I have moved from crutches to a cane this week. I can now stand with my full weight on the surgical leg, but moving still requires the aid of a single crutch or cane for balance. I have to step deliberately insuring that my leg is locked forward, not backward. The quadracep muscle has not fully recovered, so there remains instability when walking. Without a cane for balance, I am afraid that I may accidently hyper-extend the knee. Knee bend is at 60 degrees, and I am finding that I can sit at a desk with both feet on the ground for short periods of time. Bending the knee to 90 degrees or greater will require continued Physical Therapy. My right knee is still very swollen. Using a tape measure, I am 18 and 3/4 inches in circumferance around the knee. By comparison, my left knee is 16 and 1/4 inches.
I started Physical Therapy (PT) on December 22. So far I have been to 3 PT sessions, and I have been working out on my own at the home gym. My focus has been on exercises to improve flexibility (bending) of the knee. At PT, with significant effort, I have been able to get the knee to bend to 81 degrees, but the knee swells up after the PT. On the continuous motion machine, I have been able to get full extension and a knee bend of 70 degrees. I am finding that the wall slides (sitting on my back with my feet against a wall) really helps with the aid of gravity to force the knee to bend.
I had a bit of a scare on Xmas eve. As the Physical Therapist had encouraged me to use the stationary bike in my basement, I decided to give it a try. While I was not able to rotate the pedals in a full revolution, the Physical Therapist asked that I push and pull the pedals back and forth to exercise the knee joint. I began pushing/pulling the pedals back and forth. While doing this, I decided to adjust the seat in order to give my legs greater extension. As the seat was moving back, my good left leg moved the pedal to the top pedal position thus forcing my surgical leg into a larger bend of the knee. Since my feet were in stirrups on the pedals, I ended up doing a full revolution of the pedals. My surgical leg bent more than I intended, thus causing a a sharp shooting pain and a sense of something ripping in the knee joint. My knee swelled immediately, and the muscles in the back of the upper thigh area of my leg bruised and hurt.
I called the on-call physician later on that day to confirm that I did not cause damage to the knee. The on-call physician said that I probably tore some scar tissue and bent the knee more than it was ready to in the recovery process. But, he did not think I had done any real serious damage--just some additional swelling that will abate in a few days. He seems to be right as the swelling has gone down, and the tenderness and bruising of my thigh muscle has improved considerably in just a few days. Lesson learned: never adjust the seat of a stationary bike while your feet are in motion and in the pedals with stirrups.
I continue to take medications. I am still taking "norco" as a pain medication--one tablet every 6 to 8 hours, and I am also taking one 325mg aspirin per day as a blood thinnner and anti-inflammatory medication. I am finding that I need the pain medication to sleep soundly at night, and that icing of the knee during the daytime can sometimes take the place of the pain medication. I am trying to lengthen the time period between pain meds to see how long I can go without the medication. This also helps if I want to test my driving abilities. I cannot be on a narcotic if I am to begin driving a vehicle once again.
I did drive a car for the first time since surgery yesterday. Having been off the norco medication for most of the day, I drove my car two miles to the Produce Station to pick up some groceries. I was able to successfully sit (although with some discomfort) in the drivers seat. My leg bend and control of the leg was sufficient to manage the brake and accelerator. I was also able to walk to the mailbox for the first time since surgery and retrieve the mail. The cane is aiding in my increased mobility as I am able to get in/out of the car easier and carry some things in my free hand.
Overall, I am generally satisfied with my recovery to date. Other than crutches, cane, and the urinal, I have not needed any other special equipment or arrangements for the total knee replacement. Some people undergoing this type of surgery require a stay at an extended care facility for several weeks after the surgery. If not at an extended care facility, arrangements have to be made at their home to have a bed on the main floor of the house, a raised toilet, and nursing care for bathing and personal care, etc. I am fortunate to have reasonably good health and assistance of my wife Margaret and sons to avert the need for additional special care items.
My next appointment with my doctor is scheduled for January 10. I hope to have a 90 degree knee bend by then. Increasing the flexibility of my knee will remain the focus for the next several weeks.
One note of humor. This past Monday, after PT, Margaret and I did a bit of shopping. We went to Target on Carpenter to pick up a few things. I walked with the cane into the store, but then sat in a wheel chair cart provided for Target customers. Margaret then pushed me around the store. I had a little fun with this as I asked Margaret to push faster and pull wheelies. We both had a few laughs from this.
Wednesday, December 29, 2010
Wednesday, December 22, 2010
Two Weeks after Surgery
Today, December 22, marks two weeks since the total knee replacement surgery.
I am still on crutches but able to move around a bit easier this week. Pain when standing on my surgical leg is less intense relative to a week ago. Changes are incremental and gradual, but moving in a positive direction. I am able to fully extend (straighten my leg), and I can bend it about 50 degrees. Bending the leg is very difficult as there continues to be significant swelling around the knee cap area. Seems that I can move more quickly this week on crutches, and I am placing more weight on the leg and using my arms less to support my weight. I still find it difficult to sit normally in a chair without elevating my leg on a stool or something parallel to my bottom. Since Monday, I have also been in the car as a passenger on two errands. I am most comfortable sitting lengthwise in the back seat such that both of my legs are resting fully on the seat. Sitting in a normal upright position is not comfortable as there is too much pressure and pain around the knee cap area.
On Monday, I visited Dr. Denzin for my first post-operative follow-up. They took xrays of the knee, and everything looked normal. Dr. Denzin seemed pleased that I could fully extend the knee. But he was hoping that I could bend the knee a bit more than I could. He gave me additional prescriptions including one for Physical Therapy (PT). My next follow-up with Dr. Denzin is January 10. Through PT, I hope to show Dr. Denzin on January 10th a 90 degree bend of the knee. I am currently at a 50 degree bend.
One mild concern here is regaining full flexibility of the knee. I would like to obtain 110/120 degree bend in the knee. If I am successful, I may be able to squat like a catcher and catch some balls from my son Eric who is a pitcher. I have not been able to squat like a catcher for 15 years.
One thing mentioned by the physical therapist at the hospital was that some knee replacement patients needed a manipulation procedure if they were unable to gain sufficient flexibility in the knee. Evidently, some patients do not invest in the physical therapy sufficiently to regain flexibility. Consequently, scar tissue forms around the surgical area which restricts movement of the knee. For these patients, a manipulation procedure is performed where they are brought into the hospitial, anesthesized, and the knee is forcibly bent to break through scar tissue. I will work in PT to avoid a manipulation procedure.
I begin PT later this afternoon. I am looking forward to doing the exercises, particulary the ones to improve bending of the knee. I will also do the same exercises at my home gym to accelerate knee flexibility. By January 10, I am hoping that I will have sufficient strength and flexibility of the knee to be able to use the car to drive myself to the next Dr. appointment. That is a goal.
Another milestone was reached today. I took my last shot of Lovenix. I no longer have to do shots, and I am switching to a single 340mg aspirin tablet to thin the blood for prevention of blood clots. For the next month I have to take one aspirin per day, but no more shots. Administering shots to my stomach area each morning for the last 14 days was one of the most revolting things I had to do as part of the recovery process from total knee replacement. I am very relieved to have completed the Lovenix shot regimen.
One of my car errands this past week was to accompany my son Eric to his basebal pitching session in Canton on Tuesday. Eric drove our Ford Escape, and I sat in the back seat with my legs propped up lengthwise across the back seat. I also took my ice bag to keep the knee iced. At the Canton facility, Eric found a couple of chairs, one for me to sit on, and one to prop my leg on. Eric practiced pitching with his trainer, and he also practiced some hitting. It was great to be outside the house watching my son practice. It was also heartwarming to see the concern in my 16 year old son's eyes as he glanced protectively over me sitting on the sidelines.
