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I probably don't have to explain why I've posted less about this surgery than the last one. Nevertheless, here it is, day 10, and I feel I'd benefit from logging my observations.
I had the feeling that rehab would go a little faster this time than last, and it appears to be true. I got "graduated" from walker to cane by the physical therapist on day 7 largely because I confessed that I kept wandering off from the walker. I take the walker when I'm really, really sleepy and I don't trust my balance, but that's happened maybe twice. Nowadays I keep losing the cane because I forget I haqve it and I wander around for several minutes before I remember it. But my stamina's still pretty low. I can water the yard but then I want to sit down, for example.
Pain is a bit more severe some of the time (possibly because healing is faster) than last time though it is still pretty mild most of the time. However, pain management is simpler because I knew going it I was going to use tramadol instead of the big guns. Dr. Spiegel also prescribed promethazine for nausea and to enhance pain relief, but I didn't get till yesterday which was also coincidentally the first time I experienced mild nausea. I took one. No more, unless I'm gibbering and I can't sleep. It put me in a stupor for hours, which made coping with a desperately bored puppy very difficult.
I just really don't do well with sedatives, I guess.
The physical therapist (cute, young Quinn from Louisiana) also toiok me up the stairs to my bedroom. I could move in any time, but I'm waiting a couple days so it will be easier to haul things up and down before I do. I'll be wanting to pee in a bucket for a few weeks, for example (do not want to do those stairs three-four times at night when I'm taking tramadol and I'm not steady on my toes yet), which is a wee bit of a hassle every morning.
I got the staples out yesterday (yes, it hurts, but not horribly, considering) and now the incision site feels much better (though it was kind of sensitive last night during the times I was conscious). I feel like it's easier to bend my knee, though it's not nearly all the way there. It's about ninety degrees or maybe a bit more, which I think was the same at this point as last time. I believe this knee was more damaged to begin with: we did the left one first because its function had deteriorated so much that it was my current limitation. If surgery time had come a couple-few weeks earlier or later, the right one would have been first, I think. Anyway, I saw the xray and the leg looks beautiful and straight now. And I feel it when I'm standing up. Also, on the other side, I find myself spontaneously bedning my knees to attend to things on the ground now, whereas before surgery I had to consciously tell my knees to bend. So I have to say that some improvement has been immediate.
I don't know when my left knee stopped feeling like it was encased in hard elastic a size too small, or when the numb part of the skin on the left leg shrank to two spots about the size of a silver dollar. But comparing the left and right legs reveal that those changes have taken place.
I'm finding it a little harder to focus on exercises than last time, which is probably mostly due to the distractions of other aspects of my life. But the weight gain and loss took a similar route, starting about four pounds light than last time. Eleven pounds on in three days ion the hospital, thirteen pounds off in six days at home. This morning I was briefly four pounds lighter than I was the day of surgery: but I think that's a spurious reading.
On another front, I made a cup and a half of fig-apple jam this morning, and started both quince paste and apple butter. I'll continue those in the oven later when I roast the game hens on beds of vegetables for soup, and bake banana bread with those overly-sweet aplets cut into them to serve the function of raisins.
I had the feeling that rehab would go a little faster this time than last, and it appears to be true. I got "graduated" from walker to cane by the physical therapist on day 7 largely because I confessed that I kept wandering off from the walker. I take the walker when I'm really, really sleepy and I don't trust my balance, but that's happened maybe twice. Nowadays I keep losing the cane because I forget I haqve it and I wander around for several minutes before I remember it. But my stamina's still pretty low. I can water the yard but then I want to sit down, for example.
Pain is a bit more severe some of the time (possibly because healing is faster) than last time though it is still pretty mild most of the time. However, pain management is simpler because I knew going it I was going to use tramadol instead of the big guns. Dr. Spiegel also prescribed promethazine for nausea and to enhance pain relief, but I didn't get till yesterday which was also coincidentally the first time I experienced mild nausea. I took one. No more, unless I'm gibbering and I can't sleep. It put me in a stupor for hours, which made coping with a desperately bored puppy very difficult.
I just really don't do well with sedatives, I guess.
