Jessica is now Bionic -post op diary from Austin, TX

[esther_bunny]

Hello!
Some of my details are kind of fuzzy as I had my procedure on Jan 12 but I will do the best I can.
We (husband (DH) and my mother-in-law (MIL) had to be there before 7am. DH didn't look up where the Cedar Park Surgery Center was on the map the night before so we were all kind of freaking out when the GPS kept wanting us to get on the freeway that would take us away from the direction we needed to go. Turns out the GPS was right, it knew of a cut off we didn't. 

I'm first in line, yay! The nurse has me go "do my thing" in a cup but I can't. I went and sat back in the waiting room because I saw no one when I exited the restroom. About 10 minutes later same nurse comes to get me I told her I didn't know what to do and we had a little laugh. This time I was able to "do my thing" and then they had me undress and get in a bed. (The nurses told me that once I did my thing I could have a pill to relax me and water to wash it down with! I was more excited about the water!)
I met about 5 people in 3 minutes and knew I'd never remember their names.

They were all so nice and funny and laughed at my jokes and we all seemed to get along. The anesthesiologist came back to see me and I swear he should have been a surfer he was so laid back. He informed me that I would have to have a femoral block despite my feeble protest. Ugh. Ugh. Ugh. I hate that paralyzing feeling once I get back home and trying to figure out how to get from the cart to the front dor. Oh well, not much I can do about it.

Next is marking my knee. They gave me the pen to mark my knee and I drew an arrow and a tic tac toe for my doctor. The nurses asked the head nurse if that was ok and she said it was. She said some people draw HUGE things and so they generally don't like it but mine was a little funny so they let me keep it. My doctor/surgeon came in and we played out the tic tac toe...it was a draw.

I asked what type of music my doctor was going to play in surgery and they didn't know. I know he likes 80s gangsta rap so I requested some NWA. This was a first I was told my one of the nurses. 

In general I wasn't nervous and sort of knew what to expect b/c of my ACL revision surgery a couple of years agao. I was in a good mood and positive and the nurses liked that. They all came to hang out as much as they could before the procedure. We joked and basically just shot the breeze. It was nice.

Finally it was time. I was wheeled this way and that and when it looked like I was going to get wheeled in to a broom closet I found myself in a proper operating room. Met 3 new people whom I do not remember except they were all nice. The put a mask on me and asked me to take a few deep breaths and after breath 2 I was out.

--Several hours later I woke up. The partial knee replacement went so great that the company that makes the part asked to use my photos! The surgeon also found another hole in my knee and did something called an OATS procedure where he pulled a core bit of bone from one side and plugged it in to the hole, so I got a 2 for 1.  I was feeling no pain in part because of the femoral block.

A man came in and showed us how to use the CPM and I was fitted for a brace. After a couple of hours I was ready to go home. DH helped me get dressed and they wheeled me out to the car. The drive home was fine but I dreaded what was coming next. Once we got home I had to get out of the car and make it inside the house. I was so nervous! DH and my MIL helped me in and I plopped down on the stairs. Slowly, slowly I pulled myself up each chair by scooting on my butt and using upper body strength. I was crying mostly b/c of the anesthetic. Anesthetic does weird stuff to you.

We got me in to the bed and I fell asleep. We soon found out that while I was paralyzed I couldn't get up to use the bathroom. We tried a bedpan but it was unsuccessful. Even though we put puppy pee pads and towels under me I managed to make a mess. Pretty embarrassing. My MIL went to the store and bought me some adult diapers. I have to admit I've always wondered what it would be like to use them. Well now I know! They aren't bad but I did get some chafing from the drip they had put in my femoral artery. The drip was a pain medication ball that would eventually go down over the next 3 days. I hated that ball! It got in the way of everything!

My MIL is so wonderful. She changed my diapers (even put a little powder on me like a baby) and all we could do was laugh because it was such an awkward position for us both.

I camped out, had my computer, some magazines,  my meds,  my cold therapy machine, and all my dogs around me. DH and MIL switched out bringing me food. It did get tense b/c at one point I was in so much pain and I had to have my diaper changed. I couldn't turn over halfway w/out crying and my MIL called in my DH to help. He used a wrong tone and it set us all off arguing and crying. I was so upset I called my mom and my mom and my MIL talked. My MIL even asked me if I wanted to go home with her. DH was so mad! We finally figured out he was mad b/c he wasn't being asked to help more. So after everyone calmed down we all had a long long chat and worked it out.

After 3 days my MIL left and it was just DH and I. By that point I was able to shower (using a shower stool) and get around on crutches. I was still staying upstairs but that first shower felt so incredible! I had to  wrap my leg in a black plastic bag (over the brace and over the wound wrapping b/c they could not get wet until the stitches came out)- I looked like I was wearing a leg warmer from the 80s!

