Lost My Nerve

Happy Birthday to my father and grandmother. Both long gone, but very much on my mind today.

My knee was very stiff this morning and barely bent at all when I got up. I put ice on it while on the CPM machine and was able to get it to bend to 85 degrees, but when I did my exercises and tried to bend it on my own I could barely get it past 25 degrees without pain.

I've been thinking that the reason my knee feels like a dead weight is the nerve trauma from the surgery. The nerves around my knee were sliced and shoved around during the procedure and many of them have, hopefully only temporarily, lost the connection to my brain. I don't always know where my knee is in relation to the alignment of my leg (if that makes any sense). It's a weird sensation. The nerves that still work tell me I should be feeling something in the affected area, but I don't. This becomes most obvious and concerning when I am trying to roll over in bed and / or walking around without the brace.

Which leads me to my other loss of nerve. I have spent the last 23 years being afraid of my knees. I was told by my previous surgeon and my mother that my knees were delicate and had to be coddled (as much as you can a leg joint). I was told no sports where I would be moving my knee side to side and stressing my ligaments. No skiing, basketball, volleyball, tennis, rock climbing, bike riding, running, surfing, etc. I was forever wary of falling and damaging my knees. Anytime I did fall on my knee an MRI shortly followed. I remember after a fall in my early twenties where my mother picked me up and drove me to an emergency MRI before I had even seen a doctor. Basically, it was drummed in my head to try to live my life, but treat my knees like they were made of glass. Snow, which I loved as a child, started to terrify me - all I could see was slipping and falling. Activities I wanted to try were ruled out based on knee impact.

And now I wonder if I'm not progressing as quickly as I should out of fear. Last time I was in a cast for six or eight weeks, this time Dr. Williams may take me out of the brace on Monday and I am terrified of doing something that will damage my knee. I can't do hydrotherapy until my incision is healed and I can't even seem to get a clear answer on when that will be. The tape put on after the stitches were removed is barely loose, much less ready to fall off.

Well, I see Dr. Williams on Tuesday. I need to write down my list of questions and issues. Plus figure out what to where that can cover PT in the morning, doctors appointment and lunch with a friend. I suspect I may have to pack extra clothes for one or more of my engagements.

The Long Walk

I may have over done it again. After my morning CPM session I decided to walk the seven blocks to the mall and then walk back and forth throughout the mall in a vain search for a skirt or pants that will fit over my brace, while allowing me to sit and being office friendly. After my fruitless search I walked home.

A walk that before October 5th I never would have thought twice about. Today I was exhausted by the time I got home and had definitely tightened up my knee as proven by my afternoon CPM session. I couldn't get higher then 70 degrees.

I still need a skirt, but I may try to be a bit quieter tomorrow as I will be busy Sunday.

Tired

I didn't sleep well last night and got up early this morning, so this is likely to be short.

I am now going outside without my crutches and able to get around the apartment without my brace. I even took a shower today with my knee wrapped in plastic wrap.

I also had PT this afternoon and with some pain, Dina and I were able to get my knee to 85 degrees. She even agreed to see me at 8:30 am on Tuesday, so that my knee is flexible before Dr. Williams beats it up at my one month appointment later that morning. Melissa also wants me to keep the CPM machine for at least one more week.

While I am far from being able to run the marathon on Sunday, I am mostly happy with my progress. I just wish I could bend further without pain.

Healthcare, healthcare, healthcare

If it hadn't been raining things might have been different. If the weather had been better I would have ventured forth to the big wide world without my crutches and I would not have been home when the phone rang. But I was.

When they asked for my dead mother I assumed it was one of the political campaigns. I have already received eight calls from the democratic mayoral candidates campaign. All for a woman who has been gone for two years. I have learned to ask which campaign they are calling from. He simply said he was from 1199 (for those who don't know unions that's the health care workers union). I do take responsibility for still assuming he was calling for a candidate. Looking back I suspect my saying she was no longer on the voter rolls was why he told me to shut up, that he wasn't calling from a voter roll. However, telling me to shut up wasn't exactly a positive comment for either of us. While I did not yell, I got a bit more vocal in my disgust of his calling. Which lead him to call me a bitch and an idiot and hang up on me. (I may be a bitch, but you don't get to call me one!) That lead to calls and research to figure out which candidate he was calling for and a message for the 1199 administration offices, which may have contained a threat of going to the local media if I didn't get a call back. (You call me a bitch, I will become one.) I did get a call back while I was having my CPM session this afternoon. She was apologetic, promised to track down the person who called and to remove my mothers name from their call list. The ironic part is they were calling about lobbying for healthcare reform. Something I do support and my mother would have.

So that was the first of my healthcare issues. The second came as a voice mail from the company supplying the CPM machine wanting to discuss when I was returning it. I guess they are still having problems with my insurance coverage. I left a message with my surgeon's office for their opinion if I needed to start covering the $175 a week while I fight with my insurance.

