Monday, June 27, 2011

Make a Medical Binder!

Hi! Thanks for stopping by today! You are a very important person who deserves the best medical care as possible. When you go to see a doctor, you are in charge, you have hired that doctor to consult you about your medical condition(s). Be an active participant with your medical team. A great way to make sure you are kept in the loop, is to create a medical binder. I suggest a 2-3" binder (you may not fill this up today, but as time goes on, you will need the extra room found in a larger binder).

To make a medical binder you will need:
A 2-3" binder (any color)
A clear trading card holder sheet (or 2)
A permanant marker
Divider sheets
A calendar
A hole punch
A paperclip
Lined Paper
A pen

Once you have all of the materials for your binder, then you can put it together! The first page of your binder should be the trading card sheet. Place a business card for every doctor you go to, in the pockets of this sheet. You may want to use another sheet to put appointment cards in, but that is up to you. The next thing in your binder will be the calendar. Punch holes in the calendar so that it will fit into your binder. Put your calendar behind the trading card sheet(s); use the paperclip to clip on the current month. This will make it easier to find your appointment schedule, or to update it as needed. Write down all of your upcoming appointments on this calendar. Put your dividers behind the calendar and add several sheets of paper behind each divider sheet. You will need to write the following labels on each divider sheet (one label per divider)...
Medicine and Drug Allergies
Surgeries
Doctors
Medical Test Results
Questions

Now the fun begins! Sit down when you have some time and start filling out the information behind each divider. Depending on you medical history this could take from a few minutes to several hours or even days! Be as thorough as possible. You can always go back and revise your information as you need to.

Depending on your medical condition(s) you may want to go and get current test results. Current, means within the past month or so. You can always go and request a copy of the medical report from doctors, or test results from x-rays, MRI's, blood work, ultrasounds, or any other medical procedure. You will need your driver's license or current ID to obtain your medical records and they usually do not charge you if you explain that you need the results to take them to the doctor for your next appointment. Call ahead and ask for medical records. Sometimes you can get the results immediately, and other times you may need to wait a couple of days. A quick phone call can save you time and gas!

Take your binder with you to every doctor appointment! They will appreciate all of the information you have at your fingertips! Be sure to update your binder after appointments and tests.

Thanks for stopping by and taking the time to read this post. Please leave me a comment, so that I know you were here! If you have any questions, post those too! I love to hear from my readers!

Have a great day and come back soon!

Friday, June 24, 2011

Total Knee Replacement


This is a photo taken right after my total knee replacement.


This photo was taken one week after surgery! Dr. Clabeaux didn't even use stitches! My scar is healing great!

Hi, thanks for stopping by today! I wanted to share with you, a little bit about my total knee replacement. I had my right knee totally replaced on March 17, 2011 at Virginia Mason Hospital in Seattle, WA by Dr. Clabeaux. I adore Dr. Clabeaux and all the other specialists at Virginia Mason. I really feel like they see me as a person, not a patient, and they are working together to make my quality of life better. Check them out...
https://www.virginiamason.org/

Before I had my total knee replacement, Dr. Clabeaux had me take a class on total joint replacements and set me up with a website to research total knee replacements. He wanted to ensure that I had knowledge of the procedure and how it would affect me before I had the surgery.
https://www.virginiamason.org/service.cfn?id=4716

My surgery went well, but after surgery I began to have some problems. The past few surgeries I have had my blood pressure dropped. This surgery was not performed with general anesthetic, so I thought it might not drop, or at least not that much. I was wrong. First of all, let me explain what they did in leau of a general anesthetic. They first put in a pain catheter to help with the pain after surgery. They entered my leg from my groin and placed the catheter in the nerve above my knee. They put me under twilight sedation for that procedure and for the epidural spinal block they put in to help numb my lower extremeties for the surgery. I don't remember anything until I woke up, so the sedation in combination with the nerve blocks worked well! During recovery my blood pressure dropped and they admitted me to ICU instead of the orthopedic ward to recover.

I don't remember much of my first night. Somehow the next morning the nurse ended up pulling out my pain catheter. She was only supposed to turn it off! It was to be turned off so that I could regain some feeling back in my leg so that I could practice sitting up and standing and taking a few steps. My blood pressure was still extremely low, and so they would not give me additional pain medication because it would make it drop even further! That is when the trouble, or rather the PAIN, began! I remember extreme pain, and I had a difficult time rolling over on my own because it hurt so bad. I vaguely remember much after that except extreme pain, and not getting much relief because my bp was so low. The second day, I recieved a blood transfusion which helped my blood pressure a lot! They finally got my pain semi under control and I was moved to the orthopedic ward for my last night at the hospital. I was released Sunday, March 20, 2011. Since my surgery was done in Seattle, we had a 2 1/2 hour drive home. We had to make frequent stops so that I could stretch my leg, to prevent getting a blood clot.

