If you sleep on your back, either always or sometimes, I have a question for you: WHAT do you do with your FEET?

I NEVER sleep on my back, except now, post-knee-surgery, when I do it almost all the time because every other position hurts more. But I do not know what to do with my feet! My natural inclination is to have them basically as if I were standing, except that I’ve been tipped onto my back: not QUITE like that, since they tend to lightly relax forward, but basically toes pointing to ceiling. But then my feet are making a little tent of the blankets, and the blankets are too heavy for that to be comfortable.

I can let them relax more forward, so that the tops of my feet take the weight of the blankets, but that too feels uncomfortable, and as if I’m doing a stretch on purpose. I can let them flop to the sides, or toward each other, but that doesn’t really work with the knee; the knee wishes the entire leg to be in line. I’m not sure it would work even without the knee bossing me around; this is probably part of why I am mostly a side sleeper. I think for me to sleep comfortably on my back, I would need to have my feet out from under the covers, and then of course we’re talking about monsters getting them.

If you sleep on your back, what are your feet doing?

[Edited to add: I am getting bolster/pillow-under-the-knees suggestions, which is an EXCELLENT idea but the knee surgeon says I am not allowed to do that right now. Feet/legs can be propped so that legs are angled-but-still-straight, but knees may not rest in a bent position.]

We are watching season 2 of the UK version of the show The Traitors, and I don’t know if I should recommend this show to you or not. I felt as if I had already seen allllll the reality television I ever wanted to see with Real World and Big Brother and The Swan in the ‘90s/’00s, but Paul talked me into trying it by saying he’d watched most of the first season and that it was MESMERIZING to see all the wrong ways people THINK: the way they use bad logic while being CERTAIN they are using good logic. He further argued that British people are more pleasant to watch than United States people. Plus I was on 0pi0ids at the time, and not very mobile, so if someone put something on the TV I would sit and watch it.

Anyway we watched the first season, and it was indeed mesmerizing, and I found it a nice DISTRACTION as well: I can think about those dynamics, and about the most recent twist/cliffhanger, and about what will happen on tonight’s episode, instead of about Other Things, such as the way an unelected asshole billionaire is illegally and unconstitutionally dismantling our crucial governmental institutions. I will say, however, that in the final couple of episodes of season one I was WEEPING and saying “This is a BAD GAME.” Nevertheless, I agreed to start a second season, which should be informative, especially since I am no longer on 0pi0ids. William and Henry have found it riveting as well, and we keep having to pause it to talk about developments and what they mean, and after each episode we sit around for like half an hour talking about it, and it is a lot of fun to do that with kids who normally flee the scene right after dinner.

I also have two books to mention.

(image from Target.com)

One is Asunder, by Kerstin Hall (Target link; Amazon link). It is the kind of book I think I’ll like when I read the flap and see the blurb by one of my top favorites Ann Leckie, and then I start reading it and think I don’t like it, and then I end up loving it. It’s set in a different reality where small gods are real, and there are unfamiliar racial/political divides and prejudices, and people do spells for real. But when you start reading it, everything is super confusing and people are referring to things you don’t know anything about so it makes no sense, and I got kind of bogged down, and kept realizing I was skimming and missing things and had to go back and re-read. But anyway I persisted and now I really really really really want a sequel: now that I understand this world, I want MORE FROM THIS WORLD.

(image from Target.com)

The other is Beautyland, by Marie-Helene Bertino (Target link; Amazon link). I was put off by both the cover and the title, and read it only because it was recommended by someone whose reading tastes overlap strongly with mine (I was going to link here to Nicole ((HI NICOLE)) but then I went to her site to get a link to her post about Beautyland and couldn’t find it, which leads me to the potential conclusion that I read a book because I IMAGINED/DREAMED Nicole had recommended it???)—and even so, I kept letting it slide down the library pile. This is the kind of book I think I won’t like, and then I start reading it and I love it and want to recommend it to everyone, and then I get to the end and am not sure what I thought. I enjoyed the entire experience of reading it, but I like More Ending. I don’t like to feel as if I’m not entirely sure what was going on or what eventually happened. I still hugely enjoyed reading it and would read it again.

