Femurs with Dr. Shahab Mahboubian - July 2020

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The journey begins my friend. Key is, stay positive. Remain very alert and active, in mind body and soul. That will be my first tip.

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Quote from: BoneStretching on August 02, 2020, 05:47:39 PMThe journey begins my friend. Key is, stay positive. Remain very alert and active, in mind body and soul. That will be my first tip.

Hey BoneStretching,

Thanks for the message and support. It's a very exciting experience, but more challenging that I thought!  Particularly I wanted to stop pain killers starting week two, but I failed on that. The pain was unbearable at 8 or above and I had no choice but resuming Norco and Tylenol!

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Day 2 (Friday July 24) - Bye Catheter!

Catheter removed early morning! I have no trouble urinating in the urinal. Big relief 😊
However the day was dramatic in terms of exercises and walking.

Dr. M. visited me and said legs looked very good. He however wanted me to move.  I told him about my left leg pain and the sound on the first day that it made while moving my left leg sideways (i.e., laterally from left to right so I can get close to the right side of the bed to start walking). He believed it was just bones adjusting, and nothing to worry about.

Allan and his colleague (PTs) came by in the morning, but I could not move my left leg, so they left

They were so kind to come by once more and on the second attempt, I was able to take perhaps less than 10 baby steps overall from and back to my bed. The main reason is the severe pain on my left leg (upper thighs – on the outer side).

Later the OT (Anthony), also visited me to show me how to dress, but the process was too painful (bending my left leg) and instead I moved out of bed and did some very few steps and then back to my bed.

They disconnected me from the IV (morphine, etc.) early morning. I am on Norco now (two tablet each time).   I had two in the morning, and I think two at 7pm, then another two on Saturday @ 4am.

I was able to move my legs up, and did a lot of knee bending.
I also used the inhaler for deep breaths as my body temperate had risen to 100+. That solved the problem quickly!


Overall, today was tougher than the first day, but something I had expected based on other LL'ers experiences and what the medical staff had told me.

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Day 3 (Saturday, July 25) - Going Home Today


Last night I felt comfortable doing some simple bed exercises. But in the morning I feel like my feet are stiff. On a positive note, I am sure they are in better shape than yesterday.

A new PT came by around 9:45 am. I had taken my Norco around 8 am. My experience with him was great at start for a few seconds, but turned dramatic so fast that I lost confidence in him and partly even myself. He started by giving me some stretching exercises.  He said he would guide me through movements.

First I squeezed knees that also straightens legs and he approved. Then bending knees almost to 90 degrees which was good too. The drama started when he said he would lift my feet to move them to sideways. I warned him about my left leg that if it gets into a certain position, the pain goes from 0-2 to 8-9, and I asked him to avoid…. He did not listen to me to finish my sentence, and he moved my legs keeping my feet lifted. It was so painful I screamed very loudly and nurses who were passing by stopped to see what happened. I told him I could not continue that move. He said whether I still wanted to try to stand up and possibly walk and I said sure, if he has time, because I would move very slowly to avoid pain. He said he has some time. I put my feet down, stood up and then cause he seemed a bit in rush I told him that I would just sit and go back to bed. As  I was trying to bring my feet off the floor he grabbed my feet to speed up. I told him I would not need it, but he said, it would be faster. Then the severe pain on my left leg started; once gain my movements were not under my control and any tiny movements by him would elevate the pain to 8-9. I told him to not move my feet for a while, so I figure out a way to grab my feet up to the bed, and he said he cannot just keep my feet in the air for me and I have to do this fast. It was so painful and him pushing me on time, was so disappointing. I hated the experience, thinking why is he even there if he does not have time to do what I expect him to do and spend time for. 

I knew from the posts by IFS, that Dr. M. showed up for him on a Saturday two days after his surgery, therefore I expected to see Dr. M. today again.  I was still impressed when he showed up around 11 am. He evaluated my legs, and in terms of bending knees. He said that is the bending degree he expects me to maintain every day; and that I would have a quick recovery from  the surgery.

He asked me about the morning PT. He was kind enough to remember and later asked the nurses to assign a different PT for my afternoon exercise.

Later around 2 pm, Irene, an OT stopped by for any questions about going in or out of the car and also towards the restroom. Based on her recommendation we ordered during our meeting a commode. She also recommended a bathtub transfer seat if I later found out that going to the shower room would be difficult.

