Tired...

Applications for two library positions and one scheduling one in. Set up a profile on Zip Recruiter and updated my LinkedIn (temporarily, I'm going to really tweak it after reading the library book), updated my online curricula vitae and résumés for patient access, library, and general categories. Applied for various benefits. Not bad for four days.

Tomorrow I see my doctor about changing my ADHD medication. It should hopefully help keep me from making mistakes like what happened the other day.

My roommate told me a year ago, when I first started having trouble, to take my diagnosis report in and ask for accommodations so that I'd have some protection from the Americans with Disabilities Act. My anxiety kept me from doing it. I thought it would be seen as an admission that I couldn't do the job, when, of course, I could; I just couldn't do it as things were. I was afraid they'd just fire me or find some reason to let me go. And now we're here.

Well...at least I lasted long enough to get new knees.

Back to work and it was exhausting

Officially back at work. I worked two days, our lighter days at work, Thursday and Friday, while the temp who had filled in with me was still here. Thursday morning, I got up at 5:30 because I was afraid I'd oversleep (I set four alarms five minutes apart) and took most of what I'd brought home in July back in two rucksacks, one on my back, and one rolling bookbag.) I spent the morning watching a four-hour video training that was engaging. That afternoon. Then Kathryn (the temp, an excellent person who is going to come volunteer with us and once she can, hopes to come back and work for us. Everyone really liked her. Plus, she knows about Sarah Millican (the comedienne) and Cthulhu. She's read 71 books so far this year, which blows my reading challenge completely out of the water), and I took turns at the computer. After work, I did many errands, and by 10:45, I went into the bedroom, took my meds, got into bed, but didn't fall asleep till right before midnight, as I was still a little wound up. Friday I woke up on my own at 5:20 so I decided to go ahead and get up, I went to Kroger, got some things for lunch like peanut butter and jam (but forgot the bread, so wound up eating fig newtons and popcorn) and a couple of plants for work, and went into work a little early (I got there about a half an hour early, so I took an amazingly long time in the store, apparently.

Anyway, again, Kathryn and I took turns, covered each other's breaks, etc. Almost everything is the same. The only real surprise is that I am now a headquarters employee who clocks in and out, including for lunch, on the computer, which is taking some getting used to. But that will come pretty quickly. I also got my flu shot today. I learned I needed to stand more, maybe while I'm folding letters to go out, because it'll keep my legs from swelling, but also they hurt after a while if I don't. Plus, my watch makes a happy noise if I get up. It tries to tell me to get up every 45 minutes anyway, although I tend to ignore it. I will not be controlled by my machine overlord.

I left early this afternoon to go to PT, had a good session, including being able to do bridges for the first time in ages [arching the back by putting up the knees and putting all your weight on the shoulders], and doing 60 step ups (30 on each leg) which is amazing, giving I haven't been able to do steps in years. That's stepping up and down on one foot and down, but doing three sets of ten x 2 when you're not used to doing it is quite a workout. I then took the bus to my car (I'd taken the shuttle from the parking garage next to our building down the street to PT after changing from my jeans to shorts since he'd need to get to my incision for the massage part of the session). I came home, had a couple of things to do here, went to get dinner from Bourbon n' Toulouse, but went to the Sharkey Way location, even though it is across town and I hadn't been there before, because it has better parking (it actually just opened a drive through) and a vegetarian dish that the main Chevy Chase location doesn't have.

I went, got the food, and made a terrible mistake. I came back through downtown. I don't know what was going on at Rupp Arena, but the event caused a lot of traffic that didn't open up till I got onto Fontaine Road and then Chinoe. I was in bumper-to-bumper traffic. All told, I think the trip took an hour. The town's not that big.

We ate Sabbath dinner. I saved half of mine for today. I was so tired and uncomfortable. It was hard to finish. Afterwards, I took care of the dishes (my main chore, since he normally is the one who cooks), and then took my meds and collapsed into bed, exhausted, and I lasted 5 minutes, had trouble setting an alarm for tomorrow, and then I was gone. I woke up about 4:30 am and went to the bathroom, got a banana and some water, and got on the computer for just a bit. I'm going back to bed for a couple more hours.

I did snap a picture of myself in the break room in my new employee-appreciation gift t-shirt. It was supposed to be royal blue, and this was substituted, and while I look best in royal blue, I love this colour. Anyway, it's nice to be back, it's nice to see people again. But I'm glad Kathryn was here, and that I could ease into work this week. I hope I can do okay next week as I'll be back on my own. Goodness, I was so tired last night.

