Small steps (7 months)

This post is for me.  Something to look back on to remind me of the progress I am making.


Rode recumbent bicycle 29 minutes--7.5 miles
850 steps on the recumbent stepper
Up to 2 whole minutes on the elliptical and watching every second
Bridge exercise where I could lift my butt off the mat a few millimeters when I started can now be done exactly as it should be.


Feet are much improved after 2 weeks of treatment.  Hope to have complete recovery when I go back to the doctor in 2 more weeks.

What can you do when your feet hurt?

Notice where the ties begin

Insoles

Two steps forward, one step back (6 months)

Not much new to report.  I guess that's good.  I have been venturing out in public more without my cane, so that's a plus.  I noticed that going to the gym was no longer causing me discomfort and difficulty walking afterwards.  So today I ramped up the repetitions and weights a tad, and I am back to square one-- wished I had had my cane to use when leaving the gym today!  I went back to physical therapy for a tune-up.  My feet have been killing me since I have been so much more mobile.  We decided that it could be from a redistribution of weight after my leg bones returned to their normal position (see "before" and "after" x-rays), and my feet have to readjust.  I've been getting ultrasound treatments which have helped tremendously, but the old feet are still very problematic some days. Because of my foot pain, I have quit doing my treadmill walking for balance, so hopefully I won't lose much of that progress. May have to see a doctor if the foot pain persists because it is definitely slowing down my progress.  I also needed some stretching of my hamstrings.  I think I had slacked up on some of my exercises thinking I did not need them anymore, so I was given a couple more to do and told which of my old ones that I needed to be more diligent about. I still see small advances every week; they are just not very dramatic.

Some exercises that have been helpful to me (Almost 6 months)

NEWSFLASH! THIS IS HUGE! (5 months)

What a gorgeous day for deep water aerobics!  The water was sparkly and blue, the water temperature and air temperature  were perfect, the sun was warm, and it was a thrill to get back in the water.  My Y pool has been closed for the past 3 weeks for repairs, and I sorely missed my water class.  So for the past 3 weeks, I have gone to the gym 6x's/week.  I did a mixture of recumbent bicycle, treadmill, recumbent cross trainer, leg curls, leg extensions, leg press, and 33 seconds on the elliptical  for which I was obviously not ready.


To enter and exit the pool, the Y has this handy chair lift that has a chair that I sat in, and I would gently go down into the water in the chair.  I had been fearful of slipping on the steps and bending my knees, so this was great.  Then the process was reversed--I sat in the chair already in the water, and then I would be lifted out.  Yeah, it was embarassing, but hey, I got over it in a hurry.


After 3 weeks of working on the machines, I GOT OUT OF THE WATER BY MYSELF!!  The lifeguard had set the extremely heavy chair up for me, and I told him that I thought I could get in by myself, but I might need the chair to get out.  After doing my stair exercises, I decided to see how many I could climb.  Two stairs were the most I could do the last time I tried.  Breaking that water barrier where my strength was required to do the rest was amazingly easy to do.  There was no one to share my joy with except the lifeguard, and I think he was bugged that he had lugged that heavy chair and set it up for me for no reason.  

(Keep in mind these are not the steps built into the pool that are straight up and down.  They are stairs that descend at a slope with 2 handrails.)

Can't walk and chew gum (5 months)

I'm not quite that bad, but since my left leg is weaker, I am a bit unbalanced when I walk.  I had no idea that balance was a problem since I was still using my cane some.  Until I can handle curbs and stairs without assistance, my cane goes out in public with me.  Walking on uneven ground also presents a problem.  My dear ol' cane has probably prevented many a spill!  I have been walking on the treadmill since my graduation from PT. When I first started out on the treadmill, I just walked holding on for dear life. (at a whopping speed of 1.2 mph)  Then I gradually would let go and let my hands hover above the hand supports because I needed them frequently.  I am proud to say that I am now walking 40 seconds out of every minute with my hands to my sides. (and smoking at l.4 mph)  BUT, here's where the title of this posting comes in, I have to give it my total concentration.  If I glance up at the TV, I teeter.  I have to think--heel first, roll to ball of foot, and left arm swings with right leg, right arm swings with left leg....

Things I ponder...

I'm always wondering if it's normal to not be able to do something or to feel something, so I will jot down some of these in case there is someone else wondering the same things.


1.  I wonder if my knees should still be this stiff?  It's a different kind of stiffness than I had before surgery, but I sure would like to come out of this with none.


2.  I wonder if there will always be some movements that will cause me pain.  There are times when I move around in bed that I am very aware of my knees.

