Friday, August 23, 2019

6 weeks post knee replacement

As of yesterday I am now 6 weeks post total knee replacement.  I am doing very well.  I have extension at 0 degrees and bend at 135 degrees.  I have been at this for over a week now.  I can ride the NuStep recumbent stepper for 20 minutes and 3/4 mile with a load of 5.  I can go up and down stairs using the right leg as the stronger leg and take the steps one over the other instead of one at a time.  Physical therapy has been very pleased and say that I am more advanced in my recovery than is expected for 6 weeks post surgery.  This is great but it has also caused a bit of other problems.  My leg strength is weak and has been for a long time since fibromyalgia and then knee problems have kept me from exercise.  Also because of the quick recovery of movement, my muscles have not recovered as fast as the knee joint.  I seem to have a bit of a click in the knee cap at a certain point of bend and extension but the knee feels stable.  This causes a little tenderness around the knee cap area but nothing intense.  I have not taken pain meds for 3 weeks now.  Working on strengthening has caused some mild fibro flair-ups and my whole body feels very fatigued and achy.  I need to continue the strengthening exercises but have slowed down the intensity a little.  

My incision is healed up nicely.  I still have a tiny bit of scabbing that is working itself out but I am able to work on the incision massages to help soften it up.  Besides the outside incision there are two interior incisions that also needed to heal and be worked out.  I still have a mark on the skin on my thigh where the tourniquet was and a muscle tightness just above the incision.  The incision is no more red than the ones on my belly from the colon cancer surgery in April. Today my knee area is taped to see if that will help stabilize the clicking feeling at the bottom of the knee cap or I'd take another picture and post here.  My skin on the surgery leg is much dryer than that on the other leg but my skin is always dry.  The surgery leg has areas that the skin is peeling and flaking.  I removed the toenail polish last night and also noticed that the toenails on my surgery foot seem to have a white-ish film on them that also peels and flakes off.  My non-surgery leg and foot seem norman-no peeling and flaking.  Weird!  

I have 2 more physical therapy appointments in Goddard then I can return home.  I will follow up with PT in Colby but should only need to go once a week to make sure I am doing ok and that I am adjusting to the increase in busy home and farm life over the 'easy city life' staying at Karen's home.  I am excited to go home again.  It has been wonderful staying in Wichita because I would not have progressed this rapidly at home.  I will be hitting the ground running, so to speak, when I get home.  I will have physical therapy, dad will have doctor appointments and cataract surgery, Mom will have a doctor appointment and I will have lab and doctor appointment all within the first 3 weeks home.

I am so grateful to Karen for allowing me to move in with her for 8 weeks, have surgery and work on my recovery in Wichita.  She has taken good care of me.  I feel that I have not been any help to her but only let her take care of everything for me.  This next week I hope I can do some things to help her for a change.  I also am grateful to my siblings at home for looking in on Mom & Dad and helping them out as they needed help.  I can take over again in a week.  I have really missed not seeing them every day and knowing just how things really are around the farm.  It is nice having Mom in Wichita this week and next.

I will return to Wichita on October 25 for a follow up appointment with the knee surgeon.  We will see if I can impress him as much as I have my physical therapists.  

Rose

Thursday, August 1, 2019

Total Knee Replacement

Today is the three week mark after total knee replacement.    My orthopedic surgeon told me my knee was bone on bone even though I did not have a lot of pain.  It was hard to walk any distance (not that this was anything new) and really hard to walk anywhere that was unlevel.  Walking up and down the hill to Mom & Dad's house, walking through the house yard or the front drive or road that was uneven would cause pain.  At times I felt like the knee would go out from under me as I stepped on it or as I was standing I could feel the bones shift against each other.  That would cause a sharp pain.  I was concerned about the increase in pain with surgery since the pain level was not bad. I could sit and have absolutely no pain. I felt the knee was unreliable and that was a concern that I'd fall and actually hurt myself.

On July 11 I had a total knee replacement on my right knee.  I had this done in Wichita by Dr. Thomas Sanders with Advanced Orthopedic Associates.  You know you are getting old when your doctor looks the age of Doogie Howser.  I loved the care I received at the Kansas Surgery & Recovery Center. 

I actually do not remember as much of this surgery day as I do the colon surgery day on April 18.  I remember pre-op when they told me I would have the spinal epidural.  I was not happy with this and told them I wanted to be out enough that I do not remember anything-no talking, noise or smells.  I remember being wheeled from pre-op to the surgery room but do not remember anything in the surgery room or the recovery room.  The next thing I really remember is being wheeled down the hall to my room.  I ate regular food for supper that evening.  I did not have to get up to walk till the next morning. 

