Wednesday, February 26, 2014

Recovery and therapy following knee replacement surgery

Some of my friends who are considering having knee replacement surgery have expressed interest in my experiences, so I have decided to write about it and share my journey.

Monday, January 13-Thursday, Jan. 16
I don't remember surgery; I was out like a light! Even the days in the hospital are becoming a blur. My left leg was numb from a pain block. It worked very well! I also had a push button for self-regulated pain relief. I remember using it quite often the first afternoon after I recovered consciousness, but less after that.
I didn't eat much in the hospital; nothing was good. Just a few bites of each meal. Even after I came home, my appetite was very low, and my sweet tooth was gone! I took one bite of ice cream and pushed it away saying it was way too sweet! Totally unlike me, my sweet tooth is my downfall. However, I lost about 14 pounds, and since my appetite and sweet tooth have returned, I have managed to keep it off and even lose a bit more. I still have a long way to go, but I am making a start!
I did have one excellent caregiver; I don't remember what her title was (it used to be CRT I think, when my mother was in the nursing home, but they seem to have changed it. PC something, I think.) Anyway, she had a very pleasant personality, went out of her way to keep me clean and comfortable, and even suggested I use the hospital's free Wifi to listen to soothing music from Pandora on my phone! Everyone who came in my room, nurses, staff, visitors, wanted to stay because of the soothing music. :-)
Physical therapy in the hospital consisted of walking in the hall with a walker (without wheels). I made it past the nurses' station and to the elevator doors by the third day after surgery. I also began using the CPR machine, Continuous Passive Movement (description and explanation later).

I was dismissed to go home on Thursday, Jan. 16. I discovered that I couldn't get in my car, a 2009 Honda Accord! I did manage it with help after we moved the seat all the way back and lowered the seat back to a reclining position. After a week or two, I didn't need to recline it anymore and can get in and out without  help, but 6 weeks on I still need to move it all the way back. I have a temporary Handicapped tag to allow me to park in Handicapped spaces until mid April.

At home, January 16 - February 14
I haven't felt much like sitting at the computer; I can't get my leg comfortable, and I don't have a lot of free time in my day either. For the first couple of weeks or so, the strong pain medications were keeping me from hurting much at all. I was on Oxycodone when I first came home, then moved down to Hydrocodone 10 mg. On the 14th, he dropped me down to 5 mg, and I can really tell the difference. My right knee, which still needs surgery, is hurting, along with my right arm, from using it too hard on the cane and to push myself up from sitting probably. This is especially noticeable when it's almost time for the next pill.  
I do exercises in the morning and afternoon, and spend four hours a day on the Continuous Passive Movement machine, called CPM but I call it "the horse." Not because of my screen name, that was coincidental, but because I put my leg and foot in a stirrup-like device, and then the machine moves my leg up and down, backward and forward, bending and stretching. It's not bad in itself, but time consuming. Four hours a day on it! I break it up into three sessions: 1 1/2 hours in the morning; 1 1/2 hours in the afternoon, and one hour in the evening. It seems like every time I turn around I am facing more time on the "horse". I played endless games of solitaire on my phone, and even made the top 15% daily score a few times. That's wa-a-a-y too much solitaire! I finally got smart and checked out some audio books from the library.
(My favorite was a light-hearted piece by Debbie Macomber, "Summer on Blossom Street." It was read by the radio star, Delilah. I like to listen to Delilah on the radio occasionally, but didn't care for her reading. She put too much emotion, and sometimes inappropriate emotion for the context, in my opinion. I found that distracting.)
CPM machine, another view

Today (Feb. 14) they came and took the CPM machine back where it came from! Good riddance! I was very happy to see the last of it!

The Home Health care physical therapists were excellent, very patient, encouraging, and helpful. There were two of them, Cameron was the "head;" she gave me the exercises and increased the number of reps or added weights, etc. as needed. She usually came on Fridays to evaluate how I was doing. Amber was also very helpful, and had some creative ideas to help me gain flexibility. One of them, probably the most important one as far as my progress, was lunging forward with my left foot up on the fireplace hearth. That really helped me bend! I did that ten times, holding the position for a count of 20.