I think my orthopaedist will now realise I am a klutz, if he hadn't before.

I had an incident Friday after PT where I went to get into the car and instead of getting in like they tell you by sitting down and then swinging your legs in, I did it like i normally do, by putting a leg in and then easing myself in. However, this did not work. My steering wheel was set too low, so when I got in, my right thigh somehow got caught between it and my body and for a moment or two I struggled to free it, and it hurt. I went on for the rest of the afternoon, but since then it's been swelling more, and whereas my pain had fallen to a 0-1, it's been a 2-3, mostly due to the swelling, and a little sharper around the actual kneecap.

So, I did what any patient with anxiety would do. I went on MyChart and sent a message explaining this, asking if I needed to come in before my appointment that is on October 14th and have my x-rays early just to make sure everything is in place. It's probably fine, but I know there's a lot of cement used and there hasn't been enough time for the bone to heal over it much. So someone will read this Monday and go, 'really?' and pass it on to a PA, I'm sure. But I figure it would be better to speak up rather than to say nothing. If I have done something, I don't know what to do. I'm out of FMLA for the year. Hopefully, that is not the case. Sigh. Only me. Can't even get into a car gracefully and without injury.

I told myself I would not watch one of these until I was done with all this

and now I have...

Wow. PLEASE CLICK ON THE BLOCK BELOW TO WATCH A REALLY NEAT VIDEO ON ROBOT-ASSISTED TOTAL KNEE REPLACEMENT IF YOU ARE APPARENTLY OLD ENOUGH. It didn't occur to me it would be age-restricted and only available on YouTube. I assure you, it's not sexy.

By the way...

This video is from another place, but let me just say I am really happy with my experience at Baptist for a number of reasons.

1) I went to Dr Talwalkar for my knees based solely on the fact that I work with his brother, which in a way is a silly reason, but he's just as great and a very caring and experienced surgeon, and I'm very impressed with his skill and manner. He has now done three surgeries on me (also a rotator cuff).

2) My hospital stay was pleasant. The food was great. I was so exhausted from my anxiety leading up to the surgery that I slept well. I wasn't constantly bothered, but they were attentive. PT was great.

3) Pre-op testing was great. One of my former co-workers was one of the ladies who did it.

4) The surgery scheduler worked a miracle to schedule my second surgery so I wouldn't have to redo my leave and mess everything up. The next available was originally sometime about the time I was supposed to come back. She and the doctor got together and did it earlier than originally expected, and right after a holiday on his normal day, but as his only case, stuck at the beginning of the OR schedule. I have my suspicions, and I am very grateful to both of them.

5) I got a bill for a code that was written off by UnitedHealthcare, and when presented with the paperwork, Baptist instantly erased it.

6) Any correspondence I've had--with PAs, CMAs, registration staff, medical records, billing, pharmacy, even security (I thought I'd lost something at the hospital that turned up when I went to pack to go back five weeks later) was cordial, timely, and productive. It's been a very good experience.

7) The use of that attachable nerve block that attached and went home with me for five days really made a difference because I was in very little pain for the first few days relatively to others I've talked to and was able to get up and get moving quicker, even use that range of motion bike, and as a result hit my 3-week goals a week or more ahead of schedule. On the left leg, I was cleared for driving in 2 1/2 weeks, on the right 3 1/2. Even the doctor has been impressed with how it's gone. I think that made a big difference. I was up and on that walker a lot early on. It was a pain lugging around and making sure the cat didn't play with the line, and the second time I accidentally pulled on the catheter slightly, and that caused issues, but it still worked, and that's what mattered. And it was easy to box up and return, plus they give you free batteries. 😃

Anyway, I have healthcare providers in every system in this town, plus one in private practice, but I will continue to use Baptist Orthopaedics, and I highly recommend going to Janak Talwalkar if you can.

Just how bad they were and how much better they are now

I got my images of my knees today on a disc. I compared them to the ones I had from last year. It's like night and day. No wonder they feel so much better. The ones at the top are after the surgery, the ones at the bottom show the pre-surgery arthritis. It was definitely time. There was no cartilage at all. Since I'm a month out from surgery today, physical therapy was mostly functional testing today, so I'm hurting a bit, maybe a 4/10, but lately I've been a 0 or a 1, 2 tops, even with the range-of-motion bike, which is pretty amazing, especially since I was regularly an 8. Whoo-hoo!

