Wednesday, March 31, 2010

First Night

Before blissfully allowing me alone to sleep, I was informed that I had to start using the CPM machine at 11:00 that night. Just before 11:00, my husband rejoined me in the private room to help me through that first night. He brought movies. :)

Getting into the CPM was okay, but it was somewhat painful. I kept pushing it away from me to try to get more comfortable but that only made the position worse. It especially hurt when fully straightened. As wonderful as the nurses were, I don't think they were confident in CPM positioning so they kept letting me make it worse. I finally found a fairly comfortable position, though it was very incorrect, and got through those first two hours.

This is where the night got interesting. The nurse and technician got me out of the CPM machine and allowed my leg to rest straight in the bed. I don't know if was the bad positioning of the CPM or if was just the effect of movement, but I was quickly overwhelmed by a level of pain which I had never experienced nor imagined. The best way I can describe it is that my brain whited out. I wasn't aware of anything but the pain and when I did remember to breathe, it came out as hyperventilating. The worst was that writhing made me move my leg which started fresh waves of pain. I didn't know that level of pain existed.

At any rate, they increased my pain medication and eventually I was able to regain myself and rest.

Another Perspective

Writing about the day of the surgery is strange. I read back over it and don't feel like I have actually said anything. I slept through most of the major events! In that spirit, I asked my husband to relay part of the day himself. Here is his account of a highlight: meeting with Dr. Trice after the waiting was over.

Family Waiting Room

Although Dr. Trice, Allison’s surgeon, had scheduled for eight hours, the surgery ‘only’ took about four and a half. At around 3:30, Dr. Trice came into the waiting room and found our two families (Allison’s mother and both my parents had come to visit) waiting for any news. Even through one of the many assistant nurses had called a few times during the procedure to keep me informed of her progress, I was looking forward to hearing from him. He looked understandably tired, and even though I expected it, my attention kept getting drawn to the small splatters of red that stood out against the green surgical scrubs.

After meeting the family, he explained how he found the condition of the cartilage and generally what the gist of the procedure was. He produced two pages of pictures, the first a series of four images (1 2 3 4 Warning: GR 5 for all of them) outlining the current damaged area. In these he pointed out that the surgical probe was able to easily puncture the cartilage; it looked like the consistency of curdled milk. The second page was a series of four images (1 2 3 4 Warning: GR 5) outlining the steps taken in the procedure. These pictures were the most striking, and he explained that he was able to clean out the impacted area, and implant the cultured cartilage under a thin membrane of organic material. From my obviously untrained eye, the remaining tissue looked a great deal healthier than the damaged cartilage.

Additionally, Dr. Trice shared with us a series of images from what I assumed was a successful procedure. In these, a picture stunningly similar to Allison’s damaged area was compared to the same knee after the patch had dissolved. The new cartilage was silky smooth, like an overly polished piece of pure white marble. He reminded me again that this procedure had a 70 percent chance of success, so nothing is guaranteed. Although, when compared to the option of having done nothing, I will take a 70 percent increased chance of getting a result like that. Dr. Trice wrapped up by saying Allison was coming out of the anesthetic well, and that it would be a few hours until they moved her into her room.

Monday, March 29, 2010

Details

So obviously it has been a few crazy days. I will try to relay as much as I can, but it will take several entries.

Surgery Day

My husband and I got up early and got to the hospital on time. I had to wait for about an hour as they had a full schedule and there was more than enough time allotted for my preparation. I cooled my heels in the family waiting room and got to see where my husband and mother would be waiting. It was a nice room with a monitor that provided updates on patients by their numbers. The room had a view of the Baltimore harbor and you could actually see the USS Comfort docked out there.

At 9:30 they called me back and I changed into a hospital gown. Soon a series of people started streaming in asking the standard questions about any complicating factors. Dr. Trice came by and signed the correct leg for surgery. He asked if I had any questions, but the way he looked at me I could tell he knew we had been through everything and there was just nothing left to discuss. This was it.

