Post Surgery: Six Months and All’s Well. Well, mostly.

Sunday, November 24, 2019

I would love to report that at six months post surgery, I am doing spectacularly well.  Thriving, in fact.  And, in fact, that’s mostly true.  

This bionic knee is doing just great, thank you kindly.

It’s my back that’s killing me.

This latest malady started around a month ago, amid all the air travel of the past couple of months.  Long flights to the East Coast and back, followed by a short trip to St. Louis (in one of those small planes where every seat is uncomfortable), then to Madrid and back, and finally to Kauai and back.  I know, I know:  it’s sinful to complain about ANYthing when you’ve just had a mahhh-velous (if short) getaway to the Garden Island, but complain is what I’m about to do.

My back started to hurt somewhere along the way, between the trip to Madrid and the trip to Kauai.  Was it the fact of dragging my suitcase for 3km over cobblestones in the center of Madrid?  Was it all that time sitting on planes?  Was it carrying my big heavy camera lens around Kauai, trying to photograph elusive birds?  Who knows.

What I do know is that my back started to get worse, little by little, day by day.  I went to see my chiropractor, Karin.  She did her normal adjustments, and declared that my back pain was muscular in nature.  Karin believes that in the course of the knee replacement, my formerly-very-knock-kneed left leg was straightened (and made longer in the process), and that sent everything else in my body out of alignment.  Her normal adjustments didn’t do a nickel’s worth to make the pain go away. 

I started to see myself more and more as a caricature of a little old man, bent over and shuffling along.  Standing from a seated position?  Agony.  Getting out of bed?  More agony.  Just sitting for any length of time?  Argh.

Oddly, the only thing that made my back feel better was standing and walking.  What the heck?  I have long had problems standing for any length of time without my back complaining, and now it’s the thing to do. Go figure.

A week ago, I was feeling pretty miserable and desperate.  I made an appointment with Karen, my second PT.  Unfortunately, she didn’t have any time slots available until December.  So Ed sent me to get a massage.  That helped.  Some. 

Then I made an appointment to go see Lindsey for PT.  Remember Lindsey?  She was my on-again, off-again first therapist post surgery.  But scheduling with Lindsey has always been easier than scheduling with PT #2 Karen.  Happily for me, she had an appointment available early Friday morning.

It snowed lightly most of Thursday, and then more seriously Friday morning.  I thought briefly about canceling the appointment:  who wants to go out and drive in ice and snow at 7 a.m. when you can stay in your nice warm house?  But the benefit of the massage was wearing off - already - and I was feeling a bit desperate.  So I ventured out.

Lindsey did a full intake with all kinds of muscle tests.  Her take on things:  I have a disc (or two) in my back that is inflamed and causing the pain.  The culprit is most likely all the sitting on all those plane flights.  She gave me one exercise to do - a prone press-up - and told me that I basically cannot do it too much or too often.  The effect is to take pressure off the compressed spine.

For the prone press-ups, you lie on your stomach, and press your upper body up, keeping your hips down.  That’s it.  You work on holding your body up to get a good stretch in your spine.  The only equipment required is the floor and you.

And guess what?  It’s actually working!  I’m doing the stretch just about every time I think of it.  That, and ice, and limiting my time sitting:  all are working together to get this back back in working order.

It’s about time.  I mean, Saturday, November 23rd, marks my six month post-surgery anniversary.  I’m ready to rock and roll.  Ready to be more and more active.  Ready to travel some more.

If only I can stand up without getting stuck all stooped over.

Bionic knee at 6 months -
you can see that I still have a lot of muscle mass to regain.

Post Surgery 5+ Months Out: Just Like That

November 11, 2019

It’s been awhile since I checked in here.  And that, as you may expect, means that things are, more and more, returning to what is the new normal with this bionic knee.

After our travels in September, I went back to my physical therapist on September 17th.  There’s something about traveling that takes you out of yourself, and forces you to live in the moment.  And part of that living in the moment is forgetting about the bionic knee.  So when I walked into PT after those travels, things had shifted.  I stuck my left leg out on the exam table, as straight as I could make it, and Karen, the PT, said, “Huh.  It looks like you don’t need me any more.”  I had one more appointment on the books for the following week, and just for old time’s sake - and to get a final list of exercises to keep up - I kept it.  But then - just like that - I graduated from my second physical therapist.

Then the following week, I made a quick day trip to St. Louis for work.  My knee set off the alarm bells at DIA on my outbound flight, so I got the full body scan treatment.  Nothing new there.  In order to forego the entire rigamarole at the St. Louis airport on my way home, I just took off my belt and shoes, and walked through the metal detector.  No alarm bells!  Just like that, I advanced to the next phase of getting through airport security.

Ed and I walked over to our favorite coffee shop one morning to pick up a scone, or possibly a croissant, for breakfast.  As we were walking out the front door, a woman neither of us recognized yelled at us, and came up and gave us both big hugs.  What the heck?  I figured it must be someone Ed knew, but then again, he was acting as clueless as I felt.  The woman then asked how my knee was doing, and then started telling us how great hers is.  Aha!  It was Lorraine, the woman whose appointments always coincided with mine at my PT with Lindsey.  We congratulated each other over our great progress, and just like that, I felt that I had gained membership in the Total Knee Replacement Survivor’s Club.

