Hi!
Here's a run down of some recent accomplishments in my recovery period. I haven't been so quick to update my blog lately, so this is about a two week summary:
10/8/11 - 6 week follow up with Dr. Fulkerson, my orthopedic surgeon, who says I might be able to start weigh bearing at 10 weeks and to keep my brace unlocked, encouraging as much bending and movement in my knee as possible. Push for 90 degrees ROM in the CPM (working on it!).
10/14/11 - First out-patient physical therapy appointment at Boulder Orthopedic Physical Therapy with April Smith (and Megan, assistant) - they are GREAT. I completed 6 minutes of half rotations (think back-forth not all the way around) on a stationary recumbent bike. This bestowed much confidence in me hence the follow couple days of advancements...
10/14/11 - Showering on my own, no brace or trash bagged leg. Showering every morning now which feels so great and no more sponge baths for my left leg.
10/14/11 - No bucket in the shower to prop my straight leg up on; instead using the removable plastic toilet seat to rest my foot on.
10/15/11 - Sleeping without the brace on; laying on my right side with a pillow between by knees and ankles or laying flat on my back with a pillow under my knees.
10/15/11 - No more raised toilet seat & no more bucket! We ditched the raised toilet seat which was helpful because, well, it just was. And since I can bend my leg comfortably to at least 60 degrees, there is no need to prop my straight leg up on a upside down bucket on the bathroom floor.
10/16/11 - Warming up my leg in morning using the CPM which we left on the couch for the first night in almost two month. This meant no loud, bulky CPM or ice machine in bed!
10/16 & 23/11 - Helped prepare breakfast and dinner. Put a chair in the kitchen and sat and chopped fruits and veggies, stirred the pot, and occasionally stood with crutches or hobbled around to get one thing at a time... a little scary because I had to be careful not to slip.
10/18/11 - Unassisted bathing; getting in and out of the bath tub on my own (still sitting down in the tub and using the transfer bench).
10/18/11 - No more toilet seat in the bath tub - sounds funny, but true! When I was able to shower without the brace, we ditched the upside down bucket in the tub and used the 8 inch removable plastic toilet seat thingy so that I could rest my foot on something and my leg wouldn't just hang like dead weight and strain my knee. Well now my knee is more flexible. It hangs, I bend it, and try to get some extra motion in the knee while I warm up the muscles with hot water.
10/19/11 - Completed my forth out-patient PT session and did 6 minutes of full rotations on the stationary recumbent bike. Struggling to keep my hip down (raising the hip was a learned compensation to provide more leverage to bend my knee - not helpful!) and PUSH THROUGH a full rotation. April Smith (my fabulous physical therapist) had me concentrate on engaging the quad and glute of my RIGHT LEG and pushing hard with the right foot, forgetting the left leg and just letting it follow the motion determined by my right leg. All while taking my right hand and pushing down hard on my left hip to keep it from popping up off the seat. My low back and hip muscles would tense up, and this is something I'm working on changing. By the end of six minutes I had about 5 really smooth, fluid rotations. THAT felt amazing.
10/20/11 - Went shopping... like a normal person... I fulfilled needs without over doing it. I bought a new fleece-lined hoodie sweat shirt for the cold weather approaching and some new yoga pants (since that is all I pretty much wear these days). These are some things I needed but in no way felt "up to doing" in the days and weeks prior. Simple, but good progress.
10/21/11 - Disability Claim - Began a dialog with my surgeon to submit paperwork for an extension of short term disability to long term disability coverage, as a safety net. WE HOPE I can start back to work sometime around November 21st. My short term disability claim expires Nov 19th. It takes about one month to process a long term disability claim. I may go back to work by November 19th, but it may only be part time for a little while. The disability insurance company's rule is that an individual can continue to receive disability benefits, with doctor's notes, as long as the individual is working less than 80% of their regular hours. In my case that would be 32 hours or less per 40 hour work week. Doctor's notes, recommendations, specific instructions like "part time" or "light duty" or changes to the work place are required by the insurance company. I think it makes sense to get the ball rolling on the long term disability coverage as a SAFETY NET, with the goal of being back to work at 100% as close to that 12 week mark (Nov 19) as possible.
