Just call me Half-Awake Hobbles

Right now the knees not really hurting, but I do have that spacey feeling when you're not quite awake. I got home after ten pm last night and was up at 3:30 this morning to be at the hospital by 5:45 so that I could be Dr. Williams first patient of the day at 8:00 am.

No epidural this time, just a little something in my IV and I began to wake up in the OR as they were wrapping my knee and remember looking at my anesthesiologist and asking if we were done - no loud music in the operating room this time. Just after 9 (Regis and his guest host were still doing their opening banter on the tv over my bed) I was wheeled into recovery and offered a mediocre tuna sandwich and a ginger ale. By 10 am I had gotten out of bed and peed and they were ready to send me to "Phase 2" recovery and send me home.

I never even got to see Dr. Williams after my surgery, though Melissa came and told me everything went smoothly and gave me some post-op care rules. Nor, did I ever get my screws! (May that be the worst part of this operation!)

Mitch picked me up and took me to the pharmacy for my pain and anti-inflammatory prescriptions before dropping me off at home. Where I immediately collapsed on the couch with an ice pack and made a few phone calls and getting some time with one of the cats. When I found myself in some pain and waking from a doze in a position bound to give me one heck of a neck cramp, I took my crutch and hobbled to bed and passed out for two hours. Which brings us to now and this fuzzy headed feeling.

As for post-op rules - one crutch and light weight bearing for the next 24 hours at which point I can remove the bandages wrapping my full knee and just band-aid the surgery scar. I have to keep it dry for the next 10 days (so it's back to plastic wrap in the shower!) but should be able to move the knee normally. Though we did discuss I may have re-plan my Saturday as my currently scheduled photo shoot may have me on my feet too much.

Right now I'm just going to drink some juice and go back to bed. Melissa is supposed to call tomorrow to check on me, we will leave it until then.

Blood work

Yes, it's been awhile. My life has been more about bringing in a paycheck then obsessing on my knee. Though I have been getting a bit of pain lately. I have decided it is my knee preparing to lose the screws.

I am happy to report that procedure is scheduled for a week from tomorrow (if I finish and post this by midnight). I went to the hospital today for my blood work - an hour on the subway each way so they could spend less then a minute drawing 2 vials of blood. I figured it was still better then last time when my primary sent the blood to a lab that doesn't take my insurance and so we had to rush labs the morning of my surgery.

I also had to do a bit of scrambling today when the person who was originally scheduled to pick me up at the hospital had to cancel. Fortunately, I was able to find a new person. It seems ridiculous that I have to have someone at all, it's not like I'm having them move into my apartment to take care of me. Especially since this is supposed to be such an easy procedure. I asked if I could just have someone meet me downstairs at the hospital entrance, but no, Melissa insists they have to come up to the Recovery Room. Again, if all they are doing is driving me home what is the point? I can almost guarantee that whoever comes to pick me up next Wednesday is not the person I would call for help if there is a post-surgical complication!

Maybe that should be my new career - hiring myself out to people who need someone to get them out of the hospital so they can go home and be sick in peace!

In all seriousness, I just want to know that this final part will be easy and that it will mark a turning point in getting my life and my career back on track! I have been somewhat forced by the surgery into a stagnation that I neither wanted, nor was really prepared for. The thought of having to pause my life for another nine months to have the other knee done scares the crud out of me.

I want nothing more then to jump on a plane with my camera bag and just go! I have tried for some projects closer to home, but have been having funding and permission problems. I don't know maybe my life just makes more sense when I'm looking through a camera lens - or maybe it's almost midnight and I just need to go to bed!

No side planks today

I had Robert for PT today. I like him - mostly because I said I didn't want to do side planks and he said okay. Matt would have immediately decided that was my next exercise! I'm back to Matt on Monday, so I know I have to work on my home exercises this weekend!

Despite no side planks, my knee is a bit sore today, between PT and spending a lot of time standing in the kitchen baking for the last two days I'm not really surprised. Probably time for some ice.

Back to PT

I had PT yesterday with Sejal. I was feeling under the weather, so I was not as good as I hoped to be. I was feeling a bit light headed and unfocused. She did introduce two new tortures to my repertoire - one-legged bridges (which were not as bad as the second torture - I mean exercise) and side planks. I felt I should be able to distribute the weight across my full forearm like I can with front plank, but instead all the pressure seemed to rest on my elbows making me very wobbly.

All the exercises you wish you didn't know existed. Just keep repeating "this is good for me, this is good for me!"

Just when I thought I was out...they pull me back in

Got a phone call today from my PT center telling me I was approved for four more sessions. I was sure I was done with PT - I have been walking in snow and ice doing most of my exercises at home and meeting with possible personal trainers. But, I am not going to turn it down so Monday afternoon it is back to therapy for me. I will have to stop at my doctor's on the way in and get a new prescription.

