Day 11 - Milestones

Today was another day for milestones....

1) I put on long pants - well, they were my purple sweats, but they had long legs! It's nice to be a little warmer.

2) I went outside!

3) I walked down our stairs, out to the driveway, then up to the Kingsley's (the house next door), back to the Ambro's driveway - up to the garage door, then back home. This is the longest I've walked since the surgery. I used my cane - which JD bought for me in Japan when my left knee began acting up.

On the downside, I felt really faint this morning after doing the first set of 15 reps of my exercise program - not sure if it had to do with not eating yet - I'd speculate that was it. I had to sit down for a while before the cold sweats went away. Brings back the reality of the status of my recovery.


I just finished knitting a Chemo cap for a friend who's undergoing chemotherapy for breast cancer. It took just a couple of days - which surprised me...It's made of baby alpaca & silk, and is soft, and very colorful - since I used my favorite colors of purple and teal. I used a pattern in Cat Bohrdi's book - A Treasury of Magical Knitting. It starts with a Moebius for the brim, then has a lotus flower pattern. I've got a little of the yarn left, and think I'll knit one for myself using the same yarn for the moebius - since that's what goes over the ears.

Day 10 - Big Girl Steps!

Colleen (my PT) came today, and we transitioned from the walker to a cane! I can now make a loop from the den, thru the kitchen, into the hall then living room, then around the dining room table back to the kitchen! Who knew this would be such an exciting event! I'm able to almost get an even gate - although I need to think about stepping with my heel first, and to bend my new knee!

We started on standing exercises yesterday, so I've graduated from the seated in bed exercises to standing at the sink. These are a little harder, and really stretch the tendons and muscles in my thighs - but it feels good to progress.

My scar is slowly emerging from the "steri-strips" that Dr. Casscells put on after the plastic surgeon did the internal stitching. I've been reading about others who were stapled, and I think my scar will be much nicer! What do you think?

It's still a little "bruised", but all but five of the steri-strips have fallen off, and it seems pretty well healed! I've also included a picture of my ankle - which is now showing a lot of bruising - I understand that the blood will drain to the lowest point - which is my heel.... Soon they will all fade away, and my skin will be it's own lovely shade of beige! Yeah!

Day 9 days after surgery - baby steps

I'm making progress.....

1) Yesterday, I lifted my leg from the floor onto the ottoman with three pillows without the help of my trusty leg lifter (one of the tools I was given (I'm sure I bought it!) while in the hospital.

2) Last night, I got my leg up and down from bed every time (it's still about every 2 hours) without the leg lifter.

3) My Flexion (how close to my body I can move my foot in sitting position) is now at 109 degrees. It was at 103 when i left the hospital, and has gone up 2 degrees with each visit of the Physical Therapist (PT)

4) I carried my coffee into the den by myself - using the walker with one hand, and the coffee in the other (and I didn't spill it!)

5) The measurements of my right thigh, knee and calf are almost the same as my left leg - which means the swelling has mostly gone down!

Baby steps, but progress all the same! It feels good!

I'm a Knitting Fool!

One of the things that I can do well right now is knit. I have to admit, it was a bit challenging in the hospital with the morphine the first night and day, and the Percoset the rest of the time, but it's been a constant in my days since I checked into the hospital 8 days ago.

I brought with me a pair of socks that I've started twice, and two skeins of beautiful alpaca, merino and cashmere yarn to make a Moebius scarf. Those of you who have read my previous posts heard about the four false starts on the moebius..... Well, I've finished it - and it's quite beautiful - at least I think so! I've select two photos to show you 1) the whole thing with the moebius twist, and 2) the detail of the arrow pattern. I still have to block it to get the lace (open work) to show better, but it's warm, soft and wearable right now!

I also took a look at a vest that I just finished - and was very disappointed in - The yarn is gorgeous - it's Brooks Farm yarn which I got at Stitches in Baltimore in 2007. I found a vest pattern at Tess' booth, and figured it would be a good match.... Unfortunately, the weight of the wool/mohair yarn and the pattern look lovely, but the overall vest when complete was heavy, and way, way to big. So, I've taken lemons, and am making lemonade!!!!

