Known Knowns

**Note: I actually wrote this post on New Year’s Eve. Then, my computer ate it. Three days later, after much mourning and even after writing half of a new post, WordPress coughed up the original out of nowhere. Happy New Year to you, too! (I am going to backdate the timestamp.)**

I have actually been thinking about writing my 2008 Goals for several weeks; it is now five hours until 2008 so here goes nothing. The first thing I’d like to do is re-evaluate my goals from last year to see how I did.

Goal: Expand my food palate and, in particular, eat more fish.

Outcome: Good! I now consider salmon to be one of my favorite foods and try to eat it at least once a week. I even order it at restaurants where I can’t watch how it’s prepared. I also like other fish: halibut, swordfish, tilapia, and mahi mahi. So, great progress there. However, I still hate onions, so no progress there (but I wasn’t really trying.)

Goal: Do the Pike’s Peak Ascent again.

Outcome: Yes, I did it again, and you can read all about it here. All I have to say is that at one point, I seriously wished someone would just shoot me in the face. I did NOT train for it, but I did complete it. So there.

Goal: Get Roland his Canine Good Citizen certification.

Outcome: Not even close. He’s not even in any formal training right now due to my weird schedule. Also, mentally he is very much a puppy (even though he’s one year old) and very silly and nowhere near mature enough to be certified. I don’t mind though; he’s still doing really well and this is just going to be more of a long term goal.

Goal: An unstated GPA goal for nursing school.

Outcome: Well, I got all A’s, so I guess I did okay. I’m still not so good at letting the pressure off myself, especially now that I’m two semesters in and still doing so well, academically.

Goal: Improve bowling score from a 56.

Outcome: Rocked it. I bowled a 62 a few weeks ago. Boo y’all.

So, all in all, I’d say I did really well on these resolutions. In fact, 4 out of 5 ain’t too shabby at all, and I have to say I’m proud of myself. What do I have in store for 2008, you ask?

• Exercise. I know, I hate to be one of the one gazillion people vowing to go back to the gym in 2008 but maybe if I do it now, I can just maintain it and never have to use it as a resolution again. The truth is I’ve already started, so it’s not quite as cliche since I won’t be officially starting on January 1, 2008. I’m trying out this new program called CrossFit and plan to re-evaluate in three months. If I hate it, I’ll try something else, but I want to really focus on staying active.
• I’d like to make a gift to Harlaxton College, where I studied abroad and had the most amazing semester of my life, bar none. I don’t know when I’ll make that gift, and I don’t know how much, but this year I’ll do it.
• I would like to start composting. Also, I’m not going all hippie, but I did get some reusable grocery bags for Christmas, and I think I should be using the bus a little more. I’ll work on that.
• I’d like to continue the success I’ve had in nursing school in several ways: keep my mind open to things that may not initially seem appealing (like pediatrics) and refrain from gossiping.
• I will make a real effort to clean the litterbox once a week at least. I plan on doing it when I do my own laundry,which is every weekend almost without fail.

Today is my third wedding anniversary. What does it mean to me, you ask? Another day to celebrate how lucky he got when I stuck with him after he called me the wrong name. Only kidding. He’s the best thing that ever happened to me and I’m still crazy about him. Here’s the 2007 Josh n’ Caroline Photo Collage to celebrate.

I LOVE YOU, JOSH.

 January: I wouldn’t want a New Year’s Kiss from anyone but him!

 February: A facial for Valentine’s, and it wasn’t even a hint. (Or if it was, I missed that.) And a party to celebrate my acceptance to nursing school right after.

 June: Our first scuba trip to Bonaire.

 June again: Hawaii!

 July: The hottest groomsman at the wedding! (And the hottest bridesmaid, too…)

 August: The couple that suffers together stays together.

 September: Drunken karaoke. And he still likes me!

 October: I don’t know how I got the bike helmet on, or what it had to do with my costume, but, I wouldn’t want to be wearing it with anyone else.

 November: Our first $90, 10 lb. fried turkey.

 December: Still together after another cold camping trip.

