The puppypocalypse

Swelling back up from about 3cm to 8cm :(

The Puppypocalypse
Sunday was my birthday, and there were people coming over after a nice dim sum lunch to play some board games, which was awesome.  We got a text the evening before, asking if the puppy could come visit, and didn't really plan well for having both of those things happen at the same time.  I was sitting forward on the couch to reach the table while playing the board games, and the puppy decided to get my attention by using the gap behind me to walk to my injured side.  When I didn't notice her, she tried to climb into my lap via my knee :(

The pain level spiked immediately to about an 8/10, and left me yelling/crying pretty hardcore.  Ended up back on the hardcore pain meds for a while, but the pain is slowly settling over the last few days down to a 5/10.  It should be at a 3, based on how I was doing before the incident.  The swelling should also be around or below 3cm, but it's up to 8 at PT, and was probably worse on sunday night/monday.  We called the doctor monday morning, and his assistant scheduled me an emergency appointment between his surgeries to check out the bones and make sure all the screws were still in place.  There was never any doubt on my end that the screws didn't move, since she stepped on the top part where the ligament reattachment happened, and not the osteotomy site on the top of my shin, but it was nice to get that confirmed by xrays this morning.

The prognosis
He showed me how to realign the brace when the swelling fluctuates, which basically blew my mind.  He lifted up a piece that was apparently attached to a strap by velcro, and I had NO idea this entire time.  He said that it will be up to my physical therapist to send him updates over the next few weeks, to determine how much extra time I have to wait before getting from 30 degrees to 60 degrees of flexion, but from a hardware standpoint nothing was ruined.  It's likely she pushed the ligament before it was ready to be pushed, and it decided to swell up as a response, and may add some time before I can bend it safely.  It's not safe to go past 30 degrees still for the time being, which I was hoping would not be the case when I was supposed to see him in a week and some change.

My physical therapist assured me this afternoon that we will get back to where I was before the puppypocalypse, but it may take more time.  She told me to hold off on all at-home exercises besides my ankle pumps which are more just to keep the blood moving in my feet, than real exercises like the rest of my muscle contractions or lifts/bends.  I'll get an updated list of exercises for the weekend on friday when I see her next.  The swelling is a setback, but hopefully it's one we can correct quickly.

Before the puppypocalypse
Halloween was a lot of fun; had a good time sewing again, and working with lycra was new for me.  There was a pretty decent turnout of people who came over for board games and drinks, and at one point we had two games of tichu going simultaneously.  The costumes were fun too -- see below :)

Ryan as "Link", Kristin as a "Creepy Doll", Me as "Esmeralda", Mindy as "Tina", Chris as "Lurking Sith Lord", and Lupe as "Nurse Joy".  Charizard and Squirtle dressed as eachother.

Neil and I had friends over for betrayal (at house on the hill) and dinner Saturday, which was a ton of fun, even though I almost set the apartment on fire by turning on the heater when charizard was pressed up against it- luckily my super sense of smell caught the burning before things got too bad.  He escaped with minor burns, and I was terrified of a little light that came on inside the heater that meant I did a bad thing, but it went away eventually.  The heater is on right now with no apparent further consequences, and charizard is a few toasty feet from the heater.

Had a nice visit from my uncle yesterday morning, who brought blue bottle coffee and delicious yogurt things.  Was good to see him and catch up, and looking forward to my dad coming up again this weekend while Neil is away at Blizzcon and Disneyland (SO JEALOUSSSSSSS).

That's all from me right now; trying to keep up with the pain without hitting the hardcore stuff too much.  It kinda sucks a lot, but I'm glad that it wasn't worse... it definitely could have been.

One month! Turning the corner?

Incisions on knee on 10-31-13 - completely sealed!

4.5 weeks post-op.  Hard to believe I'm here already, and yet have so far to go!

PHYSICAL THERAPY

I see the doctor in 18 days for my 6week checkup.  I'm looking forward to getting 60 degrees of flexion- I'm doing pretty well with 30 degrees, and it feels good to do my heel slides now.  It's like my quad is saying thank you lol.  After I get to 60, it'll be a few weeks before they give me 90 during physical therapy and let me keep my brace at an unlocked 60 degrees.  Next week we start using the cups to break up some of the scar tissue underneath the incision (which has finally completely scabbed over/closed up), which she said will be really painful, but help alleviate future issues.  Swelling is still elevated, but I'm holding steady at around 3 to 3.5cm, which is where I was constantly pre-surgery.  She said she would have expected it to go down a little more, but that it's not a deal-breaker for it to still be swollen 4 weeks after the surgeries they performed.  As long as it doesn't balloon up again, I'm at a pretty decent level for now.

