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.