And Now for the Rest of the Story

lateral radiograph post op

Lateral radiograph with overlay

AP radiograph post op

For those who read my previous blog post describing my surgery (March 19 (more information revealed)), I apologize, I have misled you. I pulled up a picture that seemed to fit with my MRI with the medial damage. However, my procedure was a Total Knee Replacement. I think these pictures will make more sense. I found a schematic and a couple of x-rays that better describe my reality. 



continuous passive motion machine



I haven’t read  everything posted about this surgery, but felt I had a handle on it. I had only heard 2 negative anecdotes and one of them  included infection. (Pat’s story is a horror story.)  Everyone agreed that if you do the physical therapy, you will be so happy you had the surgery.  My surgeon, Dr. Robert Bane, has a fantastic reputation among former patients and healthcare workers. I, of course have extra confidence in him because his father is still practicing veterinary medicine in a near-by small community. I feel I know that he comes with more than good education and surgical skills.. At this point, my only disappointment has been the pain level. You probably know that they constantly ask you where your pain is on a scale of one to ten. . That is tough because it is perfectly clear to me that you cannot understand another person’s perception of pain. Therefore they try to establish a scale for you, using this system. I think I started with a slightly high number and relatively narrow window. I do know that I spent the first few days  at “Barely tolerable. I went into this with the belief  that I have a fairly high pain tolerance. I need to take you back a few years to sy sense of “toughness” developed. Growing up on the farm in a relatively unemotional family,  I thought Ii was pretty tough although I didn’t  remember my broken collar bone at 3-4 from falling out of the hay mow. I had had my share of smashed fingers from hammers, slipped wrenches and gate and cardoor pinches. I had had more than my share of “nad smashes” from icy wooden fences, sports and nasty cousins and friends who thought a nad punch was funny. On the negative side, I remember being knocked out by Elbert (Bud) Lewis in junior high when we boxed on the stage during noon gym playtime. That wasn’t necessary a toughness issue, but it did shake my physical confidence.  I  got to remind Bud about this last summer. He remembered more that we both ran the distances for the Silver Lake track team. Somewhere in my  writing s, I have described the “tough Mitchells in our class. During “middle school” years there was Mitchell Manns (And his gorgeous sister Della) . Also from somewhere around that time through graduation  was Mitchell Bradford. I may be misspeaking but it seems these guys would get into contests to see who could hold their arm over a burning lighter the longest. If they didn’t really do this, they were the type of guys who would.. I know they did fight a lot , and although I never got into fights , I was always glad to know they were my friends  at the “Tippy” Hop and other similar youth rumble prone occasions.. This is specifically  important here because Mitchell Bradford had total knee replacement this spring and is walking 18 holes several times a week, pain free. He admits that his pain tolerance is much higher than for most people.. Did I say that Mitch has always had one of the most tender and caring hearts I have known?  So with Mitchell’s success as my goal, I do understand that my pain tolerance isn’t what I thought it was. I am so concerned that adhesions will form that I am being diligent  with the exercises.. In the hospital, as I bore more weight on my operated leg, there was a little sideways motion. They felt it was because the nerve block hadn’t completely worn off yet.  As we moved toward going home time , everyone seemed very happy. Oh, my diabetes  control got a little messed up but seemed to  be coming around.   So, home we go.

                                                                   

