Pardon me if this post is a tad rambling

Or sort of incoherent.

Three days ago, my left calf, and behind my knee, and hamstring, and my annoying fused back started hurting a lot. I wasn't worried, because I had an upcoming visit with the physio, "Simon The Sadist" for a session.

To say my physio session rushed would be an understatement.  Yes, they were trying to clear up all clients before the up coming long holiday, and he, personally, was taking some time off. Good for him, but I felt I had been given the bums' rush. And I was charged $61 for the privilege.

Today, when I got up, I was in worse shape than I was BEFORE session. Tried to do some of my rehab exercises, and for all my efforts, I almost fell over, my knee kept giving out. I left comment on the "PhyApp" regarding it.. before I took something for the pain. Meds I haven't had to use October last year.

Yes, I hurt that f*cking much. With better living through (legal) chemistry, the acute pain is now just a dull ache. I can deal with that.

Oh wow.

I just came home from my appointment with Dr H. I told him about the Monday Mistake and my knee having no pain on Tuesday. I then old him about how I re-created the Monday Mistake, and had the same results the following day. I have been taking 300mg twice a day for the past two days, and have had no knee pain.

He said the almost instant relief of pain shows it is definitely neuropathic pain. I am now officially on 300mg capsules twice a day.

Dr H did tell me that I have to be careful not to over strain my leg, as the muscles and structures around it are weak from using a brace and crutches, but ya know something. I am just so jazzed by the fact that yes, it's not all in my head, it is neuropathic pain, and there is light at the end of the tunnel... and it's not New Jersey! ;)

I am going to experiment on myself.

Not going to take a chance with the seizure meds this time, but I'm holding off taking the morning nerve pain meds until later in the day. How much later will depend on how bad the nerves start jangling along the fasciotomy scar and the left knee.

If getting as close as I can to repeating what I did Monday evening today, Thursday, and get the same results on Friday, I'm going to have to have a serious discussions with GP and pain specialist. Because if it's the same under medicate me for years bullshit I had to put up with regarding hypothyroidism, I don't have another 20 years to wait for them to pull their thumbs out of their asses.

Saw the Occupational Therapist Friday afternoon

And was shown (painfully) how I was standing and walking incorrectly. Ian apologised for it, but I told him not to worry, because it's like telling a child something is hot, they don't believe it until they touch something hot. I wouldn't have really understood what he was referring to regarding my knee and the rest of the leg.  I have been walking with my feet turned out, and I have to school myself to keep them pointing forward.  I was also sent home with a list of exercises to do.  I did them Saturday, and my left leg is quivering in protest. Oh, and did I mention it #%$%%@ HURTS! At least it's muscular, so maybe paracetamol will help, as it doesn't help with the nerve pain in the knee joint.

Ian also advised me to wear a knee brace to keep knee stable (no side to side movement) and to keep foot pointing forward, not turned out. He was happy to hear I had a couple of DonJoy's to use.

I have to retrain my leg to not have me walking like something from a zombie movie.

I still feel like a walking Pharmaceutical Experiment. And both Ian and Dr L said yes, have to find the right combination and dosage to quell the nerve pain. 

Saw Dr L today

But this time, I had hubby wait somewhere. 

I'd felt last time that D L had a chip on his should regarding my husband calling and nagging him to push my appointment up. And that it was reflected in how talked at me, instead of to me.  All fixed.

He says that concerning my knee problem, I have 'realistic expectations’.  I'm not looking for my knee to magically feel all better. What I want is the pain level of 5 to 7 on a daily basis to lurk around three.  I'm functional at that pain level.  And I need a good night's sleep.  Dr L has given me a prescription that I am to have filled one month after taking 60mgs of Duloxetine a day, a low dose of something (forgot the name) to take around 7pm, in hopes it makes sleeping easier.

Also told me no need to split the Dulox 30mg caps to one in the morning and one at night, but to take the full 60 in the morning.
I told Dr L I was beginning to feel like a pharmaceutical experiment. He said basically, that's true. We are trying to find the right combination to get the nerve pain under control

I feel like a walking pharmaceutical experiment

Been on the Duloxetine for a few weeks.  I saw GP last week, and I told him how it would wear off late in the afternoon, or early evening. Because of that, pain was getting up up at night.  Dr H suggest I go with a 60mg dose in the morning. Uhh, seeing how Dulox hammers me with nausea, dizziness, drowsiness, I made the suggest about taking 30mg in the morning, and 30 before I had off to bed.  This was amenable to Dr H. Tonight will be 2nd night taking Dulox before heading to bed.

Saw both psychiatrist and psychologist. Yes, I have depression. Yes, I have suicidal thoughts. I sometimes actually cried when I woke up, because I woke up. Be that as it may, I'm not doing anything that will prevent me from waking up.  Both have told me when I'm not being rocked with pain all the time, the depression should be alleviated.

Still hopeful.

Well, shit..

The osteo-surgeon who did my TRKR three years ago is retired from surgical practice, so he referred me to Dr C. to see what's to be done with my left knee.

I got some good news and some bad news.

