December 27: Looking back over 2013: "The Year of the Knee"

I find that I am feeling very retrospective at this point. It's almost the end of 2013, and I have spent a year preparing for, having and recuperating from knee surgery. Here's my year in brief: 

• January: my left knee was so painful: it would catch and lock, then pop and hurt. I didn't know what could be done about it.
• February: saw my long-time orthopedist. His x-ray showed loose bits of bone and cartilage in the joint. He recommended physical therapy. After 1 session, I wondered how exercises could change the catching/locking/sharp pains.
• March: Found Dr. Gilbert. He tells me I am a good candidate for Partial Knee Replacement with Mako-Plasty surgery. I do my research.
• April 15: Tax day, and the day my left knee was fixed
• May: I suffer a set-back as the bottom stitch in the incision festers and infects.
• June: Back to all my normal activities. My leg gets stronger every day. I start noticing that the right knee hurts….ALL the time.
• July-Sept: Left knee gets better, right knee gets worse. In July I am finally able to stand sitting in the car long enough to go to visit my mom: a 3 hour trip. In October, we travel north for our annual Fall Holy Day observance: 8 hours driving the first day, 4 the second. My leg feels wonderful.
• October: My right knee has begun to make me nervous driving. I am worried about pain preventing me from stepping on the brake in an emergency. At my 6-month checkup I discuss it with Dr. Gilbert. Result: another repair.
• November: Surgery to repair my right knee.
• December: I am almost back to myself again. I still have some pain due to swelling that is within the joint. I don't quite have full flexibility back, but I will. The happiest thing is that it is healing, getting stronger daily. I will go back to my normal active schedule in January, Zumba Gold, Line dancing, gardening, playing flute, and best of all--running up and down stairs.

It has been quite a year! I hope that I will never need a full knee replacement in either knee. You see, the partial knee replacement assumes that the other half of the knee will stay strong because the knee is back in alignment. There is always the chance that the other side will deteriorate, and a full knee replacement will be needed. I hope if it does, I will get a good 10 years out of my partials!

Day 28: 4 Weeks After Surgery

I love daily noticeable improvements!! Today I walked across the room, and started down the stairs without thinking about it. I had taken 3 steps when I realized I was walking FORWARD down the stairs! So exciting!!! So now I grip both handrails, and slowly and carefully walk down the stairs. I feel like a princess, descending grandly down a staircase.

Evening as still the hardest part of the day, and sleeping. I am still sleeping mostly on my back. When I do roll onto my side, it doesn't last long, and it always hurts to roll out of the position. 

I have stopped taking pain pills, because it doesn't hurt anymore. I apply ice to my knee 1-2 times a day,

I have begun to be more active, but still focusing on taking it very easy. I have two more weeks to get back to normal activities. So for now it's up and active for an hour, then resting for an hour to an hour and a half.

Day 27: Milestone Reached!!

It was on day 27 last time around that I discovered a little blister at the base of my incision. If you look back in the archives you can see the result of that. It set me back 2-3 weeks in my recovery process! So one goal this time was to keep my activity levels lower up to this point. I have felt like I could be moving around and doing more, but for the last 7 days I have made it a point to rest and elevate more than I thought I needed to. 

Today the incision looks good, no redness, no tenderness. Yay! There are still 2 scabs of dermabond, and the tape the nurse applied at the bottom where the dermabond came off at the 2-week mark. But if I press gently along the edges, there is no tenderness like there was when I developed the infection last time.

Progress so far:

• I drove the car around the block yesterday. It felt surprisingly normal. My husband rode along, and at his insistence I made a quick stop to imitate what would happen if someone pulled out in front of me suddenly. So I can now may short trips driving, although I am not in a hurry to do so.
• I can walk up any of our stairs with alternating steps. The front steps are a bit of a challenge, as they are very high, but I can do it!
• Still walking a mile most days, still slowly, but I am less tired at the end.
• Still very tired and crabby at the end of the day..tired of sitting, tired of not bending my knee. At this time, I try to focus on progress made, and relax.
• I can lay on my right side for 10-15 minutes, on my left side with a pillow under my knee for about 5 minutes. It gives my back a little relief.
• I still spend most of the day on the couch, legs either elevated or extended.
• I apply ice after every exercise session..about 1-2 times a day now.
• I can bend my knee comfortably when sitting in a chair.

My goal at this point: back to normal activities by the end of two more weeks.

Day 24: Making Steady Progress

Over the last few days, I have increased the amount of time sitting at the computer. It is so easy to over-do!! I did too much yesterday and the result was an ache in the back of the knee during the evening and night. I try to spend no more than 15 minutes at a time. My therapist explained it to me this way: "there is still swelling in the knee, so sitting with it bent allows the chair edge to put a lot of pressure in that spot...result: pain." My plan now is to treat sitting time the same as exercises: do a bit, then apply ice.

I can finally bend my knee enough, that when I am sitting in bed, I can prop a book on my knees...well, for a few minutes, anyway. I can comfortably walk a mile--slowly, and having to focus hard on stepping evenly and keeping my balance. 

I'm still wearing the TED stockings. The post-surgery directions are to wear them daily for 4 weeks unless tolerating 1 mile walk "regularly." Since I'm not really sure what "regularly" means, and it's only 3 more days to the 4-week mark, I am going to keep wearing them. They aren't uncomfortable, and they keep my legs warm!

There are still 2 spots of dermabond on my incision, but the parts that I can see look pretty good. 

I also tried siting in the car, and much to my (pleasant) surprise, I found it was easy to move my leg back and forth between the gas and brake pedals. It was also easy to press the brake down, so I started the car up and moved it back and forth about 6 feet in the driveway. I predict I will be safe to drive next week. But I am practicing not rushing anything, so we shall see.

Beginning Week Three.

I have made good progress! In the last two days I have increased my walking distance to the magic one mile mark. Why is it magic? Because if I can walk a mile daily and no discomfort, then I can get rid of my TED stockings by the end of this week. That's only a week sooner than my post-surgery instructions, but how nice to be out of them. Actually, they are quite comfortable. I'm just tired of having white legs.

I am now able to go up our staircase with alternating steps. I go slowly and lean forward from the hip to keep the pressure off the knees, and in the glutes, where it belongs. I can also go down the stairs the same way, but only by backing down. The trick with backing down is to have a staircase where you can hold on both sides, then lean forward and watch your feet. I can't recommend backing down to everyone! But if you have the balance, it is so much easier on your knees!

I can also tolerate sitting at the computer for 15-20 minutes at a time. I try to limit it, as my goal is to stay fairly still throughout this week. It's getting hard to be so sedentary, because I feel pretty good.

I don't have much pain, but I take pain pills as soon as I notice discomfort. I don't feel like I NEED the pills - but I have been told that it is better to take them in order to avoid any build-up of inflammation. 