10/22/11 - Pampering and self-care! Got my hair cut today. Simple as that. Made me feel really good. Also went out to brunch and sat with both legs bent under the table (yay! normal!) instead of one propped up or sticking out straight. Opened several of my own doors (to public bathroom, etc.), crutched along the Boulder Creek and sat on a bench with Alon by the creek, enjoying the autumn day. I also crutched about 5 blocks along the Pearl Street mall to check out BCAP's Souper Bowlder display at the Boulder Arts & Crafts shop. Later that afternoon I took a nap for nearly 3 hours - I was absolutely wasted when I got home at about 3pm. Alon had to wake me up at 6:30pm!
10/22/11 - Guided visualization used instead of pain meds to fall asleep. Alon took me on a verbal and visual journey through the stars and deep into the earth to help easy my pain and relax. He was great! It was a new approach brought on by the fact that I was just sick and tired of taking oxy or valium to fall asleep. So Alon's technique really helped and I think has a lot of promise if we take the time to keep practicing it. Alon actually fell asleep about 15 minutes before I did in this initial trial which was pretty funny, but all good!
10/23/11 - Washed a few dishes (about 10 minutes worth of standing and "doing"). Did a load of laundry by myself - I might think twice about telling Alon about this :-) I basically dragged a bag of dirty clothes while crutching from bedroom to laundry room (about 15 feet apart), separated items, and started her up.
10/23/11 - Skyped with family showing them how I can bend my left knee and lift my leg up and down. They were very excited so that was cool.
10/23/11 - Range of motion - "Gravitational Flexion" progresses at home. I sit on the kitchen table with both legs dangling off. I bend as far as I can go. Then Alon takes one hand and places it on the top of my ankle, where leg meet foot. I push into his hand as hard as I can, then relax, then he pushes my leg back. I keep my seat, pushing my left hip down and massaging my leg in different spots. We repeat this 2 or 3 times and hold each one for a few minutes until I can't bend any further. It HURTS! Duh. Then we release my leg altogether. I bring my leg up to straight, trying desperately to kick Alon's hand that is suspended high in the air. I more like just barely tap his hand. I repeat this part a few times till the motion is relatively fluid and smooth and then return to the bending exercise.
10/24/11 - Made tea for myself and Alon and put a few dishes away this morning! After that 15 minutes of doing stuff I was tired (mostly in my arms and right leg). The blood also rushes down into my left leg/foot and my left hip is holding so much of the weight that it also starts to feel the strain. So I hustled to sit down and stuck my leg in the CPM (up to 80 degrees in CPM this morning!).
Range of motion (ROM) - At the beginning of each physical therapy appointment April and I take about 30 minutes of loosening and bending and straightening my left knee and leg. It SUCKS, but it is worth every second of torture so I can make a full recovery. Here's a recap of how I'm doing at the start of 30 minutes (when I arrive) to the end of the 30 minutes. April assures that I am doing well and making progress, despite measurements that vary and show decreases:
Degrees of ROM:
10/12/11: 67.5 to 90 (took 500mg Tylenol)
10/14/11 65 to 90 (took 7.5 mg Oxycodone and 325mg Tylenol;
10/19/11 85 to 110 (took about 10mg Oxycodone and 650 mg Tylenol);
10/21/11 70 to 90 (just barely - I was very tight and soar from PT two days prior and did not take any oxycodone before this appointment)
I think next time I am going to try 5mg Oxycodone, 325mg Tylenol, and 5mg Valium. My low back and hip muscles were going into spasm on 10/21 so I think the Valium would help with that. Also, I get pretty worked up emotionally, so the Valium might take the edge off a bit. I also think the Oxy/Tylenol helps me get through the first painful 10 degrees (somewhere between 90 and 100 degrees) and then I just deal with it. This pain and emotional management thing is an ongoing learning process!
By the way... my quad, glutes, adductor and abductor muscles are getting visibly stronger now from two weeks of PT and daily home exercise routine. I just need to make sure I keep up on my shoulder and back exercises at home (using a T-band) because I've been slacking off there with all the focus on ROM lately, and my shoulders are starting to hurt a bit (from crutches/walker and previous shoulder injuries). ALSO, my left foot is getting better but still soar/swollen (tendonitis) and not back to 100% of its range of motion yet. When I stretch the foot it almost feels like I have shin splints. Eight weeks later, the left foot and knee are still a bit swollen. Most of my bruising is gone - just one little one left on the lateral calf that we are rubbing out daily.
A bit of reflection...
I've realized a lot recently about taking things granted - my life, my body, my friends and loved ones, help and kindness from others, the way I spend my day (thinking, eating, laughing, stressing out, doing, not doing), my sanity, and my "good" moments. I have a renewed appreciation for all of these things every day.
Me at Boulder Creek this weekend.
