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Past the one year mark
It seems like such a long time ago now but on Thursday, it was a year ago that I had my knee surgery. My knee isn’t totally healed yet but I suppose it’s starting to get close to its maximum. I believe it could take a few months still to reach that point but if I’ve kept patience (sometimes) over the last year, I surely could stick with it a few months longer. One of the odd things I’ve noticed lately is that it’s as likely to be my right knee causing me trouble as my left…which probably is a decent indicator of improvement…assuming that’s it’s not my right knee getting worse…but I’m sure my left knee is improving.
I thought I’d have more to say about this anniversary of sorts but I don’t. At the moment my whole body is sore. I’ve been trying some different workouts at the gym the past few days and my body isn’t too happy about it. I’m due to donate blood on Tuesday and I planned to switch my break day from Monday to Tuesday. It seems possible my body is going to tell me otherwise…Hopefully it will all feel better in the morning and I will just it easy for a few days instead of trying too many new things and working more muscles that have been dormant. Honestly I had no idea there were so many different muscles that could be worked, especially on the bikes.
It’s midnight and I’m rambling so might leave it there. Just didn’t want to forget to make not of this milestone.
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Fitness update
The gym continues to be a regular part of daily life. I missed a day a couple weeks ago when we went to Fremantle and walked everywhere but otherwise I’m there six days a week still. The Scientist has now lost about 23 kgs overall so only has a few more kilos to go before he reaches his goal. I’ve told him he needs to find some better fitting clothes as the ones he’s wearing tend to look way too baggy. My weight has gone down a little bit and it seems maybe this might become a sort of regular thing although it’s mostly tiny amounts. Overall I’m down about 6.5 kgs so I’m getting there slowly.
It’s now been eleven months since my knee surgery and my knee still isn’t at the best level I’d expect it to be as yet. I will say that the knee isn’t giving way as regularly as it once did but it often feels like it might at any time. This surely is an improvement and it gives me hope that there will be a time when it doesn’t do this any more. Meanwhile my right knee is showing more obvious issues with the continued exercise and it seems possible I will need to have it fixed at some point in the future. I hope to avoid that for at least a year or two as I’d like to be totally recovered with my left knee and also be at my ideal weight before going through this again.
I believe some of the recent improvement must be due to changes in my exercise routines. I try to change things around a lot so I don’t get into too much of a rut. Sometimes the changes are kind of forced because my shoulder/knees/back will start hurting and so I avoid exercise that aggravates that and try something different. A few weeks ago I started doing a muscle conditioning routine called Kinetics on the Fitness on Request program. The first class was 35 minutes long and included heaps of lunges and squats, exercises that I really hate and find painful. After the first class I was terribly sore for a couple of days but I did go back and tried again. I’ve since tried all the available classes, including a 50 minute class and I can sort of do most of the routine now although I still find some of the exercises quite hard to do. What I realised just this afternoon was that all those squats and lunges must be paying off because I can do a lot more without as much pain as when I started. This shift seems to have just occurred because I’ve been struggling away with them every time and wondering whether it was going to be worth all the effort…It felt like a big accomplishment. The classes also include quite a lot of abdominal work and I’ve found those muscles are a lot stronger already. My tummy doesn’t pooch out quite as much as it used to. I remember after Game Fanatic was born the midwife told me I need to tighten my abdominal muscles to get rid of the post-pregnancy pooch. I guess I had to wait until he was all grown up to get onto that issue. :D
I’ve also been doing a lot of the spin bike classes and my stamina and endurance are getting a lot better. I recently tried doing a class that includes a time trial of twenty minutes which is quite tough as it involves four periods of five minutes riding in the same position with a few seconds of break meant to allow time to check heart rate in between sessions. I’ve also noticed my legs are getting a lot stronger and I suspect if I were to get my bike serviced I might find I am considerably improved in my cycling than I was a couple of years ago. (Bike is not being used since I fell off it two or three years ago. Not afraid to ride but it didn’t feel like it was riding properly and I keep procrastinating about getting it fixed.)
I also tried out a new bike today which is an Upright Expresso bike. It looks like this and allows you to compete online and record your results with an Expresso account. I tried it out today and it was a lot of fun but hard work. Unfortunately it’s not currently connected to the internet so I wasn’t able to use the online features.
