15 weeks. I had actually lost count this evening when I sat down to write this last blog entry, and was almost surprised when I did the calculation.
My 3-month appointment with Dr. Arendt was last week, but she was stranded in London because European airspace was closed after the eruption of volcano in Iceland. I agreed to see her resident instead, since I really have no problems of any significance. And sure enough, knee flexion is good and only a few areas on either side of my knee are still tender. The lateral numb space is shrinking -- nerve regeneration, I suppose. Because the left knee was quite painful, I asked for, and received, a cortisone shot. It feels reasonably OK now so I may have dodged the bullet for awhile.
It's hard to remember that I used to dread going to bed because pain would either keep me from going to sleep, or wake me many times during the night. No more. Nights are pain-free, or pretty much so. The absence of pain and the new stability of my right knee continue to thrill me.
I know that my recovery will probably continue for another 9 months, but I think that day-to-day progress will tend to be imperceptible until I reach another milestone. That's it till it's time to think about doing the left knee!
I am usually tired at the end of the day, both physically and mentally. However, for some reason, I felt like going for a walk last Friday after dinner. It was a beautiful spring evening, cool but pleasant, and the sun was beginning to fall in the western sky over Minneapolis. I walked west on Goodrich, across Cretin and through the lower campus of the St. Paul Seminary. It was almost dark by the time I reached the north side of Summit, so I decided not to walk across the upper St. Thomas campus, between the new construction and the library.
The walk was effortless and faster than what has been my new slow pace. I was home in no time and thrilled with myself. The next day, Bob suggested a bike ride and I figured it was time to test the new knee on an effort that would require balance and a little strength. I test drove it up and down the alley and decided that I was good to go.
The ride itself was problem free, and the only thing that threw me a little was some fatigue crossing the Lake Street Bridge toward the end of the 8-1/2 mile ride. I also disliked the traffic, but that had nothing to do with the knee. On Sunday, I was none the worse for wear.
Both knees have been stiff this week, but the new knee is decidedly better than the train wreck left one. Yesterday was the three-month anniversary of the new knee. I see Dr. Arendt on Tuesday ... and expect to write the last entry to this blog then. It's been quite a ride!
I've always loved a walk over my lunch hour and now I can indulge myself without paying the price in pain and fatigue. Even though the left knee is sore, I walk and stand easily for an hour, without wondering how I'm going to get back to work. Even better, I sleep fairly well most nights and am not awakened by pain.
Unfortunately, both knees have been somewhat swollen the last couple of days. I attribute this to hours of meetings during the day, requiring me to sit for many hours at a time. This morning, all but 20 minutes of the first 4 hours of the day were spent sitting down. I was glad that I had scheduled two meetings myself, and I allowed 10 minutes after the hour to allow me and the other attendees the opportunity to stretch.
I haven't yet achieved my goal of riding the bike or skating. Maybe this weekend!
One evening this week I realized that I hadn't thought about the new knee since the day before. Of course, the left knee felt like hell, and I was apprehensive about the months ahead with that very problematic joint.
Only the area to the right of the kneecap is still a little tender and painful. The scar looks great. It's totally healed so I've been applying fade cream to it. I'm really not at all vain, but the fact that it is fading makes me feel that healing is nearly complete.
I hope to try my bike this weekend, and maybe the inline skates too. The feeling that I finally have one stable knee is a thrill that I never expected to experience. I walked downtown several times this week and was on my feet for over an hour at at time without being fatigued. Barring some catastrophic event, I don't foresee any problems with my ongoing recovery.
I see Dr. Arendt on April 20 and will tie up loose ends then, ending the blog. I re-read most of my entries the other day, humbled as I thought about the little victories and defeats that have gone into what seems to be a successful outcome. Tomorrow is Good Friday, and I'll observe it much as I did last year. I'm the designated narrator for the reading of St. John's Passion at Nativity in St. Paul. Last year, both knees were killing me during the reading. I think I'll be fine tomorrow, and I am very grateful.
I never imagined even a month ago that I would be as ambulatory as I am. The cane hasn't been touched since we got back from Florida and the knee is pretty good. Unfortunately, the other knee feels like hell and now I know why people often seem to have a second knee done so soon after the first. If I didn't have a job to go to (and I'm grateful that I do!), I would schedule the second knee as soon as possible, even though it would mean no biking for another couple of months. As it is, the earliest I can plan surgery on the left knee will be the fall of 2011.
Last weekend, I was a lector at 5 PM Saturday Mass and I had no trouble processing down the aisle to the sanctuary, though I did ask the other lector to carry the Book of the Gospels. Last thing I need is to trip on the altar steps in front of a churchload of worshipers. I don't mind being the center of attention, but not under those circumstances. No point in pressing my luck, so I did not kneel at all. I'm quite sure now that I'll be OK reading the Passion on Good Friday, and walking toward the altar in the candlelight at the Easter Vigil.
I've been walking over my lunch hour most days, and I think I'll try a junket to Highland Village (a mile or so) sometime this weekend. I can make Wild Birds Unlimited my destination and load up on my favorite birdware and rations. I've been very busy at work every day and I have to admit that I'm tired by the time I get home, though refreshed by mid-evening. My fear of being unable to wrap my mind around work tasks with reasonable intelligence did not materialize, and my stamina is reasonably good.
My one concession to my occasionally hobbled state was the use of a disability parking space downtown St. Paul on Thursday afternoon. I had lunch with my friend Mary Jo, and then headed to a meeting at the Department of Commerce. I drove downtown -- rare for me -- because I thought I might be dragging in the late afternoon, after walking plenty during the day. The decision was correct: I was happy to ride up the hill for the last hour at my desk.
I sailed through the 2-month mark last Sunday, a beautiful spring day filled with sunlight. I cleaned the kitchen and washed the floor, and while I was tired and stiff afterward, I felt fine and went about the rest of my day enjoying the sparkling weather.
My cane has been in the back seat of my car since I returned to work last Thursday. After an easy two days last week, I was happy to be managing the work gig with reasonable success. People were watching me for fatigue and/or a limp, but for the most part, I looked just fine. Yesterday I was so confident that I walked all the way from the Centennial Building to 4th and St. Peter, to see the Saint Patrick's Day Parade. Google reports that the distance is 0.8 mile, a 16-minute walk. I didn't time myself, but the round trip didn't take me more than 55 minutes, and I watched the parade for about 20 minutes, so I was fairly happy with my little adventure.
However, the junket may have been too ambitious. Both my knees were sore by the time I got home, and I did not have a good night. This morning, I was stiff and grumpy, weary from lack of restful sleep. By noon I was feeling quite a bit better and couldn't resist going out for a walk. This time, I simply walked around the park in front of the Centennial Building, past the Department of Transportation on John Ireland Blvd, passing the Capitol and back to my office on Cedar. That walk isn't more than a mile, and there were no ill effects. In fact, I felt fine this afternoon.
I'm especially happy that I don't think about the knee all the time anymore. I can sit at a meeting and concentrate on the subject matter, rather that endure the pain as my mind wanders off topic. The other knee -- I just can't refer to it as my "good knee" -- is often more painful than the right one celebrating 9 weeks today. I walk up and down stairs with little effort and can bend it with ease.
I feel pretty good tonight and am looking forward to an active weekend. I return to lectoring at Nativity for 5 PM Mass on Saturday and don't expect any problems, although I kneeling, even on a padded surface, is certainly out of the question.
Made it through an entire day at work. Most of the morning was spent in meetings, during which I had to sit for a very long time. Sometimes in the past, I felt as though I would not make it through a couple of hours, because of the discomfort, pain and stiffness.
Today I felt fine, with only a little stiffness by mid afternoon. I didn't worry about falling on my head when I stood up, and there was no limp. Unbelievable! I always had to concentrate on NOT limping.
I bent my knees way beyond 100 degrees under my chair. I felt mentally tired at the end of the day but was not dead beat. I think it was a successful re-entry.
Finally! Going back to work on Thursday -- new job as agency technical readiness coordinator for the state's new accounting and procurement system (SWIFT). I'm looking forward to the routine and the new responsibilities, but I'm a little anxious about energy levels and mental stamina. I actually think I've made great strides, literally and figuratively, over the last two weeks so I should be fine.
The best development is improved sleeping: if I can get a good night's rest I think I can hit the ground limping only a little in the morning. Tomorrow is the 8-week anniversary of the surgery so I'll write in more detail when I've made it through the day.
I'm not exhausted at 2 PM anymore, and even in the early evening I can walk with little difficulty. The bonus was better sleep than at home -- last night I had none of the muscle relaxant, Mirapex, and I felt just fine this morning. Hoping that that I'll be just as well when we arrive home on Monday.
Looking forward to going back to work on Thursday! I think I'll be fine.
The last few days have been very active, with a lot of walking (with and without a cane) and swimming. I am still thrown off balance a little when someone shoves me or if my foot catches on an uneven surface, like the deck. I am still tired in the evening (i.e., after about 7 PM), so we tend to have dinner early or, on the night of the rocket launch, not at all.
The knee was a little sore last night, after a day of walking and a lot of time on my feet. Today I was tired out after going through most of the War Museum at Titusville. I finally sat down and didn't go any further, while Bpb visited the last hangar. Now, an hour or so after leaving the museum, I'm feeling fine again.
