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I haven't blogged since the September UK Author's Retreat because, well, whilst I was in consultation about the seemingly unnoticable (to other people) state of my knee and wasn't expecting to have surgery so soon. The backstory for how and why I was in this position at my young age is not for now - it spans three continents, starting in Hungary, involves Scotland and finally the U.S. where I lived at the time. It's also heartbreaking and I am not prepared to use this platform for the way I want to tell my whole story. However, I will share glimpses in order that the how and why I am in the position just now makes sense. I suggest getting a cup of coffee and putting your feet up. Janaury 2007- June 2018 The very short, not-detailed story: torn ACL required surgery, which I obtained in Hungary because as a U.S. citizen at 20 years old who was not in full time education (and therefore could not be on my parents' medical insurance) had no way of paying for it. I was on my own and the cheapest option was Sopron, Hungary. The surgery was done correctly but I contracted septicemia. Miraculously, I lived with it for three months until I saw an orthopaedic surgeon in the U.S. where I was living. To put it bluntly, he couldn't believe I was still alive and that my leg was still relatively in tact and did an emergency surgery - essentially saving my life from further disease and organ failure. I'm skipping a lot of detail that involves other people and emotions I do not want to relive right here and now, so fast forward to 2010. I'm married and living in England. We went to Guys and St. Thomas' hospital in London to see a consultant for an update, as I had been coping with arthritis and extremely limited range of motion (68 degree bend, 20 degree extension) as best a 24 year old can. He confirmed that I was doing well; walking, taking public transport, not on medication for depression due to severe life alteration, had a job, a social life, etc. He said he didn't want to consider a total knee replacement until I was 50 as I was too young, not in agony, coping well, and very high risk for repeat infection. The consultant said to carry on coping as well as I was, enjoy my life, etc. Come back when I'm either at least 50 or climbing the walls with pain. Fair enough. My now ex-husband and I relocated to Virginia from England for his job in 2013. I wrote my first book, The Solicitation, and became a published author of now 9 novels. That became my full-time job and my knee, although bothersome at times, was easily molly-coddled as I swam and went to the gym to maintain fitness as best I could whilst being able to rest it easily since I worked from home. June 2017 my knee starts waking me up with pain in the middle of the night. I knew things got worse. My knee also gave out on me (which it never had before) and that's when I had my first appointment since London 2010, just to find out how my knee was. An urgent care doctor came in with a terrified look on her face and said, 'you need to see an orthopaedic surgeon as soon as possible.' I broke down crying and she hugged me. That's when I knew my coping days were over. In the throws of divorce, relocation, knee pain, floating between finishing my tenth, eleventh and twelfth books as well as doing work as a supporting artist on several BBC shows, and breaking into a lead role for a short film, my whole life was buzzing around me. I didn't want to make time to 'deal' with my knee but frankly, I was tired of the pain and after an X-Ray I was fast-tracked to see a consultant. He was blunt and repeated what I knew since 2007: my knee is bad. Really bad. Never seen one as bad. In fact, so bad, that he as an experienced ortho surgeon who does knee replacements for a living, didn't feel comfortable taking me on. I was then referred to the revision consultant, so I'm being treated as if this was my SECOND replacement even though I never had one in my life. August 2018 I meet my surgeon and his assistant. I adore and trust them instantly, listening to everything they said about surgery and the risk of repeat infection. The expectations were as follows:
My response:
We signed the consent and I went home to wait for a letter assigning me a surgery date. I was supposed to have a 6-9 week heads up but due to multiple miscommunications on their end, I was given less than a week to prepare. My dear author friend, Maren Smith, set up a GoFundMe and many authors and readers poured into the fund to support me in this projected year-long recovery. Physiotherapy is going to be my full-time job or I face the outcome of the same sort of limitations I had pre-op or various other negative outcomes. Even with a somewhat miraculous recovery, I am not capable of walking on crutches to the train station and doing ad-hoc film work for up to fourteen hours, coming home and walking from the station. We nearly hit the goal within a month. There is no upper limit so should you wish to contribute the link is above. Total Knee Replacement Some of the comments I've received over the course of my operation make it obvious that if you aren't getting a new body part, you probably don't care or understand what's happening to someone who is. The basic facts of a total knee replacement:
25 October 2018 This is me on the morning of surgery: absolutely over the moon excited to be getting a new knee. I underwent a 4 hour pre-op assessment back on the day I signed papers, so that morning all I had to do was giggle with the nurses (we did laugh a lot), remove my nail polish (oops) and get fitted for my Ted stockings. Stylish. Schoolgirl chic is in, dontcha know? In this photo you can see how far out my leg was in its natural position due to the arthritis. Later in the post you can see an X-Ray of my pre and post op.   6 hours later I woke in recovery to several jolly nurses round me. My anesthetist came over and said, 'It went really well!' I was half dazed but I will never forget that moment and how surprised even I was to hear him so genuinely express those words. My surgeon came in and told me, ''we got to 90 degrees of motion." I groggily turn over and smiled as I said, "I told you." Him: You did.  I was in hospital for a week From the beginning we all knew this was not going to be a standard recovery with standard goals met as expected by a 'normal' (read: geriatric age) person going through this operation. Therefore, any milestone I hit was going to be good because the expectations were low. I was on the ward with hip and knee replacement patients and was the youngest one by 32 years. Also, the only way to get the level of motion I need for a halfway decent life was for the team to really push on my joint. You can see the bruising from where the they fought hard for me. You can also see from the hospital gallery that as the photos progress, I'm looking better everyday. Some photos show just a really lovely day of opioids. This was the day I knew I was an overcomer When was the last time you sat down and your legs were both 90 degrees? Probably today. For me it was 6 January 2007. Until this day: 26 October 2018  Note that the above photo is taken less than 12 hours after surgery and when I still have anaestethic in my system. In the days that follow I will lose multiple degrees of motion as pain and swelling take over and eventually, scar tissue tries to build up. I have to then fight to get it back and surpass even the 90 degrees this photo shows. Physio therapy was (and still is) painful And for the next year it is my full-time job. I only get one chance to get this right.  After a week in hospital, fellow author friend, Vanessa Brooks, came to look after me for the second week Vanessa made sure I got my medication, slept (no issue there as I was exhausted), ate three good meals a day and we did exercises together in the kitchen. We worked hard for 5 minutes every hour of every day in week two, to move my knee to ensure I was gaining motion. Packages and cards started pouring in from both sides of the pond. {click to enlarge photos} The district nurses came to visit and took out 25 staples  By week three I was home alone  Every day I sat on the counter at the one hour mark and for a few minutes I worked on bending. I did my ankle pumps and leg lifts. During week three I also went in to meet my therapist and get an initial measurement because we couldn't start working until week 5 to give the inside of my knee continued critical healing. I was bending at 68 degrees...three degrees more than I was pre-op. The real effort had to come from me at home, deciding whether I wanted to continue to believe I could reach full range of motion. I had between week 3 and week 5 to do my home programme before I started outpatient physio. In my home programme I continued to sit on the counter and cross my ankle over my operated leg and try to get it to bend until I couldn't handle the discomfort/pain. Rest. Repeat. I did that for five minutes or until I was in tears and then elevated my leg. Repeat every hour. I also concentrated on reawakening my quad muscle, which has not been operating fully since 2007. Physio therapy, whether outpatient or a home programme, is made up of two things: breathing and attitude. If you can learn to breath through every exercise and interrupt the correlation of pain between your brain and the body part, you will have an easier time. Having been through physio four times for my knee now, I can honestly say that attitude is 90% of physio therapy. Change your attitude and it'll change your outcome. Week 5 came and I went to my first outpatient physio. |
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December 2018
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