December 26, 2013-Today, I had my second ACI-this time patella and trochlea-as well a second  Fulkerson (osteotomy). My first ACI and Osteotomy was on my right leg , this one on the left.  went very well.  I slept much of the day and now have some energy so ill do a quick blog entry and hopefully sleep through the night.

I am getting used to crutches again. I practiced for the week prior to surgery on the crutches. Today I needed to have my husband help me do the minimal walking (car to house, bed to bathroom), but by this evening, the tranquilizers I had requested and other meds wore off and I felt steady enough to crutch the short distance from bed to bathroom-but with my husband in close proximity in case I stumble.

I again have a nerve block which means no pain!  It also means no feeling in my leg/foot. This nerve block should last 2-3 days. I use the "Game Ready" ice machine on and off throughout the day. Right now, I also use a soft stabilizer cuff, which helps to keep leg straight when out of bed.

The ice machine was delivered to the surgery suite before I went in for surgery.  We had initially paid $300 prior to the first of what is now 3 surgeries, and we though the rep said that we would not have to repay for the following surgeries.  That was true for the last one on June, but today he did not give us that deal. I do think that it may have played a part in my past two good recoveries and worth the cost.

I have to sleep on my stomach the first two nights (maybe three-I was groggy post op and my husband got the post op info from the surgeon and nurse.

Advice for any surgery:  bring at least one companion to post op and have them WRITE everything down in detail).

When i was alert before my first surgery, Dr Gillogly had told me the reason for sleeping face down and he said there is a theory that this helps the cells adhere better to patella. I believe he said it is best to lie on stomach in these first day even awake.

The CPM machine (which constantly moves your knee) will be delivered to the doctor's office tomorrow when i am rhere. I have a post off doctor appointment and my first PT appointment tomorrow morning.

I am less anxious than prior to the surgery!  I was so tense and my internist gave me a couple of  Xanax for the 2 days prior to surgery which helped a lot.  Now I am doing ok.  It seems like I'm just going to repeat the whole process of my first ACI.   But, I am not naive.  I know complications could pop up-even though the first 6 months on my right leg have gone very smoothly.......

Day 1 post op from 2nd ACI (patella and Trochlea) and Fulkerson.  The nerve block continues to numb my knee.  I can now feel touch on my toes, calves, thighs. I was a bit alarmed by slight pain behind my knee. I want to "stay ahead of the pain" and I had not taken the Percocet since early morning and it was 9pm when I felt the discomfort.  I took the Percocet at 9pm and 20 minutes later felt fine.  I am not sure of the dosage, but when I get a chance, I will look at the bottle and write it here.  I am a little "dopey" today-I keep forgetting little details like the time of tomorrow's PT appointment, immediately after someone told me.  Otherwise, in good spirits.

My husband is off for more than a week and he is helping me a lot by bringing me meals in bed, helping me move the CPM machine on and off the bed, and everything else. He also stays close to my left side when I am walking on the crutches. When the nerve block wears off and I can "toe touch", then the crutches will be easier.  I am doing fine on them, but like having him to spot me just in case and also i put my arm around his neck and he basically lifts me up and down the very small step at our front door.  My kids are staying with my mom and my brother out of state since the day before my surgery and will return day after tomorrow.

The woman who was supposed to help me when my husband returns to work bailed on us and won't be coming!  She got a full time permanent job (not just for 2 weeks like it would have been for us) and closer to her home.  My first  reaction was panic, but then I decided it is fine.  By the time I would have needed her,  getting around on the crutches should be easier and I may even be driving since they said that with the left leg, I'll be driving quite soon.  I figure if we do some take out food for meals until I can cook again (when I am on one crutch), it will still be WAY cheaper than paying for a helper.  I was going to pay her  $125 a day for 2 weeks!  A really big savings not to have that expense.  I had not wanted her for  eight hours a day, but she lives far from my house and she had said she needed a full day to make it worth her while.  Having someone in your house can be uncomfortable.  And really it is good to save the money for us... So, hopefully this will work out OK.  I do have good friends who can come over to help and do my shopping-A few close friends are also neighbors-and they want to help me.  Plus I have a teenager who can drive.....No relatives in town though...

I had PT and doctor appointment today.  The knee is swollen of course.  The doctor said instead of staples, they used fiberglass tape and glue!  I could not lift my quad at all, but with the  the nerve block it is not clear why.  I did stretches for calves and hamstrings and ankle twirling which protects against clots.  Tomorrow I go back to PT again and then it will be 2 times a week.  I was able to dangle my foot at 90 degrees, so the physical therapist said to do 90 at least part of the time on the CPM machine.  The CPM machine was delivered today-my old friend!!!   Did about 5 hours today on that contraption.

Dec. 28, 2013-2nd day post op:  Physical therapist changed my dressings today. With electric stimulation to quad, I was able to engage quadriceps and to do leg lifts. The ability to lift my leg using quad and also to bend knee more than 90', means I am able to toe touch with crutches.  With toe touch I am much more stable getting around. I am allowed to put an estimate of 20% of my weight onto that foot.  

 This evening, I had less success lifting my leg or engaging my quad too much. I think the electric stimulation probably helps.  I am disappointed about that.

December 29, 2013 3rd day post op:  Last night, I woke up and went to bathroom in the middle of the night.  My husband asked if I needed help and I said I was fine.  But, in the bathroom, I started to feel shaky and hot and in pain.  I had not taken pain killers since before going to sleep and the nerve block was drying up.  On my way back to bed, I just went down.  It felt like I fainted.  Luckily, I landed on my "good" leg (which used to be my bad leg when I had that surgery in June!).  No injuries from my fall.  My husband helped me to bed and I took the pain meds with a little yogurt (never on an empty stomach for me). 
The lesson here I think is 1. ask for help if you feel shaky-even if you feel bad waking someone up and 2. take pain meds regularly-even in the middle of the night if it seems that you may need it.  I will try to follow those rules. I do feel bad waking up my husband all the time.  Luckily, he is off work for another few days-so he can make up the sleep by sleeping late.

Today, I can do the leg raises very well!  Yesterday, I was worried that I had lost some of that ability since my session at PT.  The pain is very tolerable with Percocet every 4-6 hours.  Doing the leg raise exercises, the pain that I feel is from the osteotomy (Fulkerson), where there are a couple screws holding down bone.  Again, it is all quite tolerable, and I don't consider myself someone who has great pain tolerance.  I have been nervous about getting out of bed today, since my fall last night.  I will try to take a tour of my house in a little while, to get the blood circulating and to overcome my fears!