiment today--no Percocet at all. I took an ibuprofen this morning, another ibuprofen after lunch, and an Extra Strength Bufferin right before dinner. I will take another Bufferin before I go to sleep, and hopefully this will be sufficient to keep my few little aches and pains enough under control to sleep comfortably. Percocet still will have a place in my life (before physical therapy), but on a daily basis, I hope to use it little or not at all.

That's it--time to go to a cooler room and try to feel a little more refreshed. Is it autumn yet???

Good News

It seems to be unanimous--I'm doing quite well! Stan and I have just returned from my appointment with the surgeon, and he was just as enthusiastic about my progress as the physical therapist. What a relief it was to hear him confirm what the therapist has been telling me! This does not, by any means, mean that I can stop working; in fact, the opposite is true. Now begins the long haul of setting up a routine of physical therapy and exercise which will take place 3 times a week for the next month. That's a lot of visits to the PT "gym," but I'm going to try to work as hard at that as I have with the home physical therapy.

The other major accomplishment of my visit to the surgeon was the removal of the stitches. The nurse pulled out the long strings that were holding the incision together and now that they are gone, it doesn't look THAT bad! On the doctor's recommendation, we stopped at CVS on the way home and bought some silicone scar reduction sheets at the drugstore. They are expensive, and I'm not all that confident they'll really work, but I guess it's worth a try. While I'm not all that vain, I suppose I'd rather minimize the scar if possible.

So, good day, good doctor visit, good news.

Last Home Physical Therapy

As the home physical therapist told me today when he left, "The worst is over." If this was the worst, then I have to be honest and say that it really wasn't all that bad. I've read back over all the posts from the past two weeks, and it's certainly been a remarkable journey. I'll miss my home PT guy because I think he's been a very positive factor in that journey, but Stan, of course, has been the deciding factor. He keeps pushing me (every so mildly and patiently) to do a little more than I want. So here I am, for many reasons, two weeks after surgery walking around the house without a walker or cane or anything. I still use the cane to go up and down the staircase because I feel a little off-balance still, but otherwise, I feel confident walking around unassisted.

If you aren't a TKR patient (former, present, or future), the following may not mean much to you, but my final measurements at the end of today's PT session were quite significant. The extension on my knee today was 0 degrees--perfect. That means that I can hold my leg out perfectly straight with no bending at all in the knee. My Range of Motion (how much I can bend my knee) is 110 degrees which the therapist says is "fully functional." The ultimate goal is 120 degrees, but at 110, I'm able to do anything that any normal person can do, so that was encouraging. Now, after all that pushing to reach those goals, I have to admit that my knee has been kind of sore all afternoon/evening, but I'm relatively sure it will be back to normal by morning. It's definitely worth it!

As for daily life, I went upstairs twice today, showered, did laundry, rearranged some of the clothes in my closet, and generally puttered around. Once Stan and the granddaughters left to go swimming, I finished reading my latest mystery and then made a yummy chickpea salad which I subsequently ate for dinner. I only napped for about 50 minutes this afternoon, so slowly, slowly, life is getting back to normal.

Tomorrow I go for my two-week check-up with the surgeon. I will be very interested to see what he says about my progress. Will he be as positive as the therapist, or will he sternly tell me I need to work harder? I can hardly wait to hear what he has to say!

Grocery Shopping

Two weeks ago today I had TKR surgery. I didn't know what to expect or when to expect it. This time last week I was doing okay, but had experienced a couple of setbacks and was still extremely tired. So where am I today, two weeks into my recovery?

Exercising is going well. I will freely and cheerfully admit that if it weren't for Stan, I'd probably not do my exercises twice a day every day, but he is a firm taskmaster and has kept me focused every single day on working hard to get better. When I do my exercises now, yes, they still hurt to some extent, but they are progressively easier to do, and I can feel my knee bending more, flexing more, and having more strength.

Stan and I had quite an outing this morning, going to the grocery store to do a fairly substantial shopping. Yes, I walked up and down each aisle and managed to get through the whole shopping experience although, to be honest, I did go sit down while Stan checked out. Still, I was quite surprised that two weeks after my surgery I was out in the world doing more or less normal things. I did use my cane, of course, but that's fine. I don't mind using it for now, and actually see a few advantages (it's handy to move things that are on the floor or to scoot things toward me that are on a high shelf!).

After coming home, exercising, having lunch, and reading, I took a nice long nap while Stan went swimming. It's still SO hot that I'm not really tempted to go outside, but maybe someday it will get cool and it will seem to be a good idea to walk around the block--in October!!!

Coffee and No Naps

Another exciting day in TKR recovery land....well, not really, but it was a nice enough day. Aside from the usual daily routine of getting up, having breakfast, taking a shower, doing exercises, I can add only one new event--I actually drank a cup of coffee and totally enjoyed it. Maybe I'll live after all!

For a variety of reasons, I never napped this morning, and by 11:30 I was ready to eat my lunch and take my Percocet tablets to get ready for my next-to-the-last physical therapy session. Despite the pain associated with the usual awful exercises (heel slides, backwards knee bends), the session went well and, as has been the case each time, the therapist praised my efforts and progress. I certainly hope he's been telling me the truth, because I start out-patient therapy next week, and I fear it will be much more demanding than the at-home therapy has been. The new step forward with today's therapy was that the therapist told me to start trying to walk short distances with no cane. He said in another week or so, I should be walking around the house unassisted. Out in the world, I will still use a cane for a couple of weeks beyond that, but mostly, he said, for the sake of balance and stability. So that's another step in the right direction! (Pun intended!)

After spending an hour with Stan and the granddaughters (who returned from swimming just before the therapist arrived), I retired to my office bedroom while Stan took the girls home. I had intended to take a nap, but there were several phone calls, so in the end, I never took a nap. Now that's a big difference--my first day without a real nap.

I leave you today with no particular advice or updates, but it was a day that continued my steady but perhaps unremarkable progress. I can hardly wait to see my surgeon on Thursday to hear his assessment of my progress. Tomorrow will be two weeks since my surgery, and I'm already doing several things I didn't think I'd be able to do at this point. The problem is, of course, that I have no frame of reference, but then again, that's why I'm writing this--so someone else undergoing TKR will have at least a vague idea of what to expect.

Last Lovenox Shot

Yawn....lazy Sunday afternoon. It's been a good day so far, however, with nothing particular happening. After yesterday's unfortunate event, I'm happy to have a bit of boredom! The heat has relented by only a few degrees, so I'm still not at all interested in trying to walk outside which means that I have an excuse to continue my stay-at-home ways.

It's late afternoon and, for the very last time, I'm waiting for my daughter-in-law to come by to give me the final shot of Lovenox. While these shots are given with a small needle and aren't particularly bothersome, I absolutely can't imagine having to self-inject, and I'm IMMENSELY grateful to my D-I-L for doing this for me!

Just to recapitulate my day, I can report that I went upstairs, washed my hair, took a shower, did a lot of reading, and took a nice long nap this afternoon. My exercises are over for the day. I've done them twice today--17times for each exercise. As much as I dread doing these, and as much as some of them are downright painful, I can't emphasize enough how vitally important it is to do your exercises every day. Obviously the goal of all this experience is to get back to the mobility I had three or four years ago. Maybe I'll not get back to the flexibility I had when I was 45, but it would be nice to get back to the state I was in when I was 55 or so, and without exercise, it will never happen. So if you ever have TKR surgery (and of course, you and I both hope you don't!), do your exercises, not matter how tired you are and no matter how much they hurt!

