Knee Surgery Update

I saw my ortho yesterday, and I finally got out of the immobilizer.  It is a bit of a mixed blessing.  I really wanted to be out of the immobilizer because it was clunky and uncomfortable, but now that I’m out of it (and in a hinged knee brace) and my knee is not stablized nearly as much, I want to be back in the immobilizer.  I spent nearly five weeks with my knee not moving, and now that I do have permission to bend it (update on that in a minute) I realize exactly how weak my knee is.

As for bending the knee, the doctor bent it for the first time yesterday.  I had a really good ROM (range of motion) prior to surgery.  Yesterday, he bent it approximately 30 degrees and it hurt.  He bent it a second time at about 45 degrees and it really hurt.  Dr. Prodoehl, however, is thrilled with this.  I am now doing CPM (continual motion), which is essentially bending and straightening the leg for 15 minutes a day.  By the time I start physical therapy again on the 29th, he expects me to have all of my ROM back.  I’m thinking probably not.

He’s also ordered a muscle stimulator for me.  This will help rebuilt the muscles and tendons around my knee.  I’m still non-weight bearing until the 29th and then I can begin putting light weight on it.  Prior to getting out of the immobilizer, I was able to use my right leg with toe weight and get around without crutches.  Now not at all.  Even if I could put weight on my leg, it won’t hold me.  That should come with PT. 

As for PT, I called to set up my appointments and got Ken.  Now, I like Ken.  A lot.  Don’t get me wrong.  Ken is cool.  But he also has a tendancy to dig and dig at the knee and it hurts.  For this, I am worried.  I’m sure at first they’ll keep me to table exercises so as not to mess with the new cartalidge growing inside me.  I’m still not looking forward to it.

On the weight loss front, I learned yesterday that my pouch still works.  I ate something I shouldn’t have (too much grease) and immediately got sick.  Yay for a working pouch.

We’re going on vacation next week.  I’m excited!

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Working Again And The Importance of Following Your Vitamin Therapy

I started back to work on August 3, and it’s kept me very busy.  Lots of catch up.  For now, I’m still working from home.  As of my last appointment which was on Tuesday of this week, still no weight bearing and no bending.  I go back on Monday and he’s going to bend my leg for the first time.  Of course, I’m not looking forward to that, but yeah, it is what it is.

I also had a bone density scan this week – my first.  The doctor ordered it for two reasons – one, I was due for one, and two, the amount of arthritis I have had him a bit worried.  We have a history of osteoperosis in my family.  I was interested in getting the bone density scan for another reason.  I’m now nearly two years out from my gastric bypass.  If you have ever researched gastric bypass, you know it comes with malabsorbtion issues.  One of those things that you don’t absorb as much of is your calcium.  Ever since surgery, I’ve been on a strict vitamin and supplement regimine, including a double dose of calcium on a daily basis.  As I approach my 40s (somewhat faster than even I want to believe), I’m even more concerned about calcium absorbtion.  I take two calcium supplements per day, as well as a dose of folic acid and additional vitamin D.

I am happy to report that after two years of my strict calcium therapy, my bone density scan was NORMAL!  W00T!  That means my vitamin therapy is working!  And I’m doing what I’m supposed to do.

I can not emphasize enough the importance of taking your vits after WLS.  You don’t get enough nutrition any longer to meet your daily needs.  So take those vitamins!

Still Here – Never Fear!

Just haven’t had much to post about on the weight loss front.  Or on the regular front either, since I haven’t posted to any of my blogs lately.

I started back to work last week, and will be working from home until I’m able to drive again.  Who knows when that will be.  I’m still in the immobilizer and on crutches.  Still not allowed to bend my leg or put weight on it.  Still going stir crazy.  The incision has healed up nicely, but the skin under the ace bandage (which is under the immobilizer) is really dry and flakey and itches like all get out.  I’ve been unwrapping it twice a day to slather it up with gold bond medicated lotion, which seems to help.  The knee cap is still swollen and sore to the touch, but the joint itself is feeling pretty good.  Weak, but good.  Not looking forward to starting PT or actually bending the leg.  I imagine that it’s going to be quite painful.