It’s been a month since the knee-replacement surgery, and I should be feeling pretty good, but I am feeling pretty crummy. The case for feeling good: I can move so much better now! I have gone from using a walker to using a cane to being able to walk on my own—which means I can CARRY things in my HANDS! I can do many things for myself now! I’m allowed to SHOWER! I haven’t fallen! (If I fall, I’m supposed to go to the ER so they can check The Knee for damage.) The dozen or so let-them-fall-off-on-their-own strips of surgical tape have almost all fallen off! I have gone from needing to pick up my leg with my hands in order to move it, to being able to move that leg just using the muscles of that leg! My PT exercises have gone from “Don’t worry if nothing seems to happen; just try to activate the muscle” to being able to make something happen! The physical therapist says I’m doing so well, she’s going to have to move me from twice a week down to once a week! She’s got me working on stairs, so that I’m starting to be able to use them normally instead of like a toddler! The scar is long and alarming and bumpy but “beautiful” in medical-healing terms! I am not so far encountering infection or rejection or that thing where the knee won’t bend enough so they have to knock you back out and force it to bend and then you have to have physical therapy seven days a week for awhile! None of that!

But in the last few days I’ve had a return of mopeyness. My appetite is low; I’m not getting joy from food like I was before; I’m dreading meals, and having to take food as if medicinally. I feel queasy and on the verge of weepiness. (In case it is occurring to you, as it often belatedly occurs to me: no, I’m early-mid-cycle.) I have non-knee aches as well as knee aches, and I feel like there’s no comfortable position to be in, and I’m sick of all my nests. I’d thought I’d be itching to go back to my job, but I feel like I never want to go back there again. The days feel long, and I look forward to bedtime and also dread it because I know I’ll keep waking up. I tried sleeping in my bed instead of in the recliner, and both nights of that were so miserable I’ve gone back to the recliner. Everything is fine and going on schedule, but it feels like it’s not. I don’t know why I’d feel worse NOW than in the first week, when I remember feeling chipper despite being in so much pain and at one point literally peeing my pants in the middle of the night (the nurse warned me that can happen after a spinal block) and needing to somehow change clothes and clean up while managing a numb heavy useless leg and a walker. The opioids probably helped, even though at the time I would have said I felt nothing from them in terms of mood or attitude. Or maybe it was just the relief of having the surgery over with, and being now on the healing part, and everything being so novel and kind of interesting. Now the novelty has worn off.

I don’t know what’s the matter with me. I told the physical therapist, and she said that in her experience (she’s had multiple operations herself, which is how she got interested in being a physical therapist), any time they cut into you down to the joint/bone, especially if they take out a piece of you and put in a new piece, you should plan on it being 6 months to a year before you feel like yourself again. It takes six months, she said, before your body coats the new joint in a layer that lets the body see the joint as Belonging To Self. Right now there is still a stranger in my midst, as far as my body is concerned. She said take more naps, if I can; she said the body experiences the surgery as severe trauma, and it needs rest to help it recover. I tried not to cry while she was talking.

One of my dear friends is long-distance and asking if there’s anything she can do, but I think there’s nothing. Another dear friend is in my neighborhood and has also offered to do anything I need, and still: nothing. There’s nothing. I need the people in my household to keep bringing me food I don’t want to eat. (Henry has picked an excellent time to go on a baking kick: there is chocolate-chip banana bread to be microwaved until the chocolate chips are all melty; there is peasant bread to be eaten with butter and jam.) I need to keep doing my tedious PT exercises (I told the physical therapist it felt like a part-time job, and she said that’s how you know you’re doing enough of them). I need to look at less news—though I need to look at enough of it to be able to compose my daily communication to my representatives. I think I should watch more TV; two of my coworkers recommended getting back into Abbott Elementary, saying it was sustaining them during some dark stuff.

And I’d like to hear what’s up with you, if you have the energy. I am tired of myself, and my knee. Tell me something good, tell me something bad; how are you holding up? “It is February!,” a friend on Facebook posted; “That means next it will be March, and March means daffodils!!”

I am awake in the middle of the night (knee pain kept waking me up until finally I gave up and got up), and it is okay because during the day I have nothing to do except for icing my knee and exercising it, and taking my medicines and eating nourishing food. But the cat, who had been cozily asleep on Paul for hours, followed me downstairs and is standing nearby watching me and looking exhausted. So pretty soon I will go try again to sleep, for the cat’s sake.

I just realized I’ve had two inadvertent Dry Januarys in a row: last year because I had what doctors thought was probably the flu, and this year because of the knee surgery. Normally I think January is grim enough without adding a deprivation challenge, THIS January in particular, but that is the way it shook out. I am looking at next January nervously.

After moping to you yesterday about not getting better at bending my knee, I went to physical therapy and moped to the physical therapist about not getting better at bending my knee, and then she measured my bend and I HAD gotten better. She said mopey days are part of the process, and that this is why even when we feel mopey and discouraged and as if we’re making no progress with our exercises, we still keep doing our exercises. As Nicole (HI NICOLE) mentioned on a previous post about physical therapy, it feels as if there is room for metaphor here.

