Friday, March 27, 2009

Day 32

Yeah, I'm back already. I guess I'm the one that really needs this blog, that it's as much a part of the therapeutic process as the exercises I'm doing.

I had my second outpatient therapy session this morning, 90 minutes of fun, fun, fun. Not really. It was difficult and painful.

Jim the Therapist is pushing me hard, but the results are there. Flexibility has increased in the left leg and I should soon be able to straighten it completely. There was a window yesterday afternoon where my knee felt better than before surgery.

Unfortunately, by the time I went to bed, it was throbbing, which made for another tough night of not much sleep. That's slightly discouraging, but as Jim the Therapist confirmed, I'm ahead of schedule and I'll have to stay motivated and continue working hard to remain on the road to a full and complete recovery.

Wednesday, March 25, 2009

Day 30

I survived. No, I'm not talking about yesterday's first session of outpatient PT. I'm talking about the estrogen fest known as a 7th-grade sleepover that began last night and is lingering into the early afternoon. My daughter is having a great time, which makes me happy.

Physical therapy, on the other hand, was just as tough as I expected. Dave the therapist introduced new exercises far more arduous than those prescribed by John the Therapist, including a few using weight machines. One of his big aims is to get my leg straight and more flexible. Lying down on the therapy table, the back of my left knee was an inch or so above the surface. By the time I left, my leg had straightened further, which made the hard work (and pain) of therapy worth it.

I go back on Friday for another session and will be doing the new exercises in between. Dave did say that I seemed to be doing well. I think he pushed me to find out how far I could go. I managed to complete everything, but it was indeed hard work. I was sore afterward, but nothing too bad. Dave reminded me to apply ice often.

Dave was insistent that I should no longer keep a pillow under my knee at night because that inhibits the leg from straightening. I followed his advice and, despite all the sleepover hullabaloo, I actually slept sounder by trying to keep the leg straight for most of the night. I'm a little sore today, but I got my walking in this morning and plan to do my exercises soon. Also took a few more swings in the driveway. Still feels good.

Finally, I'm not sure how much longer I will be maintaining this online journal. It's only getting a handful of hits, although the larger purpose for creating the blog was to keep track of my progress and to provide information for anyone considering or about to undergo a knee replacement. I had found such a blog before my surgery and found it informative. It's my hope that people out there will find this blog months or even years from now.

Each knee replacement experience is no doubt unique. Mine, obviously, has been good. I'll probably check back on occasion when something significant occurs. Until then, take care.

Monday, March 23, 2009

Day 28

I guess I just had to try to scratch that itch. After doing my morning exercises, I iced the knee and then made a last-minute, executive decision. I walked outside, picked up my trusty practice 5-iron and decided to take a few easy swings in the driveway just to see if could do it. No problem.

I then decided to swing with a little more authority. Still no problems. By the time I was through, I was swinging the club with nearly as much authority as I do normally do. The knee was holding up fine, which is fantastic news.

Afterward, I ran inside and called my longtime golfing buddy, Ron, to report that I'm back ... almost. I'm still a long way from being able to play a round of golf. But it's not unreasonable to think I might be able to hit a few balls next weekend at the driving range. Again, I'll start slowly with some half wedges, but it will be way ahead of schedule for when I thought I might begin golfing activities.

Sunday, March 22, 2009

Day 26

I'm getting out and about more. I made it through my son's first scrimmage of the season yesterday on a chilly day. (A sophomore, he made his varsity debut, pitching two scoreless innings, striking out three. He also hit a ball to the warning track in right field that normally would have carried for a home run. I'm not too proud of him.)

The pain hasn't been bad, despite the stepdown from Perocet (every four hours) to Vicodin (every six hours). I went without painkillers for over eight hours yesterday without ill effect. While I'm fine during the day, sleeping remains a problem. I've not been able to sleep through the night or for very long stretches the last week. I'm apparently putting the leg in some awkward positions at night that is causing additional pain. I need to do work on sleep positions in the hope of eliminating some of the pressure (and pain).

We went out to dinner last night for the first time since surgery, which was great. Another step toward normalcy. And this evening, I'll be returning to my Sunday night cooking duties. It has always been a tradition in our household that I cook something extra nice for Sunday supper. (Cooking is one of my great loves.) I'm doing something simple, pasta carbonara, a longtime family favorite. It will be nice to get back in front of the stove.

Friday, March 20, 2009

Day 25

Woooot! I'm legal. The physician's assistant for Knee Replacement Guy just gave me permission to drive to outpatient physical therapy, which is due to begin Tuesday morning. She went along with the plan knowing that it's my left knee they replaced and that I'm stepping down from Percocet to less potent Vicodin as my pain medication du jour.

The pain persists. Despite not getting to sleep until late, I was awakened this morning with some sharp pangs, which forced me to take a pain pill and get an earlier-than-planned start to the day. I got through my exercises and walked the same distance route as in the previous two days. I'm not sure I can go much farther at the moment, although it felt slightly better today after my walk.

I'll have to push myself to go a little farther soon. John the Therapist is coming for his last home visit this afternoon, so the knee will receive more than enough work today.

Wednesday, March 18, 2009

Day 23

I've progressed to the point where John the Therapist says we've maxed out on home exercises and that it's time for me to hit the gym. If everything goes as planned, I should be starting outpatient physical therapy next week. The sticking point is whether the doctor will allow me to drive. The nurse sounded optimistic when I spoke with him on the phone today.