As for food, meh.  I’ve finally gotten my system back on track.  I’ve been eating a lot of fruit and trying to limit my carbs, but I haven’t exactly paid attention to my portion sizes (ok, the pouch tells me when to stop, but still, lots of snacking going on).  I need to start doing that.  And my period is due next week, and I’m craving things like crazy.  UGH.  I miss exercise.  I can’t even just go out for a walk.  On the plus side, though, anyone who has used crutches for any period of time knows that it is an awesome upper body and ab workout.  I haven’t been able to accurately weigh myself – but I’m not gaining. 

I’m looking forward to getting my life back to normal.  For three weeks after surgery, EVERY time I ate I got horrible pains in my lower abdomen.  Of course, once I made an appointment with my doctor, those pains went away (so I cancelled the appointment).  I think it has a lot do to with the fact that I’m finally off the prescription pain killers and I’ve got out a lot of the carbs I was eating.  I’m trying to move around a bit more as well.

You know, one thing I didn’t anticipate was problems with my insurance covering my surgery.  I anticipated issues with gastric bypass, but figured knee surgery would be a no brainer.  Of course, I did understand that the procedure I had was relatively new, but didn’t think about it too hard.  So I got my explanation of benefits this week, and was surprised to see that there were two claims for the surgery.  One for the de novo graft (for $1,000) and one for the arthroscopy (for $1,400).  Don’t you know, they said that they wouldn’t pay for my arthroscopy.  Sigh.  The explanation was there was no proof the surgery was requried.  Which made me laugh because they had no issues paying for all the PT I had, or the MRIs and X-rays, and the ortho appointments.  Or the de novo graft itself.  I guess they figured the doctor was going to have to go through my throat to get to my knee, or glue it to the outside.  *shake my head*  So, I phone Blue Cross.  And spoke to a lovely lady.  And she told me that they said I had a similar surgery in the past three years, and didn’t see why I needed it again.

o.O

I calmly explained to her that yes, I did have an arthroscopy three years ago.  On my LEFT knee.  This one was my RIGHT knee.  Because, you know, I have TWO knees.

“Oh,” she says.

And then she put me on hold for 10 minutes, in which I’m sure she had to ask her supervisor what to do.  Needless to say, they resubmitted the claim for payment.

Sigh.

So that’s what’s going on around here.  I did manage to get out and see a movie (Harry Potter and the Deathly Hallows Part 2 – AWESOME) and will be getting out next weekend with my Mom to go see The Help.  It wasn’t too bad at the theater, but my knee did ache after two hours of it hanging down.  Hopefully it will be  a little better by next weekend.  I have my one month follow up with my surgeon this week so hopefully we’ll see some progress.

Knee surgery is no joke y’all.  No joke at all.

Dealing With Surgery after WLS

My weight is holding steady.  I don’t actually know what I weigh right now, since my immobilizer is still on and I can’t get a sufficient weight.  I know I haven’t gained weight, and I don’t think I’ve lost, but I don’t know how much I actually weigh.

The worst thing is not being able to move around to sufficiently rid myself of gas.  Gas post WLS sucks.  It hurts.  A lot.  And the only way to get rid of it is to walk it off.  Can’t walk if off if you can’t walk.

Exercise is nil.  I can’t.   Using my crutches does burn some calories, and it is a great ab workout (who would have thought?).  But my arms get sore, and I can’t go too far or do too much.  My knee gets sore when I move around too much, and I’m not able to put weight on it at all.  Sigh.  Without exercise, I stall out.  STALL OUT.

I’m thinking of maybe going back to weight watchers (with an altered program for WLS) after I get out of the immobilizer so I can lost the last 30 or so pounds I need to.  Never has my goal been so cloase but SOOOOOO far off.  Sigh. 

Dealing with surgery after WLS is no fun.  No fun at all.

Two Weeks Out

I’m two weeks out from knee surgery today.  Not exercizing and eating too many carbs (thanks to my husband) are really starting to get to my poor stomach.  I’m living on gas ex and pepto bismal.  Which also means I’m taking control of the menu as of TODAY.  UGH.