I did six other standing up exercises as well: "tippy-toe" - rising to my toes and then down 30 times; "deep knee bends" - as deep as I could anyway, and improved as time went on, 30 times; "marching in place" alternating legs, 30 times; "knee curls" - bending my left knee as much as possible while standing 30 times; "sideways stretch" - with knee straight, raising left leg sideway 30 times. (Some of the names of the exercises are from the instruction sheet they gave me and others are my own invention.)

Three sitting down exercises: "leg lifts" - alternate legs, raising 30 times, sort of a "marching in place while sitting down;" "straight leg lifts" - raising legs with knees straight, holding for a count of two, tightening my front thigh muscles while doing this 30 times. After 3 weeks, she added a two-pound ankle weight to my left leg with these two. Then the "knee bends" - while sitting, slide left foot toward me, to the floor under my seat, then use the right foot to pull it even more, as much as possible, 30 times.

Six "lying down" exercises on a bed:  "Ankle pumps" - move feet up and down 30 times, this can be done sitting or lying down, helps with blood circulation to prevent clots; "heel slides" - using a twisted bedsheet as a sort of "rope", looping it around the arch of my left foot, then pulling my leg toward my buttocks while lying on my back. Pulling as far as I could, 30 times; "windshield wiper" - lying on back, moving left leg out to the side and then back 30 times (later, she added a 2-lb. ankle weight); "short arc extensions" - with a tightly rolled towel under my left knee, raising my leg to a straight position and hold for 2 seconds. Do this 30 times. (2-lb. weight added later) "Hamstring stretch" - use the twisted bedsheet looped around the arch of my left foot, raise left leg straight up, as straight as possible, and hold for a count of 30. Do this three times. "Sideways windshield wiper" - lie on right side, lift left leg straight  up 30 times (later added the 2-lb. weight).

After four weeks, HHC discharged me, saying I had met all their goals! Whee, go me! Then, that afternoon I saw the surgeon for another post-op checkup; he said these were his minimal goals, and of course I know I need much more flexibility before I will feel "normal again.

Feb. 17, 2014
I had planned to go to the Physical Therapy unit that is a part of my surgeon's group and in the same building. I was told to see Lisa to set it up after my dr's appt. on the 14th. When I arrived, I was told that Lisa had gone for the day and I should call her after 8:00 Monday morning. I tried to call several times and got either a busy signal or voice mail. I left messages but they were not answered. We had some errands anyway, so we stopped by the dr's office to try to see her in person. She wasn't available, and the receptionist at the front desk told me that PT was all booked up until the middle of next week. So, I made an appointment, but I was very upset as the dr. wanted me to start PT right away.

My husband persuaded me to stop in at Premier Physical Therapy, where he had had PT for a pinched nerve in his shoulder last November. He liked them very much, but I didn't want to; I was in a bad mood and almost on the verge of tears. (I cry when I get mad - not very effective, and certainly frustrating for me, but I can't seem to help it.) I agreed finally, and they were very pleasant, said they certainly could take me, and had me fill out paperwork immediately. I still had the dr's orders for the other therapist, and Premier called for the referral. I didn't have to do anything else, and was given an appointment for the next day! 

 Feb. 18 - 26
The first day was mostly evaluation and answering questions, with a few exercises very similar to the ones I have been doing. The PT was very patient and gentle, not at all like my fears of "Physical Terrorists"! I had been imagining something like Marine boot camp!
He did give me exercises to do at home: Hamstring Stretch - sitting on a flat surface ( I use the bed, as I can't get down and up from the floor), stretch my left leg in front until I feel a "pull" in the back muscle, then reach with my hands toward my ankle and toes, hold for a count of 15. Do this five times per set. Short Arc Knee Extension - again with the rolled up towel under my knee, but do it ten times, holding for a count of five, then resting for a count of five. Heel Slides - This time, put a bathrobe sash under my knee and slide my left heel toward my buttocks without pulling until I've gone as far as I can, then pull gently until I slide a little more. Set a timer and do this for 2 seconds, working up to 4 seconds. Fortunately, I have a timer on my cell phone, which is nearly always with me. I am still doing some of the exercises the HHC therapists gave me, the standing ones particularly, mostly to get warmed up and flex my knee. I do each of these exercises five times a day, and the Short Arc Knee Extension six times daily. I made a chart to help me keep up with them, there happens to be a dry erase board in our purple guestroom. (It was the girls' bedroom when the previous owners lived here, and is now our granddaughters' play room.)
Exercise chart following knee surgery

