Part III of ACL Surgery: First Shower and Weaning off the Pain Meds
Thursday (Three days Post-Op)
I was allowed to shower today. I just had to make sure not to let the water hit my knee directly, but it was o.k. if I got the stitches wet. With Lil C sleeping in like a teenager, my Mom helped me get up and get a shower. Without the brace on my leg, it felt awful. It also seemed to be a bit more swollen today. While my thigh already appeared to be wasting away, my knee looked so strange and big in comparison. Showering was absolute agony, but it felt so good to get really clean. My Mom stood right by the shower because I felt so unstable. Getting out of the shower was the hardest part. I never could have done it alone. Thank God for awesome Mom’s.
When I got out, I started seeing spots again and had to sit down. The shower felt good, but was so stressful and uncomfortable. Mr. BBM is going to have to rig up something a little easier for me. After icing my knee down, I went through the first round of exercises that I must do every day, three times a day. I was able to complete:
- 20 ankle pumps (to help get the fluids moving out of my knee)
- 20 ankle rotations in each direction to help with ROM and swelling
- 3 sets of 10 leg lifts (My PT said I may need help the first few days doing these, but I did them on my own with no problem.)
- 10 gentle bending stretching sitting on the edge of the bed. My Mom said it looked like I was to about 70-75 degrees which is just awesome for three days post-op.
- 10 quad sets. Today I was actually able to see my knee cap move a bit when I flexed my muscles. That’s improvement from yesterday.
I’m still in bed, making sure to elevate my leg and ice it often. There is definitely throbbing in my knee and the lowest incision is sore (the brace makes contact with it and that hurts), but I’m improving already.
Friday (Four Days Post-Op)
Mr. BBM forgot to set the alarm and wake me up for pain meds. That was a mistake. I got them two hours late and I paid for it. I’m so sore. Getting up this morning was rough. My leg started throbbing as soon as I lowered it down to crutch it into the bathroom. I couldn’t wait to get back in bed. I took my brace off and saw lumps on my legs from the swelling that accumulated in between the brace brackets. Need ice and more elevation now. I wanted to feel even better today. I’m a bit discouraged.
I spoke with my PT on the phone today. He told me to loosen up my brace over my painful incision and to keep my brace loose at night so as to eliminate the fluid pooling in my leg. It was a weepy day today. The pain meds are making me a bit nauseous, so I’ve been trying to cut back. Cutting back has been a bad idea. I think it’s just too early.
My incisions feel fine except for the lowest one. It’s the biggest one and unlike the other, has steri-strips over top of the stitches. I think this is where the drain was which would explain why it’s extra sore and a bit messy looking. I made it through my exercises today with a bit more pain than yesterday and am so thankful for a good friend who sent me a gift of candy cane peppermint tea which has done wonders for the nausea.
Tomorrow night is our family Christmas party at my Mom’s house. I’m going to try to go but am very nervous about the process of getting there and staying comfortable. I’ve been assured I can disappear to a bedroom for a rest if I need it. I’ve been requiring regular naps this week. I think I’m still catching up from all the lost sleep pre and immediately after surgery. Plus, this recovery is as emotionally exhausting as it is physically. I’m looking forward to hitting the one week mark, which I hope will bring greater relief.
I enjoyed a pre-med late night snack of peppermint tea (Thanks TKDDaughter) and English Fairings (Thanks TSDAdam). That was a nice way to end an otherwise uneventful day.
Saturday (Five Days Post-Op)
Despite a healthy dose yesterday of both prune juice and blueberry smoothie with more fiber than a cardboard box, still nothing. The Vicodin and Percoset need to go. As of this morning, I have switched to ibuprofen alone and am hoping that will do the trick. I’m nervous that it won’t but something has got to give here. (I know this is more than you ever wanted to know, but there’s not a whole lot to write about when you’re lying on your back non-stop.)
I woke up this morning without having had pain meds for several hours and getting out of bed was quite an experience. Once my leg is off the bed, the throbbing starts and I start feeling dizzy. I did manage to crutch it around my bedroom a bit and was able to put a bit more weight on my leg today. It doesn’t feel as awful as it did mid-week.
Mr. BBM is currently setting up a plastic chair in the shower and I’m hoping that today’s shower goes more smoothly. I can’t tell you how much I just want to feel normal again.
This morning’s first round of exercises brought a flexion that is knocking at the 90 degree mark. I am almost there. If it wasn’t for the throbbing pain when my leg is hanging off the bed, I think I’d be there. I want to hit that 90 degrees within the next day or two so that it’s easy by the time I see my PT again on Wednesday. It’s funny how much I want to make him happy and proud of me. I think it’s been particularly beneficial that I did a month of physical therapy first. We’ve developed a good rapport. I feel like he really wants to see me succeed and knows how to get me where I want to be.
Everyone kept telling me this was going to be a long road. It really hits you just how long after you have the surgery. Before it’s like "Yeah, yeah, long road, six months, o.k." and after it’s like "They really weren’t kidding when they said it was going to be a long road." You take extreme pleasure at an extra 5 degrees flexion and any decrease in pain is such a welcome sign of recovery that you’re ready to leap for joy. Of course you can’t leap for joy, but you do mentally. I thought that by today, I’d be getting around my house better, but it’s just not happening yet. My bedroom and I are really bonding.
I got a card in the mail today that said something about how I’ll have that black belt before I know it. I sobbed. I can’t even think about it right now because it just seems so far away. It’s not even the belt, just going back to karate in general is going to take so long and be such a mental challenge. I don’t ever want to go through this again, so I’m going to have to be so careful. I think it’s going to be just as hard mentally to go back as it will be physically to get ready.
As a woman, this surgery is also quite a blow to your wardrobe. There is nothing suitable to wear to this party tonight. I very well may end up going in a pair of my husband’s over-sized scrub pants and a sweatshirt. Oh well, they’re lucky I’m even attempting to show up.
I made it through my shower with a plastic squishy lawn chair in the shower and a card table chair outside the shower to allow me to keep my leg up. Mr. BBM had to keep repositioning the shower stream so I didn’t drown. I told him to stay near since I needed him to hand everything to me and be there in case I didn’t feel so great.
