Tag Archives: total knee replacement

Aiee! Learning Experience!!!

27 Saturday Aug 2016

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This one in the shape of “If you can Google it, never trust them to make good decisions without your input.”

A week ago Monday I had my second knee replaced, and if anything, the surgery went even more smoothly than it had last time. No nasty little surprises like the blood clots in my lungs. But by Friday I was ready to move on to rehab. Fidgeting my brains out, actually. My roommate was a tiny older woman who amused and annoyed me by complaining about how much nicer my attendants were than hers–amused, because this was a textbook case of the Golden Rule, annoyed because I have limited patience with cranky extroverts. When she left, I realized that I would never have to hear the story of how the dog pulled her down the steps again, and life was GOOD.

Then my ambulance arrived, and off I went.

Now, for those new or who have forgotten, my last rehab center was quite nicely posh, and the two weeks there were a sort of vacation. The case manager at my hospital had explained to me this time that one could never be sure of landing in the right areas, and hinted that my rockstar recovery from the first surgery might mean I would only qualify for a “skilled nursing facility.” They had reassured me that my surgical group was all over this particular one out in Boston (i.e. easier for my spawn to visit) and it was quite nice; people wanted to go back. “OK,” I thought. “Sounds like a plan.” They waved a list of rehabs and SNFs at me, and made researching them sound boring and complicated. Besides, I knew that chances were great that it all really boiled down to where a bed was open. And maybe that’s what happened here.

It took a couple extra days, as it was; and although the place they picked (NOT the one my surgeons liked) didn’t look spiffy from Google maps, their website made them look a good bit spiffier. So then there we were, on the second highest heat index day of the year, and . . .

. . . I smelled pee. And bleach. Started to panic. But then, of course it was a nursing home, with people living there, not just traveling acts like mine. My eyes met those of the sympathetic ginger dragging the gurney. “I hope you know I’m trying not to throw myself around your legs and scream not to be left here,” I said, feeling my pulse begin to rocket.

He grinned. “You’re not here yet.” Meaning I still had a bit to go before not being able to change my diapers inspired me to clean out the medicine cabinet the uh, final way. Then they left, and I started to blink back tears.

I have no idea what my deal was even now; I have no nursing home-related traumas. But this place was . . .OMG. Remember, I was expecting a nice state-of-the-art rehab facility. Luckily for me, the admitting nurse was a nice normal person who validated what I was saying, squeezed my hand, and told me what the steps were to get transferred to another place. (Complicated and overwhelming.) She overheard me asking a kid on the phone, “Remember the sanitarium level in Psychonauts? This is it,” and cracked up. Aha, gamer girl! No wonder she rocked.

The residents shuffled. Or sat in gloomy deshabille in wheelchairs. It was hot and sticky, and, I repeat, there was The Smell. No art on the walls except for a big, dour calendar of events–your basic bingo, arts and crafts, and other thrills, none of which were actually announced while I was there. I was wheeled into a room with a lopsided old lady, who started telling me her woes immediately. I noticed that my bed was only sort of made, with the pillows scattered here and there. At least they were embarrassed enough of themselves so as to keep the rips in the pillowcases face down.

The bed itself was scary. It was from I don’t know how many decades ago–it had to be cranked from the floor to be raised or lowered, and the gizmo that made the head go up and down was the squeezy thing covered in grotty-looking rubber. It had a headboard and a footboard made of cheap lumber. The mattress was a chunk of foam rubber.

I ended up having a panic attack. My first real panic attack, complete with chest pain. Mercifully, I’m prescribed a benzo to help me sleep, so they had an order for that that came through by 11. I cowered in my weird little tent (the sheet-thickness curtains went right around the bed itself) and tried to work on my breathing. I have never been so close to having something click in my brain and send me to a psych ward involuntarily. (OK, it would have been voluntary. Anything to get me the hell out of there.)

The one decent nurse apologized a lot, especially for “dinner” which was what the kitchen scraped together in the wee hours of the morning (i.e., 6:30 pm): two limp cheese sandwiches in humid wax paper, with soured canned fruit and milk cartons (it was a 94 degree day, but still) and teeny yogurt containers. I had half of one of the sandwiches and one of the yogurts, because diabetes; but it was hard to get down.

In short, you name it, they had it–nurse assistants FOB (fresh off the boat) who didn’t have much English. (I unfortunately have no Haitian Creole and had to point at things.) Roommate fell out of bed in her quest for City Hospital. Got popped in upon by residents who were lost. Strange noises. The staff went through all my stuff, ostensibly to catalog it in case of “loss.” (I got a speck of amusement at how impressed they were that I’d packed a full two weeks of panties.)

My daughter there-there’d me during our incoherent phone call that evening, but her face made up for it the next morning. “Did I lie?” I demanded. Wide-eyed, she shook her head.

