That Restless Leg Thing

I have mentioned getting that "restless leg" feeling frequently, particularly in my "surgical leg". Lately I've been feeling it in both legs, sometimes more in the right than in the left. Today it's been bothering me almost nonstop since I got home from physical therapy at about two.

I occasionally take a look online.  To me, this kind of feeling is not a "medical condition" so much as a discomfort for which there should be some simple solution. I used to think it happened when I had not exercised enough, because stretching and moving around does relieve it. However, I am exercising plenty now and I can't, obviously, get any sleep if I am getting up and wandering around to relieve this symptom.

There does not seem to be a single cause for "restless leg syndrome". Sometimes it is caused by a lack of iron, so today I bought an iron supplement (even though I am no supplement fan). There are other drugs developed for this condition but I am not willing to go there yet. I can't help but think these are neurological drugs that, in the long run, will do more harm than good. Also, they don't specifically target this condition, which is why they don't work for everyone. I hate taking drugs that I may have to take all my life. I'd rather find a better solution to end the situation.

I would love to hear from others who might have found a good solution.

Dyna, Dyna, Won't You Cooperate?

I have been diligently using the DynaSplint. If I have a chance to stay put on the couch for a while I put it on there, during the day, and later put it on when going to bed. I am trying to get up to at least six hours a day. It's been difficult.

Almost every time my leg goes into that "restless leg" feeling after the splint has been on there for a bit, usually under an hour. It happened again tonight, when I had an hour and a half to go to reach my goal of four and a half hours. I tried and tried but could not stand it. I took it off early. This is the first time my record will show me not meeting or exceeding my daily goal.

I think the only way it could happen is if I had very strong pain relief or something that simply knocks me out. One thing I have not yet tried is marijuana. Arthritis is one of the diseases that qualifies one for medical marijuana and I have learned of a dispensary in town. I think it's worth a try.

9-1/2 Weeks

The only similarity between my 9-1/2 Weeks and the movie of the same name is the inclusion of pain. In my case, the pain serves a purpose. And I don't experience a whole ton of it at a time.

Today, for example, in physical therapy, after doing the bike, the total gym, the leg extension and leg curl machines, and the foot-on-ball balance thingie and the step-up and the mini-squats and side-steps, none of which actually caused pain but instead helped strengthen muscles, I got to sit on the table and have the intern do some "mobes" on my knee. "Mobe" is short for "mobilizations" and refers to various moves the therapist makes, the hands-on stuff that is where the rubber meets the road, in my opinion. My leg was straight out in front of me and he pressed down on the thigh side of the knee, gently but surely, until it was way uncomfortable, pushing it straight. I remember from childbirth classes that we say "uncomfortable" when we really mean "painful" - but even though I realize it's a trick I think it works.

After the mobes I got hooked up to the stim machine again, both legs, with a roll under my knees. Every time the stim came on (ten seconds on, ten off) I got to straighten both legs, lifting them up as well as pressing the knee into the roll. While I was doing this I noticed that the left leg was straighter than the right! This is progress!

But perhaps I get a little ahead of my story here. Last night I hardly slept at all and this afternoon, when I tried to nap a little both legs went into uncontrolled "restlessness". Hate it. Couldn't stretch it out, couldn't walk it out. I went to PT this way and by the time I was done the restlessness was gone. I felt such a wonderful lightness and sense of well-being. There are indeed days when I come out feeling ready to take on the world. Tired as I still am.

As for the nights. I am now taking two to three percocets a night, no sleeping drug at all. And I have been doing better. Fewer spasms, fewer restless times. I may be getting over this part of the recovery. I am not going to hold my breath but it's looking hopeful.

What's ahead: my doc wants me to get to 0 and therefore has prescribed more physical therapy, essentially I think I'll be going until I get there. Yay! So happy to find that out.  I will also be getting a thing called a DynaSplint (see illustration at left). This thing gets to stay on my leg for longer and longer periods, until it gets straight (it adjusts to straighter and straighter).  Preferably 6-8 hours - during sleep, in other words.  I think this will really help.

