Sunday, January 30, 2011

Closer to Fine

At over two months out, the knee is great. Although I'm still attending physical therapy twice a week, I should be "graduating" soon. Then it will be all on me to keep up the strength and flexibility that I've accomplished. I'll have to get over the fact that it will never bend to the degree that a normal knee will, but I'm told that with 130 degrees (the maximum that I've mastered, and possibly the maximum that this knee is capable of bending) I can do most things necessary in everyday climb up and down stairs comfortably, ride a bike (back to Spinning!), etc. There's still some swelling and the numbness of my shin is looking more and more like it's permanent, but I can only hope that my left TKR has as great a resolution.

Physical therapy additions:
*Eliptical-10 minutes. When I began, the PTA asked if the resistance was too hard...or too easy. It seemed doable. A few minutes later, whew! It was really quite a workout.
*Stair stepping-Up and down, 25 reps, slowly, leading with left leg, working the quad.
*Balance and strength- stand on left leg, slight bend, 1 minute x3. Look ma, no hands!

Therapist insists that I should continue to ice the knee. Brrrr. In this weather?! At night, I just stick it out from under the blanket and it's cooled down naturally. LOL! I must remember to take time out during the day and use the ice.

Friday, January 14, 2011

A New Normal

I'm beginning to "forget" about my knee at times. Which is a good! Walking is pretty much back to normal, with no limping or favoring one knee or the other. You wouldn't even know I'd had surgery except for the 6 inch scar. The only things that slow me down are stairs and getting in and out of the car when the seat is pulled up. Stairs are pretty easy going up. I can take the steps alternating legs, without hanging onto the rails. Going down is another matter. Shallow steps are no problem but steps such as those outside my back door cause the knee to bend more than is comfortable. I take them gingerly while holding onto the rails.

I recently reduced physical therapy to twice a week, in order to "save" days for the right knee replacement, in case I schedule it for the fall. I feel like I've accomplished most of the goals set forth, and can do further strengthening on my own. Once released I'll take my exercises to the gym at Elmwood and work out a work-out.

It's official. My knee length discrepancy is 2.5 cm. or approximately 1 inch. That's quite significant, so I had a of heel lift made for my right shoe. Sidney Stokes, of Fit Feet, measured me and created the custom cork-like lift. The lift itself is NOT 1 inch. 1 inch is undoable. It wouldn't work with most shoes, and would probably be a bit uncomfortable. Instead, it's about 1 1/2 cm. Now I feel a lot better balanced. Hopefully when the next knee is done it will even things out and result in legs that are closer to the same length!

Problems that I am still experiencing at 7 weeks:
*Swelling. It's not uncomfortable, but the left ankle seems to have disappeared for good. Even after a night's sleep, the swelling remains.
*Numbness and hypersensitivity. The left side of the left leg is still extremely numb in places (and may be like that for good). The hypersensitivity doesn't seem to be as severe. I've decided to slowly decrease and then discontinue the Lyrica that I've been taking for the nerve ending pain so that I can see if it is getting better or if it is the medicine that is keeping it in check.
*The unexpected appearance of a dark purple line directly under the skin of the scar, which may have been caused by a tiny ruptured blood vessel. After a week, it is hardly noticeable.
*That "band around the knee" feeling that I've heard mentioned on TKR health boards is still there. It is really weird. It feels like someone has placed a think rubber band around the knee. It's not painful, but a very strange feeling for sure.

Monday, January 3, 2011

My PT Workout

A couple of easy days later, swelling is under control. Thank goodness, since this morning's physical therapy was quite a workout and lasted 1 1/2 hours. I thought I'd try to list the exercises we did today, which included a couple of new ones:

*First, ice on the knee, with a pad under my heel, with slight electrical stimulation, designed to relax the knee, reduce swelling, and prepare me for the workout to follow.
*Next, several minutes of biofeedback, 10 seconds of working the quad (intensely pressing the back of the knee into the table) followed by 10 seconds of rest.
*Not sure of the name of this next machine. It's sort of like a stepper. I step down with the tkr leg, pushing it back until it locks, holding for a few seconds. Then I push down with the other leg. Repeats for 6 minutes.
*10 minutes on the bike. No resistance. Simply meant to loosen up and work the bend. It's kinda hard to get the seat at the right height for the pedals and NOT stress the knee on the upstroke. Ouch. But it gets easier as the time progresses. I usually try to get a bit of an aerobic workout with this exercise. It's just 10 minutes but it's better than nothing!
*With this next exercise, the knee pushes against a pad with moderate resistance. Straighten, hold for a few seconds with knee locked, then bend. 3 sets of 10.
*The same machine is then set to do hip abductor exercises for the tkr leg. Push leg out to the side, bring back down slowly. 3 sets of 10.
*Since my quad is getting stronger, they have added in the machine where you lie back and push with your legs against a resistance. 3 sets of 10.
*I refer to this next exercise as self-torture. For some reason they have replaced the machine that bends the knee with a do-it-yourself routine. I lie on my stomach and hold a strap that is slipped over the shoe of my tkr leg. I pull the leg towards my buttocks, holding the knee at an uncomfortable stretch for 10 seconds, then slowly lower the leg to the table. This self-torture is repeated for several minutes.
*The leg curl is an easy one, but only if I'm on the right machine. For some reason, the "other" machine causes my knee to "pop". 30 reps on this and then calf stretches. With a strap hooked over the toes of both shoes, pull back for 10 seconds, and relax. Repeat for 3 minutes.
*Another new one, this exercise involves walking backwards (with a strap and moderate weight) for a few paces (until the end of the rope so to speak), then walk slowly forward. The backwards walk works the knee which is straightened pulling back until locked against the weight. Walking forward works on balance as the weight is pulling on the one knee while walking towards the machine. 15 repetitions took probably 15 minutes. Whew...I could really feel this one on the back of the leg!
*Finally, time to ice the knee and work the quad with electrical stimulation of the muscle.

After such an intense therapy session, Tommy was surprised to see me doing my at-home exercises this evening. LOL!

Saw "god" today. My surgeon. The guy I've only seen three times in my life for probably a total of 10 minutes (not counting the time he spent in surgery with me unconscious)! And I'm being generous. I am so used to NOT seeing him, that I had already asked the PA all my questions and was getting ready to leave, when she said, "Hang on, he'll be in to see you in a few minutes". Huh? And he really did come in to see me. Looked at the scar, pushed the kneecap around a bit, had me straighten and lift, then bend to my maximum. Everything looked fine, fine enough that I don't see him for 6 months!

Oh, and now I am a card-carrying metal detector setter off-er. When I cause the alarms to go off at the airport, I'll have a card to show the TSA employee who will be eyeing me quite suspiciously and take me off to be searched anyway. I'm sure it will be fun.

Saturday, January 1, 2011

Christmas and New Year's was a busy week. I managed to attend three physical therapy sessions and did a lot of work each time. Flexion has reached 130 and from what I've heard various manufacturer's replacement knees have a limit. I wonder what mine happens to be??? So we are no longer concentrating on the bending part. It's the straightening and strength of my quad that apparently still needs work. So we work.

And just when I'm feeling pretty good, I do too much. We attended a wedding the night before New Year's Eve. On my feet a lot that day, I went to bed with a pretty swollen leg and woke up with it not much better. But I couldn't afford to stay off of it on this day of all days. We had so much to do to prepare for our NYE party that night. First, we made a WalMart run before the crowds got too bad. Arrived home and wanted to just sit back and relax a bit before the real cleanup and food prep began. But no, a new problem. I seemed to have developed a UTI. On NYE of all days, when none of my doctors are in their offices. I had to go to an urgent care center to get a Rx. Sure don't want a raging infection of the urinary tract to compromise my new knee. A week of Ciprofloxacin should do the trick.

Now...back to preparing for our party. Roasts to cook. Table to set. (Thankfully the silver serving pieces had tarnished little over the year and we let go of that chore.) Cleaning house required most of my effort. Vacuum, "swiffer", dust, straighten. By 8 o'clock, and the arrival of our first guests, I was already pretty tired, but still had to cut the roasts and make the gravy! The next three hours were pretty much a blur. The roasts, although a surprise substitution, were a hit. Last year's guests who were making a return visit were expecting Tommy's gumbo. LOL!

We had a nice crowd. Friends and family. Plenty food. Sparklers and fireworks. And a grumpy old maid neighbor threatening to call the sheriff's office. Hahaha. Nothing new. Except by 11:40, after a few of our guests had departed, we agreed that we must be getting old because here it was not yet midnight and we were slowly fading too. I was exhausted. Later, when everyone had gone home, Tommy sent me to bed too, and he did the rest of the cleanup. I couldn't have managed. I hope I can recover sufficiently for physical therapy on Monday.