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One month/Six months
It’s now been a month since the Scientist and I started going to the gym regularly. I’ve gone six days a week for four weeks now and I can tell a big difference in many areas. My weight is almost the same right now but many of my other measurements decreased. I am sure the weight will follow suit with time. Â I can tell a big difference in my stamina during this time. I seem to have latched on to the rowing machine as my favorite challenge. I started out doing three minutes each workout but now I do 4 intervals of 500m each with a minute break between each. I couldn’t have imagined doing that a month ago or ever, in fact. We have rower here at home but I never quite got going with it before. The main concern with the rower is my heart rate was increasing quite a bit and I didn’t know how high it was going. When I was younger, this was less of a concern but I now have to be a bit more cautious.
The solution was to pull out my old heart rate monitor and make use of it again. The battery in the watch died several years ago and I thought at the time I had to send it to the company for a replacement. Perhaps I was mistaken because current information shows I can change the batteries myself. Fortunately we had a pack of one size battery needed for the watch. It was just a matter of buying the other size required for the transmitter as it died out at some point. With minimal expenditure, I have an additional tool for use in my fitness program. One odd thing does happen now that I’m using the heart rate monitor. It’s compatible with some of the machines which makes it easier to use them without losing track of my heart rate if I let go of the handles. Anyway, I’ve found that the cooldown period on the workouts have all increased to ten minutes instead of 3-5 (depending on the length of workout). Â The Scientist says this isn’t happening for him so we can only attribute it to the monitor.
Over the past couple of days I have worked out that I am staying under the maximum heart rate on the rower but I am in the high range, as expected. While doing my rowing intervals today, I slowed down the pace on a couple of them so that my heart rate remained within the optimal range. What was interesting is how hard it was to slow my pace.
I also started adding in some of the circuit machines into my routine. I am currently alternating cardio workouts with combination cardio/strength workouts. So far it’s working out well although I have been a bit sore when I’ve overdone it.
This week it will be six months since I had my knee surgery and it’s definitely not back to normal use, despite predictions of both physiotherapists I’ve seen. At my last visit, my physio signed off on my treatment. She was quite pleased with my progress, especially when she learned I’ve been using the gym lately. I had a bit of a setback last week when my knee gave way while I was in cooldown phase on the treadmill. I nearly fell off the back of the machine and it left  me shaken so that I started walking off-kilter again and have only mostly recovered this weekend after working hard to right the issues that have come about. I’m still having episodes where my knee buckles quite randomly for no apparent reason.
Which leads me to my surgeon appointment on Friday. He has also signed off on my treatment and says I am doing all the right things. But he also said I might still have another 12-18 months of rehab ahead of me. Or it might resolve in a few months. He says it’s all down to muscle weakness and it will happen but it’s hard to judge when it will happen. He also made it quite clear that my knee will never be perfect again…not that I was under any illusion that would be the case, especially with the arthritis affecting both knees. So while not exactly encouraging, it certainly wasn’t a total discouragement either since I know I am doing everything right. I also assume that as my weight decreases, the process will go even better.
I will finish out this update with my biggest accomplishment in some time. I can now use my healing leg to lead me up a step where I couldn’t a month ago. It isn’t easy and I can’t do it for every step. But I can do it some of the time so will have to make sure I just keep doing it and get stronger. I look forward to a time when I’m not totally worn out after a trip into town where I seem to be faced with more than the average sets of stairs.
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3 months post-op
It’s actually a week past the three month mark but I don’t suppose that matters at this stage of recovery.
I think I am doing well at this stage of my recovery. Not that I wasn’t before but I have again seen a bit of progress in the past week or two, which makes the end result seem a bit more realistic. It’s strange to think I won’t know for sure the surgery has been a success until I regain all my muscle strength and that could still be a few months away. Â I saw a different physio at my appointment last week. My usual one was on holidays and scheduled me with a colleague and now it seems I will stay with the new physio for the next appointment. I don’t really mind this aside from it feeling a bit disloyal to the original one. The “new” one is probably a bit older and more experienced and her assessment methods were more hands-on this time. Perhaps that would have been the case with the usual one too but I don’t suppose I will know now.
She has revised my home exercise routine now that I am back to more regular walking. I’ve been taking one of the dogs out three or four times a week, as the weather allows and I’m getting through the typical dog walk more quickly now than a month ago. Even when I’ve overdo the exercise I am recovering pretty quickly instead of being sore for a day or more. I am forcing myself to increase my pace while walking which seems to be working well. However, the mental aspect of concentrating on walking properly plus dealing with one of the dogs can be exhausting.
The new physio told me it’s likely she will be signing off on my treatment as of the next appointment. I guess that’s her way so saying there isn’t much else they can do and it’s just a matter of carrying on with the exercises I already have. She also said that one of my muscles is particularly strong compared to others with this surgery. I can’t recall which one it is but apparently others have a lot of trouble with it. The other physio did say a while back that most people struggle with leg extension so I wonder if it’s related to that because I have never had difficulty there.
