Thursday, Thanksgiving Day

Thanksgiving Day. I have opted out for this year..my kids have something planned for tomorrow, but I am going to stay put and keep recovering...which, by the way is going terrific! The highlights of today:

• I walked to the corner and back..about 750 feet! I felt like I could walk farther, but more is not better at this point.
• I made the pie crust, and husband made the filling: together we accomplished a pumpkin pie.(I may opt out of the big dinner, but pumpkin pie is just not something to bypass..besides that, I had fresh pumpkin all cooked up and ready to use!
• I also managed to grind up half an orange and 1/2 pkg of cranberries to make relish...which I love, and will go nicely with the turkey the kids will bring me tomorrow. 
• I don't need the crutches in the house..only when I walk outside. Inside a cane is more than enough...and often I don't need it, either!
• I washed my hair.
• One more, not-so-pleasant to talk about..but oh, so important:

Bowel movement accomplished! This may seem a silly thing to announce to the world, but it really is very important! It means the body is returning to normal function.

Yesterday when the home health nurse was here she asked if I'd had one yet. I couldn't remember, but I knew it was here in this blog, so I looked back..last time I had one at day 3. So that means my digestion isn't kicking in as fast as last time. 

I wasn't feeling constipated, but often you don't feel it until it is getting serious. If you wait that long, then you need to take a laxative, which clears the bowels, and then you start all over again! I don't want to have to take a laxative, so I had some dried fruit after dinner and drank an extra glass of water. That did the job! 

Speaking of which, do you know what stimulates your bowels? Most people have heard about prunes, but any fruit, and especially dried fruit, (with adequate water after it), will help. Graham crackers are another good one. Or fiber-filled cereals, such  as bran flakes. 

Wednesday, Day 2

A morning of chaos! Yesterday, there were some communication problems with arranging physical therapy. So this morning is spent resolving them. I finally get downstairs and settled on the couch for breakfast around 11:00am. 

The day consists of walking around the house (mostly to the bathroom and back), resting on the couch (sometimes sleeping), and checking email on my iPad. 

I don't remember my other leg hurting quite so much as this one does. But also, I don't remember being able to walk this well at this point last time. I barely need the crutches. When I went for my outside walk, I walked about 250 feet. I will have to go back and check, but I am sure I didn't go that far on Day 3 before! And I made two trips down and up the staircase in the house. 

Ice and pain pills helped a great deal. For exercise I wrapped a band around my foot so I could assist leg, and gently moved the knee joint back and forth. My therapist had told me on a phone conversation that in the past few months they have discovered that forced compression of the knee is not a good thing for partial knee replacement. (This reinforces my opinion that the rehab process for a partial knee replacement needs to be different from a full replacement.) so my focus is to gently move the joint back and forth within its current range of motion. I know that the range of motion will increase as the intracellular swelling goes down, and as I move the joint to the edge of pain. (Not IN pain, but to the edge of it!)

(Intracellular swelling is the collection of extra water within the joint capsule, which is a natural side effect of the trauma of surgery. It's the same thing that happens when you sprain your ankle and it swelling.)

Tuesday, day 1

Today, I am to check out of the hospital. Physical therapy wants to see me one more time.  My doctor has to check in, also a visit from the anesthesiologist to be sure I am not having any complications from that. The occupational therapy girl talks with me. (Her job is to be sure I am able to do all the things that occupy my time--get dressed, bathe, shower, use the toilet. She checks to see that I feel comfortable with my home environment, and  asks if someone will be there with me.)

Unfortunately, there is some confusion with the hospital case worker who is supposed to set up my home nursing and physical therapy. So instead of leaving around 2:00 like I expected, I end up waiting until 7:00. At least I got to have dinner...pizza, lemon meringue pie...yummy!

It is good to get back home. Our doggie is beside herself with joy, and climbs up on my chest for a snuggle and a nap as I settle on the couch..silly doggie! My knee hurts, but a pain pill helps me sleep for 4 hours, then another pill gives me 4 more. 

Monday, surgery day

Here we go again! Today was much the same as last time, except I was the second surgery, not the first. I checked in at 8:30. I was more alert during the pre-op. My nurse was the same lovely lady who set me up last time. This time I was awake when they put the femoral catheter in. It was not much more than a pin prick..but with a little sting to it. I don't remember the nurse inserting the IV feed last time. This time, she tried to put it in my hand, but the vein didn't cooperate, so it ended up at my elbow, which was annoying because I had to keep my arm pretty straight after that.

I was wide awake for the ride into the operating room, I slid onto the operating table and sat on the side for the epidural. Then lay down, stretch out my arm, and....."Mrs. Bordeaux...wake up!" I was in the post-op room, and the clock said 11:15. Such a funny feeling. 

Once I could start to wiggle my toes, I was taken up to my hospital room. The rest of the day was visits from nurses, Dr. Gilbert came by, the anesthesiologist checked on me. Physical therapy took me for a walk around the hall, then later on up and down the staircase. I had turkey, cranberry sauce, mashed potatoes and gravy for dinner (Yum!).

Pain pills and ice packs kept my knee from hurting too much.

During the night, I drifted in and out of sleep with the help of movies on the TV, and music on my iPod. I think the hardest part is staying in one position all the time, with the only variation being raising and lowering the bed. 

