Tuesday, August 30, 2011

Let the Therapy Commence!

I have such wonderful support from all my friends! Thank you for commenting on my blog posts and offering such great advice.

I went to my first physical therapy session yesterday. My husband came in with me, and my mother came in after she was done with her Hydro class. I am working with the same therapist who saw me after my initial injury. She is tough, and I like that. I feel like we can work well together, and that she will see me through to full function of the knee again.

Therapy is uncomfortable. I know that and I expect it. I took my pain medication so that it was in place during the therapy, and that helps. Sherree, the therapist, asked me how I was doing. I told her that I thought my bending was coming along, but my extension was still a bit stiff. We took off the brace, and I showed her my stuff. It took a couple of flexes to get the knee flat onto the table, but I did it! I was able to flex it to 95 degrees, which she said was very good. Although it felt like I was tightening my thigh muscle to the same degree as my good leg, she said I wasn't. It may be due to the nerve block they put into the muscle. She hooked me up to the ionizer, which causes the muscle to contract, and I lifted the leg each time it contracted. She checked my walking from the front and back, and said it looked very good. I have to make a conscious effort to keep my toes up and not have toe-drop. I was a bit light-headed from the narcotics, so I did not get on the stationery bike. We are going to try that on Thursday.

In the meantime, I am able to stretch my pain meds out two hours longer than I could a couple of days ago. I am able to have it up in a recliner chair for a longer time, rather than flat on my back with my knee propped above my heart. I sat in a rocking chair today, flexing and extending it. I used the can under my heel and pressed the knee down. My leg raises are getting easier, and are a lot less painful. We still have to get up at night and change out my ice pack and take a pain pill, but I am resting well.

Throughout this process, I am trying to keep a positive attitude, and focus on what I CAN do. School has started this week, and I am not there. Lots of people have been emailing, sending notes and calling to let me know they are thinking about me. What a lucky person I am to be blessed by so many friends! Although I am not at work, I have been doing important work from home, and focusing on getting healthy. I CAN spend this month getting my leg back in shape and becoming healthier so that I when I can return to work I can be the best I can be.

As always, my motto is, "Ever forward."

Sunday, August 28, 2011

A Long and Winding Road

I am writing this blog entry at the end of my third day post-surgery. The surgery itself went well. The surgeon rebuilt my ACL with one from a donor. The meniscus was partially stitched, and the parts that could not be stitched were removed. The surgeon told my husband that the surgery went well.

I plan on chronicling my recovery in the hope that it may help others who will have to experience reconstructive knee surgery. It was sometimes frustrating to know that I worked hard for seven weeks to rehabilitate the MCL, only to be pushed back to square one on surgery day. That frustration was well worth it, when the surgeon looked inside my knee. The MCL is healed, albeit still a bit loose, but so much stronger and stable than when the injury first occurred. The hours in the gym and pool brought me to this point, when I begin my recovery in earnest.

Some folks have an easy time with anesthesia. My husband and my father awake feeling refreshed, as if they have had a nice, long nap. I am not that fortunate. I awake slowly from general anesthesia. I have the feeling that I should be waking up, but I cannot, and it leaves me feeling panicked. We arrived at the hospital at 8:30 in the morning, and we didn't leave until 7:00 in the evening. My husband still did not feel that I was ready to travel the half-hour to get home, but I wanted to go between doses of pain medication. It wasn't until 2:00 AM that I felt really awake from the anesthesia.

Everything I'd read about this surgery indicated that the first 48 hours are quite difficult. I'd say that was accurate. The first day, I made the mistake of trying to be tougher than I really am. I went too long between taking my pain medications, and ended up in trouble. My husband called the surgeon's nurse, who is a wonderful person, and she helped us through the trouble. I learned my lesson about taking my medication, even before I think I might need it.

The second day post-surgery was the day of my uncle's funeral. I so wanted to attend, but it was obvious that it was too soon for me to try to go. I did not want people to have to focus worry on me rather than my aunt and her family. My daughter and her boyfriend came and went in my place. My brother and his wife were also here, and my brother did the readings for the service. My mother said several people noticed my absence and asked about me, but they were very understanding when told that I'd had knee reconstruction two days before.

Today, I slept in and generally took things a bit easier still. I went the entire day without an hour of "the shakes" and uncontrolled pain. My daughter and her boyfriend were still here. We had a lazy day, watching baseball, and visiting. I have been able to shower yesterday and today, which helps me feel better. My husband says that I'm not seeing how much I've already improved, but he has noticed. We changed the dressings on the incisions, and the knee looks very good. There is little bruising and the swelling is noticeably diminished.

Tomorrow, I have my first post-op physical therapy session. I know that it will be somewhat uncomfortable, but I am willing to work through whatever discomfort is needed. My husband will be with me throughout the week to take me to my appointments, and I know he will do his best to keep me comfortable in transit. The joint in my brace will be unlocked, and I will continue to do the exercises I've been assigned.

