Still sticking to 30 day plan – and it’s been 2 (almost 3) days now!

That leads me back to the food and addiction series. So, I promise I will return to that and write about the addiction and dependence issues. In the meantime, I am working at getting back on track with my eating.

So, here I am announcing it publicly to make myself more accountable. Interestingly, there are studies that say that announcing your goals actually makes you less motivated because it gives you a sense of accomplishment to just sort of say them out loud.

Does that make sense to you? Me? If the goals are inside my head I can avoid them forever. Not that making me publicly accountable solves all the problems but I think it does help. Especially if people really do hold me accountable.

For the next 30 days, I’m going to not eat sugar, bread, cakes, crackers, pasta or rice. I’m going to focus on my nutrition goals and not eat all those easy and tasty things. I want to get back to losing weight – especially the 10 pounds I gained the last couple months. After 30 days, I’ll re-evaluate. I still do believe in the idea of moderation but I’m not sure I can actually behave in a moderate manner. One day at a time for 30 days and we’ll see what happens.

And kick my butt if I don’t, will you?

I saw Dr. Knee Guy on Monday. He tickles me. He’s so happy and enthusiastic about my progress and apparently quite excited that the surgery went well. He told me a little about the work they had to do on the back of my knee in order to get it straight but I don’t really want to know all those details. A little oddly, he wants me to back off on the knee exercises and focus on walking, walking, walking. I return to outpatient rehab next week (yay!) and I’ll be able to go back to the Nu-Step and the recumbent bike, both of which will help me continue strengthening the muscles without much stress on the actual joint. Plus I can walk in endless circles around the indoor track.

So I finish up in home rehab – and I really have to thank Bea for all her work. She finds a way to complicate and make each exercise a little more difficult whenever I master it – but she also got me to 108° flexion at only 4 weeks. Dr. Knee Guy said he didn’t expect me to get past 90° at 4 weeks so we really are doing well. I have to remind myself every time I want to complain about how slow this is going that I’m actually a bit ahead of the game. Bea is really impressed with my general flexibility. I must give kudos to past ballet teachers. I may be old, fat and still terribly out of shape but I’m still really quite flexible after years and years of dance. Pity that I’m not that graceful.

I’ll be driving by this weekend. I insist. Assistant Dr. Knee Guy thinks I should be more confident with the cane before I drive but I’m not going to rely on the cane for a while yet. Even riding to Cassville, which only takes about half an hour, my leg is tired and I want to lean on the walker when I get out of the car. As fast as things are moving, that may not be an issue next week, we’ll see. I don’t mind hauling the walker around with me, though – I’ve done it for years. What will I do when my car isn’t cluttered up with wheelchairs, walkers and everything else I might need depending on how far I will have to walk? Won’t it be cool to not have to think about that?

Speaking of Cassville, I finally saw Mom yesterday. She just seems to be fading away. She isn’t really responsive and Betty says that she doesn’t talk much anymore. She seems to be more unsteady though I hear that she walks pretty well in the mornings with physical therapy. It’s a challenge to visit with her, I just talk and I think she knows and appreciates the visit (at least to whatever extent she can) but she can’t respond in a conversational way. Dad just can’t deal with that. He really wants to insist that she respond to him.

I finally got my glasses! Did I mention I got new lenses made? I really, really hated the progressive bifocals. The new glasses came in the same day I had surgery and it took this long to get down there to pick them up. I can see inside again! It really gets old to wear sunglasses all the time.

So where do we go from here? I need to get back on the lap-band-wagon. I did so well my week in the hospital where I couldn’t graze but it didn’t translate into doing well once I got home and I was bored to death and had the ability to graze, particularly at night. I know I’ve gained weight and I don’t look forward to getting on the scales. It’s scary – I don’t want to go back to that me but I can see how easy it’d be to do so.

I still have a lot of work to do in rehab and getting my knee and the rest of me as fit and healthy as possible. I’ll be dealing with Mom and Dad and trying to figure out how to help Dad and deal with the stress that situation creates. But – I also need to be moving forward in my life. I don’t know where I go from here and there are a lot of external factors affecting my choices and goals. I’m not going to overly stress about it – there’s a lot to do in the meantime. Still…. What comes next?

Going into knee surgery, my biggest stressor was worrying about Dad – both getting him out of the house on time and him having to cope alone for a week. That also included whether or not he should really be driving and whether he’d remember to take care of my cat. It is a little strange to be more worried about this stuff than the surgery itself – though I found time to be stressed about that, too.

I told Dad we absolutely had to leave the house by 7AM. That meant I finally got him out of the house at 7:30. I knew this was going to happen so I lied by half an hour and we got there on time. We’d been going back and forth for a week with him forgetting that I was having surgery despite constant reminders including two large notes I stuck on his fridge and bathroom mirror. He seems to be doing okay until you talk to him about details. I don’t know what’s going to happen next with him but I am worried.

I was really quite impressed with the orthopedic center. It has the surgery center, recovery, and rehab all combined in one building. I checked in, was taken to a private room to prepare for surgery, had some blood tests and such done and maybe an hour later was wheeled down to where they do the nerve block and other pre-surgical stuff. They already had a room for me (which are all private after surgery and are designed to be able to easily get around in with a walker) so they moved my stuff down there. Dad could have waited there but they also had a cafeteria and comfortable sofas and chairs in a waiting area.

I don’t remember a thing after the nice relaxing shot. I was “conscious” during surgery, I guess, with a nerve block in the front of my leg and a spinal block instead of general anesthesia. I guess that whatever they gave me to relax was really, really relaxing. The next thing I remember is waking up in my room. I wasn’t in a lot of pain right away with the blocks and everyone was really tuned in to keeping my pain level down.

