Marié Digby

As I was listening to pandora.com today, I heard Say It Again by Marie Digby. I had never heard of the artist before, but enjoyed it so much I decided to download the song. Well, for $4 more I downloaded the whole album--Unfold. I'm definitely not disappointed. She reminds me a little of Mandy Moore.

But...ugh! She too has Umbrella on her album. How many artists are going to sing this song?!?!

Post-Op Day 4

I apologize for the crappy photos, they are coming from my camera phone. Either way, here's my knee today. I think it looks almost exactly the same, perhaps a little less swelling.

I'm no longer using a crutch to walk. I might have a slight limp, but I feel like it's the same with and without a crutch.

I'm back to sleeping in the bed. Joe hasn't rolled over onto the knee, and I feel like the pain is down enough to finally be able to get into a comfortable position. Before I was sleeping on the couch.

I still have to take stairs one step at a time, and I'm trying to limit them completely. I tried alternating feet, but it put way too much pressure on my left knee and caused pain.

I'm being very diligent with my exercises. Day one I could hardly flex my knee, today I'm at over 90 degrees. The first day it hurt too much to do the bike, today I could do 10 minutes. Mind you, I'm not biking near the speed before surgery, but it feels good to be able to do start to do things again. Plus, I'm all about limiting the degree of scar tissue that forms.

I'm not going to lie, my knee can tell when I've been doing too much and I'm glad I don't have to start a rotation tomorrow. That would be too much pain for sure. I'm on the max dose of ibuprofen, and that's enough as long as I take it on a scheduled basis. I didn't like the feeling the hydrocodone gave me.

I'm starting to get antsy just sitting around. I'd love to try some more recipes, but I think that's too much standing for now. Perhaps in the next couple of days. I'm catching up on my reading, but I can only read so much in one day. I've also started cross stitching again.

I have a research paper I need to write by the end of the year. I'd be remiss if I didn't use this time to do some hard core work on it, so that's part of my plan for tomorrow.

Mom left for Baltimore yesterday. I am so glad she came out to visit and help. I definitely underestimated how little I would be able/want to do the first two days after surgery.

Plica Removal

If you can't tell, I'm bored. Here's a little tutorial on my plica removal and why I needed it.

Provided by the Bones Health Channel on eMedTV.com

I think "tightness" is a great way to describe my knee pain, especially after working out.

Provided by the Bones Health Channel on eMedTV.com

However, it seems having a plica was not my only problem, so the doc did a lateral release as well, see previous post.

So what's a lateral release?

Browsing you-tube I found some videos of arthroscopic surgeries. Some are probably better than others, but without the commentary, I have no clue what's going on. These are not my knee. I don't know if they recorded mine or not, I guess I'll find out at my post-op appointment. I also won't know my official diagnosis based on what they saw until my post-op appointment, September 3rd.

Here's an image of the forces on the knee cap. We suspect a large part of my knee pain is due to too much tension from the iliotibial band pulling my knee cap towards the outside of my body. This causes the knee cap to come out of it's natural tracking and cause pain and inflammation from the friction. When stretching and strengthening doesn't work, lateral release is a way to help decrease some of this tension. Some docs completely cut the lateral retinaculum (on the left of image above), but that can make the knee too lose. My doc does more of a "hashing" to give it some more stretch, but not a complete release. Several years ago, surgeons did way too many lateral releases and often the patients didn't have much improvement. Fortunately, my physical therapist says that her patients who have a lateral release done by my doc have almost always had improvement. She believes a large part of it is due his "hashing" technique and that he does it through an open procedure.

The videos below show the lateral release done completely arthroscopically and a full cut, not the small cuts my doc did. Either way, it gives you a better idea of what went on.

Day of Surgery

I'm already starting to get bored, so I figured I'd record my experience the day of my surgery.

The night before the surgery I hardly slept. After working evenings at the ER, my circadian rhythms had me going to bed around 2 am and I needed to wake up by 5 am for the surgery. I couldn't fall asleep any earlier, so I was exhausted that morning.

