Sunday, January 27, 2013

As Time Goes On

It has been almost 11 months since my last surgery.  I would like to say that everything is going wonderfully, but when you have had so many problems over such a long period you start to question yourself. 
I still have some numbness and tingling feelings in my legs.  I can poke and touch them, but if my Fiance rubs his foot on certain spots on my legs I just can't stand it.  It's an indescribable feeling.  It's almost as if I cannot feel it, and at the same time, it's like he is tickling me, or pushing really hard- all at the same time.  Weird. 
I wear compression socks every day.  I have 2 pairs of medical ones, and about ten pairs of Smartwool PhD compression socks.  They both have pros and cons.  I like the Smartwool ones because they help to wick away moisture, while the nylon ones make my feet sweat and stink.  The medical ones are a bit tighter, and work very well in the summer because I can wear open-toe sandals.  But I am very picky about what sandals I buy now because there has to be a band that goes across the front of the foot that is thick enough where the sock can end underneath it.  That way it doesn't look as weird, or so I tell myself.  I still have people kind of stare at me because they cannot figure out if I am wearing nylons or not.  And usually I just explain the socks, and they are very relieved because they did not want to ask about it, but you can obviously see them staring.  The only person who has come right out and asked me is my future mother in law.  One day as I was standing in her kitchen, she turned to me and said something like 'what is up with your nylons?'  It doesn't really bother me because I know that they do help a lot.  I can notice a difference in the way my legs feel after a day of wearing them versus not.  And when I do any kind of intense workout, like Insanity, I cannot workout without them on.  But if I am just doing the elliptical, I am just fine in regular socks.  However, I have become a fan of diabetic athletic socks.  All other socks seem to be too tight at the top, even my everyday Smartwool socks are too tight if I leave them up.  I have to fold them halfway down.  I have heard that there might be some companies that are starting to make cute designs for the compression socks, but for now I just have plain colors. 
Working out has not been a top priority of mine for more than two years now.  I'm not sure if I am just afraid to jump back on the horse, or if I begin a normal regime the symptoms will begin to flood back.  I still have pain in my legs, sometimes for no reason at all.  And my feet like to go to sleep quite frequently.  I have learned that I should not cross my legs,  the angle of my thighs cannot be too tight to my torso, athletic shoes often cause pressures, and I often have to change positions when in a chair or car for any length of time.  Don't get me wrong,  the numbness and falling asleep is not as in depth or frequent as it was before my popliteal entrapment release, but it is still plenty of cause for caution. 
I now live in Minnesota, and am not associated with the UW Health system in Madison, so the thought of making a quick appointment with Dr. Turnipseed to check things out is out of the question.  Where would you even begin?  For now these are just thoughts in my mind.  Will I live with these feelings in my legs for the rest of my life?  Are these the feelings of post surgery, or are they the initial feelings of yet another round of incisions?  Only time will tell.

Sunday, July 29, 2012

Getting back to it

Here we are 3.5 months post surgery and I am finally getting back into a regular excercise routine.  I think it's the fact that in the recent past every time that I begin to excercise with any real frequency I begin to experiance more symptome that I have not jumped back to the gym as fast this time.  But I am trying to mentally prepare myself and begin to better myself once again.  There is still quite a bit of scar tissue around y newest incisions, so hopefully the workouts will help to break it up.

Saturday, March 31, 2012

Real Life Begins. 3 weeks

I traveled back home last weekend. A four hour car ride is not the most comfortable, and left me with even more edema.  But at last I was home and could sleep in my own bed.  There is only one problem with this- my cat thinks she wants to sleep on my feet! Ouch.
For the past week I have been taking it easy.  I did office work on Monday, Wednesday, and Friday.  Not too much standing on my feet, and therefore not too much pain either.  I was very excited on Wednesday when I put on real socks (compression socks) and athletic shoes for the first time.  Although it is easier to use ace wraps to keep swelling down, they do prohibit a good walking pattern, and also look simply dorky.  It takes quiet a while to get the compression socks on, but once they are in place I leave them on until the moment I crawl into bed at night.  I am using over the counter compression socks at the moment, about 20-30 mmhg.  They could be tighter on the lower leg, but then again then they would be even harder to get on.  I do have a prescription for some medical grade socks, but I think I'm delaying on those in hopes that they will soon come out with some cool, non-grandma colors.  I already have 2 pairs of those that are thigh highs, and very HOT.
The incisions and blow holes are healing nicely.  I no longer have bandages on them and have starts to peel the steri strips off, little by little.  The true test will be when I am working on my feet all the time again.  Today I am working at the clinic, so it's lots of ups and downs.  But at least it's not being up all the time.  And starting on Monday I will be working my retail job again, but they are being very nice and starting me out with 4 and 5 hour shifts.  And they say if I feel up to it I can stay longer, and if not I can just go home.  It's a much better plan than what we did 2 years ago with that surgery.  Back them I though that after 1 week post op I could jump back into being on the floor full time with 8 and 9 hour shifts, and doing clinicals. HA.  You live and learn.  My body is worth much more than a paycheck.  I want to be able to use it forever and for it to work well so this time I am taking it slow and making sure that things are done right. 
The only thing that I am not doing very well right now is the working out.  I have worked out twice in the past week, but the NP said I should be working out every day.  If there was just another hour in the day I could get so many more things done.