I still can't sleep on my side, and am ever so tired of sleeping on my back. I have discovered that I can lay on my side for a few minutes, but that's not enough for good sleep. 

My knee is 2 weeks old.

It seems like so much longer than 2 weeks since my surgery! The stitches have been removed, and two little strips of tape were placed across the spots. The dermabond (glue) that seals the incision is half gone. It was loose and the nurse lifted it off with tweezers, and placed two strips of tape over that section of the incision. 

I still have tenderness around the lower stitches, a little bruise shows under the edge of the tape, and my thigh still feels a little bruised. I am walking pretty well, no crutches needed. I do carry a cane when I walk outside, but I barely need it at all. 

I am really tired of not being able to bend my knee when I sit up in bed, or sleep on my side. But hey, it's only TWO WEEKS! I am working hard at keeping my focus and not doing too much. The guideline of two hours up, two hours down is good, but I find I tire in less than an hour, then need 2 hours to rest up. So it's more like 40 minutes up, 2 hours down. 

I still apply ice after moving around for a bit. The ice feels good, and helps prevent swelling. 

I finished three projects: 
1. the memory quilt I made for my daughter is now done. 
2. Flute cleaning cloths with a little "bubble" at the top so it's easy to get all the moisture out of the head joint. I made enough for myself, my teacher, and each of her other students.
3. I made a pouch to put my iPod touch in so it doesn't get scratched. It's actually a project I began a few years ago: a tatted "evening bag" - I made a liner of felt, and added a fastener across the top. 

Look for pictures to be posted to a new page: "photos 2"

Saturday and Sunday

Saturday
I am now walking with full weight on my leg, tapping along with the crutches using a 4-point gait. That means the crutches move one at a time, alternating with the opposite leg. I am not putting any weight on my hands, simply bringing the crutches along for the purpose of balance. I shortened my walk today, because I don't want to overdue. I still managed almost a quarter mile. 

I am making steady progress on finishing my daughter's quilt. Following the doctor's revelation about the exercises has got me thinking once again about the physical therapy protocol..but I'll save that for a separate post.

Sunday
I increased my walking distance, and feel comfortable walking a bit faster. The exciting thing for today is standing up from a chair. I have a bit of understanding of the principles of Alexander Technique. It's a whole system of movement best learned from a teacher who is trained in the technique.

I have had a couple lessons, read a book, and articles on it. The awesomeness of Alexander Technique is effortlessly standing up. Until today, I wasn't bending my knee enough to use it, and mostly have been pushing/pulling myself up with my hands. This morning I decided to see if I could rise from a chair, allowing my body to lift upward from the top of my head. It worked!  Very little push needed from my hands! Yay! So that's the big thing for today. 

I am starting to walk in the house with no support. 

Monday morning:  My knee didn't ache during the night, so I guess it isn't hurting me, but it does affect my gait, so I think I will try using the cane today. Feels good to be progressing forward.

Thursday and Friday

Thursday: unremarkable. Tried to do some exercises, but found my muscles were too fatigued. So I just had a nice, unremarkable day. I am making progress on the quilt I am working on. Finished the edge finishing, which was tricky because of the 8-point star shape. It's a matter of making the fabric fold over the inside angle, and lay flat at the same time. Now I am doing the final step..quilting designs in the areas not already tied. It's looking pretty.

I am sick of leaning on crutches. Makes my hands hurt.

Friday

Physical Therapy in the morning: Getting over the fear of putting full weight on my leg. It feels wonderful to walk without leaning on the crutches, but takes me several passes back and forth in the living room to be brave enough not to. I was able to out full weight on my leg a week ago, but doing so created 3 days of pain, so that's the source of the fear. If I get through tonight without pain, then I will know that the knee is ready.

One of the exercises causes a sharp pain just below the knee on the medial side of the incision. It is leg extension while lying on my back with a pillow to hold the leg at a 45 degree angle. Then a couple other exercises create the same pain. My therapist massages (gently!) the pain away, and since I am seeing my doctor this afternoon, tells me to be sure to ask him about it.

For the rest of the day, I walk with crutches simply for balance...so nice for my hands!

When I see the doctor, stitches come out, X-ray of my knee is taken, when I ask him about the spot that hurt and describe the exercise, he says. "Why do you want to do that? If it hurts, don't do it!" My fitness background screams in my mind: "I have to do that exercise to strengthen my knee!"  As we talk I come to understand that I don't have to do that particular exercise..when my knee is ready, it won't hurt to do it, and then it will be effective.

The other cool thing he explains is that with the medial replacement they have to "disturb" the joint capsule... ie. open it up, then close it... It takes a whole to heal, and that's why I keep getting sudden pain in that spot. Ah-hah! So now I won't worry about it. I won't do exercises that aggravate it. (There is more than one way to work on knee extension!)

And lest I give a wrong impression: after a couple tries my therapist abandoned that particular exercise and gave me leg extensions that did not hurt. So she was already doing what the doctor recommended. He just added the extra bit of info. 

I did not take a walk today, because between physical therapy and getting to the doctor appointment it was enough. It was nice to get out and away from the house for a bit. 

Wednesday. Let's talk about pain...

I have a very high threshold for pain. It may come from living most of my life with some sort of chronic pain..headaches for 28 years (eyestrain--contacts fixed that), pain in my wrists for 6-7 years (caused by an injury-carrying suitcases-eventually resolved when I began weight training), shoulder pain (tension, child rearing, sewing), neck pain for 2 years (a lifetime of bad posture, which, when cured set the muscles into spasms because they had never been used properly before), migraines (menopause) and most recently, knee joint pain for the last 7 years (osteoarthritis).

The result of living with all this pain is that I don't bother with pain pills much, at least not until it gets really, really bad. I did learn with the migraines that if you are going to take something, do it ASAP, before the headache gets a grip on you.

But here is what I learned today from my nurse case worker: if you are in pain you won't heal. Somehow taking pain meds and keeping the pain under control helps your body to heal. Hmmm, who knew? So I took a pill as soon as we got off the phone. 

Today was pretty good. I can finally lift the leg without supporting it, although I am babying it. I elevated the leg twice, first thing in the morning, and after my exercises.
I put ice on it 4 times during the day, and took a pain pill before exercising and another after my walk. I practiced for the first time since the day before my surgery..such a delight to make music! I had a nice walk, and made progress on finishing the quilt which is my priority project for this convalescence. 

Things are looking up!

Tuesday, Day 8: feeling much better!

My knee is much improved! Or rather, my pain is much improved. 
Here is what I have decided:

• The exercises were OK. I didn't do too much...well maybe a tiny bit!
• The outdoors walk, using crutches is fine.
• Walking inside the house with only a cane is too much
• I probably got a little dehydrated, also not good
• I twist my knee when I get up and down, just a little, but repeated twists are not good.
• I really, really need to find a way to get the leg above the heart at least some every day.

