How to enable my home for recovery...

One of my biggest challenges in living in a very large home all by myself. Luckily, my boyfriend is here for the first 8 days post surgery, but after that I'm on my own for the remaining 7 weeks. We have been working diligently to find ways to mobilize the house for me.

Firstly, we moved my bedroom up to the main floor of the home. I was previously sleeping in a bedroom on the basement level (of a 3 story home) but stairs are my worst enemy at this time. I can get up them with crutches as long as I take my time and watch my balance. However, I cannot get down them without sitting down and doing the 'boom boom' like you did when you were 5. It is virtually impossible to not bear weight on your leg and use crutches to get down the stairs in a way that resembles walking.

The bedroom on the main floor level is great because I also have the bathroom attached to my room. The living room, kitchen, and laundry room are also all on this level. The only time I need to use the stairs is to get outside to go to my car (which is half a flight to the garage level). It's the best that we can do - and it is still much better than an entire flight of stairs up and  down everyday just to eat then sleep and shower.

Carrying things is definitely difficult. Some of my set ups include:
- Having a satchel type bag that I can wear across my body to carry things room to room
- Stool or ottoman in every general area (vanity for makeup and hair, bathroom sink to wash face, kitchen to cook...etc)
- Make space in hallways and walk ways as wide and uncluttered as possible
- Have a daily 'command center'
  -- For me this includes an area setup on the reclining couch where I have my laptop and accessories, phone, meds, small end table for water bottle and snacks, remote, and pillows within reach for elevation. I recently bought a small basket/bin to hold all of these items on the couch with me.
- Develop a routine for your ice so you can easily wrap your leg
- Still looking into getting some type of cart to push or pull more items than can fit only in a big on my shoulder...

I'm still working on how to utilize the kitchen. I can't stand long on only one leg for very long...

At my one week follow up I plan on asking for the following items:
- Shower chair (necessary!)
- Handicap (temp) driving pass
- Seated Scooter or Wheelchair for in the home - this will help me move around and also sit to do longer tasks like cook

Hopefully Wednesday will shed a lot of light on how to maneuver better along with providing further assistive devices.

Three days, the Ups and Downs

By now it's Friday evening and well - that last few days have been interesting. As I expected, the day after surgery was the most difficult and painful (as described in my last post). Thursday and today both were slightly better. More energy overall - especially in the mornings. At least when I do fall asleep I get very deep sleep. The pain has not changed tremendously. I still take the pain medication every 4-5 hours. Taking the nausea medication (whether I'm nauseous or not) definitely helps make me feel less shaking overall. Particularly later in the day when I feel like my blood sugar has dropped or I'm ready to eat another meal.

I'm starting to be able to feel some tingling where the incision must be. Normally I feel it when I'm moving into drastically different positions such as swinging my leg down and off the bed, or half picking up and assisting my leg up onto the bed or couch. My brace is unlocked in both flexion and extension. I'm doing my best to stretch as much as possible along with keeping my foot and ankle moving.

Today I went to physical therapy. There isn't a lot we can do without being weight bearing but we did go back to the basics. Heel slides, calf stretches and variations of straight leg lifts. I can also cleared to continue my range of motion work. Tomorrow I will start hanging my legs off the bed or chair to work toward 90deg.

I'm hoping that by the end of this weekend my energy and pain levels will even out more. I also hope that I will be able to back off the meds so that I can start taking 1 instead of 2 and try to move from every 4hrs to every 6hrs.

Day 1 - Post Op

As expected, today was definitely more difficult and painful than yesterday was. After coming home from the surgery yesterday afternoon I was sore, but it was tolerable and I stayed awake the entire afternoon and evening. I took my pain meds every six hours as prescribed. I was due for another dose at 1am - I knew I wouldn't make it through the whole night without them. I tried going to bed around 11pm...but set an alarm for my meds. By midnight I was already uncomfortable in bed and took my Lortab an hour early so that it would have time to kick in.

I did get some sleep, but woke up at 3am in a lot of stiff and pressure type pain. I had to wake up my boyfriend so he could get me wrapped up in ice. That alleviated some of the issue. I stayed awake for a good hour before I was able to doze off again. I made it until almost 730am when I needed another dose. Elevating the leg really does help. And for as much as it hurts to be standing and having the pressure and weight of my leg/bandage/brace it is necessary to change positions as much as tolerated so the leg doesn't lock. I've been doing my best to keep my foot and ankle moving to keep up the blood flow and prevent additional swelling or potential blood clots.

Once I ate breakfast and got back up to the couch I was a little better. I did doze off more often today. I'm much more tired and sore. I can feel more pain in the area of the incision and have been taking the meds closer to every 4 hours. I also started to feel some of the nausea. It's hard because you need to eat with the meds - but you also don't want very much either. I also have noticed I'm a lot more shaky and irritable (the lack of sleep probably isn't helping either!).

