I’m paper journaling my experience more regularly so I can remember should I have to do the other knee someday. But let’s have an update!

Surgery Day – Thursday 1/19 – could have gone home for one day surgery but PT was done before I was ready to be evaluated. Just as well as I had some bleeding under the ACE bandage that was not “usual” when I asked.

PA evaluated the bleeding under the aqua-gel dressing the next day prior to DC (and after PT evaluation and I got the go ahead for DC) – PA changed the dressing. It did not appear to be actively bleeding then, but a small spot appeared under the gel dressing before I left. By the time Dan was helping me to the bathroom later that evening, and blood was dripping out from under the dressing, we needed 4X4s and Kling and an ACE and a call to the on-call person. Bleeding slowed so thought things were settling down.

PT came the next day and ran through a few exercises. My extension and flexion were “very good”. He set up a PRN home health nurse for the next morning. PT was to come three times the following two weeks, then two times for the third week.

Nurse took down dressing on Sunday morning – which had again absorbed a lot of blood. End of story – go to ED and get evaluated after she sees active bleeding and a small area of dehiscence. More steri-strips, call in antibiotics, and use gauze and wrap and now I couldn’t take a shower until this slowed down. It took about a week to have it unimpressive enough to shower.

Meanwhile – PT must go on. The knee feels tight and swollen and I’d been well prepared for the “first couple of weeks are awful” so I wasn’t expecting it to be wonderful. I used the walker for about a week and a half and then more cane and then no cane by the end of the first three weeks. Stairs were one at a time and now can be alternating but knee still feels tight – more so going downstairs than up.

I used the opiods for about 1.5 weeks – mostly for PT or sleep. I took Tylenol PM at night and no NSAIDS for the first couple of weeks since I was bleeding. (Still took baby aspirin for a month and wore compression thigh high hose for the first two weeks.) Once the bleeding stopped, I alternately took Tylenol and Ibuprofen and until just a few days ago, took it like clockwork. To be honest, I had to guess at times but erred on waiting longer than taking it sooner since I couldn’t exactly recall last dose.

I’ve had two weeks of PT in the facility, started driving a week ago – maybe could have done it sooner but had my sister to drive me, but now I can go solo to PT.

I saw the PA at two weeks (f/u ED visit) and one month and will see Dr K at 2 months post op.

Lots of ice packs and am rotating them through the freezer. I bought an ice machine but since it wasn’t compressive, it was a lot of work to set up for no further benefit than an ice pack laid on top of a towel on my knee. That feels like a waste of $$.

I elevate a lot even now when watching TV or reading or internet-ing. Until it just feels yucky, then I lower the recliner to flex knee again.

I thought I was well prepared for what to expect, had interviewed, read online, etc. I did not expect the achy feeling in the knee joint to be so constant and lasting so long and to need OTC meds so constantly to deal with a “headache in my knee”. I think I expected the swelling, but the tightness from the incision and swelling feels more impactful than expected. But I probably did the surgery sooner than many and pre-op was not hurting with sleep or at rest. (I was more achy at the beginning of this journey late 2021 and early 2022.) If I wasn’t working full-time, I may have been able to delay but ultimately, what for? I couldn’t walk for pleasure and that’s a big goal of mine. On xray, it was “bone on bone” and that was not going to get improved when it’s arthritis.

I have nearly 12 weeks off from work, and it feels today that I will need every bit of that time to return to four days a week on my feet (at least off and on walking throughout my day).

Ultimately, there is of course improvement; it is so very gradual though. PT says “you’re doing great” so is this just what they say or do I believe them? When I walk, I think t looks better than it feels.

My retired younger sister was here for help with Dad, me and general company for us – which has been nice and distracting and we’ve watched lots of shows. She headed home yesterday.

I hear about the various spots of the timeline for when _____ improves (fill in the blank). So I need more patience and just hope I’m not going to experience any more complications than the little dehiscence!

Here are my favorite books of this past year in no particular order:

And all three Greg Iles books in his Penn Cage trilogy #2.

