Monday, March 28, 2016

From The IRS...

Just got an email. The IRS says they have my refund as I requested. It's nearly $3,000. All I need to do is click on the attachment with the cute little zipper logo and get further instructions on how to claim it. Should be easy. It comes with an 8-digit number to verify my claim.

Let's see. The URL is from something I've never heard of, but it's got "National" in its name. Good sign, right? Dot com, of course. Not dot gov. Not even anything to reliably indicate what country the email originates from. Had I claimed a refund - which in itself is peculiar, as I've never paid in this year, not yet filed, would never have overpaid by that much, and would have had any such deposited directly into my checking account - it wouldn't be acknowledged this way.

Even in my fever-addled state, I know at least that much! Come to think of it, in my fever-addled state, I wouldn't even have tried to navigate through any kind of paperwork, and the more important it was, the less likely I'd try.

Oh yes. I am running a fever. I have now for three days. It took me a while to figure it out. I know, dumb, huh? I just haven't had one in years so it took me a while to put fever, chills, fever, chills together and decide it wasn't the house changing temperatures, it was me. If I thought it was anything at all, I just figured it was my post-surgical body trying to figure itself out. How could I be running a fever, anyway? I'm taking Percoset with 325 mg tylenol, 800 mg ibuprofin, and 325 mg aspirin twice each day, with more ibuprofin filling in the middle spots for pain relief. Where does fever get a chance?

There is an infection somewhere. Urgent Care says it doesn't seem to either be in, or have migrated to, my knee, though they told me what to watch for. There are no other symptoms other than being unusually stupid,  feeling like crap, and being unable to regulate between overheating and chills, but they decided under the circumstances to err on the side of caution and prescribe an antibiotic. That was after eliminating a UTI as the infection source: that requires a different medicine.

No, I can't tell you the name. I've never heard of it before. I read the label. Twice. I still don't know what it is. I just take it. I could tell you but I'd have to wander down to the bathroom to copy the name off the label for you, and that would be a whole lot like work. Probably spike my temperature again, as well as wear me out. Ordinary bathroom runs do that too right now.

I'm saving the rest of my morning's ambition to locate the phone number for the PT folks and cancel today's session. Either somebody there last week shared something, or if I go I'd be sharing something. Bad either way.

Meanwhile this morning's crazy dreams can work on spending that $3 grand I'm not getting. So much better than dreaming I'm back in school, or falling off the high oil rig platform into an Easter egg pastel color swirled polka dotted ocean of ice cold water. (I ran that last one through my head about a dozen times until I finally landed in the stuff before waking up and found even in my dreams I cannot, after all, breathe under water. Come to think of it, that was about when the fever started.) At least there haven't been the usual assortment of work dreams, the kind where I can't deliver the package because I can't read (anything, much less a label), lost my map book, am in the wrong city or country, need to get my car fixed/returned/whatever first, am still in my PJs at home, or whatever block my normal brain can throw in my way. I hate to think what it would come up with from a fever.

My guys are taking care of me. Steve is sleeping in at the moment. So is Paul, despite my letting the dogs out/in having to walk past his futon on the lanai. He's been painting the hallway and doing a half dozen other little (or not so little) chores and hoping I'll recover soon so we can go play tourist. That, and because he hopes I'll be better soon, of course.

PT will be open soon, so I better go find that phone number. Then I can snooze some more, in between piling on and taking off my blanket and heading down the hall and back.

Tuesday, March 22, 2016

Slice of Life

Today is voting day, aka presidential preference primary day. It's a bit weird here, with closed primaries. You must have already registered with a party preference, either Republican, Democratic, or Green. You will receive a ballot with only the presidential choices open to your party of choice. You may vote at any polling place in the county, of which there are about 60. That's a way-too-small amount, and an hour after polls opened the TV crews showed long lines.

With everything I have going on, waiting in line is not my first, nor even my 16th choice, so I've done an even better thing. I've signed up for permanent early voting status, meaning for every election a ballot is mailed out and I have a couple weeks or so to fill it in and mail it back.


Steve hasn't gotten around to doing that yet. Today may change his mind. It's his busy and much anticipated/dreaded day. This morning he meets with a specialist for evaluation of that shadow on his lung x-ray, something picked up on over two months ago during an ER visit. Of all the scary possibilities, we're kinda hoping for a diagnosis of scarring left over from Valley Fever.

Once out of the doctor's office, we'll head over to the nearby polling place where he'll wait in line to cast his vote. He wasn't sure exactly whom to vote for: the most likely to or the most wished for. I reminded him of the old adage: in the primary, vote your heart. In the general, vote your head. His decision is clearer to him now.

Waiting in a long line is only slightly less anathema to him than to me right now. We're going to pack my smaller, more portable scooter in the back of the car, where I will be waiting (reading) while he votes. I'll be there to offer assistance in what hooks into where, and he can be as patient as he needs to be while in line.

The walker is in the back of the car at present too. It's just where it got set after the last trip out to PT, yesterday. Technically, it was before the trip. I walked in under my own power, refusing the cane. My lack of stamina made that a bit difficult, but the building they are in offers plenty of sitting options between the parking lot and the waiting rooms. At any rate, it is there, just in case. I haven't used it for two days now.

