Keep in mind that dates assigned by Google for posts have been manipulated in order to make blog more like a book than a blog. Actual date is December 1, 2022.
I will be living in my home confined to a wheelchair, my bed, or my recliner for at least two months—probably a bit longer. I am able to transfer to our SUV if needed or desired to move to another location, such as to a doctor, but also to visit family. My first travel away from home is an appointment with my Urologist in December 13.
While in the hospital, we added ramp to enter from the garage. We also enlarged the door into the master bathroom.
My wife Carol obtained all of my meds ready for my arrival. We have the bedside commode and shower seat ready.
A wheelchair van from Health Transport (Spry) brought me home. I can transfer from wheel chair to SUV, but it is still daunting.
Made some adjustments to ramp. Moved washer and dryer a bit and entering the home is now easy peasy. Navigating on the first floor throughout home is “tight” but not difficult. First night was excellent, slept much better than in hospital.
Spent most of the next day in wheel chair. Enjoyed the mobility. Visit from visiting nurse set up for future nursing visits. Eldest sim, Scott assembled the shower chair. Replaced dressing on right leg. Probably spent too much time in wheel chair with legs low as appeared to have more swelling, Need to spend more time with legs elevated. Second night sleep at home excellent—still awakened by pain and a bit uncomfortable not being able to sleep on my side/s.
Third day at home, routine now. Sponge bath, coffee, medicine at 8 AM. (Have all meds organized in a tray fir 24 hours.) Brush teeth, shave and rest. Then transfer to recliner so that legs can be elevated.
Red
Still having to change dressings on the 9 different surgical wounds in my legs. Still wrapping legs with elastic bandages to reduce swelling—still my legs are very swollen-probably carrying 20 pounds of extra fluid. Still have catheter installed-hope to have it removed at my appointment with Urologist on December 13.
Fourth day at home, sleeping a bit better, pain generally under control. Visiting nurse came but accomplished little, Vital signs good; bowel movements regular with laxative and fiber supplements. Leg movement improving, especially on right leg, but experiencing sharp pain in left knee when bending lower leg back toward buttocks-max pain free movement is about 75 degrees-just enough to allow leg to “hang” from chair when transferring. (90 degree bend not possible without sharp excruciating pain.) Not sure if pain is nerve, soft tissue (e.g. LCL ligament) or bone on bone. (Possibly related to repair or condition of fibula.) This was first noticed by PT when attempting a “March” movement—lifting leg while keeping lower leg vertical. Also have sharp “nerve” pain in rear of upper leg sometimes when pressure applied during transfers-/probably the Sciatic nerve.
8th day recovering at home. Finished with visiting nurse and occupational therapy. Will continue physical therapy two times per week. Slow but steady improvement. Sleeping a little better but still waking about every 1 1/2 hours. Issue with sleep related to not yet being able to turn onto side and belly because of catheter tube and leg swelling. Pain under control but still quite high after 10 mg oxycodone wears off in the six hours between doses. Tried reducing ibuprofen but noticed significant joint pain and stiffness so went back to the 600 mg every 6 hours. Will attempt to reduce doses of all meds when pain subsides.
16th day recovering at home. Appointment with urologist three days earlier resulted in catheter being removed and bladder function test performed. I failed to void after being filled with 350 ml so it was decided that I would prepare to self catheter. Great news was that evening I successfully emptied my bladder while on the bedside commode. Have voided on bedside commode since. Using urinal in chair is not as successful—geometry of commode allows a more natural “almost like standing up” position.
Reduction of ibuprofen to 400 mg four times daily was successful since two days ago. Experiment reducing oxycodone was not successful..reducing from 10mg to 5mg allowed sufficient increase in pain that affected mood and social interaction.
Sleep has improved dramatically. Elevating feet was beneficial. Only issue is at about 3:30 AM I need to urinate—transfer to commode with help from Carol is major interruption. Bending of knee range has sufficiently improved that I can bend knees to allow more sleep positions.
Physical Therapy is now almost routine with two 20-30 minute regimens of strength and stretch exercises daily. Only remaining pain from exercise is a “knob” on my left knee—probably related to extra long screw interfering with ligament. There is a noticeable “click” when knee is bent. Regular application of heating pad throughly the day seems to help. Swelling of knee and calf significantly reduced—still a lot of selling in ankle and foot.
