The next day began much like the previous, with having blood drawn at 4:00 AM. I was impressed that they let me get some real sleep up until then. It was so quiet, much more quiet than I expected in a hospital. They did take me off the morphine pump that morning too.
At about 9:00 AM, another physical therapist, Jenny, came to work with me. I was less light-headed so I was able to actually make some progress this day. I will tell you, I felt absolutely blessed that I was already comfortable and confident on crutches. I got up on those things, started zipping around, and my mood lightened considerably because here was something I could actually do! Jenny had me show her I was able to go up and down stairs (since I needed to handle stairs at home) and that I could get in and out of a chair. She went over the exercises I would need to do at home and with a physical therapist once I left. She stressed that it was my responsibility to understand the protocol and make sure the physical therapist stuck to it.
Then something important happened. Jenny helped get me into the CPM and saw that I had been doing it wrong. She got me straightened out on how to use it and we all realized that while I thought I was up to 35 degrees of bending, I really hadn't gotten past 20. I was supposed to be at 40! Kittens!
I got to work on the CPM and gained 5 degrees, but Dr. Trice came by not long after and was not happy to hear that I was only at 25. I got a little talking to about the horrible things that would happen if I didn't get back on track. Sufficiently terrified, I started to really push on the CPM.
I am sure for most people that would have been fine. However, I have a terrible habit of pushing myself too far. When I was in PT after the MFX last year, there was a running joke that no one wanted to tell the physical therapist, Sandy, when something was easy because she would increase the exercise. She always had to keep an eye on people to see if it looked too easy because they might not tell her. With me, she had to watch that I wasn't doing too much or going too far. I am just too stubborn to accept when my body won't do what I want it to do.
So by the time that CPM session had stopped, I was absolutely exhausted from the pain I had pushed myself through. I mentally disengaged and was barely responsive. A woman who I think introduced herself as an orthopedic assistant on Dr. Trice's team stopped by to check on me. I don't know what she saw that made her say this, but she said that she believed I had been underrating my pain level. I suppose the pain that first night could have skewed my rating system. So what I called a 7 or 8 and what they treated as a 7 or 8 was actually what should have been reported and treated as a 10. They gave me an IV push of morphine and changed my pain meds again.
The rest of the day went better for a while. At about 4:30 that evening I was just sitting in bed watching TV when my knee started to ache. It was the strangest thing. When it reached about a level 6 I called for the nurse to ask what immediate relief pain medication was available in case I needed it. In the 1-2 minutes it took for her to come into the room, the pain went up to an 8. In the 1-2 minutes it took for her to come back with an answer, it went off the charts. This was another attack in the ballpark of the one on the first night. It wasn't quite as bad, because I was able to hold my body still, but the white-out, the forgetting to breathe, and the hyperventilating were all still there. The speed was the terrifying thing though, as it went from uncomfortable to out of sight in a total of about 5 minutes. The nurse gave me a push of a dilution of morphine that was 8 times stronger than what I had gotten before. Once I settled down, (you guessed it) they changed my meds again.
Pain medication is far more trial and error than I realized. The hospital doesn't want to over-medicate their patients for all kinds of good reasons, so they have to start low and work up to find the right level. It is unfortunate that it took about 48 hours after the surgery before they found the right level for me, but that's just the way it goes. At least they figured it out before they sent me home, so I had the help I needed though both serious episodes.
Due to both the pain and some redness around the incision, I had to stay another night. They had found the right level of meds though, so my last night was comparatively peaceful.
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