Good news is I don't have to go under the knife. (insert muppet cheer here)

Goodish news is there is something to be don. Dr C. said yes, I do have mild arthritis in the knee, but the structure isn't in need of surgery.

However (here comes the bad news) the compression injury from Loki jumping on my knee, combined with the arthritis has cause acute nerve pain. Oral pain meds dull it slightly, but that stuff makes me groggy and fuzzy headed.

Treatment for the knee: rhizotomy. Injections around the front of the knee, under the kneecap, to sever/burn out the nerves. I asked him "If I can't feel pain, will I over do it and cause more damage?"  He said no.  So, my NEXT referral is to a pain management center/doctor.

I'm being referred, seen, referred, seen.. round and round. 

Yes, it does make a big difference

The past several months, I have been on very short rations of sleep due to knee and car accident related pain.  I had a meltdown last week, crying, ranting, and just nuts. But sleep deprivation can do that. 

Last night, I went to bed very early, and made sure my back was to the door, I was under the blankets, dim reading light. I read for about 15 minutes, put book away, shut off the light, and I was out cold. 

Woke up, check the sleep log and I had been in bed for over 9 hours, asleep for 8hrs and 35 minutes.

I got up, and wow, my knees weren't anywhere near as sore as they had been.  The swelling of my right knee was gone.  It was the first morning in weeks that not only wasn't I hurting, I felt rested and able to get up on stationary bike first thing after feeding the purr kids.

So yes, getting enough sleep does make one helluva difference.

Up before the dawn again

Sometimes, I just can't get the right leg comfortable enough to sleep well through the night.  Was up at 4:43 am (checked my watch, so know the time is right).  Let Keito and Loki into the back yard to 'dig holes in the sand'.  Checked on Ziggy, as she and Trance had another dust up yesterday.  Once again, Trance was on the losing end of things.  Ziggy is ok, though.

Fed them all around 5:30.  Keito got his insulin on time.  Ziggy, from having to groom self after the fight with Trance, hurked up her food. Of course ON the sofa. (Preen OxyAction to the rescue)  There was a HUGE clump of fur.  After I cleaned it all up, she demanded to be fed again.  Tossed some things into the washer, and they are currently hanging out on the line.

Knee feels a bit thick and stiff this morning, but there was no sciatic pain.. at first.  But when it showed up, it did so with a vengeance. Immediately did the routine Matt gave me. First five.. gritting teeth. Second set, not so bad. By the time I had finished the 3rd set of five, the pain was manageable. Have taken pain meds, and the anti-inflammatory.

One really doesn't appreciate the absence of pain, until it hammering away at you.

Physio Visit

I gave Matt the rundown of what I have been doing to alleviate the pain in my shin/ankle.  Nothing seems to be working. Even starting up the rehab exercises didn't help.

After some questions, then some pushes/pulls/twists/pokes/prods we did find out it's nothing wrong (aka, no damaged bone, or DVT). It's mild compartment syndrome, pinching the sciatic nerve that runs over the outside of the fibula, down over the ankle, to the arch of the foot. I still have some swelling from the knee replacement, nothing like it was before, but still there, and it's causing pressure on that nerve. 

Been told to continue with the pain meds as needed, and to NOT SKIMP or skip. Given some exercises/stretches to reduce the nerve pain.  Go back next week for a follow up.

Voluntarily back to the drawing board

The Tibialis Anterior pain isn't going away.  I have done the stretches and other things Matt The Physio said to do, and it's not changing anything.

After checking my blogs, and comparing when the pain started to when I was give the 'all clear' from having to do the rehab exercises, it seems the shin pain started shortly after.  I have decided to go back to the rehab exercises.  And if I see any improvement, it will just mean I have to take 10 minutes, 3 to 5 times a day, to do them again.

Here's hoping, because if it is compartment syndrome, that could end up requiring more surgery and NO thank you!

Dammit

I slept for almost 8 hours. Amazing what the combination of exhaustion and pain meds can do.  I was so happy to have been just taking the non-analgesic anti-inflammatory in the morning, and not taking the pain meds. 

Now, I'm hobbling into the kitchen to take them. 

Have left the Targin alone though. I didn't have any withdrawal symptoms so not really worried about addiction regarding it, but I feel it's a level of pain management I don't need.

It's not the knee, nor is there any breaks/micro fractures in the shin. Interesting test, use of a tuning fork. Bip, place on shin.  If there had been any breaks, it would have been extremely painful. I just felt cold metal of the tuning fork.

Matt checked for heat (sign of inflammation) and for deep vein thrombosis (palping the calf muscle..ouch) but it's none of those. There is a thin muscle between the tibia and fibula, that goes down and across the foot (the tibialis anterior). THAT is what is giving me all this grief.  The knee itself is fine.  

Matt said that as much of a downer this is (I was so happy to be able to DO things, albeit at a slow pace, but still able) it's only a set back, and it will get better.  Depressing, yes, but not untreatable.

Pardon me while I go mope/cry for a bit, ok?