The pattern for the vest is a series of connected mitered squares, and I've found that without the top arm holes (which I've pulled out), I am now just adding more squares, and will make a nice lap blanket to warm my cold calves following total knee replacement surgery! One of the limitations I've got now is I have to keep the knee exposed, so that means wearing shorts, or capris, which I can rollup on the surgery knee. I am using it now as I continue adding the squares, and will defintely use it in April with the 2nd knee.

Rob & Deb called yesterday afternoon, to see if I'd mind if they brought down dinner from Whole Foods in Philly, and came for a visit. What a pleasure! JD did have to do some cleanup in preparation for visit - since I've been staying in the guest room (the bed is higher for getting in and out of bed - and also getting to bathroom with the walker - our bedroom layout would not be very condusive.

Anyway, they arrived, with more flowers in hand, and a wonderful dinner that they "Ready, Set, Cooked". I held off on my Darvocet after 3pm so I could have a little wine with dinner, but in retrospect, have determined that one glass of wine is not worth holding off on the drugs! Maybe in a week or so....

Our dinner consisted of a lovely tossed salad with mixed greens, candied walnuts, blue cheese, and cranberries, Roasted root veggies, hashed brussel sprouts, and grilled pork chops with Penzey's Bicentennial blend. Dessert too - frozen yogurt with fresh strawberries and chocolate nibs! What a delight it was to have company, and dinner to boot!. Thanks Rob & Deb!!!

Day 4: Swelling, Green Bruising? Is it Normal?

While in the hospital, I had a drain in my knee, that had this little bulb on the end - about the size of a grenade. The nurses emptied it several times a day - of blood, and the day before I went home (Wednesday) Dr. Casscells removed the tube. I asked what I should expect - since it had been a fairly prolific producer - wondering what would happen to the blood that wasn't coming out any longer. He didn't think I would see any difference.

Well, I'm wondering if the swelling I'm now experiencing right behind my knee and in my thigh is a result of the draining since of the knee area. I've described it as feeling like my thigh is an overstuffed sausage. It's also kind of green, like an old bruise....

We've called (and left multiple messages) for both Visiting Nurses and for Dr. Casscells office just to set our minds at ease that this is normal. We started calling at 1pm, and just finally got a call back from Visiting Nurses at 4:30pm. In the meantime, I've done my PT, and iced my knee twice - trying to keep it elevated to reduce the swelling. She (Lisa) took all of my info, and is coming out to check on me, just in case.

More later.....
P.S. Deborah - these photos are for you.... You asked for the gory pictures!

Sunday AM: Turns out my Aetna coverage is only for PT visiting Nurses, not real Nurses.... So, she didn't come out after all. We talked, and she said that what I was experiencing was "probably" normal, and if the swelling increases tomorrow, to give my Dr a call, and see if he'll write a script to have the nurse come out.... So, JD did some research on the web (we should have done that earlier), and found that we can expect the swelling to slowly diminish over the next six months. Yikes!!!! I guess it (the swelling & bruising) is normal!

The swelling is down some from yesterday, and doesn't feel quite so tight. Yeah!

2nd day home

I have to admit - I was feeling quite cocky at the hospital when I was "breezing" thru PT and walking around the floor while others were in near or real tears. I think reality has hit me. Last evening, I noticed some blood at the site where the On-Q pump catheter was inserted, and decided since there was just a little of the Lidocaine left, that I'd go ahead and pull it out. So we had to bandage up that little mess, and then the Lidocaine started to wear off...

My right thigh was swollen about 2 1/2 inches more than my left, and it was making walking (even with the walker - which I was doing quite well with in the hospital) difficult. So early (9pm) to bed, with a regiman of 2 hrs on and 2 hrs off for the EBIce machine - and this morning, I feel like more myself. My swelling has dropped about an inch, and I am walking better.

Now, I've cleaned myself up, washed my hair, and with the help of Mary Lou (my neighbor), I completed my morning regiman of PT.

