The Journey is Almost Over

9/9  Therapy today and new ways to strengthen. I was doing the Total Gym with both legs, now they want me to do it one leg at a time. Boy! That's a workout! Also did the chair squat - my "good" knee was complaining about that one - surgery knee was fine. I asked my PT when do you know when it's time to stop therapy. She said I was pretty nearly there. My flex is great, extension is almost perfect; mostly I am strengthening my legs and hips. Maybe a couple weeks more, then I am through, although I feel I'll need to stretch every day from now on.  I may have to do hamstring stretches the rest of my life. My knee is stiff without them. I've decided to start doing them first thing in the morning before I get out of bed.


9/12  Another good day in PT for me. How do you know when you've had enough PT? I think I'm headed there. I went ahead and made appts. for next week, but I think that may be the end. I'll miss it. Although it's hard work, I always come out feeling good.

9/15 Yesterday, we took an architectural boat tour of Chicago. What a glorious day for it - 70's, sunny, blue skies - great fun and a beautiful city. I walked all over Navy Pier plus driving up and back, and on the way home, I definitely entered into the ODIC (Over Doing It Club.)   I had taken my extra-strength Tylenol in the morning, but forgot to take any at noon, and by the time I got home at 3:30, I was definitely behind the pain. I almost felt as if I had the flu, achy all over. I resisted taking something stronger and waited for the Tylenol to kick in while lying down on the bed. Felt much better in the evening and just fine this morning. Just about the time I think I'm definitely over this surgery, it tells me I still have work to do.

9/19 I released myself from PT today. ROM is 141, extension -3. I'll miss PT, but time to move on and establish a routine with my knee at home and keep working on that extension. I've found that putting weights on my leg and letting it hang off the bed is as good a stretch as anything.

I told my husband several weeks ago that I would be glad when I could get up and move around without thinking of my knee. Well, that day has come. I don't think about it most of the time now. It gave me a little pain this last week with the weather change, but nothing bad. The numbness probably bothers me more than anything, but I guess I'll learn to live with that.
 
Today when doing chair squats at PT, I had to stop because of my left knee. Right knee was great!  I have OA in my left knee, not as bad as my right was, so I'm hedging my bet on having it replaced. If I have to, I have to, but I've had such a good recovery with this one, I'm afraid to tempt fate. 
If I decide to have it replaced, I will probably be looking at the left knee next Spring.

 

Stairway to Heaven? No, Stairs like a Normal Person

August 24  - Had another great therapy session on Thursday. I really love these new therapists. They work me well, but never to pain. My extension was measured at -22 on Monday, by the end of therapy Thursday, she measured -16. I drove the car twice yesterday and today with no side effects. I almost feel guilty - my recovery has been so trouble free.

August 25 - I feel extremely grateful to have had as wonderful a recovery as I have, so much so that I don't know that I want to tempt fate and have the left one done.
I'm enjoying the new knee - getting up without pain or having to ssttrreettcchh my leg out first before I could stand on it is an incredible situation!
My worst problem right now is sleeping. I have good nights and bad. I'm still trying to work out the proper medication to get me a good night's sleep. I do well on extra-strength Tylenol during the day. I take an ibuprofen at night with a Tylenol p.m., but it doesn't seem to do a good job. I hate to have to take a Norco at night, but I may try a 1/2 and see what happens. My P.A. said he would send out some Tramadol if I needed it, but I've never taken it, so don't know how it works.

August 31 - Haven't posted on this thread in almost a week - been busy! I'm still loving my PT although she brought a new torture device last Monday which was exquisite (not in a good way!) It was a platform which supported my calf and leg attached to metal bars. A Velcro wrap was put around my thigh and I was given a bulb to "pump it up." I pumped until I felt a stretch in my hamstring and then had to hold it for two minutes. I did have a release in case it was too much, and by the end of two minutes, I was more than ready to release! I then was given some time to work it out, and then went for round two. All these stretches work - I've gone from -22 to -14 in 3 PT sessions.

I'm also faithfully doing my stretches at home except for a couple of days this last week when I entered the Bad Back Club. Thankfully, some rest and warm wraps got the back problem taken care quickly.

Overall, knee is responding well - taking only extra-strength Tylenol for pain and one ibuprofen at night for arthritis in the other body parts.