In October, I had a week long trip to Madrid for work.  It seemed silly to go just for three days of meetings without a chance to see some of the city, so I elected to get there on Sunday morning to take advantage of at least one weekend day.  It turned out that there was a foot race going on along some of the streets that were on the route from the airport to my hotel.  My poor Spanish was no match for my rude taxi driver’s disinterest in finding a detour, so I ended up with suitcase and backpack 3 km from my hotel, with only my feet as transportation.  Could I hoof it that far on my bionic knee?  Why yes, yes I could.  And I survived it all quite ably, thank you very much.  So much so that once I dumped all my stuff in my hotel room, I went back out and hoofed it all over central Madrid.  Just like that - thanks to the vagaries of luck with my taxi driver - I discovered that I was indeed quite capable of the legwork required to be a tourist in a compact European city.

But then in the next week or two, my knee started hurting again.  I complained to Ed that it was hurting as much as it did in the last few years before having the TKR surgery.  What the heck?  Why have major surgery to fix your knee, only to have the same old pains return a few months later?  I was not a little disappointed.  So we added this as our first order of business to discuss with Dr. Miner in my 5 month post-op appointment.  That appointment was a few weeks ago, and I opened with “what gives???”.  Heather - the PA who moonlights as an angel - explained, in her inimitable way, that my knee hurts because the soft tissues are still healing and they get pissed off.  She assured me that it’s not the same pain I had pre-surgery:  the arthritis is gone for good, I’ll have no more bone pain, just soft tissue healing and being cranky about it.  She and Dr. Miner encouraged me to keep working on my recovery with exercises, biking, swimming, water exercises, walking, weight-lifting.  Both were circumspect with how much they recommended that I could ski or snowshoe this winter (the short answer is:  very little), but Dr. Miner softened his “no running” message to “no long distance running”, which was delicious to hear.

So just like that, I graduated to the next phase, where I’m on my own to exercise and rehab the knee, knowing it’s going to be a tough road ahead.  Don’t get me wrong:  if I had carte blanche to exercise and run, it would be easy.  Walking this tightrope between needing to rehab and build strength, but making sure I don’t overdo it in a way that will damage the prosthesis or my tendons and ligaments, is the hardest thing of all.  As the medical experts have drilled into our heads, the tendons and ligaments can take 9 or 10 months to heal, so they are still very vulnerable in the meantime.  This will take patience, which has never been my strong suit.  So I’ll be continuing to check in here, and update y’all with my progress.

In the meantime, I’ve been working on getting back to the gym on a regular basis.  When my knee started to get really weak and angry last year, I started isolating my left knee in exercises so that it would be forced to do its fair share of the work.  Before the TKR surgery, I had gotten up to 20 pounds per leg on the leg extension machine;  it felt pretty respectable at the time.  The other day I made my way to the gym, and tried the single-leg approach to extensions again.  At 20 pounds, I couldn’t budge the thing.  So I backed off.  15?  No go.  10, which is the minimum on this machine?  Well, it was a struggle.  I willed my leg to lift the bar.  Nothing doing.  I closed my eyes and willed those muscles to DO SOMETHING.  Like a rusty piece of machinery groaning back to life, the bar started to lift.  The muscles around my knee were forced to wake up;  they didn’t really want to, it was clear, but wake up they did.

And just like that, I pushed the bar up. 

Post Surgery, Four Months Out: Germs, Colds, Infections

Wednesday, October 2

If you find yourself in need of a good knee replacement doc, the first thing you’ll find is that the docs who come highly recommended are all booked many months out.  Back when my knee ortho - Dr. Noonan, the one with dreamy blue eyes, who doesn’t do knee replacements - told me he couldn’t do any more for me, one of my first questions for him was:  who do you recommend?  He gave us a short list, and that was the beginning of a very focused search for the right surgeon.  

The first surgeon on Dr. Noonan’s list was the one most frequently mentioned when I sought other recommendations from trusted health professionals and friends.  So his was the first number I called.  I couldn’t even get an appointment to see him for 6 or 8 weeks, and when I had the foresight to ask how long out he was scheduling surgeries after an initial consultation, the answer was:  another 6 or more weeks.  I made that appointment, and then, as I called to schedule consults with other docs, I kept hearing the same story over and over.  Only one doc on the list was able to fit me in in less than 4 weeks.  When I asked my ex-boyfriend-doctor-friend about that particular surgeon, he warned me off, saying that he didn’t have the right experience or training to be the best.

I ended up making several appointments for consultations, and eventually saw three different surgeons.  Now, mind you, when I made up my mind that it was time for knee replacement, I wanted to get through the surgery and on to recovery as quickly as possible.  I wanted a magic carpet ride to the other side of recovery.  I was tired of being in pain, tired of not trusting my knee to get me to the local coffee shop and back, and tired of not being able to do my regular activities - running, skiing, snowshoeing, traveling, everything.  I just wanted to be done.