As he stood there in the bathroom, keeping an eye on me through the curtain, I started laughing. I’m sure the image of helping your wife shower is so much better in the head than in real life. Here I am, seemingly an 80-year old invalid with a mishapen leg, trying to figure out how to scrub her butt in a lawn chair. I just had no idea it was going to be like this. I don’t think Mr. BBM did either. I have no idea how people do this who don’t have good help. It would be pretty much impossible.
Post shower, I was able to sit up, dry my hair in a chair and GASP! put on make-up. I feel like a human being again and I’m getting around a bit better. I seem to have kicked the heavy pain meds too, as ibupofen seems to be doing the job as long as I’m not looking for complete relief. What is complete relief anyway after this surgery? I can’t wait to find out.
I made it to the Christmas party after remembering a pair of black capri cords I got last year for Christmas that I never wore because I didn’t have the right shoes to wear. I wore my brace over top and it was uncomfortable, but better than showing up in scrubs. I parked myself in a recliner chair with pillows and a rolled up towel for the entire night, minus two trips to the bathroom. It went fine, but I watched that clock like a hawk to make sure I got my ibuprofen on time. I really needed it. My sister’s boyfriend also bumped my foot twice and that made me yell out loud. I made Mr. BBM stand guard at my foot for a little while afterward. I had a couple relatives come over and joke with me, pretending to slam their hand down on my knee. I laughed nervously, and told them I still had one leg and two arms that work properly.
I’ll spare you the details on the "main event" of the night, but I will say this: a Christmas "miracle" occurred (Thank you BobSpar for the prune juice advice). I’m feeling much better in that department. I know that’s a lot of information for the random internet readers; but failing to mention that as an issue after this surgery would be just plain dishonest.
My knee is rebelling against the no vicodin/percoset evening and is pulsing with pain. I’m countering with ice and hoping for the best.
Sunday (Six Days Post-Op)
Last night was a very rough night. I could not get comfortable and did not sleep very well. I also went pretty much the entire night until around 5:30 a.m. with no pain meds at all. I guess that explains the pain. It’s not awful as long as I stay horizontal and keep my leg elevated; but when I’m up and about, I can’t wait to sit back down.
I seem to be stuck in the second plateau here. The first days are the worst by far and now I seem to be stuck in the "it’s not terrible but it’s still not great" phase. I can’t wait until this phase passes and I can be a bit more active. Maybe by Christmas? I don’t want to be miserable all day on Christmas. The one incision is just so sore. The other three don’t seem to be bothering me at all. I can’t wait to get these steri-strips and stitches off and out. I think that will make a big difference. Here’s hoping anyway.
I got a call from the hospital today. An RN called and was checking on my progress and to see how I’m feeling. She also inquired about my stay. I told her the truth, that I had some great RN’s, LPN’s, CNA’s, etc. but that I had two experiences with RN’s that were just awful. I told her in detail about them and she seemed very sympathetic. She said that’s why they make these calls, so they can improve. She offered to let me talk to her manager, but I opted for a name and address instead since I want to write it down, and make sure I have it all. When she gave me the name of the nurse manager, I almost died. I’m hoping that this person is not the same person as the nurse I had the first night. I asked the RN on the phone about it. It’s a possibility. I told her that my biggest complaint was actually against her and asked for her supervisor’s name. She gave me a name and an address. Now I just need to write it up.
I think I’d like to volunteer at the hospital as an advocate for orthopedic patients. Seems to be like there is definitely a need as my experience can’t be the only one like that.
I feel asleep watching "The Bruce Lee Story" tonight on TV. I recorded it on my DVR so that I’ll have it for discouraging days ahead.
Monday (Seven Days Post-Op)
One week post-op and I’m not where I want to be at all. My Mom says I’m expecting too much. I have screws in my legs and that’s going to take some time to feel better. I tried to go without any pain meds today and that was a mistake. I was going to try to take a shower this morning but I couldn’t do it. I had to elevate my knee again. I took some ibuprofen and am going to attempt a shower a bit later.
This morning, I completed my first round of quad sets, stretches, leg lifts and knee bends. I was able to make my heel touch my bed skirt today. That’s 90 degrees. I would have been more excited if it hadn’t hurt so badly. I’m rewarding myself with some chocolate from Adam.
We had visitors from out of town so I made every attempt to be social. After a couple hours down on the couch, it was time for a break. I have my routine down in my bedroom and I’m just not as comfortable when I’m not there.
I was determined to feel the Christmas spirit. Feeling too miserable for church and terrified that I’d be bumped by someone, we skipped this year. It’s the first year I’ve missed Christmas Eve service in a long time. To make up for it, we spent the evening watching Christmas specials and movies on TV and sipping peppermint tea.
I discovered one perk to being out of commission. Mr. BBM had to bring up all the presents by himself. He also had to assemble a train table with over 64 bolts in it for Lil C. I’m glad he had some help from his Dad and his Dad’s fiance.
I’ve gone back to the heavier pain meds for night time. I just can’t make it through the night and/or get comfortable in order to fall asleep without one. I’m not taking the full dose, but it’s just enough to help me fall asleep and stay asleep. Sleeping with an immbolizer on is no treat. I currently have a set-up of about four pillows at various angles to help. It doesn’t help much.
I’m hoping for a Christmas miracle for tomorrow: no pain.
Tuesday (Eight Days Post-Op)
I was able to put on a mostly happy face today despite the continued discomfort. I’ve been corresponding with some fellow ACL reconstruction alumni and that has helped. It’s not just my Mom. I am expecting too much according to pretty much everyone who has gone through this. I’ve been told there’s a big difference after the two week mark, and that after three weeks I won’t be constantly reminded of the ordeal from the throbbing and burning. I’m really looking forward to that.
I’ve never been one to wish my life away, but this is an all out different scenario. If I could jump ahead to when my leg would feel better, I’d gladly do so. I want to feel better as soon as possible. Today I watched my kids playing with their new toys and jumped in with them as much as I could. Lil C was kind enough to bring her brand new Mickey Mouse Clubhouse over to the ottoman I was propping my leg on so that I could play with her a bit.
