Trapped Inside Herself

She used to be trapped inside of herself, the past demons cornering her into the alley of darkness hidden deep in the perception of her psyche. She fought the demons, as they surrounded her trying to suppress her and destroy her with the false illusion of her past becoming her reality again. This is what she saw every time she looked in the mirror. She never looked at the girl in the reflection staring back at her. Her focus never seemed to pertain to the aspects of her mortal body. What her attention was zoned on was beyond the flesh and blood of the girl poised in the mirror. She was in her soul that is where she was every time the mirror forced her to look upon the eyes of her being. Perhaps this is where the origin of her new self stemmed from, beginning with the reflections of the soul, creating a raging storm between past demons and the heart deep within, ending with the rebirth of something new. It seemed her past was chasing her. The translucent ghosts of her life in the past had come to combine as a clay and been molded into an entity of “what once was.” She thought they would haunt her forever, stalking the thoughts in her mind, stealing any sense of peace her being may have had contained. These were her demons, taunting her with everything she had been, whispering lies of what she was becoming.
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They were grotesque, but she found them beautiful, as she often found many dark disturbing things. Their appearance was something derived from her own imagination. Something she maybe had found in her gruesome wonderland. Black rose vines wrapped around their bodies, skin crafted of the shadows that once clung to her soul and smothered her with her fears. Their teeth were formed of the sharp razors, glinting silver, as she had once used them to pierce her skin, releasing her pain in the scarlet streams flowing outward from beneath her flesh. Their eyes were glossy, cold, and burning red, holding every drop that has ever cascaded down her cheek, and every crimson tear she had ever set free from her flesh. From deep inside they made shrieks that of a banshee, every wave of sound woven together by threads of every scream ever to have escaped her mortal being. Oozing from their mouths was the maroon wine she spilled from her body during her past attempts of erasing herself from this dominion. All these features formed perfectly together and created the Demon Fey standing still like statues, blocking her path out of the grimy alley.

She studied them, ignoring their beastly appearance, focusing only on their internal characteristics. She stared deep into their soul-less eyes, seeing them for what the real purpose of their false existence in her consciousness was. They were shadow tinted mirrors, reflecting the sins, regrets, heartache, and pain of her past. Looking into the reflections, she knew she should’ve ran from them and fled into the fog of the future and the present. Instead, her body refused to obey the request of her logic and slowly moved toward the demons. The demons also seemed daring and invaded the space between them. Their movement was quite gracious, resembling that of a dance. Perhaps they were dancing, their bodies swaying with each step, matching the melody of her past.

Her soul maybe should have felt some sense of fear, but all it felt was welcomed by the demons. It drew her nearer to them, the attraction pulling them together like the gravity between two magnets. The gap between her and the demons grew less and less. Without permission her hand reached out towards them, lightly brushing the skin of the demon nearest to her. At that moment when they had touched, anger-wired adrenaline injected into her body like a syringe filled with heroine. It flowed throughout her being, infesting her psyche with the emotions and instincts of a deranged animal. The atmosphere grew dense with the mists of her hatred, clouding the thoughts flickering through her mind. She closed her eyes and breathed in the haze, letting herself slip into the intensity of her emotions stemming from the past.When she opened her eyes and exhaled it seemed as if her breath paralyzed the universe, stealing the reality of time. The viridian-amber shade once filling her irises with life and being, now painted over with the amaranthine shades of insanity, coloring her eyes hollow. No longer had her own spirit dwelt within her body. Something twisted and deadly was lurking in her being, infesting her veins with madness, devouring her core with a newfound bloodlust.She looks up at the demons, her lips being consumed by a sinister grin. Not only did the insanity possess her soul it, it also began transforming her physical aspects. Her original hair had been about medium length touching just above the middle of her back, the layers gave it volume, adding a seductive characteristic to it. The color was something of a light shade of chestnut intertwined with strands of white, silver, gold, and copper. It looked as if it had been stitched together using fabrics of the sand, stardust, moonlight, sunshine, and the gleam of precious gems. But now insanity had bleached it white and grown it down to her knees. Her face took shape of a more mature structure. Her light pink lips grew plumper and kissed with a hint of deep rouge. Her already pale skin lost most of its pigment and was now pale like the winter snow. Her slender body filled in with curves, bust and hips connected by a smaller waist, forming a body that of a goddess. Ebony raven wings materialized in the space between her shoulder blades, ripping the clothes of her body as they grew to more than 8 feet in height and width.Her new form, driven by insanity, positions itself into a battle stance, knowing they were going to attack. She reaches down to her sides and pulls two swords (fabricated of darkness) from their sheaths. The universe grew still and quiet, every sound and movement hushed out of existence. She stares down her foes, waiting in silence until they make their move.
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The demons break the silence, darting toward her with the intentions of a malicious origin. She spreads her wings and soars into the air, demons following close behind her. She stops and turns around, they lunge at her violently, hoping to rip through her flesh and taste the sweetness of her bodily wine. Without effort, she swings her blades, severing the heads of the first group of enemies. More attack, coming at her from all angles. Without fault she defends, her long silver hair syncing to the rhythm of her body as she dances with her blades. She flits through the sky, the light of the moon caressing her skin serves as a spotlight, shimmering over her stage of twilight and mauve. Her blades sing as they leave the demons in crimson ribbons and scarlet rain. Her raven wings flutter and fall, landing her safely on the asphalt. The blood and corpses of her defeated opponents fall to ground like snow. Insanity disappears from her eyes.
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She looks up and sees the stars gazing down upon her, sparkling with what seemed to be a hint of hope for her destiny. Without turning back, she walks away, skin flawless and untouched by battle. She smiles knowing her past is dead and that the fate of the stars is wagering in her favor. Running, she spreads her wings and takes flight. Serenity overwhelms her being as she soars away from what had once chained down her soul. Leaving the corpses behind, her past dissipates from her thoughts and her shadow self is swept away from existence. Tonight she is born anew. Today she rises out of the debris and ash of the past as a reborn angel of darkness.

