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.