Everyone got me nice stretchy legged athletic clothing this year for Christmas. It was very thoughtful considering I was thinking I’d have to wear scrubs to PT again tomorrow. I may be hurting tomorrow, but I’ll be stylin’ too.
I hope all of you had a very Merry Christmas. The silver lining to mine? Mr. BBM is going to have to figure out where all the new things will go!
Part II of ACL Surgery: Forgotten Pain Meds and More Agony
Merry Christmas to all my readers who celebrate the holiday! I’ll be spending mine on the couch with an elevated, iced knee.
This is part II of my ACL surgery story. For the first post, go here.
Tuesday
My awesome night nurse left and I was worried. I had read in many online journals that day two was the absolute worst it would get. I couldn’t imagine it getting more awful, but it would.
In walked my day shift nurse. She came in, introduced herself, looked at my chart and said, "Oh honey, ACL’s are the worst! I know you’re just in agony right now." She was right. My day shift nurse told me that she had the exact same surgery seven years ago and that she completely understood how I was feeling. I told her that I was really concerned that I couldn’t pee. She confirmed that I wouldn’t be able to go home unless I could. She came up with a plan to wean me off of the morphine pump.
My breakfast was delivered and included scrambled eggs, a bagel with cream cheese, orange juice, rice krispies and coffee. Despite the hospital having very good food, it all made me sick. I felt like I couldn’t hold my head up and I also felt nauseous. I buzzed my nurse and she came in with an injection of zofran. Zofran and I are old friends. Zofran helped me when I had food poisoning two summers ago. The nurse told me she would be right back in with saltine crackers and some percoset. It had now been 40 minutes since I had hit the pain pump button. I was getting myself off the morphine pronto. I would just deal with the pain which was increasing each minute.
I kept dozing off, but it wasn’t a good sleep. I started to feel like when I fell asleep I was forgetting to breathe and I would wake up with a start, gasping. It was horrible. One of the surgeon’s from my doctor’s practice came in with two students. He took one look at me and all three of them looked like they felt really sorry for me. I must have been a sight. I don’t remember a whole lot of our conversation. I remember telling him I was in terrible pain and that I couldn’t pee. He said I couldn’t go home unless I could pee. He gave me some encouraging words and advice. He saw my backpack in the corner and asked me if I was on winter break and where I was a student. I laughed out loud, told him the backpack was my "diaper bag" when we went to Disney World and that I was 32 years old. When someone tells you on the day after ACL surgery that you look 10 years younger than you are, you smile despite the pain. He’ll be one of my favorite people for life.
An anesthesiologist came in a few minutes later and told me he was removing my nerve block. He pulled it out painlessly and I was sorry to see that thing go. Even if it wasn’t working perfectly, I can’t imagine how much worse it would have been without that block.
I was itching something terrible and found yet another lead stuck to my side that I hadn’t pulled off the night before. I was starting to get permanent rake marks on my good leg and stomach from scratching incessantly. I couldn’t have been more miserable as my pain continued to ramp up. My leg was just throbbing and burning something terrible.
About an hour later, there was still no sign of crackers or percoset. I was in pain and I was once again sitting on a very uncomfortable bed pain willing myself to just go already, when in walked my surgeon. Fabulous. I’m so happy I was at least covered up. He asked me how I was doing and I told him, "I’m sitting on a bed pan and I’m in pain." He smiled, unphased, and started telling me about the surgery. "Your knee looked great. Perfect, expect for the torn acl. We replaced it with the allograft. Everything went fine. Your knee was perfect except for the stability." He then loosened my knee brace and said "I’m taking your drain out now" and pulled that sucker out. It hurt, but only for a second and what’s more pain when you already feel like you’re dying. I had no pain meds at the time, but I was happy to see that bloody drain go.
I asked him why he thought I couldn’t pee and he told me it was probably the morphine, or perhaps the general anesthesia had put my bladder to sleep. I told him I hadn’t hit the button for hours now and that I was still waiting for oral pain meds. He seemed puzzled and concerned when I told him I was still waiting. He finished putting my immobilizer back on and talking to me. As he was leaving, I yelled "Hey!" and he stopped and turned towards me. "So, um, you know that part where you said it wasn’t going to hurt much?" He got a big grin on his face and said, "Yeah?". I said, "Well you are a big fat LIAR!" He gave me the biggest grin and made his exit. It’s hard to be mad at a man with a smile like that.
After going almost 2.5 hours without any pain meds, I had it. I was feeling a bit more "with it" and "with it" isn’t good when it makes you even more aware of the pain you’re in. I hit the call button and an assistant came in. I told her I was promised saltine’s and percoset hours ago. She acted like she had no clue what I was talking about. A few minutes later my nurse came in apologizing with the crackers and percoset. It was 10:30 a.m. My pain level was at least a 7 when she finally arrived.
The PT ladies showed up to take me to the "gym." I was disappointed that I had a brand new therapist in the hospital. A familiar face would have been really nice; and I was so scared about what they were going to do to me at the "gym." They helped me out of bed and I was finally able to go to the bathroom upright and on my own. I felt like breaking out a bottle of champagne until I saw my reflection in the mirror. My hair was crazy in the back and my eyes looked swollen and purple. I looked defeated; there’s simply no other way to describe it. No wonder the doctor had looked at me with such sympathy.
The PT and her assistant made me crutch it to their elevated wheel chair in the hallway. It was so painful and so hard to do. I had to go so slowly. It felt like it took me five minutes to make it from one side of my room to the other. The pain was making my whole body tense up and shake. I had to keep reminding myself to relax and slowly, mechanically go through each body part in my head and will it to relax.
I was wheeled down to the gym and they put a harness strap around my waist. I had to get up, crutch it over to the stairs and learn to go up backwards with my bad leg straight and without putting any pressure on it. She also showed me how to go down the stairs. Crutches, bad leg, good leg, was the order. The PT stood behind me on the stairs; her assistant stood in front of me, holding onto the harness. I had to back my crutches up until they were touching the back of the step, same with my right foot. Then I had to hop up and backwards with the good leg, dragging the crutches and bad leg up behind me.
On the first step, the assistant had to grab my harness. I wobbled and almost fell forward. I made it the rest of the way up and couldn’t even imagine how I was going to do this at home. To get in my house? One step up, six steps down, one step up. To get to my bedroom, seven steps up followed by another seven steps up. I made it back down o.k. and told them I needed to go back to bed. I was in agony.