Just when I had started getting a little lazy and letting myself sleep until 7:30. I may get to the point where I can kick my own butt yet.

In the meantime, I know that despite my walks I have been spending too much time tied to the computer working on show submissions and book and grant proposals. Speaking of which, back to the grindstone.

128 Degrees means Graduation

So, I think I graduated from PT today. Before doing any exercises I was able to bend my knee to 128 degrees. That means my left knee now bends further then my right knee and my insurance is almost definitely going to consider me done.

Now I just have to find the right personal trainer to keep me moving forward. I forgot to ask Dr. Williams if I could Tango yet.

A+

I got an A+ from Dr. Williams today. I may feel like I am not moving at a fast enough pace, but he is very happy with my progress. He would like me to continue with PT to get my knee to 130 to 140 degrees, but I suspect not even a strongly worded letter from him and Matt will be enough to convince my insurance to open their purse strings!

Dr. Williams gave Matt high marks for pushing me. He was impressed by my leg presses, balance board catch and yoga ball bridges. And I don't have to see him again for three months.

The only set back came when Dr. W. said we may want to revisit doing my right knee this summer when the screws come out of the left knee. Once fully healed my left knee will have no activity restrictions on it, but my right knee will still have the fragility limitations. Yes, I definitely want two good knees, but can I and my bank account handle another year like this? (If anyone knows the Powerball numbers for tomorrow that would be helpful!)

I also pitched my new book idea - knee scars the coffee table book. Dr. Williams will write the forward and help identify good scars, if I can get a publisher. Any suggestions?

For now I am off to bake cookies for Matt and the rest of the PT gang. I hope tomorrow isn't my graduation, but I'm realistic.

PT Gremlins

There may be a ghost in the machine at my PT center. I have had three appointments where the time they originally gave me on my appointment print-out and the time the computer has when I arrive have been different. Friday was one of those days, so I confirmed the times for todays appointment. Sometime between when I confirmed my appointment at the session and later that day when I got the automated phone message reminding me of my appointment and this morning my appointment disappeared from their computer. So, I showed up this morning and couldn't see Matt (my appointment time had also been filled by someone else).

They were able to fit me in with Carlos. We kept to the activities Matt has had me doing, except Carlos also worked on manipulating my knee. That hurt - he actually stopped saying he didn't want to irritate me too much before my appointment with Dr. Williams tomorrow. Yikes, think what he could have done. I am bending well, just still sore to the touch.

We'll see what he says tomorrow.

Feels like 0 degrees

I missed both buses to and from PT today, so I walked the 14 1/2 blocks each way. With the wind chill it was 0 degrees F. Neither of my knees were happy. Actually, my right knee is really starting to get irritated and cranky.

More balance board catch and another new exercise of lying on my back while squeezing a giant yoga ball between my ankles and bending and straitening my knees. I can only guess what it looks like while you are actually doing it.

My left (surgery) knee is sore and hot and doesn't want to bend while I am sitting at the computer - probably time to put some ice on it and I may even take a pill (haven't had to take any pain meds for two weeks.) Actually, a nice nap sounds really good (one of the pluses of working at home).

Lots of exercises to do this weekend, while facing the knowledge that Wednesday will probably be my last PT session unless my insurance stops being quite so miserly. Did I mention a nap?!

Balance Board Catch and High Heels

Just trying to stay on the balance board wasn't enough for Matt. Today I had to stand on the balance ball and throw and catch a ball. Multitasking at it's PT best.

We also got into a discussion about high heels. I wasn't even thinking about blogging it, until Matt said he had to think about what he was saying for fear it would end up here.

I have never been one of those "Sex & the City" type women who live in their stilettos. I love my heels, but I usually carried them in a bag and wore them for short periods at specific events. Matt agrees with my old Podiatrist that they are really not good for me as they force the knee to bend - helping to give your legs that look that women love their high heels for, but wreaking havoc on joints. For a woman who has now had three knee surgeries in the last quarter century, that's probably not a good thing.

I agree in theory, but . . . they're pretty and they help me feel pretty when I wear them. So, I may scale back my collection and look at more wedges and stacked heels over stilettos, but don't hold your breath that I'll give them all up.

Matt also helped me think about some of the questions I need to focus on for my Dr. W appointment. I've said before I was told my knees were fragile after my last surgeries. I spent years in fear and babying them (perhaps not as much as I should have). What does this new surgery really mean for my activities? I'm not saying I want to go ski black diamonds, but having a better understanding of my real limitations would be nice. Things to think about before Tuesday.

Tired and Pushing

I walked too much this weekend, making my knees a bit sore and tight (though I was able to bend to 118 degrees cold in PT yesterday). I followed that up by being on my feet too much last night and today baking.

