Day Forty-Five

Another 15 miles on the Stowe bike path and another double decaf Americano.

Progress.* 
I got off the bike without help from Vince and I walked into Black Cap Coffee afterwards without my crutches or noodles for legs.  

Went for a walk with with my friend Linda who will walk my speed as if it was her speed.

Yesterday the right knee had a bit of a fever which was gone today.  There is swelling.  The right more than the left but nothing not normal.

With every ride my legs seem a little stronger but 15 miles in the wind is about my limit...and I'm not sure it would be good to do that every day at this point.

I'm unfortunately still on the involuntary simultaneous bilateral total knee replacement weight loss program.  I just started drizzling olive oil, lots of olive oil, over everything I eat except oatmeal.

*my May Day resolution is to show some progress every single day.  Hold me to it.

I already know what I'm going to do for progress tomorrow....

Day Forty

Yippee.  Physical therapy tomorrow.  I can't wait and I'm nervous.  Therapist Vinny hasn't seen me walk since I watched the Youtube videos.  I want to surprise him.  The sharp pain in the front left knee still keeps me from being able to bring my knee through smoothly but I may be able to grin a bear it for a few strides.

He sees every step I take from the time I get out of the car and walk across the parking lot until I leave.
"I saw you walking from the car," he says every time.  Then a little later, "I saw you walking down the hall."  I can't take a step without him seeing it.  I guess that's part about being a good physical therapist (actually, I think he's and athletic trainer)

Rode about 15 miles on the Stowe bike path again today.  Nothing is more fun these days.  The first pedal stroke surprised me with a painful protest at the top of it.  I forgot the knees don't bend that well yet.  A short involuntary scream, couple more revolutions and I was warmed up.  It was all good until, at the end, when I got to the car, stopped and couldn't lift my leg over the seat to get off (I probably could have but convinced myself I couldn't) and had to have Vin tilt the bike and pull it out from under me.

For my knee comrades.
Now, about my finger's blood vessel incident that may be related to the surgery...
All I was doing is sponging down the sink.  Suddenly I felt a pop in the inside of the middle section of my right ring finger.  I looked and there was a purple star shaped mass turning purpler .  I felt and it was hard.  My finger was dark red.  It hurt but not as bad as that sharp pain in the front left knee.  More of a tingle.  Half an hour later purple star morphed into a whole purple finger mid section and stayed that way.  I googled 'spontaneous hematoma finger' (sometimes you just don't know what to call things) and there were tons of forums.  Evidently I'm not the only one it's happened to.   Seems like it could have had something to do with taking coumadin (blood thinner/blood clot precaution) after surgery.  Always something.  The tingling stopped almost immediately and now, the purple band is barely visible.  I'm going to make a point of getting more vitamin K (greens...helps with clotting which is usually what you want) and vitamin C to strengthen my blood vessel walls.

Day Thirty-Nine

Nothing too profound in the way of knee progress or back-sliding today.

This morning after a couple squats, I knew they weren't going to be as much fun as the painless ones yesterday and backed off on the flexion.  I was hoping for and would have welcomed a stretching quad muscle pain but it was pain around the knee that didn't feel right.

I've been really diligent about my daily home physical therapy.  I want my progress to be more obvious but try not to be depressed when it isn't.  I want my flexion to be a little better every day and sometimes it's worse.

Walking is still a problem.  I have plenty of flexion for the walking motion but not without a lot pain and stiffness, especially on the left.  Since each step requires getting through the pain and stiffness barrier while bringing my knee through, my gait is slow, painful and robotic.

Riding my bike on the trainer is always delightful and I do it for a 20 minute Reno 9-1-1 episode or two that I've seen before.  (one day I even watched 3)

Is it OK if tell you about the blood vessel incident in my finger tomorrow?

Day Thirty-Four

Today was my first out-patient physical therapy visit that wasn't in the pool and the physical therapy that my recovered knee replacement comrades still talk about.  The physical therapy for which surgeons prescribe the pain killers.  Up until today, I've pretty much had control over my stretching, bending, pulling...basically, how much I've wanted to hurt...but therapist Vinny (no relation) showed me there is a whole other level of discomfort I was subconsciously avoiding.