Actually, I really liked about 90% of the books I read this year. 🙂

I took walking in general for granted until late September 2021. I’d have an occasional ache, and kneeling was not particularly comfortable, but nothing long term. I’m not an overly ambitious person when it comes to physical activity, but I’d been enjoying a neighborhood walk about 3 times a week on days off for a couple of years in an effort to control blood sugars and remain active. I enjoyed taking a picture here and there, noticing changes in nature – and even picking up litter as I walked. Then there was the day when a noticeable shift happened. No fall, no acute injury, no twisting – but I’d walked a couple of miles and my right knee was hurting more than usual – so I finished off the walk (another mile). It took me a few days to realize I would apparently need to consult an orthopedic doctor to see why it was this painful and swollen.

My job requires walking, so by the time I got to the orthopedic doctor about 3 weeks later, I was ingesting NSAIDS regularly to keep mobile, and even driving home at the end of the day was painful and achy. I was mentioning it often to my empathetic husband and coworkers. Ultimately, in the past 15 months, I’ve had two 8 week rounds of physical therapy about six months apart, two different orthopedic doctors were consulted, three cortisone shots administered, an MRI last January, a couple of sets of x-rays and the conclusion was – yes, there was a small meniscal tear noted a year ago – but there was also significant arthritis in the joint. At this point, bone is touching bone. Touching sounds so benign, so it’s probably more like bone grinding against bone without the cushion that should be there in between. In my Google research, I learned that arthritis can be accelerated due to an injury or impact – and a few years ago, I did fall and hit my right knee on a sidewalk. The left knee feels quite normal – for now – thankfully.

Neighborhood Pond

Since there is nothing but surgery to improve the situation, I made the decision to move forward. I was in denial for months that a knee joint replacement was in my future, but after many more months of limping and compensating in my walk, I have a date with a surgeon on 1/17. I have watched the surgery on Youtube which looks more scary when it’s going to be ME. But I’ve talked to my many friends who have had this surgery and most state that they waited too long. A random stranger at a blood drive sitting at our post donation snack table interrupted my discussion with a friend and strongly encouraged me to proceed since it helped her so much. Knee patients have strong feelings about this and I’m grateful to live in a time when this is possible as a fix. I’m thankful for insurance, for short term disability, and for family support as I go through the weeks of recovery and physical therapy in the months post surgery.

Some of the less obvious impacts of this past year are discouragement, fatigue, mentally feeling older, and facing a decision on working full-time vs. part-time vs. retiring sooner than I’d planned. Anxiety over what’s ahead is hard to avoid, but when a surgeon does 200 of these procedures a year, and visiting a friend 2 weeks post op and watching her get around well helps – (and it’s knee #2 for her).

I hope to be enjoying my neighborhood walks next year once again.

What greater thing is there for two human souls

than to feel they are joined together

to strengthen each other in all labour,

to minister each other in all sorrow,

to share with each other in all gladness,

to be with each other in the silent unspoken memories.

George Eliot

1. What was it like in the beginning? In the beginning of 2021, there was no hint of what was ahead regarding my mother’s terminal cancer. There was relief at being able to get a vaccine and feel more protected from Covid-19. I felt as though we would finally get ahead of this virus, and never anticipated such resistance to the miracle of science. Also, in January, I watched an insurrection in DC on TV in disbelief.
2. What worked well: Journaling to remember. What didn’t work well: To be totally concrete, my right knee didn’t work well.
3. Some of the most important conversations: were with my mother, father, and sister – especially once we knew that mom’s cancer would be terminal.
4. The best entertainment: Ted Lasso, Professor T (Danish version), and of late – Modern Family. My best books are on my last entry. Podcasts also entertained and educated. (Pantsuit Politics, You Have Permission, Moth, The Daily, and Popcast)
5. Who mattered – my sister was so very important in her presence with me with the experiences with our mother and father.
6. What changed? Life without my mother downstairs and watching my father adjust to life on his own. Also – feeling that Covid-19 was waning to realizing that with vaccine resistance, it will be with us and impacting healthcare for more years. And coping with a knee issue for the last quarter of 2021 shows how quickly things can change and impact day to day tasks and comfort.
7. Happiness and fulfillment: Time spent with my husband and family is very high on my list of things that bring happiness. Reading with my husband, talking about meaningful things with him, all good.
8. What did I learn? I can do hard things and bear hard things, even when I wondered if I could.
9. What is actually ending? My feeling of certainty.
10. What do I want more of? Books. Time away from work.