Monday, March 19, 2012

Progress. Day 11

It's been five days since my last post.  The long pause is because there have been no problems!  The tubes came out on Wednesday and here we are at Monday.  It seems like time is flying.  Only 1 week from today and I should be back to work, at the office at least. 2 weeks until I am back at my actual job though because it's tad too physical. 
My extended weekend was filled with progress.  I began to hobble around with only one crutch and just picking up my crutches.  It's still a bit difficult to get off the couch without the assist of the crutches.  Now I am walking around the house without crutches at all!  But I do take them for the assist when going outside.  Going to the neighbor's house proves to be an uphill and uneven endeavor, literally.  But it has been so nice to be able to sit outside the past few days and get a knee and upper thigh tan.  Seeings that I am still wrapped up from toes to knees, there is not a lot of exposed skin. 
My boyfriend, Kingsley, came down this weekend to see me and I was so happy to see him when he arrived three hours earlier than expected!!!. We laid low most weekend, watching T.V. and relaxing. But on Saturday Mom, Kingsley and I went to Super Wal Mart, and Mom insisted that I get the gimp cart.  Let me tell you that you get lots of looks, and people don't move out of the way very well for you.  But I really enjoyed Mom's scared face because she kept thinking that I was going to run her over.  But there is not enough speed in that thing to do much damage.  On the way back I wanted to stop at Culver's to get a lemon ice (my favorite), and when we drove through the drive thru I was so sad to learn they didn't have it on the menu yet.  And on Sunday before he went back to our house Kingsley and I went for a drive and did a bit of shopping at Woodman's Grocery Store.  I must say that I did a great job of walking all around the whole store with only my crutches.  That's the longest walk that I have taken so far and I wasn't even tired.  I think that's quite good; I'm proud of myself. 
As of today I haven't done much.  I've been trying to get rid of this edema that I have had going on since Thursday.  My ankles, feet, and toes look like little sausages.  My right foot looks a little less swollen after I raised it to the back of the couch while watching T.V. last night, but the left one still needs more work.  I just wonder how long it is going to take for all of this swelling to go away.  I wonder if I am going to fit into any of my shoes?! 
I have another post-op appointment tomorrow, so we shall see how that goes.  Unlike the last surgery I am not having problems and things go wrong, so the appointment shouldn't take too long.  I do need to get extra ace wraps from then because instead of using the clips they come with we throw them away because they usually reach through all of the layers and bite you.  Which is the last thing you need after surgery.  So instead we use tape to secure the bandages, but they tend to get gummy with residue after only a few days.  Plus you want to keep the bandages as fresh and clean as possible for sterile reasons. 
Every night lately I have been unwrapping the ace wraps and let my legs breathe and relax before changing the bandages out and re-wrapping them again.  And that's what I'm about to do.  Talk to you later.

