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!