The nice nurse had warned me to expect resistance on the part of the upper staff to the idea of my getting out of there, and they indeed treated me almost as condescendingly as they did the dementia patients. And why not? I was saying the same things: I don’t belong here. I want to go home. Please, just let me go home. I’m not crazy. I bolstered myself by remembering that there were laws against imprisoning people against their will unless there were compelling and legal reasons. And took my Ativan around the clock, all weekend long, until the full staff (i.e., decision-makers) showed up on Monday morning. At least they had internet and I had my laptop so I could block out the screams, hoots, and moans of the milieu.

Big stroke of luck–their visiting doctor (yup, no full-time on staff as with the last rehab) works in the same team as my own PCP, which I swear gave me points or something. Or maybe it’s just that he didn’t have a whole lot invested in bed-filling in this dungeon. Anyway, I used the big word decompensation (pro-speak for “mental breakdown”) and he admitted I made a very good case and he had no problem signing me out to go home.

By more luck, I had already been practicing going up my 37 steps by using my good leg only, so I got home on Monday afternoon, only briefly flashing on kissing the ground and claiming it for Spain.

This Monday marks the three week point, and I would have been leaving a nice rehab right now anyway. Knee is doing well–0 and 105 degrees of straightening/flexion, so I can’t complain too much over all that missed PT and OT. But it took me a few days of awakening in my own bed before I realized immediately I was home and not still back there.

Next week: I learn how to complain. Bwah-ha-ha-ha-ha. Feed me soggy cheese, I dare ya.

 

 

 

Stupid Writing

19 Sunday Jun 2016

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OK, got Long Leggedy Beasties launched as my first experiment in self-publishing, finished fine-combing Max AGAIN and am now waiting for my typographer son to finish the cover. Meanwhile, I’ve dived back into Dark Crimson Corners, which is now almost ten years old, and . . . yeesh!

It’s not that I was a bad writer back then. I was a somewhat weaker writer back then; but the yeesh! part is the intensity. This was my first novel, folks, and of course I threw everything but the kitchen sink into it–autobiography to just weird wild hares up my bum. Going through it is exhausting and I need breaks. I’ve been editing out unneeded plot threads and random asides (and changing “Pharaoh” to “Max” because Max’s book is coming first.) I’ll then put together Damascus the serial Slayer’s story (said unneeded plot thread) and run it as a sort of prequel to the rest.

After that? I dunno. By then it’ll possibly be November, and time for NaNoWriMo while battling the pain of a post-surgical knee. (Am going in for the other one on August 8th.) Seeing as I already have a stub done for Things That Go Bump in the Night (sequel to Da Kitttehs), I’m not sure what my WriMo will be. I might stick with the cat theme seeing as it seems to be working.

Oh–an aside for anybody who actually ends up *reading* the stuff: Eureka (published here) is non-canon, meaning it’ll stay here and not mess up the reality my fingers are trying so hard to make coherent.

In other news, back at work and trying desperately to do everything that needs to be done in the seven weeks remaining before my surgery, including putting together a training on the autism spectrum for my co-workers.

My allergies have been killing me, to the point where I have succumbed to using Flonase (ewww), and the new knee is still stiff with painful muscles. (The surgery has healed solid as a rock–no more bone pain!) My sleep is disrupted in that I now wake up too early. (It’s 07:30 now; been up writing since 5, and am yawning to nigh-decapitation.) Despite having tea and morning meds, I will now try to go back to bed for an hour.

And for the Next Six Weeks . . .

12 Tuesday Apr 2016

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. . . I sat around on my butt at home. Ice packs were my friends. All told, the pain hasn’t been too bad, unless I have the thing in a weird position, it’s just the Sisyphean journey to try to just get sheeping comfortable.

The PT my insurance sent out was a nice guy, but we didn’t really do PT per se–he just watched me do my exercises and evaluated how I was walking. He seemed to have a curious aversion to touching me, in fact. *shrug* My real PTs tell me it’s like that, and that they make good money, too. *shrug again*

The nurses who had to come out and give me a finger stick to check my coumadin level were a mixed bag. My favorite one was thrilled by the ferrets, and even took a selfie with one of them! It got so that whenever a new stranger came to the house, they started mugging in their cage to be let out, heh.

Finally I had to venture out into the Big Scary World at the foot of the 37 steps, but that is going well enough. I’m still easily exhausted by it, but I’m building up stamina. This means writing too, but ironically, I’ve just done enough of it that I’m tired now, and will talk about it later!

I Don’t Wanna Go to Rehab

12 Tuesday Apr 2016

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Well, I didn’t . It conjured up the picture (or whatever sensory thing it is) of old person pee; this because I know some folks who live in “rehabilitation facilities” and they’re just nursing homes. Nope, I was going home after my three days in the Beth Israel tomb and hiking up them steps like a mutha-sheeper. This was my plan.