I ate lunch, dealt with the pain by trying to distract myself with Fox News and HGTV and was told I wouldn’t be released until PT cleared me. Right now, I was not cleared. I had to do the steps again and better. In addition to all the other discomfort, my room was a furnace. My roommate and I were both roasting and getting annoyed that nurses kept coming in and covering us up with more blankets when we were clearly telling them not to! Finally, the PT assistant heeded our request and turned the thermostat down. Our room started pumping in cool air and my roommate and I got a little relief, at least in that area.
By the time 2 p.m. rolled around, my leg was hurting badly. I could feel myself tensing up again. I knew I had taken the percoset at 10:30 and that I would soon be due. When 2:30 rolled around I hit the call button and asked about my meds. My nurse was no where to be found. One of the LPN’s found my chart and said that I may have had the meds at 10:30 but it wasn’t written down until 10:50 so I had to wait another 20 minutes for another dose. Percoset takes 15-30 minutes to kick in and an hour to hit its peak. It was going to be a rough hour. My pain level was at least a solid seven now. For comparison’s sake, I never recorded a pain level over a 5 while going through over 15 hours of natural child birth. It was serious pain.
At 2:50, my roommate was having major problems. Her blood pressure dropped to 90 over 30 and she was in bad shape. There were tons of nurses trying to help her and she was moaning in pain. I was twitching at that point from my own pain (a solid 8 now), but didn’t want to call anyone when my roommate obviously needed them more than I did. At 3:00, my PT girls came in to get me. I told them I couldn’t possibly go right now. They knew right away that something was wrong. I had to pee terribly so there was that pain. Top that with my throbbing, on fire leg and I was a mess. The PT girls said they would come back for me in half an hour after I had my pain meds.
At around 3:10, one of the nurses at the main station buzzed my room and told Ana (one of nurse assistants) over the loud speaker in the room that a patient in the next room had too many blankets on and needed her to take one off. Ana was obviously annoyed. She yelled back, "I’m in the middle of an emergency here so do you think you could go do it yourself!?!" They were still trying to help my roommate get more comfortable and get her blood pressure back up. Trembling and sweating from the pain, I yelled out, "I will go take a blanket off of the patient if someone will please just get me my pain meds first." The nurses/LPN’s/assistants behind the curtain laughed and one of them said "You go girl." Ana remarked that she couldn’t believe I didn’t have my pain meds yet. As an assistant, she was not allowed to give them to me. She and I had previously bonded over the now lower room temperature, and she had spent part of her afternoon hanging out in a chair beside my bed doing her paperwork.
At 3:30, the PT girls came back into my room and asked me if I was ready to roll. One look at me told them otherwise. My forehead was dripping with sweat and I was trembling uncontrollably. "I didn’t get my pain meds" I blurted out and the tears started to flow. The PT assistant (who is an absolute angel and I am writing her a letter to tell her so) said, "What??? You didn’t get your pain meds yet? You should have had them an hour ago!" She stormed out of the room and there was much yelling in the hallway. The PT went with her and they were both going ballistic on the lazy nurses who were apparently just hanging out at the main desk. I was in too much pain to take what would have been usual enjoyment from someone sticking up for me in such a fashion.
Two minutes later, my original nurse who had disappeared in the morning came in with my percoset, a drink and apologies. She went on to tell me that she had been called to a meeting and that she had given explicit instructions to the next shift nurse to give me my meds. I didn’t care what her excuse was. I nodded at her and didn’t say a word. I had never experienced pain like that in my entire life and all I wanted to do was have it stop. The PT girls helped me get to the bathroom and now I only had one pain to deal with.
I told them I didn’t want to wait for the meds to kick in, that I wanted to go do the steps now and get the hell out of there. The PT and her assistant kept apologizing to me about what had happened, and I stopped them immediately. I told them they were the only reason I even got my pain meds and that I was so thankful for them. It wasn’t their fault at all.
By this time Mr. BBM and Big I had arrived at the hospital. I cried when I saw them coming down the hall. I was just so relieved my family was there. Despite my disheveled appearance, Big I only saw her Mommy and smiled at me and began telling me about her day. It was a fabulous distraction from the pain, and I now had advocates with legs that worked! They wheeled me down to PT and I did the steps twice in a row. The pain meds had not yet kicked in but I was determined to get them done and get out of there. They signed off on me and I was ready to go home.
Mr. BBM helped me get dressed and packed up all my belongings. The nurse gave me my discharge instructions and said she was going to call for transport to come and get me. Forty minutes later, no one had come for me. Mr. BBM, Big I and I shared my dinner tray and waited. Finally, Mr. BBM went to check on my transport and guess what? No transport had been called. Ten minutes later, when the man with the wheelchair (which looked more to me like a magic chariot to me) arrived, I was so happy. I said goodbye to my roommate, wished her well and said I’d pray that she got to go home soon.
Getting into the car was a challenge but the cool air outside, combined with knowing I was leaving made the pain seem minimal. It took me about 20 minutes to get in the house and up to my room once I got home. It was a real work out. Mr. BBM went to pick up my prescription and I thanked God I was home and had been spared another night at the hospital.
Later that night, I was breaking through with the pain meds just two hours after taking them and was miserable. Mr. BBM called the surgeon and spoke to the on call doctor. They promised me a stronger prescription in the morning when I went to PT and gave suggestions for managing my pain better through the night. They were shocked at how I was treated at the hospital and told me that unlike the two pillow max they gave me to prop up my leg there, I was really supposed to be using 4 or 5 pillows to elevate my leg. They said they would be "having a talk" with the nurses in the ortho surgical unit.
To distract me from my leg, Mr. BBM used a basin and washed and conditioned my hair while I lay in bed. The morphine had made me so itchy and it felt so good to have my hair washed.
Mr. BBM woke me up every two hours to give me either Vicodin or Ibuprofen through the night. He was amazing. . . exhausted and amazing. Besides the few seconds it took for me to swallow my meds, I slept almost the entire night. Finally some sleep and a little bit of relief.