He started out by having me sit on the table with my legs straight out in front of me while, from the top, he pushed the back of my knees into the table, one at a time, with what I could have sworn was all his weight.  It's called working on the extension which the PA told me last week couldn't be any better? 

When I came to, he was trying to sneak my heel back to my butt a little at a time.  I was still lying on the table but my this time my knees were bent like I was doing girl-sit-ups. 
"How does that feel?"
"Great," I grunted while clutching the sides of the table to keep from slapping him.
Once he got my heel as close to my butt as it was going to go, he held my foot in place with his hip while he took way too long to measure the flexion.  115 on the right and he guessed 120 on the left after dropping the calipers just before he got a good look at the numbers but knew better than to mention trying it again.   Just getting it to 115 or 120 isn't bad, it's the holding it there that makes me nauseous.

After the hour of torture he told me that my progress was "right about here" with a shoulder height, horizontal hand signal  across an imaginary vertical scale that I took to mean 'about average'.   What happened to the top 80% Dr. Huber?  Then he said that the only thing that was really bad...I don't think he actually said 'really bad' but that's what I heard....was my gait.  How can something I've been doing since I was one be so difficult?

I asked him what I should do for my PT at home this afternoon.  He said to play it by ear and that I may not be able to do much of anything given what I'd done with him this morning.    Of course I knew that would never be the case....but it was.

Day Thirty-Three

I love being laid up. 
I got two more books today from girlfriends. 
Here's what I picture.  A friend reads a book, loves it and wants me to read it too because they think I'll love it and it will make me feel better and they want me to feel better.  Am I over-thinking this?  Anyway, what could be a more thoughtful gesture? 

I'm worried.  What happens if I'm better before I read them all?  I won't have to give them back, will I?

Knee report:  not a lot of obvious progress in the last couple days.  And I'm not just saying that to get more books.

There are other ways to measure progress than with degrees of flexion.  Like today I did some cooking and dishes.  I took a shower.  I put on pants that weren't ski pants with zippers all the way up the side.  I noticed that even though my knees are clunking and clicking, which I'll supposedly be able to ignore at some point, they aren't crunching which was worse and I was never able to ignore.

I'd better call it a night.  I dozed off and woke up with my finger on the 'f' key and it took me 5 minutes to select and delete them all.

Day Thirty-One

Leg lifts with weight.

I felt like I was getting pretty good at leg lifts with only the weight of a sock.  Time to add a couple pounds.  Enter great idea.  I weighed Vince's Sketcher's (those black shoes).  They're 2 pounds a piece and probably one of the reasons he complains they're hard to walk in.   Anyway, voila, ankle weights.  Finally, a reason for Vince to have bought them.

The other day at my 4 week follow-up I found out that ACLs and meniscus' are removed.  News to me.  Not that it would have mattered to know earlier but I would have been past this set of willies.  I don't want to know about anything else they took without asking.

Day Twenty-Nine

'Supposedly they look pretty good and swelling is normal'  or  'What's another couple scars?'

Today was my 4 week follow-up with the surgeon and I can't figure out if it feels like way more or way less than that.

1.  The kid gloved x-ray tech treated me like a China doll even though the photo shoot ended with her telling me how well I was doing before I hobbled back to the waiting room.

2.  My name was called.  Feeling like we'd won something, we followed the assistant to a little room with hip and knee posters covering the walls.  She too, commented on how well I was doing.

3.  Fifteen minutes in the little room gave Vin time to read most of the posters and me time to tell Vin, a bunch of times, how I hated when someone that had no idea how I was doing told me I was doing great.  He told me they were just trying to be nice and I told him I already knew that and I didn't care.

