Recovery day 4

Andrew is off at Cole! It's his program's adult bonding summer camp thing. It sounds like he is having a terrific time and meeting some great people. I'm impressed with the sort of student resources they pump into the program. We talked during free time after one of his dinner sessions and he found a frog while he was walking outside.

Today was a bit more challenging as recovery days go. I was able to hold down more substantial food, which was nice, but my pain levels were definitely higher. I'm trying to reduce the amount of pain meds I'm taking during the day and it's a little challenging. I did take a shower today!! Woohoo! It kicked my butt. But I appreciate being clean and sedentary over a bit stinky and sedentary.

I also watched Harry Met Sally for the first time today. Good stuff!

Day 2 and 3

Everybody says day 3 is one of the worst days post surgery. Today has been challenging, but in a bit of a different way than other surgeries I've had. My pain levels remain surprisingly low overall-- I take this as a good sign that I have been using my CPM device enough to keep ahead of adhesions, and that we have been balancing my pain medication well enough between overly doped up and too little. IBU Profin does nothing to touch the bone pain when I am feeling it, but it goes a long way to decrease the swelling, which ultimately decreases the pain a bit too. 

I am completely non-weight bearing on my left leg and am not allowed to engage my quad muscles to prevent straining the healing bone and cartilage, so I need help lifting my leg on and off of the couch, and I have to wear a belt for someone to hold onto as they walk me wherever I'm going to make sure I don't slip. Any kind of a fall would be totally disastrous at this point. It's these sorts of things that are keeping me solidly at a totally dependent state. Can't get off of the couch on my own, can't get to the kitchen or bathroom on my own, no stairs of any kind, still a little while until I can shower. I'm so, so, so grateful that Andrew and my mom have been on deck to help me with this, I have no idea how people do it alone. 

Toughest thing for sure is balancing food, pain medication, and keeping my digestive system going, though. Feel free to skip this if it's TMI. I got really sick yesterday (Saturday) afternoon and found that basically everything I had eaten all day (which wasn't a ton to begin with) hadn't been digested at all and was just sitting around. I'm on several different things to help keep my digestive tract running, but there is only so much you can do while your body is readjusting after surgery. So, got really sick, took several

hours to get to the point where I could keep pain medication down without it coming back up, which put me behind on pain management, which I had to catch up with. That takes a while. I'm so glad I am not also having to contend with absolutely blinding pain that other people have described. It definitely hurts, but the meds they have given me really cut through it.

Today has been mostly sleeping, prune juice, and crackers. Also binging on Rome. Once I'm a little less cloudy headed I am going to start into a couple of knitting projects, but I have to find what very safe box I packed them into. We're getting there with unpacking, and as soon as I am more mobile, it'll go even faster! Here's to a fast recovery!

Big changes

This past month has been full of changes! 

• Andrew and I celebrated our 5 year wedding anniversary at the end of July
• I have moved into an amorphous new position at work (possibly being called Special Projects Strategist)
• Andrew and I loved up to Logan!
• I performed in Behold Zebulon, a small show for the Sugarhouse Great Salt Lake Fringe a Festival (Also got to see Rachel and Ben as they came through town and they saw the show!)
• Andrew got his squamous cell carcinoma friend removed from his knee 
• I had major knee surgery!

Right now I am laid up on the couch in our new living room. I figured I would detail the procedure and recovery so far, since this is sort of an unusual procedure and I won't remember a ton of this as we move further into recovery.

So, I have had a Fulkerson Osteotomy (aka a tibial tubercle transfer), and an ACI, which is the transplant of cartilage cells that they took a sample of from me in May and have been growing since. The Fulkerson will correct the angle between my knee cap and the top of my tibia, which is pretty extreme and causes my knee cap to grind over bone, grinding away the cartilage. The top part of the tibia, where the tendon from the knee cap inserts, is moved further inward and slightly up/away from the body. The ACI gives me back cartilage I lost (yaaaay!), and because it's my own cartilage, I have a much greater chance of my body accepting it. 

