Four Weeks After Surgery

I have been using a cane to get around for most of the last week. However, on Monday at PT, the Physical Therapist, Cathy, encouraged me to start taking a few steps without a cane. I did this at PT on Monday, and I have begun walking short distances in my home without the cane too. I have to concentrate when I walk unassisted, making certain to step heel to toe. My quadracep has recovered more this past week, and I am gaining confidence that my leg will not buckle as I walk while supporting my full weight. Knee bend is 80 degrees which is progress, but still insufficient to fully rotate the pedals on a stationary bike. My knee continues to swell with activity, but overall the swelling has gone down 1/2 inch since last week. Knee circumferance is now 18 1/4 inch. I weighed in at 184 this morning. Given that I am very sendentary with exception to PT, I am watching my weight in order to keep it in the low 180's. Weight gain on a recovering knee replacment is not a good idea.

Other Developments. With increasing knee bend, I drove my car more often this past week. I was able to drive myself for short distances to the grocery strore and to PT. I have sufficient control over my right leg to negotiate the brake and accelerator. I am more comfortable sitting in the drivers seat this week. I also contacted by boss and colleagues at work and let them know that I may come into work part-time during the week of January 10 to test my abilities at the office. This, of course, is contingent on approval from my doctor who I will see at 8am on January 10. Since my job as a University IT administrator entails sitting at a computer doing e-mail, reading or sitting in meetings and talking with colleagues, I think I will be up to the task on a trial basis. Just depends on how much walking and subsequent swelling my knee endures. Thinking that I may take an ice bag with me to work that I can use while sitting in my office to manage the swelling.

PT has become really intense. Cathy is working me hard. The PT sessions are 1.5 hours and end with an icing of the knee. I am really glad Cathy is pushing me hard. I do want to exercise the muscles around the knee to strengthen them and improve flexibility. The last PT session was exhausting, and I was in pain for the remainder of the day on Monday. Even though I did the norco pain medication, I still had trouble sleeping Monday night. My knee and surrounding area was swollen and stiff. Below you will see one of the exercises I am doing at PT. This exercise is called the wall slide which forces the knee to bend and stretch/tear scar tissue. You will note that Cathy is pushing down on my bent leg to force additional knee bend--working hard to get me to the goal of a 90 degree knee bend. Note the grimace on my face. This is painful, but I realize the benefit for increased flexibility of the knee. Once, I achieve a 90 degree knee bend, I will be able to work on a stationary bike and begin working on climbing steps using one leg per step. Not there yet, but getting closer.

One exercise done at PT is to use the Biodex (continuous motion machine) which bends the knee from a full extension to a potential 100 degree bend. As I am able to control the level on this machine, I was able to get the knee flexion up to 80 degrees this past Monday. My goal was to achieve a full 90 degree bend by January 10. The only problem with this machine is that while it forces good flexion of the knee, the knee will swell afterwards and become less flexible. But I am told that the long term benefit will be improved knee flexion. Ideally, I would like to achieve a 110 to 120 degree knee bend when fully recovered.

On the lighter side of things, I have been getting out of the house a little more this past week. In addition to running a few errands on my own, I was able to travel with my friend John on a tour of Detroit landmarks, and join my wife Margaret for a trip to the Motor City Casino. For both trips I took the cane and ice pack, and I managed to find time to elevate the knee to minimize swelling. For the Detroit trip, John and I toured Wayne and Detroit by car to see landmarks of our childhood. Of several things we saw including the grounds of Tiger Stadium at Michigan and Trumbull, we visited the Penobscot Building (http://en.wikipedia.org/wiki/Penobscot_Building) and the abandoned Detroit Train Station, known as Michigan Central Station (http://en.wikipedia.org/wiki/Michigan_Central_Station). As teenagers, John and I had climbed the stairway of the Penobscot Building to the top of the building while smoking cigars! Sad to see the Michigan Central Station abandoned. There was a banner at the very top of the building stating, "Save the Train Station". So many abandoned builidngs in Detroit--it was depressing. John and I did have a great lunch at Sinbads, near the Detroit Yacht Club. No one at the restaurant seemed to mind that I used a second chair to prop my leg up while we ate lunch.

With plenty of time to sit around convalescing, I have also finished reading two books over the last week. I read the autobiography of Colin Powell and the autobiography (Life) of Keith Richards. Wow, what a contrast in lifestyles. Both had unique and interesting experiences in their lives. Colin Powell had a career in the US Army, served in Vietnam and Desert Storm, and also worked for the Clinton and Bush Administrations. Keith Richards led a counter cultural lifestyle as a rock musician playing lead guitar for the Rolling Stones. Keith, amazingly survived the drug culture of the 1960's and 1970's, and he still plays music today for the Stones touring with Mick Jagger and other band members.