JD ran out for errands. He bought a remote control off/on for the EBIce device, since the only way you can turn it off is to unplug it - bad design. He also picked up lunch - which was a pleasant diversion. Hopefully all of the PT will work off some of what I'll be eating these next few weeks.

I'm so lucky that JD is able to be my caretaker and coach, and to have such good friends and neighbors. My house is beginning to look like a florist - but I do love flowers, so they are not going to waste!

I'm now waiting for Mary Beth my Visiting Nurse/PT person to arrive and I'll find out exactly what is in store for me over the next few weeks working here.

More later.....

I'm home!

Yesterday was a tough one - PT two times, and then again this morning. However, it was worth it. I progressed quite a bit from yesterday morning - my extension was 103 degrees - and they are hoping for 90 before you leave! Seems like I'm model student. I felt pretty good compared to some of the other people there who were really experiencing a lot of pain. I honestly believe it has a lot to do with my surgeon, and my On-Q pump which has provided local anesthesia to the knee. Thanks Dr. Casscells!!!!

I need to continue the exercises on my own ( with the help from my coach) this afternoon - and then the visiting PT person comes tomorrow to make sure I'm doing it correctly, and we have everything we need at the house.

We arrived home with a bunch of helping things - my own walker, commode, and several long things that help in a variety of ways - one helps to move your leg since it can't bend very much, one helps put on your pants, and one grabs things that are out of reach. but the best is my beer cooler - that we fill with ice, and beer, and then a nice wrap around my knee to keep it cold. Oh, actually we're not supposed to put beer in it, darn!

JD went out to get a few more items - a teak stool for the shower, another grabber handle for inside the shower.

UPS just arrived with a box of Blenheim apricots from JD's stepmom, boy are they great. They are not your ordinary dried apricots - but the best that California has to offer! Betty is having knee surgery on Feb 26th, so I'll be able to provide her some insight!

Thanks to everyone for your thoughts and words!

I'm so excited!

Don't know why, but the Pointer Sister's song is in my head.... I just got back from my second PT session, and took an extra long walk around the floor. I walked up and down the stairs twice, and got in and out of the "car"... Actually, it's more like an old fashioned jeep. I increased my range of motion by more about 15 degrees back, and about 5 degrees straighter. And to my surprise, I'm not begging for more pain medication yet! I got reprimanded for walking back to my bed by myself this morning - after I washed my hair and took my french bath - boy it feels good to get cleaned up and dressed!

The first day wasn't bad at all, some other folks are experiencing nausea, but I haven't at all. Thank goodness. My group at work sent me a beautiful flower and plant arrangement (which hopefully I won't kill later - my thumb isn't very green) - and I've now got a little helper from Nancy - for when JD needs a break.

I think the pain meds were having an effect on me yesterday, since I've knit and frogged my Moebius scarf FOUR times. I finally got it, and am now on my way to a beautiful, soft baby alpaca and cashmere scarf. I'll include a picture when it finally takes it's form.

That's it for now, we'll be off to our lunch in the Brandywine Room (no, not the one in the Hotel DuPont), but I'm sure the food will be good regardless. Thanks to everyone for your prayers, comments and emails!!

Capable and Helpful Professionals

The folks at the Joint Replacement Center have all been super. J.D. says that with help like Becky and Lisa he may check in soon!

Tuesday Morning (no discount store here!)

Is this an incentive spirometer...or some kind of bong? Only Michael Phelps knows for sure.







Jan's in great spirits, pain well managed, and has been up and down the hallway already









Jan keeps a cooler of beer on hand for any visitors (actually it's the chilled water circulating pump that chills her knee).

Notes from The Coach (J.D.)...it was a long day yesterday, but surely even longer for Jan. They had to wake her up every 2 hours overnight for blood tests and rudimentary (rude-imentary?) PT. When Jan's mom was having surgery a while back they woke her up and asked "who is the current president?"; she responded "...George Bush...unfortunately". ;-)
PT starts this morning with a walk down the hall and formal PT in the afternoon. We're doing takeout dinner from Rasa Sayang this afternoon (maybe jello for dessert!).