Seems that most of my day is doing simple tasks, taking pain medication every 4 to 6 hours, and icing the knee. The picture below taken by Chad shows me sitting by the fireplace with the legs elevated on a foot stool, and an ice pack on the right knee.
I am still on crutches but able to move around a bit easier this week. Pain when standing on my surgical leg is less intense relative to a week ago. Changes are incremental and gradual, but moving in a positive direction. I am able to fully extend (straighten my leg), and I can bend it about 50 degrees. Bending the leg is very difficult as there continues to be significant swelling around the knee cap area. Seems that I can move more quickly this week on crutches, and I am placing more weight on the leg and using my arms less to support my weight. I still find it difficult to sit normally in a chair without elevating my leg on a stool or something parallel to my bottom. Since Monday, I have also been in the car as a passenger on two errands. I am most comfortable sitting lengthwise in the back seat such that both of my legs are resting fully on the seat. Sitting in a normal upright position is not comfortable as there is too much pressure and pain around the knee cap area.
On Monday, I visited Dr. Denzin for my first post-operative follow-up. They took xrays of the knee, and everything looked normal. Dr. Denzin seemed pleased that I could fully extend the knee. But he was hoping that I could bend the knee a bit more than I could. He gave me additional prescriptions including one for Physical Therapy (PT). My next follow-up with Dr. Denzin is January 10. Through PT, I hope to show Dr. Denzin on January 10th a 90 degree bend of the knee. I am currently at a 50 degree bend.
One mild concern here is regaining full flexibility of the knee. I would like to obtain 110/120 degree bend in the knee. If I am successful, I may be able to squat like a catcher and catch some balls from my son Eric who is a pitcher. I have not been able to squat like a catcher for 15 years.
One thing mentioned by the physical therapist at the hospital was that some knee replacement patients needed a manipulation procedure if they were unable to gain sufficient flexibility in the knee. Evidently, some patients do not invest in the physical therapy sufficiently to regain flexibility. Consequently, scar tissue forms around the surgical area which restricts movement of the knee. For these patients, a manipulation procedure is performed where they are brought into the hospitial, anesthesized, and the knee is forcibly bent to break through scar tissue. I will work in PT to avoid a manipulation procedure.
I begin PT later this afternoon. I am looking forward to doing the exercises, particulary the ones to improve bending of the knee. I will also do the same exercises at my home gym to accelerate knee flexibility. By January 10, I am hoping that I will have sufficient strength and flexibility of the knee to be able to use the car to drive myself to the next Dr. appointment. That is a goal.
Another milestone was reached today. I took my last shot of Lovenix. I no longer have to do shots, and I am switching to a single 340mg aspirin tablet to thin the blood for prevention of blood clots. For the next month I have to take one aspirin per day, but no more shots. Administering shots to my stomach area each morning for the last 14 days was one of the most revolting things I had to do as part of the recovery process from total knee replacement. I am very relieved to have completed the Lovenix shot regimen.
One of my car errands this past week was to accompany my son Eric to his basebal pitching session in Canton on Tuesday. Eric drove our Ford Escape, and I sat in the back seat with my legs propped up lengthwise across the back seat. I also took my ice bag to keep the knee iced. At the Canton facility, Eric found a couple of chairs, one for me to sit on, and one to prop my leg on. Eric practiced pitching with his trainer, and he also practiced some hitting. It was great to be outside the house watching my son practice. It was also heartwarming to see the concern in my 16 year old son's eyes as he glanced protectively over me sitting on the sidelines.
Seems that most of my day is doing simple tasks, taking pain medication every 4 to 6 hours, and icing the knee. The picture below taken by Chad shows me sitting by the fireplace with the legs elevated on a foot stool, and an ice pack on the right knee.
Thursday, December 16, 2010
1 Week After Surgery - Progress Report
Wednesday, December 15, 2010 is one week since the surgery. I have been at home since December 11 (Saturday afternoon) recuperating from the surgery.
At this time I am now using the crutches exclusively to move around. I only used the walker the first day I was home as I was not confident that the crutches would provide enough stability. But, I have become quite confident with the crutches moving across the floor and up/down stairways. Each day, my leg gets a little stronger as I recover usage of the quadracep muscle. Over the last two days, I have been able to lift my surgical leg up in the air doing leg raises while lying flat. However, I cannot place my full weight on the leg yet, and I find it difficult to sit in a chair without elevating the leg. If I do not elevate my leg, pressure builds intensely about the incision area. The pressure transitions to pain if I do not elevate the leg. The most comfortable positions for me presently are lying flat on my bed or sitting lengthwise on the couch in my office so that my legs are lying fully on the couch. Icing the surgical area helps tremendously as does the pain medication I take every 6 hours.
Each day is the same protocol. Wake up at 7 to 8; brush my teeth, administer shot of Lovenix to stomach area to reduce risk of blood clots. Do two short leg workouts per day to increase flexion.
Margaret prepares all meals for me, and she also prepares the ice packs each day--one being the Cryo/Cuff which straps around my knee, and the other being the ice bag container supplied by the hospital. I use the ice bag to place it directly on the incision area. I swap between both of them throughout the day. My wife Margaret has adjusted her work schedule in order to stay home with me since Saturday. I am indebted to her care as I am unable to move about and carry things as both of my hands are occupied by the crutches whenever I walk. My sons are also helping out as needed.
I must confess that I am very unaccustomed to depending on people for basic needs. This experience has given me increased apprecation for caregivers who take care of those in need.
Since the surgery, I have lost 6 pounds of weight. Went fom 189 to 183. This does not surprise me as I hardly ate any food at the hospital. In fact, for 24 hours after the surgery, I only ate jello and water. Due to the morphine, my stomach could not handle hard foods. Now at home, I am eating better, but I am also being careful to eat low calorie, low fat foods as I am mostly sendentary due to the recuperation process.
I will not be able to drive a car for a few more weeks. I have not been out of the house since Saturday. There is snow outside, and I worry that I would fall if I tried walking with crutches at this time. In the last day, I did make it all the way down to our basement where I have workout equipement and weights. I started using small weights yesterday with my arms to maintain upper body strengthy. I will expand my work out over the next week.
Looking forward to my first follow-up visit with Dr. Denzin this upcoming Monday (December 20). This will be my first visit with him since the hospital. Assuming I pass the grade with him, he will authorize a PT program that will officially launch the workout program for rehabilitation. I will, of course, embrace the PT program enthusiastically.
I am also looking forward to getting off the Lovenix shot regimen. My last shot will be December 22, and that will mark another milestone towards recovery from this surgery.
One other noteworthy discovery from the surgery was the heat rash I contracted from the hospital stay. At the hospital I wore the standard pajamas they provide you which tie in the back with strings. My ties were left loose for the 3 nights I stayed in the hospital. My bare back and bottom were exposed to the hospital sheets where I sweated, particularly at night. Being unable to turn over, but instead lie motionless in the same position the entire night produced a heat rash. By the time I arrived at home, I had a good rash on my back that itched badly. This gradually cleared up with washing and Cortizone 10 cream. Even so, this had me a little worried as many of the allergic reactions to the medication listed rashes as a very serious reaction that requires immediate medical intervention. Fortunately, in my case, the rash was a simple heat rash. Lesson learned: bring your own pajamas to the hospital that have a closed back.