Pre-op wasn't anything exciting, just peeing in a cup, reviewing health history, etc.

I know I had IV's when I was a kid, but I don't think I've ever had IV antibiotics. We get into the OR room and they start to give me the versed, fentanyl, and antibiotics. I've always heard the nurses warn the patients that it might sting going in. Oh, my, goodness. Yes it does. Fortunately I was out right after that and don't remember anymore.

My surgery only lasted about 35 minutes. When I woke up in recovery, my first thought was, "man, that was some great sleep, finally." Then I open my eyes and realize I don't know the woman who's sitting next to me. Then it dawns on me where I am. It took me five minutes to become coherent and I know I asked her name at least twice. She mentioned my blood pressure and heart rate increased after waking up, but not to worry, it's due the pain. I realize that, but I also wonder if it could be due to blood loss, even though I know it's not a bloody surgery. The nurse looked a little surprised when I asked for my estimated blood loss. I guess that's part of treating someone with medical knowledge. Supposedly my blood loss was zero, but I have a hard time believing I didn't lose anything.

After my heart rate and blood pressure decreased, they wheeled me over to post-op. My post-op nurse was amazing and so patient. She could tell I was still in pain and offered some morphine. It's fairly common for morphine to cause a local rash and itch after being injected. I noticed my arm was extremely itchy just a few minutes after she gave me the morphine. She was spending an large amount of time with me and I wanted to make sure I wasn't taking her away from her other patients. In my half asleep state I ask her if I'm her only patient and if so if she could get me some benadryl and point to my arm. She responds, "you do have quite a rash developing there." I was out before she even finished injecting the benadryl. Mom said it looked like I was catching flies.

As an aside, getting a rash after receiving morphine is common and is not considered an allergic reaction. So if it happens to you, just ask for some anti-histamine and the itching will go away.

Post-Op Day 1

I initially thought I'd post today in the style of a progress note we'd write on rounds, but I figured I'd spare you the medical jargon. Plus, I really don't think you care if I've been able to have a bowel movement or pass gas yet. I've felt a little dizzy and nauseous today. It's hard to say if it's my body reacting to pain or the side effects of my pain meds. They gave me Norco, which has hydrocodone and Tylenol. I'm trying to switch over to ibuprofen. It's what we give our women after c-sections, so I figure it should be enough for me too. So far so good. I just woke up from my evening nap, it's sore, but not a sharp pain or anything.

Today was my first physical therapy session after surgery. They unwrapped the dressing and worked on range of motion. I definitely can't flex my knee as much as before surgery, but the PT says I'm doing well enough for day 1. She tried to put me on the bike to get more blood flowing to my leg. My knee was definitely sore and I started to get dizzy. I have a history of fainting and I didn't want fall off the bike, so we'll try that again tomorrow.

Here's my knee day 1. It's a little swollen, but not too much. I don't really think the blue is bruising, but more of the "yes" marker. The three smaller holes are about 1/2 inch. The longer scar is about 2 inches and that's where they went in to do the lateral release. Something I find funny, both Dad and Joe made the comments, "I wonder how big your scars will be." Me, I personally don't care about scars as long as my knee's starting to feel better.

I'm still walking with a single crutch, but I think I'll be able to get rid of that in the next couple of days. I have the next two weeks off from rotations, so I'm going to go light and not try to force myself. That being said, I'm already tired of living purely on the couch.

25th Book

I just finished my 25th book of the year! It's probably the only New Year's Resolution I've kept. Perhaps, one can argue I've also kept the one about keeping up with my knee exercises, but I digress. Audiobooks really helped me to my goal. I've learned I'd much rather listen to a book while driving than the radio. When I told Joe I planned on reading 25 books this year, Joe laughed and said, "I don't think I've read 25 books in my lifetime." Sigh. I'm not stopping here, but perhaps now I'll try to work on my wedding scrapbook a little more. We'll see.