Sunday, December 15, 2013

A Seven Month Update

I can't believe how quickly December rolled around.  I think we were several days in already when it really hit me that it's December already!  December 4th marked seven months since Peyton passed away.  Perhaps it was my pre-occupation with my upcoming surgery or the busyness of the season, but the 4th came and went smoothly.  That monthly marker usually hangs over me.  This month was the first month where it didn't weigh quite so heavily.  It is heavy, but I felt like the day passed by with perhaps a little more peace in my heart.

I realized recently that, in case you have been following the story about my own health issues here, I really haven't updated that in a long while.  So, unless you have been following over on my regular blog, you may not know what's up with that, between my ankle injury and the pulmonary embolism {PE}.  I was awaiting results from my ankle MRI.  I saw the Orthopedic Surgeon on October 30th as an already scheduled follow up visit from the first one I had after the ankle injury.  The MRI was scheduled after he learned about my PE.  The timing of the MRI wound up being such that he would have the results in hand when I saw him on October 30th.

The results weren't great.  I felt like things "weren't right" even before the PE slowed down my physical therapy progress.  The MRI confirmed they weren't right.  I didn't have a bad sprain and pulled ligaments.  I actually had a torn peroneal tendon.  What does that mean?  You can click on that term to pull up a link or, simply, you know the bumpy bone that sticks out on the outside of your ankle??  The peroneal tendon runs along the bottom side of that and down to your foot and up the side of your leg.  That tendon was torn when I rolled over on my ankle.  This type of injury is often seen after repeatedly doing that, which I have done for as long as I can remember - just never this bad.  The ligaments are loose and it causes the ankle to be unstable which, in turn, causes the ankle to turn over suddenly.  Ligaments can heal themselves over time.  Tendons really don't.  As soon as he was explaining this, I knew what was coming.  Surgery.

The problem with my case is that I have the recent history of PE.  The surgeon wanted medical clearance from both my Hematologist and Pulmonologist before proceeding with the surgery on my ankle.  A tentative date was set for November 21st.  On November 11th I had an appointment with my Hematologist.  He was all for me having the surgery, as he knew I was in a lot of pain.  However, he wasn't on board with it happening so soon after the PE.  Ideally, he would have liked for it to be at least 3 months from the PE which happened on September 30th.  Realizing the pain I'm in and the injury, he said anytime after the first week of December should be fine.  That meat postponing the surgery date.  The new surgery date was December 12th.

I was to show up at the hospital at 11:30am on the 12th {last Thursday} for 1:30 surgery.  Originally it was 2:30, be there at 12:30, so an hour earlier was fine by me.  He seemed to be running long, so things really didn't get rolling til closer to the original time, if not a little later.  Ron and I said our goodbyes as they wheeled my stretcher down the hall.  He was back out in the waiting room when we stopped.  Something was missing in the paperwork.  I'm not sure if it was an expired clearance from one of the other specialists I am seeing or if they were missing the clearance altogether, but something wasn't right and I couldn't go back to the OR til it was fixed!  Long story short, it had to do with the Hematologist.  They moved another guy to my time slot in the OR while that mess got sorted out.  I was in the OR at 4:35pm.

At 5:51 I was back in recovery.  That's what I first remember - someone giving that time as when I was waking up.  I was in quite a lot of pain.  I had to get IV pain meds a few times and then an oral med before they sent me home.  I was home by 7:00pm or so.

I wouldn't say my pain was out of control Thursday night.  Ron went and got my prescriptions filled, came home, and took care of my needs and I pretty much just went to bed right away.  I was in and out of sleep all night, but sometime in the early morning, I knew I'd have to get him to call the doctor's office for me to get something different or stronger for pain control.  I knew at 8:30am Friday that the meds I had weren't going to cut it.  I know the first 24-72 hours after surgery are the worst, but they shouldn't be spent in nearly that much pain.  He left a few messages and finally heard back from them at 4:00pm.  Let me tell you, that is a very long time to wait when you're in so much pain all you can do is cry, shiver with teeth chattering and pray for someone to whack you over the head with a shovel so you'd lose consciousness.  I kid with that last part but it was the worst pain I've ever experienced - and that is saying a lot considering all I've been through.