The Cedar Park Surgery Center called me the day after surgery to check on me and they mentioned that I was one of the best patients they had b/c I was so positive. That made me feel good. 

The week after the surgery I started physical therapy. I call my physical therapist The Punisher but he's really a great guy. He pushes you but that's his job. My scar tissue started to heal very quickly and that worried them. Although my flexion is increasing I still scream in agony and cry when he pushes my leg down to measure. I can't help it, it's the dang scar tissue. I can take (2) of the Hydrocodone 10mg and I still scream like a banshee.

So I go to PT twice a week and do lots of exercising at home to try and keep my leg from getting stiff. I have an appt with the doctor next Friday to see if they are going to have to do a manipulation or are going to let me try and work it out in PT a little longer. Initially I was supposed to be off work for 4 weeks but that has been extended indefinitely.

As of right now I can walk w/out the crutches but am still on the brace at 0 degrees flexion. Not cleared for driving yet. All 3 of my dogs LOVE it that I'm at home and hang out with me all day. My husband is driving me around as he doesn't have a job at the moment. He's been in a unique situation where he hasn't had to work for the past 20 years so he's been able to concentrate on his music. A year ago he decided to teach himself classical piano and has worked very hard and is really good (I'm not just saying that b/c I'm his wife). I'm thankful he's not working and can drive me around as all of our family lives 3 hours away so we are basically on our own.

I believe that catches me up to speed but if I remember anything I'll add it later.

[Brambledog]

Hope you are still feeling good and that everything is going to plan after your surgery. 

That's the most detailed and helpful surgery account I've read! Brilliant and a massive help to anyone having similar surgery and not sure what to expect afterwards. Loved the bit about your MIL powdering you  you obviously have a good relationship, and a great attitude to life. I'm not surprised the centre said you were their best patient.

All the best with your PT and recovery, hope the pain levels subside soon and you can straighten that leg without the banshee bit!

Brams 

[seerobinbike]

 

Hey You!

Glad that you decided to do a post op diary!  I also enjoyed reading this and it made me smile several times.  Ahhh....you left little to the imagination with all your great visuals. 

I have to say that I've never heard of this operation being done as a day surgery!  You poor thing.  I know what a miserable mess I was in the few days following the surgery and can't imagine having to leave the same day especially with a femoral block.  I was lucky I didn't roll right out of bed in my delirium and you went home.  Wow.  So kudos to you, J.!  Glad that you made it through all that crap and are now on the road to recovery. 

Why the partial, BTW?  I noticed that you mentioned having an ACLr a couple of years ago.  I'm guessing that you obviously had some wear and tear but am a bit surprised that you didn't need a TKR.  Just curious.

So glad that you ordered the book on Rehabbing after a TKR.  I think you will find it very helpful! 

Looking forward to seeing your progression and hoping that today finds you a bit more, um, flexible.   

Robin

[esther_bunny]

Thanks everyone!

Robin, I had the partial b/c my osteoarthritis was in just one spot and had not spread throughout the whole knee. I was the perfect candidate for this type of surgery. The surgeon also said the full replacement would be too big for my knee (I thought they came in several sizes) and I really didn't need a full one. I had this one spot where the osteoarthritis was eating my knee like Pac-Man! If I can remember to remind DH I'll try and get the photos from the surgery scanned in so you can see the hole in my knee and the OATS procedure.

Unfortunately today does not find me more flexible. I swear it's like my body forgets what it has worked on even a couple of hours later.

Today I did some stretching and rocking on the bike but the wall slide exercises were horrible. And I noticed a pain I haven't had before, on the right side (outer side) of my knee. Could be where they did the OATS procedure.

Tomorrow I plan on getting up and warming up before I head out to PT. I think that will be more helpful than just having 10 minutes on the bike before we start. I have a sinking feeling that the manipulation is going to be mandatory. Trying to stay positive though. Desperately waiting for the book I ordered to arrive.

For now I'm going to watch AFV and then the Grammies and maybe enjoy some hot cocoa!

[esther_bunny]

Well today was a horrible day.
I went to PT and made it to 94 degrees but the pain is still completely unbearable, a 20 on a scale of 1-10. My physical therapist went and told my doctor. (I told my PT that I had taken (2) 10 mg and (1) 7.5 mg of hydrocodone 45-1 hour before we started.) Within 30 seconds the doctor's assistant came back with a new prescription (Nucynta) for me to try.

They are thinking that it could be a nerve issue or just that the pain meds (hydrocodone) aren't adequate.