By the way, now that everybody's asking, my numbers are 4 and 113 (passive). This is a reflection on how much I can straighten and bend my new knee. Since I'm always doped up before hitting the torture room, I'm a bit hazy on exactly how it works and all translates out, and usually forget what was just said about three seconds later. I think the first is for how many degrees away from perfectly straight the knee gets, perfect being 0. That makes the other number for the bend. I'm still stuck at 94 active, meaning when I'm supplying all the power to the bend just by myself, I manage 94 degrees. Remember, 90 is a right angle. The goal is 120, which seems backwards to me. We're looking for a narrower angle than 90 degrees, so wouldn't that be, say, a 60 degree angle? Anyway, a passive bend, meaning the therapist pushes until just before the point where I scream, reached 113 yesterday.

I was impressed! I'm not sure I made that even before surgery.

Of course I got a bit cocky and impatient, deciding that this would also be the perfect time to cut back on the Percoset. Would it be redundant to comment that by 7PM last night I was very much regretting that choice? I finally got the pain kicked back to my current new normal a bit after 2AM and got some sleep. We're not trying that again soon. The Dr. had already cut my dosage back and I'm no longer inclined to jump the gun.

The biggest excitement we expect tonight. Paul, my youngest, just started his vacation and is flying down today, with a stopover in Denver. Previous vacations have been working vacations for him, getting the den/bedroom turned into a library. This time he's paying his own fare and limiting his labor to several smaller jobs, like pruning a bush behind a fence or moving some middling sized rocks to the front yard. He wants to get out and see the real desert this trip, see what's blooming, maybe spot wildlife.

We've got plans.

Saturday, March 19, 2016

Celebrating Small Stuff

I'm betting most of you can get your own shoes on by now without even giving it a thought. Or a passing twinge. Well, guess what? I can too! OK, just not that twinge part. But I don't need help with the shoes any more.

Mostly that wasn't an issue. Either I didn't go anywhere or it was just barefoot around the house, LR to toilet, back to LR, back to toilet.... When it was PT time, Steve was always there to help. And drive. And that help in itself is worth three cheers, even though it feels like more progress to get to where I don't/won't need it.

The first big step midweek was when I slipped both feet into a binful of soapy water and scrubbed their bottoms with a sponge on a stick. What a relief! They could have been my Halloween costume. The household dirt made their bottoms black, and the Betadine turned bits so orange I almost worried that something squirelly was going to sneak in and take off with what it was sure was a Cheeto! I made sure I stayed in that inch of water until all that mess was gone.

Next thing was getting my socks on myself, as well as off, even if it did mean a shopping trip to find something cheap enough that they were easily manipulated. White/grey cotton anklets did the trick. It took me a couple days longer to stretch the knee enough to get close enough to the shoe laces that I could manage them. I considered buying something with Velcro closings, but it's hard enough just finding shoes I can wear without crippling up my feet that I decided to forgo the experience. A couple more days stretching and there you have it!

Everybody had been asking whether I was off my walker yet, though nobody suggested how I was to know whether I was ready to do that or not? If I asked, I was simply told to wait until I was ready, not to risk damaging the knee. But how was I to tell?

Of course, once the seed was planted, the progress started. Up against the sink/counter, let go of it for a step or two, see how wobbly it went. In the bathroom, instead of doing a 180 and backing in with the walker, I simply parked it and guided myself in using the counter top, the toilet rails, the window ledge... any and everything that could be useful to prevent a problem.

There weren't any. A single step became 3 or 4, the walker got lifted and turned while I stood next to it, using my arms only for turning. My balance was OK. I still had one "good" leg, and in fact the PT was strengthening it alongside the replaced one. I could walk over to the bed, or from the microwave to the fridge, though the latter was less of an accomplishment as I regularly cheated with a hand brushing along the counter. But to the sink with a coffee mug of water to heat, no biggie.

The big thing was that it didn't hurt any more without the walker than it did with. Of course, I was not about to push it, but I didn't always need the six extra legs. Oh wait, four extra, six total. Nor using the strength of both my arms resting on its framework, a very tiring position indeed. And after a few practice stand ups in PT without hanging onto anything whatsoever, I gained the confidence that such support was becoming optional.

Of course when I am very tired, the walker is  lot less optional. That seems right. On the other hand, my "mad dash" down the hallway often leaves it parked just inside the bedroom door with 7 or 12 steps yet to go before pants tugging time. I'm trying not to get reckless about it, but independence is growing. A few steps is almost never a problem, with care. What's much more of a problem is trying to move the walker along with the used dishes from the last meal, the water bottle needing to be refilled, the three things I'm working to tuck into my pockets because this whole thing is an effort to make another trip down the hall without having to backtrack it into three trips.

PT introduced me to the use of a cane yesterday. I've tried those things on numerous occasions, never successful ones. First she fixed the height properly for me, then guided the cane to my "bad" right hand - wobble wobble - and then to putting it down at the same time as the bad leg. I could never get that part right. Always thought it ought to be on the same side as the bad leg to give it support rather than lean everything on the opposite side with either step. It takes a lot of concentration to follow through without switching out the sides or the timing, so mutch that it seems easier and more logical to just switch straight to regular walking. Much less of a tripping hazzard too, I should think.

I certainly can't carry anything along with a cane. If the pockets ain't big enough nor the waistband tight enough, whatever-it-is just ain't coming along!

