It all began back in September when we returned from the UK. No one is sure why but suddenly my knees deteriorated to the point I couldn't walk without pain and so after seeing a specialist I started a 10 point plan to try and improve them - aim to walk the Abel Tasman at Christmas time. Looking back the specialist was a bit sceptical about the success of my plan but gave me all the encouragement I needed to give it a go. Sometimes, good plans just don't work and by December I knew that the marginal improvements weren't enough to be on my feet for four days. I waved Harry off and I began to think 'operation'. The op was booked for after Mike and Rebecca's wedding - 20th March and it was great I had something to look forward to before not looking forward to the first op I have had in 24 years. I decided to keep a diary for a few reasons - but mainly because if progress was slow I could look back and see the incremental improvements I had made over the weeks. I am glad I did because at times I certainly wondered if it was worth it. I thought I'd write down a few of the things I learnt and my weekly progress as I couldn't find much on the web about peoples experiences - I know everyone is different and I can't compare myself to anyone else but it might have been helpful to know a few general things while I was recuperating - just to know I was in the range of being normal.
Before going into hospital
Harry was a gem. He made me a table so that I could have a meal and perhaps use the laptop while lying in bed. I didn't use it a lot as I found lying with straight legs wasn't comfortable (neither was any other position for the first few weeks) and the numbness caused by the drugs kept my brain from doing anything constructive except acknowledging the pain and the lack of energy. Haz also moved a bed down into the lounge which was a very good idea, as not being able to sit, stand, walk or lie for long the bed gave me a few options for watching tv or relaxing downstairs. I was still using it well into my recovery and wondered if I could make it more like a bit of lounge furniture and therefore a permanent fixture.
I wish I had bought some soft track pants. I'd found some pyjamas, with calf length legs (my fear was tripping over long pyjamas when getting them caught in crutches) but hadn't given a thought to what I could wear if going out. At home, after the op heavy jeans irritated the stitches and felt rather heavy and so until I was well enough to take a trip to the shops I settled for my new pyjama trousers around home, or when I knew friends were coming shorts (great sunny weather and warm in the conservatory which was lucky). Shorts meant shaved legs, and who else to do this than Harry - who agreed somewhat reluctantly. Girls please note its better to get a wax before op: men may shave their face most days but legs are a different shape and require considerable attention. While sitting talking to friends (and thankfully they are good friends) I noticed a long stretch of my leg had begun to grow a mohawk!! Haz was better at putting cream on my feet as I couldn't reach them for me for a few weeks, and cutting toe nails (on strict instructions). Please don't feel sorry for him.
I had tried to keep up my fitness before the op - worried about wanting to snack too much while at home and also trying to prepare the relevant muscles for the shock they were about to have. Walking and cycling helped the legs, and using cans of Indian spiced tomatoes as arm weights were occasionally used to grow the biceps. I wished I'd used the cans a bit more. By the second or third day of crutches my right arm had lost all its strength. I think it was suffering from OOS - I was gripping the crutches so tightly - scared of falling. So, I soon stopped that and after a few weeks things began to return to normal - enough for me to be able to grip a knife to sit and peel and cut veges for tea. All that was good prep for the miles I've walked over the last couple of months, two crutches in unison with my legs, and I wished I had a pedometer so I would know how many steps I had taken. During my walks up and down the street I began to sing Matthew Wilders song (well known from the ad on tv lately) ...
Ain't nothin' gonna to break my stride
Nobody's gonna slow me down, oh-no
I got to keep on movin'
Ain't nothin' gonna break my stride
I'm running and I won't touch ground
Oh-no, I got to keep on movin'
On my walks up and down the street (distance limited by the steepish hill not far from us) I met some neighbours and had conversations with lots of people - invalids seem to attract conversations! Its been great getting to know neighbours we wouldn't normally see and I have popped into see them for a cup of tea.
I didn't need to worry about overeating. My appetite went out the window - nausea, drugs, pain, inactivity who knows why. Within a month I was 2 kilos lighter. However, I did need a bit of sustenance and Harry and I contrived a really good way to reduce my anxiety over making drinks and food while not being able to stand. Each morning he made two thermoses - one for the bedroom on the window sill - I could sit on the bed and make a cup of tea, and one for the table downstairs where I could make a drink later on in the day. Breakfast thermos was accompanied by a few grapes (great nibbling food), and the afternoon cuppa with a sandwich, biscuits and fruit. After a while lunch became something to heat up - always in a plastic container with a lid - so I could carry it to the table with no chance of breaking a plate or burning myself if I did drop it. Others have mentioned that a trolley may have been useful - which would serve as a walker as well.