We shall see. I just want this to be over.

[Brambledog]

Awww that's horrible.  Hope the new drugs help a bit. Those pain levels don't sound right at all, virtually a form of torture by your therapist. Not good. You're being very stoic, and I have massive respect for you even attempting to endure such a nightmare, but no doctor can expect you to put up with it for any length of time.

Hopefully it is a short-term blip and can be sorted out quickly. I do hope it's not a nerve problem, they can be tricky things. I developed one after surgery, and for a while no one could understand why I was in so much pain... All you can do is keep pushing for them to get that pain under control - until they do you won't be able to achieve what you need to. Not your fault at all, and incredibly frustrating when you are trying so hard and being positive about everything.

You're doing exactly what you should and no doctor could ask for more in a patient. Try to keep optimistic. If they can work out what's wrong, they can deal with it and you can turn this corner.

Good luck. Will be thinking of you!

Brams 

[seerobinbike]

Oh, J...I don't like your post at all.  That's horrible that the pain is so bad for you.  That is a lot of medication to be on and still not getting any relief!  If it were just post surgery, I'd understand it but by now, you should certainly have a handle on your pain.  And after reading that you went right home after your partial, I know damn well that you can stand a lot pain.  Hum. I'm not sure what to say.  Of course you want this to be over.  I hope the new meds will give you some relief until you get this thing sorted out.

AND as the wise Brams has said, do try to stay optimistic in the face of it all.  You have a nice sense of humor and this will serve you well in the days and weeks to come. 

Sending positive and healing vibes your way, J.

Robin

[esther_bunny]

Thank you everyone for the vibes.

I added another PT session to the roster this week before I have another check up with the doctor on Friday.

Hope it's a short term blip as well. My husband is doing his best to help and to keep me laughing (he's the best).

Brambledog-when they found out it was a nerve problem what did they do?

[Brambledog]

Hi Jessica,

First and foremost (and I know this is easier said than done  ) DON'T PANIC. Just because they have mentioned the possibility of a nerve problem doesn't mean it is one. There could be several other reasons for your pain, which your OS will consider. As the wise Robin said (!) coming home the same day after the procedure you had is asking a lot of anybody.

I turned out to have CRPS (chronic regional pain syndrome) following an arthroscopy on my knee (nerves were damaged during the op and didnt settle down as they should have normally). My pain levels were out of all proportion to what they expected after a fairly minor procedure, which vexed my OS. I had also started having periods of time when my knee was ice cold and purply, or burning hot and red like sunburn. These, with the mad pain, and being unable to tolerate icing any more, turned out to be symptoms of the CRPS. I started on some meds pretty quickly and within about five days my pain levels had decreased dramatically. I'm having a bit of a flare-up at the moment, but generally my knee is vastly improved from where I was two months after the op. Nerves are strange things!

CRPS is not common, so it is unlikely you have it. 'Nerve issue' could mean many different things! All you can do is wait until your appointment with your OS and try not to scare yourself rigid by imagining what it MIGHT be....

I admire your grit in booking another pt session before you see your OS, but it might be a good idea to ask your therapist not to push things too much until after you've had that knee thoroughly checked. Those pain levels are not right, and if there is a problem you don't want it made worse. If your OS clears you to carry on PT as normal, you can push things more at your next session. A nice gentle series of exercises that move the knee without putting you through unbearable pain would be a good plan just for one session....

Glad your husband is being so supportive, it makes a hell of a lot of difference!! Keep going and you'll get past this. There are lots of things the docs can do to help with pain, you just need to make sure they take it seriously and don't fob you off.

Really hope they get this under control for you fast. In the meantime, try very very hard  not to stress yourself out about all the possibilities.... Watch something funny, make your husband wear something insanely inappropriate (and take photos  lol, after all, it is Valentine's...), spend ages online choosing a new item of clothing, research relaxation techniques and healing mantras, do a blindfold taste test on a box of chocolates, anything to distract you and pass the time!!!

Fingers crossed for Friday. (Robin, love your 'wise' comment, had me chuckling... )

Brams 

[seerobinbike]

I've been thinking about this and was wondering how long ago you had your ACL done.  Right now, you are basically dealing with at two issues...your PKR and the OATS procedure.  If the ACL was done within the past year, that would make it three procedures!  One problem many PT's make is being overly aggressive with treatments.  I totally understand the concern of both your doctor and your PT but forcing something that doesn' want to go will actually increase the scar tissue that is being laid down.  I'm with the (wise) Brams  on giving your knee a break until you see your doctor on Friday.  Just do some gentle stretching and maybe some of the most basic exercises and maybe skip the flexion exercises all together.  IDK..it sounds good in theory.  One of the reasons I say this is that yesterday my knee was pissy after my morning exercises so I skipped the afternoon ones and just did a very slow spin on the bike for about 15 minutes.  I could feel the knee loosening up and just for the heck of it, I tried the flexion. It was definately better than it had been earlier in the day.  I was at home alone so I couldn't check the degree of flexion but I'd bet you dollars to donuts that it had improved by a couple of degrees.

