Knee Surgery – Day 9

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Jan
31

This is the continuing story of recovery from partial knee surgery. The last installment was Day 7.

Day 7 was Tuesday. 8 days after my surgery. I am learning to sleep in a bed again, though it is difficult. The previous explanation was that my heels would hit the bed and force my knee to bend which was achy. So I tried putting my heels over the bottom edge of the bed. That didn’t work because the bottom is wood and very hard on the Achilles tendon. The newer way was to place a towel, rolled up lengthways and lay it over the wood. That worked. Much better. But then it didn’t. I think the explanation is more complicated than originally believed.

My knee seems to need some kind of constant motion. As soon as motion stops, the knee begins to stiffen. When it stiffens, it aches. So about every 5-15 minutes, depending, I think on what part of the knee is stretched, some further motion is needed. Day 8 was the most learned to get close to a fix of this problem. In one motion, I lay on my left side. I put a hard foam pillow under my right leg and bent it close to 90 degrees. I laid my left leg in front of the pillow so the knee was not lying on the pillow. I bent the knee close to 90 degrees as well. I was able to sleep for about an hour before I awakened with an achy knee. I tried that another part of the night. Only slept about a half hour, but either one is far better than 5 minute increments of sleep.

Day 7 was a tough night for sleeping and I got very little sleep. I used most of the night for doing my exercises. Indeed, I did exercise most all of the night time hours. During Day 8 I continued my exercises a lot of the day. When my wife got home she drove me to therapy. By the time bedtime arrived, I was exhausted. This was a deliberate act because I was so restless in sleep the previous night.

Day 8 was the most difficult day of therapy yet. Jorge was my therapist and he was a slave driver. First after checking my leg out and asking a few questions, he put heat on the knee. I should’ve figured this was the calm before the storm. After the heat, he measured my maximum knee bend which was far better than Day 1. I did some exercises and confessed that the knee hurt so badly that yesterday and today I did few exercises. I think Jorge decided today was make-up day for those I didn’t do yesterday.

After the exercises on the cot, we then did some walking assisted with the crutch. First it was with two, then one and Jorge made suggestions. I was told to walk with one crutch inside the house and two outside the house. I thought that was good because there is little room in the house to maneuver two crutches. Then we got into serious exercises. The first one involved an elastic strap around a pole. I had to pull the strap back till it was taut, and then bend my knee. Then I was to straighten the knee using only my knee quads, not my butt, and hold for 5 seconds each. I did 20. It hurt to do these, and I hardly got through them all. We then did step-ups which actually felt good.

Last, I did rocking motions on a stationary upright bicycle. The seat was high. I could hardly get on the bike due to my foot being weak. Finally I was up. What I had to do was roll my left leg around going one way until the leg wouldn’t go further, then rock the leg going back the other way, until it the leg wouldn’t go anymore that way. I had to do that for 6 minutes. I thought it was going to kill me! The forward motion of the leg was far more painful as well as far less motion than the backward motion. At my question on why this was, Jorge explained how the muscles of the leg were laid out. The muscles on top of the leg run from hip to past the knee. The muscles on bottom of the leg, run from hip to above the knee. Forward motion is done by the top muscles so they can’t go as far due to lack of development right now. Rearward motion is the under muscles which don’t come down as far and is easier, even development problems from the surgery.

When I was done with the bike I could hardly move. I hobbled back to the cot on my one crutch and lay down and got ice the rest of the time for about 10 minutes. When it was time to leave, I could hardly leave the cot. Or move. No pain, just a lot of achiness from the therapy. By the time I got home, it was truly time for some numbing pills. No more exercise this night, except walking around the house! I’m not sure I could have exercised even if I had wanted to.

Finally, it was time for bed! I decided to try the new things with the hard foam pillow and lying on my left side. Indeed, it did work and I got about 90 minutes or so extra sleep. But still, 90 minutes extra during a sleeping time of about 7 hours, isn’t really very much if the rest of the time one is turning, or trying to turn, or getting out of bed to redo the towel over the bed, etc. In short, I STILL didn’t get a good night’s sleep!

What I do before bed since this sleep issue has been with me, is just before I climb into bed I get all my calm down, pain numbing pills taken right up till it’s time to climb in. I leave the pills at the bedside and when I wake up, if the timing is right, I take another pill. Conceivably then, my body is numbed from pain as far as its going to get, and if I can get the right position I should have no problem sleeping. This should give the reader an understanding of this aggravation of aching and not sleeping. Because, usually, I never have an issue of sleep. Except now.