Which all means that when we met with Dr. Miner, and fell in love with his entire team on that first visit, I grabbed the first open slot he had on his calendar for the surgery:  May 23rd.  I was restricted by my last cortisone shot, anyway, so any opening before May 19th wouldn’t have worked for me.  To have the dates align so perfectly:  it seemed like a match made in heaven.

I spent the next couple of months getting ready for the surgery:  physically (doing as much weight-lifting and elliptical “running" and stationary biking as I could), mentally (lining up books and friends to visit and shows to binge watch), supply-wise (gathering durable medical equipment from friends).  We went to the mandatory joint replacement class at the hospital.  At work, I made arrangements for short term disability, and I found a colleague to fill in for me on my open projects.  A couple of weeks before surgery, I had my pre-op appointments with both the surgeon’s staff and with the hospital MD.  They stressed the importance of staying healthy so close to my scheduled surgery date, while at the same time, they told me to stop taking any supplements.  The hospital MD sent me home with a bunch of goodies, including an antibiotic ointment to use in my nostrils, along with an antibacterial soap to use to scrub my surgical knee, with instructions to start both of these a week before surgery in order to cut down the chance of any pre-op infections.  

Ed and I started to hunker down, wanting to avoid getting sick at all costs.  And then, just eight days before surgery, Ed came home from a work day, and said, “Stay away from me - I’m sick!”

Now, I tend to catch anything and everything nasty that’s going around, and once I catch a cold, it seems to last forever, so we both went into super panic mode.  Neither of us wanted my surgery to get pushed out;  it was already disrupting our lives immensely.  If I caught that cold or flu that Ed brought home, how long would it be before we could reschedule everything?

So Ed moved into the guest room.  It was the weirdest damn thing:  the first time we had slept in the same house but not the same bed since the day we moved in together.  We didn’t kiss, or hold hands, or hug.  He stayed as far away from me as humanly possible while living in the same house.  I stayed in my office with the door closed while I was working.  And I started searching for any and all means to stay healthy with Typhoid Eddie in the same space.

I called the surgeon’s office and told them that Ed was sick, and that I needed to stay healthy, and beseeched them:  what can I do to avoid getting his germs?

The person at the surgeon’s office said, very simply:  there’s nothing you can do except wash your hands frequently.

Me:  what about Vitamin C?

Surgeon’s office:  No, you can’t take supplements.

Me:  what about Cold Snap?

Surgeon’s office:  No.

Me:  Emergen-C?

Surgeon’s office:  No.

Me:  Isn't there anything I can take?

Surgeon's office:  No.

Me, getting desperate:  Isn’t there anything I can do???

Surgeon’s office:  Wash your hands.

And so, I washed my hands.  Frequently.  Obsessively.  Every time I turned around.  Every time I touched something.  Every time I thought about touching something.  I started the two antibiotic and antibacterial items a day or two early.  I avoided my husband.  I avoided public places.  I avoided just about everything.  And somehow, amazingly, magically, luckily, I stayed healthy.  Ed’s cold was gone pretty much the morning that he drove me to the hospital for surgery. 

At the hospital, everyone - and I mean everyone - was obsessed about infections.  This was true in pre-op, and it was equally true during my two days in hospital after surgery.  We were lectured on the importance of keeping healthy and avoiding infections, as any infection could pose a risk to the new knee.  We were back on super-vigilance, avoiding people and places that might be germ factories.  Well, heck:  we were so homebound that avoiding germ factories was easy-peasy.

Then we went on our East Coast Extravaganza a few weeks ago.  And we hit the trifecta of germiness.  First was the airplane ride.  Anyone who travels by air knows that airplanes (and airports) are cesspools of germs.  All those people coughing and sneezing and touching every surface possible, and then getting closed up in a small metal cylinder with recycled air for multiple hours at a time.  Then there was the fact that we were visiting little ones.  I mean, really, when you’re spending time with seven children under the age of ten, what do you expect?  Sloppy germy kisses, runny noses, messy hands and fingers that have been heaven-knows-where.  And finally, we stayed with my sister-in-law and her husband.  Now, I love my SIL, but lately, just about every time we see her, she has a cold, and this time was no different.  Add to all of these germ-laden environments the fact that we went from lovely warm Colorado to very cool and rainy coastal weather:  it was recipe for bad juju.

So I should not have been surprised when, the night before we left Maine, I woke up in the middle of the night with a sore throat.  That was bad enough, and then, 48 hours after we got home and I was just starting to recover a little bit, Ed came down with the same thing.  We spent the next ten days or so trading that cold virus back and forth.  We went through boxes and boxes and boxes of Kleenix.  We washed our bedding every other day;  we avoided touching each other - again - something that seemed to hearken back to that time, just eight days before surgery, when we panicked.  All those pain meds I had just weaned myself off of?  Well, let’s just say it’s a good thing we had started buying the Costco-sized versions of Aleve and Tylenol and aspirin.