My therapist comes and confirms my conclusion. She has me doing straight leg lifts, first with her helping me, and then on my own. (Until now, that lift really hurt. I have needed to use a band to help me lift my leg up and down.) Progress finally!!

I almost skipped my outside walk, but decided to walk anyway. My leg was hurting just a bit at bedtime, so I took a pill..slept well!!

My knee is 1 week old today!

Assessment: 
Pain levels: not good
Walking ability: terrific!
Flexion: stinks
Incision: healed and dry, so can be left without a bandage...I still put one on at night.
Stitches: look good, healing nicely.

Last evening and night were the same as Saturday night...painful. 
My therapist had to reschedule for tomorrow, so I am on my own. I am wanting to worry that something is wrong, but I squash that thought. I review the post surgery handout from the hospital, and my pain doesn't fit in the categories that require calling the doctors office or going to the hospital. I do communicate with one of the nurses at the hospital who assures me that the first two weeks can be very difficult, and everyone's experience is different.

The goal today:

• Get that leg elevated somehow. (Have you ever tried getting your knee above your heart, and resting there? I decide my resistance ball may work--It does.)
• Rest lying down more 
• No cane .. Use crutches every time I get up
• Walk the same distance (I can't resist the lure, and actually go farther)
• Be very careful every time I move the leg to support it and not twist it (getting off the toilet without twisting is pretty tough)

Evening: some aching but not as bad as the last two nights

Tuesday morning: I actually slept all night without pain pills!! 

Conclusion: even though I CAN walk without the crutches, I shouldn't. Darn.

Sunday

Yesterday, in the early evening, my leg began to ache. Every so often a slight movement would hurt with intensity. Sleeping was pretty rough, and at one point I managed to roll slightly into my side (So heavenly to get off my back!) but when I rolled back and tried to lift my leg to put it back on its pillow....I felt like I was stabbed in the side of the knee!! Then it ached. I sat up and gently massaged it until the acute pain subsided, took a pain pill and was able to go back to sleep.

So I concluded I did too much yesterday. I don't think it was the long walk...that simply feels good every step of the way. The exercises are a different story. Each exercise is supposed to tire the leg, but not cause pain. Sometimes it hurts before I realize it is going to. 

The goal today is to do the same walk, but skip the exercises. If my leg hurts in the evening again, then that should indicate the walking is the problem. 

It hurts, the same as last night. I am still not convinced that the walk is the problem. So I need to evaluate the problem.

As I look at today's activities, I decide that perhaps the problem is walking around in the house. When I take my outdoors walk I use the crutches so that I can focus on correct gait, and have extra stability over bumpy surfaces and the slight hill. However, in the house, I simply carry a cane along, and hardly use it at all. I also puttered about a lot during the day..transplanted some seedlings into little pots (sitting on the porch steps), fixing my own lunch (multiple trips back and forth to carry things) and sitting up more than lying down.

The biggest pain creator is when I get up or down and swing the leg out in space. If I don't move slowly, and support the leg with a strap around my foot it hurts. 

So tomorrow's plan is to still walk, lie down a lot, elevate,the leg, and use only crutches. My therapist is scheduled to come, and maybe she can shed some light on it.

Onward!!

The Sabbath, Day 5

Rest! and rest some more...it gets hard. 

I would really like to be up and busy. My mind is ready to start on projects, but my knee is not ready. It's a beautiful warm sunny November day...the kind that makes you just feel happy to be outside. We take our walk In the morning, because church is is the afternoon. I poke along at my slow, controlled pace, watching the ground in front of me for twigs, leaves and other hazards. It feels so good to be outside!

The professionals really want me walking on level, smooth surfaces..yeah...not going to happen. Our block has old trees, cracked sidewalks, and goes downhill into the middle, then back up again. So I pick the least uphill part and head west. Once I get to the corner and can turn it, there is less incline. I have to be more cautious going downhill, and uphill makes me puff a bit. 

The Therapist in the hospital taught me to use the crutches and "walk" them alternating and opposing the feet. So the left crutch moves forward with the right foot. I feel like the giraffes in the stage production of "The Lion King." It's really nice, though.

Anyway, it's so lovely out, and at my slow pace, I just keep going until I realize I have gone much farther than I thought I could! I feel like I could go even farther yet, but decide to go back anyway. 

Even though I am walking so well, stairs are another matter..and my flexion is very poor. I am so tired of keeping my leg straight, and sitting/lying on my back! I did set up a regular list of exercises, and did them morning and afternoon, plus a nice long walk in the morning, which felt really good. 

Day 4: Friday

Rain! I love a rainy day, especially when I can stay inside, cozy and warm, and watch it come down. It is a quiet day and I rest a lot. Late in the afternoon I have a visit from Sally, my Physical Therapist. Sally worked with me on my left knee, and the confusion checking out of the hospital had to do with connecting with her agency so that I could continue with someone I like, respect and trust.

It's very hard for me to work with Physical Therapy professionals. I respect their training and knowledge, and expect them to do the same for me. Yes, I am "only" a Personal Trainer, but I am highly self-educated. I understand body mechanics, and many of my clients were in the rehab process. Unfortunately, I have not always been able to find someone who would work with me from of basis of my knowledge, and that defeats the purpose of recovery. 

Sally and I have worked out the kinks, and have a good working relationship. So today's visit was to determine my status: set up base-lines in terms of ability to flex and extend my knee, walk, get up and down. We evaluated the exercises I am doing, and added a couple of goals. 

Due to the rain and the therapy, no outside walk today.

Late in the evening the kids arrive for a visit, and bring turkey, potatoes, yams, green beans and pie. Yum. (They had chosen to have their Thanksgiving Dinner today, so my daughter got a day off between school and cooking.)

Thursday, Thanksgiving Day

Thanksgiving Day. I have opted out for this year..my kids have something planned for tomorrow, but I am going to stay put and keep recovering...which, by the way is going terrific! The highlights of today:

• I walked to the corner and back..about 750 feet! I felt like I could walk farther, but more is not better at this point.
• I made the pie crust, and husband made the filling: together we accomplished a pumpkin pie.(I may opt out of the big dinner, but pumpkin pie is just not something to bypass..besides that, I had fresh pumpkin all cooked up and ready to use!
• I also managed to grind up half an orange and 1/2 pkg of cranberries to make relish...which I love, and will go nicely with the turkey the kids will bring me tomorrow. 
• I don't need the crutches in the house..only when I walk outside. Inside a cane is more than enough...and often I don't need it, either!
• I washed my hair.
• One more, not-so-pleasant to talk about..but oh, so important:

Bowel movement accomplished! This may seem a silly thing to announce to the world, but it really is very important! It means the body is returning to normal function.