As for the food choices, I knew it would be a giant step backwards, and it has. I have to eat every four hours before taking my narcotics, and frankly cinnamon-sugar toast has been the food of choice. It keeps the nausea at bay, and it is easy to make in the middle of the night when I need to take meds. I am working hard at letting this time go without beating myself up about it. I knew it was going to happen. I am willing to get back into my new lifestyle routine as quickly as I can. It is a challenge to know that I will undoubtedly put on some of my lost pounds, but I am committed to not letting myself slide indefinitely back into old habits.

Blogging throughout the process is one way of holding myself accountable. The progress I've made thusfar should not be totally reversed, and my recovery will be the better because of it.

Tuesday, August 23, 2011

Passages

My uncle passed away this morning.  His death has been months in the making.  Back in June, he suffered a massive heart attack.  He had warning signs for almost a week prior to the actual attack.  His heart stopping beating during the ambulance ride to the hospital, twice.  While the doctors tried to stabilize him in the hospital in preparation for open heart surgery, he suffered a second heart attack.  They performed a triple bypass on him on the 4th of July.

After he survived the open heart surgery, we expected that he would make a slow, but steady recovery.  He did not.  Instead, he seemed to take one step forward, followed by two steps back.  His lungs, which evidently had been diseased for years, began to fail.  The doctors tried everything they could think of to help him.  In the end, there was nothing more anybody could do.

His family has faithfully been by his side, day after day,  for two months.  My cousin cooked meals and brought them to the hospital for him daily. He always was a picky eater.  This was not the end he wanted, nor the end anyone could want.  When the end finally came this morning, it was a blessing for both the family and him.

My uncle hated doctors and hospitals.  He did not take particularly good care of himself. He ignored the warning signs his body had been giving him for years.  He had diabetes.  He had heart disease. He had lung disease.  He had reached the average life expectancy for a man in the United States.  I guess he figured that he could live on pure stubbornness alone. He would not have wanted the quality of life that was ahead of him, even if he had survived.

Knowing all this does not make his passing any easier for those family who are left behind.  My aunt has lost her husband, my cousins their father, his grandchildren have lost their grandpa, and my dad has lost his only sibling.  While the family had time to say their goodbyes, it is still difficult.

Life will go on without him, although we will miss him. His granddaughter will still be married on September 24.  In our hearts, we will know and most probably feel his presence there with us.  But, we will miss his boisterous life-of-the-party personality. New babies will be born into our family, and resemblances may be noted.  But, the children will grow without the benefit of his goofy jokes. Such is the cycle of life.

Every day, families throughout the world go through this very same process.  People are born, and people die.  Take time today, as I have, to count your blessings.  Hug  family and friends that are nearby, and confess your love to those far away.  Take stock in where your life is, and where it is going.  Think about the mark you made on this world today.  Those who have gone before us, like my uncle, have entrusted this life onto our care.
Be grateful and see the beauty in each day!

Thursday, August 18, 2011

An Achievement on the Road to ACL Surgery

It is time for another update. For those who may stumble upon this post and not understand what is happening, I had a fall the weekend before Independence Day. I was busy multitasking while going down some stairs. I essentially missed a step and fell down onto the concrete floor with my knee bent under and to the outside of my body. My ACL was completely torn through, the meniscus is shattered and laying in pieces in the joint, the MCL was torn and remained attached "by a couple of threads." Since that time (7 weeks) I have been in physical therapy to try to strengthen and retain flexibility in the MCL while my body tries to heal it. Increasing the strength and flexibility of the knee is in preparation for surgery to repair the other two injuries. This triple injury is sometimes called the "Unhappy Triad" and is usually the injury sustained when an athlete has a "blown knee."

My surgery is scheduled for one week from today. I had a pre-op exam with my family doctor on Tuesday. My blood pressure was really good, 118/79. The doc gave me the once over. I am down 32 pounds since summer began! The doc said that it would be good if I could be down some more before I have the surgery, but it will take a year or more to do that safely. So with all things considered, I am in the best shape that I can be for this operation. Everyone believes that I should have the surgery now. With the instability in the knee, there is a possibility that I could have a fall and injure the few remaining ligaments that I have.

Besides the healthy eating and tracking everything, I have been working very hard in the gym. The MCL was only attached by a "couple of threads" and the body tries to bunch that up to protect it. My therapy for the past 7 weeks has been to strengthen and retain flexibility in that MCL while my body tries to heal it. I have good range of motion in that MCL now and it is much stronger than it was. It still becomes stiff when I sit for awhile, but a little stretch and it is good to go.

Today, I had a moment when I was really proud of myself. Mind you, moments when I feel really proud of myself don't come around all that often. But, I'm trying to celebrate my successes on this journey, and today was just such an occasion. There is a sign in the pool at the fitness center where I now have a membership. The sign says that 64 lengths, or 32 laps of the pool equal one mile. When I first started working out, swimming ACROSS the pool looked impossible to me. Today, I swam 32 lengths of the pool, which is a half a mile!

Granted, it took me some time (about an hour) and I had to rest a couple of minutes between laps. Almost certainly my "built-in buoyancy" kept me from becoming a speed bump on the bottom of the pool. BUT, I am only able to kick with one leg, and I DID drag myself to and fro in that pool (the LONG WAY) 32 times! And for that, I am proud of myself.

