my knee, version 2.0

[sundial]

Redrhodie, your comment means alot coming from someone who is pretty upbeat about most everything. Thank you everyone for your kind words and well wishes. They really help!

I now have my staples out and have a few steri-strips covering a small section on my incision. This weekend I will be able to shower normally and will no longer have to rely on my hairdresser, aka DH, who has been washing my hair in the kitchen sink. My swelling is improving with each day and I am able to putter around without joint pain. What a neat thing to experience for the first time in years! I try to walk up and down the stairs once a day to improve strength and flexibility but the area above my knee still feels very tight when I try to bend my knee past 90 degrees. I know the 120 degrees flexion will eventually come so I try not to push it too hard. Still it's hard not to.

I haven't experienced the blues that comes with using narcotics for pain management as some knee patients have experienced. I got weepy once in the hospital and that was because of lack of sleep the night before and I was feeling more pain and frustration as a result. I was weepy again last night and it was due to feeling so vulnerable and achy, probably the result of a big thunderstorm that was moving in our area. Even though I was feeling down, I would not hesitate to have my knee replaced but it does come with a price--a long rehab process, and that is what made me somewhat sad. I can't be available to others who might need help. I can't drive or take my parents to the doctor or even the emergency room if they need to go. I have to rely on others for that and it's difficult to do so as I consider myself to be a fiercely independent person. I am thankful that I am progressing rapidly but I also think about what if I had been one of the patients who experienced a rough recovery with limited range of motion and lots of pain post op? There are some patients who have had a TKA that still experience pain and swelling years after the surgery.

Another thing I've experienced is the lack of empathy or understanding from those who have not had a TKA. People think that if one has a TKA that he or she will be up and at 'em and back to normal within a short time--and it seems especially true if you are young for a TKA. I had a family member that was surprised to learn that I had to use a walker to get around. They are surprised that I still sound tired on the phone just 2 weeks post op. (Anemia!)

There is not only the physical healing but the psychological healing as well. There is on occasion the fear or frustration of not being able to have the strength or endurance to accomplish a task, such as cooking a simple meal, driving a short distance, or walking in a large, crowded store. There are days when I seem to take one step backward and I feel emotionally spent. My mind can't seem to focus and process alot of information and I get overwhelmed, frustrated, become weepy and I know then that I have to rest more. There are days when I see a lot of progress too and it's those days that gives me a boost and gives me something that I can think back on when I have a down day.

Having a good support system makes all the difference in the recovery process. I could get by with just me if I had to but it's nice that I do have DH available to make sure that I'm safe, that I'm without a lot of pain, and without a lot of undue pressures that comes with life. Having that has helped me tremendously and I can rest easier because of his efforts.

[emily_in_nc]

Sundial,

Your post-op emotionality and frustrations really took me back. When I fractured my pelvis in 2005 in a cycling accident and had surgery, I experienced the same sorts of reactions as you. It takes awhile to feel even close to your old self, and I really do think you need to go easy on yourself and not fret about what you can't do or what "could" happen while you're recovering. Chances are, no one is going to need you to drive them to the ER in the next few weeks. And if by chance it happens, then things will work out. I couldn't drive for 9 weeks, so I just had to relax and realize that the world would somehow manage to revolve on its axis without me taking care of things. And it did!

[jessmarimba]

You seem to be pretty aware of what's going on and what you need to do to get through it, but I just wanted to chime in that the psychological part was the worst for me too. Physically once I was able to start rehab the progress was really apparent, but being tired and achy and having activity restrictions was just too much to take some days. And the narcotics gave me some crazy dreams (usually me doing things I couldn't do, like skiing in a bikini or something nutty) so sleeping wasn't always the break I'd hope for!

We're all here for you when you need support

[sundial]

Emily, you certainly had unique challenges to face during your healing process and your words of wisdom bring comfort to me. You were very fortunate to have had a good support system as well. A fractured pelvis is pretty serious and even more debilitating than a joint replacement. I'm thankful that you had a full recovery and that you are able to return to the things that you enjoy--including bike rides. You suggested that I let go and let it heal, that I probably won't be contacted to drive someone to the ER.