Instead, I found out that for many practical purposes, “total knee replacement” means “removing your leg and replacing it with a pillar of pain.” I needed Mommy to help me pee; no way was I going home to my kids like that.

So, off to rehab we went, me and my stuffed leopard Max, who I discovered is useful as a cervical pillow. There was a support strut up the length of the ambulance’s stretcher that dug into the sore place worn into my butt by four days in bed, and I spent an hour trying to wiggle around it and not make prolonged eye contact with the car in back of us, because weird.

My rehab hospital was in the boonies of Woburn (pronounced WOO-burn) and I was there for only two weeks, because (to quote a certain popular video game) I was filled with determination. I had three hours of therapy a day except on the weekends: an hour of individual PT with the adorable Amy, another hour of OT with the lovable Leigh, who re-introduced me to the wonderful world of personal hygiene with tactful assistance, and then Gait Group, which was boring and rubbed my nose into what a wussy I still was. Those 37 steps loomed over me like a monster guarding the gates to my longed-for home, and I was vastly relieved when Amy and I worked out how to do the hardest part, which is stepping through the door of my building.

Little by little the knee became more cooperative. I got a canned lecture on how Pain Meds Are Bad while I was there, which was weird, because my surgeon’s practice has made it clear that there’s only a certain window to bring the knee fully online, and if pain is getting in the way, it makes the whole freaking exercise pointless, and you can always just be brought off the meds if needed. (Yay! say I. Especially since the anticoagulant for the blood clots mean I can’t use NSAIDs like most post-surgical folks.)

I ordered some basic stuff while there, joining Amazon Prime to make sure it got home in time: Handlebars for my john, a bench for my shower, and a couple of reaching tools which have captivated the cat, who can’t get her tail grabbed by them often enough. I recommend all these things.

Then the golden moment came when the bestie showed up to spring me the hell out of there. It hadn’t been a bad stay–bed was comfy, roommates nice–but the night shift left something to be desired in terms of getting the pain meds out on time. (I Officially Complained, which caused a minor kerfuffle, with night service improving radically afterwards. Use that phone number on the wall, patients of the world!)

And with the help of my daughter at thar sheeping doorway, I made it up all 37 steps just fine. Yay me!

Now with Extra Titanium!

12 Tuesday Apr 2016

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So, for those of you who missed it, here’s the update/explanation for my absence: On February 8, I had my right knee replaced. Even to me, this still sounds like a “meh” in the world of bodily modification–it’s not even as if knees are interesting gooshy bits: They’re dry and chewy and we don’t even notice what they do unless they stop doing it. Well, wrongo, Mary Lou. Total knee replacement is a Big Fat Hairy Deal, considered to be one of the most painful surgeries out there with one of the longest recoveries. Everybody told me this beforehand, with the result that I was terrified out of my tiny brain.

It’s exactly 9 weeks later, and despite having told myself beforehand that the several months of recovery would be GREAT for my writing, I have only now re-surfaced to tell y’all about it. Writing is hard when you’re distracted by pain and the need to move it/ice it/be gracious to all the medical professionals in your face.

Where to begin? Well, for those of you who are sciencey, this link from my orthopods will give you pictures of the anatomy in detail. For the rest of you, they basically sawed off the cartilage-bearing parts of my knee joint off (what cartilage I had left, this being The Problem) and replaced it with this shiny titanium baby:

fake knee

(Only I think my spacer is ceramic. I’ll have to remember to ask.) This did indeed hurt quite a lot, I’m not going to lie, but it also was NOT the-most-horrible-pain-I-have-ever-had. (That trophy is shared between kidney stones and my worst menstrual cramps: I am a pain professional!) I had both local injections (to help with the immediate pain post-surgery) and a spinal with so much sedation that I didn’t know a thing until it was over–I was as much a non-participant as if I’d had a general, with less recovery yuckies.

The physical therapy team at the hospital showed up on schedule that very afternoon to get my slacker butt out of bed so I could stand on the new knee starting immediately. (I don’t know why they do this. I will ask my real PT when I see her this Friday at my first outpatient visit. Bean counters should note that yes, outpatient PT only starts at the two month point.) This standing thing is made challenging because pain, and also because those numbing injections make you super wobbly. PT don’t care; PT don’t play. There is a fairly brief window where it’s mobility v. scar tissue formation.

