Thursday, March 6, 2014

It's no fun if it's easy!

But once - just once, I'd like to try the easy way!

I tried to tell it - I warned it - I said if it didn't quit hurting . . .

The poor left knee, the one that was so busted up in that car accident so long ago, the one that had 5 or 6 surgeries in the 5 or 6 years after the accident, the one that was a complete piece of shit for the last 40 years - it refused to listen.

I'd relied on cortisone shots for years, but the last one didn't help at all.  I asked the doc for another one and he said if it didn't work last time, it won't work this time.  Damn.  So we took an x-ray, back in June or July last year, and sure enough - the thing was completely shot.  As if I didn't know that!  

Hurt like an S.O.B - I had no choice but to start using my cane again, and even that barely kept me upright.  I had vowed to have NO MORE OPERATIONS, but I eventually admitted I had no choice at all.

This is all history - I've mentioned most of it previously.  Next came two docs who refused to operate on me.  The 5 or 6 prior surgeries left too much scar tissue, too much damage, and not much of a chance for success.  Finally, my rheumatologist suggested an orthopedic surgeon who is the go-to guy among the local orthopods with problem cases.  That's me - the problem case!

I was totally impressed with the man, his operation, his staff and his attitude!  When I met him, I told him that I would understand if he didn't want anything to do with me.  He told me it was a very risky operation, for the reasons mentioned above, and that the chance of some skin dying - necrosis - was very likely, because there simply was not an ample blood supply to the damaged knee area. . .meaning possibly a skin graft at some later date.  But he was confident that he could make it better than it was.

On February 11th, I had a total knee replacement.  Dr. B used a Stryker Thriathlon System knee.  

When he visited me the next morning, he told me that I was the 'worst close' he'd ever performed.  My skin was so thin, it tore like 'wet rice paper' if they just touched it.  He'd never worked with anything so fragile.  I mentioned that I'd warned him!  I asked how the knee was - he just looked at me, and said 'you didn't have a knee!'  But he was still confident that it would be good!

The staff started me immediately on a CPM machine  - continuous passive motion machine.  That's the thingy that gently bends the knee to keep it healthy and moving...early rehab!  This was really fun (NOT!) - three times a day for two hours each time.  In the hospital, that meant 4 a.m., 2 p.m. and  Yes, I said 4 a.m.  They wake you to strap you into the weird machine and then say - just go back to sleep.  Surely you jest?! 

Then, because it was so pleasant already, the nurse set the degree of flex too high - up to ninety degrees.  The notes in the file said ninety degrees was the goal for a month out because of the fragility of the knee.  The pain almost blew me out the window!  Then, as they hurried to get me out of the machine, they caught the catheter drain line and yanked the catheter out of me.  That was pleasant too, and is, understandably not the recommended method of removal!

Are we having fun yet?

I was scheduled to have the catheter pulled the next day, so they suggested not putting it back in.  I less than politely refused.  That was another adventure - it took two nurses to reinsert the damned thing, and I know now that I'll never do that again while I'm awake!

As I have probably mentioned in previous dialogues of surgeries and pain meds, I lose complete control of my bladder when I'm on pain meds.  This has only developed in the last few years - probably a result of 50 odd operations and way too much anesthesia and too many pain meds.  It's totally embarrassing, but there's not a damned thing I can do about it. 
Amazingly, Dr. B was familiar with the problem.  No one else I've ever told about it has heard of such a thing.  He called it opioid incontinence, and that's one of those 'too bad' situations.  I can take pain meds and pee all over the floor, or I can not take pain meds and grit my teeth against the pain.
So the day after surgery, I quit taking pain meds.  It took six days to get the shit out of my system enough that I didn't pee uncontrollably!  Another reason to say NO MORE OPERATIONS! 

Other than those few little hiccups, the staff of the hospital was overall very good.  The food was another story.  It wasn't just bad, it was awful!  If it wasn't for a tiny little cup of fresh strawberries (2) and blackberries (2) each morning, there were no veggies to speak of all day long.  It was pretty much all carbs with some unrecognizable meat thrown in.  Thank heavens for friends!  Richard brought me some sugar snap peas one evening, and another day a Carl's Jr hamburger with jalapenos that tasted heavenly!

The operation was on the 11th, and I came home on the 14th - very nice Valentines Day present!  My poor little Misha was ecstatic to see me.  Richard took really good care of her while I was away, but she wanted nothing more than to sit in the window, looking and waiting for me! 