At the facility I am seeing all three PTs; Jason is the manager and he decides what I need to do, and Lewis and John direct me in doing the exercises there. Mostly, I am on a sort of low padded table doing knee lifts, hamstring stretches, calf strengthening, heel slides, and short arc extensions. Today, the first thing I did was sitting in a chair machine that had a sort of lever that I was raise up and down with my left hand; it fit on my leg near the foot to push my knee to a full flexed position. After a few of these, he moved the bar to behind my leg, to raise it up to a straightened position then down again several times, then moved to the padded table.  After exercising, they measure the flex and the straight for range of motion, then ice me down with electrodes to stimulate my muscles around my knee. Very cold, and I'm glad when that's over! I was imagining the hot tomato soup I would have for lunch!

In summary
I have made a great deal of progress since the surgery, but I still have a long way to go. Then,will have to go through this all over again with my right knee! A few weeks ago, I wondered what I had done to myself and doubted that I wanted to do it again, but now I find that I have much less pain in my left knee and it's getting better and better. The pain in my right knee tells me that it was indeed worth it, and I will do it again. 

Saturday, February 1, 2014

Where have I been? Recovering from knee surgery

I had my knee replacement surgery on Jan. 13. I haven't been here since then because it's not comfortable sitting in this chair. I'm making myself do it for a while every day.

I've been doing my exercises and am making progress, but the therapist would like to see more progress. I'm trying to push myself, esp. with the bending. Besides that, I'm on a CPM machine (I call it "the horse") four hours a day, 1 1/2 morning and afternoon, and one in the evening.

Friends from the church and neighborhood have brought us food, and hubby's very good at warming it up and combining things to make meals.

I'll check in again from time to time. Thanks for your thoughts and prayers.

Friday, January 3, 2014

2013 in pictures

After the Christmas tornado
The aftermath of a devastating tornado in Mobile Alabama on Christmas Day, 2012. This was the church where my  husband and I were married. The high school from which we both graduated was hit, too, along with several homes and other businesses. Miraculously, no one was killed or seriously injured, praise God!

 The school re-opened this September; the students were housed in mobile classrooms at another high school campus in the city from January-May, 2013. The church is rebuilding; meanwhile the parishioners are meeting in the repaired Parish Hall. For a few months they met in the building of a sister church in the city. Most of the homes have been or are being repaired. Some had to be torn down. The businesses have been repaired.

Key West, Florida
We took a cruise from New Orleans to Key West and the Bahamas, along with about 30 of our friends from church. It was a wonderfully restful time!

Happy St. Patrick's Day!
I didn't take many photos in March, just this one on St. Patrick's Day. We had begun house-hunting in preparation for a move to be closer to our children and grandchildren. This was taken in the driveway of our son's house.

Daddy's girls
Son and granddaughters, the reason for moving. We bought our new house in April, found it, liked it, made an offer, signed the papers and took possession!

A sea of boxes
Packing up our whole house, getting ready for the move

Living room with new rug
We moved in on June 1 and began furnishing our new home with pieces we already had, some items that had belonged to my mother, and a few we bought new or (mostly) from a flea market/antique store.

Brand new grandson!
Brand new baby grandson to join his sisters, ages 5 and 2!

Enjoying our pool with the family!

Jazz on the Grass
Attended a music fest on Labor Day, Jazz on the Grass

Morning sun (with "Joe the Fisherman")
A subtle (*very* subtle) change in the foliage

Cutting up at Thanksgiving
Thanksgiving Dinner with our son and daughter-in-law. The son with the children spent the holiday with his wife's family.