That's it for the day. It's still hot, dry, and sunny. We have the chance for thunderstorms this evening, but so far, we seem to be out of luck. Oh, well....maybe tomorrow!

A Bump in the Road to Recovery

While not literally a bump in the road, there was an incident on a real road this morning that, for a few hours, made me think that I had hit a proverbial bump on the road to recovery. It was strange, temporarily upsetting, but ultimately not an issue. Curious? Here's the bizarre little chain of events.

Knowing that it was going to be another very hot day, Stan suggested that we have a short outing early this morning. We needed a few things at CVS which is not at all far from where we live, so I got dressed and, by 9:15 (early for us!), we left the house to make the short drive. We left our neighborhood, got onto U.S. 50 for the short drive to CVS, and were waiting at the traffic light to turn left into the access road leading to the drugstore. The left turn arrow came on, Stan began to turn, and then braked suddenly because another car started forward coming from the other direction (he did not have a green light, but was "jumping the gun"). As one does reflexively, I braced myself with my legs, and, well.....yes, it hurt. Stan was worried but I insisted that I was okay, so we went on into CVS, although after just a few minutes, my knee began to hurt quite a lot. I didn't want to make a big deal about it, but I did tell Stan that we needed to pay and go home, which is what we did.

Usually it's not pain that bothers me, it's the not knowing what is causing the pain that bothers me, so by the time we got home, I was a little bothered because my knee had stiffened and swelled up noticeably and I was alarmed, thinking that maybe I'd injured my knee. I asked Stan to help me ice and elevate my leg, and so stayed in that position for quite a while. My knee wasn't feeling better and I decided that I should take some Percocet, eat something to counteract the Percocet, ice and elevate again, and retire to my bed. So around noon I went to Stan's office, aka my bedroom, and read for quite a long time until I fell asleep. Most, most happily, I slept for almost 3 hours and woke up feeling just fine! Whew! That was a relief! The swelling was down, the stiffness was back to normal stiffness, my knee didn't hurt anymore, and I felt energetic.

In fact, I felt so good that I came out to the family room and announced to Stan that I wanted to do all my exercises, which I did without any noticeable ill effects. So, double whew! Crisis averted! I have to tell you, though, I was worried. I kept thinking that to have gone through all this only to be thwarted by an idiot driver would have been downright tragic. Fortunately, however, the four-pronged action of ice, elevate, rest, and Percocet seems to have saved the day.

I'm now looking forward to my shot (as soon as my daughter-in-law gets off work and swings by our house) and to Stan's quesadillas. Stan makes great cheese quesadillas which, along with salsa and chips, makes a perfect Saturday night meal, don't you think? And just to be on the safe side, I think we'll not take any drives for a couple of days!

Out in the World

Not that it has anything to do with knees or health, but I simply must mention the weather. Today the temperature here reached 105 degrees, the hottest it's ever been on any day ever here--not the highest temperature for this date ever, but the highest temperature ever. I worry quite a lot that the electricity will fail, and I cannot imagine how miserable that would be, so let's all hope that the electric grid can hold out for at least another day.

Back to the topic at hand, I must say that this has been an excellent day. Before TKR surgery, one of my persistent questions was, "When will I.....?" When will I be able to stand up? When will I be able to climb stairs? Use a cane? Take a shower? Go outside?

The question of when I would be able to go outside was answered this morning, and the answer was that it occurred much earlier than I would have imagined. At Stan's suggestion, I walked out the front door this morning, down the steps, and got into the car. Just for a bit of diversion, Stan drove us around a couple of surrounding neighborhoods. Actually, the angle at which my knee was positioned in the car became uncomfortable after about 15 minutes, so I asked to go home, but it was very nice to get out and see the world. Once we returned to the house, I walked (with my cane) about halfway down the block, then turned around and came back to the house. Had it been a nice, cool morning, I would have walked farther because it feels VERY good to walk, but it was already so hot that I was uncomfortable enough to want to return to my air conditioned home.

After a brief rest to drink a soda and check my email, I went upstairs. Before I continue, I'll just mention that every since the second day I came home, I have not been able to tolerate coffee, and I've been a big coffee drinker my whole adult life, so in lieu of coffee, I'm drinking Diet Coke for my morning caffeine fix. I hope this is a temporary anomaly and that I'll be back to my coffee drinking ways by the time school starts! Anyway, after my rest, I went upstairs to take another shower, to wash some more clothes, watch a couple of HGTV shows, and to goof off.

At 11:30 I came down and faced my daily ordeal of taking Percocet, followed immediately by a cheese sandwich for lunch. My theory is that cheese helps to protect the stomach against the side effects of the medicine. After lunch, I rested for about 45 minutes (although I didn't sleep), waiting for my physical therapist to arrive. He was a little late today, and if it hadn't been for the pain I knew he was about to inflict on me, I would have felt sorry for him. Friday traffic around here is always bad, and add to that, the heat is so enervating that he looked quite "done in." We did have a challenging PT session with him pushing my knee back and back, and that hurts, but the rest of the exercises are mostly to increase the strength in my legs, and I'm finding those exercises increasingly easy.

After my busy morning and a good workout with PT, I was ready to get into my cool bed with an ice gel-pac and my leg elevated. While I read myself to sleep, Stan left for a little time to himself going to the pool. I slept two hours, and now, finally, the day is starting to draw to a close. It will be another couple of hours before the sun goes down, but on a day like this, it's a relief to have the brutal sun exit for several hours. I'm waiting for my daughter-in-law to come give me my shot, and then she and our son will stay and we'll order something (cool!!!) for a light, take-out dinner.

Did I expect to be at this point just 10 days after surgery? Honestly, no. I thought my recuperation would be more painful, more restrictive, and much lengthier. I'm surprised that I'm doing this well, although I'm still not able to get through a day without one (or two) substantial naps. My physical therapist is excellent at pushing me, encouraging me, and setting definite goals for me. Stan is an outstanding coach who really does an exemplary job at making sure I do everything I'm supposed to do. I'm sure I would have sloughed off my exercises left to my own devices, but between my PT and Stan, I'm being gently pushed toward recovery, so thanks to both of these guys!

Almost a Normal Evening

No, I didn't write a second post last night, but mostly for good reasons. Yesterday I had just awakened from a 2-hour nap after the exertion of coming down the stairs. At that point, I took two Percocets, forced myself to eat a little lunch (ice cream and applesauce--balanced, eh?), and then waited for the physical therapist to arrive.

What can I say about physical therapy? I dread it and it's hard, but it's a real ego boost. My therapist keeps telling me that I'm doing so well that I will barely need the out-of-home physical therapy. My range of motion is good and getting better. I am not using the walker and barely need the cane except for stability, i.e. I can walk across a room on my own with no problem. I can do all the exercises he makes me do although they are, shall we say, not comfortable! As much as he praises me, however, I still dread to see him come because I know I'm in for 45 minutes of at least periodic agony.

