Post-Surgery: Days 5-9 (Monday-Thursday Outpatient)
The Monday-Saturday out of surgery, from a support person care perspective, really bled together. The pain levels were pretty constant and the routine was similar. After making the mistake of hiring a wheelchair van the first two days (it was $90 a trip!), we wheelchaired to the car, transferred, and then husband hobbled into physical therapy.
Physical Therapy:
OK, physical therapy. Your life revolves around this. Let's start with the pros. Every PT was professional, caring, and very competent. This is the reason you do this with Paley - because they have a giant facility with so many therapists. They know what the surgery looks like, and they know how to get you moving and stretching. I felt really comfortable trusting them with the broken legs. Husband came in tight and left feeling better each day. You can pick your therapy schedule and they book you out for a week or month in advance. You can buy extra PT sessions but they are like $200+ (I believe) after your initial sessions that come with surgery. You can schedule Saturday PT but the normal schedule is Monday-Friday.
Cons? Because it's so busy, you don't have great continuity of care during week one when you're hurting and also fresh to the experience. We didn't repeat a PT until Friday. I sat outside and literally dozens of people are coming and going every hour. I like to be able to understand things well, and the first two therapists said there wasn't any printed information on how to do these exercises and stretching at home. I was baffled by this -- again, there was a lot to read and very good information on the sale side, so I expected something like a packet on what to be doing. The third PT session, we got printouts of exercises and stretches to do at home. You're supposed to do them for 2 hours a day (we managed in 30 minute increments), plus your PT session.
Sleeping
I guess I should title this night-time, because sleeping was not happening regularly. I read in another journal to practice sleeping on your back -- which we totally should have done. Husband is a sidesleeper, and the back position is all you've got for the first several weeks. We made a rookie mistake in how we positioned during the first week, so beware --- you don't want to just elevate the legs, but allow the knee to bend. If you sleep in a bent knee position, it keeps your knee from stretching out and can cause problems.
The best solution we found was to prop a couch cushion under the knees to the feet, and then I stuffed two pillows -- one in the hole under the thighs, and one underneath the feet. That elevated the legs in a way that allowed the blood and inflammation to go to the torso.
We made another dumb mistake (thanks to a complete lack of discharge directions) of keeping ice on too long. Ice needs to go on about 20 minutes, and then come off. We iced 100% of the time the first two days. It helps with inflammation, but it's not good for your body. We were given a Polar Ice machine that had gel pads to place on the legs. Initially we just put them on the top of the thighs, but after the swelling in the right leg hadn't subsided after several days, we had an epiphany moment and started icing underneath the knee as well.
Swelling and Inflammation
I read another journal entry (I think it was MyElevate?) that talks about inflammation. YES. Husband took the doctor's recommendations to move as a personal challenge, and I think really overdid it. That caused further inflammation. We will never do this again after Tibias, but our plan with Tibias is to take it a lot easier after the initial surgery in order to keep swelling down. A little less walking during week one. The docs said that movement causes blood flow to move out inflammation-- but it also triggers inflammation if overdone.
PT Veronica suggested very light massage touch to run the inflammation from the knees up to the torso, to pull the swelling out. My personal opinion is that pulling the nail in and out displaced a lot of marrow -- causing more swelling. But I'm not a doctor. The bruising on the right leg was substantial. The hips also swell up at the incision points.
The biggest issue was pain in the knee. Husband was feeling instability and a lot of swelling. He was concerned about buckling when walking. Ice helped with pain management, but nothing was pulling it down.
Showering
Sitdown showering worked and there were no issues with bandages peeling off. The warm water feels good on the legs, according to husband.
Let me just be clear from a care standpoint --> This whole thing looks pretty horrible in week one. The pain is high. Mobility is limited and pain-filled. There's emotional regret about breaking your perfectly healthy body. And you're not even lengthening yet. Husband planned to start working remotely on like Tuesday, but there was no way in the first few days.
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Topic: Femurs + Tibias with Dr Paley Feb 2021 (Read 4421 times)