Post Op Follow Up #1

Today was my first field trip out of the house. I got to go visit the dr office and have a post op xray and exam.

Being that I have issues making it from the couch to the bathroom and back this was going to be a struggle. The weight of the brace and the fact that I have to hold my leg straight makes it lot more difficult than the other times I have been on crutches. I managed pretty good though...being shofered to the doctor's office in the back of my own car was a trip though...

So first was the routine xray. they wanted to see how the osteonomy was healing and to make sure the screws and plate were holding.

After the xrays I met with the Dr and the PA and we talked about how things have gone so far. They took out the stitches from the orthoscope cameras they use in the surgery and looked at the incisions to make sure they still looked good. We talked about my pain levels and they were concerned i was still experiencing more pain than I should be. They adjusted my meds and they took a look at the flexibility of my knee. I was able to bend to about 70 degrees...slighty better than the 65 the cpm has me doing currently.

Overall it was a good visit...my progress is good and with the adjusted meds I should be able to do more in the CPM and get moving a little more. Below is a picture of my leg as it looks today. The swelling has dropped considerably but there is some good brusing. I also recieved pictures of my my surgery...snap shots of certain points. Once I figure out who can scan them for me I'll probably post them here.

Milestones

Wow what a day I had today. I didn't sleep so well last night..up and down all night. I just could not get comfortable. I spent a good part of the day in the CPM at level 60..a particularly painful level..luckily I was able to fall asleep while in it and catch up on sleep.

Today was an eventful day. I finally was able to get up and take a shower. The event in and of its self was monumental. I got up the stair on my butt and crutched into a shower. We set up a plastic lawn chair in the shower stall so I could just sit and clean myself with no fear of falling. I thankfully washed down the wounded leg with a damp wash cloth in an attempt to quell the increased itching.

In other very happy news for me I was able to also use the bathroom and take a dump. Its the first time i've been able to do that since before the surgery. Granted I was on a liquid diet for the first 4 days after the surgery and now I only consume about 600 calories a day...so its not like I had a real "need" to go.

My buddy Ron came and visted me today too, allowing Suzanne to get some time out of the house to herself. We sat had some pizza and and watched TV. Thanks buddy for coming over.

Tomorrow I have my first post op appointment which includes x-rays. Wish me luck...most of the swelling has gone down thanks to a fully functioning iceman so they should be able to do a good first look.

The Iceman Returns

This morning the doorbell rings early...like 9:00am. I'm stuck on the couch, not much I can do, but Suz gets the door and low and behold a new Iceman Machine....We get that upacked and to good use pretty quick. Its a lot quieter and seems more efficient that the one we brought home from the hospital, good signs that it won't wash a 6x12 inch area of my carpet overnight.

Pain today is on and off...I've begun getting muscles spasms in my upper thigh a sign I'm not using it enough. These jerk my leg back and forth a lot...and cause some good bouts of pain. The worst came as I was dozing off in the CPM this afternoon...one huge muscle spam and a jerk out of sleep and I felt like I could have been launched out of the machine...had I not been strapped in.

Today I actually ate 3 full meals....first time since the surgery that happened. Though the portions are far smaller than what I used to eat...

I'm starting to get stir crazy...i've still got 2.5 more weeks of sitting around.

Its Been One Week

OK...so week one of my recovery is in the books. And even though I've had some set backs everthing is going well. I spending my time in the CPM and balancing out the pain meds with the treatment and think I now have a hang on what my limits are in terms of duration of time in the CPM.

We sprung yet another leak in my IceMan today...this one coming from the bottom of the machine...luckily we caught it before it soaked the carpet....its now sitting inside a tupperware until the guy comes tomorrow and swaps it out for me.