Contemplating the Night

A week or so ago it occurred to me that if I were more active I might sleep better. That has usually been the case. Last Wednesday I returned to the gym, taking an Aqua class, and I have gone there every day since, except Sunday. I either do Aqua or I do a set of exercises upstairs, using the equipment. In addition, I am going to physical therapy three days a week, and these sessions tend to last about an hour and ten minutes, a workout in themselves in a different way.

By night, my leg feels stiff and I am not walking smoothly. I have to talk myself into standing tall, placing one foot down and then the other, putting my weight on the inside of my feet, pulling my stomach in. I don't always do all of this because I feel achey.

So off to the shower I go. It feels nice while it lasts, and I am for sure racking up the therms on the gas meter. But the calm does not last, not in my leg anyway.

And so I lay in bed, my leg occasionally seizing up or going into a spasm or just plain aching. The theory isn't working; more activity is not helping.

I have also started taking melatonin, two three-mg tablets at night. It hasn't hurt anything that I can tell and it might be helping. I am not taking tylenol pm but I seem to get about the same amount of sleep, fitful and interrupted though it is.  I also take Vicodin, but that supply has now run out, so I'll go back to Percocet. Hard to tell any difference between the two.

I'll admit it: I'm writing this as another means to divert my attention from sleep and my wanting it.

And at Night

I occupy myself as long as I can manage, which often isn't long, before I head for the bathroom to take some acetaminophen p.m.. I have tried different combinations of drugs at different times. Mostly, now, I take the sleep pills at eight or eight-thirty at night, and wait, if I can, for at least an hour before I head for bed. Sometimes I take Vicodin at the same time. Sometimes I wait. Always I am wanting to not take any pain pills at all, and so far always I have failed. I always take some, lately two earlier, two later, total four.

I try to find a comfortable position in bed, and sometimes I can do so right away. I read but am not sleepy. Finally, after reading a while and adjusting my position several times, I do start feeling a little sleepy. I put the book on the table and switch off the light.

The demons in my leg will often surface at this time. It's something like "restless legs", a discomfort that I cannot ignore. I try different positions again, slow down my breathing, try to let go of thoughts. It doesn't work. I switch on the light and sit up, turning my body to the edge of the bed, letting my legs fall over the side, hang there a while. I may just sit there a while or I may pick up a book again, read some. Then I may try to find a good position to sleep again, may turn off the light again, but more likely I will pull my leg up onto the bed and stretch it, pushing the knee into the soft blankets and sheet beneath it.

I look at the clock. It might be ten now, it might even be eleven or a little later. I may take more Vicodin, two more tablets. Deep breathing. A shower. Most nights I eventually get up and take a hot shower, letting the hot water cascade over my knee, over my shoulders, onto my back, then over my front, back to the leg. Sometimes I will sit and let it pour down over me, a waterfall of heat.  When I leave the shower I quickly dry off and put my nightgown back on. It is usually not too cold and I do feel some relief from the discomfort.

I sit on the edge of the bed again. I pick up a book and read some. I try getting under the covers again, place a pillow there between my legs or under the left leg. I turn to the opposite side, adjust the pillow again. I pull out the pillow and put one leg, bent, ahead of the other, both on the sheet. Then the other side, same thing. I take deep breaths, sit up again on the side of the bed, read more. Lie down, read on my side, read on my back, read on the other side.

Sometimes I am able to doze for a little while. Next thing I know it is one o'clock. Then one-fifteen. If I did not take some before I may now take more Vicodin because my legs are calling to me again, my left leg, not the right. Some time around two or later I will fall, unaware, into sleep, and not wake again until it is almost five in the morning.

The cats are bothering me. Knowing that one of them in particular will not let up, I finally get up and stumble down the hall, trying to hold myself upright, pull in my stomach, walk on the inside of my feet: in other words, trying to maintain alignment and proper posture. Rarely do I achieve it at this early time. I  dig into the cat food container with the cup measure, filling it, and then pour a third of a cup into each of three cat food dishes, each in its own special location. I return the cup to the cat food bin, close it, return to bed, turning out the lights on the way and shutting my bedroom door to prevent any further cat interruptions.

