Posts Tagged ‘pain management’
Uncharacteristic Behavior
Yesterday was a soaking wet rainy day. A good day to nap, which Cyndie did a lot and I did a little. As time passed, I witnessed the progress of Cyndie getting control of the pain that had the better of her the day before. In a prudent attempt to start with the lowest dose of pain medications after the initial anesthesia fully wore off, she ended up getting behind the level of pain the procedure caused.
Subsequently increasing the dosages takes time to ultimately catch up to a desired level of relief. However, once that point is reached, it is possible to move back to the lower dose at precise intervals to maintain the desired pain control. That relief allowed Cyndie more and longer periods of beneficial rest.
Meanwhile, the cold rain presented the horses with their own challenge. I had left the two paddocks open to each other which historically led to Mia and Light being pushed out from under their preferred overhang by Mix. When we separate pairs by closing gates, the two chestnuts have their own side to seek cover without being harassed.
As Delilah and I came upon the horses yesterday afternoon, we found all four horses squeezed under the overhang on one side. With the promise of food about to be served, I knew the congeniality under the one side wouldn’t last. What I didn’t expect was that an odd pairing of mares would happen while I was inside filling the feed pans.
Swings had uncharacteristically moved to the north side and had paired with Light. That left Mix paired with Mia on the south side; the two least expected to get along. I decided to do away with convention and set out feed pans in random order in the spots they had chosen.
For a while, as I cleaned up manure around them and refilled nets with hay, they all munched calmly in those positions. As I was pondering the novelty, it occurred to me that I should take a picture. Before I was able, they rearranged themselves back to the usual positions.
With the chestnuts back together on the north side, I closed all the gates for the duration of the rainy weather.
Just to finish off the oddities of the experience, as I was completing my tasks and preparing to head back up to the house with Delilah, I noticed Light was making things difficult for Mia and she kept retreating back out into the rain. I don’t know what leads to these periods of orneriness every so often but from what I’ve witnessed over time, the horses tend to get over whatever it is that’s bugging them a lot quicker than humans do.
Maybe they were just irritable because they didn’t like being cold and wet. I can’t blame them for that.
I’m choosing to cling to the memory of the brief moment in time when all four of them appeared to be getting along just fine squeezed together under one side of the overhang.
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Pain Management
Which is more difficult: Suffering great pain ourselves or watching a loved one suffer pain that we can’t do anything about? It hurts either way. The good news is that Cyndie is home and making great progress in coping with the immediate after-effects of a TKA.
You know, Total Knee Arthroplasty. Geesh. Loosely, arthro -joint / plasty -molding, grafting or forming. Otherwise known as knee replacement.
Progress doesn’t mean mastering. As of last night, I would describe it as the pain having the best of her. Pain: 2 / Cyndie: 1.
My biggest challenge is figuring out how to keep her from doing anything that isn’t helpful to her situation while she is on pain medication. Keeping Cyndie from doing things is akin to herding cats.
She was on the couch resting when I stepped out to walk Delilah and tend to the horses yesterday afternoon. In the fraction of an hour that I was outside, she got up off the couch and worked on hanging up new shower curtains that were delivered to our house on Monday.
That wasn’t something that needed to happen and could easily have waited for me to take care of later.
This kind of behavior makes it even harder on me when she later cries in pain and admits maybe she did a little too much. Ya think?
I’m not a great one for policing her actions in general. How do you stop a perpetual motion machine? As a result, it’s complicated for me when my role in caring for her involves trying to control her activities. She tells me it hurts if she lays too long, so she gets up and walks. Looks to me like it hurts to walk and it hurts when she struggles back into bed.
Thankfully, there was room to increase the dosage of pain meds to manage her comfort at this phase of the recovery.
The saving grace of this knee replacement is going to be the iceless cold compression therapy machine Cyndie rented. Chilled water is automatically pumped through a wrap on her knee and it cycles on and off in programmed intervals.
I was able to watch Cyndie’s initial physical therapy session before we left the recovery hotel and I asked the therapist about how important the exercises are to optimizing recovery. Her answer: they are 100% the key to achieving full range of motion but you must do them all consistently as prescribed and no more than prescribed. Shouldn’t underdo or overdo it.
Hmm. I’m gonna opt out of being in charge of that.
Hopefully, it won’t be long before the pain is managed without narcotics altering her consciousness. It’s challenging enough for me to keep pace with Cyndie’s mode of operation on normal days.
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Pushing Through
It has been a long stretch of time since I played either of my guitars. Lack of playing tends to become its own feedback loop. Arthritis in my hand discouraged me from pulling out my instruments as often as I used to, and not playing regularly led to the loss of calluses on the fingertips of my left hand. Lack of calluses fed into an inclination to not bother playing and the situation dragged on and on.