Finally, now, a couple of weeks later, we seem to have survived the cold.  Survived it enough that I went to my first dental appointment post-surgery, for a semi-annual cleaning.  One of the things we had been alerted to ahead of time was the strong recommendation that, for at least the first two years post-surgery, prior to any dental work - even a simple, routine cleaning - I would need to take a prophylactic antibiotic.  So Tuesday morning, I choked down a couple of big Clindamycin capsules, and prayed that this, too, I (and my bionic knee) would survive.

All indications are, at present, that my knee has survived the germs and general infection ordeals just fine.  But the thing is, you never know.  With joint replacement, you just never know, and you have to take extra care when dealing with something as seemingly minor as a common cold or teeth cleaning.  My knee is still warm to the touch, which means it’s still healing, and that, especially, makes me feel vulnerable.  I think I’ve survived all the germ factories.  But, if we see each other in the next day or two and you have a little cough?  Don’t be offended if I stand back a little bit. I’ll give you a proper hug the next time we meet.  Promise.

Post Surgery, Three and a Half Months: Welcome to the rest of your (traveling) life

Sunday, September 15

We’ve just returned from our first foray into the world of traveling via air with metal body parts.  The information provided by my surgeon and his staff had confirmed that yes, your new bionic knee is made of metal (titanium in my case), and yes, as a result, you will set off the metal detectors at airports.  They advised that you don’t need a TSA identification card, but you should just tell the security folks about the metal in your knee.  This all seemed pretty simple stuff.

On Thursday, September 5, we set off for the East Coast to visit family in Philadelphia and Maine.  With TSA Pre, we typically sail through security.  Not so this morning.  I put my carryon and purse on the belt to get screened, and then walked through the metal detector.  I was not surprised when it beeped;  I would have been disappointed if it had not sounded after all!  Then it got fun.  I told the TSA agent that it had sounded because of my knee, rolling up my jeans to show her my scar, but she was having none of it.  “Take off your belt and go through again!” she barked at me.  Well, alrighty, then.  My belt came off and went into a bin to get through the scanner, and I walked through the detector again, and once again it beeped.  The same very unfriendly TSA agent scowled at me and pointed to the full body scanner one aisle over.  I made it through the scanner without incident, and went to find Ed.

Ed was detained because of a multi-tool that he travels with:  this thing often catches TSA’s attention even though it doesn’t contain a knife.  While I was gathering my belt and other stuff, a small, white-haired woman came walking spritely from the scanner, shaking her head.  She looked at me and said, “I have metal in both hips and both knees and in my spine, and this always takes forever!”  Then she reunited with her family and tootled off on her way.  I started to think that maybe this metal detector facet of my bionic knee was not going to be as much fun as one would hope for.

There were a few more things that I had worried about when it came to flying with this new knee.  First, I was afraid of swelling.  And yet, what can you do about that?  I’m not sure that you’re allowed to bring a big knee-sized ice pack (made of gel) through security.  And even if you are allowed, how do you keep it cold long enough to get use out of it on a plane?  The second concern was simply the fact that this knee gets very cranky if it’s in the same position for any length of time.  And a four hour flight qualifies for long enough for it to get very cranky, indeed.  Finally, I’ve barely worn long pants at all since the surgery;  for the most part, it’s been too warm to warrant wearing them.  But more importantly there’s that whole thing with having something rub against a still-sensitive scar that makes shorts and skirts seem just fine, thank you very much.

Happily, these worries all went for naught.  There was no noticeable swelling as a result of the flight.  Hallelujah!  And we had exit row seats - with an empty seat in our row - so lots of leg room, so lots of room to stretch my legs and change up positions.  Finally, my jeans didn’t annoy my scar at all, so it was all good.

Liberty Bell

Independence Hall

Now, the trip to the tourist area in Philly was a horse of another color.  Here’s a flash:  the Liberty Bell and Independence Hall each require a trip through a metal detector.  We visited the Liberty Bell first, and my knee set the thing off.  It was a beautiful sunny day, so I was wearing shorts.  I told the park ranger that I have a titanium knee, pointing to my scar.  That was met with a stone face, and I was then thoroughly and obnoxiously wanded.  I still think that park ranger thought I was hiding a bomb somewhere on my body, but she finally let me pass.  Independence Hall is a separate facility so - guess what - another metal detector!  I was getting myself mentally prepared for another obnoxious wanting session when, of all things, I didn’t activate the detector.  Go figure.

Smiliest 2 1/2 month old ever

Engagement photos (with a borrowed nephew)

But really, it was all so very worth it.  We got serious doses of kid time.  We are blessed with four grandnephews in Philly - ages 10, 8, 3 and 2 1/2 months, and another grandnephew and two grandnieces in Bar Harbor, Maine:  7, 6 and 3.  We had serious doses of fun times with Ed’s sister and her husband, all four of their daughters / our nieces (who are responsible for all those little ones), and the husbands of the nieces.  We also got to meet the fiancé of the youngest niece, and so, now approve heartily of their upcoming wedding.  The bonus relative of the trip was my cousin Susie who, after a lifetime of living in Iowa and raising her family there (including seeing her granddaughter through college), finally retired a few years back and up and moved to Portland, Maine!  What a major life change, and how fun to spend a short time with her, hearing about all of her new adventures.