Once my PT was over, Stan asked if he could have an hour off to go to the pool to go swimming, so I situated myself on the couch to read, but it was SO hot in the family room (south side of the house) that I moved to my temporary bedroom on the north side of the house where it was noticeably cooler. I read until Stan returned, and then read some more, but fell asleep at 3:30 and slept until 5:30. My daughter-in-law arrived at 6:00 to give me my shot, and while she was here, Stan went out to Manhattan Pizza to get himself a pizza for dinner and me a BLT sandwich for dinner. Having slept so late and having finally started feeling pretty good, Stan and I had our dinner, watched some mindless TV (Hawaii 5-0, yes, it's dumb but Stan likes it and I have no particular objection), and then we actually sat around talking, and I managed to stay awake!

So that, in my very lengthy way of explaining things, is why I didn't write a second post yesterday. I think this was the first evening when I felt almost normal. I wasn't falling over exhausted at 7:30, and I felt pretty good. It was actually 10:00 when I turned out my light last night--unbelievable! Maybe there's hope that life will return to normal before too awfully much longer.

Tune in again this afternoon or evening, and I'll tell you about today. It's going to be unbearably hot, so again, let's all hope that the electricity stays on and that our air conditioners all continue to work!

Clean at Last!

A week and two days after my surgery, I finally.....drum roll.....took a shower! In these days and times, NOBODY goes 9 days without showering, but I did out of necessity. You can sponge bathe all you want, but it can't compare to a shower. Really, it wasn't much of a problem. My incision has been dry since Sunday, but I wanted to be extra-careful and so waited until several more days had gone past before trying to shower. Even today, I wrapped my knee in plastic wrap to keep the incision and all the little pieces of "steri-strips" dry. With a shower bench and a hand-held shower wand, however, I managed just fine and felt oh, so happy to be really clean! After showering, I enjoyed an hour of leisure in my bedroom watching TV, fixing my hair, and organizing a few things. It was a pleasant morning!

The glitch in the morning came when I walked down the stairs (going up had been no particular problem). For whatever reason, I've been trying to avoid painkillers for the past 24 hours, but perhaps this is an error in judgement. Going down the stairs hurt--really, really hurt, and I was so exhausted by the effort that I collapsed on the couch and, as soon as Stan had iced down my knee, I promptly fell asleep for 2 hours. So maybe I should have taken a Percocet this morning, or at least some Tylenol. I really just don't know.

Before my surgery, I read as much as I could in a short amount of time about issues with TKR, and pain medications were right at the top of the issue list. I would amend that to say that medications that help with the swelling are a big issue, but between pain (which honestly hasn't been a big issue for me except when forcing my new knee to do something it doesn't want to do) and swelling, medication is an issue. No medication comes without side effects, and those side effects can sometimes make the benefits seem hardly worth it. This is obviously something I need to work out on my own, but if you have TKR (or any major surgery, from what I've read), you will deal with this issue.

It's the hottest day of the year, and I'm sitting here on my couch hoping that we don't have a brown-out, a black-out, or an air conditioner failure. If we can get through another couple of days, maybe the weather will moderate. That would make everyone happier!

Goodbye to the Walker

Despite my continuing battle with Percocet, I have to admit that it makes it possible for me to do everything I need to do for my physical therapy. Yes, I'm a little queasy still (almost 6 hours after taking it), but I had a very good PT session and my therapist was almost gushing about how well I was doing. I only lack 5 degrees to get to my goal of 110 degrees Range of Motion (that's how far back you can bend your knee). I was 105 degrees today so I'm almost there. I can do everything else I need to do, and feel pretty good when it's all over. My therapist told me to stop using the walker and start using a cane, so only a week and a day after surgery, I'm really navigating around the house pretty well.

It would be nice to go outside and walk up and down the sidewalk just to see the world, but this being the worst heat wave in several years, I think I'll just stay inside, thank you very much! Our daughter-in-law has just been by to give me my shot and now I'm here for a bit by myself. Stan, unfortunately, is out in the heat right now trying to help our son get his car started. It's having troubles, so they're coming over in a few minutes in order for our son to borrow my car for the rest of the week to go to work. Needless to say, I won't be driving anywhere for at least a little while!

Having had such success with the "ice and elevate" strategy last night, I'm planning on doing that tonight. Hopefully I'll wake up feeling pretty good in the morning because.......tomorrow is shower day! What a big event that will be! Stay tuned for the exciting details!

Ice and Elevate

What a difference a day makes...and a change in sleep arrangements! Here's a very good hint for you if you are going through TKR. Build a "ramp" of pillows in your bed that will keep you leg elevated above the level of your heart and that will keep your leg straight. Sleep with your leg on that ramp all night. You'd think you might toss and turn, but it was my experience that I lay perfectly still on my back all night with my leg elevated. I put a gel-pac on my knee before going to bed and once more during the night Stan came down and put a new gel-pac on my knee. Doing those two things helped my knee quite a lot. Yes, it was still stiff and swollen this morning, but it wasn't nearly as bad as yesterday. As a result, I'm feeling more optimistic this morning.

The morning is already almost over and physical therapy is looming in my near future so I'll just tell you briefly that I've had an okay morning. We had breakfast, and then I spent quite a long time on my computer before finally rousing myself to take my morning sponge bath and get dressed. Not that I wanted to, but I did my exercises, and then, once I'd "iced and elevated," Stan left to take the granddaughters swimming while I went to sleep for an hour. I really can't believe how much I'm sleeping, by the way, but I am rationalizing it by thinking that the body heals best while you're sleeping, so the more I sleep, the quicker I'll get well--at least that's what I tell myself!

I've just eaten some yogurt so that I could take my two Percocets to get ready for physical therapy. I'm not sure which I dread more--PT or taking Percocets! At any rate, both seem inevitable, so I might as well do what I have to do.

Going Forward

It's 8:00 p.m. and my bedtime, but before I go, I just want to say that I did not let today defeat me entirely. As soon as my daily shot had been given, and as soon as Stan returned from the grocery, I decided that I couldn't let the day end without doing my exercises.

Yes, I did do all the exercises, 15 times each, and having done that, Stan and I enjoyed dinner while watching "No Reservations," (taped from the Travel Channel) and then I read for a while while Stan watched a Netflix movie. In a way, it was almost a normal evening, and that's the goal, isn't it? Somehow, we need to get past this and get to normal!

Do I have advice? Yes, of course I do. Don't give up. There are going to be up days and down days, but keep on trying. There's no place to go but forward, so I'm going to bed, and I'll hope for a better day tomorrow. Tomorrow will be busy, what with taking care of the granddaughters and with having a physical therapy session, so I'll plan to have a good day!

Too Cocky

When I went to bed yesterday, I was so cocky that I figured I'd be walking more or less normally in a couple of weeks, that I was going to be the best little knee patient ever, and that all that stuff about pain and swelling didn't apply to me. I was cocky, way too cocky. Today was pay-back day.

Now before you get alarmed, I'll say that I've had a fairly productive day. I went upstairs this morning, did all my laundry myself, watched a couple of TV shows that I had recorded, repacked my little suitcase, took a sponge bath, and got dressed. Once I came downstairs, I did my exercises partially, but I have to tell you that my knee was sore and swollen this morning when I woke up, and it stayed that way all through breakfast, my expedition upstairs, and lunch. By the time I came downstairs, I was beyond exhausted, my knee hurt, and it was hot and swollen.

