Encouraging News

The verdict is in--I'm done with the TKR recovery phase. I went to my follow-up doctor visit with my surgeon and, at 7 weeks post-surgery, he declared me to be completely beyond all the required mileposts. My x-rays showed that everything "inside" was perfect, my scar is well on the way to being inconsequential, and he was VERY positive about my knee. I could, of course, straighten it out perfectly, and he said my Range of Motion was 122 degrees which is well past what is considered fully functional (110 is fully functional). Not to be too boastful, but he said that my recovery was remarkable both in the short time it has taken and in scope. He was VERY complimentary of my progress and said that all surgery involved a team--the nurses, the doctors, the physical therapists, and the patient. Without my work at exercising, he said that what the rest of the team had done would not have been nearly as effective. So, whew! I feel like I just passed a big final exam and that I've received an A for my effort. It's a wonderful feeling to be sort of at the end of this process, although I realize that I have to keep up my efforts in order not to lose what I've gained.

We did discuss my right (the un-operated) knee, and his advice was to put off the surgery on that knee as long as possible (at least 3 or 4 years). When I asked about coming in for my next check up, he said that he usually had patients come back at 3 months but that I was doing so well that I really didn't need to come back; however, he said if I wanted to get a cortisone shot in my right knee right before Christmas that I should make an appointment for that and he'd give me a shot so that I'd be able to enjoy a busy and active vacation without any problems with my right knee.

Next week, in order to keep up my good work, I plan to go sign up for the open gym program at the physical therapy facility. Although it won't be quite the same as physical therapy, my hope is that it will be motivating and that I'll keep working on increasing my strength and flexibility. But just for tonight, woo hoo! I feel like celebrating! Actually, Stan and I did celebrate by stopping off for a yummy Mexican dinner on the way home. So hooray for now, but next Monday, I'll get back to the exercise bike and the leg press machine and the hamstring stretching machine and.....everything!

Home Modifications

The end approaches for regular posting on this blog. I am very excited about tomorrow when I go to the orthopedic surgeon for my big checkup. I'll get x-rayed, and he'll push, prod, pull, and bend my knee to make sure it's working right. I'm relatively sure that all will be in order, but it will be gratifying to have official verification. I can hardly wait to report in tomorrow night!

In my continuing effort to wrap up this blog, I'll comment tonight on furniture and home modifications. We did virtually nothing before my surgery, but if you read the first few entries of this blog, you'll realize that we had little warning of my surgery and were gone until the day before it occurred, so we had no opportunity to research what might be helpful, and even if we knew what we should do, there would not have been enough time to do it! So, we winged it.

The most important thing is to prepare a place to spend the first two weeks. This should be on a floor in your house (if you have more than one story) which requires no stair-climbing, and which has easy access to a bathroom. It would be nice for that bathroom to have a shower, but if it doesn't, it doesn't matter that much since you can't bathe until your incision is totally and completely dry.

You will want to have a place to spend your days. I spent most of my days on the couch in our family room. Stan moved the coffee table against the wall so that he could put a card table by the couch. On the card table, he put my laptop so that I could web browse and keep up with email (and write my blog!) while watching TV and looking out the window. Make sure you have a nice place to spend your days so that you can "do" things and take a nap, all in the same place.

I found it very helpful to have lots of pillows, mostly to build a "ramp" for my leg which would keep it well above the level of my heart. I was much colder right after my surgery than I usually am, so I would advise several light blankets which can be added to or subtracted from as necessary. Have a sizable night stand next to the bed with a lamp, a phone (that can be muted!), books, a charger for your cell phone and for your Kindle, and all the other knick-knacks you need (gum, water, lip balm,comb, etc.).

One of the things that was surprisingly helpful was a shower bench and a shower wand. I'm not sure that I could have stood up to shower the 2nd and 3rd weeks (and maybe even the 4th week) so the shower bench was a great help. Likewise, something beside a toilet to help you balance and stand up is essential.

There's probably no way to avoid getting a walker for the first 10 days to 2 weeks, but after that it's useless. If you can borrow a walker, do so. Your insurance will probably pay for a walker OR a cane, so if you can borrow a walker, get the insurance to buy you a good cane.

Having good, sturdy railings on both sides of stairs was, and continues to be, a tremendous help. Again I can only say, thanks, Stan! It was so good of you to install that extra handrail to help me get up the stairs!

Lots of ice packs--big for your swollen knee, smaller for your swollen ankle--will be used over, and over, and over for weeks. I still come home and ice my knee after a day of sitting at my desk. Using ice on my knee will continue for several more weeks, I'm sure, so get at least 3 ice wraps so there will always be a really cold one in your freezer!

I'm sure there are other things, but that's it for now. Tune in tomorrow to see what happens at the surgeon's office!

Students Arrive

School started for real today, i.e. we had students and classes, and a full day's schedule was followed. On the first morning of school, there are many confused and lost children, so I spent the first hour of the day helping mostly little ones, kindergarten and first graders, find their rooms. By the time I had walked back and forth and around our school several times, I was ready to collapse. That's more walking than I've done since my surgery! After "resting" at my computer for about an hour, I undertook the final big push to clean up my corner of the room (I'm sharing the room with others), and by the end of the day, I'm proud to say that all my boxes are unpacked, my furniture moved into its final place, and everything put away tidily. That effort, however, was quite exhausting, so after helping with dismissal this afternoon, I was more than ready to come home and put my leg up, wrap it in an ice pack, and read for an hour.

You know what I'm missing today? I miss physical therapy! My schedule had originally continued therapy until today, so I should have been there at 4:00, doing my leg presses and having my knee bent back tortuously. How could anyone not miss that experience?? But I do miss it, and I can only hope that I don't slip and slide back into my slothful, non-exercising ways. Because this is the first week of school, and because I go see the surgeon on Wednesday, I think I'll let this week slide a bit, but then NEXT MONDAY, I really will go sign up for the open gym program at the physical therapy facility. My theory is that if I pay for it in advance, I'll be guilt-driven to go and get my money's worth.

So, after a hard day at school, a good dinner cooked by Stan, and a nice period of putting my leg up and icing my knee, it's now time to go upstairs and get ready for bed so I can do all this all over again tomorrow!

Clothing

Having survived the glancing blow of the hurricane overnight, we woke to a gray, drizzly, blustery morning. Although the wind howled all night, we were relieved to find that there was no damage to the house or yard, although in neighboring communities in our county there were numerous trees down and half the county appears to be without power. We are very fortunate not to have any of those occurrences!

None of that has anything to do with my knee, of course, but I'm glad that I wasn't in the operating room when the earthquake hit last week or trying to be discharged from the hospital in the middle of a hurricane, so yes, weather does have an impact on every facet of life, doesn't it?

Tonight's topic will be fairly brief, but important, namely the topic of clothing. I did mention what I had packed to take to the hospital in one of my earliest posts, and I also advised packing a bag to keep in whatever temporary bedroom was to be used during recuperation, but let me give a little more specific advice.