Confession: I have driven a couple of times to watch the high school baseball team practice and to hang out with the other coaches. It's about a mile there and back. And I was careful. I'm in no hurry to start driving on a regular basis, but I do want to be able to take myself to PT or the baseball field or on an occasional errand.

Speaking of being on the move ... after completing my exercises this morning, my cane and I went across the street and walked a little over a quarter-mile in the park. The top of the knee puffed up a bit afterward and there was additional stiffness, but otherwise I did fine for my first walk. I'm planning another one this afternoon and will try to add a little distance each time.

Sunday, March 15, 2009

Day 20

I woke up again this morning in a fair amount of pain. I guess it shouldn't be surprising. The knee tends to stiffen when I'm not moving around. But the pain has been more acute the last two mornings, prompting me to gulp a pain pill first thing. It takes about 20 minutes for the drug to do its magic. Walking around helps loosen things up as well.

This extra pain should not be a source of discouragement. My recovery overall remains ahead of schedule. I'm walking more upright with the support the cane provides. Technically, I'm supposed to be still using the walker at this point. Continuing the theme of getting ahead of myself, I've already switched from baths to showers.

The surgery scar has nearly healed except for a few scabby patches along the incision line. The last Steri-strip is stubbornly hanging on at the bottom of my knee. My scar will be less impressive than I originally thought it would be. Knee Replacement Guy's fine work and the body's ability to heal itself will leave me with a faint, thin line through the knee, not some Frankensteinian scar. My daughter still can't look at it, however. "It's disgusting," she says.

I could not and should not be any more satisfied with the rate of my recovery. The knee is regaining function and the swelling has shrunk too the point where there is a faint outline of definition. I felt some tiny pings of pains in the knee last night similar to how your arm or leg feels after it has fallen "asleep." It was if the leg were waking up. Those little bits of pain caused more comfort than distress.

I've been meaning to address the "P" word in more detail for awhile. This seems as good an opportunity as any. While I'm too lazy to look, I'm fairly certain that the word "pain" appears multiple times in each of my blog posts thus far. It's a word, concept and reality that cannot be ignored. It's part of the program. You don't get a knee replaced if you are not in pain. And once it's replaced, pain is either warming up in the wings or is singing full-throated arias center stage. Pain becomes the background music of your life.

I'm not writing about pain to discourage anyone from getting their knee replaced. Far from it. But to ignore the subject would not be an honest retelling of the experience.

The sonuvabitch hurts. A lot.

But it won't be long before me and my knee reach a tipping point where the pain becomes less acute than before surgery. I will know that I've truly recovered when that day comes. It is, after all, the reason I agreed to this drama.

Nearly three weeks later, the memory of the pain I felt immediately after surgery has almost faded. Yet a faint recollection remains of just how much it hurt. I do recall just how much it hurt. The button on the pain pump became my savior. There were times that I looked up at the clock wondering if my six minutes were up and I could deliver another dose of Dilaudid. (Interestingly, the pump made the same noise when you pushed the button whether or not you were getting medicine. I'm wondering if they designed a placebo effect into the machine.)

The pain had grown less severe by the time they unhooked the pain pump on Day 3 and began giving me two Percocets every four hours. The pills took over pain management nicely, which is not surprising. Percocet is a strong narcotic. The next step up in the pharmaceutical continuum is Oxycontin, which doctors hailed as a wonder drug that would allow people to take one time-release pill to manage their pain for as long as 12 hours. (It didn't take long for people to figure out that if you'd get a mighty buzz if you crushed the pill and then smoked or mainlined it. "Hillbilly heroin" sells on the street for as much as $80 a pill. Percocets are an extremely popular black-market drug as well. An untold number of Americans are paying big bucks and committing various crimes to get stoned on Percs.)

I'm hooked on Percocet at the moment. I shudder to think what life would be like without them. I won't use the word "addicted," given that I'm using them appropriately, but I am drug dependent. I now understand why painkillers are the most abused drug in the world. They provide a warm, pleasant glow and make you feel pretty darn good. I look forward to the day when a simple Tylenol or Motrin will get the job done.

This need for painkillers explains, in part, why you have to wait so long to drive after surgery. Physicians don't want people with a head full of Percocets behind the wheel. The drug impairs cognitive power and reasoning. Writing is hard enough when the mind is clear. It becomes an even more difficult task under the influence, something I hope you will take into consideration as you read this blog. (While I do edit these entries, they don't receive the same attention my writing normally does. Please forgive my grammatical lapses and awkward sentence constructions.)

It's important to realize that there is a mental aspect to pain management. You have to stay busy. The less time you have to think about pain the better. I think I've done a good job in that respect. I've been reading, playing online poker and writing this journal. I've kept the television off during the day and have taken surprisingly few naps, which no doubt has helped me sleep more soundly at night.

So yes, there is pain. Lots of pain. But it's manageable. My wife explained how the pain of childbirth felto so horrifically intense one moment and then disappeared the next. With a knee replacement, the real pain begins once your new knee is born. I'm optimistic that my new knee will grow up soon and the pain will have moved out of the house. And while it will be expensive, I won't have to send my new knee to college.