I thought I had pretty much figured out all that I needed to know, but then this weekend happened. I have been having so much trouble with all my muscles aching and my back just all knotted up. It has been hard to get up in the morning. So, finally, I asked my PT for a recommendation for a massage therapist.
Lesson Learned: I should have gotten a massage a long time ago!
It is highly important to have the right type of massage therapist who knows how to actually heal the muscles, not just help you relax. Sports massage therapists seem to be the ticket. Anyway, a wonderful woman named Brandy took her magnificent elbows to the arch around my left shoulder blade. It was one huge knot from both the cane and how I have been compensating for my limp. I didn't even realize until she was done that I had been restricting the motion of my left arm. She freed it.
The next day I was sore, as expected. It has made a huge difference though and I wish I had done this months ago. I am finally starting to feel closer to normal.
Showing posts with label lessons learned. Show all posts
Showing posts with label lessons learned. Show all posts
Tuesday, September 7, 2010
Friday, July 9, 2010
First Day Back in the Office and Other Things
In the past week I have challenged myself 3 times and boy am I beat! On Sunday I went to the grocery store with my husband and I walked through the entire trip! I used the cart to support myself and didn't make any extraneous trips. If we forgot something my husband went back for it, and he found it nice that my default slow speed meant I was usually still about where he left me when he got back! I normally have a tendency to wander off. (Ooh something shiny!) Anyway, by the end of the trip I was absolutely shaking from the effort and very weak, but it was still very satisfying. I iced as soon as I got home and rested. Overall it was a good experience.
Building on that success, I went into the office on Tuesday. I managed to make it 6 hours before thecrazy nerve tingles in my knee got out of hand. It's not pain exactly, just uncomfortable niggling tingles shooting through my knee. They get worse as I spend more time in one position, and eventually get constant and very distracting. There was some soreness as I walked out of the office too. I came home, applied ice, and rested until the tingles stopped. However, the next day I was so exhausted I felt almost ill so I guess I needed that next day to recover. It's the weak muscles that are such a huge limitation now. Ice makes the tingles go away quickly, but building muscles means wearing them out first. I just lost so much muscle in my entire body by being inactive for so long.
Then yesterday I really pushed myself. I drove 2 hours to a meeting and then 2 hours back afterward. Driving has been pretty easy, but can cause those nerve tingles since it is a lot of sitting. I arrived early for the meeting and found a spare office to remove my brace and ice right away. That helped a lot. I made it through the meeting and drove back, going straight to PT where I took it pretty easy. I was so tired I felt a little disoriented, but no harm was done. It did take me a long time to get out of bed today though.
Other things going on besides me wiping myself out repeatedly: The cane use appears to be aggravating a tendon in my shoulder causing a pinched feeling. I was trying to treat it with heat and massage, but Sandy, my PT, said to cut that out and use ice. I am never sure which to reach for since random pain is just random pain to me. She said it was probably an inflamed tendon so ice should calm it. She also gave me a sample of BioFreeze, which feels pretty cool (hee hee). I need to focus on getting away from the cane soon anyway, so this is further motivation.
Also, (insert drum roll!) I have a new lesson learned.
Lesson Learned # 12: Keep icing regularly even when the swelling stops. As I increased my activity, Sandy instructed me to ice regularly. The ice has had the unexpected effect of making the straight leg raises (SLR) easier! It is finally not so painful to get in a good "locked" position. The SLR are probably the single most valuable (and most difficult) rehab exercise. I wish I had known regular icing would help with them earlier, but I am glad I figured it out.
So overall, I am making progress and wiping myself out a lot. But hey, I am not going to get better by sitting on my bum. Well, at least not all the time. I am still exhausted from yesterday, so excuse me while I go sit on my bum for a little while. But this weekend I will be back to grocery shopping.
Building on that success, I went into the office on Tuesday. I managed to make it 6 hours before thecrazy nerve tingles in my knee got out of hand. It's not pain exactly, just uncomfortable niggling tingles shooting through my knee. They get worse as I spend more time in one position, and eventually get constant and very distracting. There was some soreness as I walked out of the office too. I came home, applied ice, and rested until the tingles stopped. However, the next day I was so exhausted I felt almost ill so I guess I needed that next day to recover. It's the weak muscles that are such a huge limitation now. Ice makes the tingles go away quickly, but building muscles means wearing them out first. I just lost so much muscle in my entire body by being inactive for so long.