Sept 1 - I am going to see my two grandkids next month. Flying for the first time since TKR - that will be fun.  Back is much better now. It usually only takes 2-3 days when this happens, and it only happens a couple of times a year.
Got back to my at home therapy the last two days, and my knee is much happier. I wonder if I'm going to have to do these daily stretches the rest of my life? Not that it will hurt me, but it's amazing how stiff my knee got without the stretches. My extension is my worst - I think my flex is almost normal. My PT doesn't measure it, but it seems to match up to my other leg. My PT told me that extension is harder to get than flex.
Last night I had the funniest little feeling on my knee - like little nerves dancing around. It didn't really hurt, and it didn't last more than five minutes, but it was strange.
We hope to drive to the Folk Music festival at Geneva and hear one of my friends on the Bonesmart.org website tomorrow.  This is a great website devoted entirely to joint replacement.  I’ve gotten up a friendship with several ladies in the Chicago area.  Dulcimer Diva is the avatar name of my friend at the Folk Music Festival, and as her name says, she  plays the mountain dulcimer as well as the guitar and other instruments. 

Sept 2 - Got to hear Dulcimer Diva sing and play her guitar and dulcimer and generally had a great time at the Fox River Folk Festival today. I drove up and back for an hour or more each way, and I walked almost a mile, and had my leg down for over five hours. A little swollen and stiff, but nothing icing and elevating can't take care of. The weather was gorgeous, and the park where the festival was held was beautiful!

Sept. 3 - Had my first therapy in over a week since my back caused me to miss last week. They worked me hard as usual, but I always come out feeling good. Today my extension measured -5! Woot! That's quite a change in only 4 visits plus the in home stretches I do. They also took me to the staircase, and I walked up and down stairs like a normal person several times. Haven't done that in years! Torture device was upped to 3 minutes.  ARRRRGGGHHH!  But it works!  Spending the afternoon icing and elevating - maybe even a nap!

Sept. 5 - Therapy today! I always feel so good after therapy - tired, but good. Today we did some new stuff - walking backward on the treadmill, scooting across the floor using my heels to propel - along with all the usual suspects. She measured my ROM for the first time since I started five sessions ago, and it is now equal with my left knee at 135. Still working on the extension. If I am sitting up and pressing my knee down, I get a 0, but if I am lying on my back, it's about -8. She also measured my strength, and I am much stronger in my legs than at the beginning. It's great to see measurable success. I love this knee!

Don't Kneed No Stinking Cane!

August 13 - Today I will get to the hairdresser! A cut for sure, maybe color as well depending on boss knee. I'm focusing on stretches and biking today to work out the stiffness.

I have a TENS machine which was prescribed to me for my back. Now that I know how to use it on the knee, I may start doing that as well. It has worked really well for my back.

It's interesting that the icing,TENS and laser were not at the end of my out patient therapy, but at the beginning. Maybe that's why I didn't feel much pain during the therapy. Nothing at the end, he just told me to go home and ice which I gratefully did the rest of the day. The only other times I had therapy which was after the arthroscopic surgeries, they iced at beginning and end. They also hurt a lot more.

August 14 - I went to the Dr  today for an un-knee related appt., walked all over the hospital and parking garage, and then went grocery shopping at the commissary! I haven't been in a grocery store in a very long time - lots of things managed to jump in my cart. I did pretty well, although by the time I was ready to check out - I WAS READY! Luckily husband had ice packs and pillows all ready for me, and I packed myself into the back seat for the long journey home.

August 15 - OK, hamstring spasms in back of thigh. What did I do to start them, and what can I do to end them? Could they be from the large amount of walking I did yesterday? Is more gentle stretching in order, or should I just rest?
Jeff mentioned my TENS unit for the hamstring spasm.  I tried using it on the hamstring spasm and it worked! Yeah! Now maybe I can do some stretches to keep it from happening in the future. I did my hamstring stretches afterward, and a spasm started, but went away. I've left the electrodes on in case it starts up again. I did have this kind of pain occasionally before my surgery, so I know that my hamstring wasn't being used correctly. I need to just keep on working them, and I guess eventually they'll settle down.

August  16 -  Had some bad news yesterday. I had told the home health agency that I didn't need to have a nurse come around once a week anymore. (It really was a waste of time and money.) Well, turns out they had the contract with my therapy people, and my therapy people don't have a contract with my weird insurance, so no therapy with them anymore. Now I have to find another therapist who takes my insurance and get my Dr. to authorize it, and all this happened at 5 p.m. yesterday, so I couldn't do much about it yesterday. Therefore I had a rotten night last night.

