Tuesday, October 10, 2017

Preparing for Bend It Like Beckham with brunch

Happy Thanksgiving to my Canadian friends and family - miss you and love you guys!

It's been a challenging month for me. In preparation for surgery #10 on October 16 - that's right, Surgery NUMBER FREAKIN' TEN, my Pain Specialist and I decided that it was time to wean off of the Gabapentin, the drug that is effective in reducing my pain, but has temporarily lowered my IQ by 50 points. He suggested a rapid wean as Gabapentin's half life (the time it remains in your body) is quite short. So, you know, get 'er done. I'll save you the messy details, but let's just say that there was twitching, multiple panic attacks, tears, and horrible itchiness. It was like the worst hangover of my life, but persisting for an entire week. I was adamant that I wanted to keep my schedule as regular as possible, waking up early, getting dressed like a regular person, and heading to work every day. I think that maintaining a consistent schedule kept me sane during that awful time.  I held it together while I was at work, then collapsed on my couch at 4:00 and madly scratched the bottoms of my feet while uttering judgmental comments to the contestants on the Food Network's "Donut Showdown" ("Too much yeast you idiot!") Good times. I've since begun a new painkiller and although my dose is not therapeutic yet, the pain relief is improving, and I'm smart again. I can problem solve, produce complex sentences, and follow 2 step commands. I got my smarts back!

One might think that after 9 knee surgeries, surgery would become a routine procedure for me. It's not. With each surgery, my anxiety and fears increase. Thankfully, #10 is not a major operation. The plan is to remove the scar tissue that is preventing my knee from bending past 90 degrees and then bend my knee until my ankle hits my ass. You know, a little "Bend It Like Beckham." They've warned me that there will be pain post surgery. NO SHIT! Anyway, when I begin to think about going under anesthetic, waking up confused, in pain, and pleading for more drugs, "The pain is a 10/10!" (Aside: save your 10 for when you really need it. No one believes you if you claim 10/10 pain too frequently), it evokes sheer panic. I just have to focus on getting through this, knowing that with some hard work my range of motion will return, and my left knee can continue to get stronger. Right? I am cautiously optimistic.

In the meantime, I'm back to pre-surgery bulking. My scrawny little frame took a bit of a beating during the Gabapentin wean, and I know that I will likely lose at least 5 pounds after "Bend It Like Beckham," so I'm currently eating and drinking everything in sight...cue BRUNCH.

I thought I knew "Brunch" prior to moving here. But I was wrong. I had no idea. Here on island, brunch is an experience of pure, unapologetic gluttony, immediately followed by regret, shame, and a terrible hangover. Brunch is comprised of 4 distinct phases. Let me explain:

1) Phase 1: Pre-brunch planning and brunch strategy

It is important to select your brunch attire accordingly. Some people choose to fancy up quite a bit for brunch and others take the more casual route - that's not important. What is important, my friends, is the fit of your clothing. Ensure that you choose something loose with ample give. The biggest mistake one can make is donning a tight sexy dress, only to discover 3 courses in that you look to be 3 months along. Also, avoid long flowy sleeves. Strappy dresses are best. You don't want billowy fabric dipping in the cocktail sauce.

The perfect brunch attire: loose and sleeveless
 Brunch strategy, on the other hand, involves preplanning how to the get the most bang for your buck, and consume as much decadent food in 3 hours as humanely possible. Some suggestions include: 1) Avoid the bread and other inexpensive fillers that you can easily eat at home, 2) Load up on seafood and pricey cuts of meat, and  3) At the dessert bar, avoid things that you could easily make yourself like cookies and brownies. Choose the creme brûlées and tiramisu. Strategy is key. Brunch smartly.

Look away from the bread!


2) Phase 2: My life is soooo awesome

Around 1pm, as you are simultaneously consuming champagne, rum punch, and sangria, a warm fuzzy glow overtakes your body. You look around the table at the friends that have joined you for such a joyous event. You LOVE these people. This is the BEST day ever. You moved to a tropical island and your life is soooo awesome. You are truly living the dream. This is when the person seated next to you with whom you've only ever shared work files hugs you tightly and proclaims, "I love you!" You return from the sushi bar with a new friend and introduce her, "This is Stephanie, the amazing person who handed me wasabi!" Phase 2 is characterized by being enveloped by the warm protective bubble that shields you from the rest of the scary scary world. You have no recollection of horrible world events, troubles at home, or even the fact that you have to go to work tomorrow. Tomorrow? Is there really a tomorrow? Live in the moment! Bottom's up! You have officially achieved the ultimate (legal) high.

We are awesome. Obviously. 


Look! My new friend is holding my crutch!


3) Phase 3: SHIT!

Now phase 3 can attack as early as 5pm, in which case, you still stand a chance of survival. If phase 3 hits, however, around 9pm or later, you are screwed. I repeat, SCREWED.

It's all about the decision that you make once brunch is complete. If the adulting part of your brain hasn't been completely drowned in alcohol, you will make the responsible choice to go home and hydrate. If, on the other hand, all sense of responsibility has been washed away with bubbles, you will make the fatal error to continue your shenanigans at the beach bar, Royal Palms. If this is the case, the warm and fuzzy comfort of Phase 2 will continue to overtake your body...until it doesn't.

Once phase 3 hits, you begin to feel regret, "Oh my God. It's Sunday. I am drunk. I have to work tomorrow! What was I thinking?" You madly guzzle water and rub your extended bloated belly. You examine your reflection in the mirror. You wipe the mascara that is dripping down your face and note that you resemble a Picasso - one eye here, one eye there- your face has literally fallen off. You retreat to a dark room and ponder how you could have been so damn irresponsible. How could something that feels so right be so wrong? You are so freakin' thirsty.