It's been a week since last physio visit

And that 'shin' pain is still there, and if anything, it's worse. Yes, I can 'medicate' it away, but I've been in the process of reducing pain meds, so I really don't want to start taking them on a regular basis.  Might have to, though, as it's really interfering with my daily routine! Those who know me know that I tend to push through pain, and keep going, but sometimes this pain brings me to a dead halt.  It's not the knee giving me pain, but the muscle on the right side of my right calf, paralleling the shin bone.

If it keeps up, I will call physio, and see if I can be 'squeezed in' before the 25th, or shortly afterward.

Form two lines, please

On the left, those who have compassion for the pain I'm in because I followed physios' instructions.

On the right, those who want to nag me about doing too much, again.

There was a Canon Collective event yesterday, and since the Shelly Jetty is a flat area, easily walked (as both my physio and surgeon recommended I start taking meandering walks). Wing brought a chair, so I wouldn't have to stand the entire time. But that got rained out, so we went to the Narrows Bridge to at least be under cover from the rain.

Unfortunately, the wind coming off the Swan River was cold, and the scar over my knee stiffened up in the cold. Followed by the hamstrings.

This morning, it was (no joke) torturous to do the bending of the knee, sliding heel back as far as possible. I did all 10, but I was biting my lip to do them.

First full day without

Today is the first morning I have gotten up without having taken slow release pain medication before going to bed.   I noticed I was more restless last night, as the pain was enough to keep me from sleeping as well as I had been the past few weeks.

Also, doing my morning rehab exercises... let's just say I had to grit my teeth more than once.  

Had breakfast, and took morning doses.  Took quite a while for the pain to start ebbing, but it's manageable now.  I will be seeing Dr S tomorrow. Will see if I should just be on lower dose of the slow release pain meds or just daily supplemental pain meds.

Here, have a clue

There are some people that don't know what's going on with my knees (yes, plural) but with my right one being much much worse.  I have arthritis in my knees, it's a family trait. But, when I was 18 I injured my right knee, and about 18months after that, I developed degenerative arthritis in it.  It's been giving me trouble off and on for 40 years. My right knee has a head start on the left.

An accident last October pushed the remaining meniscus out, turning it from being an annoyance, to a borderline crippling injury. I have NO cartilage between my femur and tibia/fibula. None. That means I had bone on bone grinding when I was walking around, for months before I got to see a specialist.

Yes, I have had two rounds of drain the fluid, and synovial injections. I am on a 'diet' of anti-inflammatory and Panadiene Forte (as needed) It has made it possible for me to do normal daily activities.  HOWEVER.. walking for 30 or more minutes on uneven paving, or a walkway that slants down towards the street is a tad uncomfortable, the way giving birth is a slight pressure. 

I'm lucky if I get 3 uninterrupted hours of sleep at night. It's more like I take 2 naps at night, which means my ass is dragging the next day.  Rinse and repeat since October LAST YEAR!

I could take the Panadiene Forte more often, but I really dislike the head packed in cotton feeling it gives me. So, I walk slow. And it f&$%ing hurts to do so... read above, about the bone on bone grinding. And my left knee is causing trouble because I am favoring my right leg. My left leg, which is still partially paralyzed/unresponsive because of nerve damage from disc collapse, isn't handling the extra work very well, and THAT knee is starting to get worse.

You know that "On a scale of 1 to 10" for pain measurement?  I'm on a constant 3 at the very least, to "wanting to rock back and forth crying". Add a good sized dollop of depression into the mix, and you might have an inkling of what I am going through. So, when I mention I walked for 30 mins to get somewhere, your flippant comment and eyeroll makes me want to punch you square in the face, or just scream at you.. but I do neither.  But I do wish you could feel what I'm going through for just a few weeks, see if you'd be so cavalier and flippant afterward.

A lot of people just don't get it

Many times, when I go visit people, I smile, have a great time. What people don't see is the next day when I am almost in tears from back and leg pain. I swallow pain killers when make me lethargic, but at least keep me functional.

I didn't ask or plan for a disc to calcify in my spine, and then collapse.  I also didn't expect 6 weeks after the surgery for someone to make me walk, using a cane, for 2 kilometers. It set back my recovery at least two weeks. Then, SOMEONE not learning from what happened to me, two weeks later, we go to a cinema with horrible seats (not going to mention the hobbling walk to the cinema and back), and THEN to a cafe with even worse ones.  Did I mention the low to the ground sports car, where I was pretty my folded up in the seat, knees up at a 70 degree angle? It was all I could do not to sob uncontrollably in pain. It took me 3 weeks to recover from that movie/cafe combo.

Too often, chairs and sofas are too low (I'm supposed to sit with my knees at an angle UNDER my hips).  Getting out of them after sitting for a while is, no joke, white hot agony.  But I smile, and never let on.

Of course the next day, I am a case of "Better Living Through Chemistry". 

I can't walk faster, but I'm not 'lazy'.  Many have seen me doing yardwork, go on all day photowalks, go for long hikes in the woods, or over rocky terrain.  Stalking birds for hour after hour. 

So, when we go for a walk through the city, I have two choices. Get left way behind, or limp to walk faster and schedule the eating of pain meds the next day.  Ain't that a hoot?