Day 9 has been a good day. I have exercised at the appropriate times. Due to learning about the crutches yesterday in therapy, I’ve been diligent with the single crutch in the house. I took a walk outside, though it’s clearly winter again in this area. I used two crutches outside and walked up and down the driveway several times before heading back in. I didn’t go back in until I had a small ache in my knee that wouldn’t go away. On returning, I iced the knee, and read until the ice warmed up.

I contacted the office of my doctor. They had been supposed to send me an appointment with the doctor after surgery but had not. I got that date from them. I found that I had to continue wearing my compression sox until the doctor advised different when he saw me in the next appointment. I was told I could take the bandage off at any time, or I could allow my therapist to remove it. I was happy about the therapist as I’m not sure I want to be the first one to look at the stitches from this surgery. I’m hoping that once the bandage is removed, there won’t be so much stretching of the knee and so much pain and achiness at the site of the incision when I do exercises and therapy. The last part of the conversation with the nurse was the best – She advised I could stop taking the narcotic medication anytime I wanted to!! When I stop taking that, I can begin driving again!! Woohooooo!!!

Again, my intent is to continue this blog until I have returned to 100% in my opinion. Although I’m gaining on that goal every day, it is not yet close.

Knee Surgery – Day 10

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Jan
31

This is the continuing saga of the recovery of a middle age (at least in my mind) man who had partial replacement knee surgery 11 days ago.

Today was an enlightening day in many ways. First of all, I let the therapist remove the bandage after my doctor permitted it by phone. I was not interested in being the first to view that knee, just in case. So Jorge removed the bandage. He pronounced that the stitches appeared to be the dissolving kind. I will attach a photo of the finished product. The skin reminded me of the face of a Klingon from Star Trek. Wrinkled and dark. The line through the middle of the face of the Klingon are the stitches.

After removal of the bandage, Jorge spent a good deal of time massaging the area around the stitches. He advised the reason is that the skin wasn’t moving around. For comparison he said push/pull the skin on your other knee. It moves around freely. The left knee should be that way as well. But it isn’t. The skin doesn’t move around at all. When Jorge was massaging the skin, I could feel things like popping apart gently. I looked to see if the skin was popping up from the stiches. Jorge said this was the skin lifting off the bone, and the webbing between the bone and the interior of the skin so that the new skin will start moving around some. It felt a bit weird, but did not hurt at all.

Following the skin massaging, Jorge then had me move my legs half off the cot. He then pushed my calf of my leg toward my thigh. I was some worried about this because this maneuver had caused me great achiness since Monday’s therapy. Jorge pushed enough so that my calf nearly touched my thing. Pretty amazing! Especially since my leg didn’t ache at all doing this! Next it was my turn to do the same thing. I had to stretch my calf out as far as possible toward straight. After doing this 15 reps, I next had to stretch the leg straight out again and on return to 90 degrees, I was to pull the calf back in toward my thing again. Well, danged if the same severe ache didn’t return when I did it! Worse – the leg did not bend near as severe as when Jorge pushed it. I went ahead and did the exercise. Following the exercise I asked Jorge why I ached, and when he did it, I didn’t. Jorge said it was because I was tense because my mind wouldn’t accept I could bend the leg that far. Very cool.

Next it was back to the strap mentioned on Wednesday. To refresh the reader’s memory, I had to have an elastic strap around my leg, and it was then tied to a pole. I had to stretch the strap, then step back further. My exercise was to bend my knee slightly and after a five count, I was to straighten the leg out completely. The first time I did this today, I noticed my knee would lock when I pulled the knee back. This was a definite advancement as I could not do this on Wednesday. I did these 15 reps.

Next I went on the leg push. This is a weight lifting machine, with the only weight being the user’s body weight. The exercise is I lay on my back and placed me feet shoulder width apart and with the knees bent comfortably. I then pushed my body backward until my legs straightened. I was able to lock my legs again with this exercise. I was very happy about this development. When I shoot rifle in competition I lock my legs. It’s been long since I could lock my knees so I’m very happy with this development. It may be difficult for some to believe, but the difference in shooting for me is – knees don’t lock = rifle moves. Knees locked = no rifle movement. I’m hoping it’s the difference between not winning and winning matches.