On a related note, I made a sort of risky purchase online yesterday. The tread on my current shoes has been pretty worn for a while so I’d been planning to buy new shoes at some point. I read about a clearance sale by New Balance at their website and took a chance on buying some walking shoes. I normally prefer to try shoes on before buying but took a chance this time as I have been wearing NB shoes in the same size for several years now. I should have them by early next week so will know then whether it was a worthy risk or not.
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Knee update-10 weeks
Wednesday marked ten weeks since my knee surgery and the healing continues. After the first couple of weeks I could see definite improvements from week to week until I got to about seven weeks. Now the improvements are pretty subtle and sometimes it feels like I am going backwards from where I was earlier.
The incision has healed quite nicely and looks pretty good considering it’s only been a bit more than two months so far. I still believe it will be barely visible once it fades. I had an x-ray done and saw the surgeon last Friday. He says the bone is mending nicely and I am doing fine. BUT…it’s still pretty early days in the grand scheme of things so I shouldn’t get too frustrated at the slow progress.
I’d succeeded in getting full range of motion for my knee within the first four weeks and since then have been working on building up the muscles, of which there seem to be so many. Sometimes I feel like I am doing quite well but then run into problems when trying to use muscles that are still weak. Â I am doing better with my walking but still find myself limping at times. This is particularly true when I’ve tired myself out so it possibly is a matter of working out my own limits. I saw my physiotherapist this afternoon and she said I can walk or ride the stationery bike as long as is comfortable. I’d already been pushing beyond the original times she’d given me anyway, so I guess that will be okay…just that I have a bad habit of overdoing it sometimes and put myself at more risk of injury.
The night before my appointment with the surgeon, I started having knee pain again where it had been mostly absent for several weeks. I’d been having sporadic pains before but they usually only lasted for a few seconds and then I was fine. I mentioned the pain to the surgeon and he asked me a lot of questions about it. I was feeling okay by that time so I wasn’t too worried about it. It’s been more of a problem over the past week but I managed to avoid medication until last night, after what amounted to a particularly difficult day of trying to walk and not doing very well at it. I’d gone to a shopping mall for an hour or so and left with legs that felt much like jelly. It had been raining and the tread on my shoes was worn so I walked much like I’d have walked on an icy surface…and wore myself out really quickly. I’ve also experience my knee buckling more often than I’d like and that another mental factor last night that created more of a physical issue than I’d started out with.
The physiotherapy is going okay but it’s often hard to remember to do everything as many times and as often as I should. My physio stopped me doing mini-squats and switched me to a modified lunge instead. I’d been doing the mini squats for three weeks and still found they were hurting so I’m hoping the lunges will work better for me. I’m also to practice walking up and down stairs more. I apparently should be able to handle them with ease but I find it too difficult most of the time.
Today I was feeling rather adventurous and took one of the dogs out for a walk for the first time since surgery. It’s been a while since either has been out on a walk so I was kind of prepared to deal with some unsociable behavior. Overall it went reasonably well. Lots of nuisance barking and an attempted attack on a dog running loose. I spent much of the time correcting him so my very slow pace came in handy. Weather-permitting, I plan to do another walk tomorrow and keep working on the behavior problems. Fun stuff.
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The knee bends!
This is what I learned on Saturday when I went for my first physiotherapy visit. This appointment was far more useful than the post-op visit with the surgeon on Friday and I came away with new-found confidence. The physio got me properly walking toe-heel and she also had me bending my knee and hanging it over the edge of the table. It didn’t hurt! I think she thought I was worried about doing damage to my knee but I have every confidence that it will be just fine. I wasn’t confident that it wouldn’t hurt.
The physio also showed more interest when I mentioned the ankle pains and bruise that had come out. She suggested a couple of possible reasons and said we’d just keep an eye on it. I don’t think there’s anything to worry about exactly. Just would like to understand what is happening.
I was given three exercises to work on every day. The main one is about bending my knee as much as possible and I really don’t like it because it hurts. There are two others that are done less frequently and also cause less pain.
After that appointment I was out and about twice that afternoon. The first time I felt quite alright when I got home but the second time I pushed things a bit too far so that I was worn out when I got home. All the activity caught up with me and my knee got really swollen so wasn’t very good for movement. I’ve stayed off my feet most of the past two days and it’s still fairly swollen but I think it may be improving.