I got my stitches out today and have been cleared to go back to the gym, although I can’t swim until next week. As a self-titled “layman’s expert” on arthroscopic knee surgery, I’ve decided to write a Patient-to-Patient Guide on Survival. My mom and I always got a kick out of the lame tips that the local news was always giving out, such as “drink lots of water when it’s hot out!” and “wear a hat in cold weather.” Now I’ve decided to throw out some tips of my own. This is in no way medical advice, and may not apply to every situation; just mine.
1. Take your pain meds! If they make you ill, tell your doctor. Well-controlled pain is a hallmark to good healing. Try taking the narcotics with a large meal if they make you sick. Make sure you talk to you health care team (nurse, anesthesiologist, doctor) about your pain management right after surgery. If you have a history of nausea, let them know. We have drugs to help these kinds of things!

2. When elevating your knee after surgery, put the pillow under your ankle (not your knee) to regain full extension. Do it right away, while the anesthesia is still kind of in effect, to lessen the pain. This will help you regain the motion in your knee quickly, and is also key to getting off crutches and making a full recovery.

3. Listen to your body! This may be the most important thing. If you feel like you need crutches, use them. If you feel like you can go without, do so. Your body is an amazing communicator and will let you know almost immediately if you have overdone it. That being said, plan on spending at least two or three days on the couch with your leg up. Do not go back to work and try to move scenery 72 hours post op like I did the first time. Give yourself time. Your body will thank you.

4. Do your PT exercises. It definitely sucks during the first few days because of the stiffness and swelling, but if you concentrate on things like very slow heel slides and straight leg raises, just a few times a day will really improve your recovery and get you back on your feet in no time. If necessary, take your pain medications 30 minutes before you do your exercises.

5. RICE. I cannot extol the virtues of RICE enough. That would be rest, ice, compression, elevation. I felt that my compression stocking did a lot to reduce the swelling. I also slept with an ice bag on it, and I’ve already mentioned the minimum two to three days on the couch. If you’re going out, consider wrapping your whole leg in an ace bandage to reduce the swelling. Less swelling equals less pain equals more movement equals better recovery. Your knee will tell you when it can tolerate anything less than constant icing. Seriously.
6. Don’t forget to wiggle your foot a lot. You don’t want to end up with a blood clot in your calf, which can happen when there’s not much movement of the blood in your lower extremity. A good way to prevent this is to pump your foot up and down a few times an hour. It doesn’t even hurt.

7. Trust your team but don’t be afraid to ask questions. I’m not saying that there are never royal screw-ups, but for the most part, your health care team probably knows what they’re doing. They are there for you, to answer your questions and get you back on the road to climbing mountains, or whatever it is you need your knee for.

8. It will get better. It is hard to imagine that when you’re looking at a c antelope where your knee used to be, but pretty soon, you will not even remember what it was like right after surgery. The body is amazingly good at forgetting pain. Just don’t push your luck.

Despite the fact that my DVR/Tivo is totally devoid of anything interesting to watch, and I’ve now seen Father of the Bride at least three times, I support the writer’s strike.

People think that the actors they watch on TV make up every line that they speak, in every sitcom or movie. They don’t realize how hard it is to write funny material, week after week, with the pressure of ratings never far away. What they don’t know is that Hollywood is a collaborative effort, just like health care is. Nurses and physicians must work together to get a patient healthy, although they have differing roles. Writers and actors also work together to make sure the shows are funny or serious or poignant or what have you. If the line isn’t funny to begin with, no actor can make it funny. Likewise, a bad actor can ruin a fantastic script. It’s a big job, and I think this strike is finally beginning to call attention to that fact, especially now that the Guild is refusing to allow certain video clips be shown at the Oscars, as well as refusing to work on the Golden Globes broadcast. Good for them.

I don’t care how long it takes and how many episodes of bad reality TV I have to watch. I will support these people till they get what they deserve.

Around this time last year, I wrote a post that recapped the year’s worth of blog posts. I’m doing it again this year, by posting links to the first post of each month in 2007. Enjoy!

January: Trying to think of something interesting to write

February: My new celebrity cop out

March: Pike’s Peak Ascent 2007 registration problems

April: Feeling safe

May: Freakin’ awesome

June: Lowering the bar

July: Home again home again

August: The most fun I’ve had in awhile

September: Cat’s day out

October: I’ve never wanted anything so badly

November: Um hello

December: Full circle

I just put my crutches back in the garage where they belong! I have been getting along quite well without them since yesterday. There’s still a lot of stiffness but I am regaining my flexion and I can get to about 90 degrees without much of a problem at all. Woot! Mornings are better and by the evening I’m pretty stiff again, but I’m definitely noticing progress everyday. I think this is the way arthroscopic surgery is supposed to be.

