September 25, 2021

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Knee Jerk Reactor Part 3: Rehab Is Not For Sissies

By Jay Kerner

Anybody that’s been through it, talks about the rehab.

Rehab is a bitch.

Rehab is a battle fought between your will to get better and your outrageously swollen and ravaged tissues.

Rehab is intentionally aggravating what hurts, over and over, in various painful ways. With regularly scheduled guidance from a pro, to make sure it hurts properly.

Rehab is all about range of motion; trying to make that artificial joint along with all the ancillary muscles, ligaments and tendons, behave like new.

They started in on me in the hospital. Kept making me force it straight. I could do it, but it hurt like hell. When they tried to bend it, I could hardly do that at all.

I was gorked up on pain meds, but I remember one of them saying the straight part was the first goal. Supposedly you only have a couple weeks to regain straightening your leg. If you don’t get it by then, you never will, and you’ll always have a slight limp.

The bending can take longer to come back but keeps improving the more you do it.

They sent me home in TED Hose to protect me from blood clots. These are tight white panty hose without the panties. I only had one knee done, but I got the hose on both legs, clear to the crotch.

Ladies, I don’t know how you do it. I swear, I spent a good hour every day adjusting those damn hose! And I was supposed to wear the damn things till my follow up appointment, 3 weeks after the surgery.

Once home, I had to be responsible for my meds. Now, fess up time: I’ve got probably the best nurse in the world, in house. And my universe became the narrow path between my recliner and my raised toilet seat. I wasn’t getting away with much.

I had PT ladies come to the house six times over a couple weeks. By the time of my appointment, they said I was top 10% of all the knees they see on straightening but only about 50% on the bend.

I want to work on the bend, but frankly, IT HURTS LIKE THE DEVIL!

I can feel things tearing under the bandage. I’m sure of it.

All the while we’re managing the pain meds. You have to learn the cycle. Every pill does something. Different strengths, different times to take effect. Different effect length. Like that.

My plan calls for me to step down the strength of my meds and I’ve done that twice so far.

One of my old fraternity brothers (Hey, now we’re knee brothers, too!) told me it would be about a month before the new pain from the surgery was less than the old pain before. I’m sure it’s different for everybody but for me, that came about two weeks after. I’d begun to get concerned, because I was still having a lot of nerve pain from one spot on the inside of my knee, several inches from the incision. Ice, heat, elevation, nothing worked. Finally, while switching to a clean pair of hose, I decided to take a break before putting the new ones on. Within 20 minutes or so I realized the pain was gone. Put the hose on and guess what? That was the last of the hose. Slept so well that night I can hardly describe it.

In the hospital and for the first weeks at home, you’ll need a walker to get around and to do your exercises. Get a good one! Do as I say, not as I did. My flimsy one didn’t kill me or maim me, but we had a couple of moments.

Your PT person will have some tips on setting it up for you. Mine suggested moving the front wheels to the inside of the legs to give me extra clearance going through doorways. My cheap-ass walker was too spindly that way, had to switch back.

Oh, this is kind of funny. I came home with a pain pump machine, a little smaller than a loaf of bread, and running from a little black bag, down a little tube into a hole in my knee. Crazy stuff!

It was supposed to last 3 or 4 days if you let it go automatic, but you could push the button yourself for a boost when you needed it. I never pushed it, but I could also never remember it was there. Not one single time I got up to pee, (and I pee a lot!) did I remember the bag. Or the tube. Here I am, half asleep, full of narcotics, unstable on my feet, wheeling toward the faint light from the john when SPROING, I’m pulled back like an astronaut on a space-walk tether.

Cursing! Tripping! Catching myself before toppling. Every damn time. And each time, pulling loose a little more of the tape holding everything in place, till finally I woke up in a puddle. Thought I’d wet the damn bed till I realized I’d finally pulled the tube clear out of my leg. Made a half-assed attempt to put it back in before sticking a band-aid on it and calling it good.

So, getting back to the rehab, here are some things I learned. Time your meds. Make sure you’re at full effect before straining against ravaged tissues. This is true for your scheduled PT and the work you do in between. Find a good chair. My padded ones didn’t work. I did better with a hard-sitting dining room chair. I also did great on my porch swing. I could feel that resistance on both the in and the out.

Oh yeah, we need to talk about pooping. Sorry, we need to. It’s important.

Pain pills make it hard to poop, whether this is an area where you previously had problems or not.

They will give you stuff. Take the stuff!

They want to know the stuff is working. Tell them.

The first post-surgery poop is the hardest. They starve you, load your system with all kinds of numbing agents, then expect you to deliver. Well, it ain’t that easy, Pal!

I’m reluctant to drift into scatological humor but in the interest of full disclosure I must recount my own “first time.” It’s the one I count, not the fake one in the hospital. On that one, I strained for half an hour with an attendant knocking on the door every 5 minutes to make sure I was ok. I finally stood up to admire my work and was rewarded with…absolutely nothing.

We finally struck gold on day 3, but all my herculean effort produced was a single tiny turd. Like a little brown pearl. I was so proud. I wanted somebody to see it and tell me I was a “Good boy!”

Next day, finally, we were back in business. I only bring this up because I’ve seen what severe constipation can do to a person on pain pills. I didn’t want it happening to me and you don’t want it either.

So, we’re eating and drinking, sleeping and pooping. With long periods of streaming television and shorter periods of screaming therapy.

But I’m on the other side now. I’m already better than I was before surgery and I’m going to get a lot better.