Do any of you have recommendations for compression socks, particularly thigh-high ones, but also knee-high? I ordered some from Amazon, and they are “thigh-high” only in that they just barely reach the very bottom half-inch of my thigh. And these are socks made to fit men and women, and I am a woman, and I have short legs, and I ordered the largest size, and I could barely get them on at all. I normally wear the largest size before plus sizes begin, but I think with compression socks I may need to size up.

I hope you all realize I am prattling on about bending and compression socks and sizes to keep from leaping into the abyss. The political situation is like a firehose of polluted water. No, it is worse than that, but it is too hard right now to think of a better comparison. I know I should get back in the habit of contacting my representatives, but it feels like holding up a ziploc baggie to the firehose. (That is not the comparison I want, either, but I have come back to this several times over the last hour and I’m not coming up with anything better.) And it feels like I would spend my entire day doing nothing else but writing to them, and still not be able to keep up with all the things I needed to contact them about. Still, I will do it, because I know it helps them to be able to say their constituents are pissed about something, and that they are acting on behalf of those constituents.

I managed to pull a calf muscle on my non-surgical leg, and this has led to an era of disheartenment. Things that had become easy are difficult again.

Also, I feel as if I am not making good Bending Progress. I AM making good…what would we call it. AGENCY Progress. When I first came home from the hospital, my surgical leg felt heavy and unresponsive. The physical therapist would give an instruction, such as marching the leg up, and then she had to reassure me that the important thing was activating the muscle: it was perfectly okay that when I marched my leg up, the foot did not even leave the floor; just please activate the marching muscle ten times. I had to do a lot of in-between exercises, like using my hands to lift my leg up off the floor, and then trying to control its slow descent back to the floor: that works those same lifting muscles, apparently.

So it’s been three weeks and I’ve had a huge improvement in being able to move my leg without needing my hands or a scarf or a belt. I can march my leg up like billy-o. But the amount of BEND I can get from that march doesn’t seem to be any more than what I could get when I had to bend it with my hands. And the bending angle is what the physical therapist has to work on at each visit while I gasp and whimper, so it would be super good to be able to get more of that done on my own. That’s how I pulled the calf muscle: in the pursuit of more bend.

I know it varies hugely, but would you like to know what a knee replacement cost in my case? Just under $58,000. Our portion is a $150 surgical deductible plus a $30 specialist copay. Plus we have one of those exhausting notes where the insurance says the surgeon has billed us $1,500 for something he is not allowed to bill us for, and that we are not responsible for paying it. In my experience, that’s easy for the insurance company to say, and I can plan on needing to make MULTIPLE phone calls to get that straightened out, when the doctor’s office DOES bill us for it and then acts as if they have never heard of an insurance company telling the patient not to pay it, and then assures us they’ll straighten it out, and then sends a bill threatening to send it to collections.

I would expect the itemized bill to be interesting, but it’s only confounding. While I was in recovery, a physical therapist came by to show me how to use my walker, and how to get dressed and use the bathroom, and how to use stairs. My sense of time was very sketchy, but I’d estimate she spent an hour or so with me. There are four separate physical therapy charges, all just labeled “Physical Therapy,” for $388, $300, $300, and $287. There are fourteen separate charges all labeled “Hospital Services,” ranging from to $292 down to $10. There is one Pharmacy charge for $509, and one for $33. (I’m remembering when Elizabeth had her tonsils out, and they charged us $14 for the two chewable children’s Tylenol they gave her.) Three for “Med / Surgical Supply”: $16,720 (I wonder if that’s the replacement knee itself), $4,415, and $4,140.

I am well into the third week of wearing pajamas day and night; I’m not sure I’ve ever gone so long without Real Clothes.

I have started experimenting with walking without the cane, just around the house. Paul, finding the cane standing alone: “Surely a miracle has happened here!!” I still use the cane when I get up at night (many, many times), and first thing in the morning when I’m quite stiff and sore.

It is strange to me how much time I am spending on the care of my physical form. The careful feeding, the hours of exercise, the careful showering and lotioning/ointmenting. It feels even stranger because I am doing little or nothing for other people. I know this is the way it is supposed to be right now, and that it’s temporary, but it feels odd.

Commenters Meg and Kate, and also a couple of local friends, mentioned the importance of stool softeners after surgery, especially if narcotics are involved, and I would like to suggest that you file that information away in your heart under Very Important. Because of the urgent tone of their advice, I took evasive action and was able to avoid distress. I would add that it seemed to me the prescribed docusate did nothing helpful at all, and that it was a good idea to get Miralax and Senokot (or whatever your preferred gentle interventions may be) involved even before the medical professionals were concerned: that is, the medical professionals were saying not to worry until Day 5, and at that point to start additional medications; I would say start dabbling with additional medications by Day 2 or 3. I was concerned things could go too far the other way, but that has proved to be an unnecessary concern.