In hospital
At 2.00 the day before the op I wandered through the sliding doors, Harry thoughtfully wheeling my little lime green bag (that has gone with us on many an exciting trip to a European city). However, this was another not so exciting step on my journey through life. Some said, prior to my op, that I would enjoy the private hospital but really it didn't matter how good the nursing staff were, or the food, or the help enjoy really isn't a word I would use. Most nurses I felt were competent (though being woken up at 6.00 asking if I would like my back washed was not a positive start for the day for someone who has trouble talking in the morning at the best of times). Some took the time to tell me what they were doing with all their gadgets and bits and pieces - but others just wanted to do a job and get it over and done with. I felt more confident with those that told me what they were doing, showed me the results and explained the impact of my blood pressure dropping etc. I had a blood tranfusion (very low haemoglobin apparently) and now for the first time in my life I continually think I have a part of someone else inside me. No problems except apparently, my blood test expired just before the time I had the transfusion and so half way through the exercise they disconnected it, redid my blood tests to make sure that I was getting the right stuff - I did wonder that it might be a tad late and what the time lag was before repercussions set in might be. Tests came back o.k. and I had instalment number two later that day.
My surgeon had a good bedside manner and was pleased with the lack of bruising. "Some people look like an elephant has jumped on their leg" he said. One leg had very little bruising at all, the other a pretty purple and yellow mosaic and with cold packs and anti flam cream the bruising has reduced a bit over time, but the numbness has remained (nerves need to mend apparently). I was interested to find out that surgeons and anaesthetists work together - partnership sort of thing - and each pair do things quite differently. On the Monday night (entry to hospital) the anaesthetist was delayed in Auckland (stormy conditions had closed the airport) and so I had a different person to fill me with drugs. No epidural, but some thing that got drip fed into an area around my hips (not being a medical person that description should do). More morphine fed through the drips when I work up, which my surgeon didn't like cos it would take me longer to get up and about, but personally I didn't mind a bit. I was told to take half an aspirin each day (try cutting up a little while pill while on crutches!) while other patients are subjected to injections to stop blood clotting. I also negotiated a bit after thinking about the practicalities of some of my treatment. The nurse came to take the catheter out at 7.00 one evening - I hadn't yet managed to get out of bed quickly - and it still took me a long time to negotiate the path to the loo. Would I make it in time - did I have any control when I needed it? So, I suggested how about the next morning - when I would have slept after a good morphine dose and there would be more help if I needed it. They didn't really like the suggestion as much as me (risk of infection and all that) but agreed with the permission of the head nurse who I thanked from the bottom of my heart (stress levels reduced once again).
I was delayed leaving hospital by a burst blood vessel (a very rare occurrence I hear). While sitting on the loo - the most unglamourous state for a young lady I ask you!! blood began spurting from my left leg - I guess I should be grateful the wound was not yet sealed by my miraculously healing skin. They managed to get me to the bed, wrapped me in a number of bandages to try and stop the bleeding (thank you Nurse Janet for helping out in this unexpected adventure). I really was in incredible pain - trying to breathe through it like when in labour and all I could hear was Harry munching on my chocolates (thoughts of women knitting through those days in France when gullotines were in fashion came to mind), but I realised chocolates weren't at that time for celebration simply a coping with stress mechanism. It is a good thing I didn't have much of an appetite - what with all my chocolates gone.
Each morning I had the chance of ticking a menu for the next three meals. I hadn't realised that for some reason I would lose all the saliva in my mouth (dry as for weeks). Having ordered breakfast (toast and peanut butter) I found it stuck to my mouth and even with a sip of water the toast would not easily budge. After a couple of days I resorted to a fruit salad and yoghurt. I managed a sandwich at lunch time and some fruit, and for the evening meal usually ordered a small soup, small vege meal (pasta or quiche) and salad and a cheese board. Would have been perfect if I had been staying in a hotel and well. Harry would arrive from work, watch me eat my soup (those big spaniel eyes looking at me all the time) and then after having a few teaspoons of my main I would pass it to him. He ate the lot, and hence didn't have to cook when he got home. And that was a small meal. I saved the cheese board (at least half a Kapiti cheese each night with some brie and cheddar as well) for the moments in the night when I felt like picking (it was safe cos Haz prefers chocolates). What a treat.
I found the physio hard. I know that when you would prefer to lie in bed, be looked after and feel sorry for yourself that it is important to get moving. However - I dreaded their visits - they pushed I felt too hard, created too much pain (one told me to do exercises standing on my toes when I could not even stand, but another understood the difficulty in me achieving it), and a few times when they arrived at 8.00 I asked them to come back a bit later when I had woken up (I think there were some morning patients in the hospital as they were kept busy until 10.00ish usually). I haven't been able to get to the clinics they run (taxi fare of about $50 would be required), but have been doing exercises and walking at home. The knees feel very tight and recovery will be reasonably long I think. After the 7 week visit to the surgeon I've been going to the local physio to try and loosen the knees up a bit and it seems to be working.