Which nicely leads to my third healthcare related issue of the day. When I went to get my mail I found a letter from my insurance stating that my rates have been raised by $130 a month, reflecting "the significant increase in healthcare costs in our area." This means I will be spending about $12,000 a year so I can fight about what they will and won't cover.

That's for just me, if I had a spouse and some kids I would have to pay just under $36,000 a year. That's the price of my first co-op! And the insurance industry wants to fine someone who can't afford insurance?! According to the US Census Bureau the median income for a family of four in my state is $72,170 - which means they would have to spend half their annual income on health insurance! Somehow I suspect that families of four who don't have health insurance aren't making the median income. Maybe instead of all this party fighting congress should take a good look at what is in the best interests of the people who actually put them in Washington and deal with this! (That's my op ed for the day)

Busy Baking

If I needed proof that I was stupid yesterday I got it this morning from the CPM machine. I've been able to bend to 70 degrees since last Friday. Today I could only bend to 66 degrees and that was uncomfortable. Basically, my knee ain't happy. So I am elevating and icing my knee in between baking cakes (I always forget how much I hate food coloring).

Hopefully my afternoon session will be better.

Maybe monotony is good

I got a little stupid on my three week anniversary and pushed myself further then my body wanted to go. Including my shortened CPM session, my knee was on the go for 8 hours today with little to no rest. My knee, and the rest of me, rode three buses - standing on all three; walked 14 blocks; had physical therapy; and went grocery shopping. All without icing and elevating. (Did I mention the stupid part?) I knew I was close to the limit while walking to the supermarket, but also knew that because I was close to my limit if I went home I was not coming back out.

I got to my floor and had to sit on the stairs again for 20 minutes before I could tamp down the lightheadedness and nausea and muster the energy to walk the last feet to my door, forget carrying the groceries, jacket, messenger bag and crutches. Needless to say I am being bad and not having an evening CPM session.

I had a different Physical Therapist today from Friday. The center was a bit crazy with two therapists out sick and the others having to cover extra patients. Lena, today's therapist added two new exercises to my regimen and massaged my knee cap as opposed to Dina's forced bending. I have to say I'm not thrilled that they seem to bouncing me around different therapists - maybe it's good because each one brings something different to the session, but it makes it difficult to build up a rapport. Today Dina had to remind Lena who I was after Lena had started working with me and I was on the table directly next to the therapists computer station.

I did meet a young woman who is going through PT is hopes of avoiding knee surgery. She is a freelancer and her biggest fear is how she would pay her bills during her recovery time. She was asking me questions I couldn't answer about short-term disability. Another problem in the health care crisis in America. I know I am dipping into my savings more then I would like to, but I am fortunate enough to have a build up I can tap into.

My other issue is that I have been unable to get ahead of the pain for the past two days. I have had a steady throbbing pain on the inside of my knee. The area has also swollen and is pressing against and over the metal rod of my brace. I've even tried going back on the Darvocet to no avail. I haven't quite decided if this is general "Hey, I'm healin' here" (yes, of course my knee has a Brooklyn accent) or if I need to put a call in to Dr. Williams office. For now I'm thinking a quiet night of ice packs and elevation.

Needless to say I didn't get any baking done. We'll see what I'm up to tomorrow, but my cops may have to go cakeless tomorrow.

Monotonous

This is all starting to feel a bit monotonous. Being off the narcotics means I am getting some work done. But still being on crutches outside means it is literally a pain to go anywhere. Plus there is only one pair of jeans that fit over the brace and except for going to PT I don't like to wear my sweats outside. I am getting grumpy about the whole thing and quoting Eartha Kitt. (Points to anyone who can name my reference! It has something to do with Montgomery Clift.)

My days are up, breakfast, CPM, shower, work, errands, exercises, lunch, CPM, work, dinner, tv, bed. I either work, read, or watch videos while on the CPM depending on my mood and the rest of my schedule. Who said there has to be more to life then this? Tomorrow and Tuesday I get to try to break the continuity by trying to bake for Tuesday nights meeting. I'm bored, which leads to passivity and ennui and can't be good for my recovery.

Another rainy Saturday

My activities were once again hampered by the weather. I did go out, but did not find a leash. I did my CPM and worked on my three different leg lifts. I need to get out of this loft and be around other people. Especially at this time of year (But that's a whole other non-knee topic).

Back to thinking about where I want to go to celebrate my new knee once it's fully functional. Paris, India, or someplace new? Walk what's left of the Great Wall? Stay closer to home and discover my maternal grandfather's roots in central Pennsylvania? Learn to Tango in Buenos Aires?

All quiet on the knee front . . . but trouble in the kitchen

I did not make it to buy a leash today. Finally off the narcotics I was able to concentrate and get some work done. I will have to try for the leash tomorrow - though the idea of braving Target on a weekend scares me.