Dr. Knee Guy came in and told me that there was even more damage in my knee than we’d anticipated. (see knee anatomy) We knew that the anterior cruciate ligament and the posterior cruciate ligament had been severed in my fall. During the past years, the remnants had been worn away entirely. The new knee is made to work without those ligaments so at least I didn’t have to have cadaver ligaments (which has always kind of freaked me out). However, the medial collateral ligament was scarred in and very tight and the lateral collateral ligament was loose and allowing the knee to shift to the side so he had to repair both of these and I got to wear a knee brace again. Apparently most people don’t have to use a brace after knee replacement, I was just really lucky. Still, he thought the surgery went well and I will eventually have full function.

They left the nerve block in for several days and that’s what my little patient controlled button controlled. I was never really sure it did much of anything but the IV pole followed me around as they let me get up and start to “walk” the next day. I was honestly surprised at just how hard it was! I really had the idea that since I’d been through worse, walking after surgery was going to be a piece of cake. Not so. I shuffled. But surprisingly by Friday (3 days after surgery) I was walking quite well and for pretty good distances. In fact, Dr. Knee Guy would have let me go home if I could have done some things like get in and out of bed by myself. So instead I went to the transitional care unit – a step between full hospital and full rehab.

The TCU did not have private rooms, or at least not a lot of private rooms. I ended up with a roommate and had a little meltdown because I know how I respond to noise and feeling trapped with another person. I did feel sorry for this poor lady but (and it’s totally unfair to judge her under these circumstances) she was not a personality type I deal with well. She moved out in the middle of the night the next day – I was never told why – and I ended up with no roommate for the rest of my stay. I worry a bit that I did something — but I don’t know what. I isolated myself from the constant noise with music and my earbuds, maybe I wasn’t friendly enough.

I made really fast progress after moving to the TCU. As soon as I could get my leg in and out of bed by myself, I was up and moving around. I got ridiculously bored and activity therapy came and walked me down to the activity room and played cards with me. I did physical therapy twice per day and yeah, those exercises are hard. I was pretty determined though, since I really wanted to go home. Initially, they talked about keeping me on the TCU for 5 to 7 days (or longer). I was ready to go home after 3 days. Seriously ready. We compromised on Wednesday because the blood thinner wasn’t quite up to therapeutic levels yet and shazzam! It was good to be home.

I go back to Dr. Knee Guy this afternoon and I expect to be released to drive and probably to go back to outpatient therapy. I’ll rather miss my home PT who has a good sense of humor and keeps pushing me to get better. My new challenge? Walking upright. I tend to lean forward onto the walker (or cane). That seems to be a hard habit to break so far!

And today it just happened. My leg was like, ‘Oh this? Well of course I can do this! I didn’t realize that was what you wanted me to do…’

One more moment on the road to independence.

• I can put my right foot all the way flat on the floor – and STAND on it. I haven’t been able to do that in 8 years.
• When I walk, I have an almost normal gait though I’m still using the walker. I think it’s more that I don’t trust my new knee than it’s absolutely necessary.
• I can lift my right foot a few inches off of the floor which makes curbs and stepping into the shower a lot easier.
• I can slow-motion kick out with my right foot. At first I had no muscle control for this sort of motion at all.
• I can bend my knee a little further each day. In the CPM I can do 115° but I’m still less than 90° while sitting in my chair. This apparently is normal but a little frustrating.
• I can sit at my desk, either with my leg down or propped up on the chair beside me for about an hour at a time. This is necessary for eventually being able to sit in the car and drive.
• I can stand to do the dishes or brush my teeth though I have to consciously force myself to shift my weight to my right leg.

And I am saying BOO! to Humana, who do my prescription insurance, for refusing to approve a short-term script for Celebrex – the only anti-inflammatory I can take while I’m on Coumadin to prevent blood clots. Yes it’s an expensive medication but I didn’t have any other choices and it’s only for a couple weeks. I paid for it out of pocket because the level of pain in my other joints was impacting my rehab for my knee. Stupid insurance company! When I get around to it, Humana, you are getting a letter of complaint from me.

I feel like healing is going really slow. Everyone tells me that I’m doing great and I can’t compare myself to anyone else – we’re all different. But it feels like there are giant bands of steel across my knee that are not going to let it bend ever. I’ve got almost 100° bend on the CPM but I’m still barely making 80° on my own. Extension is a little better – I have only about a 5° bend there which is way better than it was. I can put my heel down when walking and I’ve got a comparatively normal gait already. So that’s all to the good.

Dr. Knee Guy is tops in the area and known for taking difficult cases – which is how he got me! He said that although he was expecting a mess inside, it was more of a mess than he thought it would be. Still, he thinks I should have essentially normal function eventually. I’m back in a brace right now because the two remaining ligaments were scarred in on the one side and too loose on the other so they are having to do some healing as well.

And by the way, I don’t have my new glasses yet (I hear they’re in) and I’m squinting at the screen through my sunglasses or trying to see the keyboard in the dark. Typos are going to be worse than usual.

That’s it for sitting at the computer time for now. Ow.

Overall, I’m doing well. Last Friday I was in the “what the hell did I do?” phase of recovery. I could have walked crooked or used the wheelchair the rest of my life, right? But by Saturday, I was walking better than I have in almost eight years. My heel touches the ground, my leg is almost straight and the pain (at least while walking) has decreased significantly. There’s a lot of work and therapy to do – I’ll explain when I have the energy to sit here longer. This is one of the rare occasions that I wish I had a laptop.

Again, thank you to all who have sent me good thoughts, wishes, encouragement, prayers, positive vibes and whatnot. Especially the whatnot. I’ll be back!