Wednesday
I woke up, and was shocked to find that I had very minimal pain compared to the day before. Mr. BBM helped me get out of bed because my entire body ached. I felt like I had done 500 push ups and equally as many sit ups. My neck was also killing me, along with my arms, shoulders and back. Everything just hurt. My Mom said it could be from them moving me around while I was under general. I thought at least part of it was from being so tense during the previous two pain-filled days.
I brushed my teeth and went to the bathroom (a real pain in the butt for a woman who needs to sit when you have a brace so high up on your thigh). When I came out of the bathroom I was sweating and seeing spots. I had to sit down. Mr. BBM helped me get dressed and I realized I was going to have to take it a lot slower getting up and back down.
I arrived at PT and my PT gave me a big grin. I don’t know if he was happy to see me up and alive or he was more amused at my attire. I arrived wearing a pair of shorts with a pair of extra large aqua blue scrub pants over top (Mr. BBM’s from many years ago). I also wore a t-shirt that didn’t match a thing and a black zip up fleece sweat shirt. I had attempted to brush my hair, but left the make-up zipped in its bag. I was surely a sight.
He removed all the bandaging and what I saw wasn’t as bad as I expected. I have about 8-10 stitches total (I think): two small poke holes and two larger incisions (one below and one above my knee to the sides). My knee was swollen but not as badly as I expected, and there was only minimal bruising. That comes later I guess. Here it is, two days post-op, in all its glory:
The lowest incision with the steri-strips is the biggest and most annoying.
The view from the front. Pretty huh?
Some random nick on my thigh. What the heck is that anyway?
The scrubbed off remnants of the "yes" that told the surgeon he was on the correct knee.
My PT put ice and stims on my knee and it felt so good. He also refit my brace (They had messed it up a bit at the hospital). He showed me some exercises to do. I did some quad sets and both my PT and Mr. BBM laughed because I thought I was making a killer good muscle contraction but my leg was barely moving. He also had me bend my knee and checked my flexion. 55 degrees-not bad for two days post op. I was also able to lay my leg completely flat at 0 degrees extension.
My PT gave me a bunch of simple exercises to do and I headed back out. It went really well. Unlike so many horror stories I’ve read online about getting nauseous or dizzy at PT for the first time, I felt great. I made an appointment for a week later. My goals are to do my exercises at least three time a day, and ice it a lot. In one week, hopefully the swelling will have gone down, and I can start doing more.
The rest of the day went relatively well. With the new Percoset scrip, my pain was controlled pretty well. Mr. BBM continued to set the alarm and wake me up through the night to keep ahead of the pain and it seemed to be working.
After feeling like death would be easier on Monday and Tuesday, Wednesday was a refreshing and encouraging day.
This is part II of III. For part I, go back a post. Part III will appear tomorrow.
Part I of ACL Surgery: Evil Nurses, Underwear and More than you EVER Wanted to Know
I’m back. Did you miss me? When I say "back," you should know that I’m still spending the majority of my life horizontal and that one week post-op, I am still hurting and hating being vertical. Here begins the story of the ACL reconstruction that happened one week ago today. This is part I of III. Hopefully, I’ll have some news of great progress by the end of the week. I have two PT appointments this week and an appointment to have my stitches removed. I had to divide it up into three because otherwise it was just too crazy long.
Monday and Tuesday were easily the worst days of my entire life. I don’t know exactly what I was expecting, but it certainly wasn’t what I experienced.
Monday
I woke up at 3 a.m. and was unable to go back to sleep. I arrived at the hospital at 7:45 a.m. and wasn’t called back to get prepped for surgery until almost 9 a.m. By then, I was an absolute wreck. My hands were shaking and I was super nervous.
I was led back to a little changing room and told to take it all off. I asked about the underwear, but it was a no go. I asked the nurse if she understood that I was indeed having KNEE surgery and she smiled and said she understood. Mr. BBM started joking about going commando and I just wanted to cry.
I was led over to a prep area, given a gurney, and a nurse practitioner came and asked me a bunch of questions. She was super sweet. She asked me if I had any questions and I told her just one. "Why can’t I wear underwear for KNEE surgery?" She rubbed my arm and gave me a sympathetic look. "I know," she said. She asked who my surgeon was and when I told her she smiled and said, "You have a GREAT doctor." That made me feel reassured. We also discussed his good looks for a couple minutes and Mr. BBM was a good sport as usual.
While I was waiting there, someone came in and called my last name. An older man answered just as I was about to respond and I looked at Mr. BBM with wide eyes. "Oh my GOD!" I said. "I hope they don’t confuse our surgeries! What if he’s having prostate surgery or something?" Mr. BBM almost cried he laughed so hard, and then it really was my turn.
I thought they were going to start my IV there like with everyone else, but the next thing I knew, the transport man came to push my gurney down the hallway with Mr. BBM in tow. Because he was a volunteer, he didn’t follow the "No Admittance" signs and allowed Mr. BBM to accompany me to right outside the OR to what they called the "holding area." He made some comment about being a volunteer and how he should have left my husband back behind the double doors, "but what are they going to do? Fire me? I’m a volunteer. What’s the worst thing they could do? Send me home? And how could that be bad?" He was definitely my kind of guy. He had me laughing and for that I was so grateful.
Mr. BBM said goodbye, and the volunteer left me in the holding area. I still didn’t have an IV and started to wonder if they thought I was going in awake or something. After a couple minutes and several people asking me who I was and what they were doing today (I swear 50 people asked me the same questions and looked at the same "yes" written on my left knee), a young male nurse came to get me. He wheeled me over into the PACU (Post Anesthesia Care Unit) to start my IV. There were tons of crying kids in there. There were lots of adults lined up in a row trying to wake up.
I told my nurse I couldn’t wait until I was in there after the surgery. I just wanted it over with. Jamie, my nurse, reached down my gown and put a bunch of leads on me. When I say bunch, I mean it. I thought I got them all off and actually found one right before I came home from the hospital, more than 24 hours after the surgery.