I think I'm walking without a limp, as long as I concentrate on my stride.
The swimming seems to be very good for knee flexion. My flutter kick -- very slight earlier in the week -- is now quite strong. I swam for an hour yesterday and about 90 minutes today, and I didn't have any trouble getting out of the pool. I had a vision of myself falling on my face walking up the stairs, but I look and feel strong. That's not to say that I don't have a moment of anxiety when I'm ready to get out of the pool.
Some people look at me a little strangely when I saunter -- as much as I can saunter -- into the pool area. Yesterday, a man who had been watching me brought me a chair when he saw that I was going to get one outside in the bar area. I'm learning to accept such courtesies, with whatever grace I can muster. Today, I could see that one lady was trying to figure out what my problem was, so I went out of my way to tell her. I know how it drives me crazy when I have a puzzle like that to solve.
I wish I could measure the number of degrees I can bend now. It must be close to my 120 goal. I can lie on my side and pull my lower leg fairly close to my body. The best new development is that the knee is not very painful at night so I can sleep for a couple of hours at a time. I think the lack of good sleep was at least partly responsible for my inability to concentrate on any task for longer than a few minutes. I was a little afraid, at some level, that I had suffered some cognitive losses due to MS. I'm happy to report that cognition seems OK! Whew. Dodged the bullet once again.
We spend several hours at Daytona's famous Bike Week today. Although I walked a lot and spent a lot of time in the car, I feel pretty good this evening. The weather is windy and cold, so I didn't get my swim today. I was very tempted this evening, but I am afraid of tripping in the dark on the uneven deck of the hotel, so I decided not to risk it.
I realized one of the reasons the knee was catching so much the first few days we were here. Overuse is one reason, but the other is that getting in and out of the car strained the inside of the knee. I am used to pulling myself into Bob's Yukon, with little or no strain on either knee. The Impala requires a big step into the car, strain on the less than good left knee, and then a swing of the right leg. In the beginning, I could lift the right leg without straining the knee itself, and I think I irritated that "bad" area on the inside.
I'm not exhausted by 9 PM anymore, and I even made it to about 10:30 last night. Going to bed later seems to improve my chances for a better night's sleep, as does this very comfortable bed. One of the projects when we get home is a new mattress for our bed: the one we have is too firm for comfort. It was a mistake when we bought it however many years ago (7 or 8) and I think a new mattress will add to our general wellbeing.
I walked several hundred feet outside without the cane today. It felt fantastic!
We spent most of this very pleasant afternoon by the pool. There was a very active family of three boys playing in the water when we arrived, and I felt a sudden surge of panic as I contemplated getting down the stairs into the water. I was also a little self conscious: the cane and my long scar seemed so conspicuous. I'm not sure that I've ever seen anyone leave a cane poolside while swimming.
Fortunately, common sense prevailed and I was soon in the pool. I forced myself to tread water and to do some knee bends during two sessions in the water, and I felt quite strong by late afternoon when we headed over to the beach.
I ditched the cane and headed over to the water, still in my beach cover-up. I was tempted to take it off, but I feared the admonitions of my vigilant keeper, because walking toward the water in a swimsuit would have been a step away from a swim in the ocean. The waves are not very high, and I'm pretty sure that I would be fine in the surf. The water is a little cold, and only the bravest of little boys are swimming. I can hardly stand it.
I walked at least half a mile today. Nothing for my old self, but significant for the new me. I went without a cane on the beach, and I felt my balance improving with every step. I wonder if I'm not getting a little too cocky?
The sun shone brightly today and I headed to the pool in the late afternoon. I'm not sure that I've ever seen someone show up at a pool or beach with a cane ... but there I was. I slipped into the water as easily as I did in the Dominican Republic two months ago, and it felt so great!
I swam a front crawl a little tentatively, afraid that a kick would trigger the medial "catch", but the stroke was as natural as it has been all my life. What a liberating experience! Treading water using the "bicycle" kick was effortless and painfree. In the water, no one would ever have guessed that my knee replacement surgery was only 6 weeks ago.
I walked a lot today, both before and after the pool. I almost forgot my cane twice, but I was grateful for it on uneven terrain at the Merritt Island Nature Preserve, and after dinner this evening as I walked down the ramp leaving the Cocoa Beach Pier.
The cold air on bare legs has cooled the usually warmish right knee.This was a good and successful day.
Most of the time, the knee feels as close to fine as I could hope for at this stage of my recovery. Yesterday, the pouring rain and numbing cold discouraged outdoor activities so we spent several hours in the car. The right knee was not much stiffer than the left, even after several hours of sitting.
My sleep has improved a lot in the last few days, partly the effect of travel fatigue but also because I'm in a lot less pain at night. However, with increased activity, I've noticed that the knee "catches" a lot more on the inside, especially at the end of the day. It's hard to explain what "catching" is to someone who has never experienced it. Conversely (or do I mean "similarly"?), anyone with a knee problem immediately grimaces when I use that word.
A knee "catch" reminds me of a bicycle chain that fills with grit after a long ride on sand or gravel, reducing the efficiency of gear changes. The pain starts sharply, but doesn't resolve until the knee joint returns to "neutral", a procedure that requires movement over what seem to be uneven surfaces, causing a wave of pain and some temporary residual swelling.
Last night, there were perhaps 6-8 catches before I went to bed. I dread the first catch! We'll see how today goes. I intend to hit the pool sometime today, as soon as the temperature gets out of the thirties!
Yesterday afternoon, we went down to the hotel deck because we were afraid of simply crashing in our room and missing the beautiful sunshine. In my dazed state of extreme fatigue, I forgot my cane! I decided to go forward anyway and found myself walking almost normally. The limp is giving me some pain in my back and right hip, so I'm especially anxious to lose it if I can.
I couldn't resist taking the walkway to the beach, and once there I had to walk across to the water. I was pleasantly surprised to feel my quad muscles reacting as they should, pleased with greatly improved stability, possibly because of 6 weeks of experience on ice and snow. I did tire a little, and needed Bob's hand to hold on the way back from the beach.
By yesterday evening, both my knees were so stiff that I wondered whether I had done some permanent damage. However, a good night's sleep on a very comfortable bed has done its magic. The knee, thigh and calf muscles all feel strong this morning. Knee pain is moderate but not "threatening" -- don't think it will get worse today.
I was wide awake at 2 AM, fretting a little about the folly that impelled me into the Cocoa Beach junket. I worried about the ice in front of the house, getting in and out of the cab, navigating MSP, and a multitude of other concerns. We left the house before 4, and getting to the airport proved to be as easy as it has been in the past.
Lindbergh Terminal -- son to be Terminal 1 -- itself was as close to a nightmare as a person using a cane, or someone otherwise physically or mentally challenged in some way, could ever imagine. The check-in line was very long, and nowhere was there the promised baggage check-in for people like me who had already checked in online, and paid to check 2 items of luggage. The line took forever, and then we had to start all over again with security.
There was no special accommodation at all for me, or for the very pregnant woman, or for several couples with very young children, some of them looking unhappily roused from sleep. Instead, we all trudged through the line, slowly making our way to the security checkpoint..
I had never been through security before with the new knee. Of course. the alert went off loudly and I was ushered to a small holding pen, the kind you might see at a hog market, where pigs with suspicious credentials might be quarantined. In time (a long time on this already long morning), a female security officer arrived and explained the protocol that would be part of my post-knee replacement security routine. I have read complaints by others about the intrusive procedures, but it all seemed OK to me -- if only I could be sure that such measures actually do deter terrorists!
Unbelievably, we headed to the wrong gate, G22, the gate on our boarding passes, at the very end of the G concourse. Even with the moving sidewalks, it was a very long walk that taxed my diminishing energy reserves. We soon discovered that we had to walk all the way back to G3, and during our trip back we kept hearing "last call for boarding" announcements.
Finally, we were aboard and soon underway. I had to get up several times to stretch my legs but the flight was otherwise uneventful. We did a little useless walking in the Orlando airport but baggage arrived promptly and we picked up our car. Thanks to my friend Jim Darling's advice several years ago, I had checked in yesterday and it was was so easy to simply pick up and ride.
I think the next 10 days will be very restful and helpful to me as I try to improve my energy management. I would not, however, recommend flying to anyone only six weeks post-op, except in an airport where there is some accommodation for a person with limited mobility. Or maybe it's just MSP: service at the Delta counters seems greatly deteriorated since the merger with NWA. I heard a flight attendant tell a passenger that her salary was 40% lower than it had been a few years ago -- I wonder what other factors might have contributed to lower performance and poor customer service?
An objective evaluation of the knee six weeks after surgery yields a positive overall impression: I walk well, have good balance and my mobility improves daily. I think I'll be very happy this time next year, but I do wonder why pain can still be quite debilitating. Is it because I'm a big baby who also avoids pain medication whenever possible? Or do I simply have a tendency to "overdo" -- like Christmas Vacation's Clark Griswold?
Like Clark, I've been known to overdo, so that is probably the explanation. I do know that I don't want to end up like some of the people I know who claim to be very satisfied with TKR results, and yet they can't seem to do more than walk around the block.