Lulu lobster boat

Along the Shore Path, Bar Harbor

In Maine, we availed ourselves of great food, stunning vistas, beautiful ocean walks and drives.  Our brother-in-law Galen works as a tour guide on the lobster boat Lulu, and the highlight of the entire trip was going on one of his trips.  This was watching him in his finest hour.  He is a natural talker and teller of tales, and it was a hoot to sit in the back of the boat and watch all of the other passengers warm to him and laugh at his jokes.

Return visit to the place we got engaged 5 years ago

All good things must come to an end, and so we headed to Bangor on Saturday for our flight back.  Bangor is a smaller airport so doesn’t really have a separate TSA Pre line;  you just get a laminated card that tells the security agents of your status.  This time, in an effort to avoid all of the belt-taking off and wanding and all that folderol, I simply told the first TSA agent I came to that I needed to go through the scanner rather than the metal detector.  She said, incredulously, “so you’re opting IN” for the scanner?  I started to say it really wasn’t an option, bionic knee, all that good blather, and then stopped myself.  “Sure,” I said.  “I’m opting in.”  I stepped into the scanner, stopped with my hands in the air, and then walked on through.  It was a good trip, but we were happy to be on our way home.

Post Surgery 15 weeks: Refueling

Wednesday, September 4

The other day, I got in my car to drive myself to a haircut, and the low fuel alarm dinged.  So in addition to going to the bank, and getting to the salon on time, I made a stop at a gas station.  There’s an app on my iPhone that I use to track my mileage and fuel usage, and when I added this purchase, I noticed that the last time I bought gas was in early May.  Sadly, this isn’t an indication of my great gas mileage (Ed’s Prius gets the credit for that in our family). Rather, it tells the tale of the fact that I’m just recently starting to take responsibility for my own transportation again, after all these months, leaving behind that post-surgery helpless state.

There is a kind of perverse pleasure in giving yourself to the helplessness of a post-surgery state.  You get wheeled into an operating room, and within moments, you’re off into la-la land.  When you wake up again, you’re in a recovery suite, and there’s somebody there to give you their full attention.  Ice chips?  Sure, here you go.  You graduate to apple juice, and then to some crackers, all the while the fogginess starts to lift.

You matriculate from there to a hospital room, or maybe immediately to home.  There’s somebody to take care of you, to issue edicts about all the things you shouldn’t do, and to make sure that you concentrate on the one thing that you can do:  heal.  Healing can be a full time job;  the thing is, it kind of goes on on its own merry way, and your job is to just lay around and allow it to happen.

Now, none of this acknowledges pain you might experience, or the indignities of not being able to get to the bathroom by yourself, or the fact that you feel nauseous and are lucky if you have an appetite at all.  Those memories fade.  It’s a wonderful survival mechanism of the human race that we can remember that we were in pain, and that something hurt, and even that something hurt like hell, but we actually don’t relive that pain when we think about it.  Even now, just going on 15 weeks after surgery, I can remember that, as the nerve block and the anesthesia wore off, my knee started to hurt, and to hurt like, well, like nothing you ever want to experience.  And I can remember that I couldn’t get comfortable, and as a result of the pain and discomfort, I couldn’t sleep.  But, thankfully, thinking of that experience doesn’t bring the pain or discomfort back.

But that pleasure, the perverse pleasure of the disability?  Oh, how lovely.  How lovely  to have somebody bring you food, and water, and ice, and to track your meds.  Nothing to be done but lay there and let the magic of healing take place.  Everyone and everything is designed to take care of your needs.  

In my TKR recovery, Ed set up the living room so that everything I needed was within my reach.  He cooked for me - but that’s nothing new, he always does that.  But now, over the course of the summer, he forbade me from doing the dishes, or even helping to put things away.  He took over my chores, the most heinous being cat box duty every morning.  He drove me to every PT appointment, and every surgical checkup, and he went to the pharmacy to pick up my new or refilled meds.  We were lucky that he had a slow summer with work;  taking care of me was his full time job, and I’m blessed that he took on the role of caregiver so joyfully.

So I gave myself into it.  I let Ed take on pretty much all of our home chores.  I thought about watering the plants, but that was as far as I got - at least until they started wilting and dropping leaves.  I wore the same clothes day after day, and when I finally did some laundry, I let the dry clothes sit in the dryer for hours, or, sometimes, days before I rescued them.  The stuff I absolutely needed to iron just stayed in the laundry basket.  The other stuff, I wore all wrinkled.  The line from “must be ironed” to “this is good enough” got very blurred.  It’s a good thing that I love showers, or else it could have been dire.  As it was, I was clean, but makeup?  Nah.  Hair styling?  Sure seemed like letting my hair dry on its own was the best, most environmentally sound solution - as well as the one requiring the least energy on my part.

But eventually, all good things come to an end.  You get antsy, and it’s time to start picking up the pieces and parts of life that you’ve abandoned.  And caregivers need to get back to their own lives.  One night, Ed let me wash a couple of dishes.  A week or two later, I figured out that I can sit on a little step stool and clean the litter boxes.  Another night Ed headed out to a work thing, and I learned the drill of refilling the ice machine.  And so it goes.  One day, Ed wasn’t available to take me to PT, so I drove myself - only in his car, because it doesn’t have a clutch.  Then several weeks later, Ed had an errand at the same time I had a PT appointment, so I ventured into my own car, and voila - there’s yet one more dependency gone.