Here's Jan getting prep'd yesterday: a positive attitude...and non-slip sox!
Home for 3 days:

This is Dr. Chris Casscells...a super guy with great experience, skills, and patience with patients!

Success!!!

Jan did great today...checked in at 10:30am, prep'd for surgery at 1pm, surgery 2-4pm, post-0p from 4-5, then I saw her around 6pm. The doc saw me and said everything went well. She's in amazingly good spirits and lucidity (thanks to the local lidocaine drip). On a culinary note, she REALLY likes the cherry jello.
PT starts tomorrow (and real food too!), with serious PT on Wednesday, then winding down Thursday with checkout in the afternoon.

Here's Jan...in great spirits!!!

2/16/09 - S Day.....and a little knitting

Well, I'm much calmer than I thought I would be.... I guess all of the upfront investigation and research has contributed to a better understanding of what is to come, so I'm sitting here, clean, legs shaved (don't want to embarrass myself in front of Dr. C and the rest of my surgery crew), hair washed (I don't think I'll be able to wash it the whole time in the hospital - Yikes - some of us need to wash it every day, Debbie!), and with about an hour and thirty minutes to spare before we have to be at the hospital.

I've decided to bring two knitting projects with me - my socks which have undergone a transformation (actually I had to start all over) - since Knitting weekend - I had made them way, way to large. Luckily one of the Knitting gurus with us, Janet pointed out my issue, and encouraged me to rip it all out and start over. I have to say, she was right, and now I'm almost at six inches of cuff, and will be ready to start the heel (again) later today if my mind lets me.

I'm also starting a Cat Bohrdi moebius scarf - it's a really cool diagonal mirrored arrow pattern - a little lace - and I'm going to work with a King George baby Alpaca, merino, cashmere yarn in guess what colors? Oh, you guessed - purple and teal? Yeah, OK, I'm predictable! I'll post a picture here when I've got it finished. There is a really cool UTube of Cat doing the Moebius Cast-on

Masai don't have bad knees...Jan is now a Swiss miss

<== Since my wonderful sister-in-law Joanne raved about her MBT walking shoes (which came with her dog Snickers), Jan checked them out today and she is now struttin' like a rich Masai warrior wearing Swiss engineered yuppie shoes no doubt made in China (we await our stimulus check with baited breath). But first...she'll be wearing her CROCS while in the hospital (btw, have you seen the new D/E terminal at PHL? It has a CROCs store, a Peets Coffee shop, and LOTS of security gates/lines).

Time for Jan's worser half to practice blogging...with "the kindest cut" a day away I kneed to get in blog shape. Here's another NYTimes article from last May: "New Advice". It's interesting to see how many TKR blogs are out there...most tend to be negative, but such is the nature of the Internet.

Sports after TKR? Yes! But excuse me, bowling is NOT a sport: "Non-Conforming Stress". Dr. C, can you prescribe a heavy dose of Asp(er)en? Drink lots of Buttermilk?

Yours in eminent support,
Coach J.D.

p.s. Have discovered "joint replacement therapy" has nothing to do with cannabis...

2/15 - One day more....

We saw the Holmes Bros at Arden last night, and they were wonderful. A trio of blues brothers!

JD found a very interesting article about Baby Boomers getting joint replacement surgery - check it out!

http://www.nytimes.com/2009/02/15/fashion/15generationb.html

2/14/09 - Valentine's Day

JD bought flowers, and I bought chocolate - a match made in heaven! We're heading to Arden for their Valentine's Guild Hall dinner - and a Blues concert to follow. It's always interesting to have dinner (especially VD) with 100+ other people - since this is an organized neighborhood event. Not ours, but our wannabe neighborhood. Arden is an artsy communal area of North Wilmington, where you can buy the house, and the Arden community owns the land - and you lease it. It started back in the 1920's - kind of a bohemian area - each house is different and eclectic. Some are very cool - like our friend Finn's - which is adobe like.