Following this exercise I was back on the stationary bike, rocking again. Rocking, to explain, is the user is on the bike regularly. The pedals are turned one way till the user cannot turn anymore as the leg refuses to bend further. The pedal is spun backward this time until the leg no longer bends. Rock back and forth between forward and backward turns of the pedal for 5 minutes. I was almost able to go completely turn the pedal today but couldn’t quite get over the top apex of the curve.

Last thing was to get my knee iced down till time to go. I discussed the not sleeping with Jorge. He advised a hot shower just before bed, and then do a few exercises in the bed after the shower. This may get the blood running and maybe I wouldn’t wake up so much. If I continued to do this, I may wake up less and less.

My apology for no photos. I haven’t quite figured out how to do that yet when writing.

Knee Surgery – Day 7

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Jan
28

Day 7

Yay! It’s been a week since my partial knee replacement of my left knee. This is the 4th installment of my recovery from this surgery since the first one. I skipped Day 3, 4, 5 & 6. Those days had no further therapy in the week. I will refer to any improvements made during the week in this blog.

There have been a few more improvements that just seemed to take place. For example, last night, evening 6, I stepped off the down step out of my kitchen and forgot to take the first step with my left knee. Instead, I stepped down with my good leg, causing my injured knee to have to bend. It did, I continued, and only a few seconds later I realized there had been no pain in bending my knee. Another example – Day 5, I was emptying the dishwasher but had no place to put my crutches, so I put them elsewhere and walked back to the dishwasher, sans any crutch or device assistance – no pain. And again, I simply didn’t realize it for a few seconds. Day 5 – I was trying to put on my pants, (don’t want to give too much info here) but in doing so, I raised my left foot and pulled the pant leg on over it. The day before I had not been able to lift that foot at all. Day 5 – a few hours later, my wife had to assist me with my sox, but as soon as she got the sock over my left heel I was able to reach down and pull it the rest of the way up with no pain from the stretch. It is truly amazing what these exercises and therapy do to improve flexibility in such a short time. Day 6 – Went to my gun club membership meeting. Following the meeting while waiting for my wife to come get me, I walked, with crutches, about a quarter mile! I thought I would have immense pain after I got in the car from my knee stiffening up. Nope, no pain the entire way home. Very fine feeling.

There have been some instances of almost disaster: Day 3 – decided to use my crutches more. Took the first step with them and overbalanced to the rear. If my daughter had not been behind me it could’ve been a disastrous fall. One quickly learns not to go quicker with the feet than the brain knows about. Day 6 – following the meeting, I was discussing the surgery with several interested people around and attempted to get up out of my chair. I did it correctly, but didn’t have the leverage in my right arm. When I lost my leverage, and started back down, my chair slid out from under me. The folks around realized what was happening and saved me from a bad fall.

Day 7 – I spent last night in my bed again. Couldn’t sleep again. Just like the first day after surgery. Already explained about the heel of the foot causing the knee to be elevated in the wrong way. Last night, I simply wanted to stay there. Consequently, I stayed awake all but about 1 hour and did knee exercises the entire night. I expect that to show up in therapy and repair sometime soon. I’m still undecided whether bed or chair downstairs. The chair is, without question, the most comfortable for my knee. The stillness of the night, in bed beside my wife, is where I belong. Might just have to do night time exercises and sleep in the chair during daylight.
Today in daylight was good. Several limitations have been by passed. Some examples: I put on my own socks. Prior to today I could not get to my left foot because the knee wouldn’t bend or twist and leaning down further caused the leaning, twisting to happen. When I attempted to pull the sock on the right foot, the left foot would automatically begin to twist to compensate, and enough pain would happen to make me not want to put that sock on. Until today. Today I had to go to therapy. After my daily wash, these socks, which are compression socks to prevent blood clots, are very difficult to get on. I didn’t want to wait for my wife to help me as it seemed to me that my knee had been strengthened and felt limber. I tried it and I was able to reach the left foot, no problem and pulled the sock on. The right foot was even easier. Had’em both on in about 5 minutes.

Next thing, for my wash today I decided to try a shower. The problem with that before was I could not lift up left leg up high enough to clear the tub. Plus, I could not stand on my left leg with all my weight while putting my right leg in the tub. I was nervous about it today. One reason was my wife wasn’t there to grab me, help me, call the EMT, etc. if I actually did fall. Another reason, though less of a problem, was I was worried that if I got in, I wouldn’t be able to get out!! Imagine that. I take the shower, and can’t get out. 90 minutes later the wife comes home to take me to therapy and I’m still in the shower. I’d look like a prune. “What are you doing?” She’d say. “Taking a shower. Sometimes it just takes longer”. And then, of course, I Still wouldn’t be able to get out. All total an embarrassment even for husband/wife! Fortunately that didn’t happen at all.