I have to share with you something that did transpire.

My dad called me in a panic to tell me that he had lost vision in both eyes and without remembering that I just had knee surgery, asked me if I could drive him to his doctor. He knew that he had a stroke. I reminded him that I couldn't drive and he was surprised. I knew then it was serious. My mother, who is crippled with arthritis and has vision problems, had driven little in the past several years so she had to take him to the doctor. I just held my breath hoping that they wouldn't get into an accident. He was seen by the doctor and they made arrangements for an ambulance to transport him to a nearby hospital. Meanwhile I'm lying in bed, unable to do anything much less think clearly. Hubby couldn't get off work to help and mother had to wait until DH got off work in the evening to take her to the hospital. I had to call some of their friends to ask if they could bring dad home from the hospital when it was time for his discharge. He still has 50% vision loss in both eyes and I can't help but worry about them while I am facing my own set of challenges. I had to make arrangements for home health to start working with them and try to find medical transportation for them since their doctors are out of town.

It is such a trying time and I would not wish it on anyone.

Jess, thank you for your comforting words my Fargo friend. Narcotics are funny thing. I've not had vivid wild dreams like skiing in a bikini but I have had cold food cravings for things like yogurt, fruit smoothies, cold turkey sandwiches, and chilled granny smith apples. While I was in the hospital hubby came across some Girl Scout cookies so he stocked up on the peanut butter cookies for me. I guess I timed my surgery and recovery just right so that I can indulge in a few special cookies here and there. It's odd that the only time I lose alot of weight is when my body is trying to recover from a big injury. Not exactly a weight loss plan that I would want to endorse.

[emily_in_nc]

Wow, Sundial... I'm so sorry to hear about your Dad's health emergency, and sorry if I sounded flip. The odds of something like that happening while you are incapacitated were probably fairly slim -- and yet it did happen. I am so sorry!

I was indeed very lucky in that my DH was available to take care of me (he was early retired) and could have taken care of family situations too, unless they involved leaving the state or something (in which case he couldn't have left me). I was also lucky in that nothing else transpired in either of our lives during that recovery period that was stressful and required us to move our focus away from my recovery.

Still, I was weepy at times, and frustrated/angry at times too. On the "silver lining" side, I did enjoy the naps, the reading, and the outpouring of kindness and offers for help from friends. I got lots of visits from friends and neighbors, people brought food, and I felt very cared for.

I hope that your dad will have no further setbacks and that the rest of your recovery time will be a bit less worrisome! Hang in there....

[sundial]

Emily, I didn't take your words as being flipant. As you've pointed out the odds are that stuff like that WON'T happen but in my case it did. So I am just learning to take it one day at a time.

I was thinking on the way back home from PT about the mental state changing after a traumatic injury. I don't know what you would call it. As you've encountered there are moments of feeling blue, of becoming weepy at the drop of a hat, of becoming angry or restless. I want to think that meds can contribute to it but even the days when I don't take my pain pills something is affecting my mental state. I fight the feeling of being overwhelmed. Then I go take a nap and I feel better. The body and mind work together in odd ways sometimes.

[OakLeaf]

Don't forget that pain itself works on your emotions a lot - with or without the meds - as does inactivity by itself, even when it's not enforced.

Hope things settle down with your dad and that your parents are able to find the help they need. Be gentle with yourself. Cry when you need to. Sleep when you feel tired. Vent with us here. Know that your body is healing at its own pace and you will get there.

[sundial]

Thank you Oak, your words mean alot to me. Pain does affect my mood and my mind more than I realize. Before I had my knee surgery I had chronic pain for years and I know now that it made me feel more negative as a result. Since I've had my surgery I feel as if a burden has been lifted and my mood is more cheerful. So many of the feelings of frustration, anger and sadness have diminished greatly and I feel as if I have a new personality. For once in my life I feel optimistic about everything.

Today is week 3 since my surgery and my swelling continues to diminish.