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3 weeks, 2 days post-op
Time seems to be speeding along and dragging on at the same time. It’s hard to believe it’s over three weeks since surgery. But then it comes back to me that my mobility is still quite limited and I feel like progress is taking so long.
So the good part is I have been doing pretty well going without support when walking around the house. My knee hasn’t buckled too often and usually it doesn’t totally throw me off balance like in the first few days. The couple of times I’ve been out in public have been more difficult, especially when navigating wide open spaces. The Scientist has been a great support, both figuratively and literally. as he offers me his shoulder to hang on to when I am feeling unsteady. Even short walks seem to be exhausting at this point so I look forward to more endurance.
I had my second post-op appointment today and had my steri-strips removed. My incision looks good and isn’t that big. I think my scar will be pretty minimal as it’s horizontal and will just blend in with the folds on the skin of my knee. The stitches were dissolving so the surgeon just had the end bits to remove from the incision. Then he had me tighten my quads muscles and lift my leg. I was pleased to find this wasn’t too hard as I’d only just managed this a couple days ago.
The surgeon said I’m “cheating” on some of my movements (using good leg to move the recovering one, etc) Â and has now referred me back to my physiotherapist to start working on getting my leg and knee back to normal working order. My next follow up is in six weeks with an x-ray to be done before then.
I’m happy to report that my pain levels have been pretty minimal and I’m not taking any regular painkillers. Most of the time it will be at night, especially if I’ve overdone things. I seem to have more swelling than pain now so have been using the occasional naproxen tablet to reduce the inflammation. Tonight is one of those night as I was quite mobile today and it seems to have finally caught up with me.
Below is a photo I took of my knee this afternoon. It still has part of the  X I’d had to draw on my knee before surgery.
Knee after removal of steri-strips at 3 wks, 2 days post op -
Walking unaided
It’s now fifteen days post-surgery and I thought I’d write another update. The surgeons orders were to stop using crutches last week and to drop the brace when I reached the two week mark. After the first day, I found walking without the crutches went pretty well. I did have times when my knee would buckle but it wasn’t that often.
On Sunday I had a bit of a rough patch and had a few buckling episodes. There were also a couple hours during the day when I would get regular shooting pains to a couple of spots around my ankle. They stopped about as quickly as they began. By the time I went to bed I was really aching and took painkillers. I was unable to sleep through most of the night. It wasn’t so much painful as uncomfortable and I tossed and turned through the night.
It was during this time that I got a case of middle-of-the-night-when-you-can’t-sleep neuroses of sorts. The two week point on Wednesday seemed almost upon me and I was in a panic about walking without the brace so soon. It was quite unreasonable to get so worried then and I realised this even when it was happening. But the worry-wort in me got loose and that was the result. I somehow got through Monday despite only a couple hours of sleep. By evening I was ready to crash so I put some things in order, went to the bedroom and did my exercises and tried to sleep. It didn’t happen as easily as I would have liked and it turned out to be a very broken sleep but at least there was rest. I woke early on Tuesday, did my exercises and went back to sleep for nearly three solid hours…it was a wonderful sleep.
On Monday, I happened to notice a bruise next to my ankle, just about where one of the shooting pains had been on Sunday. I found it curious but didn’t think too much about it until later in the day. I decided to press on it and see if there was any soreness. Big mistake! Â I didn’t press hard but the pain was excruciating and it throbbed for several minutes afterwards. I’m not quite sure whether I ever did anything that might explain the pains and subsequent bruise or if this is related to the surgery. It isn’t causing any problem so long as I don’t touch it so will leave it and query the surgeon next week.
Yesterday I woke up and my plan was to wait until later in the day since my surgery was in the afternoon. But the temptation to get to the toilet without the trouble of the brace was enough to get me to try it out. That went okay but I didn’t do anything else right away. A while later, I did get up and walked to the other end of the house  and stayed upright. My knee muscles were rebellious and kept trying to guard my knee so that my leg would freeze. It was obvious how much support the brace has been so far. I had to sit down at one point but ventured a bit further before returning to bed to elevate and rest my knee. It’s amazing how exhausting so little movement can be. I figured I’d spend most of the day resting at that point but did end up getting up and around a few more times during the day. I think I relaxed a bit more as the day wore on and it was more comfortable. I did have a setback when little girl puppy lunged at me from the bed as I was standing next to it. This caused me to lose balance and my knee buckled more than it has before and I was left feeling quite sore and uncomfortable. I took it quite easy after this and did the RICE routine and took pain relief again. Despite it all, I slept reasonably well compared to recent nights.