I've been trying to cut back on the Norco. I've been taking 2 extra-strength Tylenol morning and noon, but felt bad mid-afternoon and took 1/2 of a 10/325. Took a whole one at night around 10 p.m. Woke up at 1 a.m. burning up, kicked off sheets, cooled off, then got too cool, etc. Couldn't find a comfortable way to sleep and my mind was racing about the therapy problem. Finally went to the sofa with a book, read for a little while, then tried to sleep but without much success - hot, cold etc.. At least I wasn't disturbing my husband (although he says I never disturb him.) I think some of these temperature swings may be Norco withdrawal based on what I've read. It's not addiction, but dependency.  Maybe I'm trying to cut back too soon. I've decided that I will continue with the Tylenol and take 1/2 Norco as needed for a few days. I want to be through with the Norco, but I think I'm going to need more than Tylenol since I still have arthritis in my left knee, hands and back. My P.A. has been alerted, and we'll see what he comes up with next Weds. when I go back for 6 weeks post-op.

Good news!  I found a therapy place in my town (closer than the original place) that I am pretty sure takes my insurance, have had my PA fax them an authorization and have an appointment for Monday at 1 p.m. So unless we hit a snag, everything is now go for that. Other good news is that I'm going to quit carrying my cane around the house since I keep forgetting it and walking out without it, then forgetting where I left it. I will only use it when I go outside. My gait is pretty good. Husband says no discernible limp, and other than a little tightness, I can't tell a whole lot of difference between the two knees when I'm walking. Time to go and stretch the hamstrings though!

August 19 - I don't elevate and ice as much as I used to - only after stretches or if I have some twinges. Hoping to get cleared for driving this Weds. We'll see. I start my new therapy today (I hope - still have to call this a.m. and see if all the paperwork got through.) Hope they're good; I'd hate to have to change again!
Just finished with new therapy. WOW! What a difference! I really like my therapist - Tiffany is the Goddess of PT. I also feel such a difference between what she did and my previous therapist. He was a nice guy, but Tiffany is so professional. Never pushed me to pain, but I walked out feeling so energized and improved. My ROM is 125 and extension -22, so we know what we need to work on. She did something called ASTYM which was probably the most discomfort I had, but from what I read it gets better and really does accomplish healing. I'm actually looking forward to therapy on Thursday!

August 20 - Entered the Over Doing It Club today. All I did was walk around Sam's Club for about 6 items. I didn't even walk all over the store, but by the time I got out, I was wasted, and I went straight to bed when I got home and took a nap. Even with that I felt bad the rest of the day. I think I walked a lot more when I went to the commissary last week, but it wasn't as hot, so maybe the weather had something to do with it.

August 21 – Dr. was really happy with my progress today. I showed him my flex and told him the PT had measured it at 125 on Monday. He said he thought it was more than that although he didn't measure. He also thought my extension was more like -5. I'm cleared to drive as long as I'm not taking the heavy duty pain meds (which I only take before therapy.) I saw the xray of my prosthesis, and it looked pretty good. I feel like I did a lot more walking today than yesterday, yet don't feel as bad. Go figure. Also, my OS told me to take some ibuprofen for the rest of my arthritis, so I think that will help with my achy feelings. I haven't taken any ibuprofen since the first of July, and I took a lot of it before that. He made me feel really good when I shook his hand and thanked him for doing such a great job on my knee. He said, "You've done a lot of it." I don't have to go back until six months!

Kneedful Things

August 7 - 4 week anniversary - sleeping in the bed every night now, although I wake up and have to readjust frequently, I can actually sleep on my side! Yay!
Moved the pain meds to 3 times a day, going to try that for a week and then 1/2 pills for the daytime (except on therapy days)
Have really increased my extension, although not quite there yet. My flexion is almost as good as non-surgical knee, although no one has measured.
Don't have the energy drain as much, although I can still get a nap in during the day and feel the better for it. This is from someone who NEVER napped unless really sick.
Still using a cane, although I sometimes forget it, and leave it in the bathroom or kitchen. PT wants me to continue using it for now, but I am concentrating on walking w/o a limp. PT noticed improvement on that yesterday
Still get occasional pain spasms, but nothing debilitating, and they go quickly.
Still doing in home PT, yesterday he really pushed my hamstring in a good way.
Sat outside this morning for about 30 minutes with my leg down. When I got up to go inside, I just got up! Before surgery, I would have to straighten my legs out slowly and painfully, and then get up very slowly. Hey, this TKR thing really does work!