We'll be leaving for Cocoa Beach, Florida, tomorrow morning. I intend to spend the 10 days we're there as wisely as I can, with the primary objective of improving my stamina and increasing the distance I can walk. When I return to work two weeks from today, I'll have to be able to walk more than a few hundred feet without needing to rest. I also hope that the cool weather in Florida will give me an empty pool to work in! I love to swim laps, especially in the early morning, and I have a full complement of pool exercises to help with balance and knee flexion.
I'm beginning my re-entry into normal life, with only a little apprehension about a 3+ hour flight to Orlando. If we're lucky, the plane will leave on time and we'll be able to get our rental car right away. I have my fingers crossed.
Monday was a physical therapy day and I was encouraged to be able to add some resistance to the pedals on the stationary bike, and leg press 80 pounds. I started with 40 pounds 5 weeks ago and have been adding weight and increasing the number of repetitions ever since. Am now bending the knee to 115 degrees. I went out to Kohl's and Target in the afternoon, and was not too tired when I got home.
As usual, the knee was hurting big time last night and I caved and took one of the narcotic painkillers that were given to me when I left the hospital. I still didn't sleep well until it was almost time to get up, later than usual at 6:30.
Today, the knee is stiff as it usually is the day after PT. I went out with Bob this morning, and then we had lunch and got our hair cut. The pain has receded and I am hopeful that I won't find myself popping Tylenol after dinner. It is mid-afternoon now and I wish I could go out for a nice walk around the block, but the temperature is cold again and there hasn't been much melting today. Still too much ice on the sidewalks.
The point that I set out to make when I sat down to write this is that my stamina is improving. However, to my surprise I am tired right now after the activities of the morning and early afternoon, and I am thinking of putitng my head down for half an hour or so. I am not usually a napper, so I don't know what to think of this desire for afternoon sleep.
Go figure. I did stay dosed up with Tylenol yesterday and my knee was pretty good for most of the day. It was sore again by 9 PM, so I watched Brothers and Sisters in bed after tearing out my hair during the Canada-US hockey game. Bob and I were not in the same cheerleader camp and I'm sure I will not hear the end of this unless Canada eventually wins the gold medal.
I was a little nervous about spending so much time in the car when we headed down to Red Wing yesterday afternoon. However, apart from stiffness, the knee was pretty good. The eagle watching was not that great, mostly because of the large number of gawkers who had probably seen the same Kare 11 feature on Colvill Park that had so attracted me.
It was mid afternoon by the time we got home. I fed the birds -- a little iffy because the path to the feeder is a trifle icy -- and then decided to walk on the sidewalk near the deck. There is only a small section (maybe 30 feet) that was safe to navigate, so I walked back and forth enough times to cover what I thought was about 500 yards. Bob quickly dispelled that illusion and figured I'd done 600 feet. Whatever! I did most of it without the cane and felt pretty good.
Another restless night but I walked downstairs with relative ease this morning, holding on to the railing with my right hand but not reaching over to the wall for additional support. The knee is bending quite well, even in the morning after lack of use.
Looking forward to physical therapy later this morning.
As functionality and range of motion improve daily, I am convinced that the knee will work at least as well as it did before, maybe as early as Memorial Day, May 31 this year (picking a date certain gives me a target to work toward). However, when pain descends relentlessly in the evening, I worry that this familiar companion will not disappear anytime soon.
A 4:30 AM, the time I decided to get out of bed this morning, there isn't much comfort in thinking that most people seem to report less pain after knee replacement surgery. Just when does this happen? I don't want to be hitting the Tylenol bottle so early in the morning (almost 5:30 now) but I think that's where I'm headed.
Looking beyond the whine:
Going down the stairs yesterday, I forgot to favor the right leg. For me, "favor" means tighten and bend, to avoid the possibility of it "giving way" on the stairs, a very frightening and frequent event that precipitated (so to speak) the first surgery I had on the right knee over 16 years ago.
My balance is really improved. Not afraid that I'll get jostled in church anymore.
I'm tempted to ditch the cane. If we didn't have so much ice, I'd give caneless walking a try outside.
The weather has been warm for the last week, above freezing most days. The snow is melting and the days are getting longer. Yesterday, I saw an item on Kare 11 about eagle viewing in Red Wing. We see eagles on our junkets to Fort Snelling State Park but it's always fun to view lots of them, and to observe the birders and others congregating with the fervor that seems to go with this activity. That might be a destination today or later in the week.
The knee is 5 weeks old today. After the usual morning stiffness, I popped a couple of Tylenol before heading out to PT. Despite my apprehension, I pedaled fast for about 15 minutes and, by the time I got off the bike, the knee was totally painfree. Am pressing 70 lbs. on the leg press. Bent the knee to 113 degrees, so the 120 degree goal seems attainable.
By mid afternoon the heavy feeling in the right leg had returned and I walked gingerly when we went out to run a few errands around 3 PM. After all these months, I finally visited Trader Joe's on Randolph. The store is very attractive and well laid out. The shoppers were all very respectful of the cane, so there was less stress walking around in a crowded area.
The day's efforts were very successful but pain is getting me down right now and I feel totally wiped out. I think I'll break down and have a couple of the stronger painkillers before I go to bed. I'd like to reduce the recovery time from physical therapy to 24 rather than 48 hours.
Watching the Olympic women's combined (downhill & slalom) earlier this evening, I really wonder how those athletes manage to come back from their injuries, both quickly and with great success. I think there's a fine line between pushing oneself a bit too far, thereby achieving more, and living on the edge all the time, with an inevitable crash and burn at some point.
Whoever would have thought that 8 o'clock would seem like an early out for me? I wasn't sure how I would sleep, so I figured we should go to mass in the early evening instead of at 8 AM. As it turned out, I slept pretty well and felt reasonably good this morning, though stiff legged, as usual. I decided to go grocery shopping with Bob and realized, once again, what a workout very ordinary activities can present. The Midway Rainbow seemed very big -- and my entire leg was quite tired by the time we left the store. So many new obstacles!
Took it easy, for the most part, this afternoon. I did chop a little ice on the sidewalk around the house and then sat on the deck enjoying the sunshine. By the time we came out of church after 5 PM mass, I had had enough activity for the day, so I was glad to have a quick fish dinner at Culver's in Bloomington.
We got home shortly after 7 and I felt as though I had put in a 12-hour day at work. I watched Lindsey Vonn's gold medal downhill race and am now catching up on other Olympic events. Trying to make it to 10 PM before I crash.
I think this will be a good lent for me. Quiet and plenty of time for reflection, with a very profound gratitude for the progress I am making with rehab -- much more difficult and stressful than I had ever imagined.
Many years ago, I had a sore foot but decided that I would go out for my usual walk anyway. At the time, the phrase "working through the pain" was popular -- the weak gave up but those of stronger character forged forward, made even tougher by conquering pain while achieving fitness. By the time I got home from the walk, I could barely move and, after a miserable weekend writhing on the couch, a Monday morning x-ray revealed a small broken bone. Since then, I have been very skeptical of the value of working through the pain.
The knee is very painful for about 48 hours after physical therapy. I question whether I am trying to do too much, too fast, but every session seems to improve my mobility, balance and ability to execute the tasks of daily living. And there certainly doesn't seem to be any lasting damage.
Today I was outside most of the afternoon, watching Bob remove snow from the roof and work in the garage. I feel better with some color in my face, even though my enjoyment of the outdoors is passive, at least for a little while longer.
Once again, I slept fitfully last night, at least partly because of unremitting knee pain. I didn't help the situation by having coffee after dinner so that I wouldn't conk out at 9 PM. This evening, no coffee. Pain seems to be diminishing, so maybe I'll get a good night's rest.
My knee was sore during the night and I actually contemplated getting up to take a couple of acetominophen, but the pills don't sit well on an empty stomach so I slept fitfully for a couple of hours before getting up at 5. I felt much better sitting in an armchair, knees bent at 90 degrees, reading the newspaper. The knee was very stiff, though, so I wondered how physical therapy would go later in the morning.
Several inches of snow had fallen during the night so I was glad to see the sun helping Bob with the snow clearing job. There wasn't much ice when I left the house, so all I had to tackle was a little snow on the sidewalk in front of the clinic.
I was very pessimistic when I stepped on the stationary bike. After a few tentative arcs, I decided to try the 360 backward cycle, and was surprised that it was easy to pedal. After a few minutes, I felt compelled to pedal forward, knowing that Allison would ask me if I had tried. To my surprise, the leg slid right around and I continued "comme si rien n'était" for another 5 minutes. I was stunned and absolutely thrilled. I am starting to believe that I'll be able to make my "April on the bike" goal, as long as the snow melts in time.
I bent the knee to 110 degrees, at least I think that was the number, without help. I strutted out into the winter sunshine in my shorts, feeling very confident about the future. The downside: pain now, not really debilitating, but bad enough so that I think I should take something for it. Hope to postpone that until bedtime.
I've never really had much success with physical therapy before. I credit the great work of my surgeon, Dr. Elizabeth Arendt, and the clever PT regime designed by Allison Trombley.
A month ago, I was already in my hospital room after surgery, feeling very vulnerable and wondering what I had signed up for! I feel pretty good today.
I did pay for "overdoing" it yesterday on my successful driving junket. I was exhausted in the evening and went up to bed shortly before nine. I was asleep shortly after Apolo Ohno won his silver medal in the 1500 m. speed skating race. My knee was sore in the nasty, sharp way it used to flare up after I had walked too far. It woke me up several times during the night, but I still managed to sleep fairly well. Got up shortly after 5, refreshed and ready to go.