Odd

It feels really weird to weird to wear pants today rather than (one of three pairs of) shorts I have, all of which are in the laundry to be washed, so I'm wearing my wide-legged pants that allow you to push up the fabric all the way up the thigh to get to the incision to massage the patella and incision or check for flexion, etc. The only problem they make for PT is the hurdles. I have to lift my knees a little more and concentrate a bit to make sure I don't knock them over, but that's actually good. But considering it's been 21 days since I've worn pants, it just feels odd. It doesn't hurt or anything; they're healed enough not to be an issue, it's just kind of strange. Funny how we get out of the habit of things. Like when I was first driving after two months. It took the first errand we ran to really get a feel for it again. But it's all good.

Speaking of driving, it's time to go to PT. I did the ROMTech bike after taking my morning meds and some insulin since I'd been high on my blood glucose, and then lay down to put some heat on that pulled muscle, which was tight. My roommate woke me up two hours later, at 12:30, which startled me that I slept that late. I hadn't expected that and hadn't set an alarm. My appointment is at 2 pm. My blood sugar was 43. I chewed quite a of glucose tablets. It's finally 141, so I can drive. But it had been so low it took a while to come back up. I'm hoping I'll get the okay to ditch the cane in the house (to be honest, I've mostly not been using it, to my roommate's dismay). I'm using it out of the house, and of course, on the steps still.

Okay, I'd better go. It's 1:23.

 

Huzzah!

Well, I:

• Drove to the UK area to pick up my friend's jacket, which he accidentally left at a friend's house while celebrating the new year
  
  
• Drove to the grocery store to pick up food, especially as we were out of coffee, so things were dire
  
  
• Drove to Captain D's through the drive-through to pick up dinner
  
  

It was odd to drive after eight weeks, but it felt nice to get some independence back. Yay, I'm back on the road!

Today I cancelled the Chandler Pharmacy's standing order to mail me my prescriptions, so I'll have to pick up a couple after PT tomorrow. So now I can go to my appointments by myself.

To everyone who drove me to my appointments, though, thank you so much for helping me! I really appreciate it.

Yay!!!

I got my bandages off, get to drive (starting small, anyway), and have a return date, right on schedule. Woo-hoo!!! See you all in October!

Here's post bandages being taken off:

The only thing he was concerned about is on my other leg, where the robot incision is, there is some redness around it, but there's no drainage, so he said to just keep an eye on it, and if it looks worse at all, call and get some antibiotics sent over to the pharmacy. Otherwise, not only was he pleased, but he was practically amazed by how well I was doing on it and commented to that effect.

Excited

I have my post-op appointment here in a couple of hours. Wish me luck and fingers crossed! I hope to get an idea of 1) when I can drive and 2) my return-to-work date. Plus, I'm getting my bandages off, regardless. Woo-hoo!

As far as the fusion bandage, it's all but ready to come off itself:

Good news, bad news

Good news: I've been released by my physical therapist to only use the cane. I'm off the walker both inside and outside, unless I'm in a busy environment where I feel I need it to keep from being trampled. Bad news: I got on one of those boards where you slide and do leg presses today at physical therapy. The mount/dismount is somewhat tricky, and I wasn't quite ready for it, because I pulled a part of my quadriceps muscle up on the upper part of my right (operant) thigh, and it really hurt. My therapist did massage it, and it helped quite a bit, but I'm limping a bit, and it hurts to stand up. It's almost exactly the spot I hurt on my left leg earlier this month when I stood up from the dinner table. My quads are always weak, but especially now, after surgery, and they're just not cooperating with me, even though we've worked a lot on strengthening both. But this, too, shall pass, I'm sure.

In the meantime, I've already transferred all the basic items I had in my walker bag (things like my handicapped placard, lip balm, house keys, and a small planner) to my smaller sling backpack. Time to put the walker away for now. Yay!

And so of course I did a thing...

Well, I somehow managed to do a klutzy thing with my bandage last night. I've been having trouble with swelling, especially at night before bed, so I'd iced and elevated my leg, which felt like an overripe tomato. I had used an ice pack that velcroed onto the leg, so when I went to take it off, I just reached under to cover, and somehow grabbed the fusion bandage along with it. I heard it rip a bit and stopped, but about 2-3 inches came off the top, to my horror. I got up, looked at it under the light. Everything under it looked good. It was closed and healing well. I asked my roommate (since he was a certified nursing assistant back in the day) what he thought I should do, and until I could ask the clinicians the next day, he put a Band-Aid over the edge of the end to keep it flush for the night. That didn't stay all night, but it got through most of it. This morning, I took a couple of pictures, uploaded them to MyChart, and sent a message asking if I should just trim it back or if I needed to do anything else to protect the incision. A couple of hours later, they said to trim it back, and that it looked good, so I did that. Three hours after that, I managed to hit the incision against the table, and it bled like the dickens. Only me. But with pressure, it did better. I've only ridden the bike once, though, today. I've been a little wary since I whacked my leg on the underside of the table, since it scraped the incision. Pictures below to illustrate what I'm talking about. Keep in mind, I'm two weeks post-status surgery.