Stan wrapped a gel-pac around my knee, fixed a pile of pillows for me so I could elevate my leg, and then I promptly fell asleep. And I mean promptly! Stan fixed my pillows, walked over to the kitchen to fix his lunch, and I was asleep before he even finished making his sandwich. I woke up at 12:45, had some yogurt, and got myself tidied up, ready for the arrival of one of my teacher friends who was coming to visit.

As soon as my friend arrived, Stan left to go run errands and to go to the pool. I enjoyed my friend's visit, we did a little school-related work, and then she left, having been here for 45 minutes. By this time I was ready to admit defeat and went to the bathroom to take two Percocet tablets. Did I walk back to the couch? I must have because I woke up an hour and a half later when Stan returned to the house.

The Percocet has eliminated the pain, I'm only a tiny bit queasy, and the swelling is somewhat alleviated. I've definitely got a love-hate relationship with this drug. I don't like taking strong drugs, but I don't like feeling so weak either, so I guess I'll try to take just enough to keep myself going at a reasonable rate. Stan and I think I probably over-did the exercising yesterday and that all that over-stretching caused my knee to react by swelling up again. At least I hope that's all it is!

So, today has been a reasonably productive day. I did, after all, go upstairs, do laundry, and have a visitor. I just expected to make progress every day and I think I'm a little discouraged at having slipped back a little. But, after all, my knee surgery was one week ago today, and it's unreasonable to expect to be almost well again in just a week. Let's look on the bright side--I'm walking, I'm climbing stairs, I've done a little actual school work today, I'm able to take care of myself completely in terms of dressing and hygiene, so I guess I'm making reasonable progress. As soon as my daughter-in-law comes to give me my shot, however, I may consider a nap.......

On a Roll

Amazingly enough, today continued to be a very good day. We are just on a roll! Physical therapy was quite demanding, but I did all of it, and I did it 15 times! Needless to say, I was tired by the time it was over, but I never did go to sleep this afternoon, so that's also a huge milestone. I only took one nap today!

Everyone is different, but I think that, for me, the strategy will be to take two Percocet pills right before physical therapy (take them with food!!!), but not to take them any other time. Should I feel the need for any pain medication, taking regular Tylenol should be sufficient.

It was very exciting to finish all my exercises this afternoon and then to climb the stairs all the way to the second floor and back down again. Tomorrow morning I plan to go upstairs and stay a while. What excitement it will be to get my own clothes from my own closet!

Stan left me alone for an hour this afternoon so that he could go to the swimming pool and get a little exercise and have a bit of time out in the world by himself. He's done so much for me these last few days that he really needed a break from his nursing duties.

Our daughter-in-law came by after work today to give me my shot and to look at my stitches. They have been "dry" now for two days which is very good news. Being the cautious type, I'll probably still wait another day, but I'm looking forward to a real shower in the near future!

For dinner, I actually had a specific request--Subway sandwiches. Stan went to our neighborhood Subway for ham and cheese sandwiches and they were yummy! How wonderful to have "real" food! But it's been a busy day and it's 7:30--time to start getting ready for bed. I'm tired!

Best Morning Yet

My physical therapist should be here in 10 minutes, so my lovely morning is about over (no offense to physical therapists). This has definitely been the best day at home so far, and why is that? I only took one Percocet about 11:00 P.M. last night and, consequently, felt quite good this morning. So yes, I think it is the Percocet that has been causing trouble for me!

We both woke up about 8:00 and both had a bowl of cereal (still no coffee for me). I took two regular Tylenol after breakfast and then we each had a nice 30-40 minutes to check email, read the paper, etc. before starting my morning exercises. Stan really pushed me, and I have to say it hurt, but not having nausea made it much easier to get through all the exercises.

At the end of my exercises, I walked around inside the house several times, then took a very thorough sponge bath while standing at the kitchen sink, got dressed, put a cold gel pac on my knee, and collapsed onto the couch. Stan meanwhile got dressed, and we waited for our son and granddaughters to arrive.

Once they arrived, our son took his computer downstairs to work while Stan took the granddaughters to the pool, and I took a nap! The nice morning is now over, everyone has gone home, we've had lunch, and we're waiting for the physical therapist. I somehow have the feeling that the afternoon won't be quite as nice as the morning.

The Good and the Bad

The fifth day after TKR is now almost over. In many ways, it's been easier than I thought, but in several ways, it's been surprisingly hard. I think I'm making good progress with my exercises (even though my exercise sessions really hurt), I'm sleeping plenty, I'm walking better every day with my walker, and I'm getting up from a sitting position much more easily. I can truthfully say that, aside from the times when I'm exercising, I don't have much pain at all. What I do have is tightness and swelling which makes it difficult to bend my knee. Ice (in the form of gel pacs) helps a lot. If you have TKR, you want to invest in several gel pacs so that you always have a nice cool one in your freezer. The gel pacs really help with the swelling, in fact cold is the only thing that helps with the swelling.

The most significant problem I have is nausea. Whether the nausea is being caused by Percocet or by the Lovenox shots (blood thinner shots), I'm not sure, but I suspect Percocet. I may call the doctor's office tomorrow to ask if I can have some less intense pain medicine that perhaps wouldn't have these side effects. We'll see how things go tomorrow. I'll take Percocet before my in-home physical therapy tomorrow, but I will try not to take it any other time. If I have less nausea, then I'll be pretty sure it was because of the Percocet.

Other than that, however, things are going along about as well as I would or could expect. I managed to eat half a bowl of cereal for dinner and a small container of yogurt, and I managed to watch a 30-minute House Hunters International all the way through. Having had a hard time focusing and concentrating, this is a larger accomplishment than it might seem! I think I'll actually go read a bit of my mystery and see if I can follow the story line for a chapter or two!

More exciting details tomorrow! Good night!

Clean Hair

Mission accomplished--I've washed my hair. If you don't have a portable spray wand that will fit on the faucet of the deepest sink in your house (in our case, the kitchen sink), you should get one. The hair washing adventure actually went quite smoothly. Stan did have to wield the sprayer, but I was able to wash my own hair by leaning forward over the sink. So, that's done, and now on to exercises.

Before the exercises, however, I'll recap the night and the morning. Sleep is my friend. I turned out the light at 8:00 last night and slept until 7:00. That doesn't mean I slept 11 straight hours--far from it. I wake up about every 2 1/2 to 3 hours. I try to be quiet, but my thumping with the walker always wakes up Stan, so our routine is that I go to the bathroom while he prepares a new chilled, gel-pak. I get back in bed (still on the daybed in his office) and he puts the cold gel-pak on. He goes back to bed and I fall asleep quickly. Three hours later, same routine.

When I woke at 5:00 and we went through our routine, I took a Percocet and moved to the couch in the family room. I thought I might wake up for the day, but the next thing I knew, it was 7:15! Stan was still asleep upstairs, so I trundled over to the coffeemaker, got a cup of coffee, and settled down on the couch to spend some time with my computer while drinking coffee. Unfortunately, the Percocet once again worked its magic and I could drink only about half a cup of coffee. Stan woke up about that time and urged me to eat my bran cereal, which I did, but I couldn't face orange juice or yogurt or prunes or anything else. As soon as I ate my cereal, I collapsed back on the couch and fell asleep again, not waking until 11:30.