4. Leah, the PA, came in.  I stopped her before she was able to tell me how well I was doing.  Instead she asked how the last couple of weeks had been.  Vin was facing a wall, reading the last knee poster and wondering, after about 30 seconds, why I hadn't answered her.  I was trying to answer but knew I couldn't without bursting into tears.  Vince saw this was the case and said "painful" for me.  Then I burst into tears.

5.  Another second or two and I was OK.  Another five minutes and she had the highlights of my convalescence.  I told her how I hated when someone told me I was doing great.  She measured my flexion.  The left first.  "112, real close to 115" she said with total disregard to 113 and 114.  The right was 117 and real close to 120.  She was just trying to be nice.

6.  She left and returned five minutes later with Dr. Huber.  He said Leah had told him everything.  Then he said "you're doing great."  Obviously she hadn't told him everything. :).
I think she told him I had burst into tears though because had he been any more positive and animated, I may have thought he was a clown in a pediatric ward.  Told me I had to "see the trees through the forest."  As far as his knee replacement victims go, he told me I was in the top 20% like it was a compliment.  I know he was just trying to be nice but top 20% doesn't sound that good to me.

7.  I'll see him again in 2 months. Top 5%, here I come.

Day Twenty-Seven

Watching my gait in freezing 88 degree water.

My legs on the monitor.

Cool Pool. 
Had my first pool therapy session today.  Seems like 88 degrees would be warm enough but it wasn't.  Last year at this time I'd been surfing every day in Costa Rica for 2 (out of 4) weeks in 88 degree water that was plenty warm.

The whole floor of the pool is a treadmill that starts out level with the pool room floor.  You stand and it lowers you into the water at a height the therapist chooses depending on how weightless he wants you to be.  You walk while watching your legs and feet on a monitor so you can adjust your gait the way he tells you.  I think my surgeon's knee patients are spoiled.

There was a scale at the clinic and assuming my wet hair and trail shoes were less than a pound, it looks like I may have gained some weight.  If nothing else, I haven't lost any.

Yesterday was my biggest PT day so far and because of it I was a bit stiffer and more sore than I normally am which meant when the new therapist took his baseline measurements they were pretty pathetic.  My extension was good (3 on the left and 1 on the right) but my flexion (admittedly, I could have pushed it a bit more) was 100 on the left and 103 on the right.  My thought is that it is good to start in a place that is easy from which to improve.  Then there was my gait.  It was so robotic, I was almost embarrassed.

It will be interesting to see, if because I took it easier today, I'll feel better (looser, better flexion and gait) tomorrow.

Thank you for all the crutch vs. cane votes.  So far you think I look better with the cane.  Have to admit, it's a pretty classy look.

Day Twenty-Six

I can't decide if I look better with crutches or a cane.

PT said I'd need a cane so I asked my dad to temporarily send me the collapsible carbon fiber cane my brother's family gave him for Christmas.  It's like the whole being greater than the sum of its parts situation.  I think there is a walking-with-a-cane technique that I don't have yet.

Today was good.  Hours of PT* and ice.  Even a real walk.  I'm swollen tonight but I feel like it's good swelling that will be gone in the morning.  I haven't turned the corner yet but the blinker is on.
 
Cousin Nancy (Uncle Elmer's and Aunt Donna's daughter, Suzy's sister) got a new knee today.  Conversation fodder for the next family reunion.

*watched 2 episodes of Reno 911 from my bike seat.

Day Twenty-Five

You know yesterday when I said that maybe I was turning the corner?  I'm thinking there may be a few more intersections before I actually make the turn but I am headed in the right direction.

Nurse Tim came to the house and took my blood for the last time today.  Looks like I'm back to normal after my Coumadin overdose.  From now on blood tests will be 2 days a week at the hospital.  They sure don't make it easy.

Going up and down the stairs is really pretty fun especially after I realized I could go up without using the railing.  The thirty trips today felt like a lot but seems like a slow way to build up my invisible right quad.

Lots of PT and icing today combined with making popovers and home made mayonnaise wiped me out.

Day Twenty Four. PM.