The operating room had been booked for eight hours. While we knew it would be a while, that was still a shockingly long time. My husband and mother would be given updates from inside the operating room every few hours and they could leave the waiting room (or hospital) and still get updates as long as they left cell phone numbers.

The surgery was scheduled for 11:00 and we headed back there just a few minutes after. When the operating room doors opened the first thing I saw was the smile of Holly, Dr. Trice’s surgical nurse who I had spoken with at every appointment leading up to this. She knew how glad I was to finally be there. I am not sure how often patients are that happy about surgery.

They moved me over from the pre-op bed to the operating table, which was very narrow. They swung in arm rests with foam egg crate padding and began strapping me down. They put a mask over my face and told me to breathe deep. I went out like a light.

After

Things went smoothly and they were able to finish in 4 ½ hours. I woke up in the recovery room in a more comfortable bed and in some pain. I actually came out of the anesthesia much smoother than I expected. I read a lot about others having nerve blocks, but I don’t think they did that with me. My painkiller was in my IV and I had a morphine pump that I could use once every six minutes.

The recovery room is basically where they take you to wake up. Family isn’t allowed in there and I don’t really remember much, so this part is hard to write about. About all I remember is that the recovery nurse did notice my pretty toes and got a kick out of them. :)

When I was clearly stable they took me to my room in the Wenz Orthopedic Wing and brought my husband and mother up to join me. The room was gorgeous! It was big, had hard wood floors, a few chairs, and a sofa that folded out into a bed. It looked like they hired the same designers that Westin uses. I saw all this in the morning though, because my eyes were closed. I was alert, but just had no interest in opening my eyes. After seeing me get settled in, my family left since all I wanted to do was sleep. I got right to that.

Saturday, March 27, 2010

Home again, home again, jiggity-jig!

I just came home this afternoon and wanted to let everyone know I am doing fine! I will post more details tomorrow once I get some rest. Thanks for all your support!

Wednesday, March 24, 2010

S-day

Today is the big day. I am supposed to be there at 8:00 am and my surgery begins at 11:00 am. Thank you so much for all the good wishes!

Tuesday, March 23, 2010

The Final Countdown

Now you have that song stuck in your head, right?

So today is my last day. I finished handing everything off at work yesterday and gave some treats to my wonderful team to thank them for putting up with me. I am certainly not the only one this injury affects. It was kind of sad leaving. I will miss everyone.

I did get my pre-surgery pedicure this weekend! My toes remind me of cupcakes with sprinkles. (I give the picture a GR of 2 only because some people have a thing about feet.)

Stepping off the Ryzolt has been unpleasant. It is a 12-hour pill so I am taking it once a day now instead of twice. Since I am not ahead of the pain, it never really calms down. Oh well. It will be worth it to not have to go through that withdrawal again.

The instructions I received from pre-op said they will call today to tell me what time my surgery will be tomorrow. I am waiting by the phone. They said that since they are a trauma hospital, they can only schedule things so far in advance. A friend of mine had her hip surgery rescheduled at the last minute recently and she was so frustrated. I totally understand! You get so worked up with anticipation. I don't think my surgery can be rescheduled though. Once the cells are ready and delivered, they have to be used immediately.

Adding a few more things to my list that I picked up over the weekend:
- Back pillow (the kind with arms)
- Bed tray

@ Jenn - My mother used to swear by Arnica gel! I haven't thought about that in years.

Friday, March 19, 2010

Checklist

I am assembling things that will be useful when I come home on Thursday.

- Rubbing Alcohol: to remove the iodine from my skin around the incision site.

- Toilet Seat Riser: Since getting up and down will be difficult with my knee locked. I looked at a few kinds and read that some people had trouble with the all-in-one models that included both a raised seat and handles for support. So, I just got the simple riser version and separately bought....

- Toilet Support Bars: These are supported by legs that go down to the floor, so they seem more stable.