This did lead to one of the most painful medical things I’ve ever had done (up there with endometrial biopsies), which was the main PT forcing my knee back on Day 3. This produced a level of screaming and crying that embarrassed me a bit but was totes called for–and I am NOT a wussy. (In fact, I once got sent home from critical care during one kidney stone because I was too controlled about it–they didn’t figure on it being my umpteenth stone. I had an infection, btw.) This range-of-motion thing isn’t quiiiiite the emergency they claim, as the surgeon bends the knee (duh, to make sure it works) before closing. No other PT person did this to me (and none will again, bwah ha ha).

However, it did put the fear ah Gawd inta me bigtime, and I hustled my butt into all those knee bending exercises out of fear that I would once again fail to please. (Bear in mind that I was out of my gourd on pain meds, etc., so was not my usual spunky Advocacy Lass self for quite a while.) As of now I am at 110 degrees of flexion (my heel almost touches my butt), and can straighten the thing out almost completely! (This translates to “rock star.”)

The four and a half days in the original hospital were the worst part of the whole thing. Not so much pain, but I have a well-behaved cat’s reaction to Things Not My Usual Litter Pan, and the food was atrocious beyond belief. The room was claustrophobic, and in the middle of this whole adventure, despite support socks that cut into my fat little legs and annoying booties that auto-inflated, I got blood clots in my lungs. (Maybe not from the surgery. Hematological workup pending next month.) Not too seriously, but I’ll be on anti-coagulant meds for a while to come. Sigh. I miss you, Vitamin K rich veggies.

And this was one of the best hospitals in Boston. Sigh again. But, seeing as I had 37 stairs awaiting me at home, my next stop was rehab, about which more later.

Haven’t heard from YOU, either!

23 Saturday Jan 2016

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The boy (25) is off at a furry con all weekend; the girl (26) just reamed my sheep about being lax on him. I blame teh interwebs.

Teh interwebs are apparently all full of people claiming that they have Asperger’s and thus should be immune to Things They Dislike, like trying to find Aspy-friendly work. She sees her brother as having embodied this attitude, which is untrue.

The girl finds fault with everything the boy does; the boy feels like he’s double teamed and that we are out to get him. Meantime, the real problem is that he’s a teenager in an adult suit. I am still parenting him, and parenting is more complex than making rules that carry consequences. The girl (who never plans to have children) can’t see that. So I have a war going on at my house all the time. She snarls when he’s here; she takes advantage of his absence by yelling at me about what a bad parent I’m being. In my opinion. she needs to open up a 20-ounce bottle of Detachment and rub it all over.

Part of this tangle is that she blames him for having been housed and fed by his father while we were off having Adventures with Homelessness, losing bunches of our stuff and being fed rice and beans every night (not our culture). Needless to say, she can find tons of compassion, support, and excuses for her well-homed (and jobless) boyfriend, so it’s not like she’s a work ethic Nazi. No, there is just something broken in her brain–she has had a hard life, and now she has a personal demon. It’s not fair. Between that, and that she offers “suggestions” in a near-snarl–it’s hard to accept her as co-parent de facto. (Mind you, she’s sweet as pie to Me. I consider her one of my best friends.)

They were both very sympathetic when I came down with one of those norovirii last weekend. I’m still fighting the residual fatigue, and this is the first writing I’ve gotten done since I semi-quit my job. (I was depressed to see a panel at Arisia entitled “Don’t Quit Your Day Job.” I was too sick by that time, which is probably just as well.)

I made the mistake of not being firm with the Arisia volunteer team that I needed a sitting job; instead, the cane got put in a corner and I was run off my feet by a gluten-free vegan (sorry, GFVs. Every one of you I’ve met has been bossy) drill sergeant barely out of her teens, meaning that her people skills were still shaky. I escaped to eat lunch and found the staff den. Wish I’d had my test meter bundle, as I was wobbly, sweaty, and nauseated. Next time I will pay more attention to self care: (I should assign myself that sentence as a punish lesson.) “No, see the cane? I’m not physically able to scamper about putting food out. At least, not for long.” *sigh* Next time. . . . While waiting for the Ride in the lobby, I had the great joy of watching the costumes. Everybody was there. from Princess Ozma to Carmen Sandiego to a patient Pyrenees in golden leather armor from the Golden Compass.

Next time it might be a moot point, because my right knee is getting replaced in two weeks, and as soon as it heals (3-4 months) I’m putting the left knee on the chopping block too. We shall see. I’ve picked up 15 pounds since losing the cardio of the walk up the hill to work, and I’d like to get out of this body. I’ve never been this fat before, and it gets in my way. I’m still just as supportive of fat acceptance as ever, but the most intimately close chapter of it has closed for the winter.

I want my body back. I’m 5’3″ and 280 lbs.

Oh yeah, I’ve heard BAD things about long-term outcomes for “the surgery” so for once my conservative PCP and I are in agreement. It will have to be dietary changes (needed for the diabetes as well) and exercise, which is where the knees come in. Wish me luck.