3.  Will I be able to kneel?  Will I be able to squat?  Am I expecting too much?


4.  When will I be able to descend stairs without pain?  Going up isn't always a lot of fun, but going down is definitely not without pain in one knee.


5.  When will I be able to walk without listing to one side?  I really want to have a normal kind of walk.


6.  My left knee does not extend as well.  Will this always be the case or can I expect both knees to be more similar?


7.  Are most of my knee problems going to resolve with increased strength? 


8.  When will I have more stamina and be able to walk more than 6 laps on the track without paying for it later?


9.  When will I be able to get up out of a chair and immediately start walking without having to wait for my joints to lubricate first?


As you can see, my impatience is rearing its ugly head again. Afterall, it has only been 4 1/2 months since my surgery.  I plan to answer each question when I have an answer and repost this if and when I have the answers. 

BLOG update

I am so amazed.  Being the computer challenged person that I am, I only recently discovered the stats for this blog. As of today, there have been 1,011 pageviews from 10 different countries!  I realize that most of these pageviews are from people who know and love me, but the really crazy thing is that some people actually found this blog through Google and not Facebook!  I realize, too, that most of the people reading this do not have trouble with their knees, but my hope is that they will pass it on to their friends and family who do.  My sole purpose in doing this was to offer hope, encouragement, a little education, and support to another traveling this same road.  It helps to know that one is not the only person going through or has gone through something.

Knowing what I know so far, would I get knee replacements again?  Without a doubt.  Is it a lot of hard work?  Absolutely.  Do I get tired of exercising every day just to have to recuperate from my exercise? Yes, every day.  I delight daily in the new things that I realize I can now do or can do better than I could do last week.  Just today, I realized that my yoga routine was automatic again (less worry about my foggy brain) and that I could for the most part do this yoga position without too much discomfort.

I have tweaked the blog to make it easier to find articles which I have recommended for preparing for surgery. There is also a gadget at the top to make sharing the blog easier. I hope that these and other changes will make this blog user-friendly.

"Give me a 'K'..."

I'm beginning this post not sure that I will complete it or post it, but I'm thinking this stinkin' thinkin' might help someone else down the road.  Last week was a great week; I could really tell that my quads were getting strong and walking was so much easier.  The past 4 days have not been so great, and I'm not really sure why that it so. Maybe I am doing more than I realize.  Maybe my muscles are fatigued.  Maybe it was tromping around on the rugby field last week-end. (obviously as a spectator) Maybe it was too many repetitions on the machines. Maybe it's because I have gotten slack on my PT exercises, although I am doing some form of exercise everyday.  Consequently, I am feeling a little bummed--make that moderately bummed.  Crying would be cathartic.  Walking actually hurts some today.  It's been a long time since walking hurt. (just one knee, the slower healing one) I just get SO impatient.  I want to be totally well-- yesterday.  If I knew for sure that the ups and downs are normal, I could try to be more positive.  But I go immediately to the worst case scenario in my mind--that's just the way I am.  Drives my husband crazy.

OK, I'm going to post.  If you've had a knee replacement, I need some feedback here.  I could use a cheerleader about now!

4 Months

Today was my 4 months visit with my orthopedic surgeon.  We were both pretty excited about my progress and my new lease on life.  He hopes these replacements will last my lifetime, but I will go in every 5 years to "check the tread."  He says that any problems I develop will cause pain, so unless I experience pain, I don't have to see him again for 5 years!  Hot dog, hallelujah!

The X-rays on top are before surgery.  Notice the insides of my knees where the bones are sitting on top of each other--"bone on bone".  The X-rays on the bottom show my replacements on the insides and the lovely gap between the bones.  Thank God for technology and good surgeons.

GRADUATION (16 weeks)

Today I "graduated" from physical therapy.  It was a four month program-- longer than the 6 weeks I was told to expect.  I still have a ways to go, but I'm going to be doing it on my own except for occasional "tune-ups".  Periodically I will probably have to return to work on the extension of my left knee.  I was sent out with a couple of pages of exercises to increase the strength in my quads and with a T-shirt.  Some days I get really tired of most of my day being spent going to the pool or the gym and recovering afterwards from such activity.  Then other days I see the benefits of said activity, and I rejoice.  Like last  week.  We went to New Orleans to see the WWII Museum, and I thoroughly did that museum.  We got there at 1030 and shut the place down at 500.  Granted, I sat on every bench in the place, but I never would have even considered going to a museum a year or so before my surgery.  I did hurt a bit that night, but nothing that ice and naproxen couldn't help.  The next day we went to the aquarium, but I fizzled after about 2 hours.  I watched the penguins for a long time while my guys saw more of the aquarium.  Secretly, they were probably very glad that I was not up to my usual museum compulsions, i.e., no sign left unread, no exhibit not viewed.