Today I've babied it a little, walking only short distances and foregoing anything strenuous. My stair exercises are automatic now, and they don't hurt the raw, tender muscle on the inside of the knee. We went to 8:15 mass this morning, and it was quite a bit easier this week than last. Partly because of the cane, I think, and partly because my mobility is much improved. We had breakfast at Joseph's. It's amazing how different a place looks when one is concerned about heavy doors, fast moving people, rugs on the floor, wet tiles.
This afternoon we drove to the lock in Hastings where we saw a big bald eagle fishing in the open water, and a very large pair of eagles roosting in a tree. An awesome sight.
Snow tonight, and of course I feel a little apprehensive about going out in the morning. I am fearful of patches of ice under fresh snow, even though I am more proficient at catching myself now.
Flying, well, limping, solo for the first time in a month. Bob is off snowmobiling for the day with Scott, John and Chris, taking a well deserved break from the caregiving gig. My first inclination was to clean house, a favorite Saturday morning activity for many years. I worked steadily for a couple of hours, not using the cane except to put out the trash. I got rid of a number of items that have been bugging me for awhile, a much easier task when the family hoarder is out of the house. Although the original grand plan was only partially executed, I felt satisfied with my accomplishments and decided to wash the kitchen floor some other day.
I would like to report that I'm feeling great, but, in fact, my knee is tired and I can feel a strain in the quad and calf muscles. I think I've also discovered where my hamstring is and I'm beginning to understand why proper conditioning is the key to hamstring injury avoidance among hockey players. I'm sitting with the leg raised, watching ESPN so that I can see Danica Patrick's NASCAR debut at Daytona. I had tuned in hoping for Olympic ski jumping, but Danica will be fun to see.
If the weather hadn't been so challenging, I would have tried to drive ten days ago, but I think I can go out for the first time today. Nothing very ambitious: Borders in the Midway area, using my disability parking tag. I figure I can manage 15-20 minutes of shopping without running out of steam. If I can do more, I'll stop for a small Valentine's gift for Bob.
A week ago, I saved all my energy so that I could go to mass at the end of the day. I think I'm managing to do more with less effort now. I'm particularly happy with my progress going up and down stairs, one foot after the other. Slow and labored, but better!
I thrashed all night last night, and finallly got up at 6:20 AM -- late for my old self (the real me?). Allison raised the seat on the stationary bike and I was able to do the 360-degree rotation, backward, at least a dozen times. I was very happy with myself, while recognizing the fact that I can't peddle my bike backward and get anywhere. Still, it's a milestone.
I can now go downstairs, one foot after the other. I need the cane, but I feel that it won't be long before I can do the stairs on my own.
The new cane is very functional and I even wonder if I need it indoors. The kneebend measurement was 105 degrees this morning, 108 degrees when manually pushed by Allison. I walk "almost" without a limp.
This afternoon I worked on personal income tax and then sat outside on the deck for a couple of hours in the sunshine, enjoying the rays from the propane heater. It was my first time outside for any length of time, and I realized how deprived I feel when I can't get outdoors! The smell of the snow reminded me of wonderful winters of skiing in my hometown of Temiscaming. I would really love to be out on my skis!
I finally had a great night's sleep last night. The Mirapex (for muscle spasms) has worked wonders and the terrible seized up feeling I had in all my muscles has almost dissapeared. I woke only a few times during the night and needed no Tylenol or naproxen. The power of sleep is amazing: I felt much better today and was actually able to almost finish the 1120 federal income tax return for Bob's company. Any kind of intellectual effort tends to leave me feeling very "depleted", so I didn't manage more than a couple of hours of work.
This afternoon I walked around Kohls and bought a pair of Keds sandals for the summer. Stopped at Jackson Medical for my brand new cane that I hope to test drive tomorrow when I go to physical therapy. I wonder if I'll have the nerve to walk to the garage without the crutches? Stay tuned.
Made dinner. It was a simple meal of chicken from the Rainbow Foods deli, steamed broccoli and rice. I was very tired when I finished, but happy that I was still stable on my feet. For the first time all day, the knee was painful enough to warrant a couple of Tylenol.
I'm surprised that my mind doesn't seem to be either very sharp or able to concentrate on anything too demanding. I thought I would be spending a lot of time working on my favorite word and math puzzles but even the simple ones seem too challenging. I suspect that my mind will be stronger when I don't have to concentrate so hard on simple, ordinary activities.
Another milestone: I went down to the basement today. I'd been afraid to try because there's no railing for the first four stairs, and the railing in place on the lower steps is a little shaky for someone who really needs it for support.
Chris and Becky came over this evening and it was great to see them. We ordered Chinese from Cleveland Wok, so much food that I sent most of it home with them. I did start to fade at about 8:15 and they went home. I am very tired now but I do want to see the last Jay Leno Show, so I'll have to make it for another hour.
Today I realized that I would probably be fine with a cane outdoors. While I like the security of the crutches, they tend to get in the way and I think I would be happier with a cane. But not the cane I have ...
The cane I've been using in the house, only when my knee is stiff at the beginning and end of the day, is a relic from the years after Bob broke his leg in our 1985 motorcycle wreck. It's an aluminum beauty with a "prison issue" look about it, shaped like a candy cane, and a little tall for me. I think I can find something that will give me the stability that I need to feel jaunty -- well, maybe not jaunty, but safe -- in our beautiful but occasionally treacherous winter weather.
More snow today. Bob shoveled a path to the garage so that I can get to PT at 11:30. Still can't do a full rotation on the bike (trying a higher seat next time), but don't need a cane to walk around the gym. Increased weights to 50 lbs. on the leg press. Can now bend to 105 degrees, on a day when my flexibility seemed limited to me. I was not overly tired at the end of the session, for the first time.
I went with Bob to pick up his new snowblower at Sears in the early afternoon. Who would ever have thought that a trip to Sears would be an exciting and welcome excursion? Best thing is that Bob is very happy with the new machine! No buyer's remorse, as I had feared.
We stopped for coffee at Coffee Bené on Cleveland and enjoyed watching the snow blow past the window. I move fairly easily in and out of the Yukon now, but was thrown a little off balance this morning when a man many years my senior, celebrating the 4-week anniversary of his knee replacement, walked into the clinic without even a cane! Said he had forgotten it. A little deflating for me, still depending on crutches outdoors because I'm afraid of falling on the ice.
A full night's sleep is still in my future, but I must be getting enough rest because I feel reasonably energetic during the day.
Three weeks ago, I went to bed at 7:30 and woke, in pain, at midnight. Two weeks ago, it was 8:30 and 1:00 AM. Last week, 9:30 and 2:00 AM. Last night, I retired at about 10, got to sleep an hour later, and woke at 4. I had to take a couple of Alleve (naproxen)and slept, fitfully, until about 6:30. I was tempted to get up at 5 AM, my normal rising time, but I knew that I would be tired by early evening, during the Super Bowl. I am not a big fan of the Super Bowl, but I do enjoy the commercials, so I'm happy to be feeling perky at 7:30 PM.
Although I'm still far from "healed", I am feeling better. I'm practicing my slow climb of the stairs, one foot after the other. The right knee is feeling stronger. The sense of "sudden weakness" in the knee is becoming infrequent.
Bob fed the birds today. I was feeling a little fretful, with 8-9 inches of snow expected in the next 48 hours. I don't want the finches to be without sustenance. I'll be glad when I am confident enough to feed them myself -- I like to switch my feeders regularly, depending on the weather and the avian population at the feeding station.
I've had a couple of drinks tonight, and the knee feels pretty good. I would love to make it through from 10:30 - 5:00.
For many years, people who hadn't seen me for awhile would always ask about my knees. No wonder -- my mood and general outlook on life have, since I was about nine, been influenced by the degree of pain in either or both knees. My MS diagnosis in 2004 changed the question for awhile, but, compared with the knee issue, the MS has been a cakewalk, especially in the last couple of years when the disease has been so well managed.
The knee surgery has taught me the meaning of the French expression "se regarder le nombril". Literally, it means "to look at one's belly button". In the last three weeks, the world has revolved around ME! Bob has brought me most of my meals and anticipated virtually all of my needs. What was once a novel privilege now almost seems like a right. I am shocked and disappointed in myself. Too much belly button gazing.
Today I was feeling a little fractious, anxious to go to the "next stage". Bob and I stopped at Tousley Motorsports to look at this week's motorcyle purchase: it's a silver 2003 Honda GoldWing 1800 -- a pretty bike that he has been coveting for a while. Then, because Bob's snowblower is on its last legs and we are expecting more snow tomorrow, we stopped at Fleet Farm to look at the few machines that are still in stock at the end of the season. I must have walked 400 hundred years in that store, looking for the snowblowers. For me, the experience was very liberating.
We looked at more snowblowers at Sears and probably found the right machine -- strong enough to do the job and not too heavy to push up and down the steps that lead from the sidewalk to our house. Not an impulse buyer, Bob wants to look at more snowblowers tomorrow before making a decision.
I was feeling a little tired when we got home, so I rested a little before we went to 5 PM Mass. It's been hard for me to miss church for the last three weeks, but I was surprisingly nervous. Different stairs to navigate. Little kids running around. Slippery floors. Tight pews, except for the one we sat in, behind our usual spot. Still, I was so happy to be there.