Joy to the world!
Eldest granddaughter is in kindergarten now. This is her school Christmas pageant. (She's the angel on the left.). I'm so glad we live here where we can be a part of their growing up!

Birthday dinner
Another one for December, consider it Lagniappe! This was my birthday dinner with my husband. :-)

Friday, December 27, 2013

New (to me) Jane Austen blog

I've just found a most delightful blog about Jane Austen's novels, thanks to my Bookcrossing friend, GoryDetails. It's called "Bitch in a Bonnet" and I've added it to my "Blogging Friends" list over in the right margin. He's nearly finished them; he's on Northanger Abbey now, but I plan to read all his entries. I won't do it all at once, so it may take me awhile.

(By the way, the "B" word is not a word I use, but it is the name of his blog. He doesn't use off color language, it's just funny.)

Tuesday, December 24, 2013

Merry Christmas to all!

It feels like we had Christmas already, Saturday the 21st when our son and d-i-l from out of town came down, and our son here and his wife and three small children came over. We had a big dinner together: ham, sweet potatoes, rolls, and one d-i-l prepared roasted cauliflower and Brussels sprouts and the other prepared corn casserole. We had non-alcoholic sparkling cider to drink, and banana pudding, chocolate cake, and cookies for dessert.

First Christmas

Early Christmas

After dinner, we exchanged gifts. My gifts were a big hit; I think everyone was delighted, and of course that meant I was delighted too! Almost six-year-old granddaughter got a Sorry game and a joke book; three-year-old got a Princess play set (generic princesses, not Disney), baby grandson got a set of three vehicles, car, train and boat. One d-i-l got a whimsical owl clock for their playroom, where she already had a decal mural of a woodland scene, and the other d-i-l, who is from Texas, got a large Texas star to put on her wall. I think she was the most thrilled; it will be interesting to see where she decides to hang it!

Husband was in charge of our sons' presents. One got an electric tool, a drill or something (I'm very vague about tools), and the other rejected all our suggestions, and we couldn't think of anything, so he got cash.

My son's gift to me was a very special and thoughtful one. I have a small collection of little cat figurines, and have tried to match them to individual cats. A black cat cut-out with a votive candle for Shadow; a clear glass cat for Crystal, a wooden cat for Woody. (Of course, not all our cats' names lend themselves to a figurine.) I have long been keeping my eye out for a frosted glass cat for Frosty, and son found one! However, at home he noticed that it was clear, not frosted. So he found out how to "frost" glass, and did it for me!

Frosted cat, "Frosty"

Oh, and husband gave me a small gift even though I had shown him a long list of all the new and new-to-us things we had bought for our house since moving in - rugs, buffet table and lamps, framing of pictures, etc, etc, etc. He gave me a plastic duck call from Duck Commander! The girls had a ball with it!

The children played, ate M&Ms, and we halfway watched a Christmas movie on TV. (I don't even remember which one.)

Sunday morning, out of town "kids" went to church with us, and we were all going to eat together at a Mexican restaurant. They (son and family in town) never showed up, and finally called. They were at the other one of the same name, a small, local chain! So, each group stayed where we were after all.

It rained all day Sunday; we got over 5 inches before it was over. Son and d-i-l left shortly after lunch, and husband and I just relaxed with books and movies, coffee and comfortable clothes the rest of the afternoon and evening.

Today, we drove about 2-2 1/2 hours to visit my aunt, my father's sister-in-law and one of the only two left to either of us from our parents' generation. She is not doing well, is completely dependent on friends and housekeepers/sitters. She remains cheerful, though, and still has her mind, and we had a good visit! Afterward we took our friends (the ones who take care of her) out to eat and to see their daughter at work. We hadn't seen the daughter in a long time; she's always been at work when we've visited before.

Tomorrow, I'll catch up on laundry, taking out garbage, and vacuuming and cleaning the house again, and visit some neighbors. We'll wait until next week, maybe after my birthday to take down the Christmas decorations.