Again, more arranging under the covers. Sometimes I am able to get back to sleep after a while. Other times I lie there restlessly until the hour is more decent, and then I pull myself up, slide my feet over the edge, sit there a while, finally get up.  I pull the covers up, roughly making the bed. Go to my closet to grab some clothes, lay them on the bed.  I might take another shower or I might just get dressed. Before dressing, though, I sit on the end of the bed and massage the knee scar, then work the patella back and forth, and up and down, trying to loosen it. I may do some of my regular exercises then, or not. Once I am dressed I open the bedroom door and head for the office to check email.

It should not be surprising that I will sometimes feel an overwhelming sleepiness once, twice, even three times during the day. I know that if I ignore it and try not to nap I may have a better chance at night. But I rarely can ignore it, and I often will take short naps, on the couch or on my bed, trying to get warm, and again trying to get comfortable. It seems like I can get comfortable more easily at these times than I could earlier.  Yet in the in-between times I feel awake, not deprived of sleep. I manage to take my little walk, go to the gym, do various errands. Some days I go for physical therapy in the afternoon. I hope to wear myself out enough to fall dead asleep right away and stay there. So far it has not happened.

Goodby Brace

I planned to make a ceremony of it. When it was time to get up this morning, I'd sit up, carefully take off the brace for the last time, and dump it in the wastebasket. All right, that isn't much of a ceremony but I was envisioning it and seeing myself head for the shower, where I could stand under the water for the first time in five weeks.  It didn't work exactly like that.

Last night I had difficulty getting comfortable enough to get to sleep. I have had this problem from the start, and have gotten to sleep with varying degrees of difficulty. It seems like the past few days were the worst, perhaps in part because I anticipated today and my body had less patience than ever. I admit I resorted to drugs. During these five weeks I have not yet made it through a night without them. Yet they did not do the full job, and I kept waking up, jerking up to sit on the side of the bed, sometimes to get up and walk a little, and always to stretch as much as I could. I thought stretching would reduce the "restless leg" kind of jerky spasms I was having. I took another hot shower in the middle of the night, and that helped relax me for a little while.  But I kept waking. Finally, when the clock said four a.m., I sat up and took the damned brace off. Threw it down on the floor. Pulled my leg back under the covers.

It helped! The spasms were diminished, I was more comfortable, my leg felt less like a lumbering whale attached to my body and more like a living part of me. I managed to grab a few more winks this way, adjusting as needed. Definitely an improvement. I think, too, that letting my leg relax under the covers for a bit was not a bad way to adjust to the coming bigger change: standing on it without any support.

The time finally came to get up. I sat on the side of the bed, a wee bit worried, and went for it. I grabbed the cane and stood up. To my surprise, it felt shaky but stable. When I walk I can feel the muscles and ligaments adjusting to being given the whole load, causing a shimmering kind of shakiness. It's okay. I think a few days of walking on it will reduce the shaking and give me back my leg. I also think it will be easier to get more from my exercises, even though it will feel a little scarier at times. 

I took my standing shower and dressed in long pants. I will still wear shorts or short pants most of the time while I am working on the knee, for access, but from time to time it will be nice to have this option. The end of this tunnel looks just a wee bit closer now.

Sleeplessness

I can't get any meaningful amount of sleep tonight. My legs won't relax sufficiently, my arm hurts at times, I keep trying to get comfortable. When I went to bed at a bit after ten I immediately noticed that my legs were being troublesome so I took some acetaminophen pm tablets (two) and hoped that would get me through it. But they did not work. I have gotten up numerous times, read first one book, then another, took a shower, basking in the heat, tried to sleep again, and nothing.

Even before I tried to sleep I experienced some cramps. My right inner thigh went into cramping shortly after I went to bed. I worked that out, then about an hour later my left leg started to feel crampy but it did not get too far with it, then another bout with the right leg.

I only hope this does not impair me significantly later today, when I get up for real and head for an Aqua class again.