I easily lifted my right foot into the tub, and tested the tub bottom making sure there was no slippage. My left foot came over just as easily. Being nervous made me take a quicker shower. I was out in about 5 minutes, usually takes a lot longer to enjoy the heat of the water. Extracting myself was a bit more exciting. I found my left leg would not clear the tub without bending the knee. I bent my knee and immediately stubbed my big toe into the tub creating some pain for the toe, and turning the air blue with some unkind words about tubs and toes. As I lowered my pained toe, I apparently experienced further dimwittedness and slid my toe down the corner of the sink cupboard nearly cutting my toe again. Old Baptist saying, ‘your sins will find you out’. I figured for sure that was just a payback from God for cursing a few minutes before, so I held my tongue this time and managed to get the rest of the way out of the tub without further incident.

I went to therapy. Two more exercises introduced but will only be done, for now, at therapy. (1) was walking with one crutch instead of my usual two. The left leg and the crutch on the right side go out at the same time, and then the right leg walks through them. The purpose of this is to let the left leg relearn to straighten fully when taking a step. The point being that the leg has to extend to straight to walk correctly. If the leg only goes to a long bend, I will walk with a limp. Don’t want that. (2) Using a short step and between a pair of parallel bars to hold on to, I was told to step up the step with my left leg and use my quads to pull me up, then step up with my right leg. Then step back down with my right leg first so my left leg would bend, then back down with my left leg. I did 40 repetitions because it simply felt good. The therapist advised me that I could practice this exercise at home but a standard house step is considerably higher than the exercise one so I would be surprised at the amount of muscle I would be required to use to hoist myself up with my left leg. I haven’t tried it yet at home.

The therapist advised me to shower when my wife is close by rather than when no one is there, just in case. Also, I was told I could sleep in bed with my heels hanging slightly over the edge of the bed, sleeping on my back, and with nothing under my knee. When my leg is straight quicker healing occurs.

So ended Day 7, with mentions of other days previously mentioned.

Knee Surgery – Day 2 after

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Jan
27

This is the 2nd day after partial knee surgery on my left knee. I had the surgery on Monday January 21, 2013 at Mr. Vernon Hospital in Alexandria, Virginia. I wrote about the day of the surgery in the first blog. The 2nd blog was about Day 1 after the surgery. This is the 3rd blog about Day 2 of the surgery. I plan to continue this blog until I am at 100%, in my own opinion.

Day 2 is better than Day 1 in that going up steps is easier. I make it up my 13 inside steps to my second floor without any mishap. There is some pain, but thru the wonders of medication, perseverance and that I KNOW this will be better fairly soon makes the climb much more bearable. I spend a lot of the day walking around my first floor with my movable device. Jorge commented and wrote on my therapy exercises on Day 1 that I should walk more, ice more and do the exercises.

The exercises are as follows: (1) Lie down, left leg straight out. Maneuver the left foot to maximum degrees in circular ranges. Do this 30 to 50 times.
(2) Lie down, or sit down, left leg straight out. Put some kind of strap around the foot. Pull the left leg straight back so the knee bends. The instructions say until a slight stretch is felt. Jorge says until I can’t stand it. Hold for 5 seconds. Lower leg back to straight out. Do this 10 – 30 repetitions. So far, I can’t do more than 15. Very painful beginning to end.
(3) Sit on edge of chair, left leg down. Lift leg to straight out. If muscles are weak, then assist leg with the right leg until straight out. Hold for 5 seconds. Do 10 – 30 repetitions. So far, I’ve not been able to do more than 10 repetitions. However, I began this exercise not being able to move my left leg with the left leg muscles at all. Now, after 2 days of exercise, I can get the left leg up more than 45 degrees toward straight, so I know the exercise is working!
(4) Left leg straight out, best done sitting up. Using the quad muscles around the knee only, straighten the leg and press down till completely straight with back of knee flat on the table/bed. Hold 5 – 10 seconds. Do 10 – 30 repetitions. This is also a cumulative progressive exercise. Day 1 I could not even bunch these muscles. Day 2, until Day 2 therapy I had to help the knee down and it was soooo painful. I could do no more than three at a time. Day 2 therapy session and the therapist showed me exactly what to do. I was able to use my quads to do 8 of these exercises and hold the leg straight with my quad muscles alone. Since then, I’ve progressed more and more reps as well as length of hold down with the quad muscles. So far, I’ve been unable to do more than 15 reps for this exercise, but I know things will be better as time continues.
(5) Lie down flat. Same as exercise 2, except without the strap, and also release the leg and allow to slowly go forward to straight, same as exercise 4, again, without the strap, or hand assist. Hold for at least 5 seconds. Do 10 – 30 repetitions. The most painful exercise of all, as no assistance is lent by strap or hands, so the pain begins when the leg starts to bend and does not end until the exercise ends.