Phase 4: My is life is NOT awesome

This phase occurs once you awaken from passing out  post brunch slumber. It could be midnight. It could be 6am. It all depends on whether or not you took part in post brunch beach shenanigans. Waking up on Monday morning with a furry tongue, alcohol seeping from your pores, and vague memories of what you may or may not have said or participated in is a horrifying way to start your work week. You immediately reach for your phone and groan in despair as you realize you've been tagged in 32 pictures that display your Picasso-ish brunch face to the world. You feel shame. You feel regret. Think of the waste! Think of the starving children! How many glasses of bubbles did you drink? You have no idea. It was bottomless! You consumed infinity glasses of champagne! No wonder you feel so terrible.  You solemnly swear at that moment that you will never do brunch again. Until you do.

I drank this many. 


Cheers friends!

Sunday, September 17, 2017

I got a blank space baaaaby...and I'll write your name

Hey Friends!

We made it back to our little slice of paradise about a month ago. August 14th marked our three year anniversary of island living. Typically, I've found the transition from the busy, event-filled Canadian summers to the quiet, slow pace of the Caribbean "Fall" a bit challenging; however,  I'm finding that with each year, it gets much easier to adapt to island routine. Adjusting to driving on the left side of the road, dodging chickens on the school yard, and sweating my ass off in 100% humidity is no longer that difficult or strange. You just do it without thinking. On the other hand, there are a few things that I've noticed in the last month that have made me stop and think, "Riiiiight...I am not in Canada anymore."

My eye candy heading in for a dip in the sea - much warmer than Candle Lake!


1) Hurricanes

Whoa! We sure dodged a bullet with Hurricane Irma. We watched it carefully as it developed over the Atlantic Ocean and evolved into a massive Category 5 hurricane. Luckily, it passed about 200 miles north of us, ravaging the Eastern Caribbean, Cuba, and parts of Florida in it's path. It's heartbreaking to see the pictures of St. Martin and Barbuda, for example. The devastation is horrifying! I can't imagine seeing your beautiful island in ruins and losing everything you own! But it is important to be prepared so, for that reason, I am becoming hurricane savvy. I've substituted the winter car emergency kit, complete with booster cables and a shovel, for a hurricane kit. I follow the National Hurricane Center's website and watch the direction and speed of tropical depressions forming in the Atlantic. The hurricanes develop to the east of us and move from east to west. Typically these storms make a north turn somewhere along it's route. This is exactly how we escaped Irma. It was heading from east to west and made a north turn toward Florida before it could strike our island. We did experience high winds and huge waves as a result, but nothing destructible. 2017 has been a very busy storm season and I'm presently closely watching 2 more storms brewing to the east of us. We will need to monitor these carefully. What would we do if it looked like we were on the path to take a direct hit of a major hurricane? Um...not so sure on that one. We have plenty of Chef Boyardee, water, and tequila in our hurricane kit, but to be honest, if a massive storm was headed our way, I think that I would try my best to get off the island!

The purple arrow points to us. Irma decided to take a turn to the north. 

Thar she blows! 


2) Whining, Daggering, and Singing At the Top of Your Lungs!

I've noticed many interesting differences between the Canadian and the Caribbean culture. One very entertaining difference is the way in which the Caribbean people embrace music and dance. They just go for it! No holds barred! One night a bunch of us girls hit up a club for some 90's dance and drink. Our group of ladies hailed from Canada, the US and the UK. We formed our little dance circle, placed our purses on the floor and danced the night away, with heavy emphasis on upper body movements. You know, "white girl" dancing (can you picture it?) Around midnight, a group of Caribbean partiers entered the dance floor and demonstrated how it's done. All the "daggering," (a dance move that is described by wikipedia as "dry sex") and "whining," which is comprised of hip thrusting and rotating, made our moves look like a school dance on a Full House episode. Wow. Caribbean peeps just know how to use their lower body in a sexy, rhythmic way.  My hips can't physically do those things, and for that reason, I will stick to my finger snapping, shoulder shakin' grooving. I just sounded like an 80 year old woman. Ugh.

White girl dancing: heavy emphasis on the shoulders, arms, and head.  Don't forget the hair flip.  

Singing at the top of your lungs also appears to be a cultural difference. Perhaps Canadians feel a bit more self conscious about singing in public? My speech therapy room is next to the school cafeteria, and it's not uncommon to hear the cook belting out the tunes, "Jeeeesussss is inside of meeeee!" No one comments or even bats an eye, as it's just a normal everyday occurrence to hear someone singing loudly in a public place. The other day, I was waiting in line at Paperman's, the "Starbucks" of Cayman. I could have been in any coffee shop in Canada or America, waiting patiently with the other patrons for the Barista to prepare our drinks. When suddenly Taylor Swift's, "Blank Space" came on the radio and the entire coffee shop erupted in song. I looked around suspiciously, wondering if I was part of a flash mob sing-along, but everyone carried on their business, singing, "I've got a blank space, baby...and I'll write your name." I'm not gonna lie, I sang along as well. My voice is not brilliant, by any means, nor was anyone else's in that coffee shop, so I felt no qualms about joining in. I walked out of that coffee shop with a chai tea latte and a smile on my face. Pretty cool.

3) Decisions Decisions

As much as I absolutely love summers at Candle Lake, the one thing that I often feel during our summers is a sense of urgency. Because there are such limited days of hot weather, if a nice day arrives, everyone feels the need to get outside NOW! Get in the boat NOW! Drink some cold wobbly pops! HURRY! Have fun! All the summer excitement is compacted into 2 short months. Also, because we only spend about 2 months a year there, we also feel a sense of urgency to complete renovations  and household chores that have been waiting for us all winter (when I say "we," I mean "Evan," of course). It's a little exhausting (watching Evan do so much work). Haha.