Yesterday when the home health nurse was here she asked if I'd had one yet. I couldn't remember, but I knew it was here in this blog, so I looked back..last time I had one at day 3. So that means my digestion isn't kicking in as fast as last time. 

I wasn't feeling constipated, but often you don't feel it until it is getting serious. If you wait that long, then you need to take a laxative, which clears the bowels, and then you start all over again! I don't want to have to take a laxative, so I had some dried fruit after dinner and drank an extra glass of water. That did the job! 

Speaking of which, do you know what stimulates your bowels? Most people have heard about prunes, but any fruit, and especially dried fruit, (with adequate water after it), will help. Graham crackers are another good one. Or fiber-filled cereals, such  as bran flakes. 

Wednesday, Day 2

A morning of chaos! Yesterday, there were some communication problems with arranging physical therapy. So this morning is spent resolving them. I finally get downstairs and settled on the couch for breakfast around 11:00am. 

The day consists of walking around the house (mostly to the bathroom and back), resting on the couch (sometimes sleeping), and checking email on my iPad. 

I don't remember my other leg hurting quite so much as this one does. But also, I don't remember being able to walk this well at this point last time. I barely need the crutches. When I went for my outside walk, I walked about 250 feet. I will have to go back and check, but I am sure I didn't go that far on Day 3 before! And I made two trips down and up the staircase in the house. 

Ice and pain pills helped a great deal. For exercise I wrapped a band around my foot so I could assist leg, and gently moved the knee joint back and forth. My therapist had told me on a phone conversation that in the past few months they have discovered that forced compression of the knee is not a good thing for partial knee replacement. (This reinforces my opinion that the rehab process for a partial knee replacement needs to be different from a full replacement.) so my focus is to gently move the joint back and forth within its current range of motion. I know that the range of motion will increase as the intracellular swelling goes down, and as I move the joint to the edge of pain. (Not IN pain, but to the edge of it!)

(Intracellular swelling is the collection of extra water within the joint capsule, which is a natural side effect of the trauma of surgery. It's the same thing that happens when you sprain your ankle and it swelling.)

Tuesday, day 1

Today, I am to check out of the hospital. Physical therapy wants to see me one more time.  My doctor has to check in, also a visit from the anesthesiologist to be sure I am not having any complications from that. The occupational therapy girl talks with me. (Her job is to be sure I am able to do all the things that occupy my time--get dressed, bathe, shower, use the toilet. She checks to see that I feel comfortable with my home environment, and  asks if someone will be there with me.)

Unfortunately, there is some confusion with the hospital case worker who is supposed to set up my home nursing and physical therapy. So instead of leaving around 2:00 like I expected, I end up waiting until 7:00. At least I got to have dinner...pizza, lemon meringue pie...yummy!

It is good to get back home. Our doggie is beside herself with joy, and climbs up on my chest for a snuggle and a nap as I settle on the couch..silly doggie! My knee hurts, but a pain pill helps me sleep for 4 hours, then another pill gives me 4 more. 

Monday, surgery day

Here we go again! Today was much the same as last time, except I was the second surgery, not the first. I checked in at 8:30. I was more alert during the pre-op. My nurse was the same lovely lady who set me up last time. This time I was awake when they put the femoral catheter in. It was not much more than a pin prick..but with a little sting to it. I don't remember the nurse inserting the IV feed last time. This time, she tried to put it in my hand, but the vein didn't cooperate, so it ended up at my elbow, which was annoying because I had to keep my arm pretty straight after that.

I was wide awake for the ride into the operating room, I slid onto the operating table and sat on the side for the epidural. Then lay down, stretch out my arm, and....."Mrs. Bordeaux...wake up!" I was in the post-op room, and the clock said 11:15. Such a funny feeling. 

Once I could start to wiggle my toes, I was taken up to my hospital room. The rest of the day was visits from nurses, Dr. Gilbert came by, the anesthesiologist checked on me. Physical therapy took me for a walk around the hall, then later on up and down the staircase. I had turkey, cranberry sauce, mashed potatoes and gravy for dinner (Yum!).

Pain pills and ice packs kept my knee from hurting too much.

During the night, I drifted in and out of sleep with the help of movies on the TV, and music on my iPod. I think the hardest part is staying in one position all the time, with the only variation being raising and lowering the bed. 

Countdown: 48 hours

In exactly 48 hours, I will be getting in the car and heading for the hospital. Am I ready? Yes--no. Today is a day of rest, so I won't be doing anything kore today. Here's tomorrow's list:

• Change the sheets on our bed
• Move all the throw rugs out of the way in our bedroom and bathroom
• Finish gathering together any projects I may do during my convalescence and take them downstairs to the living room, where I will spend my days
• Wash everything in the (dirty clothes) hampers
• Move Granny's sewing box downstairs, and see that it is stocked with needles, thread, crochet hooks, etc
• Pack the bag that Bob will bring to me after surgery
• Pack the smaller bag I will take with me
• Sweep the driveway so there will be at least a few less acorns to walk over (a daily outside walk is part of recovery! Since our street is not level, the first couple of days, I will walk up and down our driveway.)
• Create music by playing my flute. Not so much as practice, but for the feeding of my soul.
• Do so yoga, so I am relaxed physically
• Eat reasonably..no heavy meals, but restorative foods, and hydrate my cells
• Gather together the appropriate papers to take along

That's all I can think of at the moment.

My mental state, the same as last time, is one of calm excitement, eager to get this knee fixed so it can keep up with the other one. 

Four more days

My goal this week is to wrap up the things that I won't be able to do for a while, and to prepare my house for the days of taking it easy and healing. However, life is busy, and there are always the things you can't plan ahead.

In spite of that, I am moving along nicely. I know there will be things left undone. But this time I am much more "ready" - I have stacked up things I can do without moving around a lot..paperwork and needle crafts. There's this stack of "Yoga Journal" magazines I saved way back when....time to go through and decide if I really need to keep them. I found a stack of music that needs some editing on the computer. Then there is the pile of recipes I have been saving up...this seems like a good time to go through those, too.

I have moved my computer downstairs, for two reasons:
1. I don't want to take extra trips up and down the stairs. 
2. My desk upstairs doesn't accommodate sitting with my leg up. 

For the first week, I will mostly watch movies, sleep, exercise...I remember how long it took me to just get up and get dressed in the morning...and then I needed a rest because it wore me out!

Tomorrow is a busy day: classes and hair appointment. 
Friday I plan to get the laundry caught up, finish any errands that are still needed.

9 days to go!

I have done all my pre-op tests: CT scan, chest x-Ray, knee x-Ray, blood, urine, EKG, nose swab (to check for MRSA?), blood pressure, surgery class. I didn't have to attend the class, since I was here 6 months ago, but I chose to do so, and I am glad I did!