I can definitely tell that the PT made a difference. I have been stuck at a maximum of 45 degrees on the CPM machine since my surgery. Today I was bending at 68 degrees. My knee is sore, but survivable. I'm not even feeling like I need anything stronger then the Motrin to get through the night.

I do have to say sleeping without the brace last night was wonderful, though my knee is still swollen and has nerve damage and even without the brace feels like a dead weight on my leg. But just having air able to circulate was a nice feeling. Last time I had knee surgery I was in a cast for six or eight weeks. By the time it came off my knee had tightened up and I don't think I could bend it more then 15 degrees.

The one pain I haven't figured out is the stabbing in the middle of my shin when I am lifting my leg. I can't tell is that is residual from the screws. It doesn't happen all the time, but when it does it is very sharp.

I am getting more comfortable hobbling around the apartment without crutches, but not quite ready to brave the outside without them. I finally learned to wear my old motorcycle gloves to help protect the heel of my hand, it really makes a difference. The one thing I haven't quite figure out is how to bake for my meeting Tuesday. I'm just not sure how long I can handle standing, not to mention jumping up and down to get pans out of the oven. I know I probably can't do cookies, so I am looking for any bundt cake or cupcake suggestions that don't require a huge amount of standing to mix the ingredients or a lot of time hopping up and down to check the oven. I also have a lot of frozen blueberries I wouldn't mind using.

It's a little sad I should be starting to make the pumpkin puree for freezing, but I can't figure out how to get to the farmers market, or get heavy pumpkins home, much less the time on my feet to cut, steam and puree them. Or baking the seeds. So it looks like no pumpkin bread, pie or cheesecake this year.

55 Degrees

I am exhausted and sore. I had my first real PT session today. I did leg lifts and other muscle exercises as well as forcing my knee to bend on my own, followed by the therapist, Dina, forcing my knee to bend. She had me hyperventilating in pain. At the end of the session I could bend my knee 55 degrees before I wanted to scream and have someone put me out of my misery. She sent me home with exercises involving a dog leash. Now I just need a dog leash. (That's tomorrows quest - well that and a new Metro Card.)

My only complaint was that the ratio of patients to therapist was a bit high, which meant what should have been about a 30 - 40 minute session became 90 minutes because of the waiting while she was working with other patients. I selected this place over the smaller independent physical therapists because I thought they would offer better/more PT equipment and options. But either they need more therapists, or to not schedule the ones they have so tightly.

I also spoke to Melissa, Dr. Williams' Physicians Assistant, today after two days of playing phone tag. She has stepped me down to Motrin twice a day for pain and told me I can sleep without the brace. She also implied that despite my previous assertions Dr. Williams may be a bit of a sadist. She said if he had his way his patients would be doing 1000 leg lifts a day! Yikes.

Mmm, lobster bisque

It took 2 hours, but I made it to Trader Joe's and home. I had a great lunch of lobster bisque and a ciabatta roll. My bus driver coming home was wonderful about getting right up to the curb, so I had a very easy time getting in and out of the bus. And after I got home I even managed a little bit of hobbling sans crutches. (Did I say something yesterday about not overdoing it?)

The only frustration has been playing phone tag with Melissa, Dr. Williams Physicians Assistant. Yesterday she called during the ten minutes I left to go check mail and today she called while my cell was charging in the office and I was strapped to the CPM machine in the bedroom. Maybe we can finally talk tomorrow.

Tomorrow is also my first official PT session. I can now manage leg lifts, but I can't bend on the CPM more then 44 degrees without feeling pain. According to the paperwork, I am supposed to be at 90 degrees four weeks after surgery.

With the number of people who have told me that they are facing possible knee surgery it occurred to me I should put together my knee surgery preparation and survival guide. I have been mentally working on it, so look for something posted here soon.

Don't over do it

My friend and heart attack survivor, ET, and I have been reminding each other that we have to be careful and not over do it. It's a maxim I have to work on remembering. Today I decided to walk the 2 blocks to the bank and back. I then went to the supermarket, I decided what I really wanted was some lobster bisque from Trader Joe's. I was feeling fine and considered hopping on the bus to head to the store. I called a friend to see if she could drive me and suddenly, while on the phone I was overwhelmed with nausea and lightheadedness. Luckily I was standing outside my building, but I thought I wasn't going to make it inside, much less onto the elevator and up to my floor. Once on my floor I stopped and sat on the stairs. The odd moment came when one of my neighbors came by, looked at me and asked if they should hold the elevator for me. I am sitting on the stairs surrounded by the coat, sweater, scarf and hat I had pulled off, not to mention my crutches and the only thing she asks is if she should hold the elevator.

Another reminder not to over do it. I have managed to up my leg lift count to 20. However, it hurt in a way that had me laughing. It was a weird sensation. I have also noticed I am having muscle memory of the CPM machine. There are times when I am not on the CPM, but my leg still feels the motion - sort of like when you still feel the rocking of a boat when you are on land.

