Thoughts on the one week, post surgery mark

Leading up to her surgery, the female DG spent considerable time on the internet trying to get a better idea of what she faced in her recovery from surgery to repair an Achilles tendon. (Looking back, she is somewhat glad that she didn’t spend as much time researching stage 3 glioma when the male DG was first diagnosed; she might have been more inclined to fold the tents – even in the good hands of the top-of-their-game UCSF neuro-surgery and neuro-oncology team.)

She found a ton of material about recovery from surgery following a Achilles tendon rupture – and it all sounded grim – but little about her less serious injury (severe deterioration and partial tear). So in the hopes of someone, someday, finding this post, she’s offering eight things she’s learned in the week since surgery.

1. Plan for pain but don’t be surprised if it’s more discomfort than real pain. That has been her experience.
2. Surgery takes the wind out of you – even if you’re fairly fit. She’s unclear if it’s the assault on the body itself or the anesthesia – or both. Don’t try to be a hero and do too much.
3. Do everything possible to make sure your spouse (or other caregiver)  knows how really helpless you’ll be. Being restricted to non-weight bearing activity necessitates balancing on one foot and not having the use of arms/hands (if using crutches or walker).
4. Ask your surgeon very early on if he orders cold therapy following surgery – and don’t leave the surgical center without it. More about this here.
5. Order a knee walker. There are different models.The female DG ordered hers through RentAKneeWalker. It arrived as ordered, and the customer service staff has answered two basic questions with courtesy. The knee walker allows you not only get around easier and more quickly. You can literally do more. The female DG can stand at the kitchen sink and kind of toggle between the sink and refrigerator to put a salad together, for example
6. Be ready to say no and yes. No when you’re really not feeling up to it and yes when people offer to help.
7. Spend the money on an wedge pillow to make it easier to keep your leg comfortably propped up in the “toes above the nose” position. No combination of pillows would have produced the same results.
8. Hope for temperate weather. The rarely too hot, summery temperatures of Menlo Park have been a boon.

Anything Giants is always a spirit booster

Something very, very cool arrived in the mail for the female DG today – a 1960 San Francisco Giants scorecard for a game played against the Milwaukee Braves at Candlestick, a thoughtful boost for her recovery sent by long time friend Carla McMorran. The lineup was filled out – Mays vs Aaron! – and box score neatly penciled in. Almost as fun was looking at the ads and remembering old SF restaurants and watering holes, most but not all long since shuttered.

The gift took on greater significance when she was reminded during the Giants broadcast that it was 50 years ago today that a young minor leaguer by the name of Willie McCovey make his major league debut, going four for four. The perfect tribute to the great Hall of Famer was Pablo Sandoval plunking a home run over the right field arcade into McCovey Cove.  The female DG met McCovey once during the dark days of January 2007 and boy was it a bright spot.

Normal is far away but we can pretend

The morning started with a kiss. Maybe that’s how many married households begin their day but in the land of the dual Gs (gimpy and grumpy), its a bit of a rarity. Not a whole lot of time for tenderness when it’s just a struggle to get out of bed and make your way to the bathroom.

But after the male DG’s walk (he reported extra wobbliness) and the female DG’s morning injection to ward off blood clots, it took on a semblance of normalcy, though nothing is really normal when you’re now together almost 24/7 and a marriage is used to breaks during the day. Work, lunch, more work. The comical clean up act performed in the kitchen because it really is the best sink to wash hair. And how many couples – gimpy or not – end their day getting dual manicures – and for the male DG, his first pedicure. With a few quick strokes Helen of SkyNails was able to disentangle his right toe nail, making him good to go. They couldn’t even contemplate what would happen if his right foot went south.

Glory hallelujah, the knee walker arrives

The male dual G (gimpy and grumpy) had just emerged from his nap when the UPS truck arrived with the knee walker (her selected model shown here).  The female DG was elated – help was here if what she had heard about this scooter-like device was true. Male grumpiness followed almost immediately: “You didn’t tell this thing needed assembly.” She thought: “Yea, agreed, it’s not exactly how storks deliver babies, all cleaned up, diapered, and ready to go. But it’s not in a million pieces either.”

Thankfully the angels continue to descend, this time in the persona of Maggie Pringle who was delivering one of Trinity’s Manna Ministry dinners. Mother of three fairly close-in-age and now grown children, she displayed her Christmas Eve mechanical skills immediately, helping the male D G figure out what goes where and screwing various things in when two hands were needed. A former physical therapist, she helped the female DG onto the machine for test run. And away she went!