I got permission for my first actual shower this morning, Whatever strapping tape it is they used to replace yesterday's pulled staples with, it withstood the wetting nicely. Of course, it itches ferociously as well. Not sure if that's just random healing itches, or allergic reaction to the adhesive, first application in the area. I'll find out. Eventually. Two more weeks and I'm allowed into the pool!

But today's shower felt wonderful! Not least because it was preparatory to my getting out of the house all on my lonesome for the first time since the surgery. I forget what they called it but all the different clubs at the community center opened their doors to show the passing world just what they did/made, sell what they could, distribute brochures, demonstrate techniques. I wheeled down in my scooter (OK, really, 4 hours was a bit much in retrospect, especially by the bumpy trip home!), set up back in a corner of our room with the cash box and a smile, and assisted in sales of donated items. These might have been earrings, or slabs of rock of various values to be worked on or used as coasters perhaps. We took in funds from the boxes of Cracker Jacks as well. The two women also handling this part of the room discussed techniques, classes, materials and prices of items, and gave out small bags to tuck the purchased items into purses with.  On both slower times, we three had brief conversations among ourselves, but there were not many opportunities.

It was great to be welcomed back, and EVERYBODY, friends and strangers alike, knew what the particular set of tapes across my knee stood for. There were almost as many conversations about replacements as about jewelry and rock sales. One woman showed her scar, saying "2006." I pointed to mine saying, "March", and suddenly her eyes widened as she realized what month it still was. Universally it was pronounced that I would enjoy the improvement, even from the woman who's had 1 replacement and 15 corrective surgeries on her knee and vowed never to let them touch the other knee, ever!

Overall it was a great time, not the least of which was because I could finally be somewhat useful to someone again. At least from back in my protected little corner. Now, wheeling down the hall to the restrooms brought the dependency back in a hurry. Remember: this rec center is the newest in Sun City. It pretends to follow ADA guidelines. But if you can't push open the heavy door to the restroom by yourself or pull it open on your way out, well, just forget it! Wear a diaper! Once in, there are a couple stalls with side bars to hang onto, though none is big enough to get into along with your scooter. And while the rails are nice - make that the only things which make the whole process possible! - the toilets themselves are only standard height. It was something I'd forgotten about. Before surgery I could cope. Grumble, sure, but cope. Afterwards it was nearly impossible, plus downright painful, to pull myself forward, up and off that seat.

Oh hey, isn't it pain pill time again?

Thursday, March 17, 2016

Finding Steph Again

For the third time now, Steph has moved her blogging address. Her first site was what actually got me started in blogging, part of its generalized stated purpose. It was called Quiche Morraine. Sorry, been so long I no longer have the URL. (Or maybe it's the drugs.)

Then she move to one she named Almost Diamonds, and the reason I recall with absolute certainty that its a different URL than her most recent Almost Diamonds, is that I renamed her newest under my favorites column as Almost Diamonds 2.

 That newer version has resided for several years at Freethought It was a perfectly acceptable home, I suppose, garnering lots of traffic for her, and once after a referral to something I wrote garnered 532 hits for me (!), but still not quite perfect. From my perspective as a regular reader, the ads became a pain in the neck, fingers, you name it. I always had to go over and X out the side ad which pushed all her text off the page. If I hit a link into another article of hers, I had to do it again. Chopping chunks out of the middle of her blog were thumbnail links for worst plastic surgery mistakes, ugliest animal faces, newest miracle food or suddenly discovered worst possible foods to eat for X, or whatever freak show that could expose more eyes to a new plethora of ads. After I cleared my screen ready to sign off, there were always a couple of smaller windows which had been hiding there behind my search window waiting to grab my attention.

For any of you who may have gotten lost along the way, or never started following her to begin with, her latest move is much more subtle in the advertising department. In fact, it's so subtle that so far all I see is text. Her text.


So look for her at:

Tuesday, March 15, 2016

From an Empty Mind

This morning we had just enough energy to make it to the grocery store. The route now passes through a construction zone.  Including the dumb-joke-of-the-month sign (Why does Peter Pan always fly? Because he Neverlands!), the only thing of note was a sign reading "Do Not Follow Truck".

We tried to give it some thought. Honest, we did. Noting our road was down to one lane each way, we asked each other, what if the truck is going our way? Do we have to turn? And if so, can we turn back on to the same road? The same way? How long do we have to wait before turning?

We noted that vehicle ahead of us is an extended cab truck. Does that count?  The sign didn't specify. How about dock trucks? 18-wheelers? Garbage trucks? Dump trucks?

How long ago does it make a difference if the truck was going down our road? Five minutes? Half an hour? Who is responsible for knowing that information? Who is responsible for getting that information to us? What if they won't share? Does it mean getting away with it if the cop following us to give us a ticket is by definition also illegally following that same truck?

No wonder we don't get out of the house much. Mornings are difficult.

Monday, March 14, 2016

Latest Post-Surgery Reports

This may seem oxymoronic, but I swear to you that it makes perfect sense. Even Steve, after only a moment of thought, understood exactly what he thought I was saying:

The days are flying by while the hours drag unmercifully.
Just how are the days flying by? It's more like a complete absence of an internal clock, the one that tells you which weekday it is, what's coming up on TV, how many days it's been since ... anything. Stuff should be happening, progress should be getting made, differences should be apparent. None of that is happening. It's frustrating, of course. While I don't seem capable of noting progress in, say, pain reduction or tendon strength, normality returning, I am capable of noting that very lack of progress. Yes, I know that seems an awful lot like whining, probably one of several things which has kept me from posting for the last few days. It's also something I'm not certain of clearly explaining.