The problem is I still want that bisque, so maybe that will be my activity for tomorrow, getting on the bus and going shopping. Just don't over do it.

It just takes awhile

Everyone has been telling me it just takes awhile and I finally believe them. I am still having problems sleeping at night and getting up in the morning, but everything else is getting easier. I took a shower, did my morning CPM, iced my knee and then met my friend Marion for a walk the length of our block and back. I felt like I could have kept going except, for the first time since surgery, I actually felt hungry, so I came in to make lunch. Maybe I'll try another walk this evening after my second CPM.

And I haven't been having the sweating episodes, so I am starting to think they may have been a side effect of the Percocet. The only pain I've really been having on a regular basis is actually where the screw heads are located at the top of my tibia.

Basically, I am must more positive and happy then I was just a week ago. Time for lunch.

Rain, rain go away & my surgeon shows off his photography

No outside walk today. Another storm blew in with lots of rain. I want exercise, not the flu. I did walk to my mail box where I found an envelope from my surgeon containing these images of my surgery. As a photographer I find them rather interesting, as the patient they're a little creepy. There are sixteen images in total. I can't begin to explain what they show, though I think my knee could be cast in it's own series on the SyFy network. (I think the bottom right one looks like an eye.)

I did manage 10 leg lifts today - far from David's 200, but I don't think Dr. Williams is the sadist David's surgeon was. Long story short, I didn't get my pain pill this morning and chose not to take the "as needed" pills. I had some twinges, but even that pain is better and I fell much more clear headed. I am officially getting better and if the weather ever clears up I can work on my outdoor walking.

I used to be a morning person

The meds seem to have changed my internal clock. It used to be that no matter what time I went to bed I would be awake and raring to go as soon as the sun rose. Since the surgery I am finding it harder and harder to get up in the morning and I am staying up later and later and drifting off during my CPM time.

Today I did manage to read a fluff book, but only because I napped every other chapter or so. Basically my day was spent reading, napping and using the CPM. I have got to get more focused. I did manage three pathetically low leg lifts this morning on the bed.

Tomorrow I vow to leave the loft even if it is only to walk to the top of the block and back. Monday I want to ask about getting off of some of the brain fogging pills. I think I would almost prefer more pain to this spacey unfocused feeling.

I get no feline respect

The cats have all lost their fear of my crutches and the CPM machine. I had hoped it would last a bit longer. They have also gotten accustomed to the knee brace and no longer have any trepidation about climbing, or trying to nap on it when I am in the bed or on the couch. Two have even tried to climb it when I am in the office on the computer.

It was very hard to get up this morning. Gray skies and December-like weather made it the perfect day to lie in bed. I also realized that some of my depression has nothing to do with my knee and every thing to do with the time of year. My father's birthday followed two weeks later by the anniversary of his death. While it gets easier, I still go into a slump at this time of year.

I did finally pull myself out of bed and do my morning CPM. I then decided to push myself a bit and head to the supermarket across the street and see if I could find anything to inspire my appetite. Since I have graduated to weight bearing as tolerated the trek had the added bonus of seeing how much I could tolerate. I think I did very well though by the time I got home sweat was dripping off of me from the exertion. But I definitely feel like I made progress.

As to the leg lifting issue, one friend told me yesterday that his surgeon had him on the floor doing 200 leg lifts a day. The two problems I have with that is that I'm not sure how to fit 200 leg lifts into my schedule that already includes five hours on the CPM machine and I can't figure out how I would get up from the floor! Something to think about.

30 minutes to go 3 blocks

I had this grand plan last night to prove I was on the mend and could still be independent. I was going to get up this morning and take the bus to Target to pick up a few things I wanted, then take another bus to the drug store to drop off my new prescription and then take a third bus to physical therapy. This morning looking at the pouring rain I decided not to go to Target, but figured I could easily walk the three blocks (two slightly up hill) to the pharmacy. I took me half an hour to get from my house to the pharmacy! The bus was also not a huge success. Not being able to bend my knee means there is only one seat on the bus I can take without having my foot in the middle of the aisle, and the 60 - 70 year old lady was not willing to give up her seat. So I stood, trying to hold on to crutches and the bus and then had serious issues getting down from the bus.

I got to the PT office and discovered they hadn't received my referral. That was cleared up and I met with the therapist to evaluate what I was able to do and what Dr. Williams wanted me to be able to do. I have some ability to bend my knee, though not very far and I am almost able to bear full weight on my left leg standing without my crutches. What I couldn't do, and find it utterly frustrating, is lift my left leg straight up while lying down. When standing I can kick or lift my leg with no problems, but lying down it felt like a dead weight and my brain just couldn't send the message to my leg to lift. When the therapist lifted my left leg I could only go about 80 degrees before feeling some pain. I know I've been saying my leg feels like a dead weight, but this is ridiculous. I can get the thigh muscle to tighten and move my knee cap, but there is some barrier to lifting my leg!