My therapy for the day is at 3:30PM, same place. An interesting sign is there, just inside. “No Concealed Weapons”, with a photo of a handgun, a circle around it, and a mark thru the gun. The sign is small, about 4” X 6”. Usually I carry. Not today, too much pain. We’ll see. I feel bad for establishments that believe this little sign that may not even be seen by most, would (a) be seen by murderers (b) murderers would care. These are the establishments that are targeted by murderers. Criminals aren’t stupid. Nobody wants to die by the hand of another unless they are very depressed and don’t have their own nerve for suicide. Criminals go for success. Whether theft, robbery, rape, murder, whatever the crime. A murderer would see that sign, smile to himself (usually is a man in this kind of crime), and commence fire. When the police arrived, the shooter would shoot himself, thereby removing, even the police, of some kind of vengeance. This is the ultimate put down to the public. The feeling by public, police, etc., is no one can do anything about these people. But someone could. And that someone could’ve been right there in the establishment. Except, that someone saw that sign and didn’t want to be ostracized or generally embarrassed by the establishment management. So on that day, that person died with the rest of the lambs by the murderer.

On this therapy day, I have a female therapist. Don’t know her name yet. Again, I am dressed rather skimpily for the weather, but perfect for therapy. The therapist and I discuss my surgery and she asks if I am right out of surgery and I tell her it was Monday. She massages my leg, and notes that my knee is heavily bruised on the right side of it. She says this bruising is nothing compared to what is going to show up in another day or two. And by gosh she is surely correct on that! Right now, Day 5, I have bruising all the way up my thigh on both sides, wonderful shades of purple, fading off to yellow as the days go by.

Then she comments on my actual surgery. My incision is nearly center left knee, or a smidgen off center to the left. The therapist comments that actually, the device that was inserted is to the right about two inches! Not under the incision at all! What a surprise that was! Although, as I commented back a bit, I had wondered about that. The surgeon had told me the partial was going to be on the right forward area, and clearly the incision didn’t indicate that area at all. But what an interesting thing to learn. The therapist believed that the incision was not directly over the device in my knee so that the healing would be easier, and I could get down into lower squats, or even kneel down on hard services without feeling pain from scar tissue inside the knee.

When I was done my therapy, my wife collected me, and off we went back home. The rest of the day was basically lying around until bedtime. Where-upon I decided to spend this night in my bed!! A wonderful thought, and I hoped it would continue that way! Once in a regular bed, the exercises, particularly the complete straightening of the leg were easier to feel the back of the knee on. Not any easier to do, just easier to feel.

Knee Surgery – Day 1

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Jan
23

This is the second installment of my partial knee replacement to my left knee. I plan on continuing this until I believe I am 100% again. This may not take as long as some would believe as, prior to the surgery, there were numerous things I could not do that I expect to be able to do shortly following the surgery. Among these things were: deep knee squats, getting down on my knees without double foam padding under the knees, getting back up to standing, and locking the knees in standing position. I’ve discussed these movements with others that have had full knee replacement and they can all do these movements. I discussed them with Dr. Fricka, my knee surgeon. Dr. Fricka advised that I would be able to get down on my knees but I may not want to do that due to scar tissue which would make it uncomfortable but not impossible.

On the day following the surgery – I’ll call it Day 1 – the medications from the surgery wore off. PAIN!!! I had taken my new meds which included Colace, aspirin, pain meds and others, but my knee was VERY stiff and achy nonetheless. I could hardly move it anywhere. It was hard to straighten, and pretty much stayed slightly bent. I couldn’t put weight on it. My wife came up with a movable device to assist me in walking. My knee was swollen to near twice the size of my right knee. My knee was easily the size of a large cantaloupe! Moving the knee seemed to get it more swollen; furthermore, not moving my knee didn’t seem to make it go down in size any either. I lay in bed nearly all day until my therapy which was at 4:30. I had continuing ice packs on my knee. Didn’t seem to do a bit of good for the swelling or the pain.

