Drugs and Love

Trending upward.  Each morning, each rehab in office and at home, each night’s sleep has gotten a little bit better.  Other than being in the ‘sweet spot’ of not too challenging and not challenging enough when it comes to exercises there are two major things to thank: my drugs and my wife.

Once I figured out that the doctors were giving me multiple prescriptions for pain killers for a reason and started taking them on schedule every day, the process began going better.  The trade off is that it is difficult to focus and I get a little dozey during the day.  But, as my therapist said, this is the only thing that should be on my plate right now.  Getting healed is what I am about for the next couple of weeks.  That’s it.

Prior to our marriage, my wife and I spent many hours creating our vows.  They are now beautifully written and framed above our bed.  Our minister, delightful man that he was, chose to ignore them and used the traditional vows.  I’m pretty sure that one was the ‘in sickness and in health’ one.  I am glad.

There has never been a moment that she has not thought about what I could possibly need at any given moment during this whole process.  She has been patient, kind, loving, and forceful when necessary.  And, she rarely injures herself or gets sick so I have few opportunities to show my healing chops.  I’m not going to go on and on about how blessed I have been in marriage, but I have been and my eventually recovery would not be any where close to what it might have been without her.

Enter the grind

As I have mentioned I have had the opportunity to experience many, many knee operations.  The results of a double replacement, two and a half weeks after the surgery are significant.  I can tell that I am likely to get a lot of mobility when all is said and done.  I could not really say when that might be at this time.  Every day feels a little bit better, but when I went into PT this morning my ‘numbers’, the amount I can straighten and bend my knees had gone down from yesterday morning.

Apparently this is deceptive as the knee is going to bounce around in this recovery.  My PT suggests that I look at week-long trends and not daily numbers.  My right knee, the ‘easy’ one was 6 degrees from straight today, while my left was quite a bit looser and I was able to bend it to 99degrees.

I can’t do too much.  I can’t do too little for ultimate recovery.  The narcotics are not letting me read with much focus (Thank you, Lord for creating Sports Illustrated), but I have to start getting my brain engaged again.  I also will have to get myself driving in a limited way this week.

I have about a month to get my full mobility.  Grind away.

sore, but in a good way

Well, it seems like I am sore where I am supposed to be sore, but still sore.  Each day further away from my liver complications is a day feeling better and feeling better allows me and the therapists to get after it.
Here's the trick: if you push the joint too hard, it will swell and you have to step back on your work load.  If you don't push it hard enough then the window we have to get maximum joint movement closes and you wind up with a stiffer knee than you want.  So far, I am able to keep my competitive fires banked and be content with just a moderate amount of progress every day.
I think I will start downloading photos tomorrow.

Release!

I was released from the Olympia Orthopedic Clinic’s care today as well as from Comstock Physical Therapy.  Heading home to Sitka, tomorrow afternoon and should arrive there at dinnertime.

It was extremely unfair to have to fight this crazy liver thing as well as the recovery from the surgery.  If someone could have done it, I was not that someone.  Though I have not gotten through the fatigue associated with my jaundice, the fight now turns on muscle, bone, gristle, and yes, titanium.  I think that I can win this.  According to my therapist, I have excellent range of motion at this point in the process.  I’ve not gotten the back of my knees to be able to touch the bed while lying on my back in decades.  I’ve not been able to track my left leg straight from hip to floor in 15 years.

All of this has left quads, hamstrings, calves (my poor calves are gone!) and Achilles tendons a mess that needs to be straightened out, mostly literally.  Then try to build up some bulk.  I’m told that the replacements I have gotten are rated for 135 degree bending.  I may be able to do some yoga poses that I could not in any way approximate.  Right now, I can bend to 105 degrees, tops.  If I can get 1 degree of bend improvement per week, I might be able to get to 135 degree bend in six months or so.  Good goal!  Let’s see if we can make it happen between the local PT folks and the family pushing me along.

Why I felt like I wanted to die!

And then I got sick.  Really sick.  Like the Physical Therapist said that she was calling the hospital when she looked at me.  I knew I did not look all that good, but I passed it off as being associated with the pain of the surgery.  After 6 hours in the emergency room and two nights in the hospital:

A.     I am feeling better than I have at any time since the surgery,

B.      I think I can start making some progress in my rehab

Bilirubin is the stuff in one’s blood that recycles blood cells through the liver and then is dumped into the digestive system.  It is yellow.  The baseline number in the body of it is about 1.  By the time I was admitted, my level was 15.  My eyes and skin were a sickly, sickly yellow.  After lots of interviews with doctors and nurses, all while watching U-M-Notre Dame with Mik and our friend Gene, I was admitted.  I disappointed one doctor who was pretty insistent that I sign a DO NOT RESCUSITATE order before being admitted.

Though it was clear no one knew what the heck was going on, I had diarrhea, zero energy, and no appetite.  I was, strangely, with no treatment starting to feel just a little better, the UM loss notwithstanding.  I was interviewed the next morning by a very sharp Gastro-Interologist and he started to put together the extraordinary bruising I suffered in the surgery and my overwhelmed liver.  There is also some evidence that Xeralto, a blood thinner, could have had an impact.  Also, I had been taking about twice as much Tylenol as I should have been.  He scheduled an MRI of my liver, then he mentioned that my Bilirubin level was 13 times normal was I came in and now, with no treatment, it was down to 10.  Trending correctly.  Some talk of not knowing what exactly might have happened was already being used.

By Sunday morning my levels were down to 5.  I am conscious of the fact that we are all one diagnosis away from our lives changing forever.  Cancer was discussed, but not in a serious way at this time.  It has been part of my fear.  Not yet.  I feel much better, better than at any time post-surgery. Hopefully. I can focus on just working on the knees and start making some progress.

Up and down, yet no smooth arc...

It would be easy to somehow work in a story about the last time I used the term “about an 8” was when I was describing my wife’s attractiveness.  But that would put me in that despicable group of people who break human beings down on some simple numerical scale.  It would also mean that I would not be calling my wife a 10, which if I was a guy who labeled women in such a way shouldn’t I be?  Suffice it to say that when asked to describe my pain while at my second PT appointment, I whispered through tightly gritted teeth, “about an 8”.   Don’t think I had ever been there before.

I’ll admit to being demoralized even when she asked me to do as many straight-legged lifts as possible, quitting at 20, far more than she expected, due to the overwhelming pain. It has been a week.  I should be dancing, or at least down-hill skiing.

But, after struggling to just get back into the house, jumping my OXY level to 15 mgs with a 500 mg Tylenol, things got BETTER.  Diligently following a three-hour pain-med routine with two more workouts led by Carol (who as a wife is like, a 12) I felt better and was able to move things easier and with less pain.  Could this the corner that is always eventually turned in my healing process?