Tuesday, April 15, 2014

Post-Op Day 4 roundup

Well, its been four days since the surgery so its prime time for an update.  Here it is, day by day.

Surgery day

After I woke up from the anaesthetic, I was in a Zimmer splint with the ice man pack inside.  I couldn't move my leg at all, and had to be helped from the bed to walk on crutches.  I felt nauseous and very sleepy, but not in much pain, probably thanks to the freezing they put into the leg during surgery.  Back home I kept falling asleep as the anaesthetic wore off, and I was very thirsty.  I kept ice on the knee and had it elevated.  Surprisingly, I didn't have much of an appetite, despite fasting since early the night before.  I did eat in the evening, and slept ok that night, waking up only a few times to adjust the leg.

Post-op day 1

As the freezing wore off the pain increased.  The knee felt numb and raw and swollen all at the same time.  It was painful to put it in the splint and to get up, and every movement caused new pain.  Even lying down and icing was painful.  I was prescribed Naproxene to be taken twice daily and Percocets in case pain was unbearable.  I wanted to stay away from the latter, but ended up giving in and taking one that day. 
I tried to do the exercises (knee flexion, hamstring stretches) every few hours, but without much success.  The stretches were ok, but I felt lots of tension in the tendon when flexing the knee which was decidedly unpleasant.  I figured I would do my best, but wouldn't push it too much until I saw the physiotherapist on day 3.  
The second night was less comfortable than the first, but I was still able to sleep more or less through the night.

Post-op day 2

The second day was not very different from the first.  I mostly stayed in bed, elevating the leg and icing.  Getting into the splint and walking was rather painful because of the swelling, and so was doing the exercises. 
The most important goal for the first week after surgery is to get the knee flexing to 90 degrees.  On the second day this still seemed like a very far away if not unlikely accomplishment.
That night was the worst.  Somewhere in the middle of it I finally figured out the best way to lay out the cushions under my leg - three under the ankle and lower part of the calf, two under the knee (so that the actual knee is in the air), and a thin one under my butt so the hip doesn't get too tired, with the ice man pack on the actual knee.  Not the most comfortable way to sleep, but you will if you're as tired as I was by that point.

Post-op day 3

I tried coding for a bit, but soon realized that I had trouble concentrating.  It may have been the restless night, or the post-effects of the anaesthetic, or the painkillers, but in any case I vegged out and stayed in bed most of the day.  I had a bit more luck with the exercises, pushing through the pain and getting through suppine knee flexions a few times.  
The pain was not as bad as yesterday, though the whole leg still felt swollen and raw.  I took a Percocet because in the evening my dad drove me to physio, and I knew the car ride would be uncomfortable.  Even with the pill I felt every stop and start echoing somewhere in my knee.  
Karla (my physiotherapist) changed all the dressings, and I got to see my war wounds for the first time - the incisions are actually quite small and seem to be healing quickly.  She measured my knee flexion - I was at 55 degrees at the beginning of the session, and at 66 by the end.  She massaged my leg to release the tension and get rid of fluid accumulation, and the leg felt a lot better after the session.    
To the exercises I was already doing she added: 
- knee flexes sliding up and down a wall
- calf stretches
- toe points with therabond
- quad squeezes
- hamstring squeezes
- self-massaging the hip and the quad

Post-op day 4 - Тoday

This is by far the best day since the surgery.
I slept better last night, though I still woke up every two hours to adjust the leg or to ice it for a bit.  I also felt better able to concentrate, although I decided to make it another sick day.  I walked a bit without crutches - slowly and carefully, with the split on, but without crutches!  And I got through all the exercises, pushing through the pain and feeling the flexion increase.  I spent the day reading and writing a bit, mostly sitting on a chair with the operated knee either flexed on the floor or up on another chair.   I also managed to lift the leg up about 15 cm lying down, which means that my muscles are starting to come back.  And that makes me super happy!
Another physio appointment tomorrow, and that 90 degrees no longer seems impossible.

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