Wednesday, May 30, 2012

Diary of a Knee Replacement Part IV

Let Me Introduce You
   1. TED Hose -- if you have any kind of joint surgery, you will make TED'S acquaintance. TED's are the thigh-high compression stockings that you are issued when you leave the hospital. All SJRI patients are required to wear them during the day for 6 weeks. While I view TED's presence as a relatively minor inconvenience in the whole scheme of things, I have some friends at PT who are not so nice about TED. They hate him. And I mean hate him. I don't mind TED hanging around because I think he really helps me with the swelling, edema, and pain, so he has earned his chops in my book. I do, however, agree that TED totally wrecks your fashion aesthetic, but since my social life is largely confined to visiting with friends at the Southern Joint Replacement Institute's Physical Therapy gym, I don't feel too out of place sporting my bright white TED's.
This picture made me laugh. It's like they are trying to make these
things look sexy or seductive. Trust me, there is nothing
sexy or seductive about TED hose, especially when
they get loose in the top and like to jelly roll down your legs.

   2. The Knee Immobilizer -- while you met the knee immobilizer briefly when I was in the hospital, this chick's role expands exponentially when you get home. You are required to be strapped into this lovely strait jacket for legs for 8-10 hours per day. Miss Knee Immobilizer and I hang tight at night. I couldn't abide her presence during the day, but I guess it's feasible that you could get your hours in if you were persistent with it. She's not so bad as the monster I am getting ready to introduce, but she is definitely not a friend for life, if you know what I mean.
<em>Knee Immobilizer</em> Comfor <em>Knee</em> Brace Universal 20'' Length - Bird & ...
Mine is black and looks great with the thigh high white TED Hose.
 It's a true fashion statement.

3. The Monster Man -- PAIN
  This is the one guy we all want to avoid at any cost, but let's just face it, from the minute your surgeon makes his first cut with that scalpel, this guy has your number. He's a stalker. And he loves to do his dirty work at night. While Monster Man begins to invade your boundaries in the hospital as the nerve blocks begin wearing off, he usually waits to completely ambush you until you get home.
   You are confident when you leave the hospital. Thankfully, the doctors at SJRI are firing some pretty big cannons in their arsenal against this guy, and they want you to take advantage of what they are giving you. In other words: TAKE YOUR PAIN PILLS. Everybody from the Discharge Nurse to the Case Worker to the Hospitalist to your Surgeon to the Physical Therapist -- are all saying the same thing, "Take your pain meds. Do not let the pain get ahead of you. Take them every day and take them regularly."
   The only problem with this strategy is that once you read the label, you are not entirely happy with this advice. Deep down you are worried about the pain meds. The long and the short of it is that they are ADDICTIVE. And you know it. In fact, everybody knows it. But here you are...going home with a 90 pill supply of these boogers. You find yourself hoping, "Maybe that's one a day for the next 90 days." NOT. You are also encouraged by the in-the-know medical personnel not to try to be the hero. And you are thinking to yourself, "Yeah, just don't know me."
     My hip replacement did not kick my butt in terms of pain, but my knee replacement sure has. I thought my pain tolerance was pretty high, and it is, but this pain is on a whole other level. And I have even had natural childbirth, the standard by which every woman measures another person's ability to withstand pain. I did well for a couple of days, and then this searing, burning, clawing, pressurizing pain started camping out at my door. The Monster Man would remain dormant as long as I was completely inert, but if I moved around or heaven forbid, stood up, it was right there in my face breathing its hairy fire-breathing breath all over me. Sometimes I wanted to vomit. Sometimes I wanted to scream. And sometimes I wanted to quit. It was bad.
Bottle with Pills photo

     I threw everything in the book at this particular Monster Man, but he was not giving an inch. I followed the Doctor's orders. I pushed the envelope to its limit and took the maximum daily allowance. The Monster did not leave. I keep a diary/log of all medications I take because who can remember at 2 am when you last took something. I look back at the journal now and can track the steady progression of this pain. It was building and building and building until it was a consuming fire, burning a hole in my leg from the inside out. Talk to five different knee replacement people and you will find five different stories about the pain. Some are more fortunate than I was. Some suffered more than I did.
   But the story isn't over yet. Every day when I walk into therapy (and you go five times at SJRI the first week) the cheerful therapist, in this case Che Che, asks you to rate your pain. Mine was usually in the 3-5 range until this Monster Man showed up and then I jumped to 8-9. A few times I even hit 10. That's usually where you hear the wailing and gnashing of teeth. The good thing is that my therapist listened to me. I mean she really listened to me. She helped me determine that my pain sounded more like nerve pain with its burning, clawing and licking fingers of fire. So I marched (that is a total lie since I could not have marched anywhere even if I wanted to), okay I slid my walker in front of me and dragged my knee behind it down to the nurse's station where I talked to my Surgeon's Assistant (Sweet Lindsay). I told her what was going on, she took one long look at my face and she said, "No problem, we will get you a prescription for some Lyrica."
    Lyrica. Sounds like music to my ears. And music it is. Lyrica has proven to be my new best friend. Within three hours of the first round of Lyrica, I had a 30 to 40% reduction in pain. I went from an 8-9 on the charts to a 3-4.5. It went from unbearable to bearable. I went from being a monster myself to being a relatively nice human being.
   At this point in time, I have weaned myself off of the heavy duty pain meds because they simply don't seem to work well on my pain. I was having to take so much that they were leaving me with cotton on the brain instead of normal brain cells...and I was still hurting a lot. Lyrica is not a walk-in-the-park drug, but it works for me and is one, that hopefully, I will not be tethered to for long.
   All of the knee replacements talk seriously about our pain. We joke about the TED hose, the Immobilizer, the Walker and the other accouterments, but we don't really joke about our pain. We know the Monster Man in this case is all too real. Hopefully manageable. Hopefully not with you forever. But real enough to take him seriously.
   I would that hope some Physical Therapist, or Nurse, or Doctor, or Patient Advocate somewhere is reading this and thinking, "I really need to let my patient talk to me about her pain," or "I need to pay more attention and consider other available options."
   I sure hope so because there is more than one answer to the problem of pain. The Monster Man can be defeated or at least tamed. I am proof of that.

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