PT was about balance and stretching. Working on the rocking balance board was the first time I felt the burning stretch in my left calf and thigh. The surgery definitely tightened up some muscles I hadn't really felt until now. I want to be back to "normal"! I want the swelling to go away, I want more nerves to come back. I want to be able to stand up from a chair without having to use my hands. I want to not have to think before I walk up or down stairs. I want to stop being worried that I don't have the strength to take assignments. I want to be able to wear something other then flats.

Time to stop whining. I have a roof over my head, food in my fridge, and despite periodically needing to fight with them - health insurance. I am better off then a lot of people.

A Tight 120

My knee bent to 120 degrees today. It was not easy and we had to warm it up first, but I did it. I am even managing to sit with my knees at about 95 - 100 degrees right now as I am currently in between my icing sessions.

On the plus side no planks today, though I have figured out how to set up the yoga mat and do them at home. Just keep repeating "this is a good thing, this is a good thing" - that's what gets me through my wall slides.

It is becoming obvious to me that I really need to start walking again. I have become very slow. It was almost easier when I was hobbling with a knee that wouldn't bend. Right now I'm just tired. This weekend will be a mix of home PT exercises, walking (until the predicted rain) and cleaning and organizing the house (I'm seeing laundry in my future). For now, back to the ice.

More Planks

Two days in a row of PT - I'm a bit sore. I stupidly admitted I had no where at home to practice Planks, so I got to do more during my session. Matt even tried to have me do them one legged - didn't work. I was able to bend on the table to 115 degrees, only 7 degrees less then my "good knee".

Focus is shifting a bit to getting the muscles around my knee strong, so I can walk. I am having shin splint type pains when I walk up hill. I am still a bit slower then I used to be. Time to start walking. If the weather is good I may have to take the camera out this weekend.

Matt is Mean ... but he's doing it for my own good

Matt is not maliciously mean, it's just that PT with him is hard! Today he had me doing Plank push-ups - making me an absolute liar in even thinking my core was strong. I was very sorry I didn't take a pain pill before I went to PT.

I don't know what all I did Friday, but both my knees were incredibly sore on Saturday, and even today I am alternating icing them (the Game Ready went back this weekend).

Matt also wanted to extend my PT to twice a week for the next 3 weeks, as opposed to three times a week for the next 2 weeks. (My insurance has set a use by date of February 4th). The insurance coordinator at my PT center said no, but when I got home and called my insurance they said it would be possible if the PT center submits a letter (Either my insurance has a bunch of Johanna's in their call center or I got the same woman from last week). In the meantime, I am keeping my three a week schedule until I have a better answer.

It's the nonsense like this that gets to me. If my insurance has agreed to pay for ten sessions, what the heck does it matter if I use them twice a week or three times a week. Especially, if my therapist is saying that he wants to spread them out so I am good and ready for my next photo trip. I was told, in passing today, that my insurance originally denied any more sessions, something I probably should have been told. I guess the letter from Dr. Williams helped change their minds.

Perhaps members of the legislature should have to price out and pay for their own health insurance and then they would get their butts in gear and finalize a decent health care plan! (Of course, a large percentage of them would simply go on Medicare.)

Stuck In the Middle at 115 degrees

I reached 115 degrees today, I might have gotten a tad further (my goal for the day was 118) but the table was in my way. Yesterday I was able to climb and descend a flight of stairs using both knees. I still have more muscle strengthening, but I am definitely starting to feel there is light at the end of the tunnel. And in 5 months I can get the screws removed.

The only annoyance is the continued problem with swelling. I finished my anti-inflammatory prescription Monday and I today my left ankle and calf is noticeably more swollen then my right. Now that I can finally start trying heels again I don't want swollen ankles! I have already decided that I should wear (or at least bring and put on when I get there) a pair of my highest stilettos to my next Dr. Williams appointment.

As for the CPM confusion, I spoke to Johanna (sp?) at my insurance yesterday and discovered being a bit graphic can be helpful. She reiterated what the medical supply company said, that the approval letter had been sent by mistake. My insurance only covers CPM machines for total knee replacements and manipulations. This is where I got a bit graphic and said that I had a dead persons body part attached to my knee and felt that should make me eligible for the CPM. I made her a bit squeamish with the dead person reference and she slipped from the official line and agreed with me. She did tell me that because the surgical supply company is in the insurance provider network they are not allowed to bill me, even though my insurance is still denying the claim and that it is up to the supply company to argue the denial. I see this dragging on for a while with me getting pulled around a bit.

