Post Op #1 & Rehab

I meant to write about my first post op appt and the last couple of rehab session a couple days ago, but I’m a busy girl now. J  I spend 7-9 hours a day doing some sort of rehab or recovering from rehab.  I’ve also started to venture outside which is super exciting!  My insurance approved a wheelchair so that has allowed me to go to a lot of places I would not be able to if I had to crutch.  Brad took me to Kohl’s and we wheeled all around, I then became very nauseous (another thing besides the nesting that reminds me that this experience is like being pregnant!).  This morning we went to Wal-Mart and I did really well.  I think the more I get outside the better I’m going to feel, however that pushes the Fuzzy sessions (CPM) very close together which kinda hurts a bit, but it’s worth it to get outside and feel normal.

Ok back to the Title of this Blog, my post opt appt # 1 was pretty uneventful.  I did not see the doctor, he was on a beach somewhere because it was spring break I’ll see him next week.  So I saw his nurse and she said the incision looks good and I’m doing everything I’m supposed to.  Yay go me!  I’ve always been a good student.  I saw my PT and we began the torture, otherwise known as rehab.  There is this one exercise that makes me use my quad muscle and it was the weirdest feeling to consciously tell my quad what it should do and then my quad saying “forget you I’m in hibernation and I don’t like rehab”.  Seriously my leg didn’t move even though I told it too!  I felt paralyzed, and did not like it one bit!  My PT says it will come back slowly, but I’m a girl who likes instant gratification (being an only child and all) so this process will be interesting but not in the fun way.  Oh well this is what I signed up for.  Rehab appt #2 went much better.  Word of advice take your drugs before rehab!!  You will get the best results during and hurt like the dickens afterwards because you pushed your leg so hard.  Then you get to take more drugs and the circle is complete.  I’m hoping in the next week or so I won’t have to keep taking Demerol, but for now I’m on an as needed basis.  

Week 1

So it’s almost been a week (tomorrow to be exact) since my surgery.  Things have been going better than I thought they would.  I did a pretty good job of freaking myself out before the surgery.  The internet can be a dangerous thing when you read all about ACI and what is involved in the process.  However, I’m happy to report my fears were greater than reality, which in most cases is true.  Since I’ve been home I’ve watched a ton of movies and TV shows and not read one single book that I picked out!  Reading and writing take forever when you are on drugs.  Your mind has a hard time concentrating and retaining words and ideas.  So the boob tube wins for now. 

Oh and I forgot to talk about how amazing the Leg Lifter is!!  I know everyone was waiting in suspense!  It’s such a simple tool, two loops connected by a metal enforced strap, but it makes it so much easier to get out of bed and get out of your leg brace and into the CPM machine (Continuous Passive Motion).  Oh wow I haven’t even introduced everyone to the CPM machine aka Fuzzy.  I call it Fuzzy because the lining of the machine where it holds your leg is very fuzzy like sheep’s wool and makes my foot really sweaty so I must remember to wear a sock or Fuzzy will get renamed Stinky!  I have to have my leg in this for 6-8 hours a day. (3 sessions of 2-2.5 hours each)

SHOWERING

My first shower was on Monday (Surgery + 3 days) and it was quite an event, glad I wasn’t selling tickets for it.  Looking back I think I would choose to be stinky a bit longer.  But I had my MIL and good friend coming to “Amy Sit” on Tuesday and I didn’t want them to have to plug their nose when they entered my studio apartment.  That what I call our master bedroom, because somehow my husband (Brad) and I were able to shove a futon and recliner in to it so I would have different seating options and others could hang out with me on this journey.  Ok back to the shower, it was really hard to figure out how to begin.  Normally you disrobe step in, then presto you are taking a shower.  Not for the ACI patient, you can’t even disrobe by yourself!  My shower is just that, a shower…not a tub so it’s even more difficult to figure out.  But Brad and I talked through our game plan and tried unsuccessfully Plan A, which was to sit on the built in shower sit and use the other shower seat (which is really just a plastic bench, that holds 300 lbs, so we are goodJ).  Plan B went much better which was to just sit on the shower bench and use the built in as shelf for the shampoo and stuff.  Garbage bags encased my huge leg brace and the shower curtain was used as a water shield.  It was all too much effort for S + 3 days and by the time I was done I was exhausted!

DRUGS

Ok let’s talk about drugs, (say nope to dope kids) unless you are an ACI patient.  Since I am allergic to Hydrocodone, which by the way, is in like EVERY DRUG!  They gave me Demerol instead (good stuff) and Ultram (Tramadol) (which is made by little green people who carry around itching powder.  At least that’s who I see and how I feel when I take those crazy pills!  Ultram = BAD!)  I started taking the drugs even though my pain block was still in effect, so I could “get ahead of the pain” as they say.  It’s like you are running a race with the pain and you have to be faster, which seems weird because as an ACI patient you can’t even use your big toe to balance yourself.  Ok here’s the breakdown of my medication.

S Day =        1- Demerol every 3 hours while awake, then one pill at 2 am to get through the night

S Day +1  = 1- Demerol every 3.5 hours while awake, then one pillow at 2:30am

                      1 Asprin in the morning – Helps with blood clots

                      2 antibiotics (morning, evening)                        

                      2 probiotics (morning, evening) Helps keep the good bacteria in your stomach from being               depleted which helps in digestion and yeast control. 