I hope to soon turn my road bike pedals forward. I want to be able to ride my first ride in April.

[celticgarden]

Hey Sundial, thanks for sharing your story. I have knee pain daily, especially the right, lots of grinding noises. I have wondered about this surgery and I appreciate you writing down the details. You have my well wishes for a swift recovery and I hope your parents get the help they need. The stress of not being able to help them must be awful!

Remember that the narcotics will act as depressants. I personally have zero love for them. Having had a tonsillectomy two years ago (with subsequent complications that the ENT said he'd never seen before) I took my fair share. They hardly touched the pain and in the end I switched to NSAIDs to reduce swelling, halt pain.

There's rumor in natural circles that bone broth can be helpful in healing. A google search will give you info should you be curious about it.

Hoping your positive attitude stays with you and the healing time flies by!

[sundial]

Celticgarden, you are welcome. My post may be unpopular for some of the readers and for that I apologize. When I was researching cyclists with total knees few hits came up and I thought that perhaps my personal account may prove to be helpful for those who are contemplating TKA and specifically how it affects cycling. It is an adventure in itself and if I can share my experience to help someone else, than it is worth the cyber space it takes to post my progress.

This afternoon I will have my first check-up with the ortho doc. I'm a little nervous because I've seemed to have plateaued in terms of flexion. In fact, I've lost a few degrees this week. Yesterday I was unusually stiff and I made a point of stretching thte knee on the stairwell before PT but it didn't seem to help. I want to think it's weather related. I hope anyway. I want to be able to flex my knee well for him.

As for the narcotics I take one during the day along with an NSAID and two at bedtime. I'd prefer not to be on them but when I cut back at bedtime, the night time pain would kick in and at 2 a.m. I would fumble for the prescription bottle. So for now it's 2 at bedtime.

Natural remedies are something to consider and I will consider alternatives to pain management. Chocolate seems to help. And thin mint Girl Scout cookies.
And since my body is working in overdrive I can indulge here and there without dire consequences.

[sundial]

I had a great visit with the OS. When I told him I was unusually stiff he said that I will experience that from time to time. He also reassured me that I will plateau from time to time and that it's a period of healing that I'll encounter. We went over the before\ after x-rays and it was incredible the difference the surgery has made. He wants me to use my knee and wear it out. What a cool thing to say! I also was given the ok to use my hot tub. The trip of going to the doctor plus a late lunch has not made me too tired surprisingly. So I've built up to a 4 hour excursion. Yay!

[spokewench]

Sounds like you are doing great Sundial. I have a friend who had a total knee in her late 40's early 50's. Before that she was in a lot pain, after, no pain, except of course, thru rehab. She says it is the best thing she has ever done. She is quite active, hiking the Grand Canyon with us all; riding bikes, she just did a 24 hour race on a 4 woman team; scrambling the rocks at Joshua Tree, etc., etc.

I'm sure you will find that you are so much better off now that you had the surgery. Hang in there with the rehab. Give it another few months and you won't even remember it cause you'll feel so good!

[redrhodie]

Excellent! Maybe you should keep a photo journal of the knee healing. It would be a cool flip book.

[sundial]

Thank you Spokewench. It's very encouraging to hear of others who have had a successful surgery and who are now enjoying an active lifestyle again. It's people like your friend who serve as an excellent role model for a TKA. When I got up to walk the first day after my surgery, I remember how smooth my knee was and how well it worked. I had little pain other than muscular pain at the incision site. I told my doctor then how I loved my new knee. I think about the cycling season that is upon me and I am already thinking about how the hill climbing will be easier now that I won't have the joint pain to contend with. There is so much I want to explore and do with this knee. For once in a long, long time I will be able to do so much more and not be held back by inflammation and swelling. I won't be the slow poke on wheels either because I am going to be lighter, stronger and faster. By the fall I plan on riding a self-supported century. I'm thankful that I have this knee and I can't wait to begin living again.

[sundial]

Today I turned the pedals forward on my road bike for the first time!