Tonight we attempted a shower...it was so difficult because I can't get my leg wet. Good thing I just got a nice hand held shower head and that I have some good core strength! My boyfriend had to help me a lot. I did my best to leave my bad leg out of the tub and sit on the edges. Then trying to do my hair without washing tons of water out and all over the floor was quite a challenge. The whole ordeal exhausted me. Hence why I am currently back in bed awaiting some dinner with my leg wrapped back up in ice.

Hopefully I will sleep through more of tonight and tomorrow will be better....

The doctor who called to check on me earlier today said that if I take the pain meds - followed by the nausea medication (even if I'm not nauseous) 2 hours later - the combination should enhance the pain medication and also put me to sleep. I'm going to try that before bed because I have yet to get any kind of deep sleep since 2 days before the operation.

Surgery Day! (22 May 2012)

Surgery today actually went really well. We reported to the hospital at 0545 - bright and early! Things moved along very quickly. I was checked in and prepped almost immediately. Then, before 0645 I was back in the OR Holding room to start my IV, etc. I was quite nervous (I don't do well with hospitals and needles) but everyone was really nice and caring. The only time I can say I really started to not feel well, besides basic queasy nerves, was the first IV bag of meds - I think the drip rate was way too fast. Once they slowed it down I was fine, but initially I started to feel very light headed, nauseous, and also very hot and sweaty.

 

I did opt to have a femoral nerve block along with the general anesthesia. It is supposed to block feeling to my leg and last longer than a general pain med. The doc was great about explaining it, taking me through it and showing it to me on the ultrasound. Essentially they give you some 'happy meds' so you don't even know what is going on, and they have a special injection that goes into a nerve bundle near your groin to block the leg to be operated on. 

I was the first person of the day wheeled back into the OR. I believe I was into surgery just after 0700. Next thing I knew, it was just after 1000 and I was in the Post-Op Recovery room. The 'block' wore off a lot quicker than anticipated. I could move my ankles/feet/toes right away and needed meds quickly to dull the pain to make it manageable. Overall, I woke up and came to easily and quickly. The surgeon came in quickly, then went to talk to my boyfriend almost right away. The surgeon will call me tomorrow; he had to get to another surgery asap. He said everything went very well. Ligament was a donor and that portion of the MPFL reconstruction went exactly as planned. I did have significant cartilage damage though. Therefore he did have to perform the micro fracture on the lateral femoral condyle. (This mean he drilled small holes in my femur to allow blood supply to flow through and clot; it creates an additional padding since cartilage cannot be added or repaired). This means that I will be non weight bearing for 8 wks.

Soon after I was brought back to my room where my boyfriend was waiting for me. They tracked my vitals for an hour (which was required) and made sure the pain was manageable and under control. I was able to start eating and drinking right away with no nausea which was very good. They let me dress and try to go the bathroom. That was very hard at first - standing sent a lot of pressure to my leg. Also - trying to not bear any weight on my leg was difficult considering my whole body was tired and shaky from all the medications. 

Around 1230 we left the hospital to head home. Got some food and I've been relaxing on the couch with ice since. I still feel quite awake and good. The soreness and stiffness is definitely starting to increase though. I'm sure that will be the hard part for at least the first few days. 

My boyfriend and a few other close friends are going to begin moving my bedroom up to the main floor tomorrow. There is no way I'm going to be able to live downstairs and go up and down daily solely with crutches/no weight for 2 months!

Current prognosis: non weight bearing for eight (8) weeks, wear brace every day at all times for 3 months expect when doing range of motion stretching, start physical therapy (PT) right away (already made an appointment for Friday afternoon), take pain meds and elevate and ice 4-6x day. 

My 1st week follow-up is Wed. May 30th. Luckily my boyfriend will still be here to take me to that which is great (before he leaves that afternoon). I will leave my dressing on and in place until that time. I can't see anything really. My entire leg is covered in an ACE wrap over the wound dressing and I have a nice, new and large adjustable immobilizer style brace. I'm interested to find out what the scar actually will look like.

I think that's about everything. Hopefully things will continue to get better from here. Today was what I was the most nervous about and that is now over. I'm hopeful that if I follow the doctors orders and take it slow I will make a full recovery by the end of the year (they have given me a 6mo timeline until full 'unrestricted' recovery.

Why I am writing this blog?

I decided to start this blog to keep track of my progress throughout my knee surgery and recovery. On 22 May my left knee will be operated on. I have had 3 previous patella dislocations (left knee) and will now undergo MPFL (Medial Patella-Femoral Ligament) Reconstruction as well as arthroscopic procedure called Microfracture due to my cartilage damage.

I hope that my blog can provide both hope and answers for others with knee problems like me. MPFL Reconstruction isn't an extremely common procedure but it has started to gain a lot more recognition over the past 10-20 years. There is not a large amount of information out there about it (as compared to say, an ACL repair surgery). I also did not anticipate having the microfracture but I would rather have everything taken care of in one surgery versus having to chronically have more operations performed. I will write more and describe these procedures better later...

I am hopeful that I will make a full recovery. I am slated to be unrestricted after 6 months. I'm sure there will still be a lot of work to do after that - muscle strength takes a long time to re-develop.

Cheers to the recovery road ahead!