That seems like fairly good proof that I need physical therapy. And yet I could not schedule another appointment until next Thursday because my insurance needs at least five business days to approve the PT evaluation and even then they will only approve two or three sessions at a time. (It's far from ideal but go Baucus Bill!)

Ran into friends who drove me back to the pharmacy and then home. My knee is twinging from being poked and prodded and I am ready for a nap. On the plus side I was able to stop in the bookstore and get not one, but two new sudoku books.

Dreams of Destinations

The CPM machine when not in use.

It's a fairly quiet day. Dreams of trips I can't take for awhile fill my head. Business Class seats to Paris $590 each way, Coach $300. Four nights in Dublin, with air $399. I want to grab my camera bag and get on a plane. Kashmir continues to call me back. North Africa. Even jsut walking the beach in Florida. I guess I'm going a bit stir crazy. Too long without a trip, and a while yet before I can take one.

I need to find a focus for this semi-forced idleness. I have yet to figure out how to work on my laptop while strapped to the CPM. And hopefully I can move totally off the pain meds soon so that I actually have the ability to really focus and concentrate.

I have been keeping my iPod on music with a positive message and repeating my current mantra "This to shall pass". In the meantime, let's work on having an end result that really shows why this was all worth it.

I'm Screwed

Literally. Dr. Williams put two screws through my tibia. He says I won't set off metal detectors, but they will set off wand searches. I can have the screws removed in nine months and will want to as they can be painful when I kneel. Good thing I'm not travelling right now!

I had a set of x-rays taken and the stitches were removed. Dr. Williams says I'm doing fine and the red spot is nothing to worry about. I see him again in three weeks and have the PT orders to give to the therapist on Thursday. I did get new crutches as Dr. Williams said the ones I had weren't sized correctly and I was throwing my hip up every time I swung my leg. I guess there is a difference in how you really react to crutches when you are fresh out of surgery and in pain and a week later. The recovery room physical therapist had also given me a mismatched pair of crutches which wasn't helping things. They are now a matched pair and set at 6'1". They definitely make me walk straighter. Finally, I got a lower dose pain medication, so hopefully I won't be so loopy.

Something as simple as going to the doctor (by taxi, no less) has totally wiped me out and my knee hurts from pulling out the stitches. I am trying not to take a nap, so that I can really sleep tonight.

Crisis

I finished my Sudoku book! Okay, so it's not like a "my leg fell off" kind of crisis, but I am stuck in my bedroom with no tv for 5 hours a day on the CPM machine. What am I supposed to do read a book? Actually, with these meds I don't really have the concentration for a book, so the sudoku has been an ideal way to keep some brain function while I am working on my knee.

I am feeling better today. A combination of venting yesterday, getting more then four hours of sleep last night and talking to my friend ET (she of the $160,000 heart attack) who reminded me that progress is slow but it does get better. She is doing so much better she may go home this week.

I also made a discovery with my leg. I have friends coming over tonight, so I did 4 hours on the CPM machine in one stretch so I wouldn't have to strap in during their visit. The extra time seems to have loosened or unblocked whatever was causing the swelling in my leg. The swelling is almost totally gone and I can see my ankle bone.

It feels like more then a week should have passed since my surgery. It's been a busy week and the coming one brings even more. I see Dr. Williams for follow-up tomorrow and start PT on Thursday. At least there's a Barnes & Noble in the same building as the physical therapist, so I can pick up a new Sudoku book.

If this is what hot flashes are like I can't wait for menopause!

I seem to have two temperature settings right now - double sock and sweat lodge. I went to bed exhausted at 9:30pm last night so cold I put on two pairs of socks and woke up three hours later so soaked in sweat I had to change my sleep shirt. And it isn't just at night. In the ER yesterday I started sweating so badly my hair was dripping onto my neck. Even sitting here I have been bouncing between needing the ceiling fan on and it raising goose bumps.

Waiting for Dr. Petrigliano, Dr. Williams Resident on call, to phone me this morning I focused on the fact that this is no longer the positive adventure I started out on a few wekks ago. I hit a wall sometime yesterday and I am finding it extremely hard to be sunny (yes, I can be sunny) and positive about this whole experience.