The physical therapist (cute, young Quinn from Louisiana) also toiok me up the stairs to my bedroom. I could move in any time, but I'm waiting a couple days so it will be easier to haul things up and down before I do. I'll be wanting to pee in a bucket for a few weeks, for example (do not want to do those stairs three-four times at night when I'm taking tramadol and I'm not steady on my toes yet), which is a wee bit of a hassle every morning.
I got the staples out yesterday (yes, it hurts, but not horribly, considering) and now the incision site feels much better (though it was kind of sensitive last night during the times I was conscious). I feel like it's easier to bend my knee, though it's not nearly all the way there. It's about ninety degrees or maybe a bit more, which I think was the same at this point as last time. I believe this knee was more damaged to begin with: we did the left one first because its function had deteriorated so much that it was my current limitation. If surgery time had come a couple-few weeks earlier or later, the right one would have been first, I think. Anyway, I saw the xray and the leg looks beautiful and straight now. And I feel it when I'm standing up. Also, on the other side, I find myself spontaneously bedning my knees to attend to things on the ground now, whereas before surgery I had to consciously tell my knees to bend. So I have to say that some improvement has been immediate.
I don't know when my left knee stopped feeling like it was encased in hard elastic a size too small, or when the numb part of the skin on the left leg shrank to two spots about the size of a silver dollar. But comparing the left and right legs reveal that those changes have taken place.
I'm finding it a little harder to focus on exercises than last time, which is probably mostly due to the distractions of other aspects of my life. But the weight gain and loss took a similar route, starting about four pounds light than last time. Eleven pounds on in three days ion the hospital, thirteen pounds off in six days at home. This morning I was briefly four pounds lighter than I was the day of surgery: but I think that's a spurious reading.
On another front, I made a cup and a half of fig-apple jam this morning, and started both quince paste and apple butter. I'll continue those in the oven later when I roast the game hens on beds of vegetables for soup, and bake banana bread with those overly-sweet aplets cut into them to serve the function of raisins.
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At one time I pursued the cockscomb derivative (hyanolurate) injections, but I'm just as glad I couldn't get them (no insurance or money at the time) because the one person I know who got them said that the pain and swelling for the few days after was more than the brief and mild relief was worth.
Here's my advice if he's having surgery:
Pain levels after surgery vary a lot, apparently. I haven't had anything I couldn't manage with tramadol/acetaminophen/anti-inflammatory and ice (plus a rest/exercise regime). I kind of think the thing that benefitted me the most was physical therapy and exercise advice before surgery. But when it comes to drugs you have to be open minded because everyone's different, and you might need more or less than someone else. Bearing in mind that the ultimate purpose of the drugs is to keep you capable of exercising the joint--you can't eliminate pain entirely. But strengthening the joint and increasing mobility is what makes it feel better in the long run, so the thing is to lessen physical and mental discomfort enough to work on that.
Some choices my surgeon prefers that make great sense to me are: a long incision rather than a minimal one--gives thge surgeon more room to work and actually ends up traumatizing the muscles less; conscious sedation rather than genral anasthesia, just better for the body all around and the drugs they use are pleasant so it's a good start to recovery:ice packs instead of ice machine, encourages mobility: no exercise machine (I forget what it's called, it moves your knee for you while in hospital) because it doesn't give better results than your own movements: goiing straight home instead of to a convalescent hospital because you move more at home. You detect a pattern, I'm sure.
Another thing that my suregeon and physical therapists have emphasized that I don't see everywhere is that you can't harm yourself by overdoing it unless it makes you fall or have other accidents that could hurt you in any case. You don't want to overdo it because it will cause pain and tiredness and increase the likeliness of falls, but you don't need to live in fear of overdoing it.
As to using the walker and the cane. There's no race to leave these behind, and at the same time there's no need to keep using them when you're ready to put them behind. The rule they told me is to check your gait and use precisely the degree of assistance that will make you walk most normally. I used the walker longer the first time and it looks like I may graduate from the cane sooner also, but that stands to reason since I now have two recovering knees instead of one recovering and one deteriorating!
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