Then he started checking out my veins. I told him I didn’t want an IV in my hand because I had a bad experience with that before. He tried to find a good vein on me in my arm and thought he did; but he wasn’t confident enough so he called an anesthesiologist to come do it for him. Three pokes later, I had a working IV. They all kept apologizing, but I didn’t really care because when an anesthesiologist does your IV, they use local first so I didn’t feel a thing. Plus, I joked that with all the local I was getting, I’d soon be numb head to toe so it would make the surgery easier on me. They all laughed. I was glad that at least they were at ease.
They called another anesthesiologist to come and get my femoral nerve block started. The anesthesiologist Rob, came in and went right to work. Despite being commando, he kept me pretty much covered up for having to do a procedure on my bikini line. He asked me if I wanted a sedative and I asked him if he could please put a mojito or two in my IV. He laughed and ordered versed and fentanyl. The nurse injected the meds into my IV as I asked how long it was going to take to start working. Rob was injecting local into my bikini line as the meds flowed into my vein. As the words were coming out of my mouth, I felt like I was sinking into my pillow. "Now that’s what I’m talking about," I told him. "Yep, good stuff" he said as he smiled. "On the streets you’d go to jail. In here, it’s perfectly legit."
Before he started the business of finding my nerve, one of the nurses painted my leg green as she sang me "O Christmas Tree." I’m glad they found it amusing that I was turning green, so I lifted up my head and saw that it was a pretty amusing shade of green. That could have been the influence of the IV mojito though. Probably was, now that I think about it. The ceiling was also fairly amusing.
Anesthesiologists are a funny breed. They are extremely excited about the drugs they deliver to patients. Rob started telling me about the nerve block. "These are sweet," he said. "We’re going to find the right spot here and then stick a small catheter in there and you’re not going to feel any pain in the front of your leg or knee for the entire time you’re here." Then he started commenting on my body. "Wow! Awesome!" he said. "You are so skinny. You’re not our typical 300 lb. 70-year old getting a knee replacement. This is going to be a piece of cake." I told him I didn’t realize I’d be getting showered with compliments on my surgery day and thanked him.
He stuck the needle thing in my groin and my leg started twitching uncontrollably. He spent a couple minutes moving the needle around and with each move a different part of my leg would go crazy twitching. It felt weird, but it was kind of funny. That was probably the versed/fentanyl too. After a couple moves, he found the right spot and put it in. He hooked the catheter up to the pump and I was on my way to having a super numb leg.
My surgeon walked in with a big grin on his face and asked how I was feeling. I told him I was nervous, but that the mojito in my IV helped. He patted my leg, told me not to worry, and said "you’re not going to have much pain. It’s really not that bad." He asked me if I had any questions and I told him he answered my 4000 questions the week before. He laughed and went to the OR.
After he walked away I said, "Crap! I did have a question." The nurse asked me what I wanted to ask and said she could go grab him quick. I said, "I wanted to ask him why I can’t wear my underwear!"
Everyone got a nice last laugh, and it was time to go to the OR.
They wheeled me into a icy cold OR and the nurses were buzzing around preparing things. They helped me move over onto the operating table and it was like sliding my bare butt onto a slab of ice. I left out a yell because it was so cold. They strapped my arms gently down and I kept telling them I could still feel my leg. I needed them to know, but they didn’t seem very concerned. They then put this nice inflatable thing around my shoulders and across my chest that they inflated with warm air. They also covered me up with a warmed blanket.
A nice nurse introduced herself and assured me she’d keep me covered up. The anesthesiologist came in and asked me if I felt like going to sleep. He held up my IV with a syringe in his hand. It was all happening so fast now. I heard him say, "I’m putting you to sleep n. . ." and that was that.
I woke up in the OR to a nurse calling my name. I was instantly wide awake.
People were buzzing around the OR much like they had when I first entered. "Honey, why are you crying? Are you in pain?" a nurse asked me nicely.
I reached my hands up to my face and wiped away a tear that was rolling down my face. "No," I mumbled. I didn’t even know I was crying." I blinked a couple times to make sure this was real and then I asked, "So, did you guys all have a nice peek at my ass?" The buzzing OR seemed to stop for an instant and EVERYONE laughed. The nice nurse from the beginning leaned in close to my face and said, "We didn’t see even a peek.
Back in the PACU, I was asked about my level of pain. I felt pain in the back of my calf and the back of my knee, but nothing in the front of my leg. I reached down and felt the top of my thigh. It felt squishy and funny, numb from the nerve block. I had a huge immobilizer brace on my leg (not the one I brought to the hospital and to the OR) and was wrapped in an ace bandage from my thigh to my toes underneath. I also had a drain tube coming out of the bandaging which was attached to a device and bag that collected all the blood.
I said my pain level was a 2. She asked me if I wanted an injection of morphine. "Yes please." It wasn’t horrible, but I had a feeling it would get worse. I was right. Before they gave me the injection, I was easily a 3-4. They gave me the injection. They asked me a few minutes later where I was on the pain scale. I was now a 4. The back of my knee felt tender and my calf felt awful, like a super cramped up muscle, and it was getting worse. The nurse sort of rolled her eyes at me and said that I couldn’t expect not to have any pain. I looked her in the eye, told her I wasn’t stupid and realized I’d have some pain, and that I was told by everyone to stay ahead of the pain.
Another nurse was checking my blood pressure at the time and she sort of pushed the evil nurse away and took over. I later learned that the takeover nurse had undergone an ACL reconstruction herself. She told me that it was killer for the first couple days and that I was right to keep requesting pain medicine.
They kept taking my blood pressure, and watching a monitor above my head. Every once in a while a nurse would stop in front of me, watch my monitor, and tell me to take a deep breath. I didn’t realize that I wasn’t taking deep breaths at regular intervals.
During the time I was in the PACU, I received five shots of morphine. The pain seemed to keep a bit ahead of the injections and I was getting nervous about how bad it was going to get. Eventually they hooked up my morphine pain pump, handed me the magic button, and I was transported to my room.
Once in my room, the nurses used a slide board to transfer me to bed. My leg was so numb and I was hurting, but only on the back of my leg. I didn’t want to even try it myself. I had a roommate who had undergone a spinal fusion. I had a huge window and a view of the helicopter pad. That was pretty cool, right up until Big I waved at the pilot on the night I was being released. He waved back, and I realized that they had probably seen a lot of BBM butt during the night.