It’s been 13 days since I experienced what is being called a Transient Global Amnesia (TGA) event. Seemed worth blogging about this weird experience.

It had snowed a lot in a relatively short time Monday and the roads were in very poor condition on Tuesday morning. There were tree branches down everywhere, and many areas were without power – ultimately for days for some. We only had an outage for about 8 hours on Monday, so we were fortunate on that end.

On Tuesday, I was scheduled to work and I packed a bag in case I needed to stay overnight at the hospital with potentially bad driving conditions. I headed out after my usual oatmeal breakfast. I took a couple of pictures of the road as I left our driveway (and recalled doing this when I saw them on my phone), and continued on out of the neighborhood. Although I have only 2 or 3 foggy memories of the early morning, my husband – who was working from home – says I was not acting confused prior to leaving for work.

I have texts on my phone from my colleague that I was going to be working with – discussing the issue of the roads, the people trapped for hours on I-95, and how the neighborhood roads were pretty bad and the text was sent at 6:44am. No confusion yet. I can vaguely remember this text once I was reminded it had happened and looked at it.

I left the house at about 7:40 – confirmed by the time stamp on the photos I took as I left. Dan called me while I was on my drive shortly after I’d left and after a minute or two, I told him I needed to concentrate for the drive, and this is another of my foggy memories – the phone call.

My phone shows the texts I’d made to J who’d asked me about the condition of the main road since she had an appointment and wondered about driving to it. This was at about 8:12am. I only have a vague memory as I now look at the text, but I texted her that I was in a parking lot and felt “confused”. J ended up calling me, and I drove the rest of the way to work (about a mile) while she kept me on the phone for 12 minutes. She asked if she should call the rescue squad, but I assured her I could get to work (she says). I could not remember who I was supposed to work with. I assumed I was on the way to work since I was in scrubs. I met S in our lactation office on the third floor. She had been notified about my confusion by J once I’d reached the parking garage and our call dropped. S texted me a couple of times trying to find me but once we met in the office, S confirmed that I did not know what day it was or who the president was. She walked me to the ED for evaluation and I did not protest this decision. I had no motor symptoms of a stroke (facial droop, one sided weakness) but what WAS happening was very frightening to S. During the neuro assessment in the ED, I was asked who I lived with and I said my parents and my husband. She let me know after the doctor left that my mom had died and that I was “shocked” that this had happened. (June 13) I did not remember whether my sister was at my house or in CT (she’d returned home two days before after her week long visit in VA). This was a day earlier than planned due to the pending storm, and I also didn’t remember the snowstorm.

I have no memory of the neuro evaluation, the CT Scan, the IV, the Covid test, S taking me to the bathroom a couple of times, my manager K visiting for 1/2 hour (and kindly letting S stay with me), or anything else. I can remember my husband arriving to the room I was in at about 1:30pm. He looked worried and I remember that. He tells me I still cycled through the same questions for another couple of hours and then stopped asking them as my short term memory returned. Based on what I read, I will not likely ever remember the Tuesday morning events as short term memory was being laid down in the brain (which gets placed into long term memory for recall).

One of the classic symptoms of this phenomenon is this repeating the same questions over and over every few minutes. Even my responses were the same. I was asking if I’d had the CT, did I have the MRI, confirming that it looked like I was supposed to work, saying that this was very inconvenient. These questions are not from my own memory, but from those witnessing it. S said she was looking on the internet for a description of TGA after the Neuro doctor explained that this was likely what was going on – especially when the CT showed no stroke and there were no physical symptoms present. Typical length of an episode can be about 2-8 hours. Mine was about 6-7 hours. I retained who I was, knew familiar people, could drive, could follow directions, but the repeated questions again and again were certainly concerning until everyone knew what was happening.