(1)Hospital: Although I did address my hospital clothing advice quite extensively, I would emphasize that there's no need to pack too much. I wish I had bought two pairs of nylon pajamas with long pants and short or no sleeves rather than cotton jersey. I only felt comfortable in the nylon pajamas. Rather than a robe, a bed jacket over (very loose) long leg pajamas will be just as nice looking, and you can wear the bed jacket in bed if you get a little chilled while sitting up in bed. If you (or I) really worry about having enough clothes, leave something neatly folded in your bedroom so that it can be found easily and brought to you in the hospital, but you probably won't need it.
(2) First week: Again, buy two or three pairs of nylon pajamas, preferably elastic waist and with no buttons. It's hard enough to dress yourself at this stage so make it as easy as possible. I'm not a big fan of tee shirts, but some cotton jersey tops will be easy to put on and take off which, paired with nice loose pants will be about as dressed up as you'll feel like being. I had home physical therapy starting the day after I got home, so I needed real clothes but I wanted them to be as soft and loose as possible. Pants made out of sweat pant material but which are only knee-length or 3/4 length are perfect. Your therapist will want to look at your incision and you need to have pants that can be pushed up over your knee easily but which also cover your knee otherwise. Obviously the time of year will influence your clothing choices somewhat, but even if it's really hot or really cold, you'll be inside so there's not that much variation in what you'll wear no matter what the season.
(3) Second week: Most of the clothing advice remains the same although, if weather permits, you may want to get out and have someone take you for a drive. Loose pants and a shirt (coat if it's cold, of course) should be sufficient. Wear the same comfortable clothing and make sure you choose safe shoes. By that, I mean you should not wear flats that might slip off, you shouldn't wear flip-flops or sandals. Sneakers might be a little heavy but if you like them and have someone to help you get them on and tie them, that's fine. I had some canvas shoes with nice rubber soles and a velcro strap across the top of my foot which looked okay with pants, stayed on securely, and were no problem to put on or take off.
(4) Third week on: By the end of the second week, I was more or less wearing normal clothes and certainly by the end of the third week. The only consideration at this point is to wear clothing for physical therapy sessions that is comfortable for exercising, that allows you to pull up the leg of your pant so the therapist can see and massage your knee, and that is washable. By the sixth week I was back at work and there was nothing about my clothing that was particularized to knee surgery. I still am probably wearing looser, lighter, softer clothing than usual. I'm also taking into consideration the fact that I'm wearing the silicone scar sheets on my knee, so pants that are at all a little more snug (such as blue jeans) tend to catch on the silicone sheets and pull them off. Other than that, though, there's no restriction on what I wear.

The obvious advice is to be comfortable, to wash clothes often, and to try to look moderately nice and tidy. Even if you are feeling lousy, looking presentable gives you a little boost of confidence that life really will return to normal!

Food

As in previous posts, I must ask your indulgence while, yet again, talking about the weather before TKR topics, but golly--who would have thought we'd have an earthquake and a hurricane all in the same week? It's really just a little too much, don't you think? In an effort to correlate the weather with knee topics, I'll mention that several of my friends on Facebook today have claimed that their arthritis seems much worse today as the low pressure center of the hurricane approaches. Is that really true? Does low pressure affect arthritis pain? I guess that's as good an explanation as any for the fact that both my knees are strangely achy today.

Stan and I have had a fairly quiet day, going out only once for a brief event at our granddaughter's Tae Kwon Do class, but other than that, we've puttered around the house, waiting and watching for the hurricane. So, since there's not a lot to say about the current state of my knee, and since I'll be winding up regular posting in the coming week, I thought I'd start my final set of articles. Let's talk tonight about a subject near and dear to my heart--food.

More for myself than for the edification of my small (very small) audience, I'll talk about food in terms of time. So, let's talk about food at these time periods:
(1) Hospital: It was my experience that with the morphine drip and the other pain killers that I was getting in the hospital, I felt pretty perky and had a moderately good appetite, so, in the hospital, order what you want and eat as much as you feel like eating because believe me, you won't be eating much after that for quite a while.
(2) The 1st week: Don't bother to have anyone cook for you or do much at all in the way of food preparation because it will be wasted effort. For the first 2 or 3 days at home I could eat only a few things: crackers and ginger ale in the morning, maybe some yogurt and a cookie for lunch, a little clear, plain soup for dinner. I think I ate a couple of individual cups of applesauce, and I forced myself to eat Raisin Bran cereal in the morning, but I wasn't interested in food and only ate to keep myself going.
(3)The 2nd week: My bouts of nausea continued and my lack of appetite abated only slightly during the second week. At the beginning of the second week, I still had trouble eating, but by the end of that week, I was eating real food, such as Stan's quesadillas. I couldn't eat much, but I could eat. For this time period, keep the crackers and ginger ale available, but add in some plain soups, a grilled cheese, and a bit of peanut butter on bread or crackers.
(4) The 3rd and 4th week: These were transitional weeks when I would alternately eat fairly normally (although never in great quantity) and then I'd be repelled by food to the extent that I could eat only a couple of bites at dinnertime. Stan tried so hard to cook good little meals, and they were good, but often I just couldn't stand the thought of food. My preference seemed to be for bland food such as the chicken and rice soup I made for myself. I began to enjoy ice cream and fruit (especially the cherries that were in season), but heavy foods such as big pieces of meat and spicy foods were impossible to eat. Several times during this period we had cold Subway sandwiches on flatbread and, while I couldn't always eat quite all of my 6-inch sandwich, I could eat most of it and I enjoyed what I did eat.
(5) The 5th and 6th week: The easiest ways to characterize these weeks was that I ate regular food, just in smaller quantities. Because I started back to work during this time period, I ate out several times. My meals included everything from a spicy Indian buffet (only one plate--couldn't force any more food down than that) to a Vietnamese-Chinese fusion restaurant to a New York deli style place to McDonald's to Ruby Tuesday's salad bar to Panera Bread (a bowl of chicken soup for my dinner, please). I continued to favor ginger ale but drank plenty of Diet Coke, coffee, and other assorted beverages. I abandoned cereal for breakfast and went back to my former habit of scrounging around in the refrigerator for leftovers for breakfast. By this time in my recovery, no special accommodations were necessary however, and the only difference was that I continued to eat much smaller portions than I previously would have eaten.

Perhaps I should have kept better records of what I ate and when I ate it, but for now, this seems to be a fairly good overview of what to expect in terms of food. My last thought on this subject is that nobody should be offended if they fix something tasty and appealing, presents it to the TKR patient, and is met with a look of horror and the comment that "I just can't eat anything." It's no reflection on the food, just an honest assessment of a particular moment and a particular state of being.

The Last Physical Therapy

Sigh....it's over. Who would have thought I would be so sad to have physical therapy come to an end? I am sad, however. It's been a painful but extremely positive experience to work three times a week with someone who is devoted to making me a stronger, healthier person. I suppose this is what it's like to have a personal trainer.

Just to give a few numbers, you may remember that about a week ago my physical therapist measured my knee for Range of Motion and that the measurement was 113 degrees. Today, without any pushing or help, my final Range of Motion measurement was 117 degrees. It would have been great if I could have pushed it on up to 120 degrees, but since 110 was the goal, I'm quite pleased with the 117. My therapists measured my extension which was still 0 degrees with no effort at all. She tested my strength and made me do ALL the machines to get final readings. Instead of my usual 45 minutes of therapy followed by 10 minutes with ice on my knee, I did an hour and 10 minutes of therapy with 10 minutes of ice, so it was my longest therapy session ever. In the end, I "graduated" with passing grades on every measurement. I guess I'm officially back in the land of normal!

It was a long day at school--half sitting in meetings, and half moving more furniture, unpacking more boxes, and generally wearing myself out. By the time I got to physical therapy this afternoon, I thought I was too tired to do anything else, but all that exercise left me strangely exhilarated, although still tired enough to be glad to come home and put my feet up. Fortunately it's the weekend, so I'll say good evening, go off and read for a while, and then go to sleep MUCH later than I do on a regular school night. I love weekends!

Thinking About the End of PT

How sad to think that tomorrow is my last day of physical therapy. Well, it's my last day supposing that my Range of Motion is still above 110 degrees, which I would think it would be. You never know, though. After a day at school, my knee was so swollen when I got home that I bet it wouldn't have bent to more than 90 degrees! I don't know what to do about this, because I can hardly keep my knee up on my desk the whole time I'm in my office, and when I'm out of my room teaching classes in various classrooms, I'll either be sitting (reading a story, demonstrating on the Promethean Interactive Whiteboard) or standing/walking while looking at children's work. Neither of those activities is conducive to keeping my leg "unswollen." Until such time that this naturally fades as a problem, I guess it's just something I'll have to live with.

My physical therapy location has an interesting follow-up program for its patients in which I am considering enrolling. For $50 a month or for $8 a visit, you can go to the PT gym and use their machines in an "open gym" arrangement. While they don't give you the personal treatment you get while under doctor's orders, they will help you with the machines and advise you as to exercises that might be beneficial. I've never been all that motivated to exercise on my own, but I don't want my knee to regress, so after next week's visit to the surgeon, I might consider trying the open gym program for one month. If I can force myself to go after a long day at school, I might find it quite beneficial. As I always say, we'll see!