I also had extremely vivid dreams, where I would wake up feeling someone standing by my bed, but knowing when I opened my eyes there was no one. These technicolour imaginations went on while I stayed on effective pain killers, and it was a comfort to have the light on dimly all night so when waking in the middle of the night I could double check if my night visitor was a nurse or the subject of my dreams, or if I really was at the end of the tunnel I had just tumbled through. It wasn't scary just unusual.
During the first six weeks I have also felt extremely cold - chilled to the bone - even when sitting in the sun. I've longed for a bath, but practically know I couldn't get out of it. We have gone down to the local pool for a spa a few times, which has been wonderful and these are the only times I feel really warm. As I have become more active (doing more householdy things and going for walks) it is becoming less of a problem but during the evenings I still sit with a blanket around me even with the heater on.
I had lots of unexpected visitors who bought lovely flowers and gifts. I have made the most of all the hand creams and reading material and dvds since I got home but during my hospital stay having the visitors come (though my social skills probably left a lot to be desired) was what kept me going. From my window I couldn't quite see the car park, but did see the rain and wind that they had battled to get to my little warm room. They all seemed surprised at seeing me get out of bed and sit in a chair though as I said before not having any sort of benchmark made it difficult to know if I was doing well especially when the nurses and physios told everyone hobbling up and down the corridor they were "doing really well". Having Harry there during the evenings and Sharon's support in the afternoon after the op was especially important to me. Before I left hospital I was told:
- I should be able to walk 30-40 minutes each day before my six week check up (I achieved on average 60 minutes a day with sometimes 90 minutes a day with a break somewhere in between).
- I shouldn't lift more than 5 kilos (anything with crutches is a pretty tall order).
- I can progress to using one crutch but do not go down to none.
- I can walk up hill but not down (we're in Wellington!!).
- I shouldn't take codeine and oxynorm together unless I really wanted to sleep.
I am not sure if I was told anything else - if I was I can't remember. I wondered if a little fact sheet with these helpful hints might be useful. By the time I left hospital, I could waddle 100 metres, climb up and down stairs, struggle in and out of bed, have a shower and sit for about 15 minutes and feel very sorry for myself. Thank you to all my friends who came to see me in hospital and during my convalescence. I couldn't have managed without the friendship and support. Thank you to Nicki, Beth and Naeve, Jill and Graham, Jim and Margot, Cheryl, Heather, Fleur and Leigh - for your support and being there when I needed you.
My diary
My first week in hospital (20-27 March, Week 1)
I slept alot and was of course looked after. I managed to get out of bed, have a shower, clean my teeth while leaning on the walker, visit the loo, progressed from using the walker to two crutches, learnt how to navigate steps, continued to feel very sorry for myself at times and attempt exercises such as bending and straightening knees.
Week 2 (28 March - 2 April)
I left hospital and sampled my first fresh air in a week, took a ride in the car, walked inside the house a number of times and negotiated the steps, took all the pain killers given to me, managed to lie and watch a dvd, sit occasionally and skim through a magazine, made a cup of tea using the hot water from a thermos, sit on a plastic picnic chair in the shower, reach my feet to put some cream on my very dry toes, and began to care about my appearance once more. It is a real struggle to put socks on (longer arms would be helpful), but I am sleeping well due to drugs. I've taken some walks around the garden (a spider managed to build a web across the path at face height every night) about 10 minutes at a time. District nurse redressed knees. I seem to hit a brick wall around 1.00 which lasts all afternoon (just don't know what to do with myself).
Week 3 (3 - 9 April)
Trying to spin out the effective drugs and so nights are rough (my knee jerks a lot which wakes me up in pain and I can't get back to sleep). It was very wet and windy so I've developed a 30 minute walking circuit round the house. When the weather improved I ventured up to the bus stop about 50 metres away but still like company to do that. I seem to need about 10 minutes to recover from every 1 minute of exercise. Staples came out which stung but weren't too painful. Decided to put glad wrap around the knees for a few days in the shower as they still looked a bit raw in places. Went out for brunch with Cheryl. Worked out can carry light things by hooking plastic bag over crutch handle. Did a 15 minute walk down the corner with Sharon and Aaron for company. It was Easter weekend and we went to Plimmerton, Pauatahanui, Days Bay, Miramar for walks and then a coffee or lunch. I began to manage 30-40 minute walks, although rather slow I felt I was getting somewhere.