Stan cajoled me into eating lunch--half a grilled cheese, 4 potato chips, and two spoons of ice cream--and into taking another Percocet. I didn't want to take the Percocet, but figured I wouldn't be able to do all the exercises if I didn't, so I took my pill, we washed my hair, and now I'm waiting for a little while to let the medicine to take effect before starting the exercises.

I see a nap in my future....

Two Exercise Sessions

The burning issue in my life right now is when and how to wash my hair. I washed it Tuesday morning, and it's now Saturday, so the only thing I can say is...yuck! I'm going to have to manage to stand at the kitchen sink long enough tomorrow to wash my hair. This is something I realized prior to surgery would be a problem, but I didn't quite realize the challenge it would present. If you are having TKR surgery, give some thought to how you'll solve this problem. The longer and/or thicker your hair, the more of an issue this will become. I had my hair cut the Friday before my Tuesday surgery. Now I wish I'd gotten more cut off! At any rate, I'll have to ask Stan to help me a little although I'm really trying as hard as possible to do everything I possibly can by myself.

This day has been a definite improvement over yesterday. We left off this morning just as I was about to do my exercises. Stan is being a wonderful coach and is pushing me enough, but not too much. I made the mistake this morning of not taking Percocet before exercising, so the whole experience was......less than thrilling. But I did finish all my exercises, so I felt proud of myself. Stan tried to get me to eat lunch, but I just couldn't. In fact, by the time I'd finished exercising (which took almost an hour), I was so exhausted that I went back to bed and slept 2 hours. When I woke up, it was time for our son to come over to babysit me so that Stan could go out to the grocery. A little later, our daughter-in-law and the granddaughters came over so that she could change my dressing and give me my Lovenox blood thinning shot. By the way, Lovenox shots have to be given in your stomach--double, triple yuck!

As soon as the family left, Stan put me through my exercise moves again. This time I had taken Percocet, but it made my tummy feel so bad that I don't know which is worse--less pain but more nausea with Percocet or more pain but no nausea without Percocet. It's actually a tough decision.

So, I've exercised and walked my laps around the house with the walker, Stan is fixing Morningstar Tomato Basil burgers for dinner, and then I plan on an early bedtime. I'm definitely not the life of the party, so I feel sorry for Stan being stuck here waiting hand and foot on me. If you go through TKR, try to have a back up person to come in and help so that your primary caregiver gets a break.

That's enough for today, my fourth day. I suspect more of the same tomorrow, but maybe I'll have more energy--hope so!

Pack a Bag

If you recall, I said in a previous post that the nurses at the hospital had told me that the third day after TKR was the worst. So far, I would say they are right. I felt fine in the hospital (first and second day) and crummy yesterday (the third day), but I have awakened this morning feeling quite perky.

After a breakfast of Raisin Bran, orange juice, and coffee, I enjoyed an hour of watching HGTV, caught up on email, and read a little. I'm about to go get dressed for the day--as soon as my "coach," aka Stan, makes me do my exercises. Here's another hint: Before your surgery, decide where you'll be spending your days when you get home. Pack a suitcase as if you were going on a two-week trip--lots of cool, loose-fitting shirts, underwear, toiletries, and several varieties of pants--shorts, loose capri pants, loose long pants. It will be hard to impossible to get regular, close-fitting pants over your knee, so pack elastic waist, wide leg pants. I do think it's important not to spend your days in pajamas, so try to get dressed sometime during the morning. Leave the packed bag in the room you'll be using as your bedroom. Then you'll be able to get yourself dressed without sending someone to pick out your clothes for you!

I'll do my exercises, get dressed, and tell you about the rest of the day when I write this afternoon.

The Third Day

Whew! I'm totally exhausted. I still can't say I have any significant pain, but I'm very, very tired. In fact, I'm fading so fast, that I'll try to give a brief summary of the day before going to bed for good for the night.

The therapist came at 1:30 and stayed until 2:30. I think I did quite well, or at least, that's what he said. I am already able to flex my new knee to 90 degrees and, with the therapist pushing backward on my leg, to 110 degrees. That was the only part that hurt. For the rest of the exercises, I did everything I was supposed to do--leg lifts, side slides, heel slides, and various other strengthening exercises. I was also able to walk with a cane halfway up our interior stairs, and then come down again.

Once the therapist left, I was very tired. My son, daughter-in-law, and granddaughters came over at 3:15 so that my daughter-in-law could change my dressing and give me my blood thinner shot. Once she had done that, she took the girls home, leaving my son here to babysit with me while Stan went to the store to buy a few things for me. Once Stan returned, our son left, so that was about 4:30, I guess. Then, at that point, I fell asleep and slept until 6:45.

For dinner Stan fixed me a bowl of chicken noodle soup, but I couldn't eat it all. I did force myself to eat more prunes, however!! We watched the Travel Channel while eating, but now, at 8:10, I'm exhausted again, and am going to put on my pajamas and go to sleep.

The nurses at the hospital told me that the third day after knee surgery is always the hardest, and this was my third day. I'm looking forward, therefore to a much better day tomorrow!

First Morning at Home

In the hospital, I felt wonderful, but here at home....not so much. One large difference is that I'm now taking pain medication by mouth (Percocet), and I absolutely loathe it. I loathe it because it makes me feel dizzy and woozy, and it makes me feel exhausted. My solution to this problem is to take it as little as possible--just before going to bed and 30 minutes before physical therapy. This morning, because I had taken Percocet around 5:00 a.m., I got up feeling dizzy, tired, and vaguely nauseous. From 8:00-ish (when I got up) to 1:00, I lay on the couch feeling too zonked out to do anything but doze. I didn't have enough energy or focusing ability even to watch TV, and certainly not to read. It was a discouraging morning. I couldn't face eating breakfast, but around 11:00, I ate a few Club Crackers, drank a ginger ale, and ate a plum. That was so exhausting, that I fell back asleep until 12:45.

Do I have advice for the first day home? Expect to be tired, expect to have no appetite. You should have two places in your house arranged prior to going to the hospital: a place to sleep during the night, and a place to stay during the day. Have something light to eat like crackers and ginger ale. Have some method of keeping your knee iced down. We were thinking of just using ice cubes but quickly found during the night that a ziploc bag full of ice didn't stay in place and it melted quickly. Stan had one large gel-pac so I used that this morning (it needed time to get cold) and he's gone out to buy more so I can always keep something cold wrapped around my knee. Make sure you have ample clothes near where you are sleeping so you can change out of pajamas when you wake up. It just makes you feel more human to have on real clothes!

My first in-home physical therapy is this afternoon, so I'll let you know how that goes. I also get a Lovenox (blood thinner) shot this afternoon and my daughter-in-law will change the dressing on my knee in addition to giving me a shot. Fun times!

Home!

Home!! Yes, I'm home. We did spend a lot of time waiting this afternoon, but finally, around 2:00 p.m., the assisting surgeon came to my room, put me through my paces, and declared me fit to be discharged. It took two more hours before I was finally wheeled out of the hospital, but it doesn't matter now--I'm home! Before leaving the hospital, I had to climb five steps by myself, using a cane. I walked quite a long way in the hospital corridor using the walker, I dressed myself completely unassisted, and I was able to stand up from any surface (bed, toilet, easy chair, recliner, straight-back chair). Having passed all these tests, I was ready to leave.