My recovery has, essentially, eaten up the entire summer.  Surgery was the Thursday before Memorial Day, and here we are on the back side of Labor Day.   We spent some time out shopping for a new couch on Saturday - a chore we started in the spring, before surgery, and then put on the back burner.  It was a lot of walking, in addition to the walking we did to go to breakfast, and to coffee;  and all this walking on some of the hottest days of the summer.  I managed to finish a load or two of laundry, including the dreaded ironing of the stuff that got too wrinkled to wear.  And it all wore me out much more than I expected.

So I took some time this weekend, giving myself permission to continue to refuel.  We turned on the AC and hunkered down Sunday afternoon and watched a couple of movies.  The plants need to be watered (again), and the bird feeders need to be filled (again).  But the flock of Bushtits that just flitted through our yard seemed to find enough to feed them, so I figure, all things in good time.  Ed’s making dinner while I sit on the deck and contemplate the other stuff that needs to be one:  packing for a trip back East next weekend; cleaning the tufts of cat hair that seem to multiply on their own accord - but only on the dark wood floor;  cleaning Doug’s ice machine so we can return it to him before we travel.  For another moment or two, I’ll sit here with the breeze finally cooling things off, and let myself refuel a bit more before I take another step towards moving out of the post-surgery mode.

Post Surgery: This is what TKR looks like 3 months out

Sunday, August 25

Friday was a milestone day:  three months to the day from my Total Knee Replacement surgery.  May 23 to August 23.  Only three months, and yet, it seems, a lifetime.  And a good time to reflect on where I’ve been and where I’m going.

Here’s the short story:  I am on the mend, getting better, if not every day, certainly every week. 

For the longer version, we’ll start here.  The first order of business post-surgery was to get into physical therapy and get my range of motion back.  In fact, just hours after surgery, a PT visited me in the hospital and gave me some basic exercises to do.  Heel slides for flexion.  Quad sets for extension.  Leg raises.  Ankle pumps.  The goal was to get to 0 degrees of extension (a leg completely straight) and 120 degrees of flexion.  Sure, walking was a goal too:  they had me up and walking with a walker just three hours after my surgery ended.  But there was also an admonition:  don’t get overzealous in racking up distance walking;  the range of motion is more important to start out with.

So today, I have flexion well under control:  I hit 136 degrees the last time I was measured, which is more than my first PT has ever seen in someone with TKR.  That may not be an entirely good thing, though.  The prosthetic knee isn’t really meant to go much beyond 130 degrees, and a likely reason that I ended up with bursitis may have been because I overworked the flexion and strained ligaments, inflaming the bursa where a ligament (or is it tendon) attaches. 

Extension:  well, that’s been more of a struggle for me.  I’m still fighting to get that knee completely straight, and I’m still going to PT with Karen twice a week to work on that. Now is the time;  I don’t want to give up on this now only to find myself with limited mobility in the future because I wasn’t willing to put in the hard work.  With lots of massage and pressure from Karen (this is painful - not your feel good massage!), plus some Pilates machine stretching, and the PT exercises I do at home, alone, I’m getting there - just really, really slowly.  A few days ago, Karen measured my extension at “almost 1 degree” after she had spent thirty minutes really working it.  When my friend Clay told me that he was in PT for 3+ months after his knee replacement, it sounded like a long time to me.  Now I’m scheduled out for at least another month.  It doesn’t feel so long when you’re on this side of the fence.

Progress is good on many fronts:  I’m walking now - up to three miles in one flat “hike” last weekend, and lots of daily walks that are more like one and a half miles.  (Our friend Doug, who has had his knee replaced, cautions me against doing too much walking too soon.  A few years after his TKR, he had to have a revision, and he thinks it was because nobody cautioned him properly against doing too much too soon.)  I’m on my stationary bike for up to 35 minutes now, and am working - very slowly, just to stay safe - on short little rides on the street as well.  I’m walking up and down stairs almost normally, although Ed sometimes points out to me that I’m not doing so evenly.  I’m back in Pilates class once a week:  Karen, my PT, watches out for me, making sure I don’t do anything stupid.  I’ve finally started to drive my own car again:  because I was afraid of my surgical leg’s ability to hold the clutch in traffic, when I first started driving, I drove Ed’s Prius.  Getting back to my own car felt like yet one more step in getting my life back.  And The Rolling Stones?  Making it to the concert and enjoying it, finicky knee notwithstanding:  well, that was just the cherry on top of all the other good stuff.

My knee on the left, Doug's on the right

So, all in all, after a good start and then a couple of scary and frustrating setbacks, it feels really good to be making solid forward progress.  In fact, Ed and I had not taken any vacation time this year because my knee was such an uncertainty.  But in the last few weeks, we’ve gained enough confidence in my mobility - and promises of increasing mobility - that we’ve put together plans to use up my vacation by the end of the year (my work vacation is “use it or lose it” within a calendar year) with lots of travel.  Life is looking up.