Now that Ev and I are back in Never Never Land, adulting has taken a back seat to relaxation time. Although we still have to work five days a week, the sense of urgency for paying bills and completing household chores is just...gone. There is zero sense of urgency to get outside and enjoy the hot weather, as it's hot Every. Single. Day. Don't get me wrong. We are under a lot of stress with regards to my health (the #neverbendingstory continues, unfortunately), as well as worrying about the health of family members. For those reasons we've had to make some difficult decisions recently, which makes the option to chill out and go with the flow that much sweeter (On that note, I must pay the overdue Flow (internet) bill!) It doesn't mean that I don't feel homesick, missing my friends and family back in Canada. I do. A lot. I would give anything to spend a day at Baba's house right now, chatting away and eating her cinnamon buns. But I have settled into the laid back vibe of our little island, and when I am not at work, I'm spending a lot of time resting, rehabbing, and relaxing.

This is an actual conversation that Ev and I had this week regarding an important island decision:

Me: "Where should we go for a drink?"
Ev: "Well I like the drinks in the Marriott lobby."
Me: "But then we can't see the sunset. Maybe we should go to the Marriott beach bar?"
Ev: "But if we drink outside at the beach bar the ice melts and ruins my drink. I don't want a watered down Old Fashioned."
Me: "Yep. And then the condensation drips down your leg. The lobby bar makes sense."

Haha! The struggle is real.

Cheers to cold drinks and singing like no one is watching!

Hurry! My pina colada is melting!

Dundee resumes his beach walk routine

The night before Irma passed us - red sky at night, sailor's delight

Wednesday, August 16, 2017

Time to pack up the sharks and shame the CPM

Wow! Summer is coming to an end and I have no idea where it went...well, actually, I kinda do know where it went. Approximately 252 hours of my summer were spent on the damn CPM (Constant Pain Maker) - the knee bending machine. I'm sure you are all dying with anticipation...can her knee finally bend? Did her perseverance and "never say die" attitude pay off? Did she avoid the scar-cutting, knee bending surgery? The answer is.... no. It's definitely not the fairy tale ending I was hoping for. You know the motivational saying, "You can accomplish anything if you put your mind to it"? Someone needs to add the clause, "...unless you have a shitload of scar tissue in your joint capsule."

Despite my best efforts, the knee's progress is too little, too late. It's now bending to about 85 degrees, which is progress; however, it's not quite enough to be functional (The average person's knee flexion is about 135 degrees). The Penn Med protocol states that at 12 weeks post surgery I should be able to touch my knee to my ear whilst funnelling a beer and one legged squatting on a surfboard. Not there yet. I continue to get stuck trying to get out of the bathtub and hot tub, as well as struggle to climb stairs. The knee is very stiff and painful. My surgery team in Philly suggested that it was time to come in for a scope in order to remove scar tissue and manually bend my knee under anesthetic. The surgery was booked for August 7. About 10 days before the surgery, I contacted the surgery team and requested that the surgery be postponed. I explained that I am in no place, physically or mentally, to endure another surgery and recovery. It's been a hot second since surgery #9, I'm underweight (but gaining!), still requiring a high dose of pain medications, and feeling pretty defeated at the moment. My surgery team listened intently and supported my decision, stating that I basically have until October to fix the flexion under the knife. Fine. That's a "future me" problem...I guess. Until recently, I continued to hold out hope that I could achieve flexion on my own. I've finally come to terms with the fact that I cannot fix this problem and that another surgery is inevitable. A part of me feels like I am accepting defeat. My rational side says that this is not my fault. I tried my best. My very #$%#ing best! Aside: I spent $1500 renting this damn CPM machine. I want my money back! I wish I could throw this damn machine in the lake. Note how I cannot reference the CPM without preceding it with "damn." haha.



CPM shaming
We head back to the island on Saturday and I'm back at work, full-time, next Wednesday. I had envisioned my return to work to be much different than the reality that I'm now facing. I will be heading back to work on crutches and an unbendy knee. Not ideal. It's incredibly disappointing and daunting. I'm struggling to wrap my head around how I will do this. My contract is up for renewal this year, and although I've never felt direct pressure from my employer, I feel an obligation to get back to work in order to ensure that I am renewed. I love where we live, enjoy my job and the people, and do not want to jeopardize that. Plus my job comes with the amazing health care that is covering my surgeries. I'm in a tough spot. The last year of work has been a battle - struggling to get through the work days in intense pain. My goal is to one day return to work and thrive, with my only focus on providing awesome speech therapy, as opposed to strategizing how I'm going to drive, carry materials, sit and get off of little people chairs, and walk students to and from their classroom.

This is a tough week. This is the week that I say goodbye to all my family and friends in Canada. I know that the next time we return, things will have changed. A few of my favourite people in the world are facing tough challenges right now. I wish that I could be here to support those special people in person. It's difficult saying goodbye, knowing that the next conversation will be over text, email, or Skype. I'm not a touchy feely huggy person, and I'm feeling especially flat this year (I blame the pills), so as I'm saying goodbye this week, I'm not crying or feeling particularly emotional. But I have something important to say to my family and friends, and even though I am struggling to express this verbally, I am able to put this in writing. Family and friends: YOU ARE THE BEST. You are the reason that I made it through the last 3 months. Despite the fact that I have been agitated, sad, and irrational, you did not give up on me. You came to see me, you brought me treats, you took me on the boat, you towed me on my paddle board (Kayla!), you made me laugh, and you made me feel loved. You never made me feel like I was a burden. You always encouraged, supported, and lamented with me when I needed it. I'm not sure how I would have survived the past few months if I hadn't been here, at Candle Lake, so close to the people who love me unconditionally. I am incredibly grateful for that. I won't give up. I keep going because my people need me to keep going. I love you guys. I apologize for every shitty thing that I said or did whilst angry and medicated! Thank you for sticking with me. You have no idea how much I will miss you. Soon come.