Week 4 (April 10-16)
My walks up and down the street are getting longer (2x40 minutes) and are being noticed by neighbours who stop and talk and ask me what has happened to me. I'm flicking through magazines (sometimes two or three times before I realise I'd already read them), staying in bed till about 10.00 ish, can put on my pyjamas without sitting down, still not eating much and finished the oxynorm which is the drug that really works. The scars are very irritated and don't like anything including sheets on them. I did some emailing for the first time, began finishing the scarf I started knitting a long time ago. The brick wall I hit (exhaustion, frustration, pain, despair) is occurring a bit later on in the day (just in time for Harry to get home). Some very rough nights but also some where I get a few uninterrupted hours of sleep. Late in the week I began to use one crutch around the house which is liberating as I now have one free hand. I can sit and prepare veges for dinner so I feel my contribution to running the house is returning (Harry likes this bit).
Week 5 (April 17-23)
I am still wondering if this was worth it, but things are improving which is good and I need to stay positive. Can stand for a few seconds to brush hair, or put jersey on without needing support and have started to go for longer walks (50-60 minutes). Spending more time doing emails and this blog. I am taking less painkillers during the day but still need them at night. Restless nights continue. Legs uncomfortable what ever position but lying more on my side now. First time this week I began to feel hungry and I made cheese on toast. Knees still radiate heat, but the bruising is going down. I can negotiate steps using crutches rather than handrail now. Visited dvd shop to stock up on a weeks supply (though Harry still has to put a new dvd in each day as I can't get down on the floor). Went out for dinner with Shaz and Aaron. Hung out washing for first time (one handed!), took a long time and rather exhausting. Started to use anti flam on knees now that the scar has healed and my knees are beginning to return to that wrinkly look. Starting to get a bit bored. Sat and watched Harry dig my potatoes and did a little bit of weeding while sitting on concrete steps. Bought some new trousers. There is a mouse in the house. This weekend was a walk around Lyall Bay and fish and chips where a mouse sat amongst the flax bushes and watched us chew our chips. (What is it about mice at this time of year).
Week 6 (April 24 - 30)
Harry says I am walking faster, and I seem to be going a bit further for the minutes I wander about. Still losing a bit more weight. We went for a walk to Wiltons Bush and along Friend Street in Karori. I am also doing a bit more around the house, dusting, cleaning and preparing a few more meals. We watched the ANZAC ceremony on tv and a film about Steven Hawking (maybe my body isn't so bad afterall and I need to appreciate what I have - there's always someone else worse off). Beginning to stand for longer and straighter without needing support, bad nights continue.
Week 7 (1 May - 8)
Every Tuesday seems to be a bit of a milestone and April 30 was 6 weeks since the operation. My last sleep in before starting work part time. Harry drops me off and picks me up at lunch time. First day came home shattered, too tired to even sleep but each day gets a bit better and it is good to get back into the routine. Thursday I went for a walk in the afternoon with only one crutch. I walked up hill to the little park at the end of the street for the first time and managed the down hill o.k. Sleeping a bit better cos I'm back on the codeine at night. Made some calls to plumbers to begin the renovation of the ensuite. Am able to cross feet at ankles without thinking about it, and cross my legs though don't want to remain in that position long. Started using bio oil in the hope that the irritability of scars will reduce and maybe they'll be less visible as time goes on. Enjoyed another spa at the local pool. Went for a wander around bathroom centres and tile shops and for lunch at the Italian Restaurant in Petone. In the evening went to movies 'Exotic Marigold Hotel' and so managed to sit for a couple of hours. Sunday afternoon at Pukerua Bay Beach, picnicking and walking along the road and track, tried walking on sand but that was still quite tough going. And then watched the super moon rise up above the Wellington hills (up to 30 percent brighter and appearing 14 percent bigger than other moons -as it is on its closest approach to earth).
Week 8 (8 May - 15)
Its been 7 weeks since the op and I ventured back to the surgeon, who sent me on another course of physio (more stretching exercises) and gave me some voltaren to reduce swelling (did you know prescriptions from medical specialists other than GPs is not subsidised?). Went for a long walk down to dairy and up Bannister Ave (54 minutes - snails pace), have come home shattered from work and often needed a long sleep in the afternoon. REAL HIGHLIGHTS - had my first bath on Wednesday (of which I got out of quite easily), and have permission to start biking for a few minutes a day (am managing up to 5 minutes at a time - taking it easy). Aqua jogging is also recommended but the weather is getting colder and I hate getting out of the pool when it is cold. We booked our hotel to Port Douglas in October and went to see 'Salmon fishing in the Yemen'. In the weekend we went up to Fielding to see a possible venue for Sharon and Az's wedding and caught up with Janet and Gina. Also had a nice walk in the Palmerston North botanical gardens (autumn colours great for photos) we realised how 'English' this area is - back in Wellington the trees are far more evergreen. It was a lovely Mothers Day, spending it with Sharon and Az and then having a long phone call with Mike and Rebecca in the evening. I was spoilt too - cheese, crackers, chocolates and flowers - my first Mothers Day in the southern hemisphere for quite a few years.
