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18 June 2003 — Progress Report (12)

How smart am I?

I'm so smart that the week before my knee surgery I double-paid all of my bills. Now, a month later, my mind is scattered and I can't seem to focus on anything. I finally got around to paying my bills (several days late) and look! they've already been paid.

That's how smart I am.


Computer Resources is still in debt, and I'd normally welcome the business leads that have been coming my way, but currently each one seems like a burden that I cannot possibly lift. Ah well: I'll persevere, will I not? And I'll be a stronger man for it.


My recovery continues apace, with two exceptions:

  1. Exercise
  2. Sleep
Exercise
I'm doing my exercises as prescribed by the physical therapist, but they're beginning to take their toll. I spend one hour three times per day doing the following (two sets of fifteen on each exercise, except as noted):
  • Leg lifts from my back.
  • Leg lifts from my left side — these hurt.
  • Leg lifts from my stomach — these don't seem to do anything.
  • Leg lifts from my right side.
  • Towel pulls — I extend my leg, wrap a towel around my heel, and then pull the knee into a flexed position until there's plenty of tightness (but no pain).
  • Quad sets — I flex my right quad and hold for five seconds, that's it (but it's more difficult than it sounds).
  • Knee massage: I spend several minutes massaging the four scars and then moving the knee cap from side-to-side. This is painful when I do it, but feels great when the therapist does it.
  • Squats, which are tiring.
  • Toe-raises: from a standing position, I lift myself onto my toes. These hurt my calves.
  • Closed-eye balance (ten total): I close my eyes and balance on my right leg, with the knee slightly bent, for as long as I am able. This is very difficult.
  • Weight shifts, two types. I practice taking a normal stride, shifting my weight from my good leg to my bad leg.
Think about that: three hours of exercise per day. I admit the exercise is decidedly non-aerobic (I used to be able to bike fifty miles in three hours), but it's strenuous enough for me and my gimpy knee.

I visit the physical therapist three times a week, at which I complete the series of exercises listed above, but under supervision of a therapist. I also get to do several exercises I'm not allowed to do at home: ride the stationary bicycle (slowly, ten minutes at a time), do the "shuttle" (basically horizontal squats), perform knee curls while lying on my stomach.

I'm weary of the exercises, but recognize they're the primary factor in my increased strength. I need to keep doing them, regardless of the tedium.

I can't wait for the time I'm allowed to get on my own bicycle and pedal, even if it's just around the neighborhood.

Sleep
My sleep patterns are more problematic. I have little pain in my knee (and what pain I have is due to sitting in a cramped position for several hours, from walking on it too much, etc.), so that's not the reason for my inability to sleep. It has been hot, yes, but not that hot. I still should be able to sleep.

I think the main problem is that my leg is in its brace, locked at full extension, when I try to sleep at night.

Whatever the case: I'm not getting enough sleep. And what sleep I get isn't deep and restful. I wake at 5:30 — to spend an hour doing exercises before work — and I'm a shambles.. When I get home from work I try to nap on the couch (and usually this is moderately restful, actually), but I'm only able to get an hour of sleep before Kris comes home.

I had hoped that last night would break the pattern. We had dessert with Jeremy and Jennifer, during which I had a couple glasses of wine. Then I sat in their hot tub for half an hour, exchanging pleasant chit-chat. When we left, I felt ready for a long night's sleep. Only it was 11:00 by the time I got in bed, and 1:00 before I was able to fall asleep. And I woke at 2:00 and at 4:30 and then again right at 5:30.

Argh!

I'm going to explore over-the-counter sleep aids. Any of you have advice for an insomniac?

On this day at foldedspace.org

2004This Old House   I've considered building a weblog about our house. I know that if I didn't I'll end up devoting copious space in this weblog to stories about the care and maintenance of our new house.

2001Shared Links   Some links of interest.

Comments
On 18 June 2003 (11:27 AM), Joelah said:

A little Proust, perhaps?
Ha! I slay!


On 18 June 2003 (12:07 PM), Dana said:

Ooo Good one, Joel :)

Relaxing music? Don't try to read in bed before you go to sleep?

I occasionally go through stretches of not sleeping well, but my problem isn't falling asleep, it's staying asleep. I can drop off at almost any time, but sometimes, like at night, when I'd like to sleep deeply, I'll surface, roll over, then have to re-zone out. It gets annoying, but it's not usually debilitating in the way you're describing.

Of course, I'm also feeling fairly drugged up these days, so that may have something to do with my own issues lately. I started two new medications, both in the last week, and I think it's taking a lot out of my body. I feel pretty drained.