My first nurse initially seemed nice. She asked me how I had been injured and seemed like she would be helpful. She told me to stay ahead of my pain, and to let her know if I needed anything. After about an hour of hitting the button, I felt I had sufficiently knocked my pain down enough to deal. Mr. BBM and my parents were visiting, and about an hour later is when things started to get bad.
My pain pump started making funny sounds and I was not getting relief. The pain was ramping up quickly and I was getting more and more uncomfortable. I was trying to breathe through the pain, but unlike contractions, the pain didn’t stop. My nurse eventually came in to check it. It seemed like it took her forever to respond. She then told me that I had maxed it out. I was in so much pain at this point that I was about to lose it. "What do you mean I maxed it out"" I asked her.
It didn’t make sense. If the morphine was set to run in four hour cycles and I was only allowed to hit the button every six minutes, and if the medicine would not be delivered before those six minutes were up, then it makes no sense that I could "max out." The evil nurse started lecturing me that I needed to "just relax" and "calm down" and "control my pain with positive thinking" and "with your karate training you should be able to handle this." If she had been close enough, I think I would have taken a swing at her. I have never in my life, experienced such terrible pain.
With tears streaming down my face from the pain, I calmly and coldly told her that I had been through two lengthy natural child births, and that I do not have a problem tolerating pain. This however, was intolerable and I needed something NOW. She left the room and a nurse’s assistant told me that I was allowed to have up to two additional injections of morphine. I hadn’t had a single one.
My dinner sat on my tray getting cold, because it was impossible for me to do anything but sit there very still and try to will myself to not hurt so much. My entire body was tensing up and anything that took attention away from me trying to mentally control my pain was unthinkable. I could hardly speak; I could hardly breathe.
After what seemed like an eternity, she came into my room with the morphine injection and attitude. Later I was told by the assistants that she was being read the riot act in the hallway by both of my nurse assistants. She was being a total jerk and I am so thankful that those assistants said something, which resulted in her doing something. Needless to say, I was very happy when that first nurse left.
I’ll spare you most of the details on the other "issue," but I was unable to get out of bed at all the first night which meant I had to use a bedpan. I can’t use bedpans. When I was in a car accident years ago, they tried to make me use one and I couldn’t. When I was in labor with Big I, they tried to make me use one, and I couldn’t. I just can’t do it. I did, however, have to pee really badly. I sat there on that bedpan for almost an hour. I tried relaxing, visualizing, concentrating, putting my hand in a cup of warm water. Mr. BBM ran water for me; he left the room; he came back in the room, and still nothing. It’s very hard to go when you have a roommate and her husband is visiting too. I turned my TV up louder and still couldn’t go.
Mr. BBM was feeling really sorry for me at this point. I had survived surgery, a brawl with an evil nurse, and was still in pain and now my bladder was threatening to burst. He sat on the side of my bed and massaged my hand. I poured some water down there and the combination of the two worked. It felt fabulous to finally go. I thought I had broken the seal but my night was going to get much worse.
After Mr. BBM and my parents had gone, I tried to rest. One of the nurse’s assistants was such a doll. She brought me a washcloth and a basin so I could wash up a bit. She also brought me some cookies and kept an icy drink on my tray within reach at all times. She also helped me brush my teeth. We trash talked the nurse a bit, which made me feel better. The assistant assured me that I wasn’t being whiny; "evil incarnate"(the evil nurse) had just been ridiculous and that it was her standard modus operandi.
After a couple hours, I had to pee again and couldn’t go. I tried the previous routine, but it wouldn’t work. Nothing would. The nurse’s assistants even brought me a portable potty that looked like it was a bucket on a walker. They set it right beside my bed and helped me get over there. I was in excruciating pain. My leg was just throbbing and I couldn’t even begin to imagine how awful it would feel if I didn’t have the nerve block. Despite being upright, I still couldn’t go.
I’ll spare you the details but the nurse’s assistant talked me into being straight cathed. At this point, I had enough pain in my leg. I didn’t need to be dealing with any in my abdomen so I let them just do it. It wasn’t really that awful. After you have kids, I guess you just don’t care who sees and is in your business. My night nurse was fabulous. Before her shift was over, I would need to be straight cathed one more time. I just couldn’t go and at this point, I just didn’t care anymore who saw my business. What was more humiliating? A couple minutes of straight cathing with 100% relief or sitting on an uncomfortable bedpan for an hour. I’ll take the former.
Every time I went they used an ultrasound machine to scan my bladder. When I was able to go on my own, I still wasn’t emptying completely. The anesthesia/morphine combo had really done a number on my bladder. My bladder was very sleepy and just didn’t want to wake up.
For the entire night, I was strapped into a CPM (Continuous Passive Motion) machine that bent my knee to 30 degrees and back. It was slow and actually comforting. It was like a fuzzy hammock for my leg and felt great compared to the rigid immobilizer they had me strapped into.
I was beginning to think that I was just going to have to get used to having pain. It seemed endless. I would follow the nurses instructions by hitting the button several times so that I would get a blast of it and would be able to sleep. I fell asleep for almost three hours, but woke up to a horrible firey pain. The nurses thought that my continuous nerve block must have moved inside so it wasn’t providing relief like it should. I was given another bolus of morphine, followed by a bump up in the amount I was getting through my pain pump and an increase in how often I could hit the magic button. Despite a significant bump up in the amount of morphine I was getting, it was still barely taking the edge off of the pain. I was officially "behind" my pain and that is a very bad place to be. It was excruciating, but I was increasingly feeling more out of it. I felt like this day would never end.
If I had only known how much worse Tuesday would get. . .
This is the first of a three part series which will be posted over the next three consecutive days.
Going mobile
Hi. Papa Bradstein here.
I’m not a black belt. I did receive a green belt in Tae Kwon Do, and I might be a brown belt in smart assedness (assifying?). The closest I come to having black belt skills is likely in biking, even if I can’t always keep my head up and the wheels down.
Also, I’m not a Mama. However, I am a Papa, although I’ll never be a black belt Papa, since fatherhood is a daily mobius-strip journey of 1,000 miles, with most of the miles being racked up in a loop that runs between 3B’s crib, changing pad, diaper pail, toy chest, Barky’s water dish, with detours to any heavy, sharp, dangerous, or toxic items 3B can get his little mitts on.