My pal Lizzie was here waiting for me, and, bless her heart, fed me and made me comfy and very happy to be home! Of course, I was still peeing all over everything, so we did a lot of laundry, but it was still great to sleep in my own bed!

Sleep in my own bed, with a CPM machine for company.  Still doing three two-hour stints on it every day, but at hours of my own choosing!

I was doing the Warfarin blood thinner thing with twice weekly blood tests, wearing those gawdawful TED hose and started physical therapy.

The therapists and I did not see eye to eye on this rehab stuff.  They obviously know the basics of what needs to be done, but they didn't know what they were dealing with, with my busted up body.  And they wouldn't listen to me.  So one exercise they insisted I do (if I had a brain, I simply would have refused!) has left my (crushed) right ankle in more pain than I've had for years.  Another hurt my rebuilt left hip and left me gimpier than when I started.  So I've quit going to PT.  At least at that facility.
My very sweet girlfriend Pam, from days way gone by (Jr High School), was kind enough (foolish enough?) to come play nurse and look after me.  Boy, can that girl cook - I ate like royalty while she was here, and loved every bite.  She made ice bags, and more ice bags, and lectured me when I was a little too enthusiastic about moving around, and was a godsend!  I wouldn't have made it without her!

Two weeks after the surgery, we went in to get the staples pulled.  It took 34 staples and numerous sutures to close up this incision, and it's really not happy.  I look at that picture and remember that once my legs won contests!  That's surely days gone by!!

I begged Dr. B to let me take off the TED hose...hate them!!  He wanted me to wear them for six weeks - I said four.  I guess I can live for two more weeks.  :o)

I asked if it was OK if I started driving. He seemed to think it was OK - right leg does all the work.  I said he probably should know that I drive a Mustang, with a manual transmission.  He just looked at the floor and shook his head.

Unfortunately, now the troubles have started.  (Remember, it's no fun if it's easy?!!)  The incision is so . . . hate to keep using the word fragile, but that's what it is.  Even just tiny amounts of bend (flex) would break it open, and it would leak.  And was getting worse.  I finally went in to the doc to have him take a look. 

Not good.  It has opened up in a couple places, and a bit of infection has set in.  So now I'm wearing a brace, to keep the leg straight - no bending at all!  And it's bandaged - I clean it daily and re-bandage it.  And I get to sleep in the bloody thing!  Not that I'm sleeping - I thought I was uncomfortable before!  Ha!  But at least it's smelling better!

We, Dr. B and I, are not really concerned about it, yet.  We knew that it was problematic.  So far, there has been no sign of necrosis.  We just have to watch it closely.  I go back in on Monday for a check-up.

Meanwhile, I'm off the blood thinners, and because of the ridiculous leg brace, I could get rid of the TED hose too, since there was no way to wear it with all the other stuff!!

The only other sad thing is that the wonderful hernia repair I had last fall has pulled loose.  It might be a coincidence, but all my favorite cop shows (especially Leroy Jethro Gibbs and NCIS) say they don't believe in coincidences.  A couple days after I started on the CPM machine, the 'passive motion' machine, I was feeling trouble in my belly.  I would describe it as - you know the sound it makes when you pull velcro apart??  that's what it felt like.  And now I have a big pooch down in my lower belly again.  And as you may recall - the doctor said we could never go back in there again because there was so little usable tissue, after all the TRAM-flap ridiculousness.  But I just can't think about that right now  Hurts too, though.  As I've said, probably ad nauseum, I fix one thing and two more go wrong.  Gets old.

But overall, my humor is terrific.  The knee was less swollen immediately after the surgery than it has been for years!  I was walking without aid in less than two weeks and it felt wonderful.  Now if the incision would just close up...

Think good thoughts, please!


At 8:55 AM , Anonymous Arvy said...

If that damn "Murphy" wouldn't have come up with that ridiculous law, and if "It wasn't for bad luck.....", and "Nothing goes right when your underwear's tight", seem to be quotes that have defined your existence in the past number of years but surely as the radiant Tucson Sun rises every morning over the majestic Rincon's and stunningly sets over the Tucson's, I am so hoping and praying that the day will come soon that you'll be well enough to do those little things you enjoy so much (like flower shopping and picture taking of all those unusual plants and animals you haven't yet captured with your camera). Best wishes, dearest one.


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