My knee is repairing well, we think.  There’s no way of really knowing until I start PT.  And at this point, we have no idea when that will be (reminds me, I need to send an update to my therapists letting them know surgery went ok).  I got all the staples and two stitches out yesterday.  That was the first time I’d actually seen my knee (except for a peek here and there) since surgery.  Ew.  And I almost passed out when I got my stitches out.  Learned a valuable lesson – can’t watch that kind of thing…LOL.  My knee is still quite swollen, and the doctor said he had to do a lot more work that the initial MRIs let on.  I had three very large cartilage defects, numerous bone spurs, and tendons had to be cut (which means he did perform a lateral release).

Let me tell you folks, gastric bypass surgery has NOTHING on knee surgery.  After seven days from my gastric bypass, I was feeling great.  I’m two weeks out from knee surgery and still struggling.  Knee pain is there at night (not so much during the day), and getting around on crutches is a pain in the ass.  Non-weight bearing means I am not supposed to put any weight on it at all.  UGH.  And now, they’ve replaced my staples with steri-strips.  Well, I’m allergic to adhesives.  Which means my knee is itching UP A STORM.  LOL

I miss exercise.  I miss eating right. I’ve lost weight, but I’m not eating the right things, and I know I’m not getting enough water.   Need to get my head around all of this.  Sigh.

An Update

I’m a week out from knee surgery.  The specific surgery was a placement of the de novo graft (a juvenile donor cartilage) and arthroscopy.  The surgery was both arthroscopic and open – he did the initial scope arthroscopically, so he could see the extent of the damage, and then opened it up with a larger incision, took out the knee cap, cleaned out the arthritis, and then glued the graft between the bones and to the back of the knee cap.  I can’t be 100% sure, but I also think he did a lateral release on the knee cap as it was being pulled to the right side.

This is an extremely painful surgery.  Now that I’m a week out, I’m still in considerable pain.  The knee cap is swollen.  My leg is in an immobilizer, and I am only allowed to put a bit of weight on the to to steady myself.  Otherwise, no weight on it at all – and I’m on crutches.  I took a peek yesterday at the incision (just a small peek) and I have a lot of little staples (ew).  The knee cap is padded in a ton of gauze, and then the leg is wrapped in an ace bandage, and then the immobilizer is on top of that.  I’m not to remove the immobilizer (although I have unstrapped it to take care of a slight itch I had on my shin) except to tighten it as the swelling goes down.

The big downfall of this surgery has been the fact that I’m not in charge of my diet.  Which means my husband is.  And although he tries (the portion sizes are good), between the left over nauseau from the surgery and the excessive amount of carbs he has been feeding me, I’ve not been eating right.  Top that off with pain killers and not enough fluid (my fault), I ended up with an obstruction.  Yesterday I really thought I was going to die.  My lower abdomen was killing me, and no matter how much I tried to go, I couldn’t.  I called my bariatric surgeon and talked to Chris (the nurse) and explained the situation.  She told me to call my ortho to see what his plan was but prescribed laxitives, lots of fiber and lots of water.  I called my ortho, and he switched my pain killers (which I’m only taking at night now) from percoset to tylenol with codeine.  UGH. 

So this morning, I am feeling better.  I still haven’t “gone” but the pain in my tummy is better.  I”m sticking to yogurt and fresh blueberries for breakfast and lunch will be some type of protien and some veggies.  Keeping food semi-soft and light today.  And lots and lots of fluids.  I’ve had a protien shake.  I’m having water.  I’m having some decaf coffee too (in hopes it may get things going).  Keep your fingers crossed.

Some of the perils of surgery for a post op bariatric patient.

So, I get the staples out in a week and see my ortho for my post op.  I’m off work until at least 8/2.  And my butt is soooo asleep.  Sigh.

Surgery Tomorrow

Will probably be blogging a lot more after tomorrow since I’ll be bed ridden for a while.  No weight bearing on the knee for six weeks.

Lord help my husband.

Send some good Ts & Ps my way!

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