TUMMY TROUBLES

They are all but gone, and two days ago something miraculous happened- I got my appetite back.  Now I have to keep the eating under control, but it's a releif to not be worried about be nauseous after taking a pill or having a cup of coffee.  I've still experienced the nausea with pain, but I'm told that's a normal thing.

PAIN LEVEL

I feel like I may have turned the corner that everyone said was coming.  Monday was alright until physical therapy, and after I was in a lot of pain.  I've been staying away from the hardcore stuff as much as possible, (unless I'm in an exceptional amount of pain) and on Tuesday, for the entire day the pain kept building, and the tylenol did nothing for me; I took half a Norco  and that gave me a few hours of relief before it came back again.  When I woke up Wednesday I felt sore, but not my usual throb-burn.  I did my exercises and took a nice hot shower, and felt pretty good!  I did physical therapy and told her about the pain monday, so she took it a little easier on me, and I felt good enough afterwards to go to the office for a few hours! I was definitely in pain later that night because I pushed myself so much, but it was worth it.  Yesterday I did nothing but work from home, and the pain was completely manageable with ice throughout the day, and some tylenol.  I'm still taking the Ibuprofen every day 3x for the swelling.  Point being, I feel like the pain level today (having done nothing too strenuous yesterday) is okay.  I'm hoping the trend continues, and really really want to believe that the hard part is over :)

WORK UPDATE 

I rode in the front seat on the way to the office, for the first time since my surgery- it was a pretty short drive after PT on Wednesday, but I think I'm not quite there yet.  At work, however, it was great to get some face time with my team.  We got to sit side by side and talk and hammer out some issues, and it felt so good to work with real people again.  I stuck around for the office halloween happy hour to chat and play games with my coworkers (drinking water instead of beer obviously), and had a lot of fun.  Definitely the morale boost I needed, and it seems like they were very glad to see me. 

SLEEP UPDATE

Using NyQuil has been really helpful for me, because when I wake up in pain, I get back to sleep pretty quickly.  Last night I decided I was sleep-deprived enough to forgo the nyquil (and it was late when I decided this), and what a mistake that was.  I couldn't fall asleep again once I woke up!  I was up and down constantly throughout the night until I gave up this morning, hobbled out to the kitchen and put on a pot of coffee and got online for work.  Today I will be trying to crank through as much as possible so I won't feel bad for signing off from work early, and definitely taking the nyquil again tonight.  If anyone has any suggestions on something other than nyquil like a natural supplement or sleep/pillow fort position that prevents them from waking up in pain so much, please please please advise.  My problem is waking up straining against the brace painfully, or on my side/back when I didn't fall asleep that way.  I don't want to be doing the nyquil every night forever- I'm sure even though my doctor is always amazed at how perfect my liver functions at my physical (despite that until last December I used to be a heavy drinker), my liver has had just about all the acetaminophen it can handle.

Overall, morale seems to be going up.  I think some pain relief and getting out of the apartment were just what I needed.  Friends came over to play games and such last night, which was fun and much appreciated. Looking forward to dim sum this weekend for my birthday :)

Two weeks in...

Sorry guys, this one is going to be more of a ramble/rant than a cool post with science.  I'm in quite a lot of pain right now, aggressively weaning off the narcotics.  There are more gross pictures at the bottom, with a gap above them so that whoever doesn't want to see them, doesn't have to.

Physical therapy
I'm back with my same physical therapist as when I was trying to avoid the surgery at all.  She's really awesome and understanding, and seems to think that the scar is healing well.  Yesterday she was very sympathetic to my plight, and went easy on me while making sure we did the necessary ROM exercises.  I was crying on my third rep of my first set, but it got easier once she let up on some of the exercises.  I'm really looking forward to being able to do a full leg raise by myself; I'm close, but can't quite get it off the ground/couch without a bit of help.  The bending to 30 degrees is going really well; I went from screaming when we did one to 20 degrees a week and a half ago to being able to do a full set of 10 without too much pain, and most of my second set as well (I do 3 sets of 10 total, 3x a day).  Additionally, I have quad, glute, and hamstring contract-and-hold sets (also 3x/day with 3 sets of 10).  When the pain is under control, I feel like I'm doing really well with them.

The pain :(
I had a lot of issues my first week getting my dosage right.  Last week we went to 2.5-3 hours between pills for a while, but the pain was very severe at times, and I just wasn't ready to do both my exercises and wean.  This week I now have to wean very aggressively because the doctor isn't responding to my calls about a half-refill so that I can wean at a reasonable rate.  As a result over the past couple days I've spent more time in tears than I would like.  Honestly, it sucks. A lot. I was assured by my physical therapist that because I was less than two weeks in, there was no rush to wean yet, and now I feel stuck because the doctor wont call me back, and his assistant says that no other doctor will sign a script because of the volume of narcotics I went through in the past two weeks.  I called repeatedly talking about how little they were doing for me unless I was at the maximum safe dosage, but nobody wanted to help me then :/.  She suggested I come back in for another follow up; it's possible that something isn't healing properly if I'm still in this much pain.  Or maybe I am simply a pansy.