My nursing care was wonderful and they helped keep on top of the pain control.  Physical therapy was kind and went well.  With surgery on Thursday afternoon I was asked if I was ready to leave the hospital on Saturday but I said no because I had not even been allowed to go to the bathroom by myself yet.  I was allowed to stay till Sunday afternoon before being released.  I was able to get out of bed and go to the bathroom alone and walk the halls with the therapist or nurse nearby. 

The first week was pure hell for me.  People told me "You'll be so glad you did this." or "It will be so good.".  I felt that everyone had lied to me.  I was mad at everyone that had this done before for not telling me it is the hardest thing I will have ever done.  I will tell others that ask me that exact thing.  IT IS THE HARDEST THING I HAVE EVER GONE THROUGH.   Colon cancer surgery was a breeze both physically and mentally compared to total knee replacement.  I would get out of bed for the bathroom, to sit in the recliner in the living room for a while and to go to physical therapy.  Other than that I would lay in bed in tears.  Physical pain even with the pain meds and emotional drain was just so much to me.  I do not know why I was crying but I could not stop. 

10 days post total knee replacement
Over the weekend a week post surgery I began to do a little better.  Over the second week I did not cry as much, getting around was a little bit easier.  I spent more time in the recliner but laid down each afternoon.  I did the exercises given to me from physical therapy.  They hurt but I knew I had to do them if I wanted to improve.  At the end of the second week my movement was leg straight down to 4 degrees and the leg bend was at 95 degrees.  I was told that is great for only 2 weeks post surgery.  I was riding the recumbent stepper even though I was very slow and deliberate with the bend of the knee.  I also had reduced my pain meds from two pills to one each time I needed it.  I began to have a fibromyalgia flair up because I was not taking the Lyrica because the surgeon had me on Gabepentin for post surgery nerve pain.  I began taking the Lyrica again and that improved quickly.  At the end of the second week I actually began to feel like I was a human again.

That next weekend Karen left me in Wichita alone and went to the farm for our annual family reunion.  I had 2 days alone and did nothing much but sleep.  It was very restorative for me to have a lot of quiet alone resting time.  On Monday July 29, I had a follow up appointment with the surgeon to have the 38 staples removed.  I asked a lot of questions that he answered as he pulled out those little metal staples.  He was very pleased with the look of the incision and with the amount of movement I had in the knee.  He actually said I was doing great and was ahead of schedule with my recovery process and to return to see him in October (3 months).  I was so excited to hear this.

When I got home from my doctor appointment I was putting things away in the bedroom.  I had one hand on the walker and leaned over to place something on the bed and dresser.  As I stood back up straight my blouse was caught on the rubber hand hold of the walker and when it released it caused me to loose my balance.  As I was falling backwards instinct kicked in and I tried to catch myself and my balance, throwing myself to the side instead of straight backwards onto my butt, back and hitting my head on the door frame.  I ended up against the bedroom door still on my feet but pulled my thigh muscle above the replaced knee.  The pain was so intense it took my breath away and brought tears to my eyes.  Oh, man, that was bad!

On Tuesday at PT my knee movement was at 1 degree on the flat and 114 degrees on the bend even with the pulled muscle .  The therapist was in shock at the amount of improvement over the weekend.  The PT goal in 6-12 weeks is for 0 degrees and 120 degrees.  This week PT has begun working with steps strengthening the surgery knee.  Today we began working on the stairs with the surgery leg to build up strength.  It was sore but good.  Afterwards I was tender.  I also transitioned from the walker to the cane today.  I am slow and very thoughtful with it at this time but that will also improve with more practice and use.  It will be nice to be able to get into a store or business easier.  This week I had 2 pain pills Monday before the doctor appointment, 2 pills on Tuesday before PT and 1 pill today before PT.  The rest of the time I have been using the extra strength Tylenol only. 

Today is 3 weeks post total knee replacement surgery.  I am no longer mad at everyone who did not tell me it would be the hardest thing I'd ever done to this time.  Physical therapy is not as bad as I had expected.  I feel like I will get through this and be better when it is all done.  I am not ready to go home but will try driving this weekend.  Karen is going to work on Monday morning starting a new job so I will need to get myself to PT.  It is only a few miles down the road and up a back road into Goddard to PT.  I think I should be able to do that.  I am not ready for Wichita traffic or to drive home yet but this will be a good start.  Emotionally I am doing so much better and have not cried all week.  Physically I am doing well according to the doctor and my physical therapists. 

I am grateful to be doing so well.  I am grateful to be through the worst part of it all.  I have had some health discoveries this year and some health recoveries to get through but am doing well.  I pray that as I become fully recovered that I will be stronger because of what I have gone through and to be more able to help Mom and Dad as they need more help.  I would like to travel and being able to walk easier will be great.  I have learned to pray more and with more intensity and purpose, to ask for the help I need to get through the tough times, and to pray with much gratitude.  I have still studied "Come Follow Me" and read scriptures daily even though I did not write for the first week after surgery.  I have been so blessed and am so grateful.