I started taking Celebrex this morning at Dr. Casscells direction. This is to help with stiffness in preparation for the surgery. We also discussed an interesting pain reliever called the On-Q Pain Pump which is inserted during surgery, and provides local anethesia directly to the knee for up to five days after surgery. When I was teaching a jewelry class in early January, one of the attendees mentioned that her husband had knee surgery by Christopher Casscells, and he used the On-Q Pain Pump - and found that he needed very little of the narcotic pain medication - since the knee was feeling almost no pain. I was intrigued, and asked Dr. Casscells about it, and he was very willing to do it for me too.

I think I have everything I need for Monday, I've purchased some sweats that fall right below the knee - since I'm supposed to have shorts - I figure I can roll up one leg, and at least keep the other a little warmer. I'm ready, I think. Lots of books for my ipod, and a few knitting projects that are pretty simple and won't require too much thinking.... I'm working on some socks - almost ready to move to the heel and a sweater that is pure stockinette stitch. I've also got my book from the library that is for our Book Club - Alias Grace by Margaret Atwood. She is always an interesting read....

2/13 - Friday the 13th!!!!

When I went for my orientation at the Joint Center in late January, several of the folks in my session were scheduled for today, Friday the 13th.... now, I'm not superstitious, but I don't think I'd want to have my surgery today - and not at the end of the week when the doctor is tired... I want him fresh, relaxed after a nice weekend!

I think I've done everything I can to get my "affairs" in order - I've cleaned up my office - so that it won't be the disaster it was this morning when I come back, and Andrew will be keeping my chair warm while I'm out. Project work is in very capable hands with Andrew, Tom and Vanessa, my audix message has been changed, email auto notifier has been updated, and I've got my living will from the lock box. I am confident that I won't need it, but just in case....

I can't tell you all how much it mean to me that you've sent me notes or stopped by - and wished me well...

Less than 2.5 days left...

2/12/09 - Life is Good.....Back Pain is virtually gone!

I woke up this morning to virtually no back pain! Yeah!!!!

Dr. Gold and his nurse Sharon have worked miracles on my lower back - all in preparation for the surgery on Monday. The goal was no back pain, and I think I'm here!

Life is good.....

This morning, Dr Casscells gives me my second Supartz injection in my left knee. We hope this will give me some relief until the left knee TKR in April. I didn't notice any difference this week, but from what I've read, you may not notice anything until after three injections - and some people never notice a difference - depending on the state of their knees.

I'm hopeful, cause I'll need my left knee and leg to support the right one for the first few weeks until I get my strength back!

2/11/09 - The search for the Perfect PT place

I've been visiting Physical Therapy (PT) locations - figuring that since I'm mobile now, it would be a good time to do it. I will be doing PT at the Joint Replacement Center starting next Tuesday, and again on Wednesday and Thursday, then Visiting Nurses comes to my home three times a week for in home PT. This can go on for two - four weeks, then I'm on my own (well, JD will need to drive me at least for a while) going to a local PT place.

It's interesting how many locations and different setups there are. PT Plus (associated with Christiana Hosp) has two locations - one in the basement of PMRI on Rt 52 and one on Foulk Road. They couldn't be more different. The one on Rt 52 is small, has private rooms for therapy, limited "machines", and three therapists. This is two minutes from my office. The one on Foulk Rd has a full gym, a small "pool" or tub for water therapy, open tables for therapy and I believe more therapists - it's also much closer to my home. Then there is Pro PT in Branmar Plaza, which JD previewed for me (I'm checking it out this morning), which has a larger gym, 6 therapists, water therapy.

I'm also looking for a place I can continue to work out once the PT is over. And a place that may have a personal trainer to help me and guide me to a better and fitter place.

I'm looking at the whole experience as my chance to finally get my body in shape - with someone to help me... The Physical Therapist - from now til sometime in May or June, then a trainer after - if I need it then.... Maybe I'll have religion by then, who knows.....

2/5/09 - Final Trip to Dr before Surgery

The week started out rough, but got gradually better as Dr. Gold worked miracles on my aching lower back. I will never hesitate to go to a Chiropractor again for sudden piercing pain in my back.