The intricacies of steering properly are still being learned as well as the necessity of keeping her right leg away from the turning wheels. (One gouge on the back of her calf will remind her.) And it will be a challenge to figure out how to get it and herself in and out of a car without help. But all in all she’s moving – and can even imagine a ‘knee walk’ around the block.

How quickly a world shrinks

When the female dual G (gimpy and grumpy) wasn’t catching up on agency work or admiring her day-glo pink cast, she was looking longingly out the window. Sure, she was wistfully wishing that she could be out and about – to be normal and whole. Even yesterday’s car ride for the post-op visit was a bit of a thrill.

But the real reason for her outward looking  focus today was waiting for the UPS truck to arrive with its promised delivery of drugs (yes, legally prescribed RX – the dual Gs just switched to mail order) and the much-anticipated knee walker.

Because the male DG was out a good bit today, some of the looking outward was practical. Even with a sign posted on the front door that this household was “mobility impaired” and slow to get to the front door, she lived in a state of anxiety that she wouldn’t make it there in time – and the much needed supplies, both of which needed signatures for delivery, would not arrive as promised. And if that’s not pitiful (hmmm, that word brings back long ago memories!), she doesn’t know what is.

It’s check up time with the surgeon

With the blue tubing of the Polar Care 500 hanging barely in place and the surgical bandages starting to unravel, it was clear that the post-op visit with Dr. Oloff was coming none too soon. But when you’re a two gimp household, the prospect of getting dressed, into the car, out of the car, to doctor’s office and the reverse is a bit daunting. (We promise to forever spare readers the details off the sponge bath procedures currently in effect .)

It was also to be the most activity the female dual G (gimpy and grumpy) has had since Friday. She’s feeling good – clear headed and pain free as far as her Achilles tendon is concerned. She’d feel almost normal if it wasn’t for the reminder of the dreaded walker at her side and how much it hurts her hands and arms moving from one place to another.

Having reached the SOAR office, they were quickly ushered into, for lack of better words, the fitting room where there was three (or four) examining tables separated by curtains and every kind of orthopedic device you could imagine. A certified orthopedic technician by the name of Joe removed the bandages. And there, surprisingly, was something approximating her  pre-injury foot/heel. There was no discoloration to signal the sniping that had gone on and  minimal swelling.  The male DG could see the four-inch long incision knitted together with sutures. Soon Oloff appeared to pronounce “looking good,” to encourage the daily injections that ward off blood clots (giving yourself a shot isn’t all that bad) and to give the go-ahead on the application of a cast. She’d never considered that getting a cast would be good news.

Nor had she known that today’s fiberglass casts come in a multitude of colors. She couldn’t resist day-glow pink. Mission accomplished – next visit in a week

Angels – of the human kind – descend

The idea of having an angel has become more appealing to the female DG since she’s been watching Saving Grace on TV. Of course Earl (pictured left) is a pretty cool angel.

Since her surgery on Friday, there have been a parade of human angels, many of whom the male DJ has blogged about over on gulker.com. They’ve come bearing flowers and veggies, books and puzzles, meals and prayers.

Ever since the male DG was diagnosed with glioma almost three years ago, they’ve fretted about being the ‘pity couple.’ Now that they’re double gimps, the pity meter can’t help but ramp up. But if there’s been pity, it’s been accompanied by the most generous hearts, and for that, they are grateful.

Two days down – and 28 to go

Just as the female dual G (gimpy and grumpy) was settling into the idea that the pain she feared post-surgery was not going to happen, another reality sunk in – how was she possibly going to endure this restricted mobility for another month – the anticipated time she needed to be non-weight bearing (NWB) on her left ankle.

When some people hear NWB it doesn’t immediately sink in – they think in terms of not being able to pick something up or carry something around. But NWB cuts a wider swath of restricted activity. You can’t put any weight on the  limb – no standing (not even for a second) and no walking. Add to that fact that you need to use crutches or a walker to get around – and that it takes two hands/arms to operate both – and you’re pretty much helpless and stuck.

The female DG is embarrassed to admit she just can’t get the hang of crutches. She marvels as she sees people glide with what appears to be little effort across a room or along a sidewalk. But the moment she tries to advance forward, she fears falling over. It’s a lack of stability that she just can’t tolerate.

So she’s doing her limited hobbling around the house (when untethered to the cold therapy machine) with the aid of a walker. And boys does it suck. Her arms and hands ache; her back twinges. Each step requires considerable effort. It takes forever to get 25 feet. And she’s [a formerly] fit and healthy person.