 

Peeling

Peeled back

Trimmed off

Trimmed back -  from the top

Trimmed back - the whole view

A little do-it-yourself was in order

Since there was one night I accidentally stepped in dog hack-up (fortunately I did not slide, given the walker has wheels in the front, and the brakes in the back would have only done so much), and I am a klutz (which I think we have long established), but I don't want to wake up my roommate by turning on the hall light either, I rigged up my old cane light onto my walker. I had to change the batteries and clean the contacts. I will probably be released from the walker, at least for indoors, on Friday, but it'll help until then, and I can just move it to the cane after that.

Ah, the eternal question

Do we take a nap now, messing up the newly made bed, or do we stick it out even though our lids are heavy and we got almost no sleep last night?

[And yes, I know it's not really 'made'. I don't have my duvet on right now. I just tucked the wedge pillow into it's normal configuration, put it in the centre, straightened up the pillows, and put the blankets on those so they wouldn't interfere with the handrail.]


It's not like it's not easy to put back...

So sleepy

Fortunately, I haven't had this experience much with these surgeries, but last night it took me FOUR hours to fall asleep, then it was disordered, light sleep, and I woke up at 8 AM feeling nowhere near rested. My leg was incredibly swollen, tight, and hurting. I tried ice, elevation on the wedge pillow, Tylenol, stronger meds--nothing was doing it. I finally tried side sleeping with a pillow between my knees and my operant knee on top, and that sort of worked (it's my normal sleeping position), but it still took a while longer, and it wasn't good sleep. I had to meet someone at 10 AM, and we saw each other a little early. It is now a quarter after 1,0 and I am fighting the urge to go back to bed.

Slow it down, Lisa

Got back on the bike today and took it really easy, and there was no bleeding and the pain only increased a little. I think I got used to being able to do more with the other leg and forgot how it was when I first had my surgery, and since it was going so swimmingly, I overdid it. So I'm going to take it slower. PT says I'm on the walker for at least for another week, and I agree, given the circumstances. I can do dishes and laundry. Getting up from sitting is a little hard right now, but not as bad as it was. Here's to going slower.

Listening to Ella Fitzgerald

Resting with my legs elevated after PT and taking it easy, as for some reason my leg is super swollen today. I tried the bike today and started bleeding just a bit from my incision, so the surgery coordinator said to take it easy and dial back activity. At PT, Peter (my therapist) agreed, and he massaged that part of the quadriceps muscle that got pulled on Sunday, and it feels better. He also worked some vitamin E oil into the scar from the first surgery. I was surprisingly at 86° flexion given all the swelling. The extension had worsened to 1°, which wasn't surprising. I did have some spotting through my sleeve when I did my flexion test, so I bled just slightly. It was a good session with my therapist and two students following him on Wednesdays.

Afterwards, I dropped off the nerve block pump at the post office and returned some library books as well, thanks to Brenda, and came home, got some water, and elevated that leg on a wedge pillow for a couple of hours to see if it'll help. It did earlier.

Slight setback

I went to get up last night and of all things pulled a muscle in my left (non-operant) thigh, which is fairly painful. It's making it more difficult to walk independently from the walker or cane. The pain on both sides has been about equal, a 4 at the most, and that's during certain stressful movements. I've only been taking one 8-hour Tylenol for pain for the  last 24 hours. I haven't taken any opioids all,l since I had the surgery. That Journavx did really help, but I haven't needed it, either, and it's meant for short-term use. So it's not super painful, but I'm resting the muscle so when I go out it'll be okay. I don't want to fall due to it being weak. Next appointment is Wednesday, so hopefully it will recover by then. 

I'm free!!!

Okay, so I was awoken this morning at 3:42 by an alarm telling me the pain pump was low and that we were down to the wire in terms of doses left. So I stayed up, figuring it would just go off again when it was ready to be taken apart.

Which happened about 7:20 AM.