$140,083.96

I still have my 4 month check up visit coming up and my last physical therapy visit, but this is the grand total so far for 2 new knees.  WOW!  I'm sure there is all kind of social commentary that could be made about the cost of health care, blah, blah, blah.  I am very thankful for my husband's job and his medical insurance.  I have a lot of reasons to take care of my new knees, but now I have 140,000+ more.

In the best case scenario, my new knees should last about 20 years if I take care of them.  The analogy was made that my new knees are like a new car and a teenage driver.  If the car is driven reasonably and carefully, the car will last much longer than if  the car is driven "hard".  With my new knees, I cannot run.  Not a loss.  With my new knees, I cannot play basketball.  I'm too short anyway.  With my new knees, I cannot play singles tennis.  I can play doubles tennis, but I didn't do that anyway. Of course, contact sports are out, but I'm too old for those anyway.  So activity wise, my knees should last.


Now, the biggest problem as I see it--my weight.  I lost close to 18# before my surgery.  Immediately after my surgery I lost tons because I had no appetite.  But about 6 weeks after surgery, my appetite returned with a vengeance, and I catered to it since I had lost so much weight.  Now it's time to rein it in, and get back on the program.  I am back at Weight Watchers, and now everyone knows it, and I will be more accountable.  You see, in the past, joining WW was always something I did quietly.  That way, if I failed, no one knew it. I cannot believe I am going public with this, but maybe that's just what I need to do.  I really believe that with lifestyle changes over time, I can do this.  I also know that if my vigilance to good choices is meshed with real life, I will be more likely to stick to my weight loss goals.  Give me a couple of years because I have lots to lose and lots of life to live in the meantime.

Yoga--check (14 weeks)

For the past 10 years, I have done a yoga routine nearly every morning. www.gaiam.com/product/am+pm+yoga+for+beginners+dvd.do My muscles tend to be tight, and yoga has increased my flexibility remarkably.  Towards the final days before my surgery, I had to modify my routine so that I did not have to get up and down from the floor so much.  I did all positions on the floor before doing the ones that got me off the floor.  Obviously, I have not done yoga since my surgery before today.


You probably don't remember, but before my surgery I posted what my goals were for 2 months post op, 4 months post op, and 1 year post op.  Next week I  will be 14 weeks post op so I am quickly approaching my 4 months anniversary.  My 4 month goals were

1.  to get back in the pool and on the bicycle--check (didn't dream that they would have me on a bicycle before I even left the hospital!)
2.  to be able to get up and down off the floor

I have had a terrible fear of falling and not being able to get back up. ( sounds like a potential commercial!)  First of all, I have heard that falling on knee replacements hurts way more than falling on your natural knees.  Secondly, I felt pretty sure I would never be able to get back up since I have 2 affected knees.  So last week I asked my physical therapist to teach me how to get up if I were to fall.  She said that they always teach that to amputees because they will fall someday.  I then felt a little bad that I was so concerned since I at least had 2 limbs to work with.  We went through the motions, and I realized  that I could do it if I had to do so.  Since then I have been wanting to try to do my yoga routine, but I didn't want to do it the first time alone in the house.  I wanted someone there if I needed help, but our schedules never synced.  So this morning I worked up the courage to get myself down on the floor--probably the scariest part.  Was I going to have to stay there until someone came home?  Oh wait, I would have to pick up Rick and Brad today; no one would be coming home.  Silly me, I forgot to bring a phone down on the floor with me.  Slight panic.  When it was time to get up, it required a lot of forethought and getting up the nerve to put my weight on my knees in a kneeling position.  But I did it!!  And I was grossed out at how tight my joints and muscles had become since the day of my surgery.


Having done this yoga routine for 10 years, I could do it without thinking.  Just go on automatic pilot and let my mind wander.  It was disconcerting today that I could not remember the order of the routine.  That's one of the things that I have noticed since my surgery.  My brain is still in a fog.  I don't remember with certainty things that I think that I should remember.  I'm not always sure if something really happened, did I think it?, or was it a dream?.  I still have trouble with concentration. I can no longer blame it on taking narcotics, so it is a bit of a concern.  I know that I have improved brain-wise in the past few weeks, so I am hopeful that I will continue to progress in this area.