Back in mid-March, I had my last appointment with Dr. Thomas Noonan, who had taken care of my knee for ten or twelve years.  He had been telling me, since the first time I saw him, that I would need a total knee replacement someday down the road.  Now, in March 2019, we agreed that I had exhausted all of the more conservative treatment options, and now was the time.  I had lots of questions for him, including, “how long will recovery take?”  I almost fell off the exam table when he said, “one year”.

One year?!?  Really, a full year???  I couldn’t quite wrap my head around it.  So I chose denial, figuring that a year was what it would take for someone who wasn’t active, and who wasn’t really motivated to get back to an active life.  It was only in the weeks leading up to my surgery that I started to get worried that maybe a year was the actual time needed for recovery.  I reached out to several people for advice and counsel.  One person who had had TKR told me that it took a full year before they woke up one day and realized that they weren’t thinking about their knee most of the time.

The booklet from the hospital with
info on all things TKR.
I'm retiring this from the coffee table;
happy not to need it much any more.

Now, I’m finally starting to get it, and to accept that this is just a long, long recovery.  Although I’m sleeping through the night (most of the time) these days, I still wake up pretty much every morning with my first thought:  my knee hurts.  Some days it’s the whole knee, just achy throughout.  Some days it’s a stabbing pain, something that moves around.  This knee still tells me regularly that it’s not happy.  I can’t be in one position for very long before it starts getting cranky, and forces me to get up and move.  I still ice my knee, multiple times every day.  I still have Doug’s ice machine, and I use that almost every night - although I have to return it soon, since he has another friend going in for TKR in September, and she’ll need the machine more than I do.  

I still have lots of milestones to hit on this recovery.  I’m going to hike again, and not just on flat surfaces.  I’m going to cycle outside more and more and more;  maybe next summer I’ll do the Triple Bypass.  That’s a classic bike ride here in Colorado that is 120 miles and goes over 3 mountain passes.  I’ve ridden that event three times in the past, and had signed up to ride it this summer way back before my knee wigged out.  (Good thing I bought the cancellation insurance!)  I’m definitely going to ski again:  and yes, I’m going to do some bumps, even if I have to back way off.  I’m going to run, too:  who knows how much and for how long and whether I’ll do any races, but it’s just a part of my DNA that I’m not ready to give up on yet.

For today, though:  we walked to Keith’s Coffee Bar for our Sunday church of homegrown music, and I’m sitting on our front porch with blustery winds.  There are Blue Jays noisily calling and grabbing peanuts off the tray feeder.  A hummingbird - a female Broad-tailed, I think - just stopped by a feeder, sat for a minute or so to drink the sugar-water, and then dashed off.  Chickadees are chirping in our neighbor’s front yard juniper tree.  I think it’s time to take off my ice pack, since it’s not really cold any longer, walk inside, and do a few PT exercises before I tackle the NY Times Sunday crossword.  Life could be much worse.

My bionic knee, three months after surgery

Post Surgery Week 13: Vine Street Criterium

Thursday, August 22

When I was 8 years old, I got my first bike.  It was a blue beauty, and special because it was brand new and a girl’s bike.  No hand-me-downs for me!  I had watched my big brother learn to ride, so I had a head start.  I used training wheels for just a short time, and then I was off, riding like the wind.

Well, as much like the wind as an 8 year old can ride.  The truth was, I rode all over town.  All. Over. Town.  Of course, you have to remember that these were different times, and the town where I lived until age 9 only had a population of about 200 souls.  Still, it was grand to be so free.

Something happened early in my biking career, and I fell in with a bunch of kids who liked to race.  The course was the block that was home to the town’s two churches:  one Methodist, and the other Christian.  The streets were crumbling asphalt, which meant that the corners were particularly treacherous with loose pebbles and sand and rocks.  We raced around and around that one block, and, inevitably, someone would spin out on the loose stuff, and there would be a wreck.  It never failed to happen.

Methodist Church, Henderson, Iowa

My first wreck netted me skinned knees and elbows, but nothing terrible.  What was terrible was my mom’s reaction.  She read me the riot act, lectured me on the dangers of racing, and forbade me from ever racing again.  I was sufficiently scared that I didn’t head right back out to play with the racers.

But then, time elapsed, and somehow I was out on my bike again, and somehow I ended up racing that same block with those same kids again, and pow!  I got into a bang-up of a wreck.  This time my knees and elbows were much further gone than mere road rash.  I was a mess.  I was scraped and bloodied and bruised.  I had pebbles embedded deeply in both knees.  My elbows were, well, don’t ask.  My friend Ann Phillips was there, and she lived just a block away, and her mom was a nurse, so that’s where I ended up.  Mrs. Phillips worked on cleaning me up with mercurochrome in their brightly lit kitchen.  I cried as she worked on me, and she tried to reassure me that it would all be okay, and she was going to call my mom to come get me.  That was when I blubbered:  “But my mom is going to kill me!”  Sure, it hurt like anything, but I was more scared of my mom than I was of the skinned up body parts.