She was so kind to offer to help me with standing/walking practice. I asked if she had any appointment after me, cause I was slow. She said to not worry. She then did what I exactly wanted: not touching me, but just watching me and giving me tips on how to do the next thing. She was the first to finally clarify the pain I was experiencing on my left knee. The pain comes from muscle contraction, when it is not bearing weight. This was very helpful, cause now I knew exactly where the source of the pain is and therefore I knew when to expect it and plan ahead of it. Her recommendation was to release that muscle, which I have no idea how to do so. She also recommended deep breaths. That helped a lot: this is how I was classifying my pain:  when my body weight is on both feet, there is no pain. When weight is on right leg, my left leg has this sharp severe pain; this is initially even worse, when switching weight from both feet to the right foot. I therefore made the switching super slow so I could examine my body reaction almost in fractions of a second and be ready to guide the pain to gradually appear and subside! It worked. I got a lot of confidence and thought I would be okay going to then wheelchair then the ride and finally from the ride to home.

Later Eric, the new PT came by. He emphasized the same points as those made by Irene, about my left leg's muscle contraction. I am really thankful of Irene and Eric for helping me. I could walk more than 10 feet, while Eric was just observing me and giving me tips. I believe this afternoon was successful because Irene and Eric are not only smart, but also very patient with me.

Finally it is time to go home! I loved this hospital, but very excited to go back home!   Going from the hospital wheelchair to the car was very smooth. However while getting out of the front seat in front of my house, my right leg dangled out of my control. It was so painful that I think the neighbors heard my scream. But I was finally at home.

Like the hospital nights, I woke up almost every 60 to 90 minutes. Unfortunately I forgot to ask my family to prepare some ice packs and by morning, my legs were swollen. I typically do bending and squeezing exercises anytime, including night times while I am awake, but tonight it was so painful to make any movements.

Today, with the help of my family, I could do a in-bed shower!! It was not exactly a shower, but I could wash my hair with warm water and shampoo and also wash my body piece by piece. I feel so fresh

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Day 4 (Sunday, July 26)


The major barrier is severe pain in my left leg due to its muscle contraction.   I did my first walk practice of the day starting 12:45pm and a 10 to 15 foot walk took me about an hour till 1:45 ☹


Tonight is going to be much better cause I have four ice bags from hospital ready to use in pairs, meaning I am currently using two of them and by night time the other two which are in the freezer are going to be ready to use. I fill them with water and they perform much better than any other ice packs, I have at home. They are large ice bags and they don’t get wet on the outside.


Pain level: So far as long as I don't walk or move, the pain level is 0-3. In case of any movements in bed it depends on whether they trigger the muscle contraction of my left leg, and if so, the pain can be higher say 5-6. However pain level while walking can be as high as 8. I move very very slowly to be able to manage the pain.

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Day 5 (Monday, July 27)


My first day with a wheelchair in the house. I used the wheelchair to perform additional exercises, like dangling knees, and using the wheelchair pedals as steps to move my feet up and down on the floor.
I think the moves help me better manage the left leg pain while walking later on.

However I made some mistakes today. I took one Norco (5mg)  I think two or three hours before standing to walk. It made my standing on left leg so painful. Pain level could go to 8 or higher intermittently. In the afternoon after the wheelchair workout, I thought I did not have much pain and skipped Norco and that was a big mistake!  When I started my walking, it was so painful that I had to stop and get back to my wheelchair. I then took Norco and waited for about 20 minutes or so and then tried again. The pain was more manageable around 5 or 6 (left leg). Right leg with the exception of the Saturday car departure episode, has been consistently good.
 
According to the hospital I can ( and now I know I should ) take the second tablet if I feel the pain is high. I think tomorrow I will take 1.5 tablets about 30 minutes before my walks.

Ice packs are so relieving. They are a must for this surgery and its success!  I am on them almost 24/7 !

It was a big milestone for me! After 4 days (since Thursday morning right before the surgery, i.e., 4 days of no bowl movement!!) I could do number 2    
It was a very long painful process, but overall I felt so relieved that I could poop again!  I used the commode, but the whole process was cleaner than I had pictured!

The left leg pain still is the bottleneck of my exercises and walks.

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Day 6 (Tuesday, July 28)


I took one Norco at 3:30 am to manage my left leg pain, especially after the ice packs were at room temperature!  Similarly to previous nights, I woke up every hour or so. One reason could be my habit of frequently switching between face up and face down positions before the surgery,
 but now  I am afraid to change my body to any position other than face up! which frustrates me. I guess those who are used to sleeping face up all the time or those who practice for it in advance to this surgery would be in a better mental state post-surgery

To manage the left leg pain during walking, I took more than 1.5 Norco at 7:30 am.
Around 8 am I started my super slow process of standing up and walking. I then used the commode and pooped for a second time since surgery.  I think Psyillium and all the fruits and vegetables I have been eating have helped.  I am so happy my number 1 and number 2 have not created complications

The pain on the left leg has not gotten better. It may even be a bit worse. I have a hard time putting my weight on the left foot or switching my weight from right to left.