Then yesterday I really pushed myself. I drove 2 hours to a meeting and then 2 hours back afterward. Driving has been pretty easy, but can cause those nerve tingles since it is a lot of sitting. I arrived early for the meeting and found a spare office to remove my brace and ice right away. That helped a lot. I made it through the meeting and drove back, going straight to PT where I took it pretty easy. I was so tired I felt a little disoriented, but no harm was done. It did take me a long time to get out of bed today though.
Other things going on besides me wiping myself out repeatedly: The cane use appears to be aggravating a tendon in my shoulder causing a pinched feeling. I was trying to treat it with heat and massage, but Sandy, my PT, said to cut that out and use ice. I am never sure which to reach for since random pain is just random pain to me. She said it was probably an inflamed tendon so ice should calm it. She also gave me a sample of BioFreeze, which feels pretty cool (hee hee). I need to focus on getting away from the cane soon anyway, so this is further motivation.
Also, (insert drum roll!) I have a new lesson learned.
Lesson Learned # 12: Keep icing regularly even when the swelling stops. As I increased my activity, Sandy instructed me to ice regularly. The ice has had the unexpected effect of making the straight leg raises (SLR) easier! It is finally not so painful to get in a good "locked" position. The SLR are probably the single most valuable (and most difficult) rehab exercise. I wish I had known regular icing would help with them earlier, but I am glad I figured it out.
So overall, I am making progress and wiping myself out a lot. But hey, I am not going to get better by sitting on my bum. Well, at least not all the time. I am still exhausted from yesterday, so excuse me while I go sit on my bum for a little while. But this weekend I will be back to grocery shopping.
Friday, May 14, 2010
Prone!
I have been seriously stepping up my prone exercises to straighten my leg. It has led to yet another lesson learned! (insert drumroll)
#11 Do a Complete Variety of Exercises. It was feeling hard to get all my exercises in everyday, so I ended up often skipping the same ones over and over. The prone exercise would usually make me feel unable to bend my knee very well for a good 30-60 minutes afterward (which made it harder to get other exercises in) so it was often the one I skipped. Once I started focusing on it though, it got so much easier and it got rid of that super painful "locking" in place that kept happening when my leg was straight. So, I guess all the exercises need to work together. If you can't fit them all in, make sure you aren't skipping the same one repeatedly.
Other than that, things are progressing pretty tentatively. After the microfracture last year, I was eager to get better and kept trying to do more and more. I don't know for sure if that led to the failure, but this time around I don't want to take any chances.
Dr. Trice and Sandy both said to use a scale to see how much 25-50 lbs really feels like. I did, and it is a lot of weight! I stood on the scale with about what I was initially comfortable to bear through that leg, and it only registered 23 lbs. I put more weight through it and it came up 38. I put as much weight as I possibly dared and it still came up only 47 lbs! So, as much weight as I dare right now falls inside Dr. Trice's guidance. That's good to know.
I am planning to start working from home next week (8 week mark). That was my initial plan and it still seems appropriate. My stamina is getting pretty solid and the swelling is really starting to come down, so I am looking forward to trying to work. However, I let work know that I wanted to work from home the first 4 weeks I am back. I think this will help prevent me from getting dangerously overconfident and push myself too far. It is a very real concern.
#11 Do a Complete Variety of Exercises. It was feeling hard to get all my exercises in everyday, so I ended up often skipping the same ones over and over. The prone exercise would usually make me feel unable to bend my knee very well for a good 30-60 minutes afterward (which made it harder to get other exercises in) so it was often the one I skipped. Once I started focusing on it though, it got so much easier and it got rid of that super painful "locking" in place that kept happening when my leg was straight. So, I guess all the exercises need to work together. If you can't fit them all in, make sure you aren't skipping the same one repeatedly.
Other than that, things are progressing pretty tentatively. After the microfracture last year, I was eager to get better and kept trying to do more and more. I don't know for sure if that led to the failure, but this time around I don't want to take any chances.