In and out of a vehicle five times today! How can I be physically refreshed and mentally tired? Make that exhausted.
Snow again last night. Buckets of March like white stuff, pretty but very heavy. I would have liked to help clear it this morning, but it's too soon to think that I can balance well enough to wield a shovel on a slippery surface like the deck.
Instead, I did a little light housework and made lunch for Bob and me, while he did laundry and dealt with the snow. This was my first culinary initiative since the surgery, a modest effort that did not tire me out: canned chicken noodle soup, turkey & swiss sandwich on sourdough bread.
This afternoon we drove through Fort Snelling State Park, breathtakingly beautiful under the snow. The day was warm, just above freezing, and both the Minnesota and Mississippi rivers had lost a lot of ice. We saw a few dozen deer and a lot of winter birds, including trumpeter swans that have made the shallow lake their winter home for the last few seasons.
I was on my feet a lot today so the knee is stiff and a little painful this evening. The other day, my doctor assured me that I'm not going to hurt it, so I will continue working at my return to a more active life.
Physical therapy: was dreading this morning's PT but I felt energetic and flexible. Pedaling backward, I am close to a full rotation on the bike. I could have leg-pressed all morning and all the other exercises went well too. I walked in the gym without a cane and felt perfectly stable. I could bend my knee to 98 degrees on my own, very easily. Allison pushed the knee back a little farther, to 102 degrees. I can do leg lifts forever!
Walking: I walk much more quickly and confidently now, although I'm very careful on ice and snow. In the house, I use the cane only when I'm feeling tired.
Next goal: I can go upstairs with the right leg leading, as long as I use the railing and cane. Hope to do this without the cane this time next week.
Pain: I'm aware of some pain, but it feels as though it's receding. I'm OK with OTC naproxen. Knee is stiff, but not excessively so. The "painfree" promise seems more believable today!
Fatigue: I do feel a little "fatigue". Fortunately, it doesn't have the heaviness that I associate with MS Fatigue (no sign of the MS variety for quite a while now).
Today Bob had errands to run so I was home alone most of the morning and early afternoon. A milestone: I felt well balanced enough to unload the dishwasher and put away the dishes. Seems like a small achievement, but for me, it was significant. Love that Fiestaware, but it is heavy.
I felt a little nervous because of a 2:30 interview for what I hope will be my next assignment: technical readiness coordinator for SWIFT, the state's new accounting and procurement system. My stamina must be improving; I visited a little after the interview and Bob picked me up at 4:00. It was great to stand outside in the cold for awhile, though I was wishing I could go for a little walk. Still too unsafe for me to walk on ice.
When I got home, I had a letter from HR, informing me that my doctor had cleared me for a return to work on March 11! That is two weeks later than I expected, and I'm quite sure that I'll be fine (i.e., able to work, not totally fine) by February 25. I'll deal with that issue next week.
I'm yawning now, shortly before 6 PM. Maybe that means I'll be tired enough by 10 PM to go to bed and get some sleep -- still elusive for me. Tomorrow more physical therapy, and I feel a little afraid of a "bad" experience. I had hoped to be doing a vigorous workout on the bike by now, but instead I look like a very old lady who has never been on a bicycle. In other words, I am much like my fellow PT patients. On Monday, only one other person looked younger than 80.
I think Phase II in my recovery has begun. I need to recover my strength and step up my level of activity, as I continue to improve mobility.
I had x-rays and a knee exam at the University of Minnesota today. The waiting room was full of people in various stages of decrepitude. My condition put me somewhere in the middle: quite mobile, healthy-looking, not too old and making an effort to be livelier than I felt.
The knee actually felt somewhat better this morning. The x-rays were fascinating to look at, with all the neatly fitting pieces of plastic and metal. All perfectly aligned and healing beautifully. I thought Dr. Arendt and the resident, Dr. Annemarie Geissler (sp?) were going to clap their hands admiringly as they studied the pictures. The knee exam involved a lot of manipulation and some pain, especially when Dr. G. touched the sensitive area on the inside of the knee where the "klunk" seemed to derail my recovery.
The injury that I had feared is non-existent. The "klunk" was probably a movement of the kneecap, a little painful as it repositioned itself. It is normal for the inside of the knee to be sore -- the muscle under the skin is the site of the internal incision and it will be awhile before it heals and is painfree. It's also possible that the MCL (medial collateral ligament -- which I had thought was long gone as a result of injury) was strained, causing pain.
This was our opportunity to get the ligament issue straight: the anterior cruciate ligament (ACL) is always sacrificed in a knee replacement (mine was long gone). The posterior cruciate ligament (PCL) may or may not remain, depending on the surgeon's judgement. Mine is still intact, as I had though I heard right after the surgery. The lateral collateral ligament, on the outside of the knee, remains intact.
Verdict: great mobility and healing after only 19 days. Prognosis: full recovery. Next appointment is not until April 21. Bob reminded me that the Corvette will be home by then. I wonder if I'll be able to get into it? I hope so! My goal is to be back on my bike sometime in April, after the snow melts ...
No more coumadin. Glad that I can now use naproxen and ibuprofen, as well as acetominophen. I have pramipexole at bedtime for muscle spasms, which tend to bother me in the evening. Looking forward to good night's sleep tonight.
Last Thursday, I experienced a "klunk" on the inside of my knee at physical therapy. It has been a little painful since then, and the area is somewhat swollen, with a little bump that sometimes "pops" when I touch it.
I had a really good PT session today, although my knee was too stiff to accomplish my goal of a 360 degree rotation on the bike. The workout included the leg press machine, which made both my knees feel really good. I also liked the pulley machine, a system of cables and weights that had lme lie on my stomach and straighten the "good" left leg, causing the "bad" right leg to bend at the knee. Hard to explain without a picture.
I felt really tired after the therapy and then was somewhat alarmed when the new knee felt as though it was about to dislocate. Didn't seem right so I called Dr. Arendt's office; the triage nurse didn't seem to like to sound of this. I have an appointment tomorrow morning at 11:15. I'm not freaked out or anything; just don't want things to get worse.
On a more positive note, I am much stronger than I was a week ago and the only reason I use the crutches is for stability outside. It's a cane or nothing at all in the house -- and I look very stable. The last of the steri-strips fell off my knee yesterday and the scar looks clean and very neat.
During yesterday's onversation with my sister, Marilyn, we talked about my problems with muscle spasm management. Marilyn is a psychiatrist with an encyclopedic knowledge of drugs and drug interactions. When I wondered about Mirapex (pramipexole), a drug commonly prescribed for patients with Parkinson's Disease and other movement disorders like RLS (restless leg syndrome ). In the past, Mirapex has helped me with muscle spasms associated with my MS (multiple sclerosis), Marilyn thought that I should pursue the idea with my doctor, a project for Monday morning.
Friday's exhilaration faded quickly as I prepared for bed that evening. My right leg felt as though a quantity of rubber bands -- brand new ones -- were tightly wound around my foot, calf, thigh and the entire knee area. I couldn't force the leg into relaxation, and the tension soon affected my entire body. When I got into bed, or, rather, onto bed, where I'd been sleeping for the previous 2-3 nights because the unbearable weight of sheets and electric blanket, I realized I was in for a long night.
Ensuing tears were initially the result of frustration, but soon they had no reason. The meltdown receded when I took a couple of hydroxyzine (in my opinion, this is a very poor muscle relaxant but I sure wish I'd had it for the itch from my mosquito bites in the Dominican Republic!) and I finally found a semi-comfortable position with a pillow under my knee. By 1 AM, after several hours of half-dozing, I was at my wits' end and I gook a couple of Tylenol, along with another 2 hydroxyzine. I was freezing cold so I put on my sweats and moved downstairs to the couch. I was sensible enough to be afraid of falling, but I did make it down the stairs safely and onto the couch. I started to cry again, partly because I was exhausted but also out of relief to be back in a safe place. By this time, I had wakened the cat, who had decided that it must be breakfast time. She crunched merrily for 15 minutes or so.
I managed to make it through till morning but I felt as though I had spent the night drinking cheap booze. More tears. I wondered why I had ever decided to go through with the knee surgery. I didn't know what hurt more, my knee or the throbbing head. Bob, bless him, brought me a cold washcloth for my head and the feeling passed. I felt a return to the land of the living.
We did my favorite Saturday thing (deer at Fort Snelling State Park). Despite his opposition to the mess made by my bird visitors, Bob filled the bird feeder. I spent a couple of hours with my leg in the CPM machine. For the first time, I changed my seating in the living room, moving between the couch, my favorite armchair and Bob's new recliner (VERY comfortable, but a little risky for me because of the swivel). Once again, I didn't go to Mass, deciding to give into Bob's apprehension about crowds, slippery floors, ice outside the church, and leaving church in the dark.
We spent the evening watching Julie & Julia, enjoyed more by me than by Bob, although I think we both identified with Julie's meltdown scenes! By 9 PM, the crisis seemed to have passed and I tentatively began to hope for a night's sleep. And it was pretty good! I feel great (good?) today!
I took my first post-op shower today. I had no trouble getting into or out of the tub. I realized right away that I couldn't afford to get shampoo or conditioner in my eyes. Even a little bit made me feel slightly off kilter and that's not a good sensation in my situation.