Dan left the hospital by about 4:30pm since I seemed to be ok at that point, and knowing I would be admitted, he wanted to be available to my dad and his sister in case the power went out again and definitely wanted to drive in daylight with the horrible roads. He had been texting our kids, and my sister to keep them updated, and they were all very concerned.

I had the MRI after he left and have full recall of that. The ED was very full as the Covid admissions are very high – and once it was obvious I was just needing observation, I sat in a hallway on a stretcher next to the nursing station for hours. I was able to look on MyChart to review the various test results (CT, UA, MRI, Labs) and finally got to a room in the Observation Room by midnight. A couple of co-workers checked on me in the early evening and I finally got something to eat.

Once the short term memory returned by mid afternoon, the previous memories were just there – no rushing back of all the memories that I couldn’t remember that morning (i.e. snowstorm, mom dying, sister leaving).

I got some interrupted sleep overnight (lab, vital signs) and tried to process what had happened. The next day, the hospitalist came by to do an assessment and asked me year, month, and day. I got them right after a very brief pause on year – I mean we were only 5 days into 2022! But when I said it was the fifth, he comforted me about not getting them all right. Note to doc: Check what day it is before you come in to assess a neuro patient. I showed him my phone that had the correct date so he could see that I was actually oriented.

I spent Wednesday waiting on lab results, doing another urine specimen (could not truly vouch for my “clean catch” the day before), getting a prescription called in for antibiotics for a UTI, and by 5pm – was discharged.

I had a follow up with my primary on 1/7 so I could get clearance to work the next day (Saturday) and all has been “memory intact” since Tuesday afternoon. I still have an EEG tomorrow and an ECG on 2/1 to rule out anything missed in brain (seizure?) and heart (tiny clot?) and I’m really hoping this is a “one and done” event. Based on what I’ve read, less than 10% have a future event. I may never know what precipitated it as some of the possible causes are not what happened to me that morning, other than potentially stress from the drive on very poor conditioned roads. Maybe cumulative stress from this very challenging year. And I’ll never know if I had a close call in the drive, I guess.

Addendum: The EEG I had in the following week showed some “abnormal wave patterns during the hyperventilation phase in the temporal lobe” but I did not see a neurologist until mid-March. This neurologist could not rule out an atypical seizure and suggested Keppra – suggested in that she would not sign off for me to continue driving unless I agreed to the Keppra. Ok then.

It’s now been over a year with no further incident and had my one year follow up with her. Sounds like I’ll see her in a year and discuss whether the Keppra will still be needed.

Here are some links to read about TGA.

https://my.clevelandclinic.org/health/diseases/21028-transient-global-amnesia

https://rarediseases.info.nih.gov/diseases/8172/transient-global-amnesia

https://www.mayoclinic.org/diseases-conditions/transient-global-amnesia/symptoms-causes/syc-20378531

…..in no particular order.

Shoutin’ in the Fire: An American Epistle – Dante Stewart (audio) Loved the poetry of his writing and audio made it even better.)

The Making of Biblical Womanhood: How the Subjugation of Women Became Gospel Truth – Beth Allison Barr (audio) Definitely recommended. I probably need to re-read to take it all in.

How the Word Is Passed: A Reckoning with the History of Slavery Across America – Clint Smith (audio)

Caste: The Origins of Our Discontents – Isabel Wilkerson (audio) Excellent and read her other book, too. (The Warmth of Other Suns)

Somebody’s Daughter – Ashley C Ford (print) I like memoirs and this was a good one.

Stranger Planet (Strange Planet, #2) Nathan Pyle (print) As good as his first one. He makes me smile.

Faith after Doubt: Why Your Beliefs Stopped Working and What to Do about It – Brian McLaren (print) More Brian McLaren please. (podcasts, too)

I Hope This Finds You Well – Kate Baer (print) I’ve loved Kate’s poetry since I discovered her years ago. Happy that she’s been published now (and this is book 2).