Tomorrow, I see the surgeon for the final time before my surgery date. I believe he will check the flexibility and extension I have in the leg now. I will show him the cuts that were caused by my robo-brace on the back of the knee. I will ask him to send a letter to my school district with an explanation of why I need to be out of school through September. We will discuss my post-surgery options for care. I have already decided to have a ligament from a deceased donor implanted rather than harvesting a portion of one of my own healthy ligaments. The surgeon won't know if the meniscus is able to be sutured back together until he gets into the knee and looks at the blood flow. It may be that he will just remove the pieces from the joint.

By all accounts, everything I've heard and read about this surgery, it will be a difficult recovery. Total recovery time is 6 months to one year. The first two weeks after the surgery reportedly have a high level of pain and very little weight bearing on the leg. One person told me that it could be as long as 6 weeks before I will have enough control of the leg to resume driving. I am hoping to be driving within 2 weeks. I think it is natural to feel some anxiety, especially when you keep hearing about the level of pain. Normally, I have a very good tolerance for pain, and I'm hopeful that won't fail me now. I take comfort in knowing that I have done my best to prepare my body in the time I've had.

I anticipate that I will make some backwards movement in my fitness level and weight loss at the beginning of my recovery period. I am going to do my best to keep my Spark alive and eat as healthy as I can (although I understand that I will be somewhat at the whim of my caregiver as to my food choices.) I will be doing the exercises necessary to regain function in my leg without causing damaging swelling, and that will have to be good enough for now. I resolve that I will return to the gym and pool as soon as I have permission to do so. Mostly, I will work on being patient with my body as I heal, and to be kind to myself if a few pounds find their way back to me.

This won't be easy (I am NOT a patient patient), but I have every confidence that with the help of my wonderful, supportive friends, I will continue on my journey in spite of this bump in the road.

Tuesday, August 9, 2011

Cue the Crickets

What's that I hear? The sound of crickets? That must mean there has been a lull in the blogging action around here. Why, you might ask? Well, the answer is, I'm not really sure. Here are my thoughts:

1) After working at this lifestyle change for two months now, one might think that the excitement is waning. In other words, the honeymoon is over. While that might be the case, I don't think that's exactly true. I am still tracking all my foods and making sure my calories are within my target range. It is becoming easier for me to plan my healthy meals and I have been very good about adding fruits and veggies into my diet.

2) Maybe I've been too busy? Well, maybe... but probably not a good excuse. While it most definitely takes me L-O-N-G-E-R to do everything with the robo-leg, I am also spending a good amount of time sitting, or at least looking for the next place where I can sit. I did have a very busy weekend with company in town and making a MEGA meal (4 courses) for 10 people. We were celebrating my mother's 75th birthday and my parents' 54th wedding anniversary (same day, she got married on her 21st birthday.) My mother has also been tracking her food since mid-June, so I went with the theme "Fresh From the Garden" for the fancy meal. We had homemade bruschetta appetizers and citrus juice spritzers before the meal. We had spinach and strawberry poppy seed salad, maple glazed salmon with pineapple salsa, homemade rice pilaf with veggies, and fresh green beans. I served wheat buns with honey butter that I made myself. Desert was gooey toffee bars and birthday cake that was pineapple with vanilla pudding and whipped cream topping, and homemade peach ice cream. I behaved myself and only had a tiny nibble of a bar and a very small piece of the birthday cake.

3) Maybe I've gained weight? Nope, not really. My weight tends to bounce a lot. I suspect some of the bouncing is due to sodium intake, and perhaps a bit of mid-life femality (if you catch my drift.) It isn't unusual for me to fluctuate up to 4 pounds from one day to the next. But the overall trend is down, and that makes me incredibly happy. I think we can safely say that officially today I am down 30 pounds since the beginning of summer!!!! YAY! I'm working hard not to let fluctuations get me down or make me give up. I can verify that I am eating healthy, staying within my calorie range; and I know that eventually the scale will catch up.

4) Maybe I've forgotten about exercise? No way! I've been exercising at least 3 days per week. Yesterday, the pool was very busy, so I made an extra trip in to the gym today to just do some pool work. I have read and am discovering that consistency is most definitely the key. I can feel that I am getting stronger. I have increased all the weight in my strength training, I can do three miles on the bike now (at the beginning, 1/2 mile had me huffing), and I started with 5 minutes on the NuStep machine, and I am now doing a half an hour! When I first started in the pool, the thought of swimming across (the short way) the pool looked impossible. Today, I swam not only the full length of the pool, but I did it 8 times without stopping mid-lap! I did rest between laps, but still it is progress. According to the sign at the pool, I swam 1/8 of a mile and did all my other exercises and some jogging in the water.

5) Maybe this lifestyle is becoming more routine for me? Maybe, and that might be a good thing. But, I think I have to remember not to become complacent. I need to celebrate my accomplishments. Today I was down a total of 30 pounds and I swam 8 laps in the pool! I have two weeks to go before my surgery, and I want to be in the best shape that I can be! I'm working hard and I'm proud of what I am doing!