Rainy Saturday

The summer rain is falling pretty hard this morning.  I hear it on the skylights.  I’m very happy for the rain because I don’t feel like I have to rush and do anything.  Rather I can lounge on the couch over coffee with my computer and give you an update on my knee and my RA and my weight.  After all, this is a blog that started about an overweight, 50 something woman with RA.

After the pity party post from 2 weeks ago, I did rally.  I always rally.  As a matter of fact, one of these days I’m not going to be able to rally, and I wonder what happens then.  I’m back at work and it’s exhausting and painful, but I manage to get through most of the day.  The knee seemed to be at a standstill for a time, and as a matter of fact last week one morning it got excrutiatingly painful again and I went to see the doctor.  I could barely walk into his office.  It was 30 minutes before he could see me in which time the pain and inflammation subsided a bit.  He told me that it was going to take time and patience and maybe I was doing too much and had gone back to work too soon.

Well you tell that to my clients, but I did listen to him and I’ve moderated a bit.  I make sure to elevate and ice my knee regularly.  I’ve worn the compression sock occassionally which helps.  I also had a huge revelation.  Because of the pain and discomfort and my inability to sleep I’d been taking 2 advil pm’s at night.  Which is a blood thinner, so I wasn’t helping my situation in the least by doing that.  The morning I ended up back in his office I had also taken 2mg of Prednisone to put the RA at bay and I believe that contributed to the pain and inflammation that morning.

I’m walking about 5000 steps each day, trying to get the right blend of activity and rest.  I’ve started doing mini squats to help strengthen my thighs.  I swear that some day soon I’m going to wake up and feel like I did before this bleeding episode.

On a lighter, funnier note, this week was wellness day at my office.  My company participates in wellness programs at work and in order to get the preferred co pay levels, I am required to participate.  I have a Virgin Pulse app on my phone that I track certain items with, I do competitions with coworkers and read helpful hints each morning.  Participating employees must complete a health screening either at their doctor’s office or at one of the screening days at the office.  So I did that this week.  My glucose and cholesterol were great!! My blood pressure was a tad high but I was in pain that morning.  However, I’ve lost 20 pounds since last year.  I knew I had lost weight, but didn’t know how much.  I was pretty psyched about that.  However, the BMI chart states that I am still obese.

Sigh.  I can’t win.  But perhaps I can lose 20 more by next year and get below 30 for my BMI.

Have a nice week everyone.  Stay strong and positive.

I’m not Wonder Woman

I’m done.  Really, that’s how I feel.  I’m totally done with sitting on my couch, being in pain, burning incisions and watching life pass me by.  I expected to rebound from last week’s setback a bit quicker than I have.  I still have major pain and stiffness in the newest knee that was doing so good until the joint filled with blood.  I have taken a couple of longer walks, but the knee is still stiff.  By yesterday I felt like I just wanted to have a good old cry, but I didn’t give in.

My return to my RA meds was delayed by a week due to the setback last week and that hasn’t helped.  I can manage three weeks off the meds, but then after that, the pain is excrutiating and it takes several weeks for the meds to kick back in when I restart them.  I started them Thursday, so they won’t reach full effect for another week and a half at least.  Which means the pain in my joints in the morning is strong.  I thought the knees were the worst of the RA joints, and replacing would rid my body of RA, but that’s not the case at all.  My shoulders, wrists and fingers hurt daily.

The weather hasn’t been conducive to someone with inflamed joints either.  It’s been raining like heck here for 2 weeks.  The morning might be sunny, but then the rain comes.  Today and tomorrow are just rain.  No sun.  I felt better when I saw two friends post on facebook last night about pain in their joints due to the weather.

Yes, I’m whining.  It’s totally not my style.  I promise this is the very last of my whining.

Three week mark

tkrimage of total knee replacement

 

I hit the three week mark from Surgery 2 days ago.  I had a setback over the weekend and wasn’t sure if I wanted to post about it, but decided I would.  Maybe someone else has had a similar issue.

I had the staples removed last Thursday and felt great.  My doctor was impressed with the range of motion and how good the scar looked.  He said I was healing really well and to keep it up – keep moving and walking.  Which I tried to do, but Saturday morning I was a bit lethargic and just didn’t feel right.  I told Mr. Phat that I was going to spend the afternoon on the couch while he spent a couple hours working.  Shortly after he left, the knee stiffened up and the pain started.  And kept coming, and coming.  Very strong pain.  Mr. got home about 90 minutes later and we decided that he would drive me to my surgical hospital.  Unfortunately I couldn’t move at all, the pain was excrutiating.  Instead we called the local town ambulance and they arrived quickly.  They loaded me, screaming in agony into the back of the truck and then before we even left they put in a IV and gave me some pain meds.  They couldn’t take me to the surgical hospital because it’s over state lines, so they took me to the local ER where I got very good care, but they wouldn’t do much beyond Xray and blood tests because they wouldn’t interfere with another doctor’s surgical sight.  The doctor in that ER suggested that it might be infected, in which case the new replacement joint would have to come out immediately.   They conferred with my doctor over the phone on Saturday evening, medicated me again, put me in Mr.’s car and we drove the hour to the other hospital.

Naturally I focused on infection because I had started back on the RA meds that week – one injection of methotrexate and 2 Xeljanz XR pills.  Could that little bit have brought on an infection?  I had taken my temp each day and never had a temperature, so I tried to think positive.  The thought of a third knee replacement surgery in 15 weeks was more than I could handle.

My surgeon saw us by 9:30pm, aspirated some of the fluid, discovered it was mostly blood and said it was most likely a hemarthrosis, which is bleeding into joint spaces.  My surgeon had requested that I take 2 baby aspirin daily from the day of surgery until the day the staples came out.  I’ve taken 1 aspirin for many years on advice of my Primary doctor, but 2 proved to be too much and it thinned my blood too much, causing the bleeding into the joint.