August 11 - One month out as of Saturday and doing really well; however, I have a new pain. If my knee is bent at a certain angle, and I move just a little bit, I get a really sharp pain on the outside of my knee. I first noticed it when sitting on the toilet, have had it happen sometimes in bed, and yesterday when getting on my recumbent bike, it hit. It's the worst pain I've had since my surgery, but I can make it stop if I move my knee out of this narrow angle. I've gotten to where I'm scared to have it happen because it hurts so much.

August 12 - First outpatient therapy completed. Wow! It was much longer than I anticipated - 1 1/2 hours! Of course 30 minutes of that was icing, TENS and cold laser therapy. Most of it did not hurt, although the stretches with the hamstring are still pushing the edge of the envelope. Also my quads are definitely out of shape as I found out with leg movements and the weights attached. I had to stop a couple of things that were hurting my non-surgical knee. Nothing hurt a lot, and the PT stopped when I said something, so that was good. Still no measurement, but I know that my flex is almost as good as my non-surgical knee. My extension still needs work, but don't have a number.

August 13 - Five weeks tomorrow and worst seems to be behind me. The pain on the outside of my knee is still harsh but definitely positional - so I try to avoid that position. I've been cutting back on pain meds and substituting extra strength Tylenol. I still have arthritis in my other knee, hands and back, so I need to take something for that besides the pain in the surgery knee. Still very stiff all over in the morning. It seems that I get my other body parts in a kink trying to avoid hurting my knee during the night. Surgery knee is about 3/4" bigger than other knee, so still some swelling (this is measured first thing in morning after being up all night.) I can walk without a limp if I think about it. If I don't, I sometimes relax into a limp.

Looking forward to OS visit next week - hopefully will have the movement to be able to drive. Will certainly be off the heavy duty meds during the day.

This Cane is Made for Walking

Thurs, July 25  Today I am having pain behind my knee and on the outside of my calf below the knee. Nothing horrible, just new. Had PT today and everything seems to be going along well. I tried sleeping in my bed last night, but no go. I did finally get to sleep, only to wake up with strange new pains. Finally said the heck with it and went to my recliner sofa where I slept quite well the rest of the night.

Friday, July 26 - I had a visit from old friends who drove from the Pacific Northwest to visit, so I went out for the first time. We went out for breakfast, then came back home where I iced and elevated, then out again for dinner, and back for same. I did feel a lot tireder than I would have normally. I've enjoyed the visit, but am really tired. On the positive front, I slept all night in the bed last night!

Sunday, July 28 - Had a tough morning today. I think the visit from friends and not napping as much caught up with me. We were supposed to meet our friends for breakfast, but when I started to get dressed, I was feeling so bad, I decided to take a couple of Tylenol and lie down for half an hour. I completely conked out, and my husband took pity on me and cancelled the breakfast. I woke up an hour later, and found that I didn't have to get dressed after all. Well played, husband, well played.

I iced and elevated and watched mindless TV throughout the morning, and by the afternoon, felt so much better. I also had a complete turn-around in the lower GI which I think made me feel better as well. Although things had been moving, I don't think they had been moving as much as they needed to.

Monday, July 29 - I slept on the bed most of the night last night. It's still harder finding a comfortable sleeping spot for a long time. I'm a stomach/side sleeper, and the knee will only tolerate that for a short time, so then it's the turn over, re-adjust, etc. It always takes such a long time. Finally got up about 4 a.m. and was back on the recliner sofa. Got to get back with my structured therapy today, since I let it go during the over-doing phase of my weekend.

Six hours is about all I can go without pain meds during the night, but can go longer during the day depending on what I'm doing.

Tuesday, July 30 - Had a couple of interesting things happen. First, I ran out of pain pills. I take Norco, and I had put in the refill order the day I got my staples out - last Weds. The girl at the pharmacy told me they would mail them to me because the refill date was not till Friday, but the order would be processed right away (this is a military hospital and very picky about controlled substances.) My P.A. had told me to call him if they wouldn't give them to me today, but I thought it would be OK to have them mailed since I still had some, and surely the mail would not take that long. Silly me!