Today was a somewhat mixed day. I felt a bit more confident and was able to “walk” a bit more naturally a few times. But other times my knee felt stiff and inflexible so that movement was a lot slower and I felt less steady on my feet. Still I managed to move without any fixed support and just stayed near walls and furniture as much as possible.
I’m now able to bend my knee almost to 90 degrees passively and a bit less than that using my leg/knee actively. The hospital physio told me this was my limit until I reach six weeks. But she also said I would be using the brace for four weeks and then my surgeon tells me to take it off at two. It will be interesting to see if he gives different instructions again. I’ve been working on doing a straight leg raise but haven’t got there yet. I feel I am getting close but then a day later I find my muscles are engaging a bit more…so it may still be awhile until I succeed. My goal is to reach that goal before my next appointment next Friday.
I must say the emotional part of recovery has been a bit of a roller coaster. I seem to swing from thinking recovery is going quickly to feeling like it is agonisingly slow process. I think the early loss of the crutches and brace have made it seem like I’m moving along quickly. But the actual healing is still going to take a certain amount of time. I think the surgeon’s aim in removing supports early on is to keep the muscles from atrophying as much as they would with more conservative protocols. I am grateful for this because I’ve lost a lot of muscles in a short time. If I’d been non-weight bearing and in a brace for several weeks, my muscle would have totally disappeared and I’d be starting with nothing.
I haven’t been out of the house since my last appointment but will definitely be venturing out on Saturday evening as we are going out for dinner with family. It should be good getting into the car without a brace on this time. But I will still take it with me because it’s quite possible even a short walk will be more than I’m used to at this point.
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Post op progress at ten days
The first several days after surgery have had their ups and downs. I think I’ve been fortunate in having reasonably low pain levels. I’ve been taking high dose naproxen for ten days for inflammation and using Panadeine extra most days for any other pain. I’ve switched to ordinary paracetamol/acetaminophen as of today and that seems to do the trick when needed. After a few days at home we noticed I had massive purple bruises on the back of my knee. I called the hospital and was told this was normal and just blood pooling at the back of the leg from surgery.
The brace I was given to wear when mobile has been a major irritant. I find it difficult to tolerate for long periods of time so mostly keep it off while I’m home. It’s been something of a pain at night as it’s quite noisy to do up and remove the velcro straps if I need to go to the toilet. So mostly I’ve attempted to deal with a full bladder until morning more nights.
The crutches weren’t too bad but did make it difficult to do much more than move around. I was fully weight bearing from the start so they were mostly there to keep me steady on my feet the first days.
I saw the surgeon for my first post-op visit yesterday and he was happy with my progress. I no longer have to use the crutches and I can stop using the brace more all but extended mobilisation when I am two weeks post-op. While that makes me happy I am a bit nervous about being steady enough. Walking without crutches has gone mostly well but I have to keep movement pretty slow and steady. Last night my knee buckled as I was going into to bed and I found that quite unsettling and uncomfortable even though I didn’t do any real damage. This happened again today but I recovered more quickly. I assume I will feel steadier as I build up the muscles.
The surgeon said I need to start working on doing straight leg raises and tightening quad muscles. Tonight I was noticing the difference between good and bad leg and I can clearly see my quad muscles on the good knee but nothing on the bad one. It’s amazing how the muscle atrophies in such a short time. I don’t think it’s hopeless but I will have to work hard to get things happening.
The surgeon also commented on my bruising and noticed my lower leg has some mild bruising that is fading at the front. He also noted the bruise where he second iv was placed. Curiously, the original iv location hardly has a mark on it, despite the vein rupturing. I’m wondering if maybe it didn’t rupture after all and there was some other explanation.
I need to go back and see the surgeon next time he is in the local office as my appointment was scheduled too early to remove the steri-strips. I’m not sure why it was only at nine days when he wanted to see me at two weeks but I stuck with original appointment, Anyway, I couldn’t get through to his main office to make an appointment. Apparently this alternate office doesn’t handle any of this sort of administrative work.
I did find it quite nice to be out of the house yesterday. I wasn’t up to much activity but seeing the outside world was good for a change.
Lastly my right knee is really feeling the pressure now that it’s taken over so much of the work of my left one. Even though I’m fully weight bearing, I can only bend the leg a little and I still tend to use the right to help steady myself. I noticed it was feeling far more tired and worn out today. I think the subluxations on the right are also more obvious to me now and hope it will cope with the long term recovery. Even if surgery is inevitable for the right knee, I would like to have time to properly lose weight before I take that step. One can hope, at least.
