Tuesday, May 18, 2010

NEW KNEE: DAY 8



TUESDAY: Just over one week since the surgery.
Yesterday the local area nurse came by to change the dressing and check progress (measuring various circumferences and the like). An opportunity to get pictures and here they are...not exactly what one might call pretty! I have 14 staples closing up the skin and they are due to come out toward the end of this week. The underlying sutures closing up the deeper layers will dissolve. As you can see, there is a deal of bruising. What you can see from the back of the leg is due to the tourniquet used to stop the flow of blood to the knee during the procedure. There are other areas of bruising related to retraction of the sides of the incision to expose the operating area ands on the shin and ankle where the jigs to do with the carpentry and assuring alignment were sited.

Seeing all this bruising has reinforced in my awareness that one serious risk of the procedure is the formation of blood clots that could cause a lot of trouble in the leg and other parts of the body (lungs, heart, brain, and so on). I have been careful to take my blood thinning medication and to do the exercises that offset this risk.

I am pleased to report that the wound is healing well and swelling seems reduced each time the leg is measured. It is good to be able to slack off and spend lots of time napping with my feet elevated. I now am able to walk with more or less respectable form without the aid of a stick but the stick still proves to be a good tutor as to the proper way to walk. Life is a not unpleasant routine of my five physical therapy workouts followed by some time lying with feet elevated listening to a recorded book, interspersed by short walks hither and yon (like out to the mail box).

Pain management has been excellent; I must admit that I was prepared to experience considerable discomfort and it has be a welcome surprise to have very little pain. Discomfort seems to unravel or become apparent in 'layers'. By the middle of last week, this had resolved into deep muscle pain. Toward the end of the week and over the weekend, it was related to the bruising of the outer tissues. Just recently, it has to do more with the actual incision and I will be pleased to see those 14 staples on their way! Pain puts a limit on how much the knee can be flexed but flexion happens to be the name of the game. Small advances are acceptable and achievable. Really, I am very happy to report, pain has been no 'big deal'.

I discovered one aspect of healing that I could have anticipated from my reading around depression. Healing of serious injuries results in a process around the wound site that eventually sends messages to the rest of the body to slow down (via substances called 'cytokines') so that energy can be conserved toward the healing process. This have a side effect of depressed mood. I had forgotten this until I noticed that I was not enjoying the taste of food and was finding it hard to focus when reading. I ordered up some baking chocolate (very dark) and made sure I spent some time out the sun, as well seeking the company of my neighbors when outdoors. At first the chocolate did not quite taste like chocolate but the pleasure of its taste, I am glad to say, has returned.

I did get a little 'cabin crazy' yesterday. I found, however, that I could get in an out of the car without too much difficulty, so took my self off down to the local coffee shop for good coffee, my favorite cinnamon roll, and conversation.

It turns out that getting over the insult to one's body that surgery happens to be is quite complicated and, no matter how impressive the surgery itself may be, it does require quite a bit of personal effort and dedication in the recovery phases.

From now on, I promise, only occasional reports; it may be that there are more interesting things to write about. If you have a question, put it in the comments section and I will answer it the best I can.





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