I thought surely I would get them on Friday, couldn't imagine not receiving them on Saturday, and by Saturday night, I was in full hoarding mode, counting out how many I had left, and how many hours I would have to go between each one. I contacted my P.A. on Monday morning and explained what was going on, and that I was coming to the hospital (which is 70 miles away) on Tuesday, and staying overnight while my dog was being spayed, so I wouldn't be at home to get the pills until Wednesday. I asked if he could he could get me an emergency stash if they didn't arrive on Monday. He found out they hadn't been processed until Friday (thank you unknown girl at the desk,) and if I hadn't received them by 3 p.m., he would get me some on Tuesday.

I haven't had that much pain, certainly not as much as some others or as much as I was afraid I would have, but it's amazing how not having the pills made me so anxious. I wound up yesterday with three pills. I took one at 11 a.m. and I tried to stretch out as long as I could but by 7:30 p.m., I had to take another pill which left only one. I took my last at 4 a.m., and felt completely naked. Thank goodness my P.A. came through with the emergency stash today, and hopefully, the refill will be at home when I return tomorrow. I was already stretching the time between pills longer, and doing fine, until I thought I was about to run out. I feel much calmer now.

The other thing was that my steri strips started falling off, and I could see a big opening in a couple of places along my incision. It looked bad to me, but I told me P.A. about it, and when I went to the hospital today, he looked at it and replaced all the steri strips, but he said it didn't look bad at all. Anytime I can see below the first layer of skin, it looks bad to me.

Wednesday – July 31 Three week anniversary: I can go at least six hours between pain pills, sometimes longer. I walk with cane most of time except when I forget it and walk with nothing! No one's measured my ROM, but I think it might be 110. Extension is better but not zero yet. Still have swelling from time to time, so icing and elevating is what I do most of the time.

Finally received my pain med refill by mail today. I checked the tracking number just to see where it went,and why it would take so long, and it came from South Carolina! This does not compute.

On the plus side, slept in the bed all night last night although numerous wake-ups. Am finding that it is not so painful to move my leg in bed as it was. Yeah progress!

August 1 - I think I've learned a new lesson -Just because you could, doesn't mean you should! I tried the recumbent bike yesterday, and it felt so easy that I did about 15 minutes - some rocking, some backward rotation, some forward. I had a much tougher night last night, and my knee is stiffer. I think the 15 minutes of recumbent biking was about 10 minutes too much. Gonna try some gentle stretches this a.m. to loosen my knee before PT this p.m.

August 2 - Gave up on sleeping in the bed last night. The sofa seems to offer more support to my back when I try to sleep on my side than the bed, and I love to sleep on my side. Maybe a few more weeks of healing will help me return to my bed. Trying to just take pain meds at six hour intervals, or longer if I forget or sleep through.

Last night had lots of deep aching on the outside of my leg - calf and up into my thigh. Is this the infamous IT band? I massaged it, and it felt some better, but only really subsided when I took my pain pill.

Going to get back on the recumbent bike again today, but limit it to 5 minutes a couple of times a day until I see how my knee reacts. I asked my PT yesterday during therapy about the bike, and he didn't seem to think that the bike had anything significant to offer. He said it doesn't help with ROM or strength; however, my PT at the hospital said the bike was key, and all I really needed to do. Who to believe? My home PT says that I'm improving, but doesn't measure which is OK. I'm beginning to think it may be time to start moving to outside therapy. How do you know when that's right?

I'm improving, but the therapy at home seems awfully easy. I guess I need to get my head in shape. What do I want? For it to hurt? I don't think so!

I still don't have horrible pain, just new ones, and generally quite short lived - a stab or spasm which sometimes make me go "OW!" I guess I'm just impatient, I have to keep telling myself it's only been 3 weeks!

August 4 - What was that I said about therapy at home seeming "easy?" Well, we added some stretches on Saturday that are not easy, but definitely are good. My hamstring tightness is the worst thing I deal with right now, and all these stretches are working on that. I'm still finding that every six hours on the pain meds works the best. I have the norco 10/325 and one works well for me, have never taken more than one.

Last night I slept through the 4 a.m. time, and would have taken a pill when I got up, but I have to take the empty stomach meds then. I was just sitting with my foot elevated on the recliner when it suddenly felt like someone had taken a bite out of my knee. OK, time for pain pill - that put it at about 8 1/2 hours since the last one. So can't stretch for too much longer than 6 hours right now.