One of the things that makes the days vanish uneventfully in all this is my lack of ability to concentrate on reading for even an hour at a time: me, who'd happily go through three books a day! So many things can happen within those 6 hour chunks, but I can't concentrate long enough within one to lose myself inside it. With no books "retiring" from my Kindle, no progress happens. That frustration spreads, rightly or wrongly, to cover other things I wish to accomplish. It may take 4 days to make a grocery list, after which there will be about 5 things listed and absolutely no inclination or drive to head for the store. Appetite is more habit than drive, so there's still no shove towards going.

Concentration problems also show in the simple attempt to write this blog post. I started 3 days ago.  It did not take me long to realize things made no sense, not even to me who knew what I was talking about. All that beginning - middle - end stuff: jumbled. Sentences were repeated in places, not caught after several proofreadings. They were attached to the wrong paragraphs, connected to the wrong thought, or missing thoughts entirely. The start of one sentence ended in another one completely unrelated. Each time I closed out rather than posting, another day had passed without accomplishment, however small. And whatever I had said was gone, my mental page as blank as if I'd never put anything down on it. What had I said?

Nothing, apparently.

Some drugs, eh?

I am, however, literally painfully aware of the slowness in the passage of the hours. I finally settled on 4 x day a doping, being still too goofy to follow any schedule that has variety in it from the previous day. Was I waiting for 3:30 for my next dose? Did I skip one at 6 or have it half an hour early because ...? If everything happens at 6 and 12, My fuddled brain can figure out that much. Either it's still an hour or 3 to go, or I've just taken my dose and should sit back, relax, wait for it to hit, and plan meals and activities accordingly. No point in starting a TV show that I know I'll sleep through after 15 minutes, but it will be a nice distraction about 2 hours out from next dose. I'm sure I'll need one.

I can wake from a nap, subjectively convinced that I've just had 3-4 hours of down time until a quick clock check shows that perhaps 25 minutes have fled, though fled is way too optimistic a verb. I'm sure somewhere out there is a thesaurous which I could use during some of my between-pill-times for working to find just the right amount of motion within the confines of practically no motion whatsoever. Heck, the word search might even make the time pass.

Not sure I'd recognize it if it moved around in front of me and stepped on one of my toes, however. I'd probably think it had been some kind of hallucination.

Ahh, yes, those are still continuing.They continue to reinforce my belief that I should be nowhere withing 50 miles of the steering column of a car.  It's not so much that they distract me from whatever might or might not be real. It's that when the movie scene playing in my head skips forward, I spend a full second or more trying to either remember what the previous color the background for the last otherwise-identical image was, or spend that same second processing whether or not it was even important whether I do so or not.

If this all sounds extremely frustrating to you, It's not. Not really, at least in the better moments. Of course, why should you believe the person who just finished explaining the frustrations? Maybe it's that the expectations and coping skills are both meshing and improving. With better, more regular scheduling of my PT to fit in with the meds, I can make sure to assign blocks to the task when I'm up to pushing the job. It doesn't seem important but putting those tasks on my internal schedule makes them more real. They did happen.

Tiny things show. Not every step requires a deathgrip on the walker. I can stand on one foot - or both - and reach over to the medicine cabinet to load up on the morning / evening pill supply, haul them to where TV, coffee/water/food are lined up. Evidence of planning.

I do have some reassurance of a minor bit of prefrontal cortex functioning left to me. I lost my keys. Ahah! You think: another oxymoron. Lost keys as a sign of thinking?

OK, I do get your point. But it's the processes of locating them which has been somewhat reassuring of progress.

I never used to lose car keys. When I worked, I kept one set in each pocket, patting both before leaving/locking the car. Those pockets were only emptied into a small dish on the nightstand. Habit, habit, habit. There was no "lost". Now however, I share the car with Steve. Each of us has our own pattern, such as it is. Steve still had his set so his habit pattern must be working. It was my set that came up missing. I wasn't too worried. I'm not driving and the other set was being taken good care of.

However, it began increasingly to gnaw at Steve. He was searching, hunting, questioning, unpacking, then repeating. All the steps I'd be going through were I feeling the need to find my keys. At first my lack of caring about the keys was a big part of why Steve was starting to drive me nutty with his. I was barely capable of recognizing my own keyring, much less with taking time and energy from healing and recuperating to assist in finding them. I was seriously considering snapping at Steve next time he announced which was to be the upcoming project to find them. He'd even gotten me to start imagining them getting sent out of the house with garbage or recyclables,

Luckily for him he found the need for a nap of his own before his next announced step in the hunt could occur. But he'd gotten under my skin, so maybe not so lucky for me. I made it over to the table to hunt through piles and figure out what/when/where of possible placement, also reorganizing and rearranging piles so I could drop the table leaf and there was room for a person with or without to move through the room on that side. I made it to the couch, to the master bathroom, to the clean and dirty laundry piles including pockets, into the washer and dryer, throughout the lapidary supplies, through bagfuls of hospital paperwork and supplies that of course I'd find exactly as urgent as the staff sending them all home with me found them to be.

Uh huh. Those piles will still be the same piles in three months. I'll bet on it.