                      1 – Ultram 2 times this day spread apart by 3 hours….TORTURE!!

S Day + 2 -4 = Same as above expect I didn’t take any during the night.  And added Ibuprofen as needed. And got rid of the Ultram.

S Day +5 = I only took 2 Demerols total  - One in the morning and one after my first PT appt.

And as of today S Day + 6, I've only taken Ibuprofen for pain.  I know by tonight I will have to have a Demerol, but I’m trying to not take as many drugs because they make me so dizzy and I don’t want to become an addict and end up on the show Intervention….I’ve got enough problems with just dealing with my knee people! 

 

The Big “S” Day

My surgery was scheduled for 10 am on Friday 3/16, therefore putting me at the hospital at 8 am.  I checked into the front desk and was given my “designer” hospital bracelet and was told to sign some paperwork.  Next I was taken to the surgery prep room where I got my IV and leg cleaned and prepared for the surgery.  Of course once the nurse was done, my bladder decided it needed to be emptied again.  So I'm betting that everyone has seen or at least has heard of people walking around with the gown untied in the back showing the world their bum….well that almost happened to me!  First, you look like a hot mess when you get prepared for surgery.  Your hair could rival your elementary lunch ladies with the super cute hair net they give you, then add your leg which is orange because they cleaned it with iodine making it look like a spray tan gone wrong.  Added to this hot mess was me trying to carry my IV bag and then almost forgetting to hold my gown closed in the back!  I remembered my gown was untied just as a cold draft hit my backside, thankfully I had not left my curtained off area so not no one saw!

Next the anesthesiologist came in to see what type of cocktail to give me; of course I said I wanted top shelf drugs, because I get very sick after surgery without them.  If you have never had surgery, trust me just let them give you the full scope of anti-nausea drugs.  My first surgery in 2002 they did not give me anything and I was vomiting for the first 10 hours I was home, plus trying to heal from the scope.

Then my surgeon came to talk to me and my family (Dr. Chris Arnold, Fayetteville AR) and described the ACI procedure.  He also surprised me by saying he was not going to use my own tissue graft for the periosteal flap.  Instead he would be using porcine graft instead. (Yay I’m part pig now!  My vegan cousin will never look at me the same again.)  That was news to me since prior to surgery he was going to use my own tissue.  I will have to do more research and ask him questions about why he chose that route when I have my first post op appointment on Wednesday.  The surgery itself was only 1.5 hours, which is much less than what I expected and my incision is only 4-5”. Click on the link to see a pic of my knee...not for the weak at heart, but it's not as bad as one would think. (Picture of my knee - S + 2days)   I’ve read other ACI blogs and they average more on the 3-4 hours for surgery and 6-10” incisions.  This might have something to do with not using my own tissue for the flap, another question for the doctor on Wednesday. 

Another unexpected but pleasant event was I went home the day of surgery.  An hour in the recovery room was all the hospital time I spent, which again is contrast to other blogs I’ve read where they write about 24-48 hours in the hospital to manage pain levels.  I do know that I got a nerve block and therefore the first 24 hours after surgery were more or less pain free, but there is always a feeling of pressure around my knee.  However, I could feel pinches of pain when I twisted my knee the wrong way which can spike the pain to a 9 really fast.  Note to self, don’t twist the knee!  Once the block wore off the pain increased, but so did my meds and so far I have been able to keep the pain between 3-5 on the pain scale. Except for a few hours my second night home, my pain increased to an 8-9 so my husband gave me another pill and then my brain went a bit crazy.  I remember hearing someone moaning and I felt so bad for that person, then I realized I WAS MOANING!  It was a weird out of body experience.  I also felt like I had just walked into Willy Wonka’s chocolate factory because my brain was high as a kite and I was seeing crazy colors.  Bless my poor husband who got up with me every couple of hours to check on me and help me get to the bathroom.  I’ve got more I would love to write about, but the next round of drugs have started to kick in so spelling, grammar and the ability to write coherently will start to decrease.  

Pre "S" Day

Leading up to “S” Day

So “S” Day was Friday 3/16/2012 (Surgery Day).  Sorry I’m just now updating my blog, it’s been an interesting couple of days.  First let me start with the week leading up to the ACI, I was a basket case and felt paralyzed with fear of the unknown.  You can read all about the ACI surgery and never truly feel like you have a handle on the events to come.  Now I’ve never been pregnant, but some of my friends said what I was feeling was very similar to nesting.  The need for my house to be very clean and organized was very strong before my surgery.  To the rescue was my mom, mother in law and great friend who came over and helped me clean my house.  Praise the Lord for them, because it helped me get things right in my head before my S Day.  So for all you future ACI patients…clean your house ASAP!  And for everyone else, clean your house anyways!!  Also I have no words to describe how amazing my husband has been through this whole ordeal, so patience and calm.  This is exactly what I need because under stress I’ve been known to be bit high strung. 

Just to update you on my bathroom business (because I know you were dying from anticipation), my MIL (Mother in Law) ended up buying all the riser supplies that were mentioned in the previous post.  I am very grateful for her and her ability to buy those items with pride.  She also bought me the best thing an ACI patient could get, the almighty “LEG LIFTER” (insert chorus of angels singing). I’ll elaborate more on this amazing invention later.