Somehow on the trip home, one of my stitches pulled out partially, so I'm getting a fair amount of bleeding. Hint: You should ride in the back seat of your car when driving home from the hospital so that you will be able to keep your leg straight and immobile.

Our younger son, who lives nearby, came over to help get me in the house. By the time I'd gotten inside, had eaten one piece of pizza with the whole family, and had written this post, I was extremely tired. I'm going to bed now, and will explore more topics in the morning.

Waiting

A lot of the time in a hospital is spent waiting for something to happen. After a fairly good night's sleep, I was awakened this morning again at 5:00 a.m. by the lab technician who needed two more vials of my blood. While this isn't something I would have chosen to do at 5:00 a.m., I must say that the lab tech person was entirely professional and personable. We enjoyed chatting about Pennsylvania Dutch names (which I have) and town/city names in the Reading, PA area (where she used to live). It's not much of connection, but it was enough to sustain a conversation for the 6-8 minutes she was in my room.

I did doze off after she left because, with all the interruptions during the night, I was still quite sleepy. I woke up again at 6:45, ordered my breakfast (raisin bran, skim milk, fruity yogurt, toast, and two cups of coffee), ate around 7:30 and then started my waiting game, mostly waiting for my surgeon to come by. Whether or not I go home today depends entirely on him.

Here are a few observations, while waiting, that might help someone else having knee replacement surgery:

I packed too much! The day of surgery and the subsequent evening I was still in the hospital gown. Yesterday I wore a pair of shorts and tee shirt during the day and the gray/yellow pajama set with the light yellow bathrobe in the evening (put on the pajamas after the family had left). Today I stayed in the pajamas and robe until around 10:00 and then, just because I had them, I changed into my second outfit (pink shorts, lime green tee shirt). The yellow shorts/blue tee shirt from yesterday would have been perfectly fine to wear again today, however, so I would advise just bringing one outfit to wear during the day.


As for pajamas, one set would have been adequate. I guess bringing one extra set might make sense on the off-chance that you spilled something, but I definitely didn't need TWO extra sets. If you are hot-natured, bring light, sleeveless pajamas. I am hot-natured, so the little cami top I wore to bed was plenty warm enough. I was told to bring athletic (tennis) shoes, but have not used them, so I think it's probably useless to bring them. I didn't need the sock-slippers I packed since they give you a pair of socks with rubberized soles. My toiletries bag seemed about right but I packed that very lightly. You'll need toothbrush, toothpaste, deodorant, lip balm, and lotion. Aside from a comb and/or brush, you won't need anything else.

Now let's discuss the pain issue. The nurses and therapists keep asking me to assign a number to my level of pain (1 to 10, with 10 being excruciating pain), but aside from when I've done physical therapy, I can truthfully say that my pain level has hovered between 1 and 2. Yes, I can feel my knee, but it's not painful--just swollen and stiff. I took two percocets last night right before bed, although I didn't feel a particular need for them. The nurse urged me to take two more this morning before physical therapy, so I did even though I was experiencing no pain. Again today, I did feel some pain during therapy, but it was brief and entirely bearable. The only exercise that hurts is sitting on my bed trying to bend my knee so that it's hanging straight down like the other knee, at a 90 degree angle. The therapist kept pushing my leg back and it did hurt, but it was bearable.

Stan and I are waiting for lunch to be delivered, but mostly we're waiting for the surgeon. Even though I cannot say enough good things about this hospital, it is still a hospital, and I'm very eager to go home! Having said that, I'll sign off for now and let you know in a few hours whether I go or stay.

First Physical Therapy

My day is almost over. It's 6:30 and I'm just finishing up my dinner. Stan, our son, daughter-in-law, and two granddaughters have just gone down to the hospital cafeteria to have their dinner, then once we've all finished eating, they'll come back to my room to visit a little longer. I am supposedly being discharged tomorrow, which means that I'll be blogging from home this time on Thursday.

To take up where I left off, Stan and I ordered lunch and waited for the therapist to come take us to the group lunch and therapy. When we got to the JIM (Joints in Motion) room, we found nine other patients and their coaches. An orthopedic nurse talked to us about 15 minutes and then lunch arrived. The food is plain here, but quite good. I had a cheeseburger, chips, side salad, and fruit-on-the-bottom yogurt. Stan had a grilled cheese sandwich, chips, a side salad, and a piece of carrot cake. Once we had gulped down our food, therapy exercises began. Even though I'll be honest and say that some of the exercises hurt, it was entirely bearable. I was taken off the IV drip (morphine), but was given a percocet tablet right before therapy, so that also helped with the pain associated with therapy. If you are undergoing TKR, I would strongly advise you to take any pain medication that the nurses offer. I did very well in therapy and it did hurt, but without medication, I doubt I could have done any of the exercises. As it was, I could lift my leg 10 times quite easily. I could bend my knee, but this is the exercise that hurt. Stan was told to press my knee backward and he did, but it hurt. The other exercises were relatively simple: making "snow angels," doing heel slides, and completing many isometric exercises. When all of that was finished, it felt really good to stand up and walk out to the hall (using my walker, of course).

Although I wish I could have exercised more and walked more, I was taken back to my room and have been sitting in bed since 2:00. Not to be too indelicate, but suffice it to say that I can take care of all my bodily needs by myself now, so that's a relief! Stan has been with me all afternoon, of course, and we have had a pleasantly quiet, relaxing afternoon.

As soon as the family finishes their dinner, I'll send everyone home. Even though I consider that I had a good night last night, I'm pretty sleepy so I'll wish everyone (including me!) a good night's sleep.

The Morning After

Good morning! Welcome to my hospital room where I have spent my first night in the hospital. It's now the morning after my TKR and so far I'm feeling fine. I still know there's going to be pain because everyone tells me so (doctor, nurses, physical therapist), but for now I still have a nerve-block IV drip going plus I have a button to push if I want to administer any more painkiller.

At the end of last night's post, Stan and I were waiting for the therapist to come show me how to get out of bed and into the recliner. As soon as she came and got me settled in my chair, Stan said his goodbyes and left. Over the next two hours, I sat in my chair and engaged in several diverting activities: talking to the son in Florida, talking to the son who lives here, reading my latest mystery (The Square Root of Murder by Ada Madison), watching "House Hunters" on HGTV and using my Blackberry to catch up on email and to web browse. At 9:45, the aide came back to help me get back into bed and to take my vitals. I texted a couple of times with Stan, then turned out the lights.

Even though the night was punctuated with nurses taking my vitals (12:00, 2:00, and 4:00 a.m.), I slept soundly in between their visits. I was awakened shortly after 5:00 by a lab technician who drew two vials of blood and who, again, took my vitals. This might be a good time to mention that I've had VERY low blood pressure since the recovery room. My BP has been in the upper 90s over about 60. This must be due to the medication I'm taking, but it's been interesting nonetheless.

Well, there was no point in trying to go back to sleep, so I've been awake since 5:00. There have been several people in and out of my room, and I can't express strongly enough how pleasant and professional they have been. The nursing, lab, and tech staff here are wonderful! I ordered my breakfast at 6:40 and it arrived at 7:10. Unlike last night, I was hungry and ate all my breakfast: Raisin Bran, nonfat milk, fruit-on-the-bottom yogurt, a fruit cup, and a cup of black coffee. My oh my, that coffee surely did taste like the best coffee ever! I couldn't have coffee yesterday, so I was dying for a good, hot cup of coffee. Tomorrow I'll order two cups!