Still Dancing With My Demons

I have found that information is the best way to educate my mind when I’m left with unanswered questions. Today is no different, actually Thursday was no different, as it was Thursday, yes that I had yet another bomb dropped in my lap by my friendly VA doctors. It was good news to hear that there is now a solution, but bad news because of what the solution involves when it comes to the repair and pain relief in my knee. Anyone who visits this blog regularly over the last several years will have read about my knee, my challenges with the VA, playing the waiting game, and in many ways, dancing with my demons, or at least entertaining them on a dark rainy night.

I really was blindsided as I was led to believe that I merely had ligament problems once again, but no, these two doctors took a very blunt and honest approach with me, thank you, and explained and showed me just how fucked my knee really is. First of all, bone to bone contact because of deterioration of the cartilage is a rather challenging pain to explain. As well, that same space being approximately 100% covered with arthritis. I’ve always said ignorance is bliss because it allows one to disconnect from something and become very indifferent to ones grief. So be it, not everyone has had a broken knee to include broken femur in two places, broken tibia, destroyed ligaments and muscles, and so forth. I get the precious innocence of ignorance to my personal hell. I give these doctors credit, it was like they were in my head reading my thoughts and knowing my daily challenges. It was cool but also some freaky voodoo shit was going down too, I think. It was almost nice hearing my own personal words coming out of someone else’s mouth right there in person. Anyway, below is the best description I could find about the corrective surgery. I have spent the last two days reading, trust me, but I think this might just be my answer. However, I will put this out there for y’all, if you know a better answer, please pass it on. So, here it is.

Originally written here.

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Knee osteotomy is commonly used to realign your knee structure if you have arthritic damage on only one side of your knee. The goal is to shift your body weight off the damaged area to the other side of your knee, where the cartilage is still healthy. When surgeons remove a wedge of your shinbone from underneath the healthy side of your knee, the shinbone and thighbone can bend away from the damaged cartilage.

Imagine the hinges on a door. When the door is shut, the hinges are flush against the wall. As the door swings open, one side of the door remains pressed against the wall as space opens up on the other side. Removing just a small wedge of bone can “swing” your knee open, pressing the healthy tissue together as space opens up between the thighbone and shinbone on the damaged side so that the arthritic surfaces do not rub against each other.

Osteotomy is also used as an alternative treatment to total knee replacement in younger and active patients. Because prosthetic knees may wear out over time, an osteotomy procedure can enable younger, active osteoarthritis patients to continue using the healthy portion of their knee. The procedure can delay the need for a total knee replacement for up to ten years.

Surgery

Depending on where osteoarthritis has damaged your cartilage, an osteotomy removes a wedge of bone from different areas of your shinbone. The most common type of osteotomy performed on arthritic knees is a high tibial osteotomy, which addresses cartilage damage on the inside (medial) portion of your knee.

The following surgery section provides details about the high tibial osteotomy procedure that apply in general to most other osteotomy procedures. The procedure usually takes one to one-and-a-half hours to perform.

During a high tibial osteotomy, surgeons remove a wedge of bone from the outside of your knee, which causes your leg to bend slightly inward. It is like realigning a bowlegged knee to a knock-kneed position. Your weight is transferred to the outside (lateral) portion of your knee where the cartilage is still healthy.