Two week update coming next week just before Christmas..... --Ron
At this time I am now using the crutches exclusively to move around. I only used the walker the first day I was home as I was not confident that the crutches would provide enough stability. But, I have become quite confident with the crutches moving across the floor and up/down stairways. Each day, my leg gets a little stronger as I recover usage of the quadracep muscle. Over the last two days, I have been able to lift my surgical leg up in the air doing leg raises while lying flat. However, I cannot place my full weight on the leg yet, and I find it difficult to sit in a chair without elevating the leg. If I do not elevate my leg, pressure builds intensely about the incision area. The pressure transitions to pain if I do not elevate the leg. The most comfortable positions for me presently are lying flat on my bed or sitting lengthwise on the couch in my office so that my legs are lying fully on the couch. Icing the surgical area helps tremendously as does the pain medication I take every 6 hours.
Each day is the same protocol. Wake up at 7 to 8; brush my teeth, administer shot of Lovenix to stomach area to reduce risk of blood clots. Do two short leg workouts per day to increase flexion.
Margaret prepares all meals for me, and she also prepares the ice packs each day--one being the Cryo/Cuff which straps around my knee, and the other being the ice bag container supplied by the hospital. I use the ice bag to place it directly on the incision area. I swap between both of them throughout the day. My wife Margaret has adjusted her work schedule in order to stay home with me since Saturday. I am indebted to her care as I am unable to move about and carry things as both of my hands are occupied by the crutches whenever I walk. My sons are also helping out as needed.
I must confess that I am very unaccustomed to depending on people for basic needs. This experience has given me increased apprecation for caregivers who take care of those in need.
Since the surgery, I have lost 6 pounds of weight. Went fom 189 to 183. This does not surprise me as I hardly ate any food at the hospital. In fact, for 24 hours after the surgery, I only ate jello and water. Due to the morphine, my stomach could not handle hard foods. Now at home, I am eating better, but I am also being careful to eat low calorie, low fat foods as I am mostly sendentary due to the recuperation process.
I will not be able to drive a car for a few more weeks. I have not been out of the house since Saturday. There is snow outside, and I worry that I would fall if I tried walking with crutches at this time. In the last day, I did make it all the way down to our basement where I have workout equipement and weights. I started using small weights yesterday with my arms to maintain upper body strengthy. I will expand my work out over the next week.
Looking forward to my first follow-up visit with Dr. Denzin this upcoming Monday (December 20). This will be my first visit with him since the hospital. Assuming I pass the grade with him, he will authorize a PT program that will officially launch the workout program for rehabilitation. I will, of course, embrace the PT program enthusiastically.
I am also looking forward to getting off the Lovenix shot regimen. My last shot will be December 22, and that will mark another milestone towards recovery from this surgery.
One other noteworthy discovery from the surgery was the heat rash I contracted from the hospital stay. At the hospital I wore the standard pajamas they provide you which tie in the back with strings. My ties were left loose for the 3 nights I stayed in the hospital. My bare back and bottom were exposed to the hospital sheets where I sweated, particularly at night. Being unable to turn over, but instead lie motionless in the same position the entire night produced a heat rash. By the time I arrived at home, I had a good rash on my back that itched badly. This gradually cleared up with washing and Cortizone 10 cream. Even so, this had me a little worried as many of the allergic reactions to the medication listed rashes as a very serious reaction that requires immediate medical intervention. Fortunately, in my case, the rash was a simple heat rash. Lesson learned: bring your own pajamas to the hospital that have a closed back.
Two week update coming next week just before Christmas..... --Ron
Wednesday, December 15, 2010
Saturday, Dec. 11: Discharge Day
Given that I was to be discharged from the hospital on Saturday, the nursing staff let me sleep Friday night. I think I slept a full uninterrupted 5 hours at one point. My sleep was somewhat restless as I was excited to be paroled from the hospital. I was looking forward to going home to convalesce.
Breakfast arrived at 7am. I ate breakfast sitting up in my recliner chair. The nurse removed the last remaining item attached to my body--the IV tubing on my arm. Removing this also pulled hair from my arm. I thought privately that the next time I end up in the hospital that I will shave my arm where they typically attach the IV.
The nurse also gave me the Lovenix medication. I carefully inserted the needle into the soft area near my belly button and injected the medication. The needle went in easily and hardly hurt, but as the medication entered my skin, there was a burning sensation. I thought to myself, only 11 more doses of this (one a day) until December 22. Then these shots will be behind me too.
After breakfast I proceeded to the bathroom and took a good long shower knowing that showering at home would be more challenging. I also knew it would be several days at home before I would muster up the confidence to try a shower at home. At home, I would have to stand up in the shower without the convenience of a chair like at the hospital. Once done with the shower, I got dressed in civilian clothes and sat in the recliner with my iPad reading e-Mail and browsed the Internet.
At 10am, the PT attendant visited and asked me to show her how I "walked" with the walker. I walked down the hall, and she was satisfied. I then asked her if she had something that would simulate getting into a car--that I was a little anxious about how best to get into a vehicle without hurting my surgical leg. Using a wheel chair, she took me to a PT room where they had a model of a car. I then practiced getting into the front seat of the car and getting out. This was pretty easy, but I had to use my arm strength to move my behind on top of the center console while the PT attendant lifted my leg into the car. This worked fine.
I then called Margaret and asked when she was picking me up from the hospital. She said she would be there between 11 and 12, and she would pick up my prescriptions from St Joe's Hospital too.
Lunch soon arrived: chicken sandwich, soup, and apple pie. The hospital food, by the way, was satisfactory, but not great. Margaret also arrived with lunch, and she ate the apple pie that I did not want.
It was time to leave. I signed the discharge papers. I asked the nurse if they might have a spare urinal to take home with me. I saw the advantage of having one of these at home as I would not have to get up from bed during the night to go to the bathroom. The nurse happily gave me a urinal for home.
Margaret went out to retrieve the car. The nurse moved me in a wheel chair through the hospital corridors towards the exit (patient pickup). Margaret and the nurse helped me into our Ford Escape. I sat in the front seat while Margaret drove us home.
At home, Kirk and Michelle were waiting to help me into the house. Chad and Eric had already prepared the driveway by shoveling snow and salting the walkway that I would have to traverse. Using my walker, I made my way from the driveway to the front porch. Kirk then handed me my crutches which I used to step up onto the porch and into the house. I proceeded to a chair that had a stool to rest my leg near the fireplace.
Margaret, Kirk, Michelle, and Eric sat near me, and we talked and shared amusing stories about the surgery. Kirk took a picture of my incision that included a measuring tape to show the 6 inch length of the incision.
I was happy to be home. The real work now was in front of me--the rehabilitation. A rehabiliation that I would embrace enthusiatically.
From here, I will provide weekly updates of my rehabilitation.
Breakfast arrived at 7am. I ate breakfast sitting up in my recliner chair. The nurse removed the last remaining item attached to my body--the IV tubing on my arm. Removing this also pulled hair from my arm. I thought privately that the next time I end up in the hospital that I will shave my arm where they typically attach the IV.
The nurse also gave me the Lovenix medication. I carefully inserted the needle into the soft area near my belly button and injected the medication. The needle went in easily and hardly hurt, but as the medication entered my skin, there was a burning sensation. I thought to myself, only 11 more doses of this (one a day) until December 22. Then these shots will be behind me too.