Watching this 'It's Always Sunny In Philadelphia' AGAIN at 70 rpm.

Turns out the left knee pain isn't gone like I thought it might be but I did go the whole day without screaming because of it, so that's good.  Anyway.  Seems like the 12 hour pill had something to do with my comfort last night but also, I may have started turning the corner everyone was talking about.

Today's riding and rowing and stairs and stretching and icing left just enough time for me to walk down to our neighbor Linda's mailbox and back (maybe 1/2 mile) with Vince and Max.  Yippee.  My first real Max walk and I did a bunch of it without crutches.  Funny.....milestones that weren't milestones a month ago and now everything is a milestone.  Here's where it starts to get fun.

Poor Max.  A Central Asian Shepherd (flock guard dog), he doesn't know whether to stay downstairs and guard me or go upstairs and guard Vince at night.  Lately he's been staying down with me until about 3 AM before staggering upstairs to Vin for the rest of the night.  He works so hard.

Day Twenty-Three

Five days until I see the surgeon...and do I have a lot of questions for him..... 
I picture him seeing me in the waiting room with my brief case and whispering "tell her I'm not here," to one of his gate-keepers.

This morning I did a little freehand schematic of my legs with arrows and squiggles going to different notes off to the side so I don't forget anything when I go in.  My biggest question is still...(sorry about the broken record)...how does swelling work into this whole rehab equation?  My knees are so swollen and painful even before the PT (I'm told that normally you expect the swelling after the PT which also happens) that it scares me to do some of the PT.  Should I just take pain killers to the point of being able to ignore the pain and swelling and push through the exercises?  Will I hurt anything?  Should I just bag the PT that really hurts?  What good does listening to my body do if I don't know what it is supposed to be saying?  

I'm not feeling particularly productive these days.  I think the rehab in and of itself could feel productive if I get the point where I could understand and overcome the rehab (swelling etc.) issues.  Maybe I could feel like I was moving forward instead of sideways at best.

I walked a little, with crutches, at Barr Hill in Greensboro, took a bath (keeping my knees up out of the water), and rode (a big 50 rpm) while watching an episode of 'It's always sunny in Philadelphia'. 

I hope I've gained enough weight back because I don't think I can eat another five pound oatmeal, walnut and margarine breakfast.

Here is what I think....I'll take a certain amount of time to heal no matter what I do.  It's just longer than I want it to be.

I think I'm worrying too much, but other than that, everything is good.

Day Twenty-Two

Yesterday's melt down either didn't need to happen or fixed me for today.

Not being able to walk yesterday really bummed me out (i.e. pissed me off).  Swelling seemed to be most of the problem, so today I did my in-house laps before my knees had a chance to swell.  I iced first thing.  Did a partial set of PT, that didn't include riding or rowing, then walked.  Heel first, then toe followed by bringing the knee through....over and over and over.  I was a runway model.  The amount of concentration it took was overwhelming.  Seriously.  It was oddly exhausting and I finished with a much deeper respect for the runway model profession.

Day Twenty. PM.

Can you believe that my knees will be three weeks old tomorrow?

The machine that flexed my knees (day seven post) while I just laid there and did nothing went back today so I have the whole bed to myself.

Tomorrow I get company.  Nurse Tim, in the morning, to take my blood and my temperature then PT Carla, in the afternoon, to tell me how well I'm doing.

Today seemed good.  I did my newly edited efficient PT sets, rowed, rode and walked a LITTLE at Barr Hill in Greensboro.  The drive up to the Barr Hill trail head was really rough and I had to hold my knees to keep them from clicking and clunking.

By week four I am 'supposed' to be walking unaided which seems impossible since today it would be hard to tell me from Frankenstein.  Matter of fact, I'll bet Frankenstein's gait is smoother than mine right now.

All my life I'd wished for smaller calves and never got them.  Now, I want my big ones back.   Big deal, if I'd be able to wear the slim jeans I wasn't able to get off that time in the dressing room.  And I could care less about the tall boots I could never get over my calves...the one's I saw years ago in PEOPLE magazine.