After breakfast, the physical therapist came and helped me through several of the daily goals which have been established for me and which are written on a big whiteboard in my room. The goals I've already accomplished for today are:
Do all my breathing exercises.
Get out of bed using my walker with minimal assistance (I needed no assistance).
Walk 40 feet using my walker ( I walked approximately 100 feet according to the therapist).
Take a sponge bath in my chair with the help of the aide.
Get dressed with help of the aide (pale yellow shorts, royal blue tee shirt).
Get in and out of bed by myself. (I can bend my knee to the 60 degree mark while sitting on the edge of my bed.)
Sit in chair and get up again by myself.
Go to the bathroom by myself (catheter removed early this morning).
Step into and out of shower by myself.
Lift my leg up and down unassisted (piece of cake!).

The occupational therapist and the physical therapist say that I'm doing so well that I don't need any other help and that I'll be discharged tomorrow. I know it's the result of the painkillers, but I can honestly say that I have no pain--a little stiffness perhaps, but that's all.

Stan and I have just placed our lunch orders from the extensive menu, and soon we'll go to the JIM (Joints in Motion) for lunch with all the other TKR patients and their coaches, and, following that, group physical therapy.

If you wonder what we're having for lunch, here's what we ordered.
Me: grilled cheeseburger, side Caesar salad, baked Lays potato chips, fruited yogurt, apple, Diet Coke
Stan: grilled cheese sandwich, garden salad with 1000 Island dressing, Baked Lays potato chips, carrot cake, unsweetened ice tea

Shall I sum up? I slept well despite interruptions, I have had no problems with any of the goals they've set for me, I have a healthy appetite, and my pain is, so far, nonexistent. I know I'll start feeling more uncomfortable soon (the PCA self-administered narcotic drip has been removed and I've been given a percocet tablet), but for now, everything is just fine.

Stayed tuned and I'll update you this evening!

Surgery Complete!

Wow-it's over! Somewhere under the dressing, the ice pack, and the knee immobilizer, I have a big incision and a new knee. Everything went as smoothly as it possibly could and I'm now in my private room. I am awfully sleepy so I'll hit the high points and, hopefully, write more when I'm less groggy.

The nursing staff here is wonderful! Diane was the initial nurse in pre-op and she explained everything to Stan and me. I had to undress completely, of course, and wipe myself all over with antibacterial towelettes. It was handy having Stan there to do my back! After getting into my hospital gown, I waited just a few minutes and then a medical technician entered my pre-op cubicle and proceeded to put IV connectors on the blood vessels in my hands-both hands. I continued to have my blood pressure checked along with my temperature. Next, the anesthetist came in. One thing I hadn't anticipated was being given the choice of a general anesthesia or an epidural (spinal) anesthesia with sedation given intravenously. After asking several questions, I selected the epidural and, so far, I'm pleased with my decision. Next the anesthesia nurse came in and gave me a femoral block to deaden my leg. After just a little more waiting, the surgeon arrived and spoke with both of us at length.

Although still severely nervous, I guess I began to calm down after speaking with the surgeon who is a very calm, serious, competent, and positive person. The end of pre-op was now in sight. Diane came back and gave me a "cocktail" of drugs by mouth. In addition to that, she put an anti-nausea patch behind my ear which will remain there for 3 days. An antibiotic drip was started, blood was taken, and it was time to say goodbye to Stan.

By this time it was almost 11:30. I remember the trip to the operating room, I was able to get from the gurney to the operating table by myself, and then-BAM-I was out like a light and remember nothing until I woke up in the recovery room. My recovery room nurse, Abigail, was delightful, kind, helpful, and very professional. She kept taking vital signs and working on my chart. My only complaint was extreme thirst, so over the next 2 hours, I chewed my way through a cup of ice, then drank a 12-ounce can of ginger ale, and tried to eat some crackers but my mouth was still so dry that I just couldn't swallow--a very weird experience. It was a jolly time there in the recovery room and several nurses commented on my alertness and good attitude.

I was moved to my private room at 4:00 and met my orthopedic nurse, Cheryl. It's 6:30 now and I've already ordered my dinner (chicken noodle soup, a bag of baked Lays potato chips, and a container of fruit-on-the bottom yogurt. I thought I was hungry but in the end, I could only eat the broth part of the soup with a few pieces of the chicken, half of the yogurt, and none of the chips. It tasted good but I just felt like I couldn't eat any more than that.

So far I've had absolutely no pain and no nausea, but I am very sleepy. Cheryl says that the physical therapist will be by soon to get me out of bed, into a chair, and back into bed. At that point, I'm sending Stan home and hope to get some sleep. Stan said he'd stay in the room with me tonight, but he needs a good night's sleep and there's really not much he can do. I won't have to get up to go to the bathroom since I was catheterized (while still anesthetized in the OR). So, we're waiting on the PT, and then I hope to call it a night.

I'm still in my hospital gown, but hope to put on something more attractive tomorrow. All in all, this has gone better than I hoped. I know there will be pain in my future but for now, there's no pain, no nausea, and I can already lift my leg. Time for my ankle pumps and my spirometer (breathing) exercises. See you tomorrow!

Up Since 4:00 a.m.

Nervous, nervous, nervous! I went to bed at 10:30 last night, read for 15 or 20 minutes, turned off the light and.....just couldn't sleep! I guess I went to sleep at some point, but woke up at 4:00, tossed and turned some, and decided I might as well get up.

As directed, I've washed my hair and scrubbed all over with Hibiclens (available in drugstores without prescription). It felt weird not to apply my usual face cream, mostly because I have such dry skin that I feel almost "crackly" without cream. Oh, well, who will notice the wrinkles? The directions in the notebook my doctor gave me also said not to use lotions, hair products, or deodorant. It's supposed to be 102 degrees today so yikes! We'd better crank up the AC in the car on the way to the hospital!

My surgery is scheduled for 11:00 and I'm supposed to be at the hospital at 9:00. We have terrific traffic to negotiate this morning, so we'll leave a little after 7:00. We'll probably get there early, but that's better than turning up late for something this important.

There's nothing more to say, is there? I hope it all turns out well, and I hope to post in a couple of days when I'm coherent again. Wish me luck!

What I Packed to Take to the Hospital

Let me start by saying that I always over-pack, but I have a horror of wearing dirty clothes—well, maybe not a horror, but I really don’t like it—and I want to have everything I think I might possibly need. As promised, I want to have a more “girly” slant to this blog instead of just talking about the medical stuff, so here’s what I’ve packed. I’ll let you know if I packed too much, not enough, or just right!