After breakfast I proceeded to the bathroom and took a good long shower knowing that showering at home would be more challenging. I also knew it would be several days at home before I would muster up the confidence to try a shower at home. At home, I would have to stand up in the shower without the convenience of a chair like at the hospital. Once done with the shower, I got dressed in civilian clothes and sat in the recliner with my iPad reading e-Mail and browsed the Internet.
At 10am, the PT attendant visited and asked me to show her how I "walked" with the walker. I walked down the hall, and she was satisfied. I then asked her if she had something that would simulate getting into a car--that I was a little anxious about how best to get into a vehicle without hurting my surgical leg. Using a wheel chair, she took me to a PT room where they had a model of a car. I then practiced getting into the front seat of the car and getting out. This was pretty easy, but I had to use my arm strength to move my behind on top of the center console while the PT attendant lifted my leg into the car. This worked fine.
I then called Margaret and asked when she was picking me up from the hospital. She said she would be there between 11 and 12, and she would pick up my prescriptions from St Joe's Hospital too.
Lunch soon arrived: chicken sandwich, soup, and apple pie. The hospital food, by the way, was satisfactory, but not great. Margaret also arrived with lunch, and she ate the apple pie that I did not want.
It was time to leave. I signed the discharge papers. I asked the nurse if they might have a spare urinal to take home with me. I saw the advantage of having one of these at home as I would not have to get up from bed during the night to go to the bathroom. The nurse happily gave me a urinal for home.
Margaret went out to retrieve the car. The nurse moved me in a wheel chair through the hospital corridors towards the exit (patient pickup). Margaret and the nurse helped me into our Ford Escape. I sat in the front seat while Margaret drove us home.
At home, Kirk and Michelle were waiting to help me into the house. Chad and Eric had already prepared the driveway by shoveling snow and salting the walkway that I would have to traverse. Using my walker, I made my way from the driveway to the front porch. Kirk then handed me my crutches which I used to step up onto the porch and into the house. I proceeded to a chair that had a stool to rest my leg near the fireplace.
Margaret, Kirk, Michelle, and Eric sat near me, and we talked and shared amusing stories about the surgery. Kirk took a picture of my incision that included a measuring tape to show the 6 inch length of the incision.
I was happy to be home. The real work now was in front of me--the rehabilitation. A rehabiliation that I would embrace enthusiatically.
From here, I will provide weekly updates of my rehabilitation.
Tuesday, December 14, 2010
Friday, Dec. 10: Catheter is Removed!
I slept restlessly Thursday night in anticipation of the catheter being removed from my body. I felt helpless with this tube siphoning urine from me, and shackled to the dam thing. It limited my freedom as a human and particualry as a man.
At 4am Friday morning, the nurse team visited for a BP/Temp check and a blood sample. I asked them when the catheter removal team would visit. They both smiled, and commented that Candy would remove the catheter at 6am. Candy was one of the nurses in the room with me. I blushed, but told them both how pleased I would be when this "thing" was removed.
The clock ticked slowly minute-by-mintue towards 6am. I did not fall back to sleep. Finally, at 6:05 am, Candy returned to the room to remove the catheter. She first emptied the urine bag, then asked me to take a deep breath. As I inhaled she removed the catheter--which had a burning sensation as it was withdrawn from me. While a bit painful, I was elated that it was removed. Soon after breakfast arrived, I got out of bed and sat in the rocker/recliner to eat my breakfast. Once breakfast was done, I then went to the bathroom to urinate normally, and I took a shower. This felt really good. I was able to sit in a special chair that allowed me to keep weight off the leg while I showered.
By noon, Greg and Mark visited from the U-M. It was nice to see them. Margaret and Kirk also visited again in the afternoon. By this time, my urine bottle was full as I used this to avoid walking to the bathroom each time to urinate. I asked Kirk if he could empty the bottle. Although his face turned ashen white with hesitation, he proceeded to empty the bottle in the bathroom for me.
<Margaret told me later that Kirk went home later that evening and had to have a shot of whiskey to calm his nerves from this, and get the image out of his head>
In the early afternoon, Diane and Tim paid a visit from the U-M. As they arrived so did the PT attendant. We talked a bit, but I was distracted as the attendant worked with me to climb a single step with a walker emulating the experience of stepping onto the front porch to my house. Diane and Tim left after a short time. After this, my brother and sister in-law, Dietmar and Mimi, visited. Dietmer brought me a cup of coffee from Sweet Lorraines! While we talked, Dr. Denzin who performed the surgery, came by. I asked him several questions which he answered fully.
After Dr. Denzin left, the PT attendant came by again, and attached me to the Continuous Motion device. He was able to get my surgical leg to flex from 0 degrees to 45 degrees. I had improved by 20 degrees in just one night. For two hours the machines flexed my leg.
Dietermar and Mimi left after an hour. It was nice that they visited. In our conversation, we touched on several topics including politics. Having voted for democrats all my lifetime, I confessed to them that I had voted with some guilt for the republican candidate Snyder for Michigan governor. Dietmar said he did the same, although he too indicated that he had difficulty voting for a republican. But we both agreed that a businessman was the better choice given the alternative of the democratic candidate who professed more of the same Granholm rhetoric. Mimi seemed baffled by this disclosure as our politics have generally been in agreement. She noted that Snyder may do away with funding for Higher Education and some things related to the libraries. I noted this and will watch for how Snyder proceeds in his governership. Impeachment is also possible.
Kirk, my oldest son, paid a visit after dinner. He stayed for several hours, and we talked about many things. Kirk said that he and Michelle got into an arguement about what to do on Friday night after visiting with me. Kirk said he needed timeout when he first came home, and did not want to decide on a plan immediately when he first came home from work. I smiled at Kirk and said that this sounded like a classic Mars/Venus issue. Men, in general, need time when they first get home from work to unwind, while women can just disconnect from work without needing a timeout. I suggested to Kirk that he and Michelle should read, "Men are from Mars, and women are from Venus". Kirk said that he has heard this recommendation from others too. Kirk seemed bothered that he and Michelle had an arguement.
I then took Kirk on a tour down the hall on my walker to show him the staircase that I had navigated the day before. Kirk tied up the pajama top on my back to cover my backside. Later I heard that he felt odd seeing his dad's backside so often in a short time. Yep, another shot of whiskey!
After several hours Kirk left the hospital. I thought as Kirk left how proud I was of him. He really has become a wonderful man with an excellent future. He is fully independent and he has a terrific job with Thomson Reuter as a data analyst. Moreover, he has a relationship with a wonderful young women, Michelle. Michelle, like Kirk, has a terrific character and high aspirations for her future. They are a good match. Most importantly though, Kirk is a quality human being. His mom and I are very proud.
I eventually went to sleep looking towards Saturday. Saturday was discharge day!
At 4am Friday morning, the nurse team visited for a BP/Temp check and a blood sample. I asked them when the catheter removal team would visit. They both smiled, and commented that Candy would remove the catheter at 6am. Candy was one of the nurses in the room with me. I blushed, but told them both how pleased I would be when this "thing" was removed.
The clock ticked slowly minute-by-mintue towards 6am. I did not fall back to sleep. Finally, at 6:05 am, Candy returned to the room to remove the catheter. She first emptied the urine bag, then asked me to take a deep breath. As I inhaled she removed the catheter--which had a burning sensation as it was withdrawn from me. While a bit painful, I was elated that it was removed. Soon after breakfast arrived, I got out of bed and sat in the rocker/recliner to eat my breakfast. Once breakfast was done, I then went to the bathroom to urinate normally, and I took a shower. This felt really good. I was able to sit in a special chair that allowed me to keep weight off the leg while I showered.