I recieved some clairifcation in a follow up call with the Dr's PA today. They did not break my leg all the way through during the osteonomy as I thought in the hospital, under all the drugs I must have heard something and processed it differently. They did it successfully and even so the pain I was experiencing was normal. We also talked about my pain levels and the about my foot still being swollen all appear to be in the normal range. I could not figure out why my leg itched so much, so this evening as peeled away all the ace bandages to check it dawned on me. My leg itched where they shaved it...and there was nothing at all I can about it. WHICH SUCKS!

All in all the first week has been interesting...the old saying is no pain no gain...and if I can make it through the next few weeks then my road to recovery should be paved with success and I'll get back the quality of life that I've been deprived of for so long.

A leaky Bladder

Today was a pretty bad day...the pain started as soon as I woke up and no dosage of pain meds was able to cool it off. To top it off the IceMan circulation ice pack on my leg sprung a bit of leak today. I didn't click the hose into the fastner tight enough and before I knew it I was sitting in a lot of water...this forced my relocation to another couch which has me in odd positions to keep sitting upright and it'll make it hard to sleep tonight. I spent only 2.5 hours in the CPM machine today...the pain was too great...I was able to do those 2.5 hours at 50 degrees...tomorrow I'll have to repeat the the same number as today....all 6 hours at the setting or it doesn't count.

Before and After

For some reason I am intrigued by before and after photos. So attached below are before and after pictures of my right knee. I guess I can forget about that future as a leg model.

More Visitors and some relief

Today is the first day I have the CPM for the entire day. And over the course of the day I'm able to get all 6 hours in and increase the incline up to 45 degrees today. Most of time in the machine goes ok, its funny seeing peoples reaction to everything I am hooked up to. The CPM on my leg, the Ice Man inside my pant leg, and of course this laptop on my lap.

My dad came down to see me today, braving the Cleveland snowstorms and sat with us for several hours. Unfortunately most of the afternoon I feel nausous.. the combination of sleep deprivation (3-4 hours a night) on top of not having my normal generous appetite is starting to wear on me. For dinner I force down large bowl of pasta and I start to feel better that in combination with the ginger ale has seemed to ease my queasy stomach.

The pain has eased today somewhat, moving down around a 6 or 7. The CPM has seemed to do its part in removing the stiffness. Today is the first day I've felt confident that I made the right decision undergoing this surgery...

First Visitors...and my CPM

Today my at home CPM was delivered, fresh out of the box and ready to make me wince, the guy from the company it up for me in about 15 minutes. He went over the instructions and the goals set up for me by the PT folks and my dr. Aggressive to say the least but I if ajust by 5 degrees per day I should be able to get there.

My in-laws came down today to see how I was doing, they brought food, always welcome, and we watched the Dark Knight. I was in and out of it for most of the visit, pain meds mixed with my decrease intake in food has made me spacy.

I was able to eat some meatloaf, mashed potatos and some veggies. The first real thing I've eaten since the day before my surgery. Getting back and forth from the bathroom has become easier we've got a better method for getting me up off the couch.

Tomorrow my parents are coming down, maybe with some food who knows. Tonight I think I'll sleep well, my cpm has been going for about 6 hours, working my leg up and down, with varying degrees of discomfort.

Day Four - Finally at Home

Today is Friday and I wake up this morning in hospital again, but feel pretty well rested considering the cocktail of Ambien and Percocet they gave me at about 11:00pm. I wake up feeling pretty good and the nurse comes in to change my banagages and dressings. While diassembling my knee wrappings I shoot a picture so I can remember how deformed it looked, unfortunately it appears the IceMan has been leaking a little, so while the locate a new bladder for me, the rewrap my knee and I sit and wait...and did I wait. It was about 3.5 hours before they brought the replacement piece for me. So I've lost that much of the anti-swelling therapy as well as the time in the CPM machine. Without the Iceman the CPM machine would be unbearable.