Even though I’m still a white-belt Papa, BBM was kind enough to ask me to guest post. And, despite the fact that I store bleach on the coffee table behind 3B’s high chair every so often someone writes to me with a parenting question.
Recently, I got one from Samantha that touched on several pet peeves of mine, including the bee-boopification of childhood as well as the Calderification of cribs, changing tables, and strollers. After further consideration, however, I do amend my original answer below. (Over on my blog, I also finally replied to her follow up question about babies sleeping and diaper changes, because really, who can talk enough about poop?)
Question: Crib mobiles. I don’t get it. Like, the kid goes in there to sleep. Why turn one of those on to further stimulate him? And he can’t do it himself as a self-soothing thing–it’s gotta be parent operated. Is there something I’m missing? Clue me in. Do you have one? Do/did you use it? Like/hate? Help. Same with crib toys. Don’t understand. I would think that would just keep them awake when they wanted to play? Or as a parent as long as you don’t have to get them in the middle of the night, that’s a good thing?
First–I’m so excited for you. I’m glad to hear that everything is going well with you and baby.
OK, on to mobiles…I don’t understand crib mobiles–or changing table mobiles, for that matter–for the reasons you list. I suppose that the thinking goes like this…baby has to be on his/her back, and to sleep, baby needs to be distracted from all the distractions in the room. I suppose that this works for some babies, but I suspect that mobiles are mostly for those who need to give parents gifts.
Also, mobiles are a pain. You may recall my post about setting up the g.d. crib, which would have only taken an hour if it weren’t for the g.d. mobile.
Here’s a few other things to consider about mobiles:
- The kid can’t see great distances, like, over eight inches, for several weeks, which puts the mobile–and any distractions that it’s supposed to be distracting him from–out of his focal range for several weeks.
- The music that comes with the mobiles can be grating, irritating, infuriating, and bad in every other way imaginable–and every song is an earworm.
- You will bump the mobile every time you’re laying your kid down to sleep–after having spent hours, days, and months trying to get him to sleep, at which time you will be hallucinating from sleep deprivation, your shoulders will be aching like a stevedore’s, and your spine will be irreparably hunched over in the shape of a shepherd’s crook, and at which time the mobile will make a sound, play some music, brush his face, whatever–it will wake the baby up, at which time you will light it on fire and throw it off of your balcony–the mobile, that is, not the baby.
- A mobile over a changing table is nothing but a cute, fuzzy poop magnet…don’t ask how poop would get up there–it just would. Since you’re having a boy, it will get peed on too–ever tried to put a mobile in the washing machine?
- By the time the kid can see the mobile, the music will engage him enough to keep him awake.
- By the time the kid is moving and agile enough to interact with the mobile, he’s going to be up on his hands and knees, at which time you have to take the mobile down, since it’s now a hazard.
I’ve never understood crib toys, although at 3B’s current age–17 months–I could see how they would perhaps give him something to do when he wakes up. But, they would also be something to step on to help him escape–something he would love to have, but that we’re not so keen on.
Also, he doesn’t need anything to distract him when he wakes up. He’s perfectly happy chattering away to himself, looking around the room, sucking his thumb, playing with his lovie, and rolling around until we come in. If he’s really upset, he’ll stand up and let us know, but that’s a rare event. We do have a Curious George doll in there for him, but he almost never gives George the time of day. The one thing we did consider was a mirror, you know, because our son is as smart as a parakeet, but we never got our act together to find a nonbreakable one.
Amendment: All that said, we did have a wonderful mobile next to our glider that amused and engaged 3B. We would pivot it away whenever we were rocking him to sleep there, so there might be a place for a mobile somewhere in your home.
Also, I’ve heard mobiles can help pass the time if you’re laid up with, say, a just-repaired knee. Because what better to do than watch fuzzy sheep float by and listen to the bee-boop version of Brahms’ lullaby for the 63,476th time?
Hope you feel better soon, BBM, even if only to keep me from ever besmirching your name with a guest post again.
Introductions
Hey everyone! This is my first post on Black Belt Mama so let me introduce myself though you may have seen me lurking in comments here and there. My name is Bush Mackel – Though I sometimes go as Da Mack Daddy. Now that’s not to claim that I am every woman’s dream, but only to make reference to fatherhood which I am now very well acquainted with thanks to my 7th month old son, Little Mac.
So even though you now know me through this little introduction, don’t think that the title of this post was entirely self serving… You see, last night I had a holiday potluck at my house. (Yes, I can be PC at times). Well at the potluck, I had a rare chance to talk to some of my friends (none of whom are parents) and one of them started a very interesting conversation with me on the subject of introductions and more to the point what should you introduce your kids to.
At first, the discussion started with talk of religion and whether or not to introduce Little Mac to religion. Arguments on both sides of the fence ranged from, "What right do you have to force something as important as religion on the young mind of a child?" to "Well, if you don’t introduce your kid to the church, how would they NOT hate going when they were older?" Then the talk moved to other things like chess and sports. It was at this time that I piped up and said if there was any two things I would probably introduce my kid to, it would probably be music and the martial arts.
I probably can’t put into words why I feel so strongly about music. Though as far as martial arts go, I can AT THE LEAST speak to what it did for me in my youth. In a nutshell, I was a nerd when I was younger. And I mean a nerd. Now I’d probably be more of a geek as I’ve been able to successfully straddle the fence of nerdom and social normalcy. But back then it was tough going – As it is for most young people. Weird hair, big buck teeth, tacky Christmas sweaters everyday of the year… But despite this, I always felt like I could talk to anyone because my dad got me involved with the martial arts.
I think looking back at it all, (not that I have one foot in the grave or anything), confidence is a precious commodity in life. Without it, basically everything is a nightmare. Talking to women, getting a job, making friends, negotiating better rates on your loans… Without confidence, life is just that much tougher. And I think one of the best things I’ve had going for me has been being confident in just about everything I’ve done.
Add to that all the other great benefits from martial arts… Athleticism, friendship, the ability to defend yourself – Well for me, that makes it a no brainer.
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