Mom, baby brother Dave, me, Ann Phillips

But Mom was great, and kind.  I think she knew that I wouldn’t be racing anytime soon again.

And I didn’t race again on a bike.  For a long, long time.  I had no interest in it whatsoever.

But then, many years later, I moved to downtown Denver in 2000, and woke up one Sunday morning to find there was a bike race going on right outside my window.  I mean: Right. Outside. My. Window!  It was the Bannock Street Criterium, a race that has been held annually since the early 1990s.  A criterium, or “crit”, is a bike race of multiple laps on a closed course.  The Bannock Street Criterium course is a figure 8 configuration through what used to be my neighborhood.  I was a total newbie to bike racing of any kind in the early 2000s, so this was all virgin territory to me.  I went out on the street and watched as different groups - fast, powerful men;  kids;  women looking just as fierce as the guys; - flew by in different waves.  It was fascinating to see the changeup in position each time each different group went by.  It made me think of racing around the church block in Henderson, Iowa, in the 1960s.

It was shortly after that that I met Mick, the guy I would go on to spend eight years of my life with.  Mick was big into cycling, and into bike racing.  It took a few years before he convinced me to join him in a bike race or two, but they were all uphill races in the mountains that were too vertical to build up much speed.  I was never really frightened of speed on those uphill races because, well, even while I was racing, I was going at slightly more than a snail’s pace.

But in the summer of 2005, we happened to be spending the weekend at my place on the Sunday of the Bannock Street Criterium.  On a whim, he and I both decided to enter the race.  Now, I didn’t know a darn thing about racing a crit, but I figured that I would be just riding for fun, not actually competing.  I still don’t understand the ins and outs of competitive bike racing and all the “Cats” and ranking algorithms, and how you end up racing in which category.  But it turned out that there was a Citizen’s category for women, and so there I was, lined up at the start with 6 other women in my age group, and the horn sounded, and we were off.  Our race was 5 laps on the 1.5km course.  Not terribly long, but with that figure 8 configuration and all of the hazards of racing on city streets - manhole covers, cracks and potholes, etc. - it was a real challenge.

There are few details from that day that stick in my mind as firmly as the feeling that I got as I engaged in the competition.  Once I noticed that I wasn’t getting dropped from the outset, I just went into autopilot, and didn’t even notice that I was getting into the race.  About halfway through the race, though, we went flying around one corner, and I realized that I was on the edge of my ability to stay upright.  Whew!  I was 8 years old again, back in Henderson, and I was racing around the church block.

Something about that visceral memory of the wreck and being scraped up and ouch:  well, the speed on the corners pretty well scared me, and I backed off a little.  I didn’t fade entirely;  in fact, I kept with the group enough to finish third out of the seven of us.  But, oh, how that race brought up memories!  It was fun, and it was exhilarating, but at the end of the day, I found I really didn’t have enough confidence in my skills to want to race another criterium, and I didn’t want to invest in the road rash that I figured would come with trying to get up to speed in that realm.  My criterium racing days were pretty much over after that one race.

What does any of this have to do with my knee surgery and my recovery?  Well, last Friday at PT, I asked Karen what she thought about me going for a bike ride out on the streets rather than on my trusty trainer.  She turned this right back on me:  “How do you feel about it?”  Well, the answer was:  I wanted to do it, but I was really, really nervous.

Which is how it came to be that early Sunday afternoon, Ed and I went out to the garage and pulled my town bike down off the wall.  I just bought this bike last fall, and between weather and work and travel and other distractions - like knee surgery - I had only ridden the bike home from the store and then parked it.  It’s a sweet hybrid bike, a beautiful blue baby.  It was brand spanking new, and it’s a women’s specific designed bike.  When I rode it home from the store, I thought I was on my original blue beauty.

Ed made sure that my tires had good air pressure, and I donned a helmet and gloves.  It was finally show time.  I sat on the bike and started to roll down the alley.  

Oh. My.  

I had forgotten how wonderful it is to roll along on a bike, just floating along.  This hybrid bike is built out of steel, so it’s pretty heavy, and that means it has a lovely smooth ride.  

We got to the end of the alley - Ed was riding alongside me - and turned east.  This was still going slightly downhill.  At the corner, we turned right onto Gaylord where it’s slightly uphill, just enough that I had to shift and actually put some (nascent) muscle into the machine.  We turned right at Vasser, then right again on Vine, going slightly downhill again, right in front of our house.  When it came time to the turn in to the alley, I kept going straight, and caught Ed by surprise.  “So you’re going further???” he asked.  Damn straight!  Around the block I went again, and then again.  Ed finally reined me in:  he was afraid, rationally, of me overdoing it, and having yet another setback.

So we ended the great Vine Street Criterium of 2019 at just 3 laps.  But, good heavens, did that feel fantastic.  My legs had to work more than they had worked in weeks - no, months.  It was good to feel them offer up that effort.  It was, no doubt, smart to limit the ride to just a few laps around the block.  But, trust me:  this criterium is going again soon, and longer and, well, maybe, just a little bit faster.

At the end of the Vine Street Criterium of 2019