Alas, recent activity to ready myself for the Tour of Minnesota bicycling and camping week triggered thoughts about bringing my travel guitar this year. Before fulfilling that idea, which I said back in February that I planned to do, I figured I should check out whether I could still form chords with my left hand.
I was a little rusty, but mostly functional. My session was rewarding enough that I felt inspired to try a second time a couple of days later. That went even better, despite the tenderness of starting the process of developing new calluses. Then I moved to reach a particular position and experienced the classic jolt of a painful joint.
(No, Mary, I have not had the surgery performed yet, despite your wise advice to not wait. The doctor preferred waiting, and I chose to not try convincing him otherwise.)
After that stab of pain, the rest of the session tended to become increasingly more comfortable. It seemed a little counterintuitive at first, but then I remembered a similar experience during a lumbar disc pain episode.
The body has a keen ability to constrict movement in the presence of pain, but remaining oblivious to what is happening in these situations can allow that avoidance of pain to become its own malady. I made a surprising discovery during an early assessment of my condition when physical therapy was prescribed.
The therapist asked me to show them how far I could bend over to reach toward my toes.
“Bend over!?”
My thinking was that I couldn’t bend at all without suffering that stabbing pain. That is why I was moving around like a stiff zombie!
So, I set about showing her how I could barely lean forward at all. To my surprise, those initial hints of possible pain that normally freeze any further motion did not get any worse as I pushed through them. I was able to bend a lot farther than I believed possible.
The same thing happened with my hand yesterday. The avoidance of pain had kept me from trying to play the guitar, bringing a mindset that it would no longer be possible. Pushing past that warning message of pain proved there is still some function left in the old joint.
I don’t have the strength I used to, but I can still manage a few chords for a reasonably short duration of pickin’ and grinnin’.
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Pain Transfered
Don’t let this image fool you. Delilah is almost completely back to her old self.
Tuesday, when I got home from work, Delilah was so full of energy that she wouldn’t leave Cyndie alone. After they came in from a walk, Delilah grabbed one of her squeaky toys and begged Cyndie to chase her around the house.
When Cyndie laid down on the bed for a moment, Delilah started repeatedly hopping straight into the air for more attention.
If she has any leftover pain, it wasn’t readily apparent.
Last night I gave her a fraction of a walk, keeping the leash short so she would walk beside me, at my pace. She strained to speed me up the whole way.
Every indication is that she is feeling just fine again.
On the other hand, or I could say, hoof… Cayenne seems to have picked up where Delilah’s pain left off. That mare has suddenly become almost incapacitated over an apparent flare-up of laminitis in her front feet again, particularly the side that hadn’t previously been giving her as much trouble.
It is heartbreaking to watch her struggle to move. I immediately isolated her from having access to grazing in the pastures, closing her into the smaller paddock. It seems like too little, too late, to completely turn the tide for this condition which is proving to be rather chronic for her.
Cyndie said Cayenne didn’t show signs of a problem earlier in the day, so maybe by cutting off her grass-grazing right away, this flare-up can be calmed quickly. I fear it is all part of a trend for Cayenne that may be out of our control to alleviate.
We’ve spent the summer watching George shape her hooves in increments to improve the orientation and provide her some relief, but it is a long, slow process because you can’t trim too much at a time. Now, just when we were hoping to have her beyond this problem, she is showing a turn for the worse.
We’re very happy to have Delilah free of pain, but seeing an extreme discomfort move from one of our animals to another puts a damper on our urge to celebrate our dog’s improvement.
When our animals hurt, it tends to inflict a fair amount of sympathetic pain in us, too.
Ouch.
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Sad Face
We are still waiting for significant signs of improvement in Delilah, but whatever is causing her sharp pain –even though she is simply lying on the floor or in her crate overnight– it appears to be more intense than the drugs she is on.
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Since Cyndie is trained to administer Tellington TTouch, she is offering Delilah more than just the pain killers prescribed by the vet, but our poor dog still finds ways to move that triggers involuntary vocal response of acute discomfort.
That is so too familiar to me and my degenerating discs. We have inquired with the vet about a local dog chiropractor and I’ve been wondering if Delilah would tolerate accupuncture. It helped to ease my discomfort.
There have been a couple of encouraging glimpses of Delilah’s old self appearing, but thus far they are too few and far between to allow us much release from the ongoing stress of knowing an animal in our care is suffering.
I’m looking at this as a way to help me slow down my perception of the ever-faster passing of days. With October looming large and the standing order to keep Delilah completely inactive for two weeks, I’m hoping the days will drag for a while.
It’s not my preferred way to slow down the days, but already it feels like our sad dog has been hurting for far too long. The next two weeks are going to take forever if we can’t let her have her usual luxuriously long walks.
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Relative Something 