NEW KNEES--THE GOOD ONLY! (12 weeks)

It has been a fantastic past few days.  Monday began my 12th week post op.  On Sunday, I did a HUGE grocery shopping--the cupboard, frig, and freezer were bare, and we were tired of eating out.  Granted, my husband pushed the basket and loaded and unloaded the car, but I spent well over an hour walking around the store and picking items. Then I had to put everything up once we got home.  MAJOR milestone.  Then on Monday I returned to my water aerobics class;  it was so great to see all my water friends.  I could not keep up with them, but I gave it the college try, and even stayed about 45 minutes after class to do specific physical therapy exercises.  It did NOT kill me or wear me out.  Tuesday I went to physical therapy and for the first time was able to balance on my left leg.  My left leg is what is holding me back.  In the hospital I was literally dragging it around--really kind of scared me that it was so affected.  The left leg has caused me the most pain and is an albatross as far as weakness is concerned.  Balancing all my weight on the left foot was so EXCITING to me and my therapist! Then I went to the walking track and did my four laps 2 or 3 minutes faster than the last time.  WHOO HOO!  I even came home and did some cleaning around the house which was amazing.  Today after water aerobics, I even went shopping to 3 stores. It was FABULOUS to not hurt with every step!!!!  It has been probably a year since I went shopping; if it couldn't be bought online, I didn't need it!  


I have really needed all these positive experiences.  The progress is so small on a daily basis, and it so wonderful to see all my hard work pay off in such a big way.  Oh, and thank you, Dr. Tabor!


(If balance is an issue for you, doing it in the pool is great.  It's a lot harder than on land, but it doesn't hurt.)

Practical Matters

I have been thinking of some practical things that might help someone who is following me in this knee replacement journey.  I am venturing farther and farther away from my home these days, and it requires some forethought.  First, I have to be concerned with the seating.  If the chairs are too low, it is really uncomfortable and sometimes painful to get up.  In restaurants, I have found that a chair is better than a booth.  The chair needs to have some working room around it--don't choose one too close to someone at another table. Sometimes a flattish pillow that will raise me up about an inch will be all that I need for some chairs.  That can be carried around in a tote.  Also, there is the commode issue.  For us ladies, a commode too low in public presents the same kind of issues.  At home I have a commode chair that fits over my commode with handy arm rests to use for getting up.  My literature from the hospital said that I would need that chair for 12 weeks.  I'm thinking that timing will be about right, but until I no longer need it, planning is involved.  I don't venture too far from home--it's not unusual to come home for a pit stop before finishing my errands or whatever.  I never leave the house without visiting the bathroom first.  If in doubt, I'll check the bathroom facilities for placement of handrails and the height of the commode before spending too much time in that establishment.


Have I told you more than you wanted to know?

Learning to walk (11 weeks)

Check out my walking sticks--a few seconds walking slowly and listing to the side solo, then using my walking sticks!  My therapist wanted me to walk with these to increase my cadence and create a more normal gait than the one I have with a cane.  It does feel more liberating to use them although I feel really ridiculous in public.  Going out in the snow made me feel really silly; it was as if I thought the snow might get deep enough to need them! 


This is an old story, but I think it is significant.  Before my setback with physical therapy, I went to the Y at St. Francis Hospital one day to use the machines for my core and upper body.  As I strolled in with my walking sticks, there were a bunch of older men on most of the machines I wanted to use.  I walked determinedly to an empty machine in the midst of them, and one guy speaks out with, "Are you going skiing?"  I turned to him and announced very excitedly that I had 2 new knees.  Then the room erupts with, "We do, too!!!!"  I became an instant member of a knee replacement club!  Everyone wanted to tell me his story, tell me how to use the machines more efficiently, blah, blah, blah.  My son had driven me there, and he was astounded at the camaraderie that had developed.  There was one man on the elliptical going 90 to nothing that had had 2 knee replacements at the same time like I did. ( most of the others were spaced out by several months)  He became my instant role model.  Recently when I was in so much pain and discouraged, I told my husband that I wanted to be like the man on the elliptical.  He wisely said, "Let's see, he had his surgery 4 years ago.  That's 52 weeks times 4--so he's over 200 weeks post op, and you are, um 6." Lesson learned.

Patience is not my strong suit (9 weeks)

Towards the end of last week, 8 weeks post-op, I really began to pick up in what I could do.  We foolishly got involved in a remodeling project that created so much dust in our house.  We were completely surprised by all the dust that was created by replacing floors.  We knew refinishing floors caused huge amounts of dust, but removing flooring and replacing it was just as bad.  So now I am faced with removing massive amounts of dust on everything in every room!  I surprised myself by how much I got done.  What I accomplished is only a drop in the bucket, but before last week, I usually worked for 10 or 15 minutes followed by a 30-45 minute rest before repeating.  I also went 3 whole days without narcotics.  Another biggie.  My toddler gait became a little less wide spaced, and I was really cruising in the house.  I was feeling pretty good about my knees and my progress.