- Leg lifter: I mentioned this one a while ago. It may be difficult to get in and out of the CPM machine on my own, and I am hoping this will help.

- Body wipes: I won't be able to shower for a few days but keeping clean helps tremendously with overall mood. I found these in the grocery store near the adult diapers, as they are marketed for people with incontinence. They will work for post-surgery care too!

- Dry shampoo: I haven't bought this one yet, but was informed I can get it at a drug store. It is like a mousse that you put in your hair to eliminate oil and make it feel a little fresher. It's not as good as washing, but better than nothing.

- Gold Bond Anti-itch powder: because spending too much time in bed irritates the skin.

- Gold Bond Anti-itch lotion: After my microfracture (MFX) surgery, my foot on the affected leg itched HORRIBLY and I could barely reach it. A little of this stuff felt like heaven! Note that I am not talking about the foot lotion that Gold Bond makes. That is a nice foot lotion, but it does not contain any anti-itch ingredients.

- Face Wipes: because standing at the sink to wash my face will not be comfortable for a long time.

- The Perfect Shoes: I had a pair of these that I wore all the time after the MFX, but they got pretty worn out. They are nice because they are lightweight and supportive, but what makes them perfect is that they are very easy for someone else to take off and put on. Reaching your foot is very hard! And yes, I did order them in purple.

- New curtains for the bedroom: because I will be in there a lot and want to spruce it up a bit. :)

- Non-medicated throat lozenges: because the breathing tube is irritating.

- An ottoman: I chose a round one that is 20" across. I like this one because it still isn't large, but it supports the length of my leg better than a small square ottoman. I have this under my desk in my home office that is on the same floor as my bedroom. When I can move around a little, I now have a comfortable and safe (no stairs) place to go. The ottoman is crucial. It took a while after the MFX before I could keep my leg in a non-elevated position for more than a few minutes. My foot kept turning purple! I would rather my shoes be purple, not my feet.

- Vitamin E lotion: I don't think it has been scientifically proven that vitamin E helps reduce the appearance of scars, but many people swear by it. Keeping the skin supple and healthy just doesn't seem like it could be a bad thing, so I will try it.

As you can see, I learned a lot from the MFX. The recovery for that is like a "lite" version of the recovery for ACI. It will be harder, but I am better prepared.

Counting Down on One Hand

Five days to go...

I am about to start shopping to make some frozen meals. Here are two recipes that I plan on making. I also expect I will eat a lot of graham crackers, saltines, and those Archway old-fashioned molasses cookies.

Carrot Fennel Soup - This soup is mild and sweet, but very smooth. I expect that it will be nice as a light meal when I am still getting my appetite back and when my throat is still sore from the anesthesia.

Beef and Bok Choy Hot Pot - This is one of my favorite healthy comfort food recipes. My husband doesn't care for it, so I don't have much occasion to make it. Here's an occasion! It freezes pretty well too if using fettuccine (heartier noodle). Both carrot and bok choy are hefty vegetables that can take a little reheating and not get soggy. Still, I probably won't cook them at all before freezing.

Monday, March 15, 2010

Single Digits

Today is nine days until my surgery. I have been waiting so long and now it is only nine days away. Wow.

I thought I should mention that my pain medication is squared away and the pain is manageable again. Thanks to everyone that was pulling for me for those couple of bad days! It makes a difference. Honestly I am still so surprised when someone I know starts talking to me about something I wrote here. It makes me feel very special to know people are interested in checking in on me.

Before things get crazy, I do need to give some serious kudos to my wonderful husband. He has been an absolute angel and I don't know how I could have gotten this far without him. It is hard on him too, to see me hurting and to not be able to help, but he hasn't let me down even once. Sometimes I wonder if my knee problem is just to even out a cosmic balance sheet because I have been so unbelievably lucky to have him in my life. I just had to get that out there.