Presuming that tomorrow is my final PT session, I'll wrap up my thoughts on that and then try to cover a few topics of general interest with regard to TKR surgery until next Wednesday's visit to the surgeon. Presuming that goes smoothly and I am pronounced "well," I'll just post every week or so (or less) until the end of the year. I do think it's been valuable for me, if for nobody else, to keep track of how I progressed during my recovery. As much as I tremble at the thought, I may have to do this all over again in 2 or 3 years with my other knee, but for now, I'm just SO glad to be getting better every day!

Lots of Exercise

While I can't say that the outside world (i.e. work) is particularly making me happy, I have no complaints about everything else. Family, friends, and even physical therapy are humming along nicely and happily. I worked hard today at school--pushing and pulling furniture here and there. When was the last time you moved a full filing cabinet across a room? That should count as part of my physical therapy, don't you think?

Speaking of physical therapy, I received some devastating news at my PT session this afternoon. You may remember that I had PT this week, and then one more session next Monday before my visit to the surgeon on Wednesday. Today, however, after being put through all my paces, my therapist said I was doing so well that I didn't need next Monday's session. She said we would take final measurements on Friday to send to the surgeon, and that would be it. Now I know that I've complained at length about the pain I have to endure at the end of every session (and I did again today), but I must admit that I've seen results from all my efforts and from the efforts my therapist has put into pushing me ever onward (and "backward"!).

Today's therapy was tiring mainly because I went to it already exhausted from the aforementioned furniture moving. I did all my usual exercises plus a few new ones, most notably lunges. My artificial knee is now, amazingly enough, the strong knee and my still-gimpy right knee really balked at the lunges. I wonder how long it will be until I get a new right knee.......

My therapy session was from 5:00 to 6:00 today, so Stan took me, picked me up, and then we dropped by Panera Bread for dinner. After all the work I did today, both at school and at PT, I was almost too tired to eat, but did manage to eat a bowl of soup. I'm now looking forward to taking a shower, then icing my knee for a while and reading for 30 minutes or so before going to bed. Big day at school tomorrow--open house!

Yuck

Only because I promised to post everyday until the end of August am I posting tonight. I am grumpy about work, and I am tired of sitting. My knee is hot and swollen from sitting too long, and I have a headache. Then, add to that the fact that I was in my very first, and I hope only, earthquake today. It was weird and strange and unsettling. I did remember my elementary school training, however, and was under the table (I was sitting at a table in a library) before the trembling even stopped. Everyone thought it was pretty funny, but hey, I didn't know how sturdy that school was! Getting up off the floor was an adventure in contorting my body and pulling myself up, but I managed without help.

That's all I'm going to say about today. Some days are just better off being over. I'm going to get in bed and ice my knee and try to forget today. Tomorrow isn't looking so good either....

Sitting and Exercising

What a long day it has been! I spent 3 hours this morning sitting in a little kid wooden chair in an elementary school library listening to people drone on and on. Well, I could complain about the content, but that's beside the point as far as knees go. What I can complain about is how hard it is to sit in one position for so long. I tried, unobtrusively, to stand up and take short walks, but it was still a long time to sit, and my leg almost visibly started swelling. There was a hiatus when I rode in a car for 45 minutes to get to another meeting, had lunch in a school cafeteria, and then sat for another 3 hours. Again, I tried to stand up and walk a bit during the meeting, but I felt conspicuous, and I know it's somewhat disruptive, so mostly I sat. By the time I got home (after another long car ride), by knee was red, swollen, and quite hot. Fortunately I had 30 minutes before I had to leave for physical therapy, so I iced, elevated, and took my Percocet. By the time I went to therapy, my knee was still swollen, but it was not too bad.

Today's physical therapy was from 5:00 to 6:00 p.m., the first time I've had PT so late in the day. It was more crowded than it has been when I've gone in the middle of the day, and it was obviously harder to feel energetic after a long day (even if I did sit most of the day), but it was a successful PT session. Let's see if I can recall everything I did: exercise bike, stretches against the wall, stretching on the table (the therapist pushing my knee down straight while I was on my back), and then I turned over on my stomach so she could do the dreaded knee-bending-backward routine. After that I worked on three different machines: leg press (up to 70 pounds today), the hamstring machine, and the machine (don't know the name) where I pull weight up by bending my knee backwards. I walked up and down the gym several times, going sideways with the big "rubber band" criss-crossed over my legs to provide resistance. Balance board work finished the workout and then I got to lie on the table with ice on my knee for 10 minutes, and that was the hour.

There are only 3 more PT sessions, and in a weird way I'm going to miss them. It's good to feel my leg getting stronger, and I can truthfully say that I feel almost normal now. I can walk with no effort or discomfort, go up and down stairs, and do just about anything I could do before. Remember, though, that I had two bad knees before my surgery, so now I just have one bad knee and one knee that works fine with a only few issues remaining with the surrounding muscles. Will I continue to do exercises, walk, push myself once PT comes to an end? I hope so, but time will tell.

Miscellany

Weekends are obviously a time-out period for me--no work, no physical therapy, just time to relax and regroup. Much like yesterday, I spent a lot of time relaxing today although I did go to the drugstore, the grocery store, and I did cook a minimalistic dinner. Since there's not much new with my knee (thank goodness!), I'll address two topics briefly. Tomorrow it's back to work and back to physical therapy, so we'll see how a long day treats me when I write tomorrow.

The first, and briefer topic, is Percocet. I had 7 more tablets left, and 4 more physical therapy sessions. I take no Percocet at all on the days when I don't have PT, but I'm still taking two tablets about an hour before PT. I hate to be a wimp, but I'm not sure I could get through the knee-bending part of PT without some pain medication, so I'm still taking the Percocet every Monday, Wednesday, and Friday. So, if I have 7 tablets left and 4 more sessions, you see the difficulty. I really don't need a lot of Percocet, but I decided today to go ahead and get the extra prescription that my surgeon gave me. I will, therefore, have what I need to finish physical therapy, plus I'll probably take some next Wednesday afternoon before going to see my surgeon for a check up. He isn't quite as demanding as the therapist, but almost; so, when he starts pushing my knee up, down, and sideways, I want to be able to grit my teeth and stand it without any undue moaning!

The second topic was suggested by Stan, and I may expand upon this later in the week as I near the end of my regular posting on this blog. When I wrote, the other day, about how much Stan had done for me, he mentioned to me later that he had been worried the whole time that he might do something wrong. Having never had any nursing experience, of course, he was somewhat in the dark as to what to do. We had information provided by the hospital giving a general overview of what a "coach" should do, and Stan, being the conscientious person that he is, took the admonitions in the hospital notebook very seriously. He did do everything perfectly, of course, but I can understand how he might have felt insecure and unsure of himself. It was new territory for both of us, and I would no more have known if he did something "wrong" than he would. If, however, you are having TKR surgery, I can't emphasize enough how critically important it is to have a "coach" who takes his coaching duties seriously. I can hardly imagine how anyone could get through the first two weeks without someone there to help, to encourage, to support, and, frankly, to wait upon the person who has had surgery. This being such an important topic, I think I will go into it in more depth later this week or early next week, and hopefully will be able to give a few tips, pointers, and suggestions for those saintly people who put their own lives on hold in order to take care of an invalid. So yet again, thanks, Stan!

Relax!

Which is more valuable in TKR recovery--exercise or taking it easy? Obviously there's a place for both, and I hope that I have emphasized the value of physical therapy, despite its pain, as being the "sine qua non" of recovery. BUT, there is a place and time for doing absolutely nothing. I did work hard at PT this past week, both at the PT center and at home, but today I didn't work at all. In fact, for most of the day, I reclined on my chaise longue and read--for hours! When I wasn't reading and reclining, I went upstairs and lay propped up with a couple of pillows in bed and watched TV. My leg, in other words, was stretched out straight and was totally relaxed all day. And you know what? For the first time in quite a while, there is no swelling, no stiffness, no "warm-to-the-touch" area around my knee. In fact, I feel fabulous tonight. I can walk normally, I feel energetic and capable. If I didn't know I'd had TKR surgery, I wouldn't know there was anything different about my left knee. It felt completely and utterly normal.