I got home and settled onto the couch with my walker next to me. I had to use a wallker for about 3 weeks after surgery. I started phsical therapy my second day home from surgery. It was so nice to have someone come to my house! I had a rough time walking to the bathroom, and taking a shower exhausted me (I had a chair in the shower so I could sit down and shower, thanks Grandma for the loan). I remember elevating my leg for several weeks, actually I still elevate my leg if I overdo it. I also used ice pack after ice pack. If you are thinking about a total knee replacement, some things you will need post surgery are..

a walker
a cane
several ice packs
a chair for the shower
good friends/family to support you
extra pillows
you will also need antibiotics before any future dental procedures
you will need a note saying you have a total knee replacement before going
through metal detectors for the rest of your life

I worked hard and graduated from physical therapy 3 weeks after surgery! Then I earned the priveledge to use a cane! By my first post-op appointment I was walking without a cane and without any knee PAIN! Oh JOY! It was so wonderful to walk (slowly, but walking still)without my bones cracking and without pain! I was so happy I had the surgery, I can hardly wait until I can get my left knee done.

About 3 weeks after my first post-op appointment my right knee started to swell up and get warm. I was swollen from my knee, all the way down to my ankle, and it hurt to walk. I went to my GP and he did blood work and an ultrasound, which ruled out both infection and a blood clot. The pain appears to be more muscular rather than bone related. I have seen my surgeon twice about it. He has aspirated my knee twice and each culture did not grow any infection. So my leg appear to be fine. It hurts a lot when I first stand up, and then the pain subsides as I move around. I am just taking it easy, elevating it and using ice to help with the pain and swelling. My surgeon thinks it may be scar tissue. He will se me again in 3 more months and if I am still having the warmth and swelling he will send me for a second opinion. Team Medicine, that's what Virginia Mason is all about!

If you have had a total knee replacement, or are considering a total knee replacement, please leave me a comment. I would love to hear from you! Thanks for stopping by and come back soon, you never know what you might find!

Dealing with Chronic Pain

OMG! I can't believe how long it has been since I have written on this blog! I am so, so sorry! Believe me, it is not because nothing has been going on! So much has happened since my last post which was around my last foot surgery, about a year ago!

I have had a total knee replacement (I will post about that soon), another hydrodystension of my bladder, a blood transfusion, 4 Remikade infusions and I have been diagnosed with Psoriatic Arthritis and I may have Chron's disease (I have an endoscopy and colonoscopy planned in July).

Most recently I have started taking chronic pain management classes. I was taking two classes and one has already ended. The second class is an ten week course and I just finished up week seven! We have been working through a book called, Cognitive Therapy for Chronic Pain" by Beverly E. Thorn.

We have been learning about the connections between pain and stress and how to change our thought patterns to help us alleviate stress and pain. The class is taught by two incredible women who also deal with chronic pain, so they completely understand what we are going through. We have kind of developed a familial relationship amongst the group which makes it easy to relate to one another. One of the first things we discussed was how other people perceive us as "normal" because we may look "normal" while inside we may be suffering terribly physically and/or emotionally. It is so nice to know that you are not alone! If you are reading this and you are also suffering, please leave me a comment. YOU ARE NOT ALONE EITHER!

Every class we fill out a chart, to show what our current pain and stress levels are. We use a 0-10 scale for each feeling. The pain scale is...

0 No pain, no limitations (None)
.5 Barely noticeable pain
1-2 Pain is there but is low in intensity and is manageable; no observable
limitation (Mild)
3 Functionally disabling resulting in more breaks being required; slowed
work rates, slow/altered movements, lean on nearby surfaces, increased
limp (Moderate)
4 Between 3 and 5
5 Needing to stop the activity you are currently performing; unable to
maintain current body position; very restricted movements (Strong)
6 More painful than 5 but not yet a 7
7 Tearful, needing to lie down, needing to take extra medications,
difficulty engaging in conversation (Severe)
8 Between 7 and 10
9 Between 7 and 10 with more intensity than 8
10+ Immediate emergency hospitilization, unable to speak, icapacitated,
worst imaginable pain (Maximal)

The stress scale is called the SUDS scale (subjective units of distress)
It is also a 0-10 scale with 0 Completely Relaxed and 10 Panic Attack

I created magnets with each pain scale 0-10 on them. I gave them to each member in our class so that they could take them home and teach the scale to their friends and family. It is a visual aid for others to "see" how we are feeling, so that they might understand our reactions to things that are happening around us. If you would like a set of these magnets, please leave me a comment and/or email me ssauve7@aol.com so that I can get your address privately to get them to you. Please come back soon, and I will share more of what I have learned about managing chronic pain. Have a wonderful day and thanks for stopping by! Shellie