Christmas Day. 6 weeks after my crash. Recovering slowly. Urinating and Bowel Movements normal using Bedside Commode. Transfers to and from wheel chair, recliner, bed, and commode without issue except left elbow is showing signs of excess stress and now producing pain more or less equal to injured knees. Swelling reduced except for feet and ankles. Range of motion for legs and knees improving but very slowly. Right knee is just “tight”, but left knee is limited by extreme pain at the limit. Physical therapy about 1 hour per day, 12 different exercises.
Biggest issue now at 6 weeks from crash is sleep deprivation due to discomfort in bed. Extreme arthritic stiffness and discomfort in lower back lumbar area when flat on bed. Side sleepinng with fully extended knee not yet possible but partial side sleeping is somewhat helpful. No problem sleeping in recliner for short periods. Investigating the difference between sleeping in recliner vs bed determined that “head and back up” made sleeping on back more comfortable. Adjusting bed to similar geometry allowed a good night’s sleep.
Able to reduce ibuprofen from 2400 mg per day to 1600, reducing Robaxin from 2000 mg to 1000 mg per day. Unable to reduce oxycodone from 40mg per day. Each attempt to reduce dose has resulted in unacceptable pain and general grumpiness.
Visits from family was pleasant, but Christmas in a wheelchair is “unusual”.
December 31, New Year’s Eve, almost 8 weeks after crash. Sleep still difficult, but vastly improved. Seems like a max of 3 hours sleep, waking with pain or discomfort. Fits with pain med schedule. Also able to go 8 hours without having to empty my bladder during the 11 PM to 7 AM sleeping period.
Visit with Doctors Muccino and Eaton with WellSpan Orthopedics was good. X-rays show “normal” bone growth for 82 year old. Some interference of screw head and tendons on left knee is of no long term concern-screw can be removed after bone heals. Extra pain in left knee is normal as titanium rods attached at both ends. Return for another evaluation on January 31.
A more realistic outlook for weight bearing and walking is March or April, so life in the wheel chair is more long term than Carol and I hoped. (Average healing time for Femur is 6 months=May!) We will take steps to adapt—Wayne transfers and handles Bedside Commode chores by himself. Will attempt to have dog, Lollipop learn to do business on leash outside with Wayne inside, and dog day care assistance to free Carol to return to normal life. Have successfully tested small crane setup to transfer to Mini Countryman. (Crane is used to load wheelchair) Will attempt to attend Church on January 8, with friend Jim Scalise assisting. (Jim called on January 7 and informed me that he had the flu, so the trip to Church will be a later date.)
Large emotional component dealing with long term wheelchair assignment. Quite depressing. In addition, atrophy of some leg muscles used for walking is shocking. PT is keeping “front” muscles used for lifting and straightening legs in shape. “Rear” leg muscles used for bending leg backwards cannot be exercised until we can bear weight on legs as they stress femur the same as weight bearing. Legs have a sharp “bend” exposing femur on outside of leg with little muscle on lower portion of upper leg. Still seeing significant swelling and edema of legs at knees and ankles. I had hoped that healing would have progressed further..but as doctors reminded me..”You broke EVERYTHING” And in addition to broken bones, there was massive damage to soft tissue.
Still working on weaning off pain meds. Down to only one 500 mg Robaxin. Beginning to further reduce Oxycodone from 40mg 4x daily to 25mg; 5mg at 5AM and 11AM and 5PM, 10 mg at 11PM. Will also keep trying to reduce Oxycodone during daytime. Attempt to eliminate the 5mg 11AM dose was unsuccessful as pain level (general pain entire right leg) at 1PM was excessive. I will be careful not to reduce pain meds too quickly during sleep period. My opinion is requirement for pain meds will correlate with fluid edema. Withdrawal of oxycodone can be complicated as there are real physical effects.
I am also reducing the ibuprofen from 2400 mg per day to 1000 mg; one 200 mg at 8AM, 2PM, and 2AM with 400 mg at 8PM. I have completely eliminated muscle relaxant Robaxin.
Miralax is the primary laxative taken to counteract the oxycodone’s side effect for constipation. As oxycodone dosage is reduced, it can be tricky to make the appropriate reduction in Miralax. Found that Miralax dosage cannot be reduced at same % for oxycodone.
One of physical therapy goals is to restore leg range of motion, ROM to 120 degrees. Right leg has progressed to 105-110 degrees with stiffness and no pain. Left leg only 80 degrees with extreme pain at limit. Fortunately this sufficient for walking, but not enough for climbing stairs and sitting. (Navigating stairs may still be possible using a right leg only technique.)
Above status is as of 9 weeks from accident. Hopefully will make significant progress over next 2-3 weeks.
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