• Body and Mind

    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.

  • Body and Mind

    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)  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
  • Body and Mind

    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!  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.

  • Body and Mind

    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.