Surgery
After anesthesia is administered, which may be regional, or general, the surgical team sterilizes the leg with antibacterial solution.Surgeons map out the exact size of the bone wedge they will remove, either using an X-ray, CT scan, or 3D computer modeling.A four- to five-inch incision is made down the front and outside of your knee, starting below the kneecap and extending below the top of your shinbone.Guide wires are drilled into the top of your shinbone (tibia plateau) from the outside (lateral side) of your knee. The wires usually outline a triangle form in your shinbone.A standard oscillating saw is run along the guide wires, removing most of the bone wedge from underneath the outside of your knee, below the healthy cartilage. The cartilage surface on the top of the outside (lateral side) of your shinbone is left intact.The top of your shinbone is then lowered on the outside and attached with surgical staples or screws, depending on the size of the wedge that was removed.The layers of tissue in your knee are stitched together, usually with absorbable sutures.

Day Of Surgery

At most medical centers, you will go to “patient admissions” to check in for your outpatient arthroscopic surgery.

After you have checked in to the hospital or clinic, you will go to a holding area where the final preparations are made. The paperwork is completed and your knee area may be shaved (this is not always necessary). You will wear a hospital gown and remove all of your jewelry.

You will meet the anesthesiologist or anesthetist (a nurse who has done graduate training to provide anesthesia under the supervision of an anesthesiologist). Then, you will walk or ride on a stretcher to the operating room. Most patients are not sedated until they go into the operating room.

Here are some important steps to remember for the day of your surgery:You will probably be told not to eat or drink anything after midnight on the night before your surgery. This will reduce the risk of vomiting while you are under general anesthesia.Wear a loose pair of shorts or sweatpants that will fit comfortably over your knee bandage when you leave the hospital.Take it easy. Keeping a good frame of mind can help ease any nerves or anxiety about undergoing surgery. Distractions such as reading, watching television, chatting with visitors, or talking on the telephone can also help.

Recovery Room

Following a knee osteotomy, you usually stay in the recovery room for at least two hours while the anesthetic wears off.

This procedure typically causes significant pain. You will be given adequate pain medicine, either orally or through an IV (intravenous) line, as well as instructions for what to do over the next couple of days.

Your knee will be bandaged and may have ice on it. You may have significant pain early on and you should take the pain medicine as directed. Remember that it is easier to keep pain suppressed than it is to treat pain once it becomes present, so ask the nurse for medication when you feel pain coming on.

You should try to move your feet and ankles while you are in the recovery room to improve circulation.

Your temperature, blood pressure, and heart rate will be monitored by a nurse, who, with the assistance of the doctor, will determine when you are ready to leave the hospital or, if necessary, be admitted for an overnight stay. Most patients remain in the hospital for two to four days following an osteotomy.

Post-Op In Hospital

After knee osteotomy, you usually are taken to a hospital room where nurses, anesthesiologists, and physicians can regularly monitor your recovery. Most patients spend two to four days recovering in the hospital.

As soon as possible after surgery is completed, you will begin doing continuous passive motion exercises while in bed. Your leg will be flexed and extended to keep the knee joint from becoming stiff.

This may be done using a continuous passive motion (CPM) machine. The CPM is attached to your bed and then your leg is placed in it. When turned on, it takes your leg through a continuous range of motion.

There will likely be pain, and you can expect to be given pain medication as needed. Ice also helps control pain and swelling.

For two or three days after surgery, you may experience night sweats and a fever of up to 101. Your physician may suggest acetaminophen, coughing, and deep breathing to get over this. This is common and should not alarm you. The incision usually starts to close within six days and the bandage can be removed. Physicians commonly fit you with a knee brace that may allow a limited range of movement and helps push your knee into the correct position. For a high tibial osteotomy, the knee brace pushes your knee inward, making you slightly more knock-kneed. Please note that some surgeons will cast your knee for 4 to 6 weeks to ensure that the osteotemy heals.

You may be able to put some weight on your knee, but physicians usually prescribe crutches for at least six weeks. You will be given a prescription for pain medication and usually schedule a follow-up visit sometime around six weeks after surgery.

Rehabilitation

Most patients can begin physical therapy around six to eight weeks after surgery. Unlike other surgical treatments for arthritis, osteotomy relies on bone healing before more vigorous, weight bearing exercises in the gym can begin. In the best scenario, people respond to strengthening exercises and stop wearing the brace after the first three to six months of therapy.

Light exercise is one of the most effective ways to relieve arthritis pain by stimulating circulation and strengthening the muscles, ligaments, and tendons around your knee. Strong muscles take pressure off the bones so there is less grinding in the knee joint during activities. In conjunction with a healthy diet, exercise can also help you lose weight, which takes stress off your arthritic knee.