On a brighter note, the pets have received their import permits, clearance to re-enter the Cayman Islands, in record time this year! After 3 years, blood, sweat, and tears, I think that I may have finally resolved how to successfully import an animal to the Cayman Islands. To celebrate, Dundee insisted on donning his scary shark outfit. He can't wait to wear it on Seven Mile and scare the crap out of unsuspecting tourists. Who are we kidding? He can't wait to don his scary shark suit to Macabuca and pick up bikini-clad babes.

The perfect outfit for intense tropical heat!


Adios Amigos! See you in paradise.





Monday, July 17, 2017

The Neverending Story of the Neverbending Story

Well it's approximately 9 weeks since my big knee surgery. The Penn Med recovery protocol states that at this point in recovery I should be walking, squatting, and heli skiing treacherous mountains (OK, so I embellish slightly). So I decided to rip up the protocol that is tormenting me and focus on one thing: bending my fricken knee.

My knees and I have had a love/hate relationship now for 5 years. I coddle them, massage them, offer them encouraging words, but I must say, at this point in my recovery, my knee and I are definitely going through a "hate" phase. We are not on speaking terms. The knee has one job. ONE JOB! It just needs to bend. It is so stubborn, perhaps angry with me for subjecting it to so many surgeries. Regardless, the knee has decided that it is now a non-bending appendage.

Now I must admit something before I get too far along in this blog. This knee bending business is tremendously painful and I am popping painkillers like it's nobody's business. One particular painkiller, Gabapentin, is actually an anticonvulsant drug that is also used to treat nerve pain. The pain that I suffer from is like an electrical shocking sensation to my knee - kinda like when a filling in your tooth bites down on aluminum foil. Gabapentin is quite effective at killing this pain; however, it comes with some nasty side effects that affect my brain. My thinking, memory, and processing skills are crap...temporarily, I hope. I'm positive that my IQ has dropped at least 30 points. I can't think of people's names, I can't think of common words, I can't string together complete sentences, and I can't follow or process plots in TV shows or books. I just spent a month reading and re-reading a murder mystery called, "It's Always the Husband," and I'm really have no idea who did it! Someone was murdered? Frustrating. So I will likely have to access my thesaurus numerous times to express my thoughts, and my thoughts may not be organized and sequential. Bear with me.

My surgeon in Philly gave me a deadline of 60 days to reach a knee flexion of 90 degrees. Day 60 came and went, and although I seriously considered lying, I had to admit to my Surgeon that I was reaching only 70 degrees, despite the fact that I'm spending about 5 hours a day doing my incredibly painful "bendy" exercises. This is not good enough, and indicates that there is likely some scar tissue in my joint capsule that is preventing me from progressing. Lucky for me, there is a "procedure" to "help me along." As the Surgeon's Assistant described how the surgeon would cut the scar tissue out and force my knee to bend under anesthetic, I thought, "procedure, my ass!" That's a surgery, people. Another damn surgery. Even my Gabapentin brain can process that! So they are scheduling another surgery for August. Dammit!! (and a string of many bad bad words). I can't do any more surgeries. I am surgeried out!

Why does this machine make Kirstie cry? Stupid machine.

I am; however, still...what's the word...ADAMANT that I will bend this mother f#$%in' knee on my own. I visited my Physio, Ian, and he agreed that I might just be stuck, due to adhesions/scar tissue. As he manipulated my knee, I instructed him to reef on it. No pain, no gain. He pushed it far enough that I was digging my fingers into the wall and yelling bad bad words that nice Canadian girls shouldn't utter, but alas, the damn knee wouldn't budge. When Ian was releasing the stretch, in a moment of excruciating pain, I blurted, "I hate your face!" I hope he knew I was joking. Well, sorta. Sorry, Ian. I appreciate your help. You have very nice face.

In the meantime, I am obsessed with knee flexion. When friends come to visit, I fixate on the angle of their knees and...ugh...word-finding difficulties...ESTIMATE their flexion (Wow, Darren's knees are bending well. He must be at least 125 degrees!). I notice people climbing stairs with ease and enviously watch them sit down on chairs. It's kind of a problem. My friends and family have been very supportive, feeding me, bringing me pills, entertaining me, and propping me up on the boat like the dead guy in Weekend At Bernie's. I'm back living at home again with Evan and my furry friends. Ev's Mom was here to help - cleaning, supporting, cooking, and serving all of my favorite foods, as my appetite was...what's the word..BAD...NON-EXISTENT. Thank God for supportive friends and family who stick with me through all of this. To be honest, some days I wake up and wonder if I will ever smile again. The next thing I know, I'm floating on a pineapple with my sister, grinning from ear to ear. Thank you, my posse. I love you all so so much.

No knee bending necessary for pineapple floating!

Warning: This is the paragraph where I feel very sorry for myself
I've experienced challenging recoveries, but I must say that this particular recovery has been the most difficult and painful one thus far. It's difficult to express how I am feeling. I literally do not have the words (Gabapentin stole them away from me!) I can relate to my little white dog as he sits at the window, watching the world go by. Life feels like it's moving at fast forward speed around me, while I sit stagnant on my knee bending machine.  I am so disappointed in my body. I am not asking my knee to run, jump, or dance. I have accepted that is no longer a possibility. I am simply asking it to perform the basic function of bending! I have committed the last 9 weeks of my life to rehabilitating my knee, only to receive subpar results. I feel angry that, despite my positive outlook and ugh...what's the word, like a purse.. PERSISTENCE, I have to endure another surgery. I also feel terrified, and absolutely sick at the prospect of more surgery...even if they are sugarcoating it as a "procedure" to "help me along."Why is this happening to me? Enough already. Enough!
End of pity party rant.