I met for the final time before surgery with Dr Casscells and was able to go thru my list of questions, and get answers to all of them. Now I know why I had to wait for almost 90 minutes before he saw me. If he spends as much time with each patient as he did me, he must always be running behind. I was prepared though, since I waited quite a while the last time, and brought both my knitting (I'm working on a pair of socks for myself - Rose, Purple, Teal - What else?) and my ipod with my current book.

Some of the questions and their answers - since some of you (my readers) provided me with the impetus to ask these.....

Q1. Why general anesthesia rather than a spinal (like all of the other Doctors)?
A1: Spinal causes the patient to be bed ridden for up to 8 hours after surgery, and must have a catheter (since they can't use bathroom). He wants his patients up and using the bathroom the same day as surgery.

Q2: Why not the OtisMed or Zimmer (female) Knee? What do you use and why?
A2: Dr Casscells has been doing TKRs for over 20 years, and has always used the Biomet (it's gone by different names over the years - but this is the current company). Here is a link to their website: http://www.biomet.com/patients/vanguard_complete.cfm. There are multiple other pages out there, feel free to puruse.... Anyway, What Dr. C told me is that while these other companies market primarily to the patient, BioMet is for Surgeons, and has 9 different sizes of knees (rather than 3 or 4) - and the top (that goes over the femur) and the bottom (that goes over the tibia) are interchangable - so if your top is bigger than your bottom.....All women will understand this! Also, this company uses a Vitamin E embedded cushion between the two bones for people my age (young)!

Q3: What else do you do differently?
A3: Rather than use staples to close the incision, Dr. C brings in a plastic surgeon who stitches the inner layers, and then uses steri-strips to close the incision. This ensures that the scar is less noticable, and heals much faster. Also much less chance of infection. - which I've learned is the biggest risk.

2/2/09 - There is hope....

I had a really good night on Sunday evening. My back was not spasming, and I slept pretty well. I went to an all day meeting with an optimistic outlook - thinking maybe the lower back pain was receding. After about 15 minutes sitting in the conference room, I was almost in tears, and left the meeting to call my PCP to get a referral to a Chiro. Had to leave a message, so started checking it out on my own, and got a recommendation to see Dr. Gold. He answered himself, and after hearing my saga, told me to come right in - he'd work me in.

Sharon, his assistant, was pleasant, sympathetic (which I needed right then), and she did a procedure which included sonogram with little electric charges, and then followed by targeted electrical stimulation. She covered my back with warm blankets, and I layed like that for 10 minutes. Then Dr. Gold did two minor manipulations to my lower back, and amazingly, I had very little pain for the remainder of the day - even sitting in the same conference chair - and into the evening - the meeting included a dinner out.

Even sleeping last night proved to be relatively (my knees still bother me - who would have thunk it?) pain free - except perhaps for JD, who complained of my snoring....

I feel a little tension in my lower back right now, however, I've got another appointment with Dr. Gold later today, and hope that he'll make that go away.

My ultimate goal is to have no pain in my lower back when I enter the hospital - so that I can concentrate on making my recovery fast!

There is hope.....

Weekend Knit Away

What a great weekend! This weekend away with the girls was planned well over a year ago, and got postponed with our friends in Philly's house blew up... So, we put it on hold, and one year later, seven (7) of us headed down to the Eastern Shore of MD.

My back was bothering me most of the weekend - one of the ladies with us had a lot of experience with both knee and back pain, and noticed that I was "throwing" my hips and back when I walked - to keep from putting extra pressure on my right knee.

I'm going to see if my PCP will refer me to a chiropractor this week, and see if I can get myself aligned. I think I'm totally off right now.

But the weekend wasn't all about pain and suffering. We had a wonderful bonding time. I arranged for two visits to Fiber artists - Blue Heron Yarns and The Sanguine Gryphon both in Easton, MD. What a treat - and I think it worked out well for them too - since everyone purchased a few (or many more) skeins at each place.

We had a few "classes" - great learning experience. Sandy taught a few of us Tunisian Crochet - very cool - I think it would make a great runner or placemat. Will give it a try when I can find a long crochet hook. A couple of others spent quite some time working on the Knit One below scarf pattern - using some of the beautiful silk from Gryphon.

We all decided that we would do this again, but want to do it longer next year!