Although I haven’t been noticing any pain, I started taking Tramadol again. There are several reasons for this. The first is that I paid for the prescription to be filled, so I might as well used it. (Same goes for the darvocet.) The second is that apparently I am not a very good judge of my own pain, because after I take 2 tramadol, I feel better even though if you’d asked me before, I probably would have said I wasn’t in any pain. How very odd.  It also doesn’t make me sleepy so everything is good. I can be more mobile because it hurts less, even though I wouldn’t have thought it hurt to begin with. I can’t explain this but oh well. I’ll take the pills, anyway.

On the other hand, I took two darvocet (narcotics) last night on the same principal as above, and also thinking it would help me sleep since the swelling and heat tends to be worse in the evening. Strangely enough, I slept worse than I’ve slept since the day I had the surgery. I had a hard time falling asleep, I had a hard time staying asleep. It was really odd.

So in the meantime, I’ve been spending lots of time on the couch, watching way too much TV. I’ve been watching lectures and getting ahead of the game for my pediatric clinical, so that’s good. I also have a few blog posts I want to write, a few sewing projects I need to finish, and I think I’m going to work (desk job) a few days this week, too. I am really trying to enjoy my forced downtime because as much as I want to get going again, I will be sorry to get off the couch when the time actually comes.

I’ve been incredibly impressed at Roland’s consistantly good, patient behavior. He did not once get under foot while I was on crutches and he stays nice and clear of my knee. His girlfriend, Lena, has been over to the house to play twice, and that seems to wear him out sufficiently. She is also a German Shepherd, and I think it’s really good for him to play with another one because they play exactly the same way, they don’t have to figure each other out, and they have a ton of fun wrestling and chasing each other and playing “shepherd” games that other dogs don’t get or don’t like. It’s awesome to watch. Also, Lena’s owner helps me with his training. We’ve been working on long down-stays and also playing a game called “Find It” where I hide a treat somewhere in the house and Roland, well, finds it. He’s getting the hang of it really quickly.

No pictures today because the knee looks basically the same as yesterday with just a little bit of very light, additional bruising that’s developed.

Are you tired of hearing about this yet?

I took my shower first thing this morning, before all the hot water was gone. Despite the fact that I had been taking a quick bath to watch my hair, I definitely started to reek over the past few days. It was nice to get in there and soak a little bit, in the blistering hot heat that I like so well.

I decided not to take anything medication-wise today, as the pain is almost negligible and my stomach is starting to get acidy from all the ibuprofen and I don’t want to give myself a GI bleed.  The most uncomfortable part is the incredible stiffness and the process of my knee learning how to bend again. I have really great flexion and extension at this point, but it’s pretty much only passive, meaning I can’t get my muscles to do the work on their own yet; I have to manually move my leg into position. The only other complaint I have is the warmth radiating from the knee, but that’s easily cured with constant ice.

I still have to remind myself that the surgery was only Wednesday and that these things take time. Now that I am off the narcs, I tend to think I should be “cured” by now and ready to start pushing too hard. I think this has been part of my downfall in previous knee fixes, so I’m trying really, really, really hard to be patient and gentle. It’s only been three days. There is really no point in rushing things, as I’m already way ahead of “schedule” in terms of where I’ve been in the past. I’m also young, healthy, and active, and should be fine in no time. I guess I just feel that there is this idea that arthroscopic knee surgery is pretty simple. Well, it is, really, but it’s still surgery, and I still have stitches ‘n stuff.

Despite all that, I did manage to venture out today. I took a quick (and by quick I mean excrutiatingly slow) drive to Walgreens, a mere 1/2 mile from our house. I’m also going out to eat with some friends tonight. I have rewrapped in an ace bandage under my compression stocking to minimize the swelling that will inevitably occur, and already I feel like my knee is nice and safe like a bug in a rug. The benefits of the RICE method (rest, ice, compression, elevation) are definitely noticeable. I think I’ll probably end up wearing this getup at my next clinical (starting Jan. 2), too.

Here’s the latest picture. It’s really quite pretty now that all the betadine is washing away. There’s hardly any bruising or anything! Each prior time I have developed a giant hematoma that basically amounted to a huge, black bruise that lingered for weeks. This is the most beautiful post-op knee (of mine) that I think I’ve ever seen. By the way, if you’re getting tired of listening to me wax poetic about knee surgery, fear not. This thing will be back to normal in no time and I’ll have to go back to talking about Roland’s poop.