Then yesterday, I ran into a friend who had a total knee replacement 3 weeks after me.  She was walking GREAT and gave up her narcotics long before me.  I was thrilled for her.  But then....I went home and got into a funk because I was hurting and needing my cane and was feeling sorry for myself. I wanted to be doing as well as she was. I finally gave in and took a pain pill last night and life looked ok again.  Guess if I still need pain pills, I should not be resistant to take them.


Today at the pool, a man started up a conversation about my "fresh scars".  He wanted to know all about my whole experience, including measurements of flexion and extension.  He then told me how great I was doing.  He, too, had had knee replacements, and he said that he was at my level at 9 months, not 9 weeks.  Guess this man was placed in my path to remind me that we all heal differently and at different rates.  I will continue to try to be patient with myself.

I'm on my way! (8 weeks)

This week marks  8 weeks post-op.  My 2 month goal was to walk unassisted in my house, and I have reached my goal!  The other day I was getting out of my bed, and I looked around and wondered, "Where is my cane?  Surely I didn't leave it in the kitchen!"  So I got out of bed, toddled to the kitchen, and hallelujah, there was my cane resting against the counter!  Since then I have consciously walked around my house some without a cane every day.


Today I walked 3 laps on the walking path in 11 minutes.  Before my PT setback, I had walked 2 laps in 10 minutes! I am feeling again like I have turned a corner.  As long as I can keep my physical therapist from knocking me down, I feel like my progress is going to increase, not necessarily exponentially, but certainly at a steeper rate.  Yay me!!

A reality of rehab (7 weeks)

It's been almost a week.  Last Friday at physical therapy, my therapist worked me really hard.  I knew I was in trouble when I could hardly walk out of there! I could not wait to get home and get in bed to wait for the throbbing to go away.  For the next 4 days, I could barely walk.  Both knees hurt with every step I took.  If I had been sharper, I would have reverted to my walker, but that thought never occurred to me.  I miserably walked around with my cane and left my walking sticks by the wayside.  Going back to the cane was a real psychological setback. (I just realized that I have not mentioned my walking sticks prior to this--I'll post about them next.)  I was in significant pain for a full 4 days, and the past 2 days have been less painful.  I saw my PT yesterday, told her I was not a happy camper, and she said, "that's not supposed to happen, but sometimes it does." Makes sense that I have to be tested, but I truly feel like I was set back 3 or 4 weeks.  The real bummer was that that very morning when I awoke, I realized that I had slept all night for the first time since my surgery!!  I was elated and felt like I had turned a corner in my recovery.  I was delighted that I had slept all night because I had not been bothered by pain. I went bouncing into PT and announced to everyone who came around that I was a new woman and that I had slept all night.  I haven't had a good night since.  I'm still taking 1 or 2 pain pills every day, and I'm really surprised that I didn't take 3 or 4 every day last week.

Trying to get straightened out (5 weeks)

I haven't done any posting about my pool exercise.  I've been going to the pool sporadically over the past 2-3 weeks.  When I left the hospital, my doctor in rehab really encouraged it as the best way to rehab.  It requires a lot of energy to get dressed, get there, and come home and shower, but afterwards I'm always glad I did it.  Exercising is tons easier in the water because the pain is so much less.  I do my regular exercises, plus others I have learned in the past from water therapy for a back injury. My biggest problem at the present is my extension or straightening of my knees.  The right is not so much a problem, but the left one is.  I have really worked on the straightening exercises that are no fun on land, but are so much easier in water.  I have been using a noodle under my heel to extend my leg and stretch really good behind my knee.  I have also spent lots of time walking backwards in the water.  My therapist was real pleased to hear that I had been doing that. (I read about walking backwards in my knee book that I recommend.)  Two days ago, my therapist did a lot of stretching of my left knee that was definitely not fun and left me hurting the remainder of the day.  So I was motivated yesterday to go to the pool and work especially hard on straightening my knees.  Today I was rewarded with great measurements.  The right knee measured 4 degrees--0 is the goal.  The left knee measured 7 degrees-- down from my last measurement of 15!!


I belong to the Y, so I am using pools that belong to the Y.  I have since learned that the Church Health Center has a heated pool that is therapeutic for arthritics.  The Y is 84-85, but the warmer pools are about 5 degrees warmer.  I would choose the warmer pools if I had a choice.  By the way, my husband wanted to do a video to jazz up my blog.  No way my blog is going to sport me in a bathing suit!