Tuesday: Tuesday morning I went in for my pre-op appointment. The Wednesday before I went in and got a bunch of blood labs done, and returned to finish up the list of things that had to be done right before surgery (EKG, chest x-ray, they took more blood for testing). They gave me some hospital bracelets to wear around until my surgery on Thursday, giving me the sort of drastically chic air of an escaped hospital patient, which has been all over Parisian runways recently, as I've heard. Definite fashion statement. 

Wednesday: Because we can't do anything simply, Wednesday was Andrew's Mohs surgery! It went very, very well. They only ended up needing to remove one layer, and they did an amazing job stitching him back up.

Thursday: My surgery day! We met with the medical equipment lady at 11:45am for my compression/ice machine. I checked in at 12pm. I was really, really, really nervous. The surgeons were running about 45 minutes behind, so I napped a bit and then they took me back. I learned they weren't going to put me under general anesthesia, but instead we're going to do a spinal block with a sedative. That was super far from my expectations of what was going to happen. We had maintained before this that it was general anesthesia with a femoral nerve block, and this suddenly changed the game a bit.

Not that I had any choice at that point! When I heard we were doing a spinal block I had a quiet, internal freak out, admittedly, but they gave me a decent amount of sedative and I chilled out pretty fast. The surgery itself ended up going very very well. I was told I woke up just as they were closing me up with stitches, sat up, pulled down the paper drape, demanded to watch, and complimented them on their technique and how clean the edges were, etc (all things I know nothing about but damn if I wasn't polite?). I do actually remember them washing off my leg and wrapping it, but not the stitches. 

Here's an awesome picture of the transplant in the underside of my knee: 

I slept in recovery for a while before they took me to my room. Andrew stayed with me as long as he could before he had to return to Logan (early morning doing orientation for school), and I did a lot of sleeping. I was experiencing very little pain or discomfort, because of the spinal block and truckload of local anesthetic they used, so I was groggy but not in pain.

Friday: I got to meet with the hospital physical therapist first thing in the morning! She was lovely. I still wasn't feeling much pain at all, and was feeling a bit wary of when that might kick in. My PM nurses were absolutely fabulous, but I was a bit stressed out by the AM nurses. Unfortunately I felt more than a little bit rushed by the new shift to get up and out of my room (things like they removed my catheter before the PT got there, saying she wanted it out and that it would get me out of the hospital faster, but when the PT got there she said she wished they would have left it in). I think the pain meds were making me feel a bit overly emotional too. 

But I was particularly grateful to the PT because she was very reassuring that she would be monitoring my pain levels very carefully between the two PT sessions I did with her and make sure I had what I needed. My biggest concern was that Fulkersons are VERY very painful procedures, and I wasn't feeling much pain at all. No one was able to give a good explanation as to why I wasn't feeling the pain I should have been, until later in the afternoon my mom was able to speak with my surgeon's PA and he confirmed that I had LOTS of local anesthetic, but up until that point I felt sort of like a nauseated ticking time bomb for excruciating pain. 

The PT and I practiced walking with walker and crutches, and doing stairs and how to sit and lift my leg and all that. I am completely non-weight bearing for the first two weeks. I have this terrific constant passive motion machine I'm using for about 8 hours a day:

After my second PT session and talking with my surgeon's PA we felt a lot better about how to manage pain and nausea after leaving, so we loaded me up and packed me into the van. My mom drove me up to Logan, which I don't really remember, and we got in at about 5:30pm. Had some Mexican food and I passed right out.

Saturday: At about 6:30am this morning I had my first real bout of pain. Whooooooo. Bless Andrew's heart, he slept on the floor next to the couch I'm sleeping on so he knew for sure he wouldn't sleep through my next round of medication. I don't even think the discomfort I felt is the worst of what I might feel during this whole recovery, but it was pretty nasty and I still had another hour or so before I could take my next dose of pain meds. Once it was under control I quickly returned to doing ok again, but it was a little taste of the intensity of this thing. 

Well, I guess that's it for now! I'm going to take another nap, I'm looking forward to continued improvements.