Now, you could think of all that activity as the biggest PT program  in a single session in history. Mine, anyway. Will hold that status in the future as well. Ain't never gonna do all that again! Not even though I've completed the three days necessary since then to let the muscles and tendons relax.

Four, maybe?

The important part of all that is not whether it led to the finding of the car keys. Because it didn't in fact accomplish finding them. What it did do is show that there was still something of a brain behind all the chemicals which was still capable of making and carrying out a plan. If you give me a few hours, I might even remember exactly why that matters to this posting. And if I do, maybe even have the sense to check whether I told you once or four times.

I was busy collapsing into my living room chair for the next two months of my life when that final process itself led to their locating. The chair is a lift chair, and when it hit a certain point, my car alarm went off. That told me two things. First, the keys were within close distance of the car. Not in garbage or recycling. Not gone forever. Second, the keys were somehow caught in the framework of the lift chair. It was nowhere I could find, and nowhere I was willing to continue looking for them.

Yes, you may think of those two as the same one thing. I understand. My brain is working differently right now.

About 20 minutes later Steve woke up, and my setting the chair down after greeting him set off the alarm again. Now we had both of us to look for those pesky keys at the same time. Again, Beep Beep Beep Beep. Just no keys keys keys keys. We'd tried reaching between cushions several times already, but this time I tried while putting the chair up in a higher setting. It worked!

At our next PT outing, we headed over to the local hardware store to replace the house key on the ring that got bent in the process of jamming in the works. Another day/time/burst of energy, we'll locate a car dealership and find out if the part of the electronic key fob case which connects to works to the keyring can be replaced. That bit of leather has been well chewed. If it can't be done cheaply, I'll figure out something with duct tape rather than waste a couple hundred. Probably not this month.

It was an important find, but only minor progress. Real progress reports  will hold information about being able to get my own shoes and socks on. Or making it down the hall with little enough reliance on the walker that I no longer need to do so much laundry!

What? You don't see the connection?

You must still be very young. You can probably move quickly from wherever you were when the thought struck to the actual bathroom where that thought should be implemented. Not me. Not now.

While I love having two bathrooms in the house, each one is tiny. Narrow. Requiring planning for a safe way to get both person and walker inside and lined up properly, ahead-of-time type planning, since once started there's no easy turning. (Just for fun sometime, try it.) And there are impediments.

It seems it takes a similar amount of time for a novice to back an 18 wheeler into it's dock as it does to turn a 180 in a well-used lender/walker  and back oneself across the bathroom without catching the slightly wobbly wheels on the door frame, missing the same frame with my hip, dodging the side rails of the lender toiler seat and managing a squat with all the necessary wardrobe out of the way, but not so fast the tendons are overstretched to the point of being required to find a spot on the floor for a fetal position because you missed the most favorable stopping point on your way in.

Now THAT would be progress!

 We could even pack the earplugs away. Maybe. You know, for the screaming. No, not for the embarrassment. Not even for all the extra laundry. Maybe not even for the need to get somebody's attention to arrange an assist lift out of that tiny space that one well person can barely get in/out of. But just because all that would hurt like absolute hell!

Well, no, I haven't actually had it happen, at least not yet. Just saying, doncha know.

Wednesday, March 9, 2016


I'm past ready for things to start getting better. I'm sure you've been there. Different reasons, different timing, same loss of humor.

For me of course the big part of it is the unrelenting pain. That's not completely true, of course, because after a while if I don't move in the wrong way the pain melts way back. Hell, if it didn't I'd never get any sleep. We both know that not the case. It's may be weird but it is sleep.

Toss in the unending anticipation of pain, the knowing that every time you want to do something you have to prepare yourself to go through that first. Is it worth it? Do I really need that full shower? How about if I just wash... well, nevermind. And actually a full shower would be a blessing, but I'm still restricted from getting fully wet.

Do I bother to answer the phone? How about that next call? Or is the phone even close enough to be an issue? Where did I leave it anyway? If I do answer it, will it upset my medication schedule? Sound stupid? Well, while I explain that, let's just pile on the awareness of how stupid much of the whole thing is, spiraling down even further. If I have to put down what I'm carrying, either a pills supply or the food or a balanced beverage with which to take them (mustn't spill, mustn't run out at just the wrong time), does it change the timing? Will I simply get so distracted by the call that any memory of what the schedule is supposed to be flies right out the window? It doesn't matter how many times I tell myself that the last one was 4:30 so I can take another at 8:30 and one after midnight if I'm awake then, any little whisper of doubt  is an eraser across the memory board. It's primed for erasure anyway, since "oversleeping" sets the schedule back.

Steve hasn't been perfectly well, further frustrating both of us. How can I pile more onto him? He's doing so much extra for me already, without complaints. But how can I stand more piled on me? Just trying to cut stresses back adds yet another layer, subtle, but there. There's that new little glitch in conversation that boils down to yet another way in this particular situation of needing to examine whether one more thing can be added to the carry pile this trip, or do we really need one more trip? I want to make it easier on both of us without burdening both of us with overplanning. Or maybe this is one of those things I can take on as I regain my independence.

At some point it all gets to be too much. Meltdown!

Yes, there are tears. Apparently much needed ones. None of which, as we're all very well aware, are well-justified in the wider scheme of things. But somehow the burden starts to lift, what wasn't possible becomes possible, what was about to be too much to bear becomes bearable.