By noon, Greg and Mark visited from the U-M. It was nice to see them. Margaret and Kirk also visited again in the afternoon. By this time, my urine bottle was full as I used this to avoid walking to the bathroom each time to urinate. I asked Kirk if he could empty the bottle. Although his face turned ashen white with hesitation, he proceeded to empty the bottle in the bathroom for me.
<Margaret told me later that Kirk went home later that evening and had to have a shot of whiskey to calm his nerves from this, and get the image out of his head>
In the early afternoon, Diane and Tim paid a visit from the U-M. As they arrived so did the PT attendant. We talked a bit, but I was distracted as the attendant worked with me to climb a single step with a walker emulating the experience of stepping onto the front porch to my house. Diane and Tim left after a short time. After this, my brother and sister in-law, Dietmar and Mimi, visited. Dietmer brought me a cup of coffee from Sweet Lorraines! While we talked, Dr. Denzin who performed the surgery, came by. I asked him several questions which he answered fully.
After Dr. Denzin left, the PT attendant came by again, and attached me to the Continuous Motion device. He was able to get my surgical leg to flex from 0 degrees to 45 degrees. I had improved by 20 degrees in just one night. For two hours the machines flexed my leg.
Dietermar and Mimi left after an hour. It was nice that they visited. In our conversation, we touched on several topics including politics. Having voted for democrats all my lifetime, I confessed to them that I had voted with some guilt for the republican candidate Snyder for Michigan governor. Dietmar said he did the same, although he too indicated that he had difficulty voting for a republican. But we both agreed that a businessman was the better choice given the alternative of the democratic candidate who professed more of the same Granholm rhetoric. Mimi seemed baffled by this disclosure as our politics have generally been in agreement. She noted that Snyder may do away with funding for Higher Education and some things related to the libraries. I noted this and will watch for how Snyder proceeds in his governership. Impeachment is also possible.
Kirk, my oldest son, paid a visit after dinner. He stayed for several hours, and we talked about many things. Kirk said that he and Michelle got into an arguement about what to do on Friday night after visiting with me. Kirk said he needed timeout when he first came home, and did not want to decide on a plan immediately when he first came home from work. I smiled at Kirk and said that this sounded like a classic Mars/Venus issue. Men, in general, need time when they first get home from work to unwind, while women can just disconnect from work without needing a timeout. I suggested to Kirk that he and Michelle should read, "Men are from Mars, and women are from Venus". Kirk said that he has heard this recommendation from others too. Kirk seemed bothered that he and Michelle had an arguement.
I then took Kirk on a tour down the hall on my walker to show him the staircase that I had navigated the day before. Kirk tied up the pajama top on my back to cover my backside. Later I heard that he felt odd seeing his dad's backside so often in a short time. Yep, another shot of whiskey!
After several hours Kirk left the hospital. I thought as Kirk left how proud I was of him. He really has become a wonderful man with an excellent future. He is fully independent and he has a terrific job with Thomson Reuter as a data analyst. Moreover, he has a relationship with a wonderful young women, Michelle. Michelle, like Kirk, has a terrific character and high aspirations for her future. They are a good match. Most importantly though, Kirk is a quality human being. His mom and I are very proud.
I eventually went to sleep looking towards Saturday. Saturday was discharge day!
Monday, December 13, 2010
Day after surgery - Afternoon
By noon when the morphine had worn off, I felt much better. No groggines nor nausea. For afternoon PT, the attendant asked if I wanted to climb steps. I said yes with some apprehension. I followed the attendant down the hall on two crutches. We approached a door which he openened, thus exposing a stairway with about 12 steps. He instructed me on how to hold the crutches and how to step up with my good leg. I went up the steps successfully, but it was painful and exhausting. I went down the steps leading with the surgical foot, or bad leg as he called it. To remember this, he suggested thinking of leading with the good leg when going up to heaven, and leading with the bad leg when going down to the other place. I found this cute, but useful to remember. I proceeded down the steps, and then proceeded to my room to lay in bed in once again. My leg was throbbing with pressure at the incision--as if the incision was ready to burst. The PT person felt confident that I could now navigate the 13 steps in my house leading to the bedroom. I was also confident, but a bit anxious. Climbing those steps at the hospital wore me out. I was sweating.
The PT attendant then placed my leg in continuous motion machine to flex my leg from full extension to a 25 degree bend. The machine manipulated my leg for nearly two hours.
Before the PT person showed up, Margaret and Chad paid a visit. Like Kirk and Eric, Chad appeared apprehensive when he gave me a hug while laying in the hospital bed. Chad noticed the urine bag beneath my bed and saw the hose traveling up under my sheets. He winced at this.
I showed Chad the breathing device that I had to inhale deeply with in order to enrich my blood cells--a device to prevent pneumonia. When I took a good long inhale (toke) of the device to show Chad how it worked, I then handed it to him and said earrr... Chad smiled and got the joke.
In the late afternoon, Margaret returned and soon thereafter my boss Bob from the U of M paid a visit. I showed bob the incision, and we discussed his wife's recent surgery with a hip replacement. There were parallels with her surgery and my own.
I told Margaret and Bob that I had to give myself a shot in the belly for 14 days to aid in the prevention of blood clots. The medication is called Lovenix. A nurse had already instructed me in how to do this, and I did give myself a shot, though with some trepidation.
Bob left at about 5pm, and Margaret kept me company until 7pm. Margaret shared some of my dinner by eating the dessert. After this, I continued reading the Memoirs of Ulysess S. Grant, focusing on the section detailing the surrender of Robert E. Lee and the Army of Virginia. Both generals worked hard to end the war as they both indicated that they had no desire to continue further effusion of blood between the soldiers of the North and South. The South was in ruins with Shermans march. The North outlasted the South based on greater reserves of resources.
I finally fell asleep only to be awoken for a BP check and more pills by midnight. The nurse mentioned that (tomorrow) at 6am on Friday--2 days after surgery that they would remove the catheter. I was elated as I really wanted to be paroled from the catheter. The nurse smiled when she noticed my elation, noting that most men were very happy to hear this news....
The PT attendant then placed my leg in continuous motion machine to flex my leg from full extension to a 25 degree bend. The machine manipulated my leg for nearly two hours.
Before the PT person showed up, Margaret and Chad paid a visit. Like Kirk and Eric, Chad appeared apprehensive when he gave me a hug while laying in the hospital bed. Chad noticed the urine bag beneath my bed and saw the hose traveling up under my sheets. He winced at this.
I showed Chad the breathing device that I had to inhale deeply with in order to enrich my blood cells--a device to prevent pneumonia. When I took a good long inhale (toke) of the device to show Chad how it worked, I then handed it to him and said earrr... Chad smiled and got the joke.
In the late afternoon, Margaret returned and soon thereafter my boss Bob from the U of M paid a visit. I showed bob the incision, and we discussed his wife's recent surgery with a hip replacement. There were parallels with her surgery and my own.
I told Margaret and Bob that I had to give myself a shot in the belly for 14 days to aid in the prevention of blood clots. The medication is called Lovenix. A nurse had already instructed me in how to do this, and I did give myself a shot, though with some trepidation.
Bob left at about 5pm, and Margaret kept me company until 7pm. Margaret shared some of my dinner by eating the dessert. After this, I continued reading the Memoirs of Ulysess S. Grant, focusing on the section detailing the surrender of Robert E. Lee and the Army of Virginia. Both generals worked hard to end the war as they both indicated that they had no desire to continue further effusion of blood between the soldiers of the North and South. The South was in ruins with Shermans march. The North outlasted the South based on greater reserves of resources.