Wednesday, March 14, 2012

OUCH!!!! Day 6

Well today was the expected and determined to be the day that the tubes came out.  As I had said earlier I had 4 drains put in my legs after surgery, one for each incision.  I had a different Nurse Practitioner today than i have had in the past, but I don't mind.  I cam prepared too.  I took 2 pain killers before the appointment, and I tryed mixing it up.  But nothing ever seems to really help.  I took one percacet and one oxycodone 30 minutes before my appointment.  As I entered into the room I removed my shoes, lifted mysef onto the table and slid out the foot extender.  I've got this down.  The NP asked about pain etc, and I said it was average, and we got to work.  We took off all the ace bandages, gauze wrap and gauze pads.  Next I asked for a towel to hold (squeeze) instead of Mom's hand.  The NP walked me through everything each time which was nice.  We started with the right outside incision. First she snipped the stitch holding the drain in at the top; no pain. Then she removed the stitch;, slight pain.  Next she removed any crusties that had formed over the opening; more pain.  She then said she was going to make me breath a bit, and pull the drain out in one swift motion.  I will warn you; this hurts like a BITCH.  I have been through this many times now and this is by far the worst part of surgery.  Last time I was given a morphine injection, and that didn't even help!  I said I was ready, and in about a second and a half it was out.  It hurt, but not absolutely horribly.  Wow, it wasn't horrible.  Don't get me wrong, you could feel it being sucked out of a tiny hole, and it hurt, but it has been much, much worse in the past.  We moved onto the right inside.  She snipped the stitch, took the stitch out,  removed the crusties, this was all just like the last one, maybe a bit worse.  Next came the bad part.  She pulled the drain out, and ohh my lord.  You know it hurts when it takes your breath away.  You can't even breath at all, can't swear, can't move.  That's when you know it's bad.  That is what it normally feels like.  The left inside was just the same excruciating pain, but thankfully the left outside only hurt as much as the right outside.  Why is this; I cannot explain.  All I can say is that after you go through something like this, childbirth should be a breeze; however it will take longer.  I took a few pictures at the visit, including one to show the size of the jackson-pratt drains.  I'll give you a hint.  Do you know how big a pen is?  At this point we are all done.  We put some gauze over the open 'blow-holes', we now call them these from all the fluid that came out of them after the drains were out and the NP was expressing the incision area.  The holes may also may resemble blow-holes in their size too.  We wrapped them up and we were on our way. 
If you can believe it I was already feeling better.  To get those drains out turns the recovery process forward about 10 steps.  I went home, ate some lunch, took a small nap, and enjoyed the 81 degree weather we had today! Awesome.  Did you know it's the middle of March in Wisconsin, because Mother Nature apparently turned the weather forward at least 10 weeks.  But that's okay with me. 
As we are getting into the evening I have been icing quite a bit today, but haven't had any pain meds since before the appointment this morning.  Mom gave me my injection tonight and it barely hurt! And we undid and redid the ace bandages and gauze because I thought it was leaking onto the ace bandages, but it was not.  We replaced the gauze and rewrapped the bandages, and we should be good to go.  I cannot wait for tomorrow, because I get to shower as soon as the blow-holes are scabbed over.  Well I might do it a bit early, as I have not been able to do so since surgery; gross I know.  But that's all for now, we are on the final stretch!!!!!

Monday, March 12, 2012

Day 4, Monday

I'm not very surprised at anything happening right now.  Not too much sleep again, lots of napping, and quite a bit of pain with any sort of movement.  It seems that as long as the bandages are loose enough on the ankles there is usually no pain while I am not moving, but as soon as I begin to adjust, the pain begins.  The right leg hurts more than the left and the anterior incisions hurt more than the posterior.  I had the first follow up appointment today.  We took all the ace bandages, gauze wrap, and gauze pads off for the first time.  Each drain (there are 4 of them) is attached by a single stitch just above the associated incision.  In my opinion these are not very well attached.  If the tube moves at all you can feel it, and the stitch moves and therefore is painful.  I just got done un-wrapping and re-wrapping my legs again. It seems that no one can get the bandages set perfectly like I can (and that's still far from perfect). Mixed with the fact that the drains are coming out of my legs at 4 different points and attached by a single stitch means that I need to help secure then with the bandages so they can not be pulled by anything.  And I've had to tape down one of the drains because two of the drains/balls keep getting tangled when I walk and therefore stopping me in my tracks.  I'm already moving slow enough as it is. 
The legs overall are not too swollen.  There is a puffy spot below each of the anterior incisions.  My Nurse Practitioner was not too concerned about it though.  I still have quite a bit of fluid coming from each of the drains, but to be able to take them out there should be less than 10cc's coming form each drain.  We will leave them for the next appointment on Wednesday, which is what I figured.  I have too much experience to even have had a glimmer of hope for the drains to be taken out today.  But I am quite sure they will take them out on Wednesday because they will have been in place for 6 days and at that time they start to pose more of a caution of starting an infection rather than being a tool to remove excess fluid.  I will give you a small precursor to Wednesday's post: there will be a lot of drugs taken, and an extreme amount of pain involved with the removal of the drains.  The last time I had the drains removed I was given an extra shot of morphine in the hospital and was still jumping off the bed in pain.  I was given percocet from the hospital, but got a prescription for oxycodone today because the other medicine was making me sleep all day.  I've also had a low grade headache for a few days and a touch of nausea, so I'm hoping that switching meds will help all around.
In other funny happenings, Mom calls 9PM the strip and shoot hour.  AKA, she strips and measures the drains, and gives me my blood thinner shot which also hurts a lot (but hurts less the slower that it is injected). 
No more fun news.  Dad and I are on our own tomorrow as Mom attempts to go back to work.  I have a feeling my sister, nephew and niece might show us at some point.  I just hope Dad and I can agree on what to watch on TV all day long.  haha
 