I think people expect me to be nervous about the upcoming surgery. Describing the recovery blows most people away. I think I finally found an analogy that makes sense to many people. Everyone knows that the traffic is bad around Los Angeles. During rush hour it can be mind-numbingly bad. The on ramps there have a stoplight to mediate the flow of traffic merging in during busy times. I feel like I have been stuck at one of those stoplights for a very long time! I know that once it turns green and I can get on the highway that it will still be insanely slow going. But right now, I am not moving at all. I want to get on that slow highway and start making my way to recovery. It will still be rough, but it's better than staying here stuck on the on ramp.

@Lottie - I know! Someday I will have normal knee function! I do try to stay focused on the end goal.

@Shae - Wow, that soup looks good! Do you freeze it at the point before you add the cream and then later add it when reheating?

@Jess - I feel your pain! Hope it is sorted out by now.

@Mike - Still trying to find a good date!

Monday, March 8, 2010

Well that was "fun"

I just had a really truly awful weekend, but I did learn a few things from it. Unfortunately it is kind of a long story.

The last time I went to my pain management doctor, I got a prescription for the painkiller I have been on for a few months now. It is kind of expensive and I still had about 2 weeks worth, so I sent the new prescription into the mail order delivery service that my pharmaceutical insurance coverage runs. Their delivery is fast and the co-pay is lower, so I figured that was a smart move. Boy was I wrong.

I got an email from them saying there was a delay in processing it. I still had about 5 days of meds left, so I called and asked what the issue was. The person I talked to didn't know, but said I could either get a filler prescription from my doctor in the meantime or I could transfer the prescription to a local pharmacy. I chose the filler prescription. So, I got another week's worth of painkiller called into a local pharmacy by my doctor and figured things would be fine.

Well, the next week was coming to an end, and I had no further communication from the mail order service. I only had a day's supply left, so I called and inquired how to transfer the prescription. The person I spoke with said that they just needed the pharmacy to call and confirmed that the prescription was available to be transferred. I called the pharmacy and they took the request and went to make the call. Everything sounded fine.

That was on a Friday. The pharmacy called and left a message later that day, but I was unable to get back to them until Saturday morning. Apparently when they called the mail order service they were informed that the prescription was not available to be transferred. I was told twice that it was! I called the mail order service (and tried not to lose my temper) and was informed that they didn't like the number of pills prescribed and that they were unable to contact my doctor, so they revoked the prescription (!!!!!) and sent it back to my doctor. It was gone. There was nothing I could do.

So, remember how this is Saturday? I called the emergency line for my doctor and was told they would not contact the doctor for prescription matters only. I needed to be in pain. I guess I can understand that, since this is a pain management doctor. Most of his patients are on opiates and probably beg for more all the time. However, I had been told specifically not to stop taking the Ryzolt suddenly because there can be nasty withdrawal effects.

All day Sunday I experienced those nasty withdrawal effects. Whee.

I do always try to find a silver lining, and I decided it would be verifying whether the pain was bad enough to warrant continuing the meds. I hate taking pills and always seek to stop as soon as possible. Unfortunately the answer is yes, I still need them.

So I learned that once your prescription leaves your hands to a mail order pharmacy you are taking an awful risk that you will ever actually see that filled. I also learned that you can never assume things are fine. You always have to press and find out exactly what the hold-up is. If I had pressed the first time I called, I would have been able to just get a new prescription instead of a week's worth. Finally, I learned that withdrawal sucks and I will definitely go through the trouble of stepping the Ryzolt down for the three days prior to the surgery, as was recommended.

Sigh. 16 days to go.

Thursday, March 4, 2010

Counting the days

There isn't much going on right now. Every morning I wake up and think how many days are left. Right now, it is 20 to go. I am almost to the teens.

I do have a few things that will come up before the big day. I have my pre-surgery pedicure and I also plan on doing some cooking of freezable comfort food. Might as well share pictures and recipes!

I wish I had more to say, but all I would do is start whining about pain and that just isn't good for anyone. Hang in there with me everyone. Nearly there.