Stretching

In the first few weeks of rehabilitation, your physical therapist usually helps you stretch the muscles in the hamstrings, quadriceps, and calves while flexing and extending your knee to restore a full, pain-free range of motion.

Aerobic Exercise

When pain has decreased, physicians generally recommend at least 30 minutes a day of low-impact exercise a day for patients with arthritis. You should try to cut back on activities that put a pounding on your knees, like running and strenuous weight lifting.

Cross-training exercise programs are commonly prescribed when you have arthritis. Depending on your preferences, your workouts may vary each day between cycling, cross-country skiing machines, elliptical training machines, swimming, and other low-impact cardiovascular exercises. Walking is usually better for arthritic knees than running, and many patients prefer swimming in a warm pool, which takes your body weight off your knees and makes movement easier.

Strengthening

Strength training usually focuses on moving light weights through a complete, controlled range of motion. You should generally avoid trying to lift as much as possible with your quadriceps and hamstrings. Your physical therapist typically teaches you to move slowly through the entire movement, like bending and straightening your knee, with enough resistance to work your muscles without stressing the bones in your knee.

Once your physical therapist has taught you a proper exercise program, it is important to find time each day to perform the prescribed exercises.

Recovery at Home

You will likely feel pain or discomfort for the first week at home after an osteotomy, and you will be given a combination of pain medications as needed. A prescription-strength painkiller is usually prescribed and should be taken as directed on the bottle.

Swelling in your leg usually decreases over a span of three to six months after surgery. There may be some minor bleeding for a few days, but by the time you are released from the hospital, most bleeding should have stopped. If you notice an increase in swelling or bleeding, you should call your physician.

Physicians generally recommend that you avoid putting stress on your knee until the bones have healed. Putting weight on your knee too early may damage the bone surface and prolong healing time.

Here is what you can expect and how you can cope after an osteotomy:Icing your knee for 20 or 30 minutes a few times a day during the first week after an osteotomy will help reduce pain. Ice therapy may need to intermittently continue for a few months if pain bothers you.As much as possible, you should keep your knee elevated above heart level to reduce swelling and pain. It often helps to sleep with pillows under your ankle.Immobilize your knee in the prescribed, hinged knee brace for about six weeks. You may remove the brace for brief periods to perform passive motion exercises with the aid of a physical therapist or a CPM machine. Range of motion exercises are important for healing. Regaining full extension is just as important as bending your knee.Your leg may appear slightly bent after the surgery as it heals into its new alignment.Most patients have to keep the incision dry for seven to ten days. Your physician can recommend a surgical supply store that sells plastic shower bags. Wait until you can stand comfortably for 10 or 15 minutes at a time before you take a shower.Crutches or a cane may be needed for between six and ten weeks, depending on the pain. It is difficult to describe the amount of pain any given patient will experience.Six weeks after surgery, your physician usually gives you a check-up. X-rays can determine how your bones are healing and whether you are ready to begin rehabilitation.You may have to take between six weeks and six months off from work, depending on how much you rely on your knee to perform your job.

Prevention

After rehabilitation, preventing osteoarthritis is a process of slowing the progression and spread of the disease. Because patients remain at risk for continued pain in their knees after treatment, it is important they are proactive about managing their conditions.

A fall or torque to the leg during the first two months after surgery may jeopardize the healing of your bones. You should exercise extreme caution during all activities, including walking, until your physician determines that your bones have healed.

Maintaining aerobic cardiovascular fitness has been an effective method for preventing the progression of osteoarthritis. Light, daily exercise is much better for an arthritic knee than occasional, heavy exercise.

When you have arthritis in your knees, it is especially important to avoid suffering any serious knee injuries, like torn ligaments or fractured bones, because arthritis can complicate knee injury treatment. You should avoid high-impact or repetitive stress sports, like football and distance running, that commonly cause severe knee injuries. Depending on the severity of your arthritis, your physician may also recommend limiting your participation in sports that involve sprinting, twisting, or jumping.

Because osteoarthritis has multiple causes and may be related to genetic factors, no simple prevention tactic will help everyone avoid increased arthritic pain. To prevent the spread of arthritis, physicians generally recommend that you take the following precautions:Avoid anything that makes pain last for over an hour or two.Perform controlled range of motion activities that do not overload the joint.Avoid heavy impact on the knees during everyday and athletic activities.Gently strengthen the muscles in your thigh and lower leg to help protect the bones and cartilage in your knee.Non-contact activities are a great way to keeping joints and bones healthy and maintain fitness over time. Exercise also helps promote weight loss, which can take stress off your knees.

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