I can appreciate the sense of humor returning as I grab half a sec to reflect that the term itself, meltdown, has been contributed to my mental conversation by a friend who's had to deal with way bigger challenges that anything I'm working on and whose life circumstances so much more justify the event even as the word is supplied.

So, meltdown? Pause. Reset. Carry on.


Tuesday, March 8, 2016

Sleepwalking? Sleepsleeping?

Life's getting than usual. I first blame the drugs. I think I'll call what's been going on "sleepwalking" even though no part of actual walking has been happening.

Think what that would be like to wake up to! OUCH!

I find myself over and over today coming abruptly out of a dream in the middle of an arm movement that would have put me directly into the action of the dream. It's never anything remarkable in itself. One or the other of us is handing something to the other one, say, or picking up or dropping off something. If it were real it'd be happening all though our dream lives. We don't think about it any more in our dreams or its lack. Our internal screen simply skips from scene to scene, from here to there to elsewhere, no passage of time, no logic.  We want to go somewhere, we simply shift to being there. Dreams simply don't take us through the motions so much as skip by them.

But one of the things we take for granted in REM sleep is the paralysis. Eyeballs roll and muscles may twitch. Arms don't move around: "Here, put this on that table." They just don't. Fortunately the very difference of having movement brings wakefulness. That very awareness of how weird the movement is becomes part of the experience. Waking-up me knows this just doesn't happen.

Except my arm is now in a position that shows it just did. It just grabbed something, caught something, placed something, felt something which doesn't exist. And as soon as it is over, I return to sleep knowing both that it has and will happen again.

Since I'm only aware of one sleepwalking episode in my life, about 60 years ago, I can't look back, take it apart, and examine the details. Thus I'm not even confident I'm supplying the right label here. But when there just has been motion, I don't know what else to call it.

Even "better" is when something else unusual happens. Because of the meds and the fairly constant napping through the days and nights, I've gotten used to  something of a pattern. None of those naps are very long. I know. I've been watching the clock each time the eyes open. I want to know whether it's time I can take another pill yet. Much as I do not wish to push the intervals shorter between pills because that's the beginning of a problem, neither do I want to stretch the timing out past the first available second where I could begin the process of pain relief for this next cycle.

Each interval lasts 4 hours.

I know just how little I sleep at a single time. Really, trust me on this. It can be very disappointing.
 It's dark, it's quiet, it's boring, and I can't get up and do anything about any of it. Not for, say, 47 minutes. Ummm, 46.  Ummm, 45. The ice is warmed but it's not worth the pain to get more. I kinda need to pee but it's not worth the effort to get out of bed when I will have to do it again in, ummm, 43 minutes now. Make that 42.

So I knew it was OK that both Steve and I relied on me to wake up in time for him to finish his nap, get dressed and off to eucher, because I'd be moving by then anyway.

Only I wasn't. His somewhat timely arrival at the club was only accomplished because we have our phones with us so I don't have to yell into another room and hope he'll hear it before I go hoarse. Cell calls penetrate. He was out of his bathroom and making his way down the hall to his shoes by the time I'd made it to my bedroom door on my way to my series of errands, including securing a pill (not for pain), fixing my supper, getting out a fresh ice pack, figuring out how I was going to get all of that plus two water bottles attached to something so I could haul them into the living room and still have a hand ready in time to hit the light switch there.

It all happened.

I'm going to assume Steve made his cards games, as he hasn't returned.

Once he does, we have another thing to put on the to-do list, in the area of things we now have to figure out how to accomplish, much less in a timely and pain free manner and without somebody skipping meals or meds. It's a routine that's no longer going to start with "depend on Heather to..."

Monday, March 7, 2016

Pain Management ... II

First off, that's an oxymoron.

Further, it's an increasing spiral, a feedback loop. You need to manage pain well enough to be able to tolerate the stretches you need to do to lessen the pain so you can tolerate the...

You get the picture.


I write about this stuff so much that you'd think it was fascinating or something, wouldn't you? It's more the opposite however. It doesn't fascinate. It overwhelms. Just when you should be able to concentrate on getting past it, overcoming it, the sledgehammer knocks you off kilter and all you're left with is wondering if you can still breathe. And why.

Some of it has got to be the furniture. The chairs in PT are just the right size and sturdiness that you can reach behind for the properly supported push off, taking the effort on the arms and the intact knee rather than those recently sliced apart knees. If you can manage so the pull is the right kind in the right place, the pain backs off. Then all the world seems possible.

At home the opposite rules so the opposite rules. Nothing seems possible. That leg which actually can manage bearing the strain is in instant recoil, dragging you down on the floor with it.

Or at least it feels like it does. Or should.

The car is no better. It used to fit me perfectly, and therefore I fit the car perfectly. But one of the axioms of a bucket seat is that everywhere is uphill out of it.

It seemed so desirable at the time. I guess it still must to the Great Unwashed, perhaps the Great Washed. (I pledge you this: I'll quit checking you for your washed/unwashed status if you'll quite checking me.) At any rate, bench seats are still not among the standard options. Push bars are not bolted in. Nor welded.

Toilets are better, but only if you were warned in time to go out and pick up the elevated seat with the side bars. And warnings also apply to those physical ones which wake you in time before your.... Oh wait, we've talked about this too.