That's it for this Saturday night. What an upbeat way to end a day--feeling great! Sometimes, you just need to get off your feet and relax!

All Alone

What has happened to my physical therapist? She has metamorphosed from a stern, semi-disappointed (in me) curmudgeon into Ms Enthusiasm. Not that I'm complaining! It's a strange occurrence but welcome. At the end of today's session she counted the number of PT sessions I have before I next see my surgeon (4 more visits), and said that I was doing so well that she thought there would be no need for any further physical therapy. After all my griping, you'd think that this would be welcome news, but I realize the benefit of PT and I'll miss the enforced physical rigor. There's just no pleasing me, is there?

Work was particularly strange today because, aside from the secretaries and the custodians, I was alone in the building. The rest of the staff went on a "field trip" to a fairly distant aerospace facility. While I'm sure it was an interesting and valuable learning experience, it just wasn't in the cards for me to go. First of all, several hours on a school bus (2 hours going and 2 hours returning) sounded horrendous. I could hardly imagine sitting on a bus without moving for that long. Then there was the tour that involved several hours of walking (with occasional seated events for presentations). Even my physical therapist, bless her heart, agreed that it would be a very bad idea, and volunteered to write me an excuse. That wasn't necessary, of course, because nobody doubted my reason, so as everyone else left this morning, I went to my room where I spent the day piddling around, making cute calendars, filling out my lesson plan book for the whole year, unpacking supplies, and doing other exciting school room activities. I got up and walked the "circuit" around the school about every 45 minutes; otherwise, my knee and lower leg began to swell and get impossibly stiff.

Now I am free for two whole days--no school, no PT, no obligations. These days are drawing to a close since even weekends get busy once school is in session, so I plan to enjoy myself. Don't worry, I'll do my exercises, and I plan to ice and elevate whenever possible to work on reducing swelling. Even though I'm doing very well, my knee still feels swollen; however, when the therapist measured the circumference of my knee today, she seemed very pleased, saying that my knee was not nearly as swollen as it had been two weeks ago. It doesn't feel like it, but numbers don't lie, do they?

That's it for today. Time to enjoy a relaxing Friday evening at home!

Thanks, Stan!

There's nothing like sitting for most of a day to stiffen up the knees and legs. Even though I tried to get up every 45 minutes and walk around the halls of the school today, I still spent a lot of time sitting at my computer. Every time I would finally stand up, I felt SO stiff. The moral is: keep moving!

The days between my physical therapy sessions are inconsequential from a TKR point of view since I spend most of the time just recovering from the previous day's PT session. I do plan to do some exercises tonight, however, since even the few exercises I did on Tuesday seemed most efficacious on Wednesday. The most effective knee-bending exercise seems to be going down the stairs. I'm not sure if I can explain this well, but try to picture this scenario. I lead off with my right foot (the good knee) and step down one step while leaving my left foot on the step above. My left knee is now bent but I stand there and try to bend my knee even more, sort of "crouching" with my right knee so that the left knee has to bend more and more. I do this until it is almost too uncomfortable to bear, and then I stay in that position for 10 seconds. I proceed down the staircase, doing that every time my right foot is on the lower step and my left foot is on the upper step.
It might not sound like great exercise, and it's not. It's not exercise, but I do think it's a good way to stretch the knee cap and surrounding muscles which is my goal. After yesterday's success, I want to maintain and improve my Range of Motion and besides, I have to go up and down the stairs anyway, so I might as well get some benefit from that activity!

At school today I chatted with the mother of one of my students who said that her mother and her father-in-law had both had TKR surgery within the past year. She made an interesting observation which may or may not be true, but just for the sake of controversy, I'll pass it along. She said her mother's convalescence and rehabilitation had gone more quickly and smoothly than her father-in-law's because, she said, women know they have things that they have to do and that they can't sit around waiting for someone to do it for them. I think that may be true in general, but in my particular situation, I have to stand up for Stan. He did EVERYTHING for me from changing my bandage to washing the clothes to fixing food for me to keeping ice on my knee to cleaning up the house. So, while it may be true that many men expect women to take care of them, I can truthfully say that nobody, male or female, could have taken better care of anyone than Stan has taken care of me!

Work and a Work Out

The dreaded day has come all too soon--school has begun for teachers. We had 61 days of summer this year and yes, I know that's nice, but it's not the three months everyone always talks about, and we don't get paid during the summer, so I guess it's good to be back earning some money. In addition to going to work today, I used my lunch time to go to physical therapy, and since this is all about my knee and me, let me tell you about that.

My physical therapist has not been nearly as effusive and as complimentary as the home physical therapist was. She's a lovely young woman, and I think she does a great job, but I always feel like I'm not quite measuring up to her expectations. Especially after Monday's PT session, which I felt was a debacle and which left me feeling like a total wimpy failure, I was very discouraged. As I said in yesterday's post, however, I determined that I would work harder. With that in mind, I had done a lot of knee bending yesterday and after dinner last night, I lay on the couch on my stomach and pulled my leg backwards with a rope to try to duplicate what the therapist does. It was not fun, but I kept on pulling until I couldn't stand it anymore, and it must have paid off because after a truly agonizing episode on the table today with ever more backwards knee bending, I had progressed 8 degrees since last week in my Range of Motion measurement. I was at 105 degrees last week, and today I measured at 113 with no help from either me or my therapist pushing on my leg. In other words, I could pull my leg up and backwards all by myself to 113 degrees and, for the first time, my therapist showed a glimmer of enthusiasm. She exclaimed that I wouldn't believe it, that I had surpassed the 110 degree goal (what you need to "graduate" from PT). Then of course, she told me that it was all well and fine to get to 113 but could I maintain that until the next time, and the next time, and the next time.... She's a hard taskmaster, but she is pushing me to achieve what I need to achieve to be fully mobile and flexible again.

In addition to my usual bending torture, my therapist had me working hard, hard, hard on several new machines today. I pulled weights up and down with my ankle. I worked on a rowing machine, and I got hooked up to something that made me slowly lift and lower weights using my whole leg. I have to tell you--I can barely walk tonight! Every muscle I have hurts! But it was worth it! I can bend my knee to 113 degrees!!! You have no idea how good that makes me feel. Now I just have to do it all over again on Friday.......

Last Night of Summer Vacation

For me, a teacher, the summer is now over, and work begins tomorrow. I'm always a little glum at this point in the year, but in addition to my regret that summer is over, I'm also full of trepidation about how I will manage to go to work all day every day. Fortunately, for teachers, the first day back is spent mostly in meetings, so aside from the strain of sitting for a long time, I should be able to get through the day fairly well. I will go to physical therapy during my lunch break so I'll come back feeling pretty exhausted, but hopefully I can just sit quietly in a corner listening to someone else talk tomorrow afternoon.

After yesterday's very, very, very challenging physical therapy, I woke up this morning with every muscle in both legs aching. How will I get through another physical therapy session tomorrow? Honestly, I don't know, but I guess you do what you have to do. I'm pretty sure that I'll be ready to go to bed EARLY tomorrow evening!

Because yesterday's "knee-bending" exercise was so horrific, I've been trying to do some moderate backward knee bending today, and even here at home, it just hurts. Have I slipped backwards? It's too late tonight and I'm too tired, but maybe starting Thursday, I'm going to revert to my old home physical therapy set of exercises for a few days. I've got to do something to get my leg back on track!

It just occurred to me that today marks the 5th week since my surgery. On the previous "anniversaries" of my surgery, I had thought I was doing quite well, but after the last couple of physical therapy sessions, I'm feeling less sure of that. The knee-bending issue bothers me and makes me feel decidedly inadequate. I must try harder so that I can "graduate" on August 29 (my last scheduled PT session) and on August 31 (when I see the surgeon again). Note to self: must work harder!!