Dr. Trice and Sandy both said to use a scale to see how much 25-50 lbs really feels like. I did, and it is a lot of weight! I stood on the scale with about what I was initially comfortable to bear through that leg, and it only registered 23 lbs. I put more weight through it and it came up 38. I put as much weight as I possibly dared and it still came up only 47 lbs! So, as much weight as I dare right now falls inside Dr. Trice's guidance. That's good to know.
I am planning to start working from home next week (8 week mark). That was my initial plan and it still seems appropriate. My stamina is getting pretty solid and the swelling is really starting to come down, so I am looking forward to trying to work. However, I let work know that I wanted to work from home the first 4 weeks I am back. I think this will help prevent me from getting dangerously overconfident and push myself too far. It is a very real concern.
Saturday, May 8, 2010
More Lessons Learned
Just adding a little more to the list....
#9 - Keep Taking Tylenol. The pain isn't so bad most of the time now, so it is easy to forget to take Tylenol before you do things that will make the pain worse. Taking Tylenol before PT and before bed are absolute requirements. The one time I did not take it before PT, I could not do a single straight leg raise. Why make it harder? It's hard enough.
#10 - Limit Exercises Before PT. Before one PT session, I was working on leg extension (getting it straight), but it just made the PT harder. Limit exercises within a few hours of meeting with your physical therapist to only quad sets and leg bending exercises. Those both help prepare you for the session, while other exercises can make actually make the session harder.
By the way, I have an appointment with Dr. Trice on Monday. We will likely be trying 25% weight-bearing, so I am very excited. I will let you know how it goes!
#9 - Keep Taking Tylenol. The pain isn't so bad most of the time now, so it is easy to forget to take Tylenol before you do things that will make the pain worse. Taking Tylenol before PT and before bed are absolute requirements. The one time I did not take it before PT, I could not do a single straight leg raise. Why make it harder? It's hard enough.
#10 - Limit Exercises Before PT. Before one PT session, I was working on leg extension (getting it straight), but it just made the PT harder. Limit exercises within a few hours of meeting with your physical therapist to only quad sets and leg bending exercises. Those both help prepare you for the session, while other exercises can make actually make the session harder.
By the way, I have an appointment with Dr. Trice on Monday. We will likely be trying 25% weight-bearing, so I am very excited. I will let you know how it goes!
Sunday, May 2, 2010
Lessons Learned
I have been lucky enough to do a few things right that I didn't expect would matter so much and I have also just figured a few things out along the way. This is different from my checklist. These are my lessons learned (a.k.a. things I would have liked to know beforehand).
#1 - This Will Suck. The first few days were quite painful. In fact, the first 2 1/2 weeks were pretty awful. You have to be prepared for just how awful it will be, both in planning and mentally. However, it only stays that awful for 2-3 weeks. Then, if things go smoothly, suddenly it isn't so bad.
#2 - Know How to Use Crutches. Get confident on them. If you have stairs in your home, learn how to go up and down them with crutches. Figure out how to get and out of your bathtub or shower. I am talking more than a dry run. Use them until you are comfortable and confident. Practice with your leg in a normal position (slightly bent, held in front of your body), in a locked brace position (straight, able to move forward with the crutches on each step), and in a totally weak position (straight, unable to move your leg forward at all - this is more of a shuffle). I went through all three.
#3 - Quad Sets. Practice these until you can isolate the quad muscle and just do the exercise without moving your foot or pressing your knee down (two different methods used to show people how to activate the quad). If you haven't been to PT yet and don't know how to do a quad set, then here is a video showing how. Not only will your quad benefit from any strength you build up before the surgery, but it will be 1000 times harder to do the exercise after the surgery. It's only 100 times harder if you have practiced a lot (and I do mean a lot).
#4 - Stockpile Entertainment. I watched all 7 seasons of the West Wing in the first two weeks. Then I watched two seasons of Burn Notice, one season of Leverage, and one season of The Closer. Now is the time to borrow books, movies, and TV shows on DVD from your friends and family. Do not leave yourself to the mercy of daytime television!
#5 - Get Help. For the first week at home, if you can have someone there to help you all day then do it. For the next 2-3 weeks after that, try to have someone stop by once a day for an hour or two. You can't do laundry. You can't cook. You can't go to the store. Even if you get something delivered, you can't get the stupid box inside the house because you can't pick things up with crutches. That's just the sheer logistical side. Add in that every time you get up it's painful and you just need help. Accept it and plan for it.