Nevermind then. Next month will find you with increasing familiarity with soapy liquid. Visitors,  just try a quick swipe of Vicks under the nostrils.

At least be polite!

Speaking of, everybody who talked to me about home care hit the volume-control-off button in their vocal cords when they discussed this. Yes, we got a shower seat, and a hand-held. Even a grab bar. But there was something else in everybody's sentence about what to use when it's desirable to get the body clean and wet while keeping the incised part of the thigh dry. Dirty, if you have to leave it that way around the newly opened microbial highway to Heather Heaven, but for now, DRY! UNTIL WE TELL YOU TO, THAT'S FOR HOW LONG.  It was assumed that whatever that magic word was, it was heard. Understood. And referred to something actually on hand once at home. That, or that the past/future person to discuss this did/will have done the job better.

It goes something like this: "And they've all told you about               have a sufficient supply, right?"

They all managed to skip over that wince on the face as I shifted my weight. Nobody saw the dull gaze off into space as the latest meds finally hit, making everything passing by for the next 23.7 seconds vanish into the ether. However long it took for me to register that I did not, in fact, know what we were talking about, and further that it might be appropriate if we both made sure I actually did possess such arcane knowledge, the next topic was on the agenda.

I'm sure it's much the same thing going on when I suddenly realize I do not recognize this actor on the screen, have no idea of his motivation or culpability, and barely can note nor express that the background color has just flashed in a color not seen for three edits.

It's almost as if one has experienced a brief hallucination. But of course we're not having those, are we? Surely not on these meds? I mean, wouldn't it be way more fun if we were? So likely it was just a brief nap or something.

But hey, if anybody out there knows what that secret is.....

And, ummm, if those really are hallucinations, let's not bother the doctor about it right this minute, eh?

Ohh, wow! That's an actual color?

Saturday, March 5, 2016

Pain Management

First, just a note to let you all know I'm out of the hospital. Slept in my own bed last night. Slept. Well.

I learned some interesting things the last few days on the topic of pain management. Pain I know well. Management has long been more of an issue.

Way back in the day something called Darvon seemed to be doctors' first choice. Never did much for me. Not for headaches, not for sprained ankles, not for abcessed teeth. Apparently I'm not alone in my lack of fondness for the stuff. It's no longer available.

It was so lousy at fulfilling its task that for decades afterwards I had no real hope of an effective painkiller without addiction strings. Codeine had weird side effects got itself tagged with "allergy" next to it. Not exactly precise, but a word that saved long discussions. Acetaminophin or aspirin were the fallbacks and again. Other than the reputation, they didn't have much going for them. Ibuprofin was a breakthrough. But still: limitations.

That was me since 1985.

About 5 years ago I discovered dilaudid. A REAL painkiller. No high, at least not for me. No problems weaning myself off. Doctors really have to be arm-twisted to give it. It seems it does the best job out there these days of leading to addiction. But hey, it still works. It's still the only thing that really does, at least for me.

When I had to leave ibuprofin behind before surgery, I got switched to Percoset. One of those oxy... drugs. It kept my knees from killing me pre-surgery. It's not perfect. Way better than nothing, though. I could function moderately around the house, and I could tolerate PT.

After surgery there were two main options, administered alternatively, occasionally overlapping. One was Perc, the other dilaudid. Perk was a tablet. Dilaudid was the reason they kept the IV port in, and usually administered shortly before PT on the theory that it let you actually get through it, and maybe even continue to live the half hour following. You know, without killing the next person you saw. But they wanted to get me off the IV before I could leave the hospital. I saw their point, since I'm not personally into self-administered IV meds., but then they went in the wrong direction.

They tried substituting tramazol. For both meds. They knew I could tolerate Percoset but pulled me off that anyway. No, it didn't leave me likely to wind up killing the next person through the door, but only because I couldn't move enough to get out of bed, much less far enough to untangle the "pain free" leg from the wad of pillows and sheets it was entrapped in. After all, a half inch of movement in the better leg was still enough to deal a hatchet blow to the bad one. Heck, I couldn't move enough to  slide my butt an inch off the latest sheet wrinkle that decided to grow into a mountain range.

So here's the list: in major pain, wrapped and trapped by bedding, in a dark room because somebody thoughtfully turned off the room light that they no longer needed. I tried yelling - oops! too much inhaling moves the chest, connected to the hip, connected to the thigh... connected to the knee.... As it turned out later, all the noise out in the center of the ward was because of some kind of staff meeting and after bedtime was supposed to be an non-demanding time on the care staff, so even if I had felt up to a full chested roar, it wouldn't have been heard. Oh sure, you say, I could've reached for the call button - if it were in reach, and if where I was pushing on whatever this thing in my had (call?) (phone?) was the right point, and if it... oh nevermind, whatever this thing had been connected to, it no longer was anyway.

I did mention pain, right? And of course by then I had to pee.

Luckily for me - or the blessings of good engineering and experience with cranky, screaming, hurting, post-op patients - their call boards are rigged up so that if/when you pull a cord out of the wall, a whole new kind of alarm goes off and somebody comes rushing in.

Also lucky for me, I had a threat and was willing to use it. I REALLY needed to pee by now, but was refusing to do so in the proper place until they got my pain levels down.

"Bring me my dilaudid!"

They did.

Two doses, IV.