12 hours later, I still feel clean! I have never before truly appreciated the great gift of clean, plentiful, hot water. I will never again take my morning shower for granted.
Today, even I was tempted to stay in the house. I feel somewhat chilled much of the time and the weather looked so very cold! However, I successfully fought the inclination to spend the afternoon watching TV and headed out on the daily outing, a project that could never even be initiated without Bob's help and vigilance. He's the driver too, and I'm getting more than my share of destination choices.
Today, we headed to beautiful White Bear Lake, where an ice fishing contest tomorrow will be a main event of the St. Paul Winter Carnival. There were a log of ice houses out on the lake, and we saw a couple of trucks heading out to the ice house colony with portable houses and fresh provisions. A couple of smokers were sitting on the deck at the VFW -- that building used to be blue with smoke before Minnesota cracked down on smoking indoors a couple of years ago.
Another major milestone: I can get into the Yukon pretty well now, and today we dared to get out for a cup of coffee (tea, in my case) at Caribou Coffee in White Bear. I was a little afraid that I wouldn't be able to get back in the truck, because my strength diminishes later in the day. I was delighted that there was no problem at all either boarding or, just as important, disembarking safely. I still have this fear of strangers having to stuff me into the truck like an unwieldy heap of deer of other wild game.
I'm often asked if I'm in a lot of pain. That's a difficult question, because the pain in my knee feels more like the threat of pain than anything else. It is very stiff and the knee doesn't seem to tolerate cold. The muscles in my entire leg seem tired and "old". The muscle relaxant medication (vistaril) is somewhat helpful but I think it would take a very large dose to actually relax the leg. Except very occasionally, I take nothing but Tylenol; I am hoping the vistaril will help me sleep tonight, as I'm feeling a little tired already and would lover to have a good night's sleep -- later, though, not quite yet.
I never imagined that I could be even remotely interested in the products marketed on daytime television. Today, I found myself enthusiastically listening to Jamie Lee Curtis' wise words on "regularity" and the help provided by Activia. Looks damn delicious, especially with those fresh strawberries that must have been picked before the freeze in Florida. I've become pretty good with the products on "The Price is Right" too. I'm still a little week on the value of cars but a little Consumer Reports studying should help remedy that deficiency.
The high point of my day is "the outing". Today, I had a physical therapy session. I wanted to show off my unaided walking to Allison Trombley, the physical therapist at the Institute for Athletic Medicine. She watched me walk a few feet, admittedly a little tentatively, and then gently told me I wasn't "ready" yet. By the way, Allison is the best physical therapist I've ever worked with -- I usually reach an impasse after the first or second session, mostly because I don't respond well to being bullied. Allison has a very intelligent approach to rehabilitation and is quick to find a new method if her first approach isn't successful.
I can now bend the right knee to 98 degrees, only a couple of degrees shy of a rotation on the stationary bike. Leg lifts are very easy. I've adapted one of the exercises performed with a belt (the kind used as a restraint in nursing homes)to a little routine with a knitted scarf. I hold the ends in each hand and put my foot into the "sling". It makes leg lifts and the flexion exercises much easier initially perform and, ultimately, perfect. Unfortunately, something "clunked" in the new knee right at the end of the session and it is feeling a little sore this evening.
Next stop was the a blood test. The "INR" number was higher than it should be so my Coumadin (warfarin) dosage has been reduced a little. I hadn't thought, until today, that the avoidance of bleeding to death is every bit as important as blood clot prevention! Not that bleeding to death is on the radar or anything ... but of course I like to know the absolute worst thing that could happen to me. It's hard to beat the Mayo Clinic!
I was so happy with myself yesterday after bouncing up into the Yukon like an enthusiastic dog. Today I was like a horse afraid of going over the jump. I simply couldn't make the leap of faith necessary to quickly get my left leg from the running board to the floor of the car, holding on to the loop above my head to pull myself into the truck. Bob ended up shoving my rear end unceremoniously onto the passenger seat and stuffing me in before slamming the door shut. Later on, I practiced the maneuver and couldn't figure out why it had seemed so daunting only a few hours before.
One day seems much any other, except that I slept last night. I tried sleeping on top of the covers with only a light blanket over me. The absence of a heavy electric blanket over my legs made sleep somewhat more peaceful -- at least it was possible. I still thrashed around, as much as anyone can thrash with a bum leg, but the night was still more comfortable that it had been previously, either in the hospital or at home. If I can manage to rest reasonably quietly, Bob will be able to come back to bed.
We drove out to Hudson and through the snowy countryside to Stillwater this afternoon. I was surprised that the snow is still quite white. We stopped at Menard's on the way home and I enviously waited in the truck while Bob shopped, since I didn't want to risk a fall in the parking lot: I imagined myself prostrate in the snow, Disabled Parking sticker at my side, the contents of my purse strewn all over for all to examine. I visualied the good samaritans gingerly picking me up and plopping me in the back seat, just to get me out of soght. Fortunately, we were all spared that scene and I enjoyed watching customers file in and out of that busy Midway store.
It's late afternoon now, and I'm starting to get a little tired. I'm going to resist the temptation to nap, not just because it seems plain wrong but also because a nap now will rob me of sleep later. From a more positive perspective, I have to think I'm doing pretty well. Knee isn't too painful anymore. My balance is pretty good and I can walk without faltering until about 7:30 p.m. I can feel my strength returning, and I'm looking forward to seeing how I do on the stationary bicycle tomorrow. It's been nearly two weeks since the surgery: so far, so good.
I woke up this morning feeling somewhat unmotivated. My first phone call of the day was to the clinic at the U, because I had almost run out of the blood-thinner, Coumadin, a drug I'll be taking for another couple fo weeks to prevent blood clot formation. The nurse was surprised that I have been going to physical therapy at the Institute for Athletic Medicine about 1.5 miles away, rather than have a therapist come to the house. I did know that home therapy is available, but I also know that I getting out every day is important to my mental health.
Later, I enjoyed talking to Jim Darling, whose wife has had both knees replaced in the last year or so. It's encouraging to hear that Maryellen is now painfree. I find the painfree state hard to imagine at this point, but it's good to know that there may be some pain relief in my future after all.
I have been whining to get into Bob's cushy, comfortable GMC Yukon rather than my Ford Focus, which has never been too great for the knees, even under good circumstances. Bob, on the other hand, was afraid that I might slip and that he, of course, would be blamed for even letting me out of the house into the winter ice. As it turned out, hoisting myself up into the front seat wasn't difficult, once we figured out the best way to get the job done.
I'm happy to be walking around the house unaided for much of the day and am beginning to think that I am doing pretty well, overall. I hope I've reached the summit of my preoccupation with the knee, and will soon be able to think about other things. For now, though, I'm looking forward to the good night's sleep that eluded me last night.
After the Vikings' stunning, heart-breaking 31-28 overtime loss to to hte Saints in the NFC championship, I felt that I needed some good news today. Headed out to physical therapy at about 9:30 AM, a little fearful of slipping on the fresh snow that had coated the deck during the night.
A very old woman shuffled into the PT waiting room shortly after I arrived. I watched her workout as I went through mine, afraid that she would trip on the carpeting in the gym, especially since was wearing a pair of outdoor boots, with an inflexible rubber sole. She almost did fall once, and I reflected that if she had fallen, I would have been off the hook in the help department with all those physical therapists in the building.
I started on the stationary bike today and am very close to getting my leg to do a full rotation -- maybe later this week. When I got back to the waiting room, Bob had already worked over the other patients' companions, and I learned that the elderly woman was also recovering from knee replacement surgery. Bob joked that here she was, a week after surgery, walking unaided! My sense of humor is somewhat diminished these days, and I was furious that such an unlikely candidate was recovering better than I.
Of course, we have no idea how along that woman is in her recovery! I did decide, though, that it was time to ditch the crutches, at least in the house. I've been making short hops without the crutches, but didn't go any "distance" before today. Thinking that I still needed some support, Bob resurrected his old cane and I welcome the luxury of a free hand..
I'll be afraid to head outdoors crutch-less, but I have a feeling that the crutches may have a limited future. I have a crazy vision of dropping them off at St. Joseph's Oratory in Montreal.
I do a hell of a job sliding the crutches ahead of me up or down the stairs. This morning I even got the newspaper on the front steps with a perfect manoeuvering of my right crutch. Still, I'm ready to go on to the next thing now. There's no one around to see my well rehearsed "brave invalid" look and there's not enough drama in the story to interest even me. Enough of this gig!
I had secretly hoped that I'd be making plans to go back to work in a record breaking time. However, I don't think that's going to happen, so I might as well stop moping. I'm enjoying the US Figure Skating Championship events this weekend and I've had just about enough skating, just in time for the Vikings-Saints game.
I wrapped my leg last night in a giant Ace bandage and was able to sleep quite a bit better with the knee nicely protected. I strapped the right leg into the CPM (continuous passive motion or movement, I forget which) machine early this morning, and fired it up for a couple of hours. I think the machine is helping -- the knee has lost some of its stiffness and seemed to be "good to go" when I got out of bed. While I can't take a shower yet, I've gotten fairly adept at the "sponge bath". The first couple of days, Bob helpd me wash my hair but I'm fine doing it myself, and glad that I don't get dizzy.