Well, Stan says it's time for me to go to bed, so for the last evening of my summer vacation, I will say goodnight, and have hopes that work will go smoothly.

Oh, My!

Just to avoid my perpetual whining about physical therapy, let me update our housekeeping arrangements. As you know, if you have read this blog since its inception, I spent the first two and a half weeks after surgery sleeping exclusively on the daybed in Stan's office which is on the main floor of our house. On July 31, I moved downstairs to the basement to sleep because, to be honest, I just can't stand the heat. Even when I turn down the thermostat for the evening, it's still in the mid-70s upstairs and I find that to be quite miserable for sleeping. I've always liked sleeping in a cold room and like nothing better than to keep my window open ever so slightly even in the dead of winter, so I find it refreshing and relaxing to sleep in the basement which stays around 62 degrees (more or less) year round.

Stan's office has slowly returned to normal since I'm no longer even napping in there. I still reserve the right to lie down on the daybed, however, on a hot afternoon if I want a cool, quiet place to read for a while! The family room long ago returned to its former state (on August 1), so the house is mostly back to normal. I go upstairs to shower each morning and, although it's not completely necessary, I have left the shower bench in my shower. It's nice to wash my hair sitting down and using the hand spray, so I may leave the bench there for another couple of weeks, but eventually it too will be retired.

That's what's going on in the house--not much, but satisfyingly back to ordinary life. And now I will whine just a little bit. Physical therapy is great for the first 45 minutes. I do a lot, I use the machines, I stretch, I get on the balance board and wobble, I do all sorts of things that are quite gratifying. You know what's coming though, don't you? Yes, the horrible bending the knee backwards routine! Today, however, the therapist took it to new heights of pain. She pushed back and then told me to push my leg as hard as possible downward while she was pushing hard backward. OH, MY!!!! It hurt so bad. I got through the first two rounds, but on the third round, when she pushed my leg back as far as I could stand it (farther really) and then made me push downward, it was so utterly painful that I told her I couldn't go on. Oh, just 5 more seconds she assured me, but I gasped out my refusal and pulled my leg away. It was just awful and I regret to say that my boasting about my stoical nature and my ability to endure pain must now be retracted. I couldn't stand it. I'm sorry, I feel like a failure, but I couldn't. How will I endure it all over again on Wednesday, and Friday, and Monday, and......? Even the Percocet (which I still take right before therapy, and only then) didn't dull the pain enough to endure this last challenge. Well, I'll try to work on it tomorrow afternoon here at home, and see if I can't stretch my knee some in preparation for Wednesday. But oh, my!

Silicone Scar Sheets

Although I posted this morning, that post was really for yesterday, so here's the blog post for Sunday. After last night's less than wonderful conclusion (swelling, tenderness, exhaustion), I woke up feeling better and have continued to feel pretty good all day. The swelling has not entirely dissipated, but it's mostly gone. Sometimes the cause of the tenderness/swelling/heat in my knee is mysterious, but yesterday it was pretty clear that it was caused by sitting in one place for over two hours, a mistake I don't plan to make again anytime soon.

Since there is very little to say about today--quiet day with a little exercise, a little cooking, lots of reading, no naps, a nice dinner at home--I'll devote today's blog to silicone sheets that are supposed to help reduce the appearance of scars. There are many brands of these silicone scar sheets available, and I have no intention of trying to advertise or recommend a particular brand. Being the thrifty person I am, I bought the drugstore generic brand, but I'm sure the name brands are great and perhaps better. I've only used these sheets for two days, and I already think my scar looks better. It doesn't look as "thick" and it seems to be perceptibly softer. The instructions say that to be effective, I should wear the sheets at least 12 hours before removing, and that it will take 4 weeks for noticeable improvement to take place, but I am so far quite encouraged, even after just two days.

These sheets are expensive (which is why I bought the generic brand), but if they really work, then I definitely think they will have been worth the money. I also bought the standard cocoa butter which I have rubbed onto the scar when not using the silicone sheets, but aside from softening the skin, the cocoa butter doesn't seem to make any real change. Now I realize I am very early in this process, so I'll try to remember to address this topic one more time before ending my regular posting, but for now, I'm a real fan of the silicone scar sheets.

So Sorry

Let's just pretend this is Saturday night, okay? I've not missed a daily posting since I started Knee and Me, but when we got home last night, I was so tired that I just wanted to fall on the couch and go to sleep. Stan, being the good influence that he is, got me a snack (you'll see why in a minute), told me to go upstairs to get my pajamas, didn't make me do my exercises, and got me tucked in bed where I promptly fell asleep and slept for almost 11 hours. So I'm sorry I didn't post last night, and I promise to post every day until the end of August when (as I've said before), I'll probably stop the daily posting and just post occasionally when something important happens. Back, however, to yesterday....

We were thrilled (well, I was) to wake up to a gray and drizzly morning yesterday. It was a perfect day for staying inside, starting a new mystery book (and getting 2/3 of the way through it by afternoon), taking a nice hot shower, lolling about watching some TV, having a bowl of hot chicken soup for lunch and then...napping away the afternoon. I knew we were going to have a big night out, so I thought the nap would help me feel rested enough to face a late evening. Strangely enough, I think it had the opposite effect.

Our son, daughter-in-law, and granddaughters picked us up at 5:30 to go to a nearby town (but still a 30-minute drive) to meet a young family whom we knew before we moved here. We met at an Asian fusion type restaurant where we proceeded to sit in one place for over 2 hours. The food was, well, not the best in my opinion, although it was a very lovely, attractive, and busy restaurant. Still, we enjoyed seeing our friends and their children. BUT, sitting in one cramped position for two hours really put a strain on my knee and lower leg. By the end of the time, I could almost feel my leg swelling up, and my knee was very hot and stiff. Finally I had to be the one to break up the party, but I really felt like I would start crying soon if I didn't stand up and move my leg. When I tried to stand up, I needed to lean heavily on the table and have Stan pull me up, and it hurt! Once I stood up and walked up and down, I started to feel better, but I was ready to go home!

Once we finally got home, neither of us having eaten much of our food, Stan fixed us a small snack, got me situated on the couch with my leg iced and elevated, and we watched TV for 30 minutes. By then, I felt well enough to get on my PJs and go to sleep. So that's my excuse, and I'm sorry I didn't write last night. Won't happen again, I promise!

Birthday Celebrations

This time of year is full of birthdays for our family and, as it turns out, for lots of little friends of our granddaughters. We had one granddaughter's birthday party yesterday, two birthdays today (Stan and our daughter-in-law), a birthday party tomorrow for a little friend, a dinner out tomorrow night with old friends and their (relatively) new baby, and a birthday Sunday for a little friend. Ordinarily this wouldn't be a big deal, but it is more tiring than I would have expected. That's one thing about TKR surgery--it apparently takes quite a long time to get back to your normal level of activity and energy, even if you feel quite good--and I do feel quite good!

The main event of the day was physical therapy. Not being a particularly athletic person (okay, not at ALL athletic), I've been surprised by how much I enjoy the "gym" aspect of therapy. The recumbent bike is fun, the leg press machine feels quite good, and the machine where I pull weights up with my knee is challenging but also feels satisfying in a strange way. It just feels good to use muscles and to know that they are getting stronger. The therapist also had me walking up and down the gym sideways, as she has before, but this time with criss-crossed elastic bands providing a lot of resistance. I could really feel a lot of pull up the back of my legs and into my hips, so that was great exercise. BUT THEN......two forms of torture were inflicted on me. The first one was the pushing down on my knee quite vigorously when my leg is stuck up in the air at a 45 degree angle. That hurts, but my extension (how straight I can hold my leg) is still at 0 degrees (i.e. the best it can be), so even though this hurts, it's not unbearable. But, oh, my! The therapist really pushed back hard and long on my knee this afternoon--five times, holding for 30 seconds each time. I just can't begin to emphasize how badly this hurts. I know it's for my own good, and I suppose I want her to do it, but I've come to dread the "Lie on your stomach on the table" command. I know that agony is about to ensue! But all good (and awful) things come to an end, and then I get to sit up with pillows and ice packs and watch the big screen TV until I feel better!