Then they unpacked me, an impediment at a time, so that once I was willing to move, it would again be possible physically. I also had them remove three of the pillows wound around my legs, remove the inflator/deflator thing on the good leg, pull blankets down off my feet, and relocate me into the recliner so I had proper hand/arm support to be able to move without falling.

Nobody had to scrub the floor that night after all. And I finally had been shown how to hang where onto which exactly so that I could safely use toilet paper myself instead of relying on the kindness of strangers. Now that's what I call freedom! By some odd coincidence, every staffer who'd been in to help with that last task had been male. Yes, you do get used to it, but I always figured a girl shouldn't have to.

I returned to the chair afterwards and next thing I knew it was the start of the morning routines. I never did wind up back in that bed.

One part of morning routine was a check in by the hospital internist. We discussed my zero response to tramadol and what can be used instead. My next threat in the arsenal was to refuse to leave if they couldn't figure out how to manage my pain. I mean, this was the point of the whole exercise, wasn't it?

This doc knew not only what I was talking about, being himself immune to the possible benefits of tramadol, but having a possible solution long-term. Short term, fine, give me something different so I can sleep right now. But long term, here's a guy who actually listens to more than the actuarials  and those folks who think that Brand W should work so that's what you'll get. So let's go to work trying to prevent this happening next time.

The solution is a DNA test that Medicare will actually pay for. You caught that? Medicare will actually pay for the test!

It's about how we metabolize different drugs. For example, alcohol: I'm one of those who can have a drink, get high nearly instantly and be well into my hangover before I'm out of the door heading home. Drunk just isn't fun. I don't know if the test checks on ethanol, but it came into the conversation as an example of how metabolisms differ. Apparently there is a segment of us who  metabolize tramadol nearly instantly so nothing is left to kill pain in a few short minutes. This test keeps us from wasting money on expensive painkillers that don't work anyway and are gone so fast that a newer bigger dose seems like a good idea.

Now that seems like a big step down the road to that cherished fantasy, actual pain management.

I'm willing to give it a go.

Wednesday, March 2, 2016

My Dearest Love

If I'm doing this right, it won't pop up on the blog until after you drop me at the hospital for Wed. morning surgery. Considering the medication load, who knows how that'll work out?

I firstly want you to know how much I love you. But you do know that already, as do I about you. I also want you to know a few other things. Surgery, after all, has risks. I'm planning to be just fine, but...  Belt and suspenders, right?

If all is not well, check out the "Documents" file in my file box first. If I'm too scattered to get stuff filed properly, keep looking. I filled out the medical power of attorney as well as the living will, short version, during check-in at the hospital. The regular will is somewhere in that box too, with the official copy on file back in Minnesota. Just where yours is. As for the living will part, we have discussed this at length. My philosophy is basically identical to what Mom's was. Don't let your loss challenge your judgment.

Oh, and taxes haven't been filed yet. Sorry about that. Not something to dump on somebody you like, much less love. Ask Paul about sorting it all out. Check my cell directory. No, it's not protected. No passcode needed.

But everything is going to turn out OK, so there is something very important to tell you about for the next few weeks.

I plan to be cranky. Not because I want to be, but because I know the process will be both painful and a lot of work. With your big heart, I know you will want to get in there and help me with everything. I need to ask you not to do that. The biggest part of the recovery process is about me learning how to function, how to regain independence. What good is a new knee if I can't figure out how to use it to get up out of my chair or fix lunch? The first thing we both need to remember is that the other one won't have been fixed yet, and it's a son of a gun.

Mistakes will be made, of course. We will both learn. In the meantime, please know that my frustration, no matter how clumsily I say it or how you hear it, will not be directed at you. It will be aimed at myself, for not planning ahead, for not figuring it out yet, for everything taking so long to get fixed. In no way would I choose anybody else to be there for me, as friend, love of my life, and recovery coach.

If - when - I unthinkingly snap at you, it will never be  intended to hurt you or drive you away, but I can certainly understand if that becomes the knee-jerk result. We've been through this before as well. Deep breaths, reminders of how much we love  and like each other, remembering each other's good intentions, and lots of patience. Yes, patience, even if the struggle means it takes twice as long to get to the toilet as it should have in order to keep the floor dry!

Sorry about that! You'll get to clean that up too. It'll be just one more of the things we can laugh about later, recalling the ways older bodies continue to fail us. Ask me where the proper rags are. And file it all up there along with fart jokes. Next to our both needing to keep a sense of humor.

I'm going to need the dogs - aka my dog - to not be jumping on my lap. Good luck helping me with that. Perhaps the first few nights you can keep her with Fred with you at night. Give us time to figure out how it'll all work. She's such a total ditz when it's time to open that door, and I'd like a chance to get my legs under me first before I have to start dodging her. Yes, I know she's not your favorite critter. But when you truly need to feel needed and helpful, this will be first choice for how. This, not the skyhook for helping pull me up out of the chair or off the bed. Not fixing lunch for me to save me the trouble of walking out and back, because I will need that walk. And the one to the bedroom because I forgot to pack the phone in my pocket. And the extra trip bringing groceries in from the car, even though it's really easy for you to help and you are always gallant enough to do so.

When I do need the help, like walking through the uneven rocks in the yard, I will ask for it. It may be after I've been stupid and gotten myself backed into a logistical corner. But I will ask. You trust me to ask, and I'll trust you to be there when I need you. Together we'll get through this, my love.