I finally fell asleep only to be awoken for a BP check and more pills by midnight. The nurse mentioned that (tomorrow) at 6am on Friday--2 days after surgery that they would remove the catheter. I was elated as I really wanted to be paroled from the catheter. The nurse smiled when she noticed my elation, noting that most men were very happy to hear this news....
Day After Surgery - Morning
At 6am, the day after total knee replacement surgery, I am visited by the pain management staff. They tell me that they will remove the epidural, but ask if I want one final long lasting injection of morphine that will get me to noon. I ask whether it will cause me to feel nauseous and groggy. She says yes, but adds that most patients request it to avoid pain. I choose the road most traveled. She applies the morphine, and then removes the epidural. Removing the epidural involves removing considerable tape from my lower back which hurts as she removes it. Any hair on my lower back was removed. The doctor and I share a laugh noting the scene from the movie, "40 Year Old Virgin", where chest hair is removed with wax and tape.
I continue to be visited by nurses every 2 - 4 hours for BP check, temp, etc. I continue to be given a battery of pills. At 10am, I visited by the PT staff. They ask me to sit up in bed. They help me to move my surgical leg to the floor. They ask if I feel dizzy. I answer that I do. We wait a few minutes. After this, they help me out of bed to stand with a walker. They detach the IV and oxygyn, but attach the urinal bag to the walker. Yes, I am wearing a catheter (argh!) so that urine is automatically siphoned from my body. The PT person asks me to take a few steps which I do with the walker. I barely put any weight on my right leg. Pain was less the issue,as intense pressure bothered me most. I could hardly bend my leg at the knee. I walked to the door of my room and back to my bed aided by the walker. The PT person was satisified, and said he would visit with me later in the afternoon. I mentioned to the PT staff that my challenge when returning home was to navigate 13 steps in my house to the bedroom. He noted this and asked if I had family who would be available to me when at home. I replied that my wife and sons would help me. He noted that many patients often went to an extended care facility after total knee replacement surgery. He cautioned me not to underestitmate the convalescence time and care needed for total knee replacement. He emphasized the knee replacement was "major surgery", not a mere arthroscope.
At 8am on Thursday, I was visited by one of the surgical staff who removed the bandage from the knee. The 6 inch incision was very clean without sutures. The skin on the outer surface was glued together. Sutures were used for the deeper layers. He also removed the drain plug from the surgical site that was 3 inches below the incision. The drain was used to remove blood that collected at the site after surgery. I think they emptied that drain bag 4 to 5 times. Each bag, in my mind, seemed to be the typical amount that one donates to the Red Cross. I privately wondered if I had lost too much blood.
At 10:30am, I again threw up. I was still feeling groggy and nauseous. The nausea feeling lasted up until noon when the morphine wore off. As the morphine wore off, I became more aware of the pain. On a scale of 1 to 10, the pain level was at about a 4. But Ifelt much much better.
In place of morphine they asked which narcotic I would like for pain management. I indicated that I once had vicadin. They told me that vicadin was not stong enough. They suggested Norco, and I accepted. But I added that I was not a big fan of drugs to control pain, and would prefer conservative methods for pain management. They acknowledged this, but still gave me a Norco tablet which also had some Tylenol.
I continue to be visited by nurses every 2 - 4 hours for BP check, temp, etc. I continue to be given a battery of pills. At 10am, I visited by the PT staff. They ask me to sit up in bed. They help me to move my surgical leg to the floor. They ask if I feel dizzy. I answer that I do. We wait a few minutes. After this, they help me out of bed to stand with a walker. They detach the IV and oxygyn, but attach the urinal bag to the walker. Yes, I am wearing a catheter (argh!) so that urine is automatically siphoned from my body. The PT person asks me to take a few steps which I do with the walker. I barely put any weight on my right leg. Pain was less the issue,as intense pressure bothered me most. I could hardly bend my leg at the knee. I walked to the door of my room and back to my bed aided by the walker. The PT person was satisified, and said he would visit with me later in the afternoon. I mentioned to the PT staff that my challenge when returning home was to navigate 13 steps in my house to the bedroom. He noted this and asked if I had family who would be available to me when at home. I replied that my wife and sons would help me. He noted that many patients often went to an extended care facility after total knee replacement surgery. He cautioned me not to underestitmate the convalescence time and care needed for total knee replacement. He emphasized the knee replacement was "major surgery", not a mere arthroscope.
At 8am on Thursday, I was visited by one of the surgical staff who removed the bandage from the knee. The 6 inch incision was very clean without sutures. The skin on the outer surface was glued together. Sutures were used for the deeper layers. He also removed the drain plug from the surgical site that was 3 inches below the incision. The drain was used to remove blood that collected at the site after surgery. I think they emptied that drain bag 4 to 5 times. Each bag, in my mind, seemed to be the typical amount that one donates to the Red Cross. I privately wondered if I had lost too much blood.
At 10:30am, I again threw up. I was still feeling groggy and nauseous. The nausea feeling lasted up until noon when the morphine wore off. As the morphine wore off, I became more aware of the pain. On a scale of 1 to 10, the pain level was at about a 4. But Ifelt much much better.
In place of morphine they asked which narcotic I would like for pain management. I indicated that I once had vicadin. They told me that vicadin was not stong enough. They suggested Norco, and I accepted. But I added that I was not a big fan of drugs to control pain, and would prefer conservative methods for pain management. They acknowledged this, but still gave me a Norco tablet which also had some Tylenol.
Surgery Day
Up at 4:30am. Prepared right leg with anti-bacterial application provided by hospital. Margaret and I make our way to the hospital and arrive at St. Joe's Hospital at 5:30am at the Imaging/Birthing center for admission. By 6am, I am called to the surgical prep room. IV is inserted. Blood pressure is taken -- 124/77 which was good. Questions asked about health history--5 previous scopes on knees. Three on the left knee, and two on the right knee. The right knee that was to be operated on was initially injured while playing baseball for the US Army while assigned to Schofield Barracks in Hawaii during the summer of 1975. The right knee was again operated on by surgeons at the Ann Arbor VA Hospital in 1986. Hence, the surgery today would be the third surgery on the right knee with an absence of 24 years since the last surgery.
At 6:30, the anestesiologist visits me and prepares me for the epidural which will numb me from the waist down. Afer the routine risks are expressed to me, and I sign the authorization form, the epidural is applied, and the first round of tranquilizers is injected into the IV. I become very relaxed. I am then moved to a mobile bed and wheeled to the OR. I recall 6 attendants then lifting the sheet I am on off the bed and moving me to the OR table. Overhead, I see the OR lights and several faces staring over me in preparation for the surgery.
The next conscious thought I have is coming out of a deep wonderful sleep. I see several people over me in a sort of mist who appear to be cleaning up. They tell me that the surgery was successful. I was completely unaware of the 2.5 hour surgery.
I was then wheeled to the recovery room. A nurse began checking my vitals, and watched over the drainage on the surgical site. The nurse indicates that she knows me--that our sons played baseball together as teenagers. The nurse was Mollie Cleary, wife of Bob Cleary who coached Chad's 14 year old baseball team. Bob was a doctor at St Joe's Hospital. In the recovery room, Mollie and I shared updates on the trials and tribulations of our respective sons. I thought, of course, what a small world. It was comforting to talk with Mollie as I lay in the recovery room, dozing in and out.