Sleep deprivation 
My biggest problem is waking up in pain a few times, and eventually between 5 and 8 am, not falling back asleep.  We go to bed between 12 and 1 or so most nights, but I am usually awake longer because I can't fall asleep easily, now that I'm basically off the narcotics.  The pain yesterday morning when I woke up was excruciating, and I sat on the couch for a few hours after taking an extra strength tylenol and an Ibuprofin 600mg icing my knee; eventually after about half an hour of crying I freaked out and took half a norco.  I'm normally a tummy sleeper, but obviously with this clunky brace on, and the pain I'm in, sleeping in any position besides on my back is very difficult to get into/out of, and generally results in me needing to readjust after short periods of time, which I can't do well if I want to sleep.  I'm looking for sleeping positions that worked well for other people; if you know of any please email/facebok/text me, I would love to try something other than just laying on my back, hoping I'll pass out.

Wound healing pics below. They show the incision, so if you don't want to see it, don't scroll down :)

When the doc sent me home after my first post-op appointment, he told me the steristrips would come off on their own, and to leave them alone until about thursday, and help remove them after that point.  

Friday came around with no sign of them budging so I took matters into my own hands...

There was one that was stubborn (left picture), and the ones around it were bleeding a bit more, so I left it alone, and took it off in the morning (right picture)

 Yesterday when i was cleaning the wound with antiseptic spray, I noticed a yellow-blood tinged pus draining from the nasty spot on my lower incision and freaked out.

See? That's totally gross.

But this morning aside from that nasty spot, pretty much everything is lookin good.  My physical therapist advised me to keep the butterfly bandages on until theres no blood at all. 

Post-op Checkup #1 Complete!

Yesterday I went to the doctor to have my dressing changed, and x-rays taken.  It was my first time leaving my apartment since the surgery, and while it was nice to get out, it was very taxing on me.  Also, given the full disclaimer that I was on narcotics at the time of the sighting, I'm 95% sure Adam Savage and I share an orthopedic surgeon.  Seems like it's plausible that his wrist is BUSTED! I crack myself up...  Either way, I wish either Adam or his doppleganger a speedy recovery :)

Anyway, good news for me!  The x-rays came out normal, which means that so far I'm healing just fine :)  He took out the sutures on the skin and put some sterilization tape over the wounds, which will come off on their own.  With the dressing gone, it's a lot easier to lift my leg, and do my exercises.  I can start weaning off the pain meds later this week too, and I start physical therapy tomorrow- so much going on!  Here are some of the less *icky* pictures from my orthroscopy.  I will include some of the more gruesome kind at the bottom of the page (below a large gap) so that nobody *has* to see them, but the option is there.

I'm alive!!

First and foremost: Owwwwwwww!  

Now that that's out of the way... Surgery went as well as it could have :)  Final operations were:

1 - lateral release

2 - bone removal

3 - fulkerson's osteotomy

4 - MPFL repair (not reconstruction!!)

Less than a week! (again...)

I've been in a ton of pain for the past week; it seems the cortisol injection my dr. gave me has worn off, and I've been having a pretty rough week.  Even a few steps without the crutches can be incredibly painful.  On the bright side, the surgery is coming up, and the prep work is almost done :)  Special thanks to anyone who volunteered to help move my stuff tomorrow in exchange for beer, pizza, and company.

New Surgeon!
After a long time dealing with my original OS's office trying to get the scheduling finalized, I thought I had October first locked in.  The assistant lady went on vacation again before I got all the details confirmed, and it was difficult to get answers.  I had my family change flights to accommodate the change in date, and then last week she called me asking to push out to the third.  I called up the guys at UCSF that I saw for my second opinion, and they had me scheduled for the first with all of my pre-op appointments and post-op instructions emailed to me within minutes.  Literally minutes!  And they're a 5 minute drive away, as opposed to the other side of the city, which is great.  Sure it wont be with the surgeon who i spent the most time seeing and growing to trust, but at some point the tradeoff isn't worth having my family rebook their flights.  And this new guy seems super legit; both times I saw him he was amazing at explaining all the technical details of what he would do and why.

Second opinion: yeah, your knee is pretty messed up.

Today I got some good news, as well as some bad news at my second opinion.
The second opinion Dr. took some xrays and looked at my MRI.  He says that there's no point in going back to physical therapy before surgery, but I should still continue as many of the exercises as I can.  Balance ones especially will be key.