August 5 -  I'm working on getting my pain pill to a schedule which covers the night and therapy.

Last night, I took one at 9:30 p.m., slept in the bed (on my sides!) til 6 a.m. (of course I had numerous wake-ups during the night as I had to adjust, but I would go right back to sleep.) When I did get up, I had some painful spasms, but took a pill at 6:15 a.m., and now all is well. My therapy is generally around 2:30 to 3:30 p.m., so I'm planning to take another pill around 1:30 p.m, and if I can, not take another until the bedtime dose. That will put me to taking 3 pills in a 24 hour time period (compared to 6 when I first started taking them,) which I'm willing to go with for a while. My next step-down will be to cut the daytime pills in half, we'll see how that works. My P.A. said that I would be taking pain meds for at least 8 weeks, so I'm just at 4 weeks now as of Weds. I'm not worried about getting addicted as long as I am taking the pills for pain.

I will say that I have not had the pain that I thought I would have, or that others seem to have had. I consider myself very lucky.

One Step at a Time

Wednesday, July 17 - After escaping the fiery pits of Mordor yesterday, I took it very easy today.  The home health nurse came by and set up everything for my in home therapy.  The therapist might get by today, but if not, would definitely be here tomorrow. I iced, elevated and slept a lot.  The swelling in my leg had definitely gotten worse after Tuesday's trip to Hell, but all day of RIES, and things were back on schedule.


Thursday, July 18 –Slept fairly well on recliner again only waking for bathroom and pill popping.  Nice long, hard sleeps.  About 4 a.m. however, I woke and knew I wasn’t going back right away.  Messed around with the computer a little, contemplated going to the bedroom but didn’t want to wake the puppy too early. Once she gets up, everyone's up!  Finally did what I did the night before and stretched out on the sofa with pillows propping up surgery leg, and slept on my left side.  Heaven!  Didn’t awake til puppy came through close to 6 a.m.
Supposed to have therapy today since he didn’t come yesterday.  Anxiously awaiting this as one hears of so many different kinds of therapists.
Therapy was exhausting, but not too bad.  Lots of gentle stretching.  My extension is the worst right now, so anything pushing that was "ouchy."  However, once the stretching was through, I felt a lot better walking.  It really does loosen up my leg.  The therapist wants me to use my walker more than the cane, so I've decided to use the walker every time I take the hall trip to the "necessary" room.  Then, I walk backwards, stretching that hamstring some more.

Sunday, July 21 After my harrowing day in the ER, I have slipped into a routine. I sleep on the recliner sofa each night. With all the pillows, the ice machine, and pain meds, I actually get a fairly good night's sleep. Last night I was awakened before pain pill time with my newest pain - a sharp spasm which hurts like the dickens, but only lasted seconds. It was only about 15 minutes before pain pill time, so I took it and went back to sleep. Slept through the next pain pill time by over an hour, and then for the first time, had to make a bathroom trip. So almost a whole night!

My wonderful husband refills the ice machine and hands me my morning coffee, and I surf the internet for a bit, taking the empty stomach meds. Then breakfast, and some therapy on my own. I'm doing stretches, leg movements, walking and walking backwards. In home therapy is Tuesdays and Thursdays. So far, the PT is doing well. No massages yet. I envy the guys with the massages that I read about on Bonesmart.org, but he's pushing me without major pain. My biggest weakness is extension. The hamstring is tight, so I'm trying to stretch that whenever I think about it. My ROM was 90 in the hospital, and they told me not to push past that until staples are out. My therapist did measure close to 100 the first day he came, but he said I was cheating (?), so it didn't count. He didn't even measure last visit.

I find that a nap during the day is inevitable. If I stay awake through the sleep promptings in the a.m., I'm down for the count in the p.m. This is from someone who could NEVER sleep in the daytime unless ill.

My appetite has returned although I can't eat as much as before (which is a good thing!) Part of this I believe is because I froze so many meals prior to my surgery, so I know the stuff I'm eating will taste good, and it is all on my Weight Watcher diet as well. I have actually gained a couple of pounds since I returned from the hospital, but I had also lost seven pounds in 5 days, so I knew that wasn't going to stay put.