During the late afternoon and evening we went out to eat with our son and his family to celebrate Stan's birthday and our daughter-in-law's birthday (yes, they really do have the same birthday). It was a lovely meal in a marvelous restaurant (just to give a plug, it was Clyde's Willow Creek Farm, a beautifully restored colonial restaurant). Returning from that, we had a nice Skype conversation with our Florida son and his family. Despite everything that I might complain about, I can't think of any possible improvement on life than to be blessed with a wonderful husband, a sweet mother, sons I'm proud of, daughters-in-law who are just as nice as I could have ever hoped for, and the most beautiful, precious grandchildren EVER!

Driving

Guess what I did today? I got my hair cut. Now, that may not seem to be a big deal to you, and in the past, it wouldn't have been even worth mentioning, but the big deal for me was that I drove all by myself to get my hair cut. I feel like I am a grown-up human being again! I can go places without imposing on Stan, and that's really important to me. He's been so wonderful this past month and has done EVERYTHING for me, but he deserves to be set free! So today he was able to go to the pool while I took myself to the salon. Life really is getting back to normal!

Other than that groundbreaking event, we had a nice, family type of day. One of our granddaughters had a birthday party this afternoon, so we went to help out with that which meant that I was on my feet off and on for an hour and a half. It was fun, but being around a bunch of little kids all making pizzas would have been exhausting no matter what. This evening was quite exhausting, but we wouldn't have missed it for anything, of course. Had you told me even two weeks ago that at the four-week mark since TKR surgery that I'd be able not only to attend her birthday party, but that I would be able to help the little guests make and cook their pizzas, I wouldn't have believed it.

Am I dreading physical therapy tomorrow? You bet I am! But I'm going to keep plugging away and, in a few weeks, it will be over and then it will be my responsibility to keep myself active enough to continue my progress. Maybe I should appreciate this enforced exercise activity while I have it!

We have two more birthdays tomorrow--my husband and my daughter-in-law share a birthday, so between those celebrations and PT, it will be a very full day. Time to get some sleep!

One Month Anniversary

Having forgotten to do so yesterday, I'll mention that yesterday was the four-week anniversary of my TKR surgery. My, time flies when you're having fun, doesn't it?

Just to recap, in case I (or someone else) might want to know what to expect at certain times during the recovery, here's an overview of my life right now, expressed in terms of TKR topics of interest:

1. The incision site: The incision is now completely healed. There are no more scabs and right now, it sort of looks like someone who has had a sunburn: slightly pink with some peeling skin.
2. Pain: Yes, I still have intermittent pain, but it's never severe enough to cause any impediment to my daily life. My knee generally hurts after physical therapy, but so would your knee if you were doing what I'm doing!!
3. Swelling: As you know if you have kept up with this blog, I have swelling every few days for no apparent reason. It's distressing when that happens, not so much because of the discomfort, but because of the perplexity as to why it happened and what, if anything, could be done to prevent it.
4. Sleep: For the first two to three weeks (especially the first two weeks), I was sleeping all night plus 2 to 4 hours during the day. Those times are over for the most part. I still rest in the afternoon usually, but often don't fall asleep. After today's PT, I did sleep/doze for about 45 minutes just to escape the ache in my knee! As for nighttime sleep, I'm generally going to bed around 10:00 and waking up sometime between 7:00 and 8:00 a.m. Those times are about to end because school starts next week, but for now, I might as well indulge myself.
5. Appetite: This has been strange. Most days I'm eating normally now, but every 3 or 4 days, I will get that old queasy feeling and will feel like all food is disgusting. If only that feeling would last for the indefinite future.....well, no, not really, but I guess having no appetite every once in a while isn't all that bad.
6. Mobility: As you will have read, I'm more or less walking on my own everywhere I go now. I have been taking my cane with me still when I go out in the world, but today my physical therapist told me to leave it at home. She said it was time to stop depending on anything to help me. Okay....... The good news, however, is that the therapist measured me again today, and I have 0 degrees extension (i.e. I can extend my leg until it is perfectly, absolutely straight) and I have 105 degrees of Range of Motion (that's the angle at which I can bend my knee). There's nowhere else to go with extension since that's all anybody can do. I will need to keep working on range of motion, however. My surgeon said that the most I could ever hope for would be 120 degrees, but that if I could keep it between 110 and 115, I'd be able to do anything I want to do except sit on my heels (which I never could do anyway). So, when I complain about my therapist, I know she's trying hard to get me to that 110/115 point and I appreciate her dedication. I will try to get there before the end of August when my therapy ends.
7. Stairs: I have been using my cane to go up and down stairsteps, one step at a time (i.e. bringing both feet onto a step before progressing to the next step). No more of that sissy stuff for me as of today! My therapist took me out to the stairwell of the building without my cane and had me climb up and down two flights stepping up normally (one foot over another). It was an effort, but I did it. Going down stairs is still much more difficult than going up the stairs, however.
8. Pain medication: The only time I take Percocet now is before physical therapy. I'd like to say I could be stoic enough to go through all that pushing, pulling, straining, and movement without medication, but I'm not there yet. Even with the Percocet, it still hurts, so I'm just not brave enough to do therapy without a little help. I'm about out of the initial prescription, but I did get another prescription from my surgeon at my two-week visit, so I'll probably get it refilled early next week in order to get me through the remainder of my physical therapy sessions.
9. Physical Therapy: For all my whining about how hard and painful it is, I must admit that seemingly innocuous exercises really seem effective. Aside from the horrible bending-the-knee-backwards episode at the end of every session, I really wouldn't mind the rest of it. It's demanding and leaves me a tad tired and sore, but exercise is supposed to do that. It's the bending-the-knee-backwards that just absolutely kills me! Where's my ice pack???
10. Daily Life: One week from tomorrow, the school year starts again and I return to work. I am planning to go to work, and I think I'll be okay, but I do plan to use sick leave if and when I feel I need it. I've been accumulating sick leave for years and have used relatively little, so I figure if I devoted my whole summer to recovering from TKR (instead of taking off 6 weeks during the school year), I can indulge myself with the occasional day off if I start feeling run-down or too terribly stiff and sore. Around the house, I'm doing more or less what I usually do. I've been doing laundry for a couple of weeks, have fixed a couple of meals (although it's still SO hot that neither of us is interested in hot food), and take care of small chores like loading a few dishes in the dishwasher and making beds. Stan is still doing the major housework like vacuuming and most of the routine straightening up. For the first time today, I drove the car home from the grocery, so that hurdle has also been breached. I guess there's no excuse at all not to go to work next week, is there?

Well, that's a summary of my state of being at the one-month mark since TKR surgery. Since I still have no frame of reference, I am going to assume that I'm doing pretty well. I'm having busy enough days and seeming to survive them well enough, although I'm still very tired quite early in the evening.

Stan and I had another full day of activity today. We kept the granddaughters with Stan overseeing most of their activities (bike riding at a park, swimming for two hours in the afternoon). I meanwhile did a little bit of laundry, went to a VERY demanding physical therapy session, and prepared a minimalistic dinner. I did lie down to rest this afternoon, but spent most of the time reading and a little time dozing. On the way back from taking the granddaughters home, we stopped at the grocery and, as I said earlier, I drove home--the first time behind the wheel really since our Florida trip in June.

It's been another day in the life, therefore, and I'm getting ready to wind down and to start thinking about how nice it will be to sleep as long as I want in the nice cold, dark basement. (I'm not a vampire, really I'm not!!) Fortunately there's no particular reason to get up early tomorrow, so I'm going to indulge myself in a very lazy morning.

So, the second month of my recovery begins, and by the beginning of my third month four weeks from now, I fully expect to be almost back to 100%. Wish me luck!