Once they got me put back together and into the relative comfort of the cpm I was relased to go home. The ride hom was nothing short of eventful, starting with cramming me into the front seat of Suzanne's Grand Am. I got into the house without any issue, but several times lost my balance and felt as if I was going to tumble, My biggest scar yetr came after waking up from a 40 minute nap to get up and go to the bathroom, I was standing the next thing I knew i felt like I was falling...i was able to catch my balance, but to this point unsure if i put any weight down on the bad leg. Scared and freaked out i sit on the couch..trying to relax and let the pain meds take hold of me. I've not eaten much..which I fear is one the reasons I keep loosing my balance.

Today the pain is about 8 out 10.

Days 1 thought 3

Tuesday February 17th:

I arrive at OSU East at about 9:00 am for my pre-opt appointment. The nerves are starting to build as I am led to the back to gown up and be outfitted with all the gizmos and gadgets that will keep me alive and monitored through the procedure. I'm informed the surgery will take about 3.5 hours. In reality it took almost 5.5. No major complications coming out of sugery, normal grogginess and slighly elevated BP.

I'm moved into my room to rest the night. The pain is pretty intense once the post operative Nerve Blocks wear off. i thrash and toss about as little as possible until they bring me some high dose pain meds to make tolerable. It was a long night.

Wednesday February 18th:
I'm woken out of sleep all night with lightning jolts of pain. On a scale of 1-10 I'm hovering around a 9.5. Probably the most pain I've ever been in. Ever. About 700am Stephanie, Dr Flannigan's PA , and another fellow come by to follow up. I learn the defect in my knee was about silver dollar in size and during the course of the osteonomy my leg broke. This explains my exrememe sharp pain and why I was so uncomfortable. Otherwise the surgery was successful, and providing I follow all the stringnet protocol should make a good recovery. During the course of the day they get me up on crutches so I can feel the weight of the brace, plus the IceMan, on my leg so I can be more comfortable moving aroud when I get sent hom. Even being up for those short 10 minutes was painful. To help me sleep at night they give me a nice mixture of Oxycotin, Percocet, and Ambiem.

Thurday February 19th

I woke up this morning after a fitful night of sleep. I was up and down all night with my blood pressure spiking and fits of pain shooting through my leg. They finally got me comfortable and asleep around 4:00am. Later that morning Physical Therapy came in and introduced me to a medieval torture device, called the CPM or a Continous Passive Motion Machine. As the machine moves is flexes my knee joint which is supposed to assist in healing. I thought I was pain yesterday, today was a whole new expereince. Once my body addapted to the movement and my pain meds were ajusted again, I was able to fall asleep in the machine for several hours. My flexibity improves all day, I was able to icrease my range of motion from 10 degrees to 30 degrees. Pretty good for one day. I have to be in this thing for the next 8 weeks or so to keep my range of motion high. This evening the pain is bearable...i'll sleep the best I can, with the hopes I will go home tomorrow.

The Backstory

In this blog I will chronical my experience having the ACI procedure along with a high tibial osteonomy.

This surgery is my last hope for some sort of normal knee function, as i have gotten older my knee has progressively gotten worse. This will be the fourth knee surgery I have had on the same issue. The first being in the summer of 1996 following my senior year in High School. The second was in Dec of 2003 following a minor cartlidge tear. During that sugery they found a major articular cartlidge defect. We went through a variety of programs, injections, and solutions to lessen the pain in the knee but due to the size of the defect and the location I would never be pain free without a largely invasive surgery.

I was referred to Dr Flannigan from Dr. Kaeding due to Dr Flannigan's familiarity with the ACI Procedure. On November 21st I had the first of two surgery's for the ACI procedure. The first part was a minimally invasive orthoscope where the Dr took two pencil eraser sized biopsies of my cartlidge and sent them to a company called Carticel where they would grow new cells.

This leads me to where I am today laying in a hospital bed recovering from the full ACI procedure and a high tibial osteomomy (realignment of the knee joint) I will begin with updates tomorrow. As the pain meds are kicking in typing is becoming increasingly more difficult.