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.

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