Company All Day

After a day of sitting in a regular chair for several hours, I can tell you that sitting is harder than moving around. It's quite interesting, in fact, to note that my knee and leg feel just as stiff after sitting still for several hours in a hard chair as they do after exercise. So, note to self and advice to you: if you have to sit all day for a class, a meeting, or at a computer, get up every 30 minutes. I don't care if it does cause a stir or people do frown, get up, shake your legs, do some up and down tip toe exercises, walk a few steps, but do something. With all this complaining, however, I should add that it was really nice to see people and to talk about something other than the state of my knee. There's still a world out there, apparently!

Stan was gone all day running errands while I had people at the house, so he's about as tired as I am. And that's tired! Will I manage to get through physical therapy tomorrow? I don't know. Oh, I'll manage, of course, but right now I'm so tired I'm not sure I could walk out to the car. With all that said, I'm just going to say good night and trust that I have something more interesting to say tomorrow.

A Real Work Out

The torture I am paying for (better known as physical therapy) ratcheted up the intensity today. On the one hand, I'm proud of myself for being able to do everything my therapist throws at me; on the other hand, I'm not sure if getting some dread disease that required quarantine wouldn't be preferable! Seriously, I know I'm getting a good workout, and despite the pain she inflicts, I actually like my physical therapist and think that she really knows what she's doing. If only it didn't hurt so much! Yeah, you're thinking, how bad can it be? Well, you try having your leg stuck out straight at about a 45 degree angle and having somebody kneel next to you and push down hard on your knee. Yeah, it hurts! And that's not even to mention the perennial favorite, having someone push your knee backwards as far as possible. When I left therapy today, it was very useful to have my cane since it saved me from the ignominy of staggering along with my hand on the wall to hold me up. Well, perhaps I'm making it sound worse than it really is, but not by much. Really and truly, not by much!

Before I went to my therapy this morning Stan took the girls swimming for an hour. I, meanwhile, stayed home and did some work for school (and for a meeting) which I should have done earlier but hadn't. By the time Stan and the girls got home, I had finished my work, and as soon as they showered and dressed, we headed off to my therapy. They dropped me off, had lunch, picked me up, and then we all came home for an hour before heading out to Costco. I know, I know, sort of dumb to go to Costco on a hot day after having my knee jerked around for an hour, but I really wanted to buy these cool sherbet desserts that Costco is selling because I'm having a meeting here tomorrow and it seemed like a good idea to have something sweet.

Once we finally got home, I was pretty exhausted, so I've been hanging out on the couch, iced and elevated, too tired even to think about dinner. Stan's gone off to swim, so I'll close it out for the evening. I'm ready to descend to my cold basement and sleep for as many hours as possible!

A Digression About Bandages

If you read yesterday's lament about my swollen knee, you will perhaps be happy to know that a good night's sleep in the cold basement did help me wake up feeling better. My knee and lower leg have teetered on the edge of starting to swell again today, but I've used ice when I felt my knee heating up and have, for the most part, kept the swelling down to the bare minimum today. I'm still very puzzled as to what brought this on so suddenly, but perhaps I'll never know. All I can do is to keep doing what I've been told to do, to try to eat and sleep as well as I can, and I'll just hope for the best.

Today was a very quiet day for us. I went upstairs three different times today doing laundry, to take a shower, and to take an afternoon nap. I guess going up and down the staircase counts as exercise, doesn't it? And that reminds me to mention that Stan has now installed a hand rail on the wall side of the staircase leading up to the top floor. Even though I have been using a cane when I climb the stairs, I'm now able to use the handrails (holding on to each side), so that makes it just a little bit easier to climb up and down. I did exercises today, but I did the old set of home physical therapy exercises. They just seem to give me a better workout without causing residual pain, so that's what I did!!

Stan also suggested I mention a few other small topics that have been important to me in my recovery. They may not be of interest to other TKR patients, but if I ever do this again (for my right knee), it will be useful to have a reminder for myself. So today's topic will be knee bandages. For the first ten days following my hospital release, my daughter-in-law changed my knee dressing when she came to give me my Lovenox shot. By the end of that time, my incision was dry and she told me to leave the bandage off during the day, so that's what I did. I continued, however, to have Stan tape a bandage back over my knee every night, and you know what? I'm still doing that. Now I realize that nothing will probably bother my knee anymore, but until all the scabbing is completely gone (and it's almost, but not quite, gone), I feel more comfortable with my knee covered. To save money, however, we are using Curad Non-Stick Pads (8 x 3 inches) and Johnson & Johnson Hurt-Free Paper Tape. The tape really is hurt-free so pulling it off in the morning is like pulling sticky-note off your skin--barely perceptible. This has been a cheaper alternative than the more sophisticated bandages that have the adhesive on the bandage itself. I plan to use these maybe 3-5 more days, or until there are no more scabs. I'm just particular, and I don't want all my tossing and turning at night (I'm a VERY restless sleeper) to do anything to the incision. I know it's no longer necessary, but it makes me feel better, so I do it.

Tomorrow will be a busy day--babysitting the granddaughters, physical therapy, shopping for presents. Time for bed, and here's hoping there's no swelling to complicate the full schedule.

A Minor Setback

Why, after several stellar days of progress, did I wake up (after a very restless night of non-sleep) with a hot and swollen knee and lower leg? Have I done too much the past few days? Been on my feet too much? Done too many exercises? Done my exercises wrong in some way? Who knows? I didn't exactly feel bad, and I had a pretty busy day off and on, but my knee and lower leg definitely weren't in as good shape as they had been recently. Consequently I spent a lot of today with my knee iced and elevated (back to the old tried and true!). It's helped some but my left knee is still warm to the touch, and my left ankle is still slightly swollen. Oh, well, I can but hope that I'll sleep better tonight and wake up feeling just fine again in the morning.

In my reading on various websites and forums, I always--and I mean always--read that the swelling and tenderness last several months. Because my swelling had been going down fairly consistently, I guess I thought I'd be exempt, but perhaps this is a good reminder that it's still just been three and a half weeks since my surgery and I can't expect to be on my feet most of a day without consequences. Even Stan, who generally pushes me (ever so gently) to do as much as I can, let me off the hook today. My knee and leg were obviously not up to par and needed some time off.

When I wasn't hanging out on the couch or on the daybed in the office/bedroom, I was out with Stan going to Walgreen's and Harris Teeter. I also actually cooked a real meal tonight (shepherd's pie), so even without doing my exercises today (my knee screamed "no" every time I tried to bend it), I figured I did enough walking to give my knee enough movement to keep it flexible.

So for tonight, I'm just going to give up, try to sleep, and anticipate that tomorrow I'll feel MUCH better and be back to my exercises. Skipping one day is okay, I guess, but I've got to get back on track tomorrow. Wish me luck!

Varied Topics

There's not a lot to say about today, so I'll summarize quickly and then address a couple of general TKR surgery/recovery issues that maybe I should have addressed previously. And, just as a preliminary "warning," I'll mention that I plan to continue this blog until I finish therapy and then I'll let it die a dignified death. My main purpose was to have a record of the surgery and recovery, and presumably the formal recovery period will more or less end when therapy concludes. I may occasionally update it after a doctor visit or at the 3-month or 6-month anniversary, but mostly I'll just keep up the daily posting until the end of August which is when therapy ends.

Today was fairly non-eventful. Stan and I kept our granddaughters for several hours today while their parents were at work. Stan took them swimming in the morning, but for the rest of the day, we just all hung out here. I fixed lunch for everyone (yes, I'm sort of "cooking" now), and then we all did different things around the house and in the backyard, so it was a day when we weren't particularly busy, but we really couldn't do anything else. I did my exercises all by myself both this morning and this afternoon. Usually Stan supervises and keeps pushing me to do one more-just one more-okay, maybe two more! When I did them myself, I didn't do any extra, but I did do them. The one where I lie on my stomach and bend my leg backwards is the same one that causes me so much pain at therapy sessions, and it's none too comfy at home, but at least there's no hand pushing my leg ever backwards. Still, it was uncomfortable and I was ready to ice down my knee when it was over. And by the way, I'm not taking any Percocet at all except for two tablets right before I go to physical therapy. I take a couple of ibuprofen after breakfast, and that generally gets me through the day.