I am trying to focus and tying up the last-minute details so that a week from now I will be approaching surgery day relaxed, rested and calm. But the next three days are going to be busy: I am playing my flute in church today, have an annual recital tomorrow, and the next day a trip down to San Diego to spend a day and a half with mom (130 miles one way).

I am still recovering my diet after having a tooth removed. So I am taking special care to choose wise food choices. I am also hoping the scale will show another milestone of weight loss--meaning 1 more pound down. (I have only managed to drop 2 1/2 pounds in the last 4 months--grrrr!) I wanted that to be a much bigger number, but my body is really resisting!! Hopefully as this knee gets strong, I will be able to exercise more effectively, both aerobic and weight/resistance programs. 

Countdown to knee number two: 10 days to go

Here we go again! The same as last time, I am eager, excited, and a little unsure. Eager and excited because it means the pain goes away, and my leg can become as strong and solid as the other one. Unsure, because naturally, as soon as the decision was made it stopped hurting as much! Forntuately, it hurts just often enough to remind me that yes, it is a good decision. Also, it has given away more than once, and it's my driving leg. So repair is necessary for the safety of others when I drive.

My preparations are moving forward:

• There are sewing projects ready to go, with all the supplies (thread, needles, etc) in a lttle box in the living room where I will spend my days. 
• I have a small box with gauze, band aids, povidone-iodine and pain pills tucked under the end table by the couch--ready for the daily bandaid change.
• I set up an electric tea kettle which will make it possible to brew a cup of tea, or make a cup of coffee without having to carry it from the kitchen. I am going to leave the fixings in the kitchen, because it is good to get up and move about. (For the first few days, I will be using crutches, so carrying hot water would be a bad thing.)
• I have moved my computer downstairs to a table in the dining room. Last time I found sitting at my desk very exhausting, because I could not prop my leg up. I think I remember it was that way for 2-3 weeks before.
• I have a box where I am collecting the things that will go into a bag for my husband to bring to me after my surgery is done and I am settled in my hospital room.

It seems there should be more, but that where it is at the moment.

Onward I go!!!

Surgery and the Dentist

If you have never had joint replacement surgery you may not know the connection between surgery and your dentist. I knew, and still messed up! 

Here's the deal: bacteria from your mouth is your enemy for the rest of your life! It has been discovered, that even as much as 10 years after a joint replacement, a visit to the dentist to have your teeth cleaned can release bacteria into your blood stream, which wanders around your body and attaches itself to your replaced joint causing major problems. To combat this, you will take antibiotics before every dental visit.

This is also why you cannot have dental work done starting 2 weeks before your surgery, and up to 3 months after. 

My advice:

If you can, go get your teeth cleaned at least 1 month prior to the surgery, and make sure to take x-rays! That way if you need any work done, there is time to recover before you get your new joint.

My (miserable) experience:

I had my usual appointment, they took x-rays, and discovered a cavity which looked bad enough that the dentist was concerned there could even be abcess under the crown. And guess what day I sat in her chair and heard this....Two weeks and 3 days before my surgery date!

Long story short, I spent a miserable weekend in fear that this would delay my surgery. At this moment everything is still on track (10 days to go!). I had a rushed appointment to see first my dentist for thorough evaluation, and then a surgeon for extraction. Now I am weak and worn out from not being able to eat much for 3 days. 

So, take my advice, and get that dental work early done if at all possible!

And here we go again….!

Now that my left knee is so fabulous, my focus shifts to the right knee. It has also been in a state of deterioration for a number of years, just not quite as bad. I was told 6 years ago that I was looking at steady deterioration in both knees, with 8-10 years of pain management and then full knee replacement. So I am not surprised to be back doing this again.

My left knee was fully collapsed on the lateral (outer) side. The right one is 80% collapsed on the medial (inner) side. So you may be wondering why I don't wait to fix it? Simple: it hurts ALL the time! It is different from the other leg, but the pain is enough to keep me from sleeping, and inhibits my activities. The biggest reason though is this: I don't want to be the cause of an accident where someone (as well as myself) gets hurt. The right leg is the braking leg, and there are times when the pain in the knee makes me feel like I need to pull my foot off the brake. Not good.

So, the Monday before Thanksgiving, I will once again undergo MakoPlasty repair of the medial side of my right knee. How do I feel? Excited, mostly. The nice thing about this is that I remember a lot of the first experience. I will be better prepared. Already I have set up a medium sized storage box with bandaids, povidone-iodine, Q-tips, gauze pads. I also washed my TED stockings and tucked them into the box. It is stashed under the end table by the couch where I will spend my days. I have an electric tea kettle which will sit on the end table, and a small cooler so I can have my husband put bottles of cold water and juice in it at the beginning of the day. 

Tomorrow I will assemble the shower chair, and set up the bathroom. I know where my crutches and canes are. I have a quilt I have been working on all pinned so that I can work on it on my lap and not need to sit on the floor to work on it. The needles, thread and everything needed to work on it are in a little box. I have some crochet work that needs repairs, and that is being collected in a box. I have a few books I have been wanting to read tucked next to the couch.

I pulled out my list of exercises, and have reviewed them. I am also working at building up my glutes, hamstrings, and quads in preparation.

So onward I go. I will continue to post my progress here. Hopefully there won't be any more surprises, and no infection to set back my recovery this time. 

My knee is 6 months old!

Time to celebrate!! 🎉🎈🎉

I am so happy with my knee! It feels wonderful, and I am now doing (almost) everything I want to. At times when I am walking along, I suddenly become aware of how incredibly strong it feels, and then I giggle to myself. 

The only thing I am not (yet--I hope!) able to do is to crawl on hands and knees. This may not be a big deal to most people, but I really want to be able to do certain Yoga positions, like cat/dog sequence, which require hands and knees positions. Now, to be honest, I have not worked at it in a controlled progressive way. It's more a matter of occasionally putting myself in that position, with no weight on my left knee, then gradually allowing a bit of pressure. I do this ONLY on a cushioned firm surface (good carpet and pad). 

Happy, happy me! This surgery has given me a new life. What an awesome thing.

Four Months - Stairs!!

I know I said I probably would not make another post before my 6 month mark, but something truly exciting happened a few days ago...I ran up the staircase in our house! I didn't even think about it, I simply hopped up the steps. When I got to the top I giggled out of delight. My husband's voice came out of his office and he asked what was so funny. For the next two days I giggled every time I ran up the stairs. Then, going to my flute lesson, I noticed that I could climb the staircase in the parking garage for the first time without pulling on the handrail. (Going down is still a bit uncomfortable.)

How long has it been? I can't quite remember the last time I could do this...probably 10 months, at least. This "new" knee has given me so many gifts, and running upstairs is just the latest delight. I also tried grocery shopping for the first time...success. 