On 18 June 2003 (12:49 PM), Drew said:

I do have a few recommendations regarding sleep aids, having had acute insomnia during certain periods of my life. My suggestions fall in several categories, which I'll detail below.

Psychological/Behavioral:

Develop a bedtime ritual - set a regular bed time, start winding down an hour beforehand.

Reduce stimulation - no television, no internet, no exertion before bed

Don't nap during the day

Get some cute pajamas - putting them on before bed helps the mind realize that it's time to stop processing and rest

Cut caffeine from your diet

Herbal:

Valerian - this stinky root is thought to slow the nervous system, helping you stay asleep

Melatonin - your brain produces this as you fall asleep, I've found this very helpful. Both of these are available at any drug/vitamin store.

Over-the-Counter:

Excedrin PM - pain killer and mild sedative

Sominex (et. al) - may help you fall asleep faster, but probably won't help you stay asleep. It is non-addictive.

Prescription:

Ambien - very effective sleep aid. Gets you to sleep, and keeps you asleep. It's half-life is such that you function well the next day. However, it is addictive and must be used carefully to avoid developing a dependence.

Sonata - effective sleep aid. Works more quickly than Ambien and has a shorter half-life. Better suited for situations where you wake up in the middle of the night and can't get back to sleep. Not as habit forming as Ambien.


On 18 June 2003 (01:13 PM), Jeremy Gingerich said:

More wine. Instead of 2 glasses try a whole bottle (or better yet 2!). You'll sleep just fine. Combine this with the Proust mentioned by Joelah and your set.

The only side effect is the lack of interest you will have in your excercise routine.


On 18 June 2003 (02:01 PM), Dana said:

Ah, Ambien doesn't work that great. Didn't have much effect for me when I was on it. Shrug. Everybody's different when it comes to some of these meds, though.

RE: Andrew's caffeine suggestion. I'll second that, but add chocolate and sugar. At least, try not to have any caffeine, chocolate, or sugar after dinner, if you can manage it. In fact, try not to eat much of anything right before bed.


On 18 June 2003 (02:09 PM), J.D. said:

Andrew's suggestions are helpful; I'll look into them.

As for caffeine: I'm not a large consumer of that drug. I have it from time-to-time, but make a point of refraining after, say, 3 p.m. I know it has a strong effect on me, so I keep away.

Chocolate and sugar, on the other hand, are a problem. I'm an addict.

I think that a bedtime ritual might be a keen thing. For years, Kris has urged me to come to be earlier, at a set time. I've resisted out of sheer stubborness, and a lack of tiredness.

I thought of another thing that might be causing problems: I do my third set of exercises just before bed. Eh? Eh? Sounds like a possible culprit to me!

My favorite suggestion so far, though, is Jeremy's: I'll have to try the two bottles of wine thing.


On 18 June 2003 (02:30 PM), dowingba said:

I wouldn't suggest taking any over-the-counter drugs whose purpose is to make you go to sleep. They tend to be quite addictive, and I'm sure you wouldn't want to go through another withdrawl. Gravol works pretty good. Too good, actually. Every time I've taken it I've slept through alarm clocks and such.


On 18 June 2003 (02:52 PM), Tammy said:

Count sheep!


On 18 June 2003 (02:58 PM), Kris said:

I'm glad to see you admit that it's been "sheer stubborness" (see jd's comment above)!


On 19 June 2003 (08:14 AM), Not telling said:

J.D.,

I find that I fall asleep easier after having sex...Post-coital slumber.


On 19 June 2003 (08:47 AM), Lisa said:

Given a wish by the mythical genie, I would definitely choose to live on two or three hours of sleep a night. (Imagine all that you could accomplish!) The genie has not arrived yet, and I find that lack of sleep quickly becomes debilitating.

Craig, a champion insomniac at times, likes the OTC sleep aid called Calms Forté. The bottle claims that it’s all natural and homeopathic, if such things are important to you. (Side rant: natural ingredients are still drugs—so many people assume that they’re somehow freebies in the medication world. I have no problem with herbal remedies, but I think they should be treated as medicines and not glorified salad.) Anyway, Calms is sort of a step up in strength from melatonin, which Drew mentioned above.

Personally, I prefer Sominex, which Drew also mentioned. Or, if you want to join me in my pregnancy nausea medication, you’ll find that Phenergan is fabulous for its side effect of drowsiness.

Hope you find some respite. Sleeping with a leg brace sounds awful.


On 19 June 2003 (10:19 AM), Amy Jo said:

Melatonin for a couple of nights usually works for me.


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