I also have a little pharmacy tip: your insurance can’t tell you what medications you can or can’t have, they can only say whether or not they will PAY for it. So for example, one of the pain medications my doctor wanted me to have was rejected by our insurance, which said it needed a prior authorization. We waited four days while doctor and insurance and pharmacy went around and around, before finding out that the cash price of the medication was sixteen dollars, so we just paid that sixteen dollars and took my medication home. (And over a week later, we got a letter from our insurance company REJECTING the prior authorization from the doctor ANYWAY.) Obviously some medications are going to be not sixteen dollars but sixteen hundred dollars, and that is a different story—but it is worth asking what the cash price is, especially if you are ill and/or in pain and not up to dealing with the pharmacy/insurance/doctor rigamarole.

In the midst of a flurry of new-president-first-day executive orders/actions that ranged from horrifying to ludicrous, I reached the two-week post-surgical milestone for my knee replacement. I saw the surgeon, who removed the bandages and said the mess underneath looked “beautiful,” and cleared me to remove the compression stockings and, even better, to SHOWER. I went home and took a nice long shower and washed my hair twice and got into clean soft clothes and felt wonderful. Except for all the news, which was unrelenting and terrible.

I sure would appreciate it if journalists could make it clear when it’s “Something he wrote on a piece of paper that will immediately change laws/lives” vs. “Something he wrote on a piece of paper that will take years for the courts to resolve and in the meantime will have no affect on our lives other than the heavy burden of despair that someone would WANT to do this.” I suppose sometimes they don’t know, either. There are a lot of things he “couldn’t do” that he has done, because it turned out the people who were supposed to stop him chose not to stop him, or that there were no stopping mechanisms in place because no one but him has needed to be stopped from doing these things.

Home physical therapy has ended, and I saw the local physical therapist for the first time. She told me I was going to hate her for ten minutes out of every session, and then she told me to relax and breathe, and then she MANUALLY BENT MY KNEE, so much farther than I have so far been able to bend it—WAY past the point where it feels to me as if I come to a hard stop and literally cannot bend it any further. Afterward, while I was panting and wondering how loudly I had yelped, she said “Was I right? Do you hate me?” and I said “Not yet.” Her efforts have made me work harder at my physical therapy exercises at home: the more I can bend myself, the less she will have to bend me.

For those of us who consider this Inauguration Day to be a day steeped in horror and disbelief, a day we were hoping would somehow be prevented at one of the many, Many, MANY points it seemed like it clearly should have been prevented—how are you planning to spend the day? I have been partly in denial/hope, and partly distracted by the knee surgery, and partly not WANTING to think ahead or make plans.

In fact, one possible plan is to have no particular plan and spend the day as we usually would. That’s still a frontrunner for me.

Another possible plan is to mark it in small ways that are more deliberate. For example, posting something on Facebook in commemoration of MLK Jr. Day, though I find it’s hard to get that right. I’m already incredulous that the day is the same day as the inauguration (and pre-mad at some of the things we might see and hear because of that); that makes me even more reluctant to seem to be using MLK Jr. Day as a way to make an “I’m ignoring the inauguration” point, if you see what I mean.

But it’s the KIND of thing I mean. For example, tomorrow would be a real good day to make donations to NPR, the ACLU, Alight, any other organizations that fight against the bad things we expect in this coming era. It would be a good day to order some Ruth Bader Ginsburg forever stamps, or a Dissent is Patriotic t-shirt, or an equality/rainbow yard flag, or a little spontaneous gift for a friend. It would be a good day to do some volunteer work, or to donate blood, or to write some postcards, or to bring treats to a place that’s open despite the holiday. It would be a good day to do anything that feels like Doing Any Small Measure of Good.

(image from usps.com)

(image from ACLU.org)

It would also be a good day to wrap up in a throw blanket and drink something hot and treat yourself like you’re ill, or suffering heartbreak, or recovering from knee-replacement surgery. Watch some riveting or soothing TV. Read a book you got for Christmas and have been saving for a special occasion. Eat soup and saltines and drink ginger ale; or buy a pint of some extra fancy ice cream, maybe get some Pringles too. Use any shampoos/soaps/lotions you save for special. Do some restorative yoga and/or meditation and/or witchcraft. Get take-out. Burn a nice candle.