Celebration and Frustration

I take back every "not entirely their fault" thoughts I've had about insurance companies since my PT charged my insurance for doing nothing but icing my knee. I got a call today from the people who provided my CPM machine telling me that my insurance is refusing to pay for my first CPM rental because they mistakenly sent me the authorization letter approving it. Admittedly I did get letters both authorizing and denying the CPM machine (dated the same day), but the denial letter did not say the authorization letter was a mistake and at no point (until today) was the medical supply company told by my insurance company that the approval letter was an error. In fact I faxed a copy of the approval letter to the supply company and was told they spoke to my insurance company about it.

So now I'm being told it's not being covered, that I need to go have a fight with my insurance company and I may be stuck with the $175/week rental fees. (That loud noise you just heard was me screaming in frustration.)

On the plus side, I was able to bend on the wall to 113 degrees yesterday. And I got a new exercise involving a rubber ball between my legs that actually had me sweating and made my muscles a bit sore today. Add to that the shocking news (especially considering the previous paragraphs) that my insurance approved 10 PT sessions, and I may be done with PT the first week in February.

I’m walking normally most of the time – did you know you needed 100 degrees of mobility to walk normally? – and have even started being able to do stairs, I’m slow and still throwing my hip a bit. Finally, my knee isn’t tightening up the way it was when I’m walking around.

There was a woman in PT yesterday who had replacement surgery a month ago and was practically screaming in pain as her therapist tried to bend her. I remember that, but as I get better it feels a long time ago. I guess that’s the body’s coping mechanism (otherwise women would never have more than one child via natural childbirth).

I guess I no longer have any excuses for organizing my apartment and getting my life back. I don’t think I will feel truly healed until I can go out with my cameras and not have to worry I won’t get the shot.

For now, it’s back to trying to reach someone competent at my insurance company.

Bad Day, Sore Knee

Fell off the planet for a bit there. Finally a problem that's not knee related.

The knee is a bit sore today. I've been practicing my stairs. Yes, I can sort of do stairs. At PT on Wednesday I managed a full bicycle rotation for the first time since surgery. It was also my first session with Matt. It was interesting to have a new therapist. I like Matt, though he did work me. He gave me some new exercises, including a new home one to strengthen my hamstring.

The CPM went back yesterday, though I am holding on to the Game Ready for a bit. I am currently not authorized for any more PT, but hopefully Dr. Williams' office faxed a letter for my insurance for my physical therapy center today. We'll see on Monday.

For right now, it's time to concentrate on the issues in the rest of my life and we'll see next week.

Tired

Very long day with a sinus headache.

Dr. W was unimpressed by my glare. He said the swelling was unexpected. He wants me to focus on mobility. Trying to ride a bike when I am not in PT. He did say he would write a letter to help convince my insurance to cough up more PT sessions. And he wants to see me in a month.

More tomorrow.

Health Care - a Recurring Theme

I went without my anti-inflammatory pills yesterday. Not because I couldn't get the four blocks to the pharmacy, but because my insurance and pharmacy decided it was not time to renew my prescription. The ten days of pills may have ended on Saturday, but as far as the powers that be were concerned I was not due for a refill until at least today.

All that really meant for me was that I had some extra swelling, not fun, but not the end of the world. This made me think, what if it had been heart medication, or an oral cancer treatment. Somehow I doubt I am the only one this has happened to.

Add to that the fact that my insurance, in all it's money saving wisdom, only authorized two physical therapy sessions. It's a bit ridiculous that my physical therapist and I have to fight so hard for these sessions, especially when they take them away because they authorize more (see December 30th).

My problem remains that the bending on the CPM is not translating to bending when I am using my own muscles, my knee tightens when I walk (especially in this cold) and most importantly, it still doesn't bend enough to be of use when I am getting up from low chairs and sofas (and being six feet tall almost everything is low).

I think I need to speak to Dr. Williams about what I can and can't do at the gym outside of PT.

Probably pushing

Spent yesterday out of the city with friends. I did ice, though not with the Game Ready. I seem to have survived.

Today it's puttering around doing chores - cleaning, laundry, fun stuff like that.

I have been able to maintain the CPM at 120 degrees, but can't get to a comfortable position, unless I move to the floor, to really bend more then that. The real plus came when I discovered I can bend my knee more comfortably in bed. I still can't get it bent far enough to get it under me to use it to push up from chairs, but that should come (soon I hope!).

I see Dr. W on Tuesday. While I am working on letting go of the negativity, I may still have to give him a good glower!

Welcome to 2010

I celebrated the New Year by pushing my knee a bit. First running errands in the morning, followed by cooking in the afternoon and celebration in the evening. So I am trying to be very good with ice and quiet today. I can definitely feel the stiffness.

As for the reason for the celebration last night - it's a new year. 365 days spread ahead with all kinds of possibilities. My black eyed peas are simmering in the crock pot and I am feeling inspired to clean and organize. Simplify my life. Create my art. Bend my knee.

It's a new year, anything is possible!