Happy Library Week.

Day Nineteen

Tried ice on my knees and heat everywhere else this morning to loosen up.  Couldn't have hurt....and it may have helped.  Felt proactive anyway.

The knees are swollen, clunky and numb but I guess that's probably normal.

Walking was easier and smoother yesterday than today and because it was easier and smoother yesterday, I was probably more active than I should have been.  I rode and rowed yesterday because it was easy too.  I'll bet that's why the knees aren't bending that well today.  That's what I get for listening to my body (and showing off for the physical therapist).  I listened to the body messages that came in loud and clear today and backed off a set.

According the the PT, the only thing limiting my activity is the short term pain and swelling so whatever I can make myself do....do.  I'm not going to hurt anything because the knees are brand new.  She said if I do something and it hurts for more than 20 minutes after stopping, it may be a good idea to hold off on that one for a while.

I'm focusing on getting protein like a good girl and other than not being able to really move, I feel good.

Tomorrow's goal is to do something that I can fool myself into thinking is productive.  Finish the sweater I'm knitting?  Wrap up the pretty worthless online short story class I'm taking?  Decide on just one of the six books I'm picking at and go with it? 

The vitamin e hasn't helped yet, I can still see my scars.

Hang in there with me, something interesting is bound to happen at some point.

Day Eighteen

My friend Linda came over again to take me for my morning walk.  Sounds like I'm her pet doesn't it?  We went to the Rainbow Farm mailbox and turned around.   I turned around there just because it's not very far and if I shouldn't be walking, I doubt there would be much harm done.

Nurse Tim came and other than my blood being a bit thick again, I'm good.

PT came to say I'm doing great.  I rode the bike for twenty minutes twice.  My flexion was good enough to do complete pedal strokes with the arch of my foot on the pedal.  (ball of my foot on the pedal is where I want to be).  Yesterday, in order to go around, I had to point my toe with my heel on the pedal so I'm bending like crazy, relatively.  Active Left = 2/117 and Active Right = 1/115.  (active means I'm doing it by myself and yes there is pain). 

Rowed for more than 5 but less than 10 minutes and edited my PT 'set' so I'm not repeating any of the exercises.  For instance, being able to ride the bike takes the place of a bunch of other exercises and is more dynamic (i.e. better). 

Two more 'in home' physical therapy visits and they kick me out into real rehab. 

Just in case putting vitamin e on a scar makes it less visible, I slather it on.

Day Seventeen. AM

Neighborhood potluck in Tyler, Minnesota

Deviled eggs (top left in specific deviled egg tray) are popular in Tyler.

 I figured it was about time for a picture or two.  And with my appetite coming back........

Since this blog is supposed to be an honest day to day account of what it is like to prepare for and get new knees, I feel like have to continue complaining if that's part of the day to day even though it could get tiresome for readers with good knees.  Sorry.

I feel like I should should warn you with a headline if there is a complaint coming up but my definition of a complaint could be different than yours.  More than likely,  something you would interpret as a complaint, I would not.

Whatever.
Since the last couple of nights have been sleepless for the most part, I took a 12 hour time-released pain med last night before bed.  I woke up a ton but getting back to sleep was a breeze.  (I don't feel like that's a complaint even though it started out sounding like it was going to be).  This morning around 7 when I got up for good (complaint coming), I couldn't imagine being more sore and stiff (and cold which is probably unrelated but still a complaint).  I took a pain med, iced both knees, had Vince build me a fire and in no time there was improvement in all categories.

OK.  Time for my version of PT which I hope does more good than harm.  I say that because I feel like I don't really know.  Have the last sleepless nights been because I do too much PT?  Not enough?  or is it unrelated?  Do my therapists have to think more outside the box when it comes to me?  Why do I feel like I'm different?  (maybe because I usually am?).  I feel so helpless.

I feel like I got some complaining out of my system right there.