At 1:00, I am moved to the hospital room. I become aware of the several tubes attached to my body. I have oxygyn in my nose, and IV in my arm, morphine pumping into the epidural feed in my back, and a catheter inserted into me draining my urine. A nurse gives me several pills (cellobrex, antacid tablet, stool softene, etc). I am told that morphine is being automatically fed to me to control pain. I am also informed that I can inject additional shots of morphine by pressing a hand button--which I did use several times. The pain was intense at times.
At 3:00, doctors ask me to wiggle my toes. Feeling began returning to my legs. I become mildly aware of pressure (not pain) at my right knee.
Margaret tells me that the surgery took a little longer than two hours as the doctors had to work extra time to insure a solid fit of the prosthesis in the knee. There were several bone spurs that had to be cleaned up.
Margaret, Kirk, and Eric visited with me late in the day. I was very groggy and nauseous after the surgery. Eric and Kirk seem a little anxious at seeing their dad so helpless. Eric mentioned that the last time he recalls seeing someone with oxygyn in their nose was when he saw his Opa shortly before death. Margaret added (privately later) that the boys were unaccustomed to seeing their dad like this--as I represented a model of heath to them.
Margaret and the boys leave. The nurses visit with me every 2 to 4 hours to check blood pressure or give me pills. I continue to feel nauseous. I finally throw up into the container they provided. The nurse tells me that this is quite common when taking morphine. I eventuall fall into a restless sleep, more like several cat naps for the remainder of the night.
At 6:30, the anestesiologist visits me and prepares me for the epidural which will numb me from the waist down. Afer the routine risks are expressed to me, and I sign the authorization form, the epidural is applied, and the first round of tranquilizers is injected into the IV. I become very relaxed. I am then moved to a mobile bed and wheeled to the OR. I recall 6 attendants then lifting the sheet I am on off the bed and moving me to the OR table. Overhead, I see the OR lights and several faces staring over me in preparation for the surgery.
The next conscious thought I have is coming out of a deep wonderful sleep. I see several people over me in a sort of mist who appear to be cleaning up. They tell me that the surgery was successful. I was completely unaware of the 2.5 hour surgery.
I was then wheeled to the recovery room. A nurse began checking my vitals, and watched over the drainage on the surgical site. The nurse indicates that she knows me--that our sons played baseball together as teenagers. The nurse was Mollie Cleary, wife of Bob Cleary who coached Chad's 14 year old baseball team. Bob was a doctor at St Joe's Hospital. In the recovery room, Mollie and I shared updates on the trials and tribulations of our respective sons. I thought, of course, what a small world. It was comforting to talk with Mollie as I lay in the recovery room, dozing in and out.
At 1:00, I am moved to the hospital room. I become aware of the several tubes attached to my body. I have oxygyn in my nose, and IV in my arm, morphine pumping into the epidural feed in my back, and a catheter inserted into me draining my urine. A nurse gives me several pills (cellobrex, antacid tablet, stool softene, etc). I am told that morphine is being automatically fed to me to control pain. I am also informed that I can inject additional shots of morphine by pressing a hand button--which I did use several times. The pain was intense at times.
At 3:00, doctors ask me to wiggle my toes. Feeling began returning to my legs. I become mildly aware of pressure (not pain) at my right knee.
Margaret tells me that the surgery took a little longer than two hours as the doctors had to work extra time to insure a solid fit of the prosthesis in the knee. There were several bone spurs that had to be cleaned up.
Margaret, Kirk, and Eric visited with me late in the day. I was very groggy and nauseous after the surgery. Eric and Kirk seem a little anxious at seeing their dad so helpless. Eric mentioned that the last time he recalls seeing someone with oxygyn in their nose was when he saw his Opa shortly before death. Margaret added (privately later) that the boys were unaccustomed to seeing their dad like this--as I represented a model of heath to them.
Margaret and the boys leave. The nurses visit with me every 2 to 4 hours to check blood pressure or give me pills. I continue to feel nauseous. I finally throw up into the container they provided. The nurse tells me that this is quite common when taking morphine. I eventuall fall into a restless sleep, more like several cat naps for the remainder of the night.
Tuesday, December 7, 2010
Knee Surgery
Less than 18 hours away from Surgery. Closing on work matters, and preparing my mind to be incapaciated for several weeks while I recover. Some anxiety beginning to arise as the reality of the impending surgery takes on form.
In the last few days my right knee has survived some rigourous activity without too much pain or swelling. I have been working out on the Precor eliptical and stationary bike without pain, and I have been walking significant distances at work without the usual pain and limp. I guess I am having a few good days for a change. This has made me wonder if I could wait another year or two before doing this surgery. I mean, shouldn't I be wheel-chair ridden before doing this surgery?
As I reflect, however, on the past year, I do recall many times where my knee was painful and swollen after routine activities. This included mowing the lawn, golfing 9 holes with a cart, painting the house, at work walking the 1/2 mile to Palmer Commons from LSA for IT Commons meetings, or at work when I hosted the Google presentation for campus. In all these situations, my knee was painful, inflexible, and swollen.
My doctor says that the xrays show that my right knee is "shot". He says that only a knee replacement will provide relief from pain and swelling. But the doctor added that the time to do the knee replacement is my call as it depends on my own tolerance for pain and desire to have an improved quality of life.
In spite of the anxiety to do this surgery, I must remind myself that the pain, swelling, and bow-leggednes will not go away until I do the knee replacment. The time to do this surgery is now.
For background on total knee replacement, the reader may find some of the following links helpful:
http://en.wikipedia.org/wiki/Knee_replacement
http://www.medicinenet.com/total_knee_replacement/article.htm
And for pictures of the prosthesis, the parts installed into the knee to replace the diseased joint, see:
http://www.bonesmart.org/knee_replacement.php?gclid=CML8n7aZ8aUCFdLLKgodl3pCmQ
Finally, for general pictures on the knee operation, see:
pictures-total-knee-replacment
In the last few days my right knee has survived some rigourous activity without too much pain or swelling. I have been working out on the Precor eliptical and stationary bike without pain, and I have been walking significant distances at work without the usual pain and limp. I guess I am having a few good days for a change. This has made me wonder if I could wait another year or two before doing this surgery. I mean, shouldn't I be wheel-chair ridden before doing this surgery?
As I reflect, however, on the past year, I do recall many times where my knee was painful and swollen after routine activities. This included mowing the lawn, golfing 9 holes with a cart, painting the house, at work walking the 1/2 mile to Palmer Commons from LSA for IT Commons meetings, or at work when I hosted the Google presentation for campus. In all these situations, my knee was painful, inflexible, and swollen.
My doctor says that the xrays show that my right knee is "shot". He says that only a knee replacement will provide relief from pain and swelling. But the doctor added that the time to do the knee replacement is my call as it depends on my own tolerance for pain and desire to have an improved quality of life.
In spite of the anxiety to do this surgery, I must remind myself that the pain, swelling, and bow-leggednes will not go away until I do the knee replacment. The time to do this surgery is now.
For background on total knee replacement, the reader may find some of the following links helpful:
http://en.wikipedia.org/wiki/Knee_replacement
http://www.medicinenet.com/total_knee_replacement/article.htm
And for pictures of the prosthesis, the parts installed into the knee to replace the diseased joint, see:
http://www.bonesmart.org/knee_replacement.php?gclid=CML8n7aZ8aUCFdLLKgodl3pCmQ
Finally, for general pictures on the knee operation, see:
pictures-total-knee-replacment
Wednesday, December 1, 2010
December 1, 2010
Getting ready for a total knee replacement on my right knee on December 8. I want to document the surgery and recovery so that others can learn from the experience. Before doing that, however, let me give you some background on why I need a total knee replacement and why I am doing this at 55 years old.
