Knee blog: second weekend home

This has been a weekend of perplexity.  There is such a thing as too much information, especially when so much of it is contradictory. "Rest up, save your strength," say some.  "Make sure to prop ice your knee and your foot up higher than your heart," say others. I DARE you to do anything constructive or interesting--such as read, go online, talk comfortably on a phone or watch any TV not mounted high up on a wall when you're flat on your back. "Don't spend too much time sitting." Really? How much is too much? How long at a time? How long is too long? Sitting in a restaurant for the duration of a meal? Riding in a car? (That was what made me forgo a proffered lift to the Woodstock Folk Festival). Plowing through e-mails? "Frequent short walks are key." How frequent? Every few minutes? Every hour? How short is short--am I supposed to pace aimlessly around the first floor of my house or are necessary trips to kitchen or bath sufficient? "Take only one trip up and down the stairs a day." So I'm still sleeping on my first floor because my walk around the block requires descending and ascending my front stairs--and wearing only what clothes and underwear (mostly tees, shorts and sweats) I have stashed downstairs.  I took my first walk around the block today--not quite "around," since it's double the length of the typical long street block--and it took so much out of me that I had to nap upon my return.  I'd been proud of ambulating around the house without my cane...until I re-read my surgeon's advice to keep using assistive devices until I could walk painlessly without a limp when unaided.  (Especially when I am also told to expect some pain for the next few months, even after being cleared to drive).  I hadn't read that far at first--I was just so delighted to not need a walker and not be in constant moderate-to-severe pain.  "Don't let the pain get ahead of the meds." "Start weaning yourself off opioids." Really? How fast to wean? How long a dosing interval is too long to stay ahead of the pain?  I hate feeling sleepy and dozey, but I hate staying alert & unmedicated for fear of too much pain.  How much pain is too much pain? Compared to how I felt in rehab I'm much more comfortable; compared to in the hospital my pain's barely a 1 or a 2, but it's there--especially when doing maximum flex, or the muscle pangs when the neural pathways in both legs reawaken and it shoots to a 7-8. "Take 1-2 every 4-6 hours as needed for pain," says my Norco prescription.  Gee, that helps.  Started out in rehab on 2 every 4 hours round the clock (even being awakened to take them--though often an hour or even two late), transitioned to 2 every 5 hours (except not to wake up to take them--and then when I sleep 8 hrs. between doses I'm chided that it's "too long"), then 1-1/2 every 5 hours. What's next? Stretch the interval to 6 or drop the dose to 1? Or, if I stretch the interval to 6 hrs, go back to 2; or if I drop the dose, shorten the interval back to 4 hrs.? "Sleep on your side with a pillow between knees but keep legs straight." "Bend your legs when on your side to avoid back pain."  (How am I supposed to rehab if my back goes out)? "Don't put any pillows under your knee." (What am I supposed to do about that horrid hamstring-stretch pain I get when I elevate "properly," making rest anything but restful?) "It's okay at this point to put a pillow under your knee." Everyone I consult--the vague instructions on my discharge sheet, my visiting nurse, my PT, my husband, all give conflicting instructions. I just want to get better, get off opioids but control my pain, and prevent blood clots (my Coumadin stops with this Thursday night's dose).  

It's the uncertainty that is almost as bad as the inconvenience, disruption of routine and pain.

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