I am tired emotionally and physically. I am starting to hate. I hate how much of a hassle everything - even the most simple of chores - has become. I hate that I can't even manage some tasks like sweeping up kitty litter that spilled while I was scooping it. I hate that I have to psych myself up for a simple trip to the bathroom. I hate that my hands hurt from the crutches. I hate that my left leg hurts, not only from the surgery, but from being stuck in the brace 19 hours a day. I hate that my right knee is grinding every time I sit or stand. I hate that Dr. Petrigliano thinks that my thrush isn't "that big a deal" and won't let me treat it. If it spreads I'm going to hate him even more. I hate that I haven't had a full nights restful sleep for more then a week. I hate that I can't take a shower without having somebody nearby because I might slip. I hate that simply cooking food in the oven requires more thought and planning then it should. I hate that I have laundry in the dryer and can't figure out how to take it out and put it away. I hate that no food is appetizing and I have to force myself to eat so I can take my meds. I hate how fuzzy and apathetic my meds make me feel. I hate that if I don't take my meds I'm equally miserable, but with the added bonus of pain. I hate that I have lost control over my internal temperature control. I hate that what I really want is to curl up in bed and have a good cry. I hate that I can't do that. And most of all I hate that I have lost the ability to look forwards to the end goal and stay positive.

A Long Day in the ER

I wanted to talk about happy news today like the fact that I got a letter from Oxford, my insurance, yesterday stating that they had approved payment for my CPM machine, but even that was taken from me as today's mail brought a letter from Oxford dated the same day as the first, with the same reference number denying coverage for my CPM machine. And of course it is almost 5pm so the office is closed for the day. I don;t know if they will be open Sunday, or if this will have to wait until after the holiday weekend. And that just adds to my already long, crappy day.

I woke up around 5am uncomfortable from staying in one position all night and tried to get more comfortable and doze. Gave up on that around 6:30am, got up and had breakfast. While sitting on the couch I looked down and noticed that my left calf, ankle and foot were very swollen and a bit red. They had not been like this when I had my shower yesterday. The calf was sore, but I couldn't tell how much of that was after-effects of the surgery, the brace or the CPM machine versus something new. Around 7:45am I finally decided to call my surgeon's service. It took 3 calls of 5 to 10 minutes of sitting on classical hold music before I even got the service to answer the phone. I left a message and then after waiting some more called my wonderful neighbor and nurse, Lori (you may remember she supervised my nervous first bandage change). She came over and decided that I probably didn't have a blood clot, but wanted to take me to the ER anyway. After some hemming and hawing I finally agreed, so off we went to Methodist Hospital.

She dropped me off just before 9:00am at the side door closest to the ER entrance - which was locked, meaning I had to walk down the block to the main entrance and then walk the lobby, that can best be described as a perfect skate park, back to the ER. I was exhausted by the time I finally signed in. (Note to Methodist - if you want to keep that side door lock for security reasons set up a camera and a buzzer so that the ER receptionist can let people in!)

I saw the Triage Nurse around 9:30am. Told her my concerns, lifted my left sweatpants leg to show her the swelling, got an elevated blood pressure, but no temperature and went back to the low, uncomfortable chairs in the waiting room. Called into the ER around 11:45am. Another long hallway to get to my cubicle. Before I even saw a Doctor an Orderly came by to take me for a Doppler. I learned later it is the new procedure that someone - I guess the Triage Nurse can order tests so that when you see the doctor they have a better picture of your condition. (I'm guessing it will be the new thing Insurance Companies fight about.)

So just after 12:00pm I was up in Ultrasound and getting a Doppler scan on my left leg. One thing to be happy about today - no clot. Back in the ER by 12:30pm and the Resident, Dr. Hawkins, came to tell me that sometimes Doppler doesn't find the clot (enough, no clot makes Erika happy). She agreed my right calf and foot are colder to the touch then my right, but I have a pulse in my foot and could she look at my incision. She went to get more gauze and wrapping while I took off the brace and dressing. She seemed surprised that I was not expecting her to do everything for me. There was a red spot on the outside of my knee, I guess where the new ligament is located. It was hot to the touch - the only spot on my knee that was warm. She decided to have her Attending take a look at it.

At 1:54 pm (I had figured out where the tv remote was hidden and changed the channel from college football to CNN) the Attending arrived and decided that I may have an infection and gave me two prescriptions for antibiotics and sent me home.

When I got home there was a call on my answering machine from the Doctor covering for my Surgeon this weekend. He had been in rounds and finally called me back at 10:34. I had him paged. He didn't respond, so I called the service again - this time they answered. He called me back within 10 minutes.

He was happy I had had the Doppler, but was not happy the ER hadn't taken blood. He didn't think I had an infection and told me not to take the antibiotics, but to call again tomorrow if it was still red and hot.

So basically it was a very long day. I do have to say "thank you" to Lori for coming over and taking me to the hospital and Jan for coming to pick me up. My only request is that you consider lower riding SUV's for your next vehicles!

Excitement - a shower & thoughts on healthcare

It is sad when the big thing in your life is taking a shower. That was the excitement for me today - doing my CPM machine and then taking a shower. Getting in and out was a bit hard, but feeling fully clean is wonderful. I didn't even mind the trash bag taped to my left leg.

I had another low grade fever last night. I wonder if that is just part of the process. When you have a cold your fever will often be higher in the evening - at least mine tends to be.