So far so good! Honestly, this has been (so far) the easiest of all my knee surgeries. I’ve actually been hobbling around without crutches, although it’s more comfortable with at least one. (Even with two, I’m still weight-bearing.) I attribute it to aggressive anti-inflammatory meds, narcs that don’t make me sick (and thus, well controlled pain,) and laying with a pillow under my ankle instead of my knee, which promotes more extension in the joint. These things seem simple and obvious, but, for example, I don’t recall being put on an anti-inflammatory last time, which can have huge consequences in terms of pain. (More swelling equals more pain.) Now, (48-72 hours) is usually the worst in terms of pain, so we’ll see how long the trend continues and how many steps backwards I take today and tomorrow.

Here’s a gross picture for your viewing pleasure. I was able to take my dressing off today, although I have to leave the TED hose on for another week. Enjoy!

Brian over at Inrepair.net tagged me in this post that includes seven things about him; a post which I shall now emulate. But before I do, can I just say that I LOVE being tagged? I do. So, thanks again, Brian! Also, Brian tagged me, like, 2,000 years ago so forgive me for taking so long.

Without further ado…

1. I’m terribly afraid of the dark, which is one (of the many) reasons why I got a German Shepherd.

2. Lately, I’ve been thinking that when I die, there won’t be a god to judge me, but instead, it will be all of the patients I ever cared for.

3. I was my high school’s sophomore class president.

4. I like the smell of gasoline. I wish it came in a Yankee Candle.

5. I’ve been a Stage Eater since before I can remember, and people frequently point out my habit. When I eat Captain Crunch Berries (a disgustingly sweet, sugar cereal primarily marketed at nine-year-olds) for breakfast, I eat all the squares first, then all the berries, which leaves the milk a nice purple color. I do the same thing with Skittles. I typically eat the colors that I dislike the most, first. If I have a meal that involves french fries, however, I always eat my fries before anything else on the plate. No exceptions. Fries are best consumed hot and greasy.

6. I wrote an opinion column in college. I once wrote something negative about a fraternity event and soon after, started receiving threats. It got to the point that I wouldn’t walk on campus alone. I continued to write nasty things about said fraternity until I graduated.

7. I have been saving my mail since I was in elementary school. I have several shoeboxes full of all the notes and cards I’ve received, including notes I passed during class. I have ever wedding card we ever received. I also printed and saved special emails.

I had kind of a long night last night. I was generally uncomfortable, sleeping on the couch on my back, with some pain in my knee, and I had also napped during the day so I sometimes found myself wide awake despite the pain meds.

Speaking of pain meds, I’m having a great time. Normally they make me sick to my stomach but this time around I’m tolerating them really well (at least so far.) I haven’t had one bout of nausea or vomiting. My original plan was to stay as far from the narcs as possible but last night I changed my mind due to the pain. (I view it like a labor plan; you can go into labor thinking you won’t have an epidural, but the best outcome is one in which you allow yourself to be flexible if necessary. Sorry, I have my OB clinical up soon so I’m switching mindsets.) I was nervous that I would spend the night in the puker, but apparently the anesthesiologist loaded me up with enough anti-nausea meds that she saved me from a different world of hurt. I hope it continues that way.

I felt good this morning despite sleeping poorly, so I took a pseudo, and incredibly acrobatic bath (can’t take a shower or get the dressing wet till Saturday) and changed all my clothes. This in and of itself made me feel like a new human being. Since starting clinicals at the hospital, I always try to encourage my patients to get cleaned up every morning even if it just meant letting me give them a bed bath (most of them don’t protest but a few did.) It just makes you feel so much better, even when all you’re going to do is lay around like a slug all day. Anyway, I am now laying on the couch waiting for my body to tell me I over did it, but it was so worth it for the shower.

A word about my husband: he is a real gem. He has been keeping me on a regular pain med schedule as well as diligently checking the circulation and pulse in my operative leg. It’s incredibly endearing. Most ladies would kill for someone to take care of them as well as Josh does to me. As well they should, too. I’m a lucky girl to have him.

With all that, here are a few pictures (for you, Jim!) I only have two right now because I can’t take off my dressing until Saturday but they’re kind of fun, anyway. I have never documented (at least not thoroughly) my 2 previous knee surgeries but I think now that I’m in nursing school, it’ll be a little different. Here ya go…one of the leg and one of my most amazing hair.