Overall, I'm very pleased with where I am currently. Wednesday will be staple removal day, and the two week anniversary. I'm quite mobile using walker and cane to get around. I still take pain meds around the clock and ice and elevate whenever sitting. The newest spasm pain that started yesterday is the worst pain I've experienced, but it comes and goes so quickly, I can't complain.

I've had one experience that lets me know that I have a totally new knee, and that things will be very different once I get past this rehab. On the last day in the hospital, the PT wanted me to put my foot on a step and lunge forward for a stretch. I looked at her and said, "Do you know how long it's been since I could lunge?" The grinding, popping, and pain that would occur had I tried that previously would have been mind boggling. I did it for the PT, and HAD NO PAIN! The future is NOW!

Tues., July 23  Had my 3rd PT today. Feel stronger and can move more without pain every time. After PT this time however, I had what seemed like deep bone pain on the outside of my leg below my knee. My husband has this little vibrator he was given when he was having nerve pain after a botched carpal tunnel. He held that vibrator over the area and just lightly ran it up and down. It was amazing how much better it felt.

Tomorrow I get the staples out.

Weds., July 24 - Staples removed today with very little discomfort.  What was discomforting was seeing the flesh gape open in a couple of places.  My OS and P.A. didn't seem to think this was a problem.  I now have a series of "steri-strips" down my incision and no longer have to have any kind of dressing on it.  They said after a couple of days, I can shower without anything over the incision (except the steri-strips) as long as I don't scrub the area (not to worry.)  The strips stay on til they fall off naturally.  They just asked me to show my flex and extension and were quite impressed.  My P.A. thought the ROM was about 100, but no one measured.  He said I will probably be taking pain meds about another 6 weeks and won't be driving at least that long.  I have to keep wearing the TEDS until I don't have a problem with swelling which was not today.  I made the mistake of riding in the front seat on the way up to the hospital.  I'm still paying for that even though I'm at home now and elevating and icing.  I got in the back seat and elevated and iced in the car, but the 90 minutes of leg hanging down had already done its dirty business.

One Does Not Simply Walk into Mordor

I had a really great night at home.  Although I tried to sleep in my bed, I could not, but had really hard sleep in the sofa recliner.  I awoke to the glorious scent of real coffee brewing (not de-caff!)  How wonderful it was to go down my own hall to the bathroom, sit in my own sofa and reach for my own computer.  We’ve rigged up a table next to the sofa for the computer, and then a bed tray to put over my lap to keep the laptop off my knee.  I was able to hug my puppy and give her a good rub-down, until she decided that my ice machine was just too tempting not to be tasted.  That’s why we have the portable fence – invalid on the inside, puppies on the outside.  All in all, a stellar first morning until . . .

I was sipping my coffee, surfing through mounds of email etc., and waiting for time for breakfast when that same awful feeling came over me.  The dizziness, cold sweat, trembling hands – only this time I had not taken a pain pill since about 2 a.m., and was waiting to eat until I took one.  I remembered what the Dr. said, and hastily googled heart attack symptoms in women.  Good night, I had three of six!  Reluctantly, I told Jeff we needed to go to the ER.  Just for drill, because I had wondered if my “incident” yesterday was a low blood sugar, we decide to test it with Jeff’s glucometer.  I have a 70.  I know that my fasting blood glucose is usually in the mid-eighties.  We decided to go to the ER here in Homewood rather than risk a 70 mile drive.  I wish we had driven the 70 miles.

Anyway, we stowed the puppy in her crate and took off to the ER.  Jeff went inside and told the security guard who came out with a wheelchair.  I’m still very shaky and understandably scared.  He wheels me up to the clerk, and I try to tell him that I’m six day post-op total knee replacement with symptoms of a heart attack.  I say try, because a custodian was loudly vacuuming the rug right next to me, and I could barely hear what I was saying much less the clerk. Turning off the vacuum when a patient comes in should be standard protocol, one would think.

I do get taken into triage right away where they ask the usual questions, and I tell them about the Dr. at the Navy Hospital which is mainly why I’m here.  I also tell them about the 70 blood glucose taken at home, but they are not impressed.  They think  a 70 will not have any of the symptoms as I described.  I’m wheeled into a room with another doorknob bed, covered with electrodes and stabbed with knives.  Seriously, they got right to running the EKG, setting up the most uncomfortable IV I’ve ever had, and taking blood.  Then I sit.  And I sit. And I sit.  Occasionally the blood pressure cuff goes off, but other than the occasional blip of the screen.  Nothing happens.

