Post-op Check-up

I went in for my post-op check-up today. I had hoped to see the surgeons because I have some questions, but they weren't there. I suppose it is normal to see the physician's assistant for check-ups though, the surgeon's time is much more valuable and in demand. The PA did say she would have the surgeon call me though, so it seems I can still ask him my questions.

I didn't understand my discharge instructions, but luckily I didn't do what I thought I was supposed to do. I was somehow under the impression that I should do as much as I could, just don't put any weight on my right leg. My leg has been pretty swollen though, so I have been spending almost all day and night in bed with my leg up. I went to see my therapist yesterday and stopped at a small park for some fresh air before heading home (I have been going a little stir-crazy in bed for 2 weeks now). I had planned to attend my group yesterday afternoon as well, but I just wasn't up for it. My leg was so swollen after only 2-3 hours of being up on the crutches that I couldn't see a couple of my stitches and my arms were shaking from using them to support my body weight. I'm glad I have been listening to my body rather than blindly following instructions that were incorrect and could have been harmful to me.

Me at the park after therapy. While I probably shouldn't have been up and around, I think the sunshine did me a lot of good.

Today I learned that I should actually be spending about 23 out of 24 hours each day in bed with my leg up. Sadly, I will need to keep doing this for another 2-3 weeks until the swelling goes away. I am glad to have clear instructions now though. It reduces the amount of anxiety that I experience around what I am and am not supposed to be doing. They also want to raise the level of physical therapy I participate in as an attempt to offset the level of inactivity I am forced into right now. The home physical therapist has only come once so far and they want me to be doing more than just once a week. That means I will have to be going to the clinic for therapy, but  it will be nice to get out of the house for a couple hours.

While I was at the clinic today they removed my stitches and the suture tape strips and replaced them with new suture tape strips. Well, she removed all but one of my stitches. My very top stitch was so tight it was causing pain last night so I carefully cut it and removed it myself. When she looked at it she said she could tell it was too tight and it was fine that I removed it. (What could she really do about at that point anyway?) I no longer have to keep it covered with bandages after today either. I just have these suture tape strips now and when they fall off on their own, I won't have anything on the incision at all.

Still pretty swollen after my trip to the clinic today. There were 14 stitches alternating with 13 suture tape strips. Looks really good.

I was also told today not to use the Smart Crutches I bought for myself until I am able to start putting weight on my leg. She normally loves them, but right now they don't allow me to go completely without weight bearing. They are advertised as being able to be used for non-weight bearing- a strong, healthy young man even demonstrates in the video on their website. Unfortunately for me, I don't have the upper body strength to actually pull that off. Until I am able to start trying to walk on my leg I can't use them. Other than not having the upper body strength to use them completely non-weight bearing I think they are superior crutches to the "armpit" ones.

The good news I got today is that I should be able to start putting weight on my leg (thus able to start using my new crutches again) much sooner than expected. The PA told me today that I am healing so well they are hoping that in 3-6 weeks I will start trying to walk on it a little bit. I really hope they aren't getting my hopes up for nothing here. I am not going to plan on it or even expect it. I will just keep doing my best to heal myself and let it be a nice surprise if I am promoted to weight bearing sooner.

Some more good news today is that our laptop got fixed so I can work from bed now! It is none too soon either. I have to finish a workshop on Ableism/Differently Abled Oppression and I have a couple of articles to write. I have a short non-fiction book that is almost ready to publish that I am really excited about. But none of these things could be done from bed and I my leg swells too much if I try to sit at the computer (like what happened when I wrote I Survived Surgery!). It feels good to be doing something useful again, I have been feeling like a slug doing nothing except scrolling through Facebook on my phone.

Me, happily writing this blog article on the laptop with my leg up!

The next steps from this point are buckling down to work hard in physical therapy and in  3-6 weeks I can start trying to put weight on my leg. That is when we will find out how well this thing works. It looks so good I am afraid that it won't work as well as it did before surgery. I am glad that now I can recognize that this is all just fear and anxiety trying to upset me. I don't have to let it.

I Survived Surgery!

Before surgery on the top. After surgery on the bottom. The bottom is still very swollen in this image so it might look a little different later on. Since I can't put any weight on it for 3 months I won't know for that long if my knee still works the way it is supposed to and the improvements happened that were planned for.

I went in to the hospital on Thursday March 6th to have my leg straightening surgery (technical name is "high tibial wedge osteotomy") as scheduled. Before going in to the operating room they brought in an ultrasound machine to put a catheter in the nerve in my groin area. This made my whole knee area numb, like getting a shot of Novocaine at the dentist's office. That made the whole experience a LOT less painful.