Also – Returning to Greg Iles and his back list have provided some of the most entertaining fiction this year. He tells a great story and I’m reading through the Penn Cage series. Nice to know I can still manage a long book if it’s so very good.

https://www.gregiles.com/novels

September 9, 1932 – June 13, 2021

She probably would not have described herself as strong, but she lived through a lot of painful experiences.

She was generous and kind when she could have easily hated and been bitter, but she never had a bad word about anyone. “She’s *or he’s* so sweet”, she’d say about almost everyone.

She lost her mother when she was 22 and her servant heart brought her home to take care of her father and two youngest siblings.

She married a kind and honorable man when she was 24 and over the years, was grateful for his “patience” with her. They of course had patience with each other in this marriage of 64 years.

She loved having children – two daughters of her own – and babysat for so many more, before and after having her own. Always a caregiver.

In her 20s, she lived a farm woman’s life; cooking, cleaning, doing laundry, hanging clothes out in the cold Maine winter weather until the clothing was frozen stiff, and taking the frozen clothes in to thaw in the wood stove warmed kitchen. She cooked simple meals, churned butter, and made homemade bread and doughnuts, and chocolate cakes. She loved music and hummed along. She sang to her little daughters: “I love you, a bushel and a peck, a bushel and a peck, and a hug around the neck” and “You are my sunshine, my only sunshine…”

In her 30s, she moved to Connecticut, suddenly far away from familiar friends and family and spaces. She found herself struggling with clinical depression. This unwelcome visitor would return on occasion over the years but she made her way out of it with time, family support, and medicine.

She faced breast cancer later in life two separate times and survived what her own mother did not.

Her world was entwined with his, and she quoted him often, and deferred to him most times. “He only ate half the cookie….I ate the rest!” “He saves the smallest bits for leftovers”, she’d say in frustration. “He only puts ONE slice of ham on his sandwich – he doesn’t eat enough”. But they spent their days together, ultimately in a retirement lasting nearly 28 years. Their days started with a kiss and ended each night with a kiss, decades of breakfasts and dinners together. He called her his honey, darling, baby, sweetheart. She would just smile at all of this and shoo him away.

She was truly a friend to anyone she met. She had friends in Maine, Connecticut, Virginia, and Florida. Facebook helped her connect or reconnect with them all. She loved visiting, talking, and phone calls to friends and family in all the states. Facebook got a bit more complicated in the last couple of years, and we rescued her occasionally from posts she didn’t mean to post, a LIVE Chat she didn’t intend, and unlinking from some groups she’d liked accidentally – like “Mothers Who Love Vodka”. Was that an accident? 🙂 She’d sigh and wonder how she’d done it.

She had “macular” (degeneration) and six pairs of glasses that were somewhat interchangeable. I’m not sure she knew which pair worked best on any given day and she was always misplacing the “pair that worked best”.

She had a dry sense of humor and I grew to appreciate it more as something we shared.

She felt the losses resulting from aging and physical deficits, and in the last few months, mourned the loss of her hair as she was told she faced cancer once again. This time, cancer would win.

It felt like a full circle moment one morning when she looked up at me during one of her dressing changes on her head, and said “I don’t know what I would do without you”. So many times, she had told me about her own mother saying the same words to her when she helped her mother in her last months. So many dressing changes, but also so many conversations that would not have happened. We bought doughnuts or milkshakes on our drives home from appointments since “I guess I don’t have to worry about that now”.

A little over a week before she died, we returned home very late after a blood transfusion. I helped her into bed where he was already sleeping. He woke as I was helping her in under the covers. I re-checked her bandage under the cover one last time, and saw that they were already holding hands. We all miss her, but he misses her the most. Being prepared for the loss is not the same as experiencing and living with the loss, he says.