My doctor had told me to not try to kneel on my knee until I hit the 3 month mark, so after the point I have gradually let my knee take a bit of pressure on hands and knees. I have really missed being able to do this Yoga posture -- Cat/Dog is so good for your back. I can now take about 75% weight on my knee. 

Last month our local pool offered free water aerobics two days a week. Being in the water felt so wonderful, and I truly believe those classes helped my knee gain even more flexibility and strength. It also seemed to help the scar improve in appearance. (I always put sunscreen on it when I am going to be outside with it uncovered.)

So onward and upward. I am so grateful to have been able to go through this process. I didn't expect it to take so long to recover, but I have to say, it is well worth it!!

Three Months post-surgery

I am still making little, delightful discoveries about my "new" knee. The other day I was at a cafeteria-style restaurant where you carry your food on a tray to find a table. It was quite busy, and as I backed away from the counter with a tray full of drinks, twice I had to stop suddenly and back up a bit because another customer backed up in front of me. No big deal, right? Right. Here's the big deal: I executed this simple little move without any sensation of loss of stability. It was so totally cool!!

There's more:

• I can carry a bag of groceries without feeling pain in my leg and knee.
• I am teaching a Zumba Gold class for the summer...no pain, no sensation of weakness in my leg.
• The numbness on the other side of the incision is almost gone, so it feels almost normal when I brush my hand over it.
• A shopping trip to the garment district in LA was no big deal...walking several blocks, and in and out of fabric stores.
• My music is still delighting me...I can stand with such solidness and confidence. It is a thrill to feel so secure while I play, and frees my mind to focus on tone, air-flow, finger movements. So special and sweet.
• And finally, my other leg is not hurting so much. I hope that means it is getting a much-needed rest!

Now, here are the other realities that are not-so-nice, and which, in comparison to the positives, relatively unimportant.

• I still have a sense of discomfort in the scar itself. It sometimes feels tight and "pulls" when I bend my knee.
• Often it feels "itchy" - but I don't want to scratch it, so I rub it with the palm of my hand.
• Clothing over the scar is still sometimes annoying, but much improved.
• I am not yet putting weight on my knee in a hands-and-knees position. My doctor told me to not try that until now, but I know it is still quite sensitive. This limits my Yoga practice, so I hope to conquer it by the time I make a 6-month update.
• The scare above my knee where one of the stitches didn't heal nicely is ugly. It looks like a scab with skin over the top of it. 
• My leg still tires and needs rest and elevation in the evenings.
• I can no longer sit with my legs crossed--either way! This is probably a good thing in the long run, but it is very uncomfortable right now. My hips are just not comfy with both legs down...so I am in love with my exercise ball which I use as a footstool!
• I get quite exhausted if I sit for more than 1 hour at a time - so going out to a play, or a longer meeting is uncomfortable, and likely to make me more tired the next day.

So, this is what 3 months after partial knee replacement is like. If I did not have the experience as a personal trainer, I would still need the help of a good physical therapist. As it is, I only had the 3 weeks of in-home therapy, and there isn't a lot that can be done while the joint is still swollen and stiff. (Although the therapy I received was much needed!)

I need to be focused on specific strength and stretches on a daily basis. (I don't always manage this.) I am not quite 100% back to normal, and yet I am doing pretty much anything I want to do. And that is pretty good, indeed. 

I am so grateful to the doctor, the nurses, assistants and hospital personnel. This has been a truly rewarding experience.

8-week Check-up

Life is getting back to normal! Proof: I am now at 9 weeks post-op, and just now posting my 8-week check-up. 

The doctor pronounced my knee to be healing nicely with no more indication of infection. It is still wise to be watchful, because for some crazy reason, our bodies like to attack joints that have been replaced. 

He noted that the scar is looking as it should and told me to not worry if it looked redder on some days. It is new skin and will take time to look "normal". 

Here's the rest of his advice, nothing new or surprising to me, but after over 15 years in the fitness business, I have counseled literally hundreds of people to do these same things. Nevertheless, it's good review:

• Lose some weight. Every pound you take off relieves your joint of 3 pounds of impact.
• Eat a sensible diet: lean meats, LOTS of veges, fresh fruit, LOTS of water. Avoid coffee, sugar and excess fats.
• Wear good, supportive shoes...ALL the time. Whenever you walk in bare feet, sandals or other loose shoes, you are most likely wobbling and putting extra torque on your knees.
• EXERCISE! (My personal favorite) Avoid things that create extra impact on the knees, so don't take up a running program, or a sport like basketball that stresses the knees in a range of angles at fast speeds.
• Get enough sleep. That's when the body heals itself. Eight hours is the recommended minimum for adults. Some of us need more, some less. You know your own body!
• If you expose your scar to the sun, it WILL get darker in appearance. So if you care, and need to be out, make sure it is either covered or has sunscreen...or both. (Did you know it is possible to have suns exposure through some fabrics?--yes, it is.)
• and speaking of water...If you don't measure it somehow, you will most definitely NOT drink enough!!

This will probably be my last post until my 6-month check-up.

At this point in time, my personal journey will continue. My "good" (right) knee is now the "bad" one. It is different -- it hurts all the time, a little bit; whereas the left knee would send out excruciating bursts of pain from time to time. The x-rays show that my right knee is 80% collapsed on the medial side. In comparison, the left one was bone-on-bone on the lateral side. 

I had hoped that the pain in my right knee was the result of over-use due to the decline of the left. But it is now looking like that is not the case. If nothing changes in the next few months, I will be looking at another repair. Hopefully by that time, I will have a better idea of how well my body is taking this first repair.

"Nothing is sure in life, except death and taxes." I don't know who said it, but it is so true. The partial knee replacement is a gamble. I have known from the beginning that it may only buy me time and a full replacement could still be in my future. I figured before I made the choice that it is worth the gamble.... and I still feel the same.

This surgery has given me back so much mobility! More than that, it has improved my flute performance, and made me less tired on a daily basis.

It was a GOOD CHOICE!

Look back for an update in November, 2013.

7 Weeks and one day after surgery

Fifty Days:  Today I feel normal again. I feel truly good. 

I have energy...seemingly endless energy! Just yesterday, I would become tired very easily and quickly. But today I awoke and felt full of energy...like I could quite simply pick up and do everything I was doing before surgery..and better, because my knee isn't hurting all the time.

Not only do I feel energy, but I feel happy, joyous. I still took it easy, with a nice, long rest after lunch...which was after an hour of working out with the physical therapist, and another hour shopping at two different stores. Pretty cool.

The infection on my incision seems to be healed or very nearly healed. It is still pink, but it doesn't hurt when I press on it. (And that "other" infection is healing up, too.)

I now have full extension of my knee, but still need to work on strength and flexion. I can navigate stairs with only one handrail, although it feels better with two. 