Two pairs of knee-length pajamas—boxer style bottoms and tank tops, nice soft, light jersey fabric. One pair looks like pajamas (white with little pale green anchors all over), but the other is a regular style v-neck tee shirt (solid coral—my favorite color) with coral and white abstract print knee-length pants. The coral pajamas look enough like real clothes that I think I could wear them to physical therapy, or at least wear them while doing my walking exercises in the hall.
The next three items all coordinate and look nice enough for when visitors come:
o One pair of Capri-length pajamas—nylon pants with wide, floppy legs (pale gray and yellow abstract print) and a matching cami-style top (pale gray)
o Jersey fabric nightgown that matches the Capri pajamas—could also be used as a long top for the pajama bottoms (same pale gray and yellow abstract print)
o A bathrobe, knee length, wraparound style—lightweight waffle weave fabric (solid, light yellow)
1 pair of non-skid slipper socks
2 pairs of jersey knit floppy wide-leg shorts (1 pale pink and 1 pale yellow) and 2 roomy knit tee-shirts (1 royal blue to go with the yellow shorts and 1 lime green to go with the pink shorts
1 pair of athletic shoes and 2 pairs of cotton socks
1 pair of suede moccasins (slip on so I don’t have to worry about getting them on or tying them)
4 complete changes of underwear
Small toiletries bag: the usual stuff like toothbrush, toothpaste, deodorant, small tube of lotion, lip balm and pink tinted lip balm (in case I’m feeling like I should make an effort to look better), shampoo and conditioner, comb and brush, face cream
My cell phone and charger
A yellow legal pad to record my thoughts

In a separate bag which my husband may or may not bring to me depending on how I feel and how much time I have will be the following:
o My Netbook (a little bitty computer)
o A paperback mystery
o My diary
You see, I really do over pack! I’ve read other hints like a special pillow, an extra blanket, candy, diet Coke, etc., but I’m counting on the hospital and my husband to take care of anything I may need. Okay, time for me to start thinking about bed! Wish me luck!

Preparing the House for Homecoming and Recuperation

Since we were gone until a day before my surgery, and since I only had a couple of days from the time my surgery was scheduled to leaving on our trip, I didn’t have much time to prepare. We have a 3 story house with bedrooms and bath (with a walk-in shower) on the top floor. On the middle floor are living areas, kitchen, and a half-bath, and in the finished basement is a living area, open bedroom, kitchenette, and a small bathroom with a walk-in shower.

Since I’m not confident at all that I’ll be able to climb stairs for the first couple of weeks, I’m taking over my husband’s office on the middle floor. There’s a comfortable daybed in his office, so I’m planning to sleep there for the first week or two. Even though I’ve been reading a lot (the Delphi Forum being very helpful: http://forums.delphiforums.com/n/main.asp?webtag=onourfeet&nav=start&prettyurl=%2Fonourfeet%2F), I’m just not sure when I’ll be able to climb up to the bedroom, so I’m planning on spending at least two weeks on the middle floor. My understanding is that I can’t shower until my stitches are removed, so I guess I’ll take sponge baths in the half-bath on the middle floor, and I’ll wash my hair in the kitchen sink. It’s not my idea of cleanliness, but unless I can climb stairs sooner than I think will be possible, it will have to do.

Other than moving my toiletries and lots of comfy, loose clothing down to my temporary quarters, I really can’t think of much else to do. My husband, Stan, is retired, so he’ll be with me all day every day and will be able to get anything from upstairs that I need. From what I read on the Delphi forum, I don’t expect to have lots of appetite at first, but if I do have a “hankering” for something special, Stan will fix it, order out, or go get it!

Our family room has a wonderful couch with a chaise at one end, so I think I’ll try to spend a good bit of time there every day watching TV, doing my exercises, and reading. I have lots of regular books, plus my Kindle is loaded up with plenty of mysteries, so I hope to be able to read as much as I want without feeling guilty that I ought to be doing something useful!

Is there anything else I should do? It’s all happened so suddenly, and I’ve had so little time, that I feel slightly unprepared, but at least I haven’t had a lot of time to worry, so maybe it’s all for the best!

A Brief Background--the day before TKR surgery

While there are a few personal accounts of Total Knee Replacement (TKR) experiences out there on the internet, several questions I had were not answered. So, from a “girl” point of view, I offer up an account of my TKR surgery from a more practical point of view.

Although you don’t need to know a lot about my personal history or circumstances, I will tell you that I am a public school elementary teacher who has been experiencing knee pain for about 6 years. Until about 18-24 months ago, it was controllable by taking Bufferin (my favorite pain killer) and ibuprofen. I was able to do just about anything I wanted to do except run (which I never did anyway). During the last 18-24 months, however, my knees started feeling much worse. I still took painkillers and I still led a very busy life, working all day, going to all those faculty and committee meetings in the evening, and teaching an adult ed class two evenings a month. My husband (let’s call him Stan) and I keep quite busy helping out with the grandchildren (2 early elementary girls) and spending time with our son and daughter-in-law who live a couple of miles away. We go as often as possible to visit/help my mother who is in her mid- 80s. She lives 650 miles away, so it’s a long haul to get there, but we try to drive to see her every 6-8 weeks. Although she lives in an apartment building that is restricted to senior citizens (62+ years requirement) which has the convenience of a good cafeteria and the amenities of social groups and activities, I’m an only child, so I feel a great obligation to do whatever needs to be done for her that she can’t do for herself. We also have a son who lives 750 miles away with his wife and two preschool children, and we drive to visit them three times a year. Once (or sometimes twice) a year, we have the whole family in our house for a holiday (sometimes Christmas, sometimes July 4, even Halloween!).

The point of all this is that I want you to understand that I felt I was too busy to go to an orthopedist, and certainly too busy to have TKR. There was never a point in my year when I had 6-8 weeks free and clear for surgery, recovery, and rehabilitation. That all changed two days after school was out this year.

On June 22, right before we were due to leave on a family visit tour, I went to an orthopedist, thinking he would give me a cortisone shot, maybe recommend a few weeks of physical therapy, and that would be that. Instead, I was told that my left knee was in such bad shape that I was in danger of suffering much more extensive damage. Because I’m a teacher and have to go back to work late in August, and because of the precarious condition of my knee, I was scheduled for surgery on July 12. My surgeon gave my right knee a cortisone shot, told me to enjoy my visit with the family, and that he’d see me July 12. I was in total shock and almost numb with the sudden and unexpected bad news, but there was too much to do to dwell on my shock for very long.

For the next two days, I was in a panic. We were scheduled to leave on a two week visit to family (our son, and then after 8 days there, to my mother’s for 5 days), so I had two days to get my pre-operative physical and all my lab tests completed. Added to this, I was still working mornings, writing curriculum for my school district. By the afternoon of June 24, however, everything had been accomplished and, Saturday noon, June 25, we left on the first leg of our journey. Over the course of the next two weeks, I had a wonderful time with my family, celebrated my 62nd birthday, and once at my mother’s, worked hard running errands for her, attending to her medical needs, and visiting with other friends and relatives in my hometown.

My husband and I drove home, arriving on July 10, and on Monday morning, July 11, I took care of several items of business related to my impending surgery. There was also much unpacking, washing of clothes, and organizing and, in addition, we babysat our two granddaughters all day. In a way, it was a little hard not to have a quiet day to make sure everything was in order, but on the other hand, I’d probably have been in a tizzy and would have gotten myself more and more worried, so we enjoyed the day, had a fun little-kid lunch out at McDonald’s and generally tried to survive the oppressive heat. It's comforting to be back in a normal routine, even if it is only for a day.

My last evening at home will be spent going over final preparations around the house, showering with Hibiclens, washing my hair, and watching a little TV. There comes a point when you just want it to be over!