If you have a chance, tell us what you have been doing for PT.  How many reps/sets are you doing and how many times a day?  It's just as easy to overwork it as underwork it. 

Hope today finds you feeling a bit better.  This is a great board for feedback; many people on here probably know more about the knee that many doctors know.  No fooling! 

Hugs back at you!   Robin

Brams...I figured you to be wise since I know you and Lottie are friends.   

[esther_bunny]

Good advice Brambledog

Robin, my ACL revision was done 2 years ago.

I just tried doing some wall slides after warming up a bit and letting the Nucynta start to work. No dice. Nucynta does not seem to really offer any pain relief. The first one I took yesterday made me sleepy. This morning I felt loopy for about 15 minutes and the one this afternoon was like I took an ibuprofen.

I feel like my knee is going to pop open. I'm wondering if I'm being a baby of or if my pain tolerance is *really* high b/c I lived with chronic pain for so long.

They say God only gives us what we can handle but I'm not sure he read my file before I had this done.



 

[esther_bunny]

Ugh. My boss just sent an email saying she was sending a courier to come pick up my work laptop and cell phone as I'm not supposed to have it while I'm out on short term disability leave. I *don't* have the computer and distinctly remember leaving it at work with the person who is covering for me. As for the cell phone, I did have one but it never worked properly so I had the service turned off. The actual phone is in a cabinet at work.

How hard is it to walk over to my cubicle to see if the laptop is there? What happened that made her think I have the laptop? It's frustrating b/c she sent the email at 3.45pm today and I'm just now getting it. I'm sure she is asleep.

This is not the kind of stress I need. I'm hoping the person covering for me has it and will bring it with her when she goes to the office tomorrow morning.
Of course now I'm going to obsess over it all night because where could it have gone? Ugh. Ugh. Ugh.

[Brambledog]

Hi again Jessica,

Hope your knee is doing ok today. I am no surgeon nor possessor of all knee-wisdom  but PLEASE do not push your knee at all until you have seen your surgeon. Something is wrong here. Your pain levels are off the scale, which isn't right, and that 'something's about to pop' feeling so soon after surgery is not good. They got you out of the hospital so fast after quite a major procedure, and there could be something wrong which needs sorting out. I'm not saying there definitely IS a problem, but your symptoms could indicate one, and for the sake of two days it really isn't worth the risk.

You're not being a baby at all. Your attitude is very positive, but you can't move forward with this until they can get your knee to a point where you can exercise it reasonably comfortably.

As for your work issue, it sounds like they are being complete muppets. Give them a ring, explain the situation and tell them who has the laptop and phone. Honestly, some employers just have no idea. Grrrr!!!!

In the meantime, try to relax and look after that knee...

Brams 

Robin - I thought I recognised your name from the 'going from bad to worse' thread I look in on every now and then. Hope things are going ok for you now, and you are having a 'good' day! 

[esther_bunny]

Thanks Robin. My laptop was on my desk in my cubicle the whole time. My boss just never bothered to get up and go check. This like this and other stuff she does is making me look for a new job. (I got Bell's Palsy back in late Nov./early Dec because of the amount of stress I'm under).

As far as PT today: no dice. The 50mg Nucynta (I think it's milligrams, I know it's 50 of something) is like taking an ibuprofen. Only made it to 91 degrees today.
I really don't think it's a medication issue. I think it's either scar tissue or nerve damage.

Quite frankly I'm ready to just ASK my doc for a MUA just so I can get past this roadblock. I know once I get enough ROM to make a full circle on the bike I plan on using that as a motivator.


I feel like I'm *thisclose* to the breakthrough.

[seerobinbike]

No...you mean thanks Brams!  Glad that they found your laptop at work.  Duh! 

You may be right about the manipulation.  I tried to find it before posting here, but I read a post the other day on this site about a guy who'd been having problems with flexion, had the manipulation done and immediately got to 120 degrees.  Hum.  Maybe if you Google that it might come up?  Anyway, I thought it looked promising.  Obviously, something is up.  Your appointment with the OS is on Friday, right?  I'll be anxious to see what he thinks about your lack of flexion and all that pain.  Breathe deeply in the meantime.

Robin