Her faith was both simple and complicated – believing in a God who loves everyone, but feeling unworthy of that love. Depression, early childhood trauma, and a black and white view of faith and right and wrong and sin and worthiness and Depression can complicate belief, trust, and faith. Eighty eight years of being unsure, and now I believe she is at peace and knows at last that God always did love her.

https://poets.org/poem/notes-other-side A link to the poem my sister read at our Celebration of Life.

I’m reading a book called Share Your Stuff. I’ll Go First by Laura Tremaine. She also has a podcast called 10 Things to Tell You that inspired the book. There are ten chapters and Laura shares portions of her own life and then there are writing prompts and questions for your own responses; a conversation with someone, or a journal entry, or in this case, a blog entry. I’ve actually used prompts from her in previous entries, so I’ll try them again.

Chapter One is “Who Are You?”.

Photo by Ivan Aleksic on Unsplash

I’m Val and I am a blusher. This is at least one part of who I am. I guess I’ve always been shy, but my first vivid memories that I was turning VERY red – causing further embarrassment – were in 9th and 10th grade. I remember a teacher commenting about it in 9th grade – and it’s amusing to think that he was one of my favorite teachers. (Why didn’t his comments make me mad?) My first vivid memory of blushing and being very conscious of it was in 10th grade. It was English class and I can even remember what the room looked like at my old high school. Tall windows, sun shining in. I’m not sure what the exact circumstances were, but it might have been comments around my 16th birthday.

Over these many decades, it has been an annoying buzz in the background of my life; wondering if any given situation would make me blush, and knowing some situations or people would definitely cause me to blush. I would be dreading it, and the dread would cause it even when I was long past any anxiety or shyness with a situation or person. Erythrophobia is the fear of blushing.

Having someone – a non-blusher obviously – point out that one’s “face is sooo red” would then worsen the symptoms. Trying to avoid circumstances that I feared would put me at risk for blushing obviously had an impact one’s life. But when it was impossible to avoid the risk – like a job interview, a presentation, then I’d dress appropriately:

Blushing does not only involve one’s face; a blotchy neck and hives is especially noticeable. I’ve been asked if I was having a medication reaction, if I was sunburned, if I was “ok”?

I’ve generally avoided public speaking as much as possible. High school oral reports were dreaded. Spending many years at home with kids, I didn’t face a lot of situations where I’d blush out of social anxiety. Starting a job and college at 39, entering nursing school at 44, and over the years, having a job involving talking to patients or superiors – plenty of blushing times. (Following a husband into his pastoring world for a few years, music ministry as a barely adequate piano player – fun times.) Eventually teaching a breastfeeding class as a lactation consultant, ironically, no blushing. I guess when I was the authority and fully prepared, the risk is greatly eliminated. But speaking to my peers in a teaching situation, I start out pale and end up blotchy. Talking to anyone in authority = blotchy neck eventually. Having difficult conversations with anyone – there is just no hiding my feelings or anxiety.

Menopause and hot flashes in my fifties exacerbated this and in my current job, I spent nearly a decade wearing turtle necks or a scarf, and when a hot flash started, the heat under a warm shirt or scarf did not help reduce any blushing. I started wearing make up foundation to even out the tones on my face if I was blushing underneath it.

The most irritating and frustrating aspect of this trait: you cannot fake anything. Your anxiety or stress or anger is revealed for all to see. Fight or Flight, as I learned in anatomy many years ago, permits the blush to happen rapidly (sympathetic nervous system), but the blush has no way to disappear quickly (parasympathetic nervous system). Hormones are fun and uncooperative. Hormone Replacement Therapy during menopause helped eliminate some of the hourly (!) flushes for a few years, but when I stopped the hormonal therapy, I also decided to stop wearing the turtle necks at work, and just go with it. I think I was tired of worrying about it all the time. It’s not like people who were familiar with me were surprised at a red face or blotchy neck, and new people would just learn that I really was “ok”.

I’ve always been aware of how much this trait has impacted my life, but in typing it out, it’s rather frustrating to realize just how MUCH a part of me this was. The trait hasn’t left. I just don’t have a lot of energy left to over worry about it.

I read 42 books and these were my top nine in random order. Hoping to read more in 2021.