I woke up in a lot of pain, despite the nerve block. They gave me several different types of IV pain drugs but everything was making me severely nauseous. I actually threw up a couple of times later in that same day. The first 2 days were almost unbearable. The nausea was much worse than the pain and I was so miserable. Eventually, about 48 hours later and with the help of 2 anti-nausea drugs, I was able to start taking oral pain drugs. I normally take 20 mgs of Methadone for long-term pain management but in the hospital they broke it into 7.5 mgs every 8 hours. That helped ease the trauma on my stomach.

The first couple of days were rough emotionally too. As many people know, it is almost impossible to get any rest in a hospital. The lack of sleep, stress of being operated on, pain, effects of pain drugs, nausea and my own emotional struggles all conspired against me for a bit. I was at least able to explain to some of the nurses that I suffer from such severe anxiety that it can make me irrational at times. They were very understanding. I also told them straight out that I was afraid my reactions to the anxiety would get me kicked out of the hospital again. Several nurses and aides went out of their way to reassure me that wasn't going to happen this time. That made me feel a little bit better.

Saturday morning was a new day and a totally different experience from that moment on. I got some good sleep Friday night and my nausea was almost completely under control. I had some fruit and toast for breakfast that stayed down and my outlook was greatly improved. By Monday morning I was doing so well they were ready to let me go home.

I can't put any weight on my right leg for 3 months. For the first 3 weeks I have to use a Continuous Passive Motion machine for 6 hours a day. I also have a Physical Therapist coming to my house for the next several weeks. Right now I can only do things like move my foot around and slowly bend my knee. Eventually we will be working up to more difficult stuff.

Been home now for about 5 days and really starting to get antsy. I can't do much except lay down with my leg up to keep the swelling down and spend 6 hours per day in the CPM machine. Today was the first day that the swelling was down enough for me to post to the blog. Hope to write more again soon!

You can find my journey in photos here.

The Big Day Tomorrow

Well, tomorrow is the big day. I am now seriously anxious about my surgery. I have trust in the doctor and all that, but I also have a mental health condition that makes certain things more difficult for me to cope with than the average person. (I have Borderline Personality Disorder.) I also can't take traditional medications for anxiety because I have opposite effects from them, they make me paranoid and extremely anxious/agitated.

When I had my last surgery they gave me anti-anxiety medication in the IV as part of the “anesthesia cocktail”. I never imagined they would give me that so I didn't mention my inability to take that type of drug. (Now I list them as allergies). The anxiety built in me all that day in the hospital. I had a bad reaction they kicked me out of the hospital in the middle of the night some time. I wasn't given any pain medications or even crutches! It was a traumatizing experience. I have to spend several days in the hospital this time. I am afraid of having another panic attack and being kicked out again because of it.

Sometimes I feel really overwhelmed with having MHE and a serious, disabling mental illness both. I feel like when I get control of the pain in one, the other one takes over. My therapist spent the last 2 sessions I had with him helping me develop a plan for dealing with my anxiety. After our conversation I loaded some guided meditation videos onto my phone, I am bringing my therapy workbook, a list of healthy coping skills and I am going to let the hospital staff know ahead of time about my anxiety issues. On Thursday, Friday and then starting again on Monday I will also have phone access to my therapist. I leave him a message and he gets back to me as soon as he can.

I am bringing my Kindle, which has about 600 books on it besides being a tablet. I will have my smart-phone, my journal and some resources to help me cope. Already packed in my bag are my own fuzzy blanket that I really love, a stuffed Tigger to remind me to stay positive and a stuffed doll my mom made for me called a “Dammit Doll”. The Dammit Doll is designed to hit non-living things with while yelling “Dammit, dammit, dammit”. Great for stress relief! In addition to all of that, my husband and I have been working on a plan for him to help me remember to breathe deeply when I start to feel stressed. I jokingly started calling him my Lamaze coach! I wish I could take my therapist with me to the hospital but I am very grateful to have such a supportive, loving husband by my side.

About 4 days ago the stress really got to me and I cried for about half an hour. It was during the conversation with my husband afterward that I realized it isn't really the actual surgery that has me anxious. It is being in the hospital after that is making me about to panic. That was an important distinction because it let me plan accordingly. Just having that realization eased some of the anxiety.

Along with my anxiety I also feel some anticipation. My legs are fairly crooked and as a young kid my classmates used to pick on me pretty bad about it. I used to fantasize all the time as a child about having straighter legs. I would dream about being a witch (like Samantha Stevens) and casting a spell on them, of finding a genie in a lamp (like "I Dream of Jeanie") to magically fix them. Once I got to be a little older I knew that there was no magic twitch of a nose or blinking nod was going to fix things. I stopped letting myself dream about it at all then, figuring that I was never going to be able to pay for a “cosmetic” procedure. I know that my legs can never be perfectly straight but I am really excited about it being straightened even just a little bit.

Time for me to finish packing, lay down for a few hours before I head for the hospital. I probably won’t get any sleep but figure I have plenty of time to sleep during surgery! Please keep me in your thoughts.