Today was the big "first post-op outing". We went to Burger King, where my brand new Disabled Parking tag gave us a premium spot near the door. Then we headed down to visit my deer at Fort Snelling State Park. The deer were plentiful, but the real thrill was hearing, and then seeing, a yellow-bellied sapsucker http://en.wikipedia.org/wiki/Yellow-bellied_Sapsucker . I'm quite sure that I saw one in the same spot last
year, perhaps a little later in the season.
January is Minnesota is often bitterly cold, as it was for the first two weeks of 2010. A few years ago, I knitted myself a soft, very warm scart that I wind around my head and face if I make the mistake of going out for a walk that turns out to be longer than originally intended. I wouldn't have needed that scarf in the last 10 days, even if I had been able to go out for a walk. Most days, the temperature has been above freezing.
I was hoping to venture out a little farther afield today, perhaps down to Fort Snelling State Park, to see the deer. I abandoned that idea as the morning wore on and puddles of water began to collect on the snow. The sidewalk is both mushy and slick. No amount of grit can make it safe. There will be no deer watching today, nor my usual Saturday evening Mass, either. Nothing good could come out of a walk on the ice.
In the last week, I have avoided using the Continuous Passive Movement Machine. It is a very heavy piece of equipment with a crude device that holds the lower leg and bends it, at the knee, to a predetermined angle and back to 180%, a set number of times perhour. The angle must be increased over time, with the objective of attaining the maximum possible range of motion in the affected leg. While its effectiveness is subject to debate among orthopedists, my doctor and the U of M are major believers so I was sent home with one "on loan".
My first attempt to use it last Sunday was unsuccessful. The pain was excruciating as Bob strapped me into it, a device that would not seem out of place in a museum of medieval torture pieces. I swore off it until today, when my leg felt so stiff that I was willing to try it one more time. Let's just say that it keeps every moving well, if not merrily.
I'm off the machine now, sitting with a blanket around myself, watching the US Figure Skating Championships. I have to say that it's wonderful to watch an afternoon of skating, feeling no guilt! I've begun the obligatory hand wringing that necessarily precedes the Vikings Saints game late tomorrow afternoon in New Orleans. If the Vikings make it to the Super Bowl, I don't know if I can take the excitement!
I think it's possible that I may be rounding the corner. I dozed a lot yesterday and wondered if things were getting worse, not better! This morning, I had that "hungover" feeling again, a little disconcerting because I had to get to the clinic for my blood test at 8:45. Fortunately, the bad stomach went away quickly and I have had a good morning.
Because of the freezing rain, the deck and sidewalks were very icey and Bob and I were both afraid that I'd lose my balance, but fortunately I had no problems at all. After the blood test, we took a little ride to downtown St. Paul, and I enjoyed seeing the ice sculptors at work. It is a little too warm for ice sculpting, and I hope the work can be completed and judged before the sleet and freezing rain predicted for the weekend.
I've been sitting (again!) and, of course I'm getting tired of being "laid up". I think I'm getting better because I hardly need the crutches anymore. I'm fairly stable and can put all my weight on the knew knee. The swelling in my leg seems to be reduced today, even though it's still quite tender. If this were summer, I'd be out for a walk.
The drugs really do knock me out so I hope I can reduce my need in the next day or so. When that happens, I'll have a real sense of recovery.
I've never had too much interest in being "average"; I tend to prefer the extremes. Early on in the total knee replacement "process", I decided that I was going to be better than everyone else in every possible way. I worked on the post-op exercises for about a month and figured that I was about as prepared as anyone could be for this surgery.
I got out of bed as soon as I could. Started walking right away and re-mastered the art of crutches. Thanks to Scott's work on railings, I felt secure hauling myself up and down the stairs. By yesterday, I was ready for the first "real" post-op test. I waltzed through the strength, mobility and range of motion exercises with the physiotherapist. After making quite an impression on the clinic staff, I walked out jauntily with my exercise program in hand.
And then I hit the wall -- not literally, fortunately. I spent the rest of Wednesday feeling tired out, stressed out and in pain all over. My right tibia still feels as though someone took a hammer to it. My feet have been so stretched than I wonder if I'll ever experience "normal" again. I am very happy that I don't have PT again until Monday!
Meanwhile, I had hoped to go out for lunch today but freezing rain has made the landscape overly dangerous, at least for now. I may yet revisit my goal of having the "best ever recovery", but for now I'll be happy to get through the day in relative comfort.
The last time I displayed so many colors was after the 1985 motorcycle accident that left me bruised from head to toe. For awhile this afternoon, when the intensity of the colors alarmed Bob, I worked myself into a mental frenzy, imagining myself bleeding silently under the skin, like some member of the Russian royal family. I'm quite sure that most of my reaction is due to a dramatic temperament and rather too much imagination. The physical therapist did not seem unduly concerned this morning.
The PT thought I had good mobility, 90 degrees already. The angle must get to at least 120, I think. I was quite a sight outside today. The temperature had fallen a little since yesterday, and my summer jacket and shorts looked a trifle odd, even for me. I had been counting on going to lunch, and when Bob insisted that we go home after the morning's workout, I started to cry again, imagining that he was ashamed of his decrepit -- and crazy -- wife, outside in shorts in the middle of January. Fortunately, the mood passed and I enjoyed the afternoon.
Despite all the ratings woes and public NBC infighting, I enjoy watching Jay Leno at 9 PM. My diminished mental state seems to enhance the quality of all TV, so I'm looking forward to a a little guilt-free self indulgence.
Woke up at 6 AM feeling as though I should be wearing a lampshade on my head. Must be much more of a party animal than I had previously imagined. Wait! No party. The "lendemain de la veille" feeling involved no fancy drinks. Just a drug hangover. Well, that's reassuring!
Seriously, feeling better now. I'll have Bob help me wash my hair in a little while, and then dress for PT at 11 AM http://www.athleticmedicine.org/Clinics/c_144265.asp. The weather here is warm, so I think I'll put on my shorts here and head out ready for a workout. I am feeling a trifle apprehensive about physical therapy!
The last time I did any significant physical therapy, I was recovering from 2007 knee surgery on my left leg (the other one). For some reason, when I was doing one of the exercises that involved "climbing down" a wall, my leg slipped like a free falling elevator. The pain was agonizing; I have quite a voice, and my vocabulary can be colorful ... anyway, they packed me up and pushed me out of the clinic door faster than I could say "let's try that again!".
The synapses seem a little slow this morning ... my mind gets lost in these simple little stories. I'll have another report from the field later on, when my IQ begins to inch up.
The lovely teacup bouquet is from my college friend Sheryl Smolkin, who also has significant health issues to resolve this year. We reconnected through Facebook, and have enjoyed revisiting our friendship.
Thank you, Sheryl! Looking forward to a healthy 2010, and to a reunion sometime this year!
I felt so terrific yesterday from all points of view: general wellbeing, mobility, skill with crutches, pain management, medication calendar, appearance of the knee, progress only 4 days after surgery, general ability to "get the job done". Fatigue did set in at about 8 PM but no matter. Thought a good night's sleep would take care of everything.
Tried to make it through the entire night without any medication. Bad idea! Woke up at 4:30 AM feeling as though I had been dumped out of a truck and run over by a semi. I had my nice medication calendar ready ... but it was for 6 AM on. While my mind was still functioning, I decided to have a couple of Tylenol until it was time to get up.
More or less did the trick. Had an early out for a post-op check-up and blood test. The obstacles are now expected: a couple of stairs here and there, very icey conditions on the sidewalks, narrow traffic routes in buildings, including my clinic. There is a general inability to address the very basic needs of people on crutches or otherwise mobility challenged. There is, in fact, very little awareness of the difficulty of standing for a long time on crutches, of having no place to ease a leg up and rest it.
We were home by about 9:45 AM but I was totally exhausted. Had coffee and a Diet Coke. I was happy to answer my email. I would really like to go out for a ride in the car but Bob likes me plunked safely here, away from the general hazards of life in the winter.
A couple of decades ago, our neighbor, Gus, said that he always declined pain medication because he preferred to self-medicate with a good belt. While I'm not prepared to go that route, I can see where a stiff drink could take the edge off the pain and stress!
So: this time yesterday, I was feeling that my progress was superior in every way. Today, I'm a little more grounded. Let's just say that I'm maintaining!
I think I will bop the next person who refers to this surgery as a journey. "Journey" always seems to carry promises of learning, appreciation for other people, life lessons, wisdom, enlightenment ... "Trip" is a little lighter. Maybe some beverages along the way. Laughter. "Trippy" stuff. So far, none of either. No journey; no trip ... yet.
The morning of preparing to spring the coop left me tired and cranky. The nurse went through a ream of paperwork, the most significant of which involved how to take each of the 7 medications I went home with. Last week, I fully expected to be weaned of major painkillers and I certainly didn't intend to have any narcotics going home with me. I adjusted that expectation fairly early on, so I did have an interest in the medication management session.
The nurse had the great idea that it would be best if the Oxycontin (2X daily) could be administered in the late evening and early morning (say 8 PM and 8 AM), rather than in the middle of the afternoon and late at night (2 PM and 2 AM), so she thought I should try to delay the Oxycontin dose (due at 2 PM) until 8 PM. At about 4 PM I went into a major meltdown, sobbing with such force that I couldn't manage the crutches, let alone the pain control strategy.