Countdown: 48 hours

In exactly 48 hours, I will be getting in the car and heading for the hospital. Am I ready? Yes--no. Today is a day of rest, so I won't be doing anything kore today. Here's tomorrow's list:

• Change the sheets on our bed
• Move all the throw rugs out of the way in our bedroom and bathroom
• Finish gathering together any projects I may do during my convalescence and take them downstairs to the living room, where I will spend my days
• Wash everything in the (dirty clothes) hampers
• Move Granny's sewing box downstairs, and see that it is stocked with needles, thread, crochet hooks, etc
• Pack the bag that Bob will bring to me after surgery
• Pack the smaller bag I will take with me
• Sweep the driveway so there will be at least a few less acorns to walk over (a daily outside walk is part of recovery! Since our street is not level, the first couple of days, I will walk up and down our driveway.)
• Create music by playing my flute. Not so much as practice, but for the feeding of my soul.
• Do so yoga, so I am relaxed physically
• Eat reasonably..no heavy meals, but restorative foods, and hydrate my cells
• Gather together the appropriate papers to take along

That's all I can think of at the moment.

My mental state, the same as last time, is one of calm excitement, eager to get this knee fixed so it can keep up with the other one. 

Four more days

My goal this week is to wrap up the things that I won't be able to do for a while, and to prepare my house for the days of taking it easy and healing. However, life is busy, and there are always the things you can't plan ahead.

In spite of that, I am moving along nicely. I know there will be things left undone. But this time I am much more "ready" - I have stacked up things I can do without moving around a lot..paperwork and needle crafts. There's this stack of "Yoga Journal" magazines I saved way back when....time to go through and decide if I really need to keep them. I found a stack of music that needs some editing on the computer. Then there is the pile of recipes I have been saving up...this seems like a good time to go through those, too.

I have moved my computer downstairs, for two reasons:
1. I don't want to take extra trips up and down the stairs. 
2. My desk upstairs doesn't accommodate sitting with my leg up. 

For the first week, I will mostly watch movies, sleep, exercise...I remember how long it took me to just get up and get dressed in the morning...and then I needed a rest because it wore me out!

Tomorrow is a busy day: classes and hair appointment. 
Friday I plan to get the laundry caught up, finish any errands that are still needed.

9 days to go!

I have done all my pre-op tests: CT scan, chest x-Ray, knee x-Ray, blood, urine, EKG, nose swab (to check for MRSA?), blood pressure, surgery class. I didn't have to attend the class, since I was here 6 months ago, but I chose to do so, and I am glad I did!

I am trying to focus and tying up the last-minute details so that a week from now I will be approaching surgery day relaxed, rested and calm. But the next three days are going to be busy: I am playing my flute in church today, have an annual recital tomorrow, and the next day a trip down to San Diego to spend a day and a half with mom (130 miles one way).

I am still recovering my diet after having a tooth removed. So I am taking special care to choose wise food choices. I am also hoping the scale will show another milestone of weight loss--meaning 1 more pound down. (I have only managed to drop 2 1/2 pounds in the last 4 months--grrrr!) I wanted that to be a much bigger number, but my body is really resisting!! Hopefully as this knee gets strong, I will be able to exercise more effectively, both aerobic and weight/resistance programs. 

Countdown to knee number two: 10 days to go

Here we go again! The same as last time, I am eager, excited, and a little unsure. Eager and excited because it means the pain goes away, and my leg can become as strong and solid as the other one. Unsure, because naturally, as soon as the decision was made it stopped hurting as much! Forntuately, it hurts just often enough to remind me that yes, it is a good decision. Also, it has given away more than once, and it's my driving leg. So repair is necessary for the safety of others when I drive.

My preparations are moving forward:

• There are sewing projects ready to go, with all the supplies (thread, needles, etc) in a lttle box in the living room where I will spend my days. 
• I have a small box with gauze, band aids, povidone-iodine and pain pills tucked under the end table by the couch--ready for the daily bandaid change.
• I set up an electric tea kettle which will make it possible to brew a cup of tea, or make a cup of coffee without having to carry it from the kitchen. I am going to leave the fixings in the kitchen, because it is good to get up and move about. (For the first few days, I will be using crutches, so carrying hot water would be a bad thing.)
• I have moved my computer downstairs to a table in the dining room. Last time I found sitting at my desk very exhausting, because I could not prop my leg up. I think I remember it was that way for 2-3 weeks before.
• I have a box where I am collecting the things that will go into a bag for my husband to bring to me after my surgery is done and I am settled in my hospital room.

It seems there should be more, but that where it is at the moment.

Onward I go!!!

Surgery and the Dentist

If you have never had joint replacement surgery you may not know the connection between surgery and your dentist. I knew, and still messed up! 

Here's the deal: bacteria from your mouth is your enemy for the rest of your life! It has been discovered, that even as much as 10 years after a joint replacement, a visit to the dentist to have your teeth cleaned can release bacteria into your blood stream, which wanders around your body and attaches itself to your replaced joint causing major problems. To combat this, you will take antibiotics before every dental visit.

This is also why you cannot have dental work done starting 2 weeks before your surgery, and up to 3 months after. 

My advice:

If you can, go get your teeth cleaned at least 1 month prior to the surgery, and make sure to take x-rays! That way if you need any work done, there is time to recover before you get your new joint.

My (miserable) experience:

I had my usual appointment, they took x-rays, and discovered a cavity which looked bad enough that the dentist was concerned there could even be abcess under the crown. And guess what day I sat in her chair and heard this....Two weeks and 3 days before my surgery date!

Long story short, I spent a miserable weekend in fear that this would delay my surgery. At this moment everything is still on track (10 days to go!). I had a rushed appointment to see first my dentist for thorough evaluation, and then a surgeon for extraction. Now I am weak and worn out from not being able to eat much for 3 days. 

So, take my advice, and get that dental work early done if at all possible!