#6 - Track Your Pills. When I came home from the hospital, I was taking 5 pills and one injection regularly at intervals ranging from 3-24 hours. It was extremely common for me to forget if I took something. I recorded everything I took so there was no question. This was helpful for setting my mind at ease and preventing dangerous mistakes (since usually the answer was yes, I did take it). There is no way I could have gone without a log.
#7 - Bend Your Leglifter. This may not be important for everyone, but I was very happy once I figured this out. The leglifter is a great little device, but every time I used it I felt almost as though I was putting weight through my knee. Eventually, I bent the head of the leglifter so I was pulling the foot up (GR2 for feet), instead of towards me (GR2 also for feet). In the early days of maximum suckage, this little realization helped a lot.
#8 - You Will Be Tired. This might manifest itself differently for others. I don't sleep well at night, and during the day I can easily get completely exhausted by simple acts, like bathing. I have taken quite a few serious naps. As I am slowly getting stronger, the need for naps has subsided but I do still tire very easily.
Since this is more of a reference post, I will add more as I think of them. I probably still have more to learn!
#1 - This Will Suck. The first few days were quite painful. In fact, the first 2 1/2 weeks were pretty awful. You have to be prepared for just how awful it will be, both in planning and mentally. However, it only stays that awful for 2-3 weeks. Then, if things go smoothly, suddenly it isn't so bad.
#2 - Know How to Use Crutches. Get confident on them. If you have stairs in your home, learn how to go up and down them with crutches. Figure out how to get and out of your bathtub or shower. I am talking more than a dry run. Use them until you are comfortable and confident. Practice with your leg in a normal position (slightly bent, held in front of your body), in a locked brace position (straight, able to move forward with the crutches on each step), and in a totally weak position (straight, unable to move your leg forward at all - this is more of a shuffle). I went through all three.
#3 - Quad Sets. Practice these until you can isolate the quad muscle and just do the exercise without moving your foot or pressing your knee down (two different methods used to show people how to activate the quad). If you haven't been to PT yet and don't know how to do a quad set, then here is a video showing how. Not only will your quad benefit from any strength you build up before the surgery, but it will be 1000 times harder to do the exercise after the surgery. It's only 100 times harder if you have practiced a lot (and I do mean a lot).
#4 - Stockpile Entertainment. I watched all 7 seasons of the West Wing in the first two weeks. Then I watched two seasons of Burn Notice, one season of Leverage, and one season of The Closer. Now is the time to borrow books, movies, and TV shows on DVD from your friends and family. Do not leave yourself to the mercy of daytime television!
#5 - Get Help. For the first week at home, if you can have someone there to help you all day then do it. For the next 2-3 weeks after that, try to have someone stop by once a day for an hour or two. You can't do laundry. You can't cook. You can't go to the store. Even if you get something delivered, you can't get the stupid box inside the house because you can't pick things up with crutches. That's just the sheer logistical side. Add in that every time you get up it's painful and you just need help. Accept it and plan for it.
#6 - Track Your Pills. When I came home from the hospital, I was taking 5 pills and one injection regularly at intervals ranging from 3-24 hours. It was extremely common for me to forget if I took something. I recorded everything I took so there was no question. This was helpful for setting my mind at ease and preventing dangerous mistakes (since usually the answer was yes, I did take it). There is no way I could have gone without a log.
#7 - Bend Your Leglifter. This may not be important for everyone, but I was very happy once I figured this out. The leglifter is a great little device, but every time I used it I felt almost as though I was putting weight through my knee. Eventually, I bent the head of the leglifter so I was pulling the foot up (GR2 for feet), instead of towards me (GR2 also for feet). In the early days of maximum suckage, this little realization helped a lot.
#8 - You Will Be Tired. This might manifest itself differently for others. I don't sleep well at night, and during the day I can easily get completely exhausted by simple acts, like bathing. I have taken quite a few serious naps. As I am slowly getting stronger, the need for naps has subsided but I do still tire very easily.
Since this is more of a reference post, I will add more as I think of them. I probably still have more to learn!
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