This is a good place to mention that I didn’t really think we would need help at home. After the boys visited me in the hospital, they had a meeting and mobilized an army. WE ARE SOOOO THANKFUL. Thankful first that at this time within our family there is time available for people to be at our house helping out. Thankful also that it is within their hearts to do so.. At this point Bruno hasn’t been here, but the only people who have bumped into my leg inadvertently have been adults.  The first problem was the evening we came home., I have mentioned that my diabetes control had gotten a little shaky. Well it seems that I was “not myself” Sunday evening. My blood glucose had dropped to 33… hmmmm.. We have been keeping track and have kept in in line sense. Monday  went as expected except that my entire right leg got swollen and the knee was swelling more.. Through that we worked out the tasks of keeping my foot elevated when sitting up and keeping the knee above my heart when in bed.  Oh, when I got out of bed, my left foot slipped off the covers and my right foot came to the floor “more quickly” than I had planned.. It gave me a bit of quick pain, but nothing of concern.  The next morning,  (Tuesday) it was Sophia, Ava, Georgia and I. The girls  had really stepped up and had done so well. However, they had stayed up a little late, so when I needed to get up Tuesday Morning, we had to wake Sophia. She and Ava came in and we started the procedure. Sophia seemed a bit “out of it” but responded that she was “just tired” when asked how she was.    We found out later that she had a headache and was dizzy, but thought she could “get through this, then could go rest. Again, I asked her if she was  OK. She gave this little grimace, shook her head slightly “no” and fainted, falling on me, with both of us crashing to the floor. OMG!!!   Foul language came pouring from me, Ava ran to get Georgia who thought we were having an earthquake. I couldn’t see Sophia because the end table we fell on was between us. Georgia came and untangled us from the table and Sophia was sitting on the floor against the chest of drawers, but “asleep”. She soon regained consciousness  and Georgia and Ava got her something to drink and out of the scene. Georgia started calling for Greg and Jeff.  I had gotten to a relatively comfortable position, lying on my sides. If fact, it felt quite good since I hadn’t laid on my side since Thursday morning.. The boys got here and lifted me back up and we were in business. When told about the incident, then next door neighbor made sure we had their cell numbers so we could call them should a similar incident occur again. ( We could have run over and pounded on the door, but that’s not where our mindset was. (It’s nice to know that you have neighbors available for such stuff..)  Fortunately, we had a home care nurse scheduled for 8am (one of the reasons we were trying to get things moving. We also had a physical therapist schedule for early afternoon. They both agreed that it appeared that no damage had occurred in my knee. The nurse also examined Sophia and said she was “OK”  Apparently she may be manifesting a syndrome that her mom and sisters went through. I think they are having her seen by a doctor, just to make sure. 

From then on, everything has been good. Good night’s sleep with pain level nearly constant at 3 (that’s good for me.) Got back on the computer. The Continuous Passive Motion machine that I came to love in the hospital because it gave me the confidence that adhesions were not forming, was discontinued until Dr. Bane could see me on Friday and get an x-ray. They want to be sure there is no damage before allowing the machine to “force” my knee into motion. We are also to put off the stretching exercises, only using isometrics to strengthen muscles..  This morning, Mahala helped me with the early morning stuff and Sophia just woke up to come help me get out of bed. She came in and looked very much like she did on the fateful morning. I said, “Mahala, keep her away from me.”  We all had a good laugh.

Here we are now early Friday afternoon., waiting for the Physical Therapist to come. It should be a very eventful meeting. Rod and Charlie took me to see Dr, Bane. Georgia stayed home and tried to rest. Her dental situation has gone from bad to worse. . She is in constant pain.. We did get hold of her dentist who is in Chicago and he started her on antibiotics for yet another root canal ablation.. (If you don’t know that word, get off your butt and look it up.)    Dr. Bane was happy with the x-rays.  He thinks the slightly extra laxity in my joint is due to the same problem we have been fighting with the exercises. The Therapist talks about a “guarding syndrome, where the muscles “refuse” to work as an effort to guard the limb. I do know that if I get my leg up in the air, I can hold it there, but I can’t initiate the move…. Really weird. Now that we know that there isn’t anything wrong with the joint, I expect Dr. Bane to turn the Physical Therapist loose to become a “Physical Terrorist”. I’m not afraid, however because he has been so gentle to this point. I need to read some on the guarding syndrome, but at least I don’t feel like such a wimp. All we have to do is to convince my muscles that it is OK to contract when asked to do so. Thanks to all for your prayers. As I said, we couldn’t be more blessed for the home care we are getting, both from the professionals and the family. It’s nice to know that where there is a need, the need will be met. I said yesterday that I felt about the way I expected to feel when I came home from the Hospital (4 days earlier). My intent for this post was to clear the air. I wanted people to know that it wasn’t a painless procedure. Either those who “witnessed” to me about this surgery just forgot those first few days, they are much tougher than I, or they just lied. When I think about it, nearly everyone started their description a few weeks after surgery. Now I know why. I can say that here a week after surgery I feel pretty  good in all respects. I just can’t get this leg to do what I want. I’m sure Raymond will get things going. I’ll have to post again once I reach that place where people start bragging  (in a good way) about the things they can do. So, Mitchell, make those trips around the course for me til I’m able to do something similar. I don’t golf (Right Terry???) but I am so ready to tend the garden, etc.. I’m sure the therapy folks will have something a little more vigorous for me.