It seems to me that in addition to physical therapy after the surgery the patients should be given a physical therapist to get in shape for the surgery. I have good core muscles and they have been very helpful. Being able to sit up in bed and get out of bed, sofa and chairs you need good abdominal muscles, especially with the weight of the braced leg. Having good thigh muscles. I had to lift my braced leg up to get the garbage bag on and taped before my shower. The other thigh is getting a workout since I can't put weight on my left leg while getting up and down. (The problem is that I can hear and feel my right knee grinding and popping, but that is a whole other story.) The other pain is the crutches, my underarms and the heels of my hands are sore from getting around.

I think surgeons or their PAs should give all surgery patients an exercise list - like they do with your physical therapist - to prepare you for surgery and the aftermath.

I got an e-mail from my cousin that got me thinking about universal health care again. Wendy is a University professor in England, so she has their NHS coverage. She is having knee issues too, but according to NHS guidelines is considered too young for replacement surgery. She now has to see a specialist, I guess the equivalent of Dr. Williams. It seems to me in some ways it is very similar to an HMO. I had to get a referral from my Primary to see the Surgeon. She may have a longer wait time to see the specialist. I originally had about a month, but was able to fill a cancellation.

But would NHS have approved this surgery? I certainly consider it medically necessary and I don't think Dr. Williams is the kind of surgeon who cuts just because he can, whether or not it's in the best interest of the patient. But would I meet the criteria used by the British system? This is going to pester me. I will have to ask Dr. Williams if he has any colleagues in England he would be willing to ask.

I whole heartedly believe we need some sort of public option for people who can't afford private insurance but don't qualify for Medicaid or Medicare. I have spent time without insurance and know the fear of having an emergency and not knowing how I will pay the bills. I also believe health care costs are out of control and the whole system needs an overhaul. My Godmother had a massive heart attack this summer, she had emergency surgery and spent over a week in the Cardiac Care Unit. Her insurance sent her a statement of the bills submitted by the hospital. Not including her surgeon the bills run about $160,000. She has a small co-pay and I suspect her insurance pays the hospital less then half of that figure. So how is that cost realistic and how does anyone without insurance even begin to deal?

Day 4

I had a low grade fever last night, but seem to have slept it off as my temp was back to normal this morning. I also had a horrible allergy headache from all the pollen etc. being blown around in the heavy winds yesterday. I dream about being able to roll around in my sleep. I think I pinched a nerve in my shoulder last night, my left pinkie finger is still feeling a bit numb.

I had a friend who is a nurse come over last evening to supervise the changing of the bandages. It was easier then I expected. My incision is covered in suture tape and I am happy to report no drainage or signs of infection. Lori said it looked good. It is still very swollen around the knee cap. Melissa at Dr. Williams office had said I could cover it with big band-aids. I didn't have any so I used the dressing the hospital gave me at discharge.

I was very proud of myself this morning. I got up and had breakfast, took my pills, spent 2 1/2 hours on the CPM machine and then managed to scoop kitty litter, take the trash out to the shoot 40+ feet and 3 steps away and then go downstairs and check my mail. It was wonderful just to get out of the loft - even if the view was just the hall and the lobby.

It's funny, when I have the option I can spend the whole day in the loft without even thinking about it, but being limited I yearn to get outside and am getting a bit stir-crazy. I am trying to decide if it would be pushing too hard to put on shoes and go to the supermarket across the street in search of band-aids and something to spark my appetite. The real question is could I figure out how to get shoes on?

Another day

Somehow it was harder to get up this morning then yesterday. I suspect part of it is not being used to sleeping in one position. When I'm in bed my leg feels like a dead weight in the bandages and brace. And then there is that first "ouch" moment as I'm lowering my leg off the bed. The pain pills help, but I don't really like how loopy and sleepy they make me.

I did manage 2 hours in the CPM Machine (which for the second time my insurance has decided to deny - I've already mentioned my feelings on universal health care). The poor cats, they want to climb on the bed with me but the movement and sound of the CPM machine freaks them out a bit. One friend said I am lucky I don't have dogs who might bark or try to attack it. The cats are also not a fan of the crutches, but at least have a healthy respect for them, I was afraid I would wind up tripping over a cat and go splat.

I completely agree with the need for Physical Therapy clearance before you leave the hospital. Can you get around on crutches and in my case manage the 3 stairs to my loft. But some basic Occupational Therapy would be nice too - especially for those of us who live alone. Figuring out how to get in and out of bed was very difficult, not to mention getting in and out of the CPM machine. I finally figured out it is easier to leave the brace on for stability to lift my leg into the CPM machine and then remove the brace. Getting out is harder.

To get in to the bed or the sofa I wind up doing high kicks to lift my leg onto the surface and then sit or lie down. I don't know if that is the correct way to do it, but it is what works for me.

I get to take the dressing off today and get a look at what was actually done. Melissa, Dr. Williams PA, says I can just put big band aids over the suture line, though the hospital sent me home with lots of dressing and more ace bandages.