What ultimately happened is that my oxycodone prescription was already a hefty dose.  I was already taking the max dose at the shortest intervals with no effect whatsoever.   They changed the dosing schedule and the amount to take of that prescription at certain time periods so that three out of every four hours around the clock, I could get something.  It wasn't necessarily the same each time, but there was only one "off" hour out of every four.  If I didn't need it, I could skip but I had to stick to each hour being specifically as directed.  I wasn't skipping anything.  I finally got relief and Saturday morning was fairly good, all things considered.  The pain started to creep back up on me, but so were some of the side effects of taking that much pain medication.  I have been setting alarms round the clock to make sure I didn't miss any doses, but at some point early on during the night Saturday night, I realized that this strict schedule made sense on paper and upon review of it in writing...every time.  However, when it came to grabbing the bottle of meds and sorting out how much {1 or 2} to take, it wasn't computing.  It made me question things to the point where I knew what I should have taken at a certain time, but wasn't sure if that's what I'd actually done.  I realized the best solution, since my pain was actually lessening at that point, was to take nothing {I wasn't absolutely needing it} until I could get to the start of a new four hour cycle safely - where I wasn't somehow taking two doses with 2 pills in a dose within one 4 hour period.  Confused yet??  I kept setting those alarms just to be sure I wasn't losing any ground on pain control.  I wound up not taking any oxycodone until almost 1:00pm today!  I took some Tylenol in the morning, but that was it.  And I wasn't needing the oxycodone, so this was good!  I did start taking it in the afternoon and this evening ramped it up to the higher dosing, but I'm thinking that the end of the days are going to be bad, so get used to it.  The more frequent dosing caused me to go through my prescription faster.  At least I know that I can make it to Monday with what I have left.

Recovery so far hasn't been pleasant.  They were definitely right about the first 24-72 hours.  I'm now past the 72 hour mark.  As I said, I think the end of the days will be more painful.  It was with the injury before surgery anyway.  The peroneal tendon has been repaired and a couple ligaments tightened up.  I am now in a very heavy soft cast until I see the surgeon for a follow up on December 27th.  I don't know if I'll be put in another cast or just back in the boot at that time.

I am fortunate that Ron's mom had already been planning on visiting at this time before the surgery date was changed to December 12th.  She arrived on the 11th and leaves Tuesday.  It's been very helpful to have her here.  I really appreciate everything she has done. I also appreciate Ron and Moira's help.  Ron has taken a few days off.  With everything we went through earlier in the year, he's not got a lot of days off remaining, so it's a good thing it's almost the end of the year!  Ron and I already asked each other for forgiveness for ourselves for times when we might become frustrated or lose patience with the other.  I hate being in this much pain and being so dependent.  I don't like asking for help.  However, I simply cannot do things without help right now.  I am trying to do a little more each day - and more quickly than I probably would have if I hadn't had the blood clots to contend with.  Our main goal right now is to do our best to prevent that from happening again.  There's more of a risk after surgery anyway, but after surgery already having blood clots...that's a little different!

We did our best to help minimize Moira's concern for me and this surgery, but she's a worrier.  She's been through so much with us, especially this year.  I tried to play up the fact that I was excited to get the surgery over and done with so I could get on with the business of truly recovering.  I don't know how much she bought that but it was all I had.  She sees the pain I'm in now.  It's hard to put on a brace face when you want to scream in agony, but you do it anyway.  Or you try.  But she knows I'm hurting and she worries.  I find myself again playing up the fact that the worst is over and now I am really on the path to recovery and healing.  She probably doesn't know about the next few weeks of fear of blood clots happening that Ron and I worry about.  We are just praying that that won't even be an issue ever again.  She's such a strong girl.  I am proud of her.

Keep us in your prayers, please, as we go through this healing and recovery period.  It's a long road ahead, but as I keep saying to Moira, this time that road is leading to true recovery.  The worst is over.

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