I ask for something to elevate my leg, and am given a pathetic thin pillow.  I’ve had no pain meds since 2 a.m., and I have no ice.  One of the nurse technicians seems anxious to help and tells us they’re still backed up from yesterday when it was a seven hour wait.  I have a very dry mouth and haven’t eaten since a milk and cookie snack the night before.  She brings me some apple juice and graham crackers which I gratefully eat. 

I checked in at 7:40 a.m.  Around 10 a.m., a lady who identifies herself as the nurse tells me the Dr. will be in as soon as he can.  I understand the problem with ER's,  and ask about some pain medication.  She brings me back some Norco.  I can only assume that since nothing has been done to me since the original triage, that the EKG didn’t show anything. I'm obviously on the low end of the totem pole for care.  In fact, the longer I lie there, the more I begin to believe that it was a low blood sugar event even though I don’t have diabetes.  I have felt much better since the juice and graham cracker.

Around 11:30 a.m., the Dr. comes in.  He seems really nice, asks the usual questions and in response to mine says that the EKG was normal, but they want to run an enzyme check and a urine test just to make sure everything’s OK.  I know this is standard procedure, so nod my head, and he leaves. 

Now it begins to get strange.  Nothing happens.  No one comes in to take more blood.  No one asks me if I can do a urine sample.  Nothing.  Jeff goes home to take care of the puppy and himself since he has had no breakfast.  The nurse come in when the monitor goes off for some reason, and I ask her about the tests and she says something to the effect that” if people didn’t come into the ER when it wasn’t an emergency, they wouldn’t have this back –up.”  I thought this was pretty inappropriate since I had been told to go to the ER and said as much.  This also did not answer my question about the ensuing tests.  She did, upon prompting, get me some more pillows and some ice for my knee. 
I continue to wait.  Hours pass.  The nurse technician feels sorry for how uncomfortable I am, and changes the doorknob bed for another in better shape.  It does feel a lot better.  I have the urge to go to the bathroom and knowing that the Dr. was going to order a urine sample, mention that that could be taken before I evacuate my bladder completely.  This does get me a specimen bottle which I fill and turn in.  I go back to the room and wait.

During this time, I do get in touch with my primary care Dr’s nurse, and explain all that is going on.  I’ll tell her I think it’s just a low blood sugar event, and she agrees that a 70 would give me all those symptoms. 

Sometime around 3 p.m., I think, the nurse technician come in to take my blood.  I’ve only had a couple of juice packets and I tell her good luck on finding a vein.  She digs around in my arm, I see the single vial that she has filled, and then she leaves.  I never see her again. At some point, the Dr. comes in and apologizes for the wait but says there is some confusion in the lab about the second enzyme test, but that he hopes it is cleared up, and I’ll be leaving soon.  This is the first I’ve heard about a second enzyme test.

Sometime after that, the nurse comes in with all the blood paraphernalia to take my blood again.  She says someone lost the second blood sample.  I show her on my arm where it was taken.  She takes about three vials of blood.  She also responds to my dehydration and hunger by bringing me a turkey sandwich and some more juice.  My husband asks her how long this might take.  She says it’s about a 20 minute test.

We wait forty minutes.  Still nothing.  My husband goes out to ask about the test.  Someone flippantly tells him there’s no such thing as a 20 minute blood test.  Every time anyone comes close we ask how long, what’s happening etc.  We are given no answers, no explanations.

Finally sometime after 5 p.m., a new nurse comes in and brusquely begins to explain about how long all the tests take and why I needed them etc.  It seems that the second enzyme test has to be done several hours apart.  I’ve already been here over nine hours; I tell her I just want out of there.  The Dr. said negative on the heart tests, and I just want to go home.  She is much more informative that almost anyone has been all day, but treats me as if I’m the whiney butt who has to be tolerated while they’re saving my life.  It’s pretty obvious that she’s the closer who’s trying salvage a very poorly done job. 

Suddenly, blood tests are done (BTW, 2^nd enzyme test completed at 4:20 p.m. – it is now 5:40 p.m.) paper work appears, and ONLY ten hours after I originally checked in, I’m out of there.

I felt like I had escaped prison.  It was the most horrible day of my life.  If the Navy Dr. hadn’t been so insistent the day before, I probably would have just gotten a glass of orange juice at home and felt better.  At least I know where NOT to go in an emergency situation in the future.