I spent the night in the hospital for observation while waiting for the test results on the aspirated fluids, to be sure there was no infection present.  Thankfully, tests showed no infection.  No surgery necessary, just some ice and rest.

I’ve been home since Sunday afternoon, back on my perch in the living room on the sofa.  I’m tired of being here, but thankful that this will resolve on it’s own with time, rest, and ice.

Monday, Monday

Good morning friends.  I’m doing fine except for the itching!!! It’s driving me nuts!! I have been itchy since the second day in the hospital, right on the incision, around the incision and all over my body.  Benadryl doesn’t really help, half a pain pill helps when it’s really bad, and mindfulness works only to a point.  Naturally it’s at it’s worst when I lay down, so sleep has been elusive of late.  My fitbit says I’m sleeping about 4 hours a night.  No wonder I’m tired during the days.

Three more days and the staples come out and I cannot wait!!

Good Evening

Happy Mother’s Day.  It was a low key day here, as the week has been.  Had Total Knee Replacement of my right knee last Monday, came home from the hospital on Wednesday and have been working on healing since.

From the very beginning, the procedure and the interaction with the hospital was far better than 11 weeks ago when I had the left knee replaced.  The hospital had completed their transition to the new computer system so I could tell that everyone on the staff was less stressed.  My ortho and the  Anesthesiology team was on alert to be sure not to repeat the painful visit to the recovery room that I had last time.  They were so good with the concoction that they gave me as I left the OR, that I slept soundly for almost three hours in recovery.  And the nurses on staff made sure to medicate me before I went up to the floor.  I was in my room by 3:30pm and the PT and OT were there at 4:30 to get me up. And I got up, went to the toilet and sat in my chair for dinner.

What a difference.  One of the physical therapists said to me that all joint replacements are different and I certainly believe it.  This new replacement has had a few episodes of pain, but nothing like the prior one.  I have pretty good mobility as well, and was at about 93 degrees bend the first day.  I used the walker at home for a day and then switched to the cane.  You can’t carry a cup of coffee when you’re using a walker.

Another big difference is the bruising.  My first knee had almost no bruising.  This one has varying shades of purple, brown and yellow from my groin to my ankle, both front and back.  So while it’s fairly ugly to look at, the pain level is minimal.

I’m off all my RA meds except for one celebrex per day and unlike the prior surgery, I’m having NO RA symptoms, which I find amazing.  I’m barely taking pain meds so that’s not mitigating the RA symptoms.  I just feel pretty good.

Admittedly, I’m a little tired of my couch, and my icing machine and my pj’s.  I’m looking forward to getting a few steps beyond rehab and back to living.  I can see the weeds growing as I write this.

T minus 9

One week and 2 days before the other knee gets replaced.  I am so glad.  It’s so painful all the time.  Every movement hurts.  I saw the doctor this week for my pre surgical appointment and he took xrays that I’m not going to share here, but just rest assured that it was ugly.  Bone on bone throughout the entire knee.  I’m sure it’s my imagination but the pain seems worse since I saw the xray.

We talked about this surgery and you might recall that the last surgery had a little glitch in the recovery room where my body had metabolized the epidural, and the pain was increasing and my room wasn’t ready and they said they couldn’t give me pain meds in recovery and they needed my doctor’s permission.  I’m sure the doc was back in surgery, and I never believed the bit about not giving pain meds in recovery.  Isn’t that what recovery is all about????

At any rate, my surgeon acknowledged that people do metabolize medication at different rates and that when I was coming out of the OR into the recovery room he would make sure that they gave me some pain mediation right at that time.  I was much relieved to hear that – it was the only thing that I was really reticent with having another surgery.  Other than that, I am ready to face this head on and I look forward to when I will not limp when I walk and when I can actually set out with my dog on a 2 mile walk.

That comes closer with each day that passes.

April Showers

It rained here Friday night and yesterday.  Cold, damp, rainy day.  I treated myself to a day in my PJ’s.  Did a few things around the house, did some reading, watched some sports and the movie Patriot’s Day.  It was better than I expected.  I had read some harsh reviews when it first came out, but I thought it was well done and I shed a few tears.

And tomorrow is Opening Day for Baseball.  I’m excited for a new season and my Red Sox.

My knee?  The new knee is just over six weeks old.  Boy does it feel good.  I get an occassional twinge of pain, but all in all it’s terrific.  I saw the doctor last week and he was very pleased that I could fully straighten and bend the knee.  The only issue was some dissolvable stitches that had not quite dissolved all the way and were poking their way thru the scar.  So he had to gouge in there and clean them up.  OUCH!!  Not pretty.

My primary reason for the visit wasn’t to check on the new knee however, but to talk about the other knee.  The “Old” knee.  The formerly good knee turned very bad knee.  I feared he would tell me that it was too soon to consider replacing the other one, but since I’ve been seeing him for that knee since June of 2009, he was emphatic in his agreement with me that now’s the time.  I am bone on bone and the pain is excrutiating.  Sleep eludes me most nights because it’s too painful and movement wakes me up.  There is no meniscus in that knee and I’d had it glued together with Hyaluronic acid injections for about 6 years, but the injections are no longer covered by my health insurance and the orthopedic wasn’t confident that it was the best choice.

So…. drum roll please…… I will be having the other knee replaced on May 8th.  I wish it was tomorrow.  In the meantime, I will be working very hard for the next 5 weeks to catch up on my clients from being out for the first knee, and I need to get ahead for the upcoming surgery.

So end of the summer I will be back in action, running fitbit weekly challenges and maybe taking in a round of golf.  I wonder how the new knees will impact my golf game?