Luckily, I do have a back-up plan if this knee bending thing doesn't pan out. There is a delightful little pirate ship in Cayman called the Jolly Roger that sails out every evening for a...ack, whats the word...sounds like ethnic...AUTHENTIC pirate experience. This ship is presently for sale for a steal of deal at $799,000 CI! I could be the peg-leg pirate (no knee bending necessary) and Evan could entertain hoards of tourists nightly in his pirate gear (because he loves large groups of people...and dressing up as a pirate). Perfect. It's always good to have a plan B. How do you save a drowning pirate? With CPARRRRRRRRR. haha. Is anyone laughing? Anyone?

Behold: The Jolly Roger in all it's glory!

The logical, non-medicated part of me knows that I will get through this. I always do. 

Cheers, Friends. Never ever take for granted a bendy knee!

Why are we so awesome? Because we ARRRRRRRR






Friday, June 9, 2017

I'm struggling ... and I blame Mike Fisher

At this point in my surgery "career," I feel like I can identify and describe all of the emotional stages of post op recovery. I'm pretty sure these specific stages are not published anywhere, nor is there scientific evidence to support them - so don't quote me in your next rehabilitation paper.  However, I have predictably experienced these stages after each and every one of my 9 knee surgeries. In addition, I have witnessed others experiencing similar emotions after surgery. Let's call this a subjective qualitative post: "The stages of post op recovery."

The first stage is survival. As soon as you gain consciousness in the recovery room, your goal is to just stay alive. Your body has been through severe trauma and you are relying on your medical team to give you the most effective cocktail of drugs to prevent you from experiencing agonizing pain. It's a difficult phase; however, your brain shuts down all thought processes and goes straight into flight or fight mode. You don't worry that you just flashed everyone your lady parts. You don't give a damn that you just peed the bed. It doesn't bother you one bit that you just told the Physiotherapist to F$%# off. You are strictly in survival mode. It's primal, it's dirty, and it can be horrendous.

Survival mode lasts anywhere from a few hours to a few days. Once your body has recovered from the shock of being cut open, your brain switches back on, the endorphins start pumping, and you start to reflect. "Wow, I got through that. I did it!" Enter the "Elation" phase of recovery. In the elation phase, you are so fricken happy you survived that you feel like hoisting your surgery trophy (they really should present you with a victory token) in the air and shouting, "I did it!!!" The drugs are still free flowing and you excitedly post an update on social media bragging about your survival. You begin texting everyone you know, exaggerating events to add to dramatic effect and your feelings of achievement, "Doing great. I almost died, but I made it!"

For me, the Elation stage of recovery was prolonged due to the travel back to Canada. My Mom, Ev, and I were all concerned about the trip from Philly to Saskatoon. It was evident that my knee was not bending enough to fit behind the seat in the plane, and so we had to be creative with my seating and positioning during both flights. I was quite concerned that I wouldn't be able to fit on the plane and would be stuck in Philly forever. It wasn't particularly comfortable, there were a few tears - but we made it. Once I settled in on my Mom's couch at Candle Lake, elation kicked into high gear. "I did it! I'm a survivor! I am awesome! I can do anything!" I happily sipped my Timmy's steeped tea, enjoyed my view of the lake, and prepared to settle in for 6 more weeks of recovery.

Predictably, the elation stage of recovery soon deflated into the stage I like to call, "When reality punches you in the gut." For me, this occurred in the middle of particularly frustrating episode of Dr. Phil. "OMG. I am stuck in this brace that locks my leg straight out in front of me for 6 more weeks. OMG. I am on crutches with no weight bearing for 6 more weeks. OMG. I still can't bathe myself nor can I put on my own underwear." Ugh. The "when reality punches you in the gut" phase hits, it literally feels like...well, like someone has punched you in the gut. It's difficult to catch your breath and panic ensues, usually followed by a severe case of self pity. Although this phase of recovery only lasted a few days for me this time, it was significant. My Physiotherapist with Penn Med explained my recovery protocol prior to leaving Philly. As he outlined the dates at which I should be achieving specific goals (i.e. 90 degree knee flexion at 3 weeks), I nodded, confidently thinking, "pfff, 90 degrees. No problem. I'm not a rookie. I'll probably bend to 110 degrees just to show them." When Penn Med physio questioned, "Does this all make sense?" I responded, "This ain't my first rodeo." Yep. I actually said that, like a cocky little shit who thought she was above Autologous Chondrocyte Implantation and meniscus transplant surgery. No biggie. Reality punched me in the gut when I met with my Physio in Canada and realized that at 3 weeks post surgery, my knee was stubbornly stuck at 35 degrees flexion. My Physio calmly and kindly explained that we needed to step up the exercise to ensure that my knee didn't get too far behind the expectations. All I heard was, "You are failing physio. You are a failure." I don't fail (well...there was that one time that I dropped out of that weather class in University. Who knew weather could be so complex? And to be fair, I did drop out before I could fail) Anyway, I went home and forced my knee into 36 degree flexion, crying in pain and feeling incredibly sorry for myself the entire time.

Luckily, phase 4 of recovery was right on the horizon. I call this phase the "F#$% YOU!" stage of recovery. This phase is defined by irrational anger. Instead of focusing on the fact that my knee is not bending, I am stuck in a straight legged brace for 5 more weeks, and am still struggling to put on my own underwear, I have decided to focus my anger on random people and events. Cue Mike Fisher, captain of the Nashville Predators. As we watched Nashville smash Pittsburgh in game 4, I suddenly became enraged with Mike Fisher.

"How did Mike Fisher get a trade to Nashville?" I questioned Ev as we watched the game, "So he was able to just request which team he wanted a trade to? Just because he was with Carrie Underwood they agreed to trade him to Nashville? And now his life is just perfect. Un#$%#ing believable."

I heard the angry words spit out of my angry little mouth and realized that what I was saying was absolutely ridiculous; however, I couldn't stop. I slammed Mike Fisher throughout the entire game. Evan, wide-eyed, glanced at my Mom and Step-Dad and commented, "Ya! I hate Mike Fisher too!" Good answer. Oh my poor family (Ironically, I am actually cheering for Nashville. And Mike Fisher seems like a good dude).