Six Weeks, Post-Op

I have finally hit that 6-week mark. I feel like the last 3 weeks have been a process of "two steps forward, one step back." I began this journey anticipating a fairly easy ride with no complications. Too bad it didn't quite go that way--but life is made up of such things. Here is where I stand today:

• The infection at the base of my knee is on the run, but not conquered.
• I am off the antibiotics, because they led to a yeast infection.
• I can navigate most stairs going up, but I try to always take it mindfully and slowly. I apply my knowledge of proper step-technique by leaning forward from the hips, and using my glutes to lift my body.
• I can go down stairs, but have to be able to support some weight by holding onto handrails-preferably on both sides.
• Yesterday I sat down and crossed my "new" knee over the other, without even thinking about what I was doing. It felt good! (I know, sitting with the legs crossed isn't good for the knees, spine and hips. But it is a benchmark to be able to do it.)
• I walked a mile the other day.
• I did a full hour of Yoga..not all the poses I did before, but most.
• Tomorrow I start back to all my normal activity schedule, which means teaching a Yoga class and a line dance class, taking part in two Zumba Gold classes plus all my work about the house.
• I can work in the garden for an hour: did a little bit of digging with a shovel (gently, and only for a few minutes)--worked with the weed whacker (maybe 15 minutes)--pulling weeds (20 minutes)
• I can straighten my "new" leg to the same extent as my other leg! (Prior to surgery, it would not go completely straight. There was about a 3-inch gap between my knee and the floor.)

My goals for the next few weeks:

1. Kick the infections

2. Continue to build flexion of my knee.

Progress! Finally.

The last three days have finally brought a sense of progress. My energy is returning more quickly than I had dared to hope. The first day of "normalcy" was pretty slow, as I discovered as few as 20 minutes would require an hour to recover. 

The next day (Thursday), I met with my new physical therapist. I don't know yet if I am going to be happy with her or not. So far in this process, I have felt that all the therapists are too focused on my glutes, and not enough focused on my knee. It frustrates me that they do not give me specific exercises and goals to work on. So I have decided to take the bull by the horns, and write my own fitness program.

Taking control this way gives me a sense of purpose and progress. So I am back to walking on my street, and have started a specific exercise program focusing on flexion/extension in fluid movements, even pacing when I walk, good posture, and strength for all the leg muscles. 

I had a client a few years ago who had total knee replacement of both knees. I was his rehab person after the first 3 weeks. He did great! So I suppose I can take care of me as well as anyone. 

And meanwhile, the therapist can look to my future. Both of the therapists I have worked with since my surgery have focused on the glute activation which current studies indicate will protect the knees and hips in the long run. So I learn what I can from them, and take care of myself at the same time. Win-Win.

Friday showed marked improvement. I discovered that as long as I take it very slow and mindfully, I can actually navigate the staircase in our house using my new knee to lift or lower my body on a step. This is a BIG step for me! 

For the last two weeks I have gone down the stairs backward, (carefully and holding both rails), and up the stairs by leaning way forward and placing my hands on the steps, so kind of crouching/crawling my way up the stairs. In each case my focus has been to lift and lower myself with glute power, and not knees. This little technique comes from years of teaching step class students to lift with their glutes and not their knees. It's a good thing.

Thinking about the connection between step exercise and my apparently useless glutes makes me wonder...how much of what these therapists are seeing is a result of the past three years of deterioration? Makes me want to go back to step class!!

So this is looking good. Today is a day of rest, and then tomorrow I get back to working my knee. Oh, and finally yesterday, the little infection spot looks a little better, and didn't hurt every time I touched it. Perhaps the castor oil bandage is helping? I don't know. But it's nice to see some indication of healing, finally!

Forward progress, Hopefully!

After 7 days of moving as little as possible, I see my doctor again. The infected spot is no longer oozing, but it is very tender, and quite red. My doctor explained the purpose of barely moving. 

A test was done with two Petrie dishes of bacteria, one kept still, and the other on a gently vibrating platform. The vibrated bacteria grew significantly faster. So what we have done is allow my body the maximum opportunity to fight the infection by keeping its growth rate done, and assaulting it with antibiotics. 

Now the course of action shifts: it is time to put a bit of stress on the knee. I continue antibiotics for another 7 days, and watch it closely. If the red area grows, or I start to see streaks of red from it, or if I develop a fever, it's an emergency call to the doctor. If it starts to ooze again, I go back to clean/neosporin/bandage daily. 

I begin physical therapy again, and start back toward my normal lifestyle. I am mentally eager to get moving again! I am also scared that this infection is going to move into the joint and require drastic intervention. 

Today I took it fairly easily..my energy is low due to the inactivity of the past weeks. So I watch the clock: 1 hour sitting (I still have a quilt to finish!); followed by movement and exercise for 20-40 minutes. I focus on doing exercise and movements that will flex and stretch the knee to promote blood flow and fluidity of movement. I go for a walk,  (Yay!), and I go to the store to get m prescription refilled.

I am to check with my doctor again in 7 days. I have also decided to put a castor oil soaked bandage on the red spot at night, to promote healing and to keep the skin soft. I don't know if this is wise, or if it will help. But I have used herbs and natural remedies for many years, and castor oil is supposed to be good for healing infection. I have used it in the past for bruises/muscle strains. 

Days 31 - 33

Even though today is Day 31, I am going to get ahead of myself today. I am still resting and allowing my body to fight the infection. There isn't going to be anything new to add until I see the doctor again at the end of Day 33. So....there is nothing to report for the next three days: just more of the same: rest, rest, rest-fight off frustration and boredom--and try to keep a positive focus and expect a good outcome. 

I may finish that quilt yet!

Day 30

Sit, sit, sit. I am so very tired of sitting!!! I really had expected to be fairly back to normal by now. I feel too good to be so sedentary. 

The good news is that the infection seems to be going away. When I do get up to move about a little, I can walk quite normally. The staircase is getting easier to manage, although I still cannot go down the stairs with alternating steps. 

I want to share a little tip on stairs: Going down backward is easy on the knees!

I spent 15 years teaching step classes. One of the first thing a step instructor is taught is that stepping forward off the step bench during exercise is very dangerous and damaging to the knee, but backing down is safe and not damaging.

During my 6 years as a personal trainer, I worked with a number of clients who were recovering from knee problems, or had joint replacements. One of the things that was always a challenge for these clients was going down the stairs. I always encouraged them to (carefully!) back down stairs to take the pressure off their knees. 

Since my surgery, I have needed to go down the stairs in what I call "baby steps" - bad-foot/good-foot for each step. The problem is,  my "good" knee was taking a beating! I live in a two story house, and even though I try, sometimes, I just need to go up and down during the day. 

So when I felt I could try it, I tested going down the stairs backward, with both hands on the rails, watching closely my foot placement, and leaning forward so that my glutes have to take the weight. It didn't cause any pain, so I have been backing down the stairs since then. 