I had therapy at 4:30. Here was a severe problem. I could hardly move. I couldn’t walk, with or without my movable device. I just kind of slid along with it and hoped I wouldn’t fall down. Next problem, it was COLD outside, probably around 25ish degrees, wind blowing. A fine day for someone with half a leg to be out in, trying to get to therapy. To complicate matters more, I wasn’t allowed to drive. I had to depend on someone else to drive. It’s hell to be helpless!

My daughter took me to therapy and me and my wife went in together. Due to the sox I had to wear to prevent blood clots, I could not wear long pants. I can’t tell any readers how ludicrous I looked to myself. I wouldn’t have been the slightest bit surprised if the therapists hadn’t just burst out laughing at my appearance. We left the house at about 4PM. Keep in mind the therapy location is only about 2 miles straight down I66 from my house. We got there very shortly. It took me well over 15 minutes to get my little self out of the SUV, to the pavement. When one is in extreme pain just to move the leg, twisting the knee, then the ankle, and moving around on the car seat just to get one foot out of the car, is nearly a screaming fest. Fortunately, I was able to keep my screeches to myself. From there, my wife helped me into two sets of heavy pull doors. They hadn’t seemed near this heavy when I came to see about appointments a couple weeks before. Both sets of doors had the handicap push buttons. They were too far to reach but my wife got one of them. The door I thought would open didn’t and the other door nearly knocked me down. Geez! It sure hadn’t seemed so difficult on the last visit. Maybe I should’ve come here beforehand and familiarized myself of the door operations, heaviness and how far things were from each other.

Finally! I got into the building. And it was warm inside!! Hallelujah! Hadn’t been warm for the last 15 minutes or so! I got into the therapy office. Very small. Seats were filled up with older and infirmed people…..suddenly I realized that could apply to me. That was really a disappointment by itself. But no problem, I didn’t have to wait very long and was called in within 5 minutes. I saw a man who seemed to be in charge of the program there. This was Jorge. We talked for a while. I realized as I was talking with him that I could hardly hold my eyes open! Thought for next time with this therapy business, take my heavy-duty medication after my appointment, not before!

While discussing my knee, Jorge was moving it around. Pain. Much pain..No matter which way or how much he moved it. Plus, I seemed to have no muscle tension. Jorge hung my leg over the side of the gurney I was on and told me to bring it up to level. I couldn’t move it, any. Nor could I move it back and forth, or slide it onto, or off the gurney. Jorge advised me that the swelling was normal and, in fact, was a good sign in that things were progressing as they should. I felt a bit better about that. I was truly worried that swelling was not a good sign. Jorge advised that one of the main exercises I was to do would be to straighten my leg completely. Jorge said if I couldn’t straighten it completely, I would walk with a limp. I determined that was not to be. I will not walk with a limp. There were other reasons to want a straight leg but for now this was the prime one.

After about a half hour discussion, Jorge released me back into the custody of my wife, saying to her, “I went easy on him today. Didn’t make him cry”. I thought, ‘well you weren’t too far with all that moving around though’. My daughter came back to pick me up. I exited the same dang two doors, this time, pushing was a lot easier as I could get my weight into the doors and they seemed to open easier. My daughter opened the door for me and nearly froze waiting for my pokey self to get to the truck. Getting in was the same pain as it was getting out. I never knew that moving other parts of my leg would hurt my knee so much when it never did that before. Live and learn to respect your pain. I rode on back to our house, and again wiggled on out of the truck and hobbled on into the house.

Getting out of and into a house with multiple steps, when one leg is in pain, is in itself an aggravation. Your loved ones are there to help, but they can’t. The steps are not wide enough for me and anyone else to stand beside me. I can’t use my movable device because it is also too wide to fit the steps with me on them. Therefore, it is up to me only to hobble up the steps. Here’s the drill: To exit, and go down steps – turn around and back down like you would on a ladder. My surgery was on my left knee. I cannot over-bend that knee, nor can I over-straighten it or I will be in near screaming pain. First step down is on the left foot, straight out, straight down to the next step from the top. Quickly move the right foot down to the same step as the left one is on. Yes, that means my weight is now all on my left foot of the knee I just had surgery on. If I do it quick, it isn’t a problem. Too quick, or too slow it IS a problem. I learn quickly what the correct speed is. Continue until you get to the bottom.