Mike Fisher is mocking me, "Haha, Kirstie can't bend her knee!"

So here I am, sitting unhappily at the F&%# you phase of recovery. This is a tough phase, as your irrational anger can most definitely push visitors away. I consciously try to utter positive statements like, "It's coming along" and "It's getting there," when friends and family inquire about my recovery...but let's be honest, I am not going anywhere for a while. My Physiotherapist is now manually bending my knee (NOOO KELLY CLARKSON!) and the CPM (AKA Constant Pain Maker) has finally arrived from Winnipeg (the CPM is like gold in Western Canada!) I thought I could progress without it, but it's apparent that it is necessary for my recovery.

manual bending: like a very slow full body wax
I'm looking forward to the "Insolent toddler phase" of recovery, which, according to my calculations should arrive in approximately 3 weeks time. If you recall from my last major surgery experience, at 6 weeks post op I became defiant, refusing help from others, hoarding food, and asserting that I could do everything by myself. Click here for a real treat. Oh goody, can't wait for that one! haha. When I say "haha," I'm not actually laughing, by the way.

Ok, Friends. Thanks for listening. I will get through this. Eventually my knee will just have to bend. Right? Thanks for all the encouraging texts, emails, phone calls, and visits - the visits have had a miraculous effect on my mood. It's difficult to be angry when you are at Grandma's house, eating her incredible tarts and chatting with Baba while crunching on her fabulous pickles. My buddies are also super distractors from my icky mood. Last weekend they put sunglasses on my face and gently placed me in the boat like the guy in "Weekend at Bernie's." I think it was fun. Me and my unbendy knee feel loved!

Cheers to Mike Fisher. Go Preds!

Here's a pic of me on the boat! Wheeeee!

My friends took me to the beach. What a great day!


Friday, May 26, 2017

Surgery #9: When American Healthcare slapped me in my polite Canadian face

You know that saying about the best laid plans, right?

I felt like I was an expert surgical patient the morning of my surgery. I was cool. I was calm. I was prepared with an arsenal of post-surgery weapons, including digestive cookies for nausea, a metal-free hair tie,  a list of questions for my Anesthetist, and a host of meditation techniques to calm my nerves and ease my pain post surgery. I had essentially been preparing for this surgery for a year, exercising both physically and mentally, as well as undergoing surgeries #7 and #8 which were prerequisites to this cartilage implantation surgery

So when the nice lady behind the Registration desk at the University of Pennsylvania Hospital informed me that I was at the wrong hospital, I felt a bit...well...panicked.

As my mom, Ev, and I hopped in another uber to take us to the Pennsylvania Hospital (no "University"), I looked anxiously at my watch. It was 9am - the exact time that I was scheduled to check in. The Uber driver informed us that we were about 40 blocks away from my Pennsylvania Hospital. He also informed us that traffic was not flowing on this Monday morning. I attempted to remain calm in the backseat; however, the drive was anything but relaxing. The streets of Philadelphia were out of control. It was UPENN graduation, so we dodged thousands of joyful grads in their caps and gowns and waited patiently for proud parents to cross the street. I felt like screaming, "Congratulations on such an impressive achievement... but get the F&*$ out of our way!" Like a video game, our route was foiled with obstacle after obstacle including garbage trucks, front-end loaders, and blocked streets. The three of us remained silent, anxiously watching the time tick. Thinking, "what's the worst that could happen?" it dawned on me that they could cancel or postpone my surgery. Yikes.

We finally arrived almost an hour and a half late to Pennsylvania Hospital. At that point I was in full blown panic mode. They quickly whisked me away to prepare for my surgery. Unlike my last surgeries at the surgery centre, where they carefully hung my clothing in my fabulous PennMed garment bag and delivered a nice dose of Versed to calm my nerves and make me forget, they carelessly threw my clothes in a plastic bag and instructed me to climb up into a stretcher. Off I went, panicked and choking back tears. This was not the plan. Where's my Versed?!

Once I was rolled onto the surgery floor, I was "stored" in the pre-op room, where the Anesthetists prepare their patients and patients meet with their Surgeon to discuss the surgery. I met with my surgeon who informed me that it would take at least 5 hours to transplant a new meniscus and implant my cartilage into my lesions. 5 hours? No one mentioned a 5 hour surgery! Again, I felt unprepared..and..where the eff is my Versed? I met with my Anesthetist, a quiet, elderly looking man, who probably had 40 years experience under his belt. I requested a post surgical nerve block, an injection that numbs the knee for hours to help ease pain after surgery. Trying to regain control, I took charge of the conversation, asserting, "How many nerve blocks have you performed?" The Anesthetist kinda glared at me and huffed, "It's not rocket science." Perhaps I pissed off my old guy because when I woke up 6 hours later, I was in excruciating pain, and it was apparent that the nerve block did not work. Shit sticks. I had lost control again.

The next 24 hours were rough. I was admitted to a private room with a fantastic nurse who shared my name. Kirsten tried everything to get my pain under control. I was injected with Dilaudid, Percocet, Gabapentin, and muscle relaxants - you name it, I got it. Nothing eased my pain. Mom and Ev took turns holding my hand and helping me breathe through the tears. When pain became intolerable, I began snapping my fingers, which is a strange pain reaction, but indicated to my "team" that things were bad. They finally decided to equip me with a PCA, a device that delivers Dilaudid on demand, with a push of a button. I pushed my little button all night long and finally was able to settle down for a few hours. There was a cot in my room, so thankfully, my Mom stayed the night and Ev went back to the condo to stay with the pets.

