Tuesday, August 6, 2013

arthroscopic knee surgery - making it gluten free

Ok so there is no real trick to making a surgery gluten free, it is surgery! But the recovery time can be tricky so here is my list of things I wish I knew before I had arthroscopic knee surgery. (This site is pretty great and has images that didn't make me want to throw up = I recommend.)

Pack your bag with all your identification cards, paperwork, doctors' names and contact info, and your allergy list. Pack one or two snacks - you might need to take a small amount of food with your medication when you wake up from surgery.

Wear very loose fitting shorts or pack them for the ride home. You aren't getting any form of pants on for a while.

Narcotics cause constipation - you should have a game plan for dealing with this and a back up plan for when that doesn't work.
Plan A - magnesium citrate. I really like NaturalCalm but found it wasn't enough
Plan B - senna tea. I like Smooth Move but usually don't drink it because it is strong for me. Well this is the time for that strength. A friend brewed up several cups and iced it down and kept it in the fridge. This was a huge lifesaver since I wasn't the most coordinated while on crutches.
Plan C - propylene glycol. I really hate this stuff, but it was useful to help get the wheel going again
Plan D - saline enema - this is not pleasant but some find it necessary

Yes, you read correctly, I had a 4 step poop game plan. It is far easier to plan ahead than have to phone a friend to get you supplies.

Other supplies to have on-hand
Aspirin - you may be put on an aspirin-a-day regiment for a few weeks post-op. I don't normally stock this in my home, so its good to ask and have some ready.

Compression socks - you will be given a set to wear home, and wear for 2 weeks. I am an avid supporter of support hose, but the hospital kind have openings at the foot, which I found itchy and uncomfortable when it was time to get back to work. A good friend went out and bought me a full-foot pair that were easier for me to use while walking. Warning - they don't hurt but are pretty much spanx for your feet and legs - aka will make your feet and legs incredibly toasty. Having a second pair was nice to be able to wash them and air them out.

Baby wipes are a nice-to-have extra. Since you can't shower for a few days post-op it is great to be able to "wash" your face without trying to close your eyes and balance over a sink. They also are pretty fantastic when you spill food down  your arm... not saying that will happen but juice is in general, juicy.

Totally not necessary, but I was pretty grateful for a grab-bar in the bathroom to help get on and off the toilet. It is harder to do with crutches than I thought and it was nice to be able to be able to steady myself and get the crutches up and under my pits. (They cost about $15 at Home Depot - make sure the bar is secured into a stud or you will rip it out.)

If you got some sleep, congrats. You are probably waking up to the desire to drink a large amount of water filtered through some delicious beans. Sorry. Grab you stuff, throw on your medical bracelet, and make the trek to the hospital.

After you check in, breathe. This is a great time to give your personal belongings to your designated ride home buddy.

Once you are called back to sport a fancy hospital gown, you will get asked a lot of questions. Your medical history will be gone over several times. If you get motion sickness you might get extra medication. You will be given a prescription for post-op pain meds. Really important to remind them that it needs to be gluten free. They will ask you a bunch of times what surgery you are having and even mark it with a pen on your body. Maybe you will freak out the night before and create your own body art.

After waking up your body might think "that's not so bad". You are on a lot of drugs - listen to the nurses. They are your best allies in getting everything accomplished like not falling down or successfully peeing in the toilet. Nurses are also the ones who tell you the absurd things you said in the operating room, like "I think we should all get donuts together". Nurses are awesome. Nurses will also try to feed you graham crackers. Stay vigilant and stick with your packed snacks.

I got sent home with a knee wrap that contained ice packs - which is probably my second favorite part of knee surgery. If  you can, ask for an extra set of ice packs. It is great to keep one in the freezer at all times.

You will get a take-home sheet of dos/don'ts post surgery. The nurses recommended keeping my knee elevated above my heart to help with the pressure/pain. This is pretty difficult to manage on your own. They suggested a pile of blankets/quilts but my favorite was a giant triangle pillow. It isn't the cheapest thing, but it stayed in one place - unlike the moving blankets - and I could easily adjust it for sitting and lying down.

As you can see, everyone loves geometry!

Since I had a back injury, I also used a cervical back roll for support. It ties around and helps keep the lower spine in a neutral S-curve to prevent further injuries to my less than happy slipped disks. It does make you look like a child in the shallow-end but it was totally worth having one less thing to worry about when slouching on the couch.

Hopefully you have gotten some sleep. You may be tempted to take a look-see at your wound. Don't. You might need a friend to remind you that that is a horrible idea.

It is really helpful to have paper or a chart so you can write down when you take medication. I found it really easy to forget time. It was also helpful to keep track of things since I needed to take an aspirin 1x a day, but was not allowed ibuprofen. It was the most useful when waking up in the middle of the night with pain to know if it was ok to take more medication or not.

This was the most painful day for me. I was pretty surprised.

If and when you are ready to head back to work, you are likely off of narcotics. Pain management is still going to be a pretty important part of your day. I chose to add tart cherries into my daily smoothies and/or taking additional tart cherry supplements. Why? Basically they are close or as effective as NSAIDS for inflammation. They also taste awesome, so it is hard to really complain about eating something that is delicious and helpful.

PT is not fun. PT is going to make you do unfun things so that in the future, you can do fun things again. Do your PT. Listen to your therapist and be honest about your pain. Just because you could do ____ before surgery does not mean you can do it now. You need to rebuild muscle and it takes weeks to gain back what you lost. Ice after PT is probably my favorite part of PT. Ice is your new best best friend.

You have stopped being able to do every form of exercise - congrats, you have loss muscle mass and gained weight. There is some of this that you can control and then there is the lure of potato chips. First off, cut yourself some slack. Then realize what you can and can't change. For me, I decided to make a few dietary changes and deal with the rest of the fall out.

- I cut out sugar and cream out of my coffee (hard at first)
- avoid foods that are easy for me to over eat (see potato chips). I asked for a house-wide ban.
- try to make sure there was green veggies at every meal
- breakfast became a green smoothie

None of this caused me to loose weight, but it did help prevent me from gaining more. Normally I don't talk about such things, but if you having surgery on a joint, the last thing you want to do is put more strain on it. Excess weight = strain.

The other great part of going to PT is that if you are anxious to get to exercise again, you can work with your therapist to be able to add more movement to your daily routine. I got really stoked to be able to do plank again so I could start rebuilding my back and core strength, but I only felt comfortable doing so after working with my therapist to make sure I could do it safely.

So there you have it, everything I wish someone told me ahead of time and then some. I hope you never need to use this info, but also feel free to ask more questions.


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