The maneuver to go up the steps is as follows: Step up to the first step from the bottom with the right foot. Step up from the bottom with the left foot. Again, yes, the weight is on the left foot for a few seconds till the right foot establishes the next step up. But again, speed and control is quickly learned if one gets tired of the pain. Continue with this maneuver until you’re at the top.

Since I was returning home from therapy, I did the ‘up-the-stair’ movement to the top of the porch. At that point, my movable device was handed up to me and I used it to balance while I unlocked the door, turned off the alarm, entered the house with my device sideways, and moved the dog out of my way. You never think of all these little maneuvers till you have to do them with half your body basically tied behind your back. When I’m inside, now time to decide where to sit so I can have blankets on, ice on the swelling and be able to get up to go eat, bathroom, where ever else I need to get to.

Now here’s a problem I’ve never had before, that I’ve had several times since surgery. How long do I let my bladder fill up before I get up to go? Usually one can wait for a long time before that quick run to the bathroom, but when one is hampered by having one leg that doesn’t want to do right, then maybe one ought to go as soon as possible after the first inkling. Otherwise, it could be painful to hold it while attempting to leap out of the chair/sofa/bed/etc. while maintaining some decor and not curse and scream about having to go and maybe not making it to the end of the trip! Yes, I always made it, but I’ve now gotten much better at feeling that first tingle of pre-knowledge, so to speak!

Other problems never having before: Sitting in a chair. I have a lounge chair I sit in during some of the day so I can lay back, relax, and/or do my exercises. First time I tried sitting down after surgery it was painful because when one sits down, the legs automatically bend to accommodate the lowering to be in the chair. I quickly found out that the best way for me was to straighten my left leg out as far as possible, lean over to the right, back my right foot up until I could lower myself almost to the chair seat, then quickly move my right foot out and under my left ankle to give it support. From there, I generally fell the rest of the way into the lounge chair. That worked with the sofa as well. The dining room chair was a bit more difficult as the table there so when stretching the left leg out, the danger of striking the table with the left leg was great. I only did that once before I found that the best way to deal with this was to back the chair out, slide the leg under the table, and sit down. Then scoot the chair back to the table, taking care not to bend the left leg much. After a couple tries, I got better at not bending the left leg too much.

At the end of the day, comes bedtime. The bed had special problems. My first two nights following surgery I couldn’t sleep in a bed. It was weird, but when lying down on the bed, my pain came from having my left heel forced down on the bed, which pushed my left leg up and bending it all the time, causing pain. No matter which way I turned, somehow my left leg was forced into bending while lying down. So I slept in my lounge chair the first two nights following surgery. Not much pain at all. Which meant I got to sleep.

And that was Day 1.

My Left Knee – Thru the Surgery

Posted by DetectiveEstes in Detective Estes' Corner      No comments

Jan
21

This is a short story about the partial replacement of my left knee. I thought if someone were considering this type of surgery, they could read this and get an idea of how they would feel following surgery based on how I feel.

After having arthritic pain in my left knee for years, by September, 2012, it was evident that I had a lot of pain that was not going to go away, in both knees, not just the left one. In November I went to see Dr. Kevin Fricka of the Anderson Clinic Orthopedic Group. See their website at www.andersonclinic.com. This group of orthopedic surgeons operates out of Anderson Clinic and Mt. Vernon Hospital. Anderson Clinic is located at 2400 Army Navy Dr. in Arlington, Virginia and Mt. Vernon Hospital is at 2501 Parkers Lane, Alexandria, Virginia. I chose Dr. Fricka specifically because he works with another doctor who specializes in anesthesia so the patient feels less pain following surgery. This is Dr. Nitin Goyal. I am one of those who really don’t like pain. No pain or less pain is far better than any pain, in my opinion. I had read about Dr. Goyal in one of the newsletters from the group.

I made an appointment to see Dr. Fricka and went to see him. Dr. Fricka is, I believe, a typical orthopedic surgeon. He is tall, about 6’5″; big, probably around 250 pounds, and muscular. I read once that orthopedic surgeons have to be muscular because they have to lift their patient’s dead weight limbs and hold them in place during surgery. Dr. Fricka examined my knees and advised that a full knee replacement would not be necessary on either knee. I did have arthritis in the left one, and wear in the right, but not to the extent of a complete replacement. Dr. Fricka explained the procedure to me along with the procedure of the anesthesia.