I was shocked when they removed my PCA the next morning, just as my pain was becoming controlled. My new nurse, Andrea, informed me that the PCA delayed my discharge and I had to be discharged by 6pm that evening. Say Wha??? That was the moment that the American Healthcare system slapped me in my unknowing polite little Canadian face. As I struggled, once again, to get my pain under control with injection after injection of medications, Mom and Ev met with the billing agent and a member of the Orthopedic Team who explained that my 5 hour surgery was coded as an "Outpatient procedure," which included a maximum of 24 hours in hospital, if needed. Anything extra was billed. An extra night in the hospital could cost up to $10,000. The medical team agreed to prepare a case for me, stating that I was in "intractable pain," however, they could not guarantee that my insurance would cover the cost. Frustrated and upset, I decided to go home, and requested that my Nurse numb me up with meds, so that I could transfer into an Uber and get back to our condo. I was very scared, as my pain was still a 10 out of 10. Again, I felt like I had lost control.

Surprisingly, the transfer home was better than I expected. Mom and Ev were so calm and cool, and I had a really great porter who helped me into my Uber without increasing my pain. I made it home, got into bed, and got absolutely baked on prescription pain meds for the next 3 days.

My memories of Wednesday, Thursday, and Friday are mostly a blur, to be honest. I required assistance to do everything, including going to the bathroom and getting dressed. Evan informed me that at one point while assisting me to the bathroom I questioned, "Why are we here?" Unsure of how deep and profound I was going with this, Ev responded, "Like on Earth? Like in Philadelphia?" and I responded, "No, like why are we in the bathroom?" I didn't really realize how stoned I was until my television began switching languages mid program. I turned to my Mom and asked, "Why is the TV switching languages?" I could tell by her concerned look that it was time to sober up from this "trip."

So that brings us today. It's been 12 days since my surgery. My pain is under control and I've drastically reduced the amount of medication I am taking. My Television is no longer switching languages, I can follow the plot of a 30 minute sitcom, I can go to the bathroom by myself, and I am orientated to place. Haha! The five of us (Dundee and Biloxi too!) are still in our little dark 800 square foot condo in downtown Philadelphia. We fly back to Canada on Sunday. My surgeon reports that my surgery went well and I now have the daunting responsibility of ensuring that my knee does not bear my weight for 8 weeks. I've been here before and I know that I can do it. I spend my days on a machine called a Continuous Passive Motion (CPM - AKA Constant Pain Maker), which slowly bends my knee, increasing it's flexion each day. It's uncomfortable and was, initially, quite painful, but it gives me a purpose to my day. My Physical Therapist has also provided me with a list of exercises to get my knee flexion (bend) to 90 degrees as soon as possible. I'm nervous about flying home, and fitting behind the seat, as I can only currently bend my knee to 30 degrees.

Overall, the surgery experience and post op was not as I had planned. But now that my pain is under control and I'm gaining independence (today I put on my underwear ALL. BY. MYSELF! #winning). I feel pretty upbeat, positive, and motivated to ensure that this surgery is a success. I'm relieved that the surgery portion of the experience is over. My Mom and Ev have been so awesome. If I so much as adjust my pillow in the night, my Mom immediately becomes alert and ready, "What do you need sweetie?" Although Evan is still working full time, he takes the time to arrange garbage bags, stools, and footrests to shower me every few days. I'm so lucky to have such a fantastic support system. I'm prepared for the fact that flying home on Sunday will be challenging. It's going to be a stressful day for Ev, Mom, Dundee, and Biloxi (#lindsaycircus). I hope that my pain is controlled and I'm relatively comfortable during the 2 flights back to Saskatoon. I can't wait to see my family and friends and settle in at Candle Lake for the summer.

Cheers Friends! I'm comin' for you Timmies - start steeping the tea!

Is there a knee under there or they did they remove that?
The view from my couch. If you look up...way up...you can see sky.

Resume the position on the CPM - Constant Pain Machine


Off to my Dr appointment - doing our best with an office chair on wheels and a cutting board

This guy is really stinking up our condo, but he's such a good buddy


The animals are restless and have resorted to staring competitions.


I reached 30 degrees! Whoohoo!


The Lindsay Circus on the road.











Saturday, April 29, 2017

Relax!

"Relax!"

That is the single worst thing that you could say to someone who is NOT relaxed. However, I often find myself commanding my body to relax, "Relax. Stop worrying. Relax!"

Our bodies are not Siri. Despite the incredible feats that our body can accomplish, it does not always respond on command. By ordering our body to "Relax!" our sympathetic nervous system doesn't just comply, inhibiting the "danger! danger!" signals to our adrenal glands. Our adrenal glands don't simply stop producing the stress hormone, cortisol. Our breathing doesn't just automatically slow it's rate. We simply cannot control our reaction to stress by commanding it to "RELAX!"

I've been working with my Pain Psychologist to identify and challenge negative thinking patterns and behaviour that is affecting me. It's called Cognitive Behavioural Therapy, which has helped to change the way I think and feel about situations, and as a result, has helped me to chill out and experience less pain.  It works! It's taken a lot of homework and practice, but I'm feeling much more equipped to deal with stress and anxiety, specifically as it relates to my condition and pain.

But...I still have challenging days where negative thoughts spin out of control and my strategies just aren't as effective. Cue Easter Break 2017. I had 10 days off of work. Although I had a few appointments throughout the week, the majority of my schedule was wide open. Lots of time to "relax."

I found myself laying by the pool, book in hand, listening to the waves crash in the distance. "Relax. This is nice."

I found myself sipping my tea on the couch, cuddled up with my cat, watching celebrity interviews on the Today show. "Relax. You enjoy this."

I found myself exercising in the pool, stretching my muscles and feeling my body move effortlessly in the water. "Relax. This feels good."