Despite the high levels of pain in my left leg, I overall feel improvement, E.g., from the time I started to stand up to walk and use the commode and then clean myself, took half an hour today. Yesterday it took much longer! as my movements were slower.

These days I don't feel like working, so I mostly pass my time online, or in front of TV sitting on the wheelchair.   

Evening was okay. I took 1.5 Norco tablets and then half an hour later could stand with manageable pain on my left leg and then do a short distance walking towards my bed.

Now that I am on wheelchair I can use the vanity and floss and clean and brush my teeth, which more hygiene than doing them in bed!

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Day 7 (Wed., July 29)


Tuesday night and Wednesday morning were the worst sleeping times since the surgery and most likely one of the worsts ever. I had my ice packs, but still very painful. I finally gave up and decided to take half a Norco tablet. Also put a soft blanket under my thighs close to the knees (among the many positions and stretches I tried) and finally fell asleep for a couple hours.

Today has been my best day since the surgery in terms of rate of improvement on a daily basis. I could walk about 15 meters (around 50 feet or so) going from bed to walker to restroom to walker to the living room. Then transferred to wheelchair and spent the time mostly running errands online and chatting with friends online.

I also decided to stop using the commode (after using it two times, once yesterday, and the first time the day before yesterday), and instead go to the restroom.

I took one Norco and then stood up and walked using the walker for short before transferring to bed, but also spend at least  10 minutes on teeth flossing, etc. Also took help from family member to wash my hair on the vanity while standing.

I feel fresh, but I prefer the real shower. I plan to do that on Friday.

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Day 8 (Thurs., July 30)


As usual, my sleeps are so low quality. I wake up very frequently. The night of Wed. and early morning this Thurs. were no exception.

That said, I am overall happy cause I feel great progress. I did several standing and walking paths, including the first walk exercise that was 20 meters or so.

One major improvement is that my legs quickly warm up and putting and removing weight on them (e.g., switching weight from one to another) is not painful.
I also use more of my shoulder strength at the turns to not put too much pressure on my  legs, now that I can feel them without much pain!
I am able to finally raise my legs in bed even left leg with not much pain.   
Being on wheelchair gives me much better options than staying in bed and doing almost nothing!

I increase the number and level of difficulty of stretching exercises every day. It is now much easier for me to do leg lifting while sitting or standing or in bed.
 

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Day 9 (Friday, July 31) - 0.33 taller


I also decided to not use ice while at sleep, hoping to overall improve sleeping.

My sleeping was perhaps a bit better, but I still woke up every 90 minutes or so.
 
It seems my plans to discontinue pain killers (Norco) keeps failing as I have describe below:

I did not take any pain killer (Norco) since yesterday afternoon.
My first morning walk was okay, but soon after, while resting in bed, I developed shivering and sweating around 9 am! Even multiple layers of clothing and a blanket, could not stop that. I also felt a lot of pain in my legs, mainly left. I gave a high chance it was because I had stopped Norco, about 18 hours ago.

The online info on Norco states the symptoms of stopping it as sweating, mood swing, shivering, and pain. Since I did not have any other pain medication, I had to resume on Norco once more to be able to function, especially that today I will have my first appointment with Dr. M. since coming home.

I took half a Norco tablet and in 5 minutes I was back to normal. I walked into the shower room. This was the first shower since the surgery last Thursday before the surgery, to be more precise, 8 days and 8 hours! I have washed my head and body at the vanity or in bed on day 3 (Sat.), day 5 (Mon.) and 7 (Wed.), but shower brings my cleaning game to the next level
 
After the shower I got ready and we went to the doctor. Doctor M. was happy with my healing and said I am doing great. He knows my personality, so he said I have some tough competition. Apparently a patient from Hawaii was able to back to normal at month 6, and in one year did the Ironman Triathlon. Also he said he had a military personnel who was very tough and determined and a 16 year old who recovered very well.

He wanted me to be careful to not break the nails just because I wanted to break the record of recovery 😊

Eddy from the ERC team came by to show me how the magnetic lengthening device works. Both the doctor and Eddy were excited about the new device. Apparently unlike the old device needing 3 minutes per 0.33mm session, this new devicde can do 0.33 in one minute!

By the end of the presentation, I was supposedly 0.33 taller 😊

I went back home and by 4:30 pm, the symptoms of shivering, pain, and sweating started. With Dr. M.'s permission I decided to give Tylenol a try. I took the first Tylenol at 8 pm. It is not as effective (strong and fast) as Norco. But after 20 minutes or so, I could walk again, use to restroom and go back to bed to sleep. The directions on the Tylenol box read 2 tablet every 4 hours and maximum of 6 tables per day.

I took another Tylenol around 11pm.