Saturday, March 10, 2012

Surgery Day

Yesterday, Friday March 9th was surgery day.  We arrived at the hospital right on time (7:45 AM) and began checking in.  Upstairs in my pre-op room I started to go though more and lots of repeat questions with the nurse when she got a call that said that surgery was being moved up an hour.  Which is good, because it's usually running late.  So we began rushing through things, lots of washing, vitals, IV, antibiotics, etc.  Physical therapy came but I said I was confident in how to use the crutches and we only have 3 stairs to get into our house.  I was the easiest patient of her whole day!  The anesthesiologist came in, and a few moments later Dr. Turnipseed was in to see me too.  Sure enough they took me to surgery a few minutes later.  As we arrived in Operating Room #3 we were the first ones on the room, but it was all set up.  I slid over to the surgical bed, everyone came in, hooked me up to lets more equipment, gave me some good drugs in the IV, and I was out.  There was no counting down or anything. 
I woke up in the recovery room just after 11AM, there was a PACU nurse and a student nurse.  Taking lots of vitals, asking me if I knew where I was, how the pain was, etc.  The male nurse from the OR came in and checked on me too and explained to the student about my surgery because she was not familiar with it before this.  He explained that compartment syndrome is most common in athletes who do alot of pounding.  He said that the fascia that surrounds the muscles was too tight and doesn't slide along each other, so they go in and take a piece of fascia out from the muscle.  And the Dr. stuck his finger in the incision between the muscle and fascia and separated and tore off the fascia from the muscle because it had adhered to itself. 
They had decided to put me on blood thinners after surgery to help prevent against any more blood clots, and therefore to help prevent against and extra blood and fluid collections they decided to put a JP drain in each incision.  YUCK.  Not only are they unsightly, but the drains need to be stripped, drained and measured every 1-2 hours for the first 24 hours, and 2X per day thereafter. 
From the PACU I went down to recovery room 208 around 12PM.  The next few hours were filled with lots of vitals, toe wiggling, pain management, and napping the whole time.  I did not push through the requirements of getting released.  To be able to go home you need to drink, eat, and pee.  When I arrived in the recovery room I napped a bit, then Mom came in and I had a few more ice chips.  Then something happened which I have not yet experienced after surgery.  Puking. Between the meds and the traveling, it happened.  But as soon as it came on it was gone.  Napping, followed by more napping and some more napping, I ate some more ice chips, and finally asked for some juice and crackers.  It wasn't until almost 5PM when I finally decided it was time to use the restroom and think about heading home.  I got dressed, the nurse gave me my first injection of enoxeparion (blood thinners) in my belly, and gave us a whole lot of dressings, wraps and other miscellaneous things to take home with us.  I took a wheelchair down to the first floor and just after 6PM we were on our way home.  By this time I was beginning to feel hungry so we stopped at Culver's to take some dinner home with us. 
We ate dinner, took more meds and watched some television.  About 9PM we decided to attempt our spotted night of sleep.  Mom is on the long couch, I'm on the small cough with the recliner fully extended, and Dad (who just had a total knee replacement 18 days ago) is in the big recliner.  Mom set the alarm for 2 hours and we all fell asleep.  The alarm went off every 2 hours and Mom stripped my drains, and game me more meds.  Of course we woke up more than just every 2 hours but we won't say who was snoring.  Also, the right ankle seemed to have been wrapped up too tight because every time I woke up I was trying to adjust it.  Finally I just unwrapped the right foot from the toes to the bottom of the ankle.  Much better. 
Morning came about 9AM and we slowly began to stir.  The pain is much greater today than it was yesterday,  But we are trying to keep it under control with meds and ice.  Lots of napping again and trying to be a bit more awake today.  Mom redid my right ace bandage to ensure I am being wrapped correctly.  I want me feet as high as I can get them.  It seems that they are the most comfortable with about 4 pillows under them and the heels to be a bit higher than everything else.  I can feel the anterior (front) incisions more than the posterior (back) ones. 
Sam and Alexis cam over to Mom and Dad's house today to help take care of us and set things up for an upcoming wedding shower.  And Dad went with the neighbors to a surprise birthday party for another neighbor. 
The pain today is worse than yesterday but no where near as bad as it was in the Fall for the popliteal entrapment release.  The good news is that from here on out I should just get better and better.  I can't wait for a week from today to see how much improvement is made.