Now to address a couple of topics that I perhaps should have mentioned previously. When I left the hospital, I was fully expecting to be sent home with one of those "continuous passive motion" machines. Everyone I had read about and the one person here in my area that I knew who had TKR surgery had one of the CPM machines. My doctor did not prescribe one for me and I was somewhat perplexed because it really seemed to be standard practice. When I questioned the hospital therapist, I was told that I already had a range of motion of 90 degrees which meant that I didn't need the CPM machine. I also thought everyone was supposed to use a knee immobilizer for a couple of weeks, but again, when I questioned the therapist, she said that I could already extend my knee almost completely straight, so I didn't need an immobilizer. I'm sure my doctor and therapist knew best, and I guess my progress has confirmed their recommendation, but I really didn't get a full explanation of why these wouldn't help me to be even better than I might have been. All I was told was: work hard at physical therapy!!! And when you've worked hard at physical therapy, work even harder. For the most part, that's what I've done. Yeah, I'm human and I've sloughed off a day here and there, but I've tried to do what I was instructed to do, and so far it seems to be working--but it still hurts!

Ouch

Ouch---really, I mean it. OUCH! I really should have been careful about what I wished for because I really got a workout at physical therapy today. Some of it sort of felt good in the sense that I can tell the strengthening exercises are working and it is gratifying to be able to do things that I couldn't have done even before my surgery, but I have to say that when the therapist starts bending my knee backwards, that doesn't feel at all good. In fact, for the first time in any therapy session--hospital, home, or out-patient--I actually said "ouch," but I said it in a very moderate tone of voice. No girly screams from me!

The rest of the day was delightfully normal for several reasons. First, we had another moderate day which makes it nice to be outside. Second, I had an extended fun time upstairs this afternoon while Stan was at the swimming pool. I washed my hair, washed clothes, watched TV, reorganized my earrings (a bigger job than you would think), and read about half of my latest new book. Late this afternoon, our son, daughter-in-law, and two granddaughters came over for dinner (just take-out pizza) and for a nice relaxing chat after dinner. It was just a normal day, but after all the abnormal days of the past three weeks (has it really been only three weeks and two days???), a normal day seems wonderful!

Stan and I concluded the day sitting on the front porch watching a catbird try to coax her fledgling out of our holly bush. What a lot of chatter catbirds make! There was a light and steady breeze, and it was just...normal and ordinary, and WONDERFUL!

Cool Enough to Cook

Again, unrelated as it is to my knee recovery directly, I was thrilled to wake up to a gray, overcast, cool, drizzly day. What a morale boost! The temperature never got above the low 80s, so it encouraged Stan and me to go out again shopping and eating out. That's probably as good as any therapy session!

My leg was somewhat sore from yesterday's physical therapy session, so I guess the therapist made me work harder than I realized, and that's a very good thing. I want to work hard and I want to get back to normal. I can walk fine without the cane now, although I think I walk somewhat stiffly. When we go anywhere, as we did today, I still take my cane in case I need steadying going up and down a step or curb, but on a flat surface, I think I'm fine.

Speaking of going out reminds me to mention that I now have a handicap parking tag to hang from my rearview mirror. I was somewhat startled on my initial visit to the surgeon back in June to be given an application to get a permanent handicap tag. Upon reading the requirement to get a permanent handicap designation, I saw that I did indeed fit the requirement of having a permanent prosthesis (i.e. my artificial knee), so I'm set. Am I using my handicap privilege? Yes, for now I am, and I probably will in huge spaces like mall parking lots. Around my neighborhood or at school, I imagine I'll gradually discontinue using it as I get back to 100% (unless there's no other place to park, and then, yeah, I'm using it!!!).

Well, it was an otherwise quiet day--a 45 minute nap, and then I made my yummy chicken and rice soup for dinner which just hit the spot on a moderate, cloudy day. Hey, I really cooked! That's a first since my surgery. Maybe Stan will get a full home-cooked meal one of these days yet!

Three-Week Anniversary of Surgery

After yesterday's less than stellar experience at the outpatient physical therapy center, I had low expectations for today. While I can't say that I think I got a lot out of today's experience, it was better than yesterday. It started off with riding a stationary bike, then went on to some stretching exercises against a wall and on an exercise table. The therapist lifted and stretched my leg up and back as far as it would go which felt surprisingly good. The only exercise that hurt a little was one which involved lying on my stomach and pulling my leg up and backwards with a cord which I pulled until I couldn't stand anymore bend in my knee. In the end, however, I still feel I got more of a workout with my home therapy. That may change on Thursday when she promised to make my workout more demanding. After the therapy, she iced my knee down for 10 minutes, but really, it wasn't necessary. It didn't feel hurt, stiff, or swollen like it did after home therapy. And yes, I did take two Percocet tablets before the therapy, but I did that before home therapy, too. I'm sure this will get more demanding, but at $30 co-pay for each session, I'm more interested in getting my money's worth.

Yesterday and today have both been pretty good days. After I wrote yesterday, I got ambitious and moved all the furniture in the family room back to the way it was before Stan rearranged it for my rehabilitation. He had moved a couple of pieces of furniture and had put a card table by the couch so I could lie on the couch, read, web browse, watch TV, and have everything at hand. All that is cleaned up now, and our house looks normal again. That's an amazingly uplifting experience, believe it or not--maybe my period of invalidism is almost over!

We have had a quiet afternoon, taking naps, reading and doing nothing much, but everything is just fine for this my three-week anniversary of my surgery. Who knew things would go this well! Aside from still feeling a little more tired than usual, I'm doing about what I'd do on a summer day any other year. I'm not driving, although I think I could, but that's all for the best. If I don't drive, I don't go shopping, and if I don't go shopping, I don't spend money. So see, there's always a silver lining!

A Non-Event

Although it's been a good day, I have to say that the first out-patient physical therapy was a non-event. All the therapist did was take yet another extensive history and do an evaluation. Don't medical professionals ever share the information they collect about a patient? The therapist (who was very nice and whom I don't mean to disparage) kept asking me what my doctor had said about this and what the home physical therapist had said about that. I don't know! Really, I've had so much flung at me in the last 3 weeks, and much of that time I think I was in a drug-induced stupor, that I'm not entirely sure who said what or what they said. Can't these people fax or email basic information to one another?

Mostly, therefore, I sat or lay on an examining table trying to answer questions. After lying there for many minutes with both of my legs completely straight and stiff, she suddenly asked me to flex my operated knee so she could measure my range of motion. Now, when the home therapist measured, he did it at the end of my exercises when the muscle was as loose as it would get. Today the therapist measured it when it was stiff from being straight and immobile, so there was obviously a discrepancy. Last week at the end of my exercise routine, I had a range of motion of 110 degrees. Today, with a stiff leg, I initially had 92 degrees although she pushed my leg until it was at 100 degrees. I would like to have protested that the measurements were not done in similar manners and thus the results weren't really terribly comparable, but oh, well....they do what they want to do. Other than that, she asked me to walk up and down, and that's really all I did. I have a set of new exercises to do to prepare for tomorrow when, presumably, I will actually start doing something; however, after all her "no pain, no gain" warnings, I'm not sure I want to go back!

Stan and I have had an otherwise normal day. The morning was typical although Stan was out early working on the little walkway he's building in back of our house. After the therapy appointment, we stopped at the store to buy some salad fixings for dinner, and then came home. Stan has gone to the pool, I've been reading, but not napping! For the first time since my surgery, I'm not sleepy enough to take a nap--a little tired, but not really sleepy. Is this an anomalous event, or have I turned a corner and won't need to nap anymore? I suspect the former!

So, that's it for today. It's still horribly hot, in case you were wondering, so again I make my excuses for not going outside to take a walk or even just to sit on the porch. It's 97 and the sun is blazing down in a cloudless sky, the humidity is high, and it's just not my kind of weather, so back to reading.