My only concern is that the medications and/or anesthesia may have given me thrush. My mouth is constantly dry and I think there is some white stuff forming on my tongue. I got thrush after my last surgery and I seem to recall it feeling like this.

Long day at the Hospital

A very long day at the hospital. Arrived at 7:00 am, surgery was slightly delayed because the hospital lab misplaced my blood work - what is it with my blood? - I still haven't decided if walking to your operating room and climbing onto your operating table is empowering or a bit creepy. As I was waking up from the anesthesia the heavy bass of whatever they were listening to worked into my dreams. In fact that is the first thing I said to the Anesthesiologist, is that next time I get to pick the music.

I got into recovery around 1:00 - 1:30 and they wouldn't even call my friend picking me up until 3:00 pm and we didn't manage to leave the hospital until 6:30pm. And it turns out that most people who have this surgery spend at least one night in the hospital. Dr. Williams offered me that option, but I just wanted to get home and metaphorically lick my wounds in peace. Had I realized how many times I was going to have to get up to pee out all the IV drip they gave me I might have reconsidered. But home I came wrapped ankle to thigh in ace bandages with a brace on top.

This was not the nice simple, easy surgery I imagined. They cut open my knee using almost all of my original 9" scar line moved a ligament he said was really not in the right place and put in a cadaver ligament. I am still processing that. I have a piece of somebody else in my body. It is certainly not as big as an organ donation, but still someone else lived with this ligament. And I have to wonder did they have a good life? Were they happy? Were they active?

Dr. Williams says no high heels for three months, so there goes my fall boot season! I see him to have my sutures removed next week and then start PT after that. Now if I can just lesson the pain, stop having to pee all the time and figure out an easier way to get in and out of bed and on and off the couch this will be much better.

For now, it's back to bed to do a couple hours on my CPM Machine.

Who says we don't need universal healthcare?

I guess my main question about a public healthcare option is would every provider have to accept it? Or would it be like current HMO's (like my plan) where you have to find a doctor, hospital, pharmacy and lab that accept the reimbursement amounts from the plan?

After yesterday anyone saying a public option isn't needed is sitting smugly with their own private insurance. I am self-employed, I am fortunate enough to be able to pay a fairly high premium to have HMO coverage. Without it I couldn't even dream of this surgery. That said Oxford (my insurer) has denied every post-surgical machine except for the brace. They denied my CPM Machine and the "game ready" cooling machine. And yet want to sing the praises of how little my out-of-pocket expenses will be for the surgery.

My personal favorite came at around 4:00 pm yesterday when Dr. Williams office called to ask if I knew that the lab (Quest) where my doctor had sent my blood work didn't take my insurance. (My doctors office knows this from previous blood work, but hey) So the lab notified my doctors office and arranged to send it to a different lab. Somewhere between the first and second lab my blood was lost. And again, no one bothered to bring this up until 4pm on Friday afternoon.

On the plus side, that came after so many other problems and issues during the day that it pushed me from screaming, crying and main-lining Ben & Jerry's to hysterical laughter.

Forget Universal Health Care, how about a doctors office capable of staying in communication with a patient with out making the patient look like a bitch trying to hyper-manage everything herself!

In the meantime, I have today and tomorrow to finish my surgery to do list - never did have the MRI my surgeon wanted. And Monday morning I have to be up around 5 am to be at the hospital between 7 and 7:30 for another round of rushed blood work and whatever else before surgery. And I probably won't be home until 3pm or later. At least I'll get some sleep during the day.

Frustration

Four days to surgery. I should find out today what time I have to be at the hospital on Monday.

Right now my frustration level is higher then my fear factor. Dr. Williams better be an amazing surgeon to make up for the problems with his office staff. It took 3 phone calls to just get someone to return my call and actually schedule the surgery. Then, despite telling me I would receive an e-mail with the list of blood tests and such I needed from my Primary, I had to call the office from my doctor's office to have them fax the needed tests. I finally do get an e-mail requesting other information and when I respond to that and mention that Dr. Williams wanted me to have an MRI so he could access any cartilage damage I never heard back - and that was a week ago.

Yesterday I got a call from a medical supply place saying that my insurance was denying coverage for one of the post-op equipment (a continuous passive motion machine) because I was not having a full knee replacement. So I called my insurance, who stated they needed a letter from my surgeon stating my need for it. Called the doctors office - explained the problem, was told I would get a call back that afternoon for more information. No call. Did I mention it is Friday and my surgery is Monday?

I suspect were I one of his pro-athlete clients I would be getting a better response from his staff. Believe it or not, I don't actually enjoy being a nag and I am sure he has other patients, but still.


I had a major internal debate when I started this blog on if I would list my surgeons name and the facilities where I was having surgery and physical therapy. I'm still not sure, but I will say if you are having surgery with him and you are not a celebrity or pro athlete be prepared to be frustrated with his office personnel.