Meanwhile, the fact that she’s near helpless – and the ongoing care necessitated by the cold therapy machine – is turning up the male DG’s grump meter. He’s not used to being on call but rather he’s used to having some things just done – things that the female DG did to offset his gimpiness. But now she’s gimpier. This was a “competition” that would have preferred to avoid.

All praises to the Polar Care 500

When the female Dual G (gimpy and grumpy) awoke following the surgical repair of her left Achilles tendon – which Dr. Oloff has characterized as ‘textbook’ in execution and expected outcome – there was a blue tube poking out of her foot to mid-calf bandage. It was attached to what she know refers to as “the new miracle on ice” – the Polar Care 500 cold therapy machine. It’s one of similar models that, while not covered by most insurance companies because it’s ‘comfort’ not ‘necessary’ care, provides continuous soothing cold water to the surgical site and is designed to reduce pain and swelling.

Now 24 hours later, there appears to be no significant swelling – and the female DG is relatively pain free. There is some kind of ongoing discomfort, but she has a hard time characterizing it as pain. (The litmus pain test to her, like many women, is child birth, and this was way on the other side of the scale.)

She is so convinced of the unit’s efficacy that she urges anyone having orthopedic surgery so ask the doctor early along the diagnostic path about what ‘he/she does for post surgical swelling and pain,’ and if part of the answer is not ‘order cold therapy treatment’ (presume there are other brands than Polar Care) she’d be tempted to march out of the office right then and there. (According to Oloff, these kinds of devices have been in use for about a decade but are increasingly popular.)

There are really only two drawbacks to cold therapy. Because of its continuous nature, the recovering patient is tethered, so each bath room visit or other movement requires stopping and unhooking the tube from the surgical site to the machine’s pumping tube. The female DG was able to get the thing undone but it was hard for her to hook it back up, requiring the services of the male DG pretty much 24/7. In its favor, if he could reattach it with his near useless left hand, anyone should be able to. The other downside is the monitoring required to make sure the mix of ice and water is correct.

Otherwise: this thing is a miracle and incurred only a minor amount of grumpy and groaning from the male DG.

Note to all insurance carriers: Have to believe there must be some statistics about negative consequences (falls for one) of prescription pain killers of the strong enough variety – Oxycontin or Percocet – that providing an alternative to their usage, or at least minimizing their usage, provides some cost benefit to the carrier.

Day of surgery anxiety

The morning began like any other. The alarm went off at 6:00 am. The Dual Gs (gimpy and grumpy) rose, dressed and headed for the Page Mill YMCA. The female DG did her usual 45-minute drill on the elliptical machine. The male DG managed to contort his back on some darn machine so severely, he could no longer move his neck from side to side (in addition to having only partial use of his left arm and leg).  Just what they needed on the day of her Achilles tendon surgery.

The female DG  never used to be anxious about medical stuff or being around medical staff. But that was clearly before the idea of immortality vanished. Was that sometime in her late 40s, mid-50s, when the male DG was diagnosed with glioma? She’s unsure.

But anxious she was when she arrived at 9:30 am at Waverly Surgery Center for what the staff kept referring to in an oh-so-chipper manner as her “procedure.” Don’t know if that word was supposed to make her feel better about the fact that some surgeon was about to open up her ankle and whack away at her tendon – or if it’s just more convenient. Everyone else in the pre-op waiting area during her less-than-an hour wait was indeed having a procedure – colonoscopies to be exact.

She noted that there seemed to be an inordinate number of nursing staff and at least one too many lectures going on. A nurse was telling another victim – oh, patient – that Obama was “going where he had no business going because he didn’t have a clue” in reference to the current health care reform legislation.

She was soon joined by Dr. David Berger – at least she’s 90% sure that was the man behind the mask. The usual pre-op pratter took place (pleas from the female DG to do whatever possible to prevent post-surgical nausea and wooziness). By the end of the visit, an IV line was open.

Then a visit from the cutter himself, Dr. Lawrence Oloff, the go-to-guy in the area when it comes to sports podiatry. The purpose of the visit – to determine if he was going to open her up while prone (she thinks lying face down) or laterally. The verdict – the latter.

Then almost 20 minutes earlier than scheduled she was wheeled into the operating room. She’s always curious about these compact spaces – so much smaller than they look on TV. But this morning she had no time to scan the scene – she was out. Then next thing she knew she was waking up and thinking, “Why don’t I hurt?” But she didn’t – and she wouldn’t – at least not that much for the rest of the day.