I initially injured my right knee while playing baseball when serving in the US Army. During the summer of 1975, I was playing baseball for the 1-62nd Air Defense Artillery unit assigned to Schofield Barracks in Hawaiil. During an evening game I was playing left field during twilight. A long towering fly ball was hit to left field, and I camped under the ball to catch it. As the ball descended to earth, I suddenly realized that I was not deep enough to catch it, so I quickly back-pedaled. At some point, I either stepped into a hole or simply hyper-extended my leg while stepping with my full weight to the ground. I recall sudden pain and a loud pop in my right leg. I tumbled to the ground, but was able to catch the ball as it landed in my up-raised glove. The players in the infield just stared at me wondering why I did not quickly get to my feet. From a lying position, I threw the ball the best I could back into the infield, but I could not get to my feet. My leg felt like it was broken. Eventually, Major Fajito, who was the team manager ran out to the outfield and helped me off the field. My knee had already swollen, and I could not put any weight on it. I sat out the rest of the game with ice on my knee. Later that evening at the division dispensary, the on-call doctor determined I had sprained the knee.
While the initial swelling went away, and I was soon able to walk normally again. Something did not feel right. My knee seemed tender and unstable. Eventually, I noticed that the knee would buckle on certain movements. One night while out disco dancing in downtown Honolulu, I recall pivoting on my knee during a dance only to have my knee buckle from beneath me and fall to the floor. Army doctors then began doing additional tests on the knee. They injecetd a dye into the knee and then reviewed the xrays. It was determined that I had a torn cartilage. Surgery was finally performed at Tripler Army Medical Center in Hawaii in January 1976. As arthroscopic surgery was still in its infancy, traditional knee surgery (medial menisectomy) was performed on my knee. During the surgery to remove the torn cartilage, doctors noted that the anterior cruciate ligament was absent. Hence, it was confirmed that I had torn the cartilage and the ACL. In street parlance, I had completely blown out my right knee at 20 years old. Doctors told me then that the question of a total knee replacment in my future was not a matter of "if", but rather a matter of "when".
The doctors were right, and the "when" was answered with the year 2010--thirty five years after the initial injury. At 55 years old, I decided that the time to replace the knee was now and not postpone the knee replacement any longer. I have been bothered by this knee since 1975, but particularly over the last 10 years. In 2003, I had to give up running entirely, and I noticed that knee flexibility signficantly decreased. My right leg increasingly bowed with time too. Walking became increasingly limited as short distances such as a 1/2 mile caused pain and swelling in the knee.
Throughout the years, doctors have advised me to postpone total knee replacement until my 60's. Total knee replacement surgery (which is considered major surgery) has traditionally been performed on men/women who were significantly handicapped and 65 years or older. In effect, total knee replacement was a last chance procedure to return wheel-chair confined seniors to some form of pain free walking, but for simple things like light house work or walking to their mailbox, not a surgery for active people.
Until recent times doctors have been reluctant to perform total knee replacment on younger patients as these patients were likely to "wear out" the prosthesis and require a second knee replacement. However, with data now supporting that the knee prosthesis will last up to 30 years, and that active people can benefit greatly from the surgery, doctors are now performing the surgery on younger patients with the age for candidacy now moving into the 50's. Doctors now say that people desiring active lifestyles can do well with total knee replacement provided that high impact sports (running, basketball, etc.) are avoided. For those that do bike riding, swimming, doubles tennis, golf (wihtout a cart), long distance walking, etc. that the total knee replacement should survive these sports and provide a pain free experience.
For me, the knee replacment is all about quailty of life. Aging into your senior years does not have to be a life of joint pain and sendentary lifestyle. For me, the senior years will continue to be an active lifestyle.
I initially injured my right knee while playing baseball when serving in the US Army. During the summer of 1975, I was playing baseball for the 1-62nd Air Defense Artillery unit assigned to Schofield Barracks in Hawaiil. During an evening game I was playing left field during twilight. A long towering fly ball was hit to left field, and I camped under the ball to catch it. As the ball descended to earth, I suddenly realized that I was not deep enough to catch it, so I quickly back-pedaled. At some point, I either stepped into a hole or simply hyper-extended my leg while stepping with my full weight to the ground. I recall sudden pain and a loud pop in my right leg. I tumbled to the ground, but was able to catch the ball as it landed in my up-raised glove. The players in the infield just stared at me wondering why I did not quickly get to my feet. From a lying position, I threw the ball the best I could back into the infield, but I could not get to my feet. My leg felt like it was broken. Eventually, Major Fajito, who was the team manager ran out to the outfield and helped me off the field. My knee had already swollen, and I could not put any weight on it. I sat out the rest of the game with ice on my knee. Later that evening at the division dispensary, the on-call doctor determined I had sprained the knee.
While the initial swelling went away, and I was soon able to walk normally again. Something did not feel right. My knee seemed tender and unstable. Eventually, I noticed that the knee would buckle on certain movements. One night while out disco dancing in downtown Honolulu, I recall pivoting on my knee during a dance only to have my knee buckle from beneath me and fall to the floor. Army doctors then began doing additional tests on the knee. They injecetd a dye into the knee and then reviewed the xrays. It was determined that I had a torn cartilage. Surgery was finally performed at Tripler Army Medical Center in Hawaii in January 1976. As arthroscopic surgery was still in its infancy, traditional knee surgery (medial menisectomy) was performed on my knee. During the surgery to remove the torn cartilage, doctors noted that the anterior cruciate ligament was absent. Hence, it was confirmed that I had torn the cartilage and the ACL. In street parlance, I had completely blown out my right knee at 20 years old. Doctors told me then that the question of a total knee replacment in my future was not a matter of "if", but rather a matter of "when".
The doctors were right, and the "when" was answered with the year 2010--thirty five years after the initial injury. At 55 years old, I decided that the time to replace the knee was now and not postpone the knee replacement any longer. I have been bothered by this knee since 1975, but particularly over the last 10 years. In 2003, I had to give up running entirely, and I noticed that knee flexibility signficantly decreased. My right leg increasingly bowed with time too. Walking became increasingly limited as short distances such as a 1/2 mile caused pain and swelling in the knee.
Throughout the years, doctors have advised me to postpone total knee replacement until my 60's. Total knee replacement surgery (which is considered major surgery) has traditionally been performed on men/women who were significantly handicapped and 65 years or older. In effect, total knee replacement was a last chance procedure to return wheel-chair confined seniors to some form of pain free walking, but for simple things like light house work or walking to their mailbox, not a surgery for active people.
Until recent times doctors have been reluctant to perform total knee replacment on younger patients as these patients were likely to "wear out" the prosthesis and require a second knee replacement. However, with data now supporting that the knee prosthesis will last up to 30 years, and that active people can benefit greatly from the surgery, doctors are now performing the surgery on younger patients with the age for candidacy now moving into the 50's. Doctors now say that people desiring active lifestyles can do well with total knee replacement provided that high impact sports (running, basketball, etc.) are avoided. For those that do bike riding, swimming, doubles tennis, golf (wihtout a cart), long distance walking, etc. that the total knee replacement should survive these sports and provide a pain free experience.
For me, the knee replacment is all about quailty of life. Aging into your senior years does not have to be a life of joint pain and sendentary lifestyle. For me, the senior years will continue to be an active lifestyle.
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