Problem: I was not relaxed. My jaw was clenched. My fingers were chewed until they were raw (stress causes me to forgo food for fingers). My stomach churned with nerves. My tried and tested meditation techniques were only providing temporary relief from anxiety. I was sucking back a daily vodka paralyzer, which only made my head ache. Boo. People attempt to emulate my environment with sound machines and heat lamps, and here I was, in a tropical paradise, cocktail in hand, and unable to relax! RELAX DAMMIT!

On Wednesday, I met with an Orthopedic Surgeon on island who is new to me. I can't recall his name, but I do know that he is Finnish. I required this Surgeon's signature to authorize my cartilage implantation surgery at the University of Pennsylvania Hospital, which is scheduled for May 15. Over the past 4 years, I've had dozens of appointments with at least 8 different Orthopedic Surgeons. Each of these specialists agree that my condition is severe and rare, and the majority of these specialists state that there is no treatment for this condition. This is why I sought out a Surgeon who researches my condition at a University known for its medical advancements. He believes that this upcoming surgery could result in very positive results for me. I'm putting my trust in this person who has presented me with a few decades of research and a history of positive results with respect to my rare condition. If I can't trust him, who can I trust?

So it shouldn't have surprised me or gotten under my skin when the Finnish Doc kindly agreed to sign off on my surgery, but then expressed skepticism with regards to a positive surgery outcome.

Instead of spewing out the numbers, the research, and the evidence that support my upcoming surgery, I sat in silence. I felt my shoulders rise defensively to my ears. My heart fell. And there it was. Doubt.

I listened intently for 10 minutes as he expressed his apprehension regarding the surgery. Instead of breaking down and crying in the Orthopedic Surgeon's office (my MO),  I composed myself, straightened my back, and spoke in a calm, confident voice, "Do you have any alternative solutions for me?"

Taken aback he responded, "No."

"Okay then. Thank you for your time. I am a strong person. I am educated. I am very aware of what this surgery entails. It was nice to meet you." This man was not going to see my tears.

Surprisingly, the Surgeon nodded and responded, "I can see that. I wish you all the best."

I took my signed paper and exited the hospital in the middle of a massive thunderstorm. Fitting. I then sat in my car and... well, I cried. Ugh. Good times. RELAX!

I've been enthusiastically explaining this surgery for the past year, "It's incredible. They are harvesting my cartilage in a lab! They will implant it back in my knee. Isn't technology and modern medicine amazing?" The reality is, I'm just not so sure. I want to be sure. The research is convincing. The science side of my brain tells me that this surgery makes sense. However, I've underwent 8 surgeries, and although many of them have provided temporary relief, I have yet to experience more than a year of reprieve. Am I doing this because I believe in it? Or am I doing this because I have no choice?

So I have some doubt. Instead of bottling up that doubt and facing the world with a brave face and enthusiasm for modern medicine,  I decided to tell people. I met with my island besties on Thursday for a really fantastic pre-birthday celebration at the Kimpton Spa. I sipped champagne, soaked in the waterfall hot tub with perfectly pedicured toes and admitted to my friends that I am afraid. They listened. They reassured me. And I felt better. I began to relax.

I messaged with my Canadian buddies. I told them about my appointment and we chatted back and forth. They called the Finnish surgeon bad names. And I felt better. A little more relaxed.


I'm calling it: Best Pina Colada on island at the Kimpton

Spectacular spa day with my island girls

My new wine glass, "Ship Happens." These girls know what I like!

The next day, my 38th birthday, Ev and I hopped on plane for a quick 45 minute flight to Jamaica (Confession: I drank the complimentary in-flight rum punch at 7:00AM) and settled in at Strawberry Hill, our own beautiful cottage nestled 3100 feet above sea level in the Blue Mountains. Immediately noting that there was no TV and the only sounds were the cool mountain breeze blowing through our cottage, the chirping of birds, and the occasional distant sound of honking (the road up the mountain is so narrow that you must honk when you are driving to warn oncoming traffic!), I was initially concerned that there wasn't enough action to distract me from my anxiety. I was so wrong. It was wonderful. Ev and I spent hours drinking Red Stripes on our mountain deck (because Jamaica!), watching and feeling the clouds pass directly in front of us, listening to Bob Marley's greatest hits (because Jamaica!), and just hanging out. We indulged in spa treatments, amazing meals and cocktails, and soaked in the serenity and peace. At night, our little cottage echoed with the sound of the rain on the roof and the wind blowing through our louvered wooden windows. Our four poster bed was heated and I don't think I've ever slept so soundly. It was just awesome. Although I have a severe dislike for the word, "romantic" (If you have to state that something is romantic, is it really romantic??), I will say that the weekend was "mystical." Yes, that's the word. Mystical. We discussed my fears about my upcoming surgery - but it didn't consume my thoughts or our conversation. We just thoroughly enjoyed each other's company,  and I submitted 100% to relaxation. Caveat: Do not go to strawberry Hill with someone you don't like. You will be spending a lot of time together. We observed a bird-watching couple arguing mountainside and pondered the possibility of them starring in the next Dateline Murder Mystery (the husband is always guilty, by the way). Ensure that your travel partner is your best buddy for this particular getaway.

Despite the mystique of Strawberry Hill, the experience didn't magically wipe away all my worries and fears, but I feel better about things. I am afraid. I have doubt. But I've made a decision to have this surgery. I am committed. The surgery is booked. My cartilage is growing in a Boston lab as we speak. It is the right decision because it is the decision that I have made.

One Love!

The view from our mountain cottage

My birthday dinner - 38 isn't so bad!

just flexin'

My knees are soaking up the freedom!

Jammin' 




A Biloxi Mama and her little Biloxi kittens. The resort is looking after these guys in return for pest control!

So I ordered the complimentary rum punch on the 7am flight. It was my birthday!

Breathtaking scenery


Ev's showing me how to "wine"

Cheers!

My new buddy. Apty named "Whitey"

The lights of Kingston from 3100 feet