There would be a small amount of light anesthesia. After I was relaxed then there would be an insertion of anesthesia similar to an epidural in my back which would numb my lower extremities. The surgery would then take place. This epidural was of great upset to me. I was very worried about someone sticking a needle in my spine! How much pain would that be? I figured a lot and I was really upset about it. I discussed this with Dr. Fricka. He was adamant about this method of anesthesia prior to surgery. His reasoning was the epidural would numb my legs only and the insertion would also let the doctors quickly know about any respiratory or heart issues immediately. I figured I’d better look into this so I wouldn’t be full of anxiety pressures.

The surgery would only be done on the part of my knee that is painful. The knee was x-rayed for current wear & tear. Dr. Fricka pointed out the parts to me he would be doing surgery on and that these were the parts rubbing together without much, or in a couple places, any cartilage between the bones. Dr. Fricka said this part only would be ground down somewhat, and a piece of material replaced the ground down part. The other side would also be ground and another piece of material would be wedged into the bone. Dr. Fricka had an x-ray of a finished product and showed it to me. On seeing the x-ray, the work being done was obvious.

Dr. Fricka said the recovery was about half the time of a full knee replacement. This is due to the method used. In full knee replacements, tendons and ligaments have to be cut then repaired and this is what a lot of the healing is. The surgery was set for January 21, 2013 and I was to be at the hospital at 6:30AM to be the first patient at 8:30.

Within 30 days of the surgery I had to have a physical. Part of the physical was a heart EKG, and also a blood test to make sure I had enough clotting in my blood. 10 days prior to the surgery I had to stop taking any blood thinning medicine such as Ibuprofen and aspirin. Five days prior to the surgery I had to stop any other medication that was not life preventative.

I talked to several women I have great respect for on the epidural; my wife, daughter in law who just had a baby, and my doctor. My daughter in law advised me not to worry about it; I may not even feel the prick of the needle. My doctor commented it was a very short needle and I’d probably not remember it. My wife said it wasn’t anything to worry about. I thought if all of these people so close to me felt the same way, I could just put my bother aside until there was something worth being bothered about.

On January 21, I arrived at Mt. Vernon Hospital at a cold 6:15AM. My wife and daughter came along too, for driving me on the return and for personal assistance. I entered the Hospital at the Yellow, Out-Patient Unit. Upon entry I left my name at the front desk. Shortly thereafter I was escorted into the registration office and my complete ID and health insurance information was collected. Following that I was then escorted into a nurse’s office. My blood pressure and heart rate were collected and an IV needle was inserted into the back of my hand for future use. Next, the entering nurse and I went to my room for the surgery. The IV needle in my hand was now used to set the IV in my hand.

The anesthesiologist, a woman doctor, entered my little space and we discussed known allergies I have to certain medication. The anesthesiologist was then ready to go. I wasn’t. I had to go to the bathroom. Sometimes nerves just take over in the bladder area. I quickly eliminated the very minor amount of liquid and headed on back to my room. Upon entry I found my anesthesiologist in a cell phone conversation with the surgeon, apologizing to him that ‘he had to use the bathroom’, meaning me!

At about 0815 the anesthesiologist then inserted the relaxation stuff in my IV and within what felt like about 3 seconds I was relaxed! The anesthesiologist then inserted my epidural, and loosed whatever was in it, into me. For those that are waiting for how it felt, I can’t tell you. I literally cannot remember when the epidural was inserted, what it felt like, and what my legs felt like after that. I have forgotten all except the first relaxation stuff in my IV. Pretty amazing. The anesthesiologist did comment that I may have headaches and they would deal with that later. To date I’ve had no headaches.

Sometime later, I noted it was 1100 when I woke up. About a minute after that, I went back to sleep. Next time I woke up was about 1230 in the afternoon. My wife was invited into the cubicle. We talked a bit, and I got light headed. The nurses treated me and my wife left for a while. At about 2PM I awoke again. I stayed awake, but was still somewhat light headed until about 4ish. And then it was like a light clicked on then and I was fine. After a few more minutes of checking my blood pressure, I was released. I wasn’t in any pain at all. I guess those medications stay with you for long times.

This is what the photo of a partial knee surgery looks like. Click on the thumbnail to see an expanded photo.

xray of surgery

This was the surgery. The next parts are of my knee recovery.