Let's just say that I now understand how people might inadvertently overdose on narcotics. Bob helped me get upstairs to our own bed ("my" bed, for a couple of days, and we worked on the medications list, trying to figure out how to take each of them. I realized this morning that it would be very easy to put each one on a calendar at its proper time, simply using the calendar features of Outlook or some other electronic calendar. I haven't done that yet, but I will do so soon. Thank you, everyone who called during the evening. I'm sorry I couldn't talk to you. You would have wondered if some brain shredder had gotten hold of me.
I watched a little of the Golden Globes and pretty much got the pain addressed. I didn't take any more medication until 6 AM. Bob brought me coffee, fruit and yogurt for breakfast. I am sitting at my desktop computer, with my right foot on the floor -- leg not quite 90 degrees but it's not too far from a right angle. I can lift my leg now and the quad feels fairly strong.
I'm walking quite well on the crutches. And the crutch is a hell of a hooker tool - I can grab anything with it and expertly guide a selected item to its destination. I am hoping to get outside a little today, but may not have the stamina yet. Tomorrow morning I have to go to my clinic for a blood test. I have to begin physical therapy ASAP, so I may try to get something going after the clinic visit -- same building. Bob just finished vacuuming and I'd better get back to bed before I get caught at the computer!
It's remarkable how self centered one can become, so quickly. Some kind of instinct for self preservation, I suppose.
Until fairly late in the day yesterday, I was still too sick to get too serious about the idea of going home. I had a meltdown in the mid-afternoon I simply couldnt handle the stress of all of my visitors, the conversation with the physical and occupational therapists, the rug rash I had picked up from the hospital sheets, the absence of any real "comforts" (except the hot blankets, which I ask for). Feeling uncomfortable and out of sorts, I burst into tears. Fortunately, this is not Bob's first rodeo and he took the outburst in stride.
I quickly got into my "routine". Early wake-up. Trip to the bathroom -- a big event (I wouldn't want to be desperate because it takes a lot just to get the knee immobilized so that I can get on my way). Pills -- the collection consists of Tylenol, vistaril (muscle relaxant), oxycontin. The vistaril is very helpful because of the muscle contracts in my upper and lower leg after the surgery. The first night, the medications kept me pretty well sedated. The second night, I slept well but was happy to wake up at about 4 AM. Last night, the napping during the day pretty much killed my night's sleep. I really couldn't get comfortable, no matter how I tossed and turned. At one point, I rolled up my blankets one at a time and pitched them over to the chair.
I find myself looking forward to food, even though it is not too appetizing. Meals appear with a cover over the main course (not necessarily a main course, but sufficiently large to be given "main course" trappings). For some reason, I was reminded of the dinner tray scene (s?) in "Whatever Happened to Baby Jane" http://www.joancrawfordbest.com/filmswhatever.htm.
One of my favorite nurses is Enrico ("Rico") Johnson. He and all his siblings have very unlikely name combinations ... Rico is a great one for hospital "insider knowledge". Last night, I heard a "Code 21" over the broadcast system. At the University of Minnesota, a Code 21 is a call for the team that deals with "mental halth disturbances", or "violent outbursts". I think I'm going to incorporate "Code 21" into my personal shorthand.
At 4 AM, I figured I could get up witout calling too much attention to myself. Of course, getting up means going to the bathroom, taking the latest set of meds, begging for a cup of coffee, hauling out my laptop. I've been writing for awhile with the machine positioned on my good leg but I really need something of a repositioning.
I think I may be released ... this morning, I hope. Yesterday, I wondered if I would be ready but today I feel more able to cope. The only obstacle is the 12 noon start time for the Vikings vs. Cowboys game ...
Until I attended the knee and hip replacement workshop about a month ago, I thought that occupational therapy was "crafts" and I was looking forward learning a new skill while in the hospital. The occupational therapist I saw yesterday burst out laughing when I told her this, and then turned serious. "You would still get to do crafts", she said, "if you were in the hospital for mental health issues". Next go-round, maybe.
I really liked yesterday's PT. Faye didn't go for any patient babying and seemed to know exactly how to deal with me, not necessarily an easy task. We dumped the walker right away and I used crutches instead. She looked at the tasks I would have to accomplish as sequential and inter-related. By the end of my second round of PT in the afternoon, I could pull my very heavy leg to the side of the bed and stand on it, immobilized, quite easily. Walking with the crutches is very easy. May only tendency is to want to take steps that are too large for my abilities.
I was surprised that I already knew how to deal with steps; I must have practiced it before or after another of my knee surgeries. I felt that I could navigate stairs fairly safely even now.
The occupational therapy with Katy was less helpful, since I already know the "coping" techniques that have been acquired during a lifetime with knee problems. I was really interested in hearing Katy talk about some of the challenges addressed by patients with cognitive issues. It seems that it's much easier dealing with someone like me, not disabled by age or illness, and still pretty much playing with a full deck.
Minnesotans are justifiably pround of the quality of medical services in our state -- there aren't too many health issues that can't be addressed right here in the Twin Ciites.The Mayo Clinic is a favorite stop for patients who need answers. Even north central and northern Minnesota have state of the art medical facilities.
I'm alarmed that we may not keep pace. Budget cuts have hit the health care sector hard; there are visible signs everywhere. For the most part, I find the staff very competent and dedicated. The really good young ones are proud to be employees of this prestigious teaching hospital. Some others just have that dumb, dull look one finds everywhere, one of indifference and boredom. Some of the nursing assistants don't know how to use the equipment (e.g., continuous passive motion -- CPM -- machine) and just throw it on however it wil go. I sense a certain tension among the staff, between those who are good (and most do 90% of the work) and those who are simply here to get a paycheck.
The quality of the hospital facility varies from location to location. My room is poorly organized and cramped. The patient care paraphernalia is in various places around the roo. The hospital bed is many generations behind what is now "standard" in hospitals. There is no comfortable place to sit with my laptop. On the other hand, I had X-Rays yesterday in a brand new imaging wing where pictures were taken without the need for me to leave my wheelchair.
The young transport person told Chris and me that he had graduated in imaging (I forget the name of the diploma) but couldn't find a job. He figured he'd rather be working in a hospital close to the action than working somewhere else. He seemed so driven to serve that I hope he's successful in his job search.
Now I know what that expression means. I've been pretty much out of the picture since the surgery, drifing in and out of consciousness. I did watch CNN most of Thursday night and part of yesterday. That isn't my usual habit but TV is quite an entertainment package.
My check-in on Thursday went like clockwork, with the exception of the need for last minute cultures (I won't go into the details) because they had produced unsatisfactory results at my pre-op physical several weeks ago. I had no sedative at all until I was in the operating room. The OR really impressed me. Quite large, populated by a surgical team of 6 or so. Lots of supplies like gowns piled within reach. Do they change gowns midway thhrough the surgery? There was a very large patient tracking monitor and one end of the OR. It was very cold! The doctors, nurses and assistants were very matter of fact and I certainly didn' get the idea that I was their first knee replacement! When I woke up in the recovery room, I was told by several staff that the knee had been very bad and that no other option was possible -- maybe that's just standard cognitive consistency talk.
The first day I had no solid food at all and I don't expect to gain any weight here. How do you ruin a scrambled egg? Did it come out of a box? The coffee and tea, however, are not too bad. Nurses and others are of uneven quality and competence. The night nurses seem to be the best. I had a nurse yesterday who was much nicer to Bob than she was to me. I am being quite a bitch, though, so maybe that influences the level of care.
I got email through the link I sent out from several people and I was really happy! A volunteer delivered mail at least twice yesterday, may three times. Bob, Chris and Becky have come to vist. The ADD has pretty much kicked in so I'm not a very good patient; I don't make my visitors feel good about themselves, so there's no need to hop in your car.
I have a small, poorly designed room ... but it has a great view of St. Paul. I keep the curtains open at night and, of course, all day. I've made the mistake of summoning the nurse by accidentally hitting the call button.
After years of indecision, I'm going ahead with total knee replacement surgery on January 14, 2010. The surgery is scheduled for 8:00 AM on Thursday, at the University of Minnesota Medical Center - Fairview, Riverside Campus. My surgeon is the wonderful Dr. Elizabeth Arendt, who gave me 16 pretty good years out of this right knee after a successful operation in 1993.
The original plan was to replace the left knee, the one that has been nothing but trouble since the mid-nineties, and only marginally helped by two "bandaid" arthroscopic interventions in the last 6 years. However,the "good" right knee, objectively in worse shape, has been very painful since last summer so, in December, we made a decision to go forward with the right knee. To my dismay, the left has returned to its habitual painful state in recent weeks.
I expect to be out of work for about six weeks, a prospect that I find more frightening than the surgery itself. My sense of self, and of self-worth, is tied up with work -- and I'm not sure I will do so well with three nights in the hospital and the possibility of transitional care if I'm not ready to go home yet. I'll post updates as soon as I can type!
The first blog was a simple travel journal written during a cruise to Alaska a few years ago.
I enjoy recording events in both words and pictures -- blogging is one more way of staying in touch with family and friends in this wonderful, connected world.
I've been retired since April of 2013, and there's no shortage of things to do or activities to enjoy. I enjoy writing about everything ... and nothing.