Maybe that would make you stir-crazy. Maybe you need to take action. Sometimes when I feel crummy, I will tackle chores that make me feel crummy, since I’m already feeling crummy anyway. Clean the bathroom, maybe sob a little. Scrub that irritating mold in the shower that keeps coming back, with clenched teeth. Really put the arm muscles into scrubbing the kitchen sink. Use a toothbrush around the faucets. Do laundry, maybe do a few soak loads with stain treatments. Pay bills and use the RBG stamps.

After my first pregnancy, I knew from experience that when I got a positive pregnancy test, I was on the verge of two months of feeling too tired and sick to do anything, and so I would use those last few interim days to do all the things I thought I’d appreciate when I was feeling tired and sick. Nice clean toilet to barf in! Nice clean shower to cry in! Nice clean sheets to sleep in! Nice clean kitchen to eat saltines / walnuts / grapefruit juice / cold pizza in! What things do we think Future Us will feel grateful to Current Us for doing? (Or maybe you are already Future Us, and it is too late to clean bathrooms.)

Sometimes in anticipation of a storm or a trip or the collapse of democracy, I find it soothing to Get Ready in small assorted ways. I change the batteries in my little pre-lit birch trees and flameless candles, and charge up the batteries I took out. I plug in all our electronic devices, and the back-up batteries for those devices. I buy extras of groceries. I get caught up on laundry.

Maybe it’s time for a distracting project. One of my friends has committed to sending one piece of snail mail every single day for a year; she’s signed up for Postcrossing as part of this. Another friend has signed up for a group sewing class: she wants to learn to make quilts with a sewing machine. I’m planning to send Valentine’s Day care packages to the twins and several of their friends; maybe I will spend some time tomorrow shopping for heartsy things.

Today the visiting home physical therapist switched me from a walker to a cane, though I am still supposed to use the walker at night, or when I am tired or if I am particularly sore. The surgery was just under a week and a half ago, and the physical therapist says she thinks I’m over the worst of it. She will come for the last time on Monday, and then on Tuesday I will begin physical therapy at a local place in town, and on Wednesday I will see the surgeon and he will remove the bandages and see what’s what, AND THEN I WILL BE ABLE TO TAKE A SHOWER.

MOST of not-being-able-to-take-a-shower has not been as bad as I’d thought. It isn’t as if I’m working up a sweat, or even going outside. Every day or two I take a stack of washcloths and a lot of time, and I manage to end up feeling fairly fresh. But my hair. My hair! Ug. I tried using dry shampoo, but if anything that made it worse. I’d thought about going to a salon to get it shampooed, but the reason I qualify for a home physical therapist is that the surgeon declared me medically housebound for two weeks: I am not to leave my home, not only because I’m temporarily disabled but in order to avoid infection and illness. So then it feels iffy to leave to get my hair washed. A friend has offered to help me wash it in the sink, and that’s one option; another friend is sending me a shampooing shower cap, so that’s another option; and there is also the tough-it-out option.

The pain has been a significant issue to deal with, especially now that I am expected to taper off the 0pi0ids. I have been extremely lucky so far in life, and I don’t have experience with dealing with pain that goes on for so long. I only know how to take a pill or rest or stretch, and if those don’t work I am out of ideas. I did ask the physical therapist if there were any soothing exercises I could do (it seems as if we are focusing primarily on strengthening and upsetting the knee), and she said not really. She said heat can be helpful, but the surgeon does not want me to use heat on this incision; she said light massage can be helpful but probably not very. She said the knee is kind of a tricky joint for soothing after surgery; mostly we really do just try to strengthen it and bother it.

Right now it hurts most when I rest it, or hold it still for too long; there is no comfortable sitting/lying position. In some ways this is an advantage: it makes it easy to get up and walk laps around the house every hour, as I am supposed to do; and it makes it pretty easy to make myself do my physical therapy exercises three times a day even though I hate them and they hurt, because moving the knee makes it feel better overall. But it makes sleep difficult. I will startle awake, NEEDING to get up and move the knee. That is not restful. And it huuuuuurts, and it KEEPS HURTING, and as I say I have led a lucky life and so I am short on coping mechanisms. If this were going to go on much longer, I would investigate coping mechanisms. But I suspect there are not many good ones: the people I know who have chronic pain do not seem to get to the point where they’re like “Yep, no big deal, just endless pain!”

By the way, if you are hoping to be distracted from an upcoming looming event, may I recommend knee replacement surgery? Other surgeries may also work. The visiting home physical therapist said she’d see me for the last time on Monday the 20th, and I thought, “The 20th. Why does that date ring a bell?”