Anyway, the bandage came off, the little wire came out with the bandage and no real tugging on my part, which is nice. Last time I tugged just a bit. This time, I was dealing with more of a biohazard situation; there had been bleeding and fluid leakage from the solution, and it was a bit of a mess, plus I had the wire, and it was all attached to an IV bag that had to be cut off from the pump, then tossed into the trash.  Then the box had extra batteries you removed, you took everything out of it, turned off the pump, put its pouch in a plastic bag, and then chucked it into a box, placed two stickers and voilà, you have a postage-paid return box ready to go.

I am so glad to be free. Not only do I not have to worry about:

1. walking away from the pouch.
2. trying to get to the bathroom in time and get my pants down.
3. making sure the cat doesn't play with it.
4. making sure a dog doesn't chomp it.
5. rolling over it while getting into bed.
6. having it fall over while placing it down.
7. having it move while biking.
8. or, just randomly anything that will jerk that wire, it is a relief.

Plus, as a bonus, I can now take a shower!!! I just have to make sure I put cling wrap around my incision. Yep. It's generally waterproof but just needs a bit of help. The pump...that was not waterproof. I so feel like I need a shower. Even that stuff you disinfect with, that you shower with every day for five days, then wipe down twice before surgery? It makes you feel tacky, like tacky to the skin. Not clean. I want to feel clean.

Twinsies

The left leg is at 5 weeks of healing, the right leg is fresh, with a bandage, but they have matching incisions now. It may look bad at the moment, but I'm sure at some point they'll fade to such a point I won't even think about them, but what I will think about is how I'm not hurting like I was--already. Yes, three days post-op and granted, I have a nerve block (seen on the upper right thigh), but even once that came off on the other one (and that should happen sometime in the next 12 hours or so), there was less pain than before. I'm so glad this happened that I was able to lose the weight. That I had insurance to do this with. For a bunch of things. I hope this one goes as well as the other, and I'm going to do everything I can to make that happen. 

Today

So this time I started 'cruising' around the furniture a little earlier, meaning if I have something to hold on to, I feel pretty good about not having the walker, at least in my bedroom, where the bookshelves are three feet from the bedrail or desk, for example. I am being careful otherwise, particularly of the dog gates. I wouldn't go across the kitchen or living room in the more open areas. But the house is fairly small, so there aren't spacious areas, anyway. The bathroom is too narrow for the walker, so I keep my normal collapsible cane there as it is light and won't hurt the tile if it knocks over. It easily fits between the sinks, which fit together and are on pedestals, not with vanities. The steel cane is reserved for the stairs, which I'm taking it easy on as I've switched 'good' vs. 'bad' legs and muscle memory changes hard, but so far, so good.

I'm doing pretty well. The pain with the nerve block hasn't been over a 4, maybe a 5, for a minute or two.. My flexion is down from what it was right after surgery, but that's because of swelling, although there is nowhere near the swelling there was last time. The extension is 1° [they want 0°] and flexion 74° [90° at 3 weeks, so not bad] (both a little better than the same time with the left knee). While I've always considered my left knee my 'worst' knee, and yes, it was, Dr. Talwalkar said that with the exception of the grooved patella they had to put the button behind, both were in terrible shape, and the right was about as bad. The surgery was definitely needed. if not overdue.

The only issue I'm having is with the nerve block. I didn't have any issue before, but this one may have been tugged slightly and bled. With me being on aspirin, it probably looks worse than it is. It may have mixed with some fluid that wasn't absorbed by the nerve, so we've shut the machine off for an hour to see if that'll give it a chance to take up the bolus of rhindrocaine. I've only got a few hours left, maybe 10? of the solution, I'd like to not have to take it out, as it's really helpful, especially in terms of moving around and doing the ROMTech bike, or for that matter this afternoon I straightened up my room on my own, which gave me the feeling of a little independence and gave my roommate a little break. After all the stuff going around the surgery, etc., and taking care of me, I think he needs and deserves one.

I'm not up to doing chores yet, probably, but I can get my own water (I have a cupholder on the bag on my walker) or ice. And the dogs seem to be doing pretty well. I had to go outside my room without notifying him, and they were fine, so we tested them at dinner, and they did well. They just have to be reminded to not sniff me or get too near occasionally, but generally, they leave me alone, and they're very wary of the walker, so I mainly keep my leg surrounded by that. It seems to be working. They'd pretty much been trained to stay off me with the left leg already. But I'm still keeping track of where they are at all times, just in case.