Day Fifteen

Today should have been my best new knee day yet but I decided to feel sorry for myself instead.
The physical therapist came at 7:30  and before long we got extension/flexion measurements of 0/100 on the left and 0/102 on the right.  We worked up a good mount for the rowing machine, did a couple makeshift squats and a stiff but comfortable pedal stroke.  She told me I should replace my crutches with a cane, which to me is a visual move toward elderly, to her it's one step closer to freedom.

I blame the crappy day on last nights non-sleep.  I'd finally get comfortable enough, nod off, then wake up ....five minutes later!  Over and over.  I feel like I'll never function again.  Like I'm not me.

I did 2 1/2 to 3 sets of PT instead of my new 4 set regime.  The whole feeling sorry for oneself is such a waste of time.  Who ends up suffering?! 

Maybe someday I'll watch a youtube video of a knee replacement which, from what I hear, will answer any questions one may have about why it feels like it does where.  But not for a while.

Tomorrow will be better, I'll make sure of that.

Day Fourteen

PT came early.   A different therapist which is OK.  To me, they all seem good.  Each of them has a little different method of getting to the same place with me.   I don't feel like I need the consistency of the same therapist every day because I know enough about how things work to be able to decide which of their suggestions are best for me.  Having several therapists gives me a bigger selection of exercises from which to choose.

My flexion was a little less this morning than yesterday which could have been that
1. it was 'just a little less' for some reason
2. it was a different therapist with a different kind of calipers
3. today she measured me on the bed and yesterday she measured me in a chair. 
I decided I wasn't going to get too hung up on the measurements until there was more consistency in measuring and just keep doing everything right and often.

Last night was lousy.  Pain.  Seems like the four sets of exercises wiped me out.  I was tired way earlier than I usually am. 

My definition of a set is:
a bunch strength and flexion lying on the bed
a bunch strength and flexion using the kitchen counter for stability
strength and flexion using the stairs
a bunch strength and flexion using the bike
then:
ice really often
doing laps in the house whenever I think of it

Even though the four sets wiped me out yesterday, I did four sets again today.  My last set was great.  I'm sure it was partly because I took the pain meds according to the prescription but my flexion was good.  It felt really tight on the bike but surprisingly, didn't hurt.  Matter of fact, it was very enjoyable. 

From what I've read, it feels like my knees are more swollen than they should be at this point.  The swelling is what is keeping my flexion sucky.  They are both swollen along the top.  I want to call the surgeon tomorrow to talk anti-inflammatories since the swelling seems to mess with the therapy at this point.

Day Eleven

Warning....extra boring as I am documenting some stuff.

Last night was the best sleep so far.  If I didn't have to pee several times a night I feel like, with the ms contin, I could have slept through the night.  So.  No, because of the peeing, I didn't sleep all night, but the ms contin (sounds like a rapper) made getting up to pee and then getting back to bed comfortable. 

My cumidin is keeping my blood thin enough.  Getting cut and bleeding could be scary.  So could a blood clot which makes balancing the cumidin very important.  (a surgery situation....not a specific knee situation)

PT didn't come :( so I didn't get to try my bike.  But, when she comes tomorrow I'll have new platform pedals so I don't need to fuss with cycling shoes.

Up and down the stairs several times.  I feel like a kid that just realized there was such a thing.  More than anything I'm concentrating on building up my right quad.  That's the one that disappeared.  I feel like, without crutches, my leg could collapse.

Did a bunch of PT. 

I feel like I have baker cysts in the back of both knees again.  Not painful but very uncomfortable/annoying partly because of associating baker cysts with the old knees.  I don't know if PT aggravates them or not.  I'll ask tomorrow.  I think it has something to do with swelling s if PT causes swelling then I can assume......something?

I know it is just day 11...should I still be walking like Frankenstein?

Pain, sometimes fairly severe, is on the inside of the left knee.  It's there, but not as severe on the right but the right also has a painful spot on the outside top right.  Nurse Tim said the pain on the inside is not uncommon.

I showered.  My expectations were too high.  I thought it would feel better than it did.