IF YOU WANT TO TRY THIS: it is ESSENTIAL that you can hold on firmly and go slowly enough that you don't fall!!!

Day 29

I saw the doctor again this morning. The infected spot seems to be a bit better. It has been draining on the bandaids, and the area around it isn't quite so red and puffy. My doctor is pleased and feels that the antibiotics plus the povidone/iodine--antibacterial ointment--bandaid treatment are doing the job. 

I am to continue that process, and stay inactive for another 5 days...I may finish this quilt yet!! I sure am glad I have plenty of movies to entertain me, and the doggies are good company. 

Word to the wise: if you work in an office, then it is reasonable to be pretty much back to normal in 30 days; but if you have a job that requires you to be on your feet, or have a very active lifestyle..better allow at least 6 weeks to recuperate before you expect to be back to normal. 

I'm glad that I have two more weeks before I have to be back teaching my line dance class, althoug I would be thrilled to be back to teaching now, I am not read to do so.

Day 28: Boredom of a sort

I spend the day doing pretty much nothing, sitting with my feet up, and the doggies on each side of me on the couch. I feel a bit bored, because I finally am feeling like I want to be more active and doing things about the house. Up until now, I have actually enjoyed the inactivity.

I have been busy all this time, mostly doing needlework: I made 3 sweaters for the doggies, a shawl for me, and have been working on the decorative stitching of a quilt. Until the last few days, my brain has been a bit foggy, and I have enjoyed working my way through our video library. 

The spot at the base of my knee is sensitive to touch, and the redness has spread a bit. It feels quite hot. I am taking antibiotics, and eager for the day to pass. I see the doctor again tomorrow morning, and look forward to hearing good news...and fear hearing bad news. I don't know what the next step might be if he thinks the infection is not just a stitch. Not knowing creates fear. I push it constantly away from my mind. 

One interesting thing: I asked my doctor for the surgical report...very interesting to read through. Now I understand why my shin has felt bruised....it is! 

Day 27: Set-Back

My incision continues to be itchy and stiff. I am massaging it, and gently rubbing it to desensitize and soften it. But this morning I noticed a red bump on each side of the incision at the very base. It isn't very big..but as I massaged it mid-day I found a tiny bit of pus coming out of it. So I canceled going to Zumba Gold class (bummer!) - and called the doctor. Then waited until late afternoon to go see my doctor.

His assessment: "It is not unusual for this spot to have a problem, because there isn't much blood supply here. If we are lucky, it is just a stitch that hasn't dissolved yet. If we're not, then we have a joint infection." 

He didn't say what happens if it is a joint infection, and I am not asking, because I am hoping for the best! So it's shower/betadyne solution/anti-bacterial creme/bandage for the next two days, then I see my doctor again.

It is quite uncomfortable, and a bit discouraging, as I was just starting to feel like I could move about a bit more, and now I need to be "very quiet" - not quite "go to bed" - but close to that. And no more Zumba for "a couple weeks." 

Bummer! - - - - but hoping for the best; and for now, back to my couch.

Day 26

Not much to report today. Still feeling the frustration of wanting to do more, and not able to do so. I did manage a half mile walk...in two pieces: one in the morning and one in the evening. But each time I get back to the house huffing and puffing like I normally would be at the end of 15 minutes of medium-high intensity low-impact aerobics! Disgusting. 

Must practice a LOT more patience!! 

I spent part of the day locating a physical therapy out-patient clinic. So at least that job is done. I am on my own though, for a week and a half.

Day 25: Mother's Day, 2013

I wish I had known how tired I would still be at this point of recovery! I would love to take today to hop in the car and go spend some time with my mom. Fortunately, my mom is a sweetie and has had both knee and shoulder replacements, and understands recovery.

So. Another day of laying around on the sofa. I took a bit of a walk, got tired. I had visits from my children, a phone visit with my mom. My son came and cooked barbecue dinner..scrumptious! And sitting at the table for half an hour, the thermometer at 80 degrees inside and 92 outside, was enough to send me back to my couch to put my feet up. We all had a good time, and then watched the ending of the movie "Ever After" together. It was a GOOD day.

Unfortunately, at this point I am daily fighting frustration, because I want to get busy again, my brain fog is clearing, but I am quickly reminded that my body is just not ready! Fortunately, I am surrounded by people willing to remind me to take it easy and heal.

I am moving better, and the scar is softening and allowing a bit more movement. The outer side of my knee, where the prosthesis is, has a funny kind-of-numb feeling. The bottom of the scar, and the spot where the IT band was detached and reattached is still very sensitive to touch. 

For a page with a good illustration of the IT band, click here.

Day 24: Sabbath

What a lovey morning!!! I awoke to find that the sheet on my knee didn't bother me at all! It feels so lovely, that I just lay in bed and enjoyed it. Then I sat up to read a bit, and when I did, I pulled both knees up to support my iPad.....wow! It bent!! Without any effort at all! And no sense of having to work to hold it in that position.

Now THAT's what I call progress! So apparently the "desensitizing" and the massage worked wonders. 

I will be playing my flute at church today. Church is quite a challenge, especially since I still don't feel up to sitting normally yet. 

Everyone is so happy to see me and how well I can walk. However, in the process of getting ready driving over, visiting before services, I am quite tired by the time church starts. After I play, I move out and sit in the lobby to listen to the rest of the services from there. That way I can sit on the landing of the stairs, with my legs extended and lean my back on the wall. It's more comfortable than you would think! 

After services, I visit with a few more people before heading home to grab an ice bag and put my feet up.. It has been a good day. This is probably the most activity I have had yet. It's amazing how tired I am!

Day 23

Today was my last at-home physical therapy. I have to say I thought I would be much better by this point in time. I really expected to be back to almost normal in a month. This may seem unrealistic but considering my fitness level and background, I just expected to heal much faster.  

So this is my reality: I still spend most of my time sitting with my feet up..not above my heart, but level with my hips. (I have had very little swelling. If I had more, then I would be long down with my feet above my heart.) I can manage about 90 minutes up and about, and then I am quite tired and need to rest and apply ice. 

I can't bend my knee much beyond 90 degrees without feeling a lot of resistance from my incision, and it is so sensitive to touch that even the sheet laying across it at night is painful. The area where the new joint is in place is mostly numb. The spot on my shin where the computer leads were feels bruised. The spot just below my knee where the IT band inserts feels bruised. I can walk without a limp...as long as I think about every step.

Today my therapist taught me how to "desensitize" my scar..by gently brushing it with the softest fabric I have available. I think I am going to go through the roof as she demonstrates this technique for 2-3 minutes! 

And she showed my how to gently massage and move the skin on each side of the scar to loosen up the scar tissue which has developed as a natural part of healing. This process will ensemble the scar to stretch and help me to bend my knee.

I still need a lot of help! I hope my insurance will consent to out-patient physical therapy.