Day 25 - Walking without a Cane (sometimes)

I've got to check back to see when I was able to stop using the cane, but I don't think it was this early. However, once I'm sitting for a while, I wish I had it!

I'm still icing quite a bit - and elevating - since the left knee is still swollen. I saw Dr. Chris on 5/7 - and he was pleased with my progress on both knees. Steve R measured me at 115 and -1 on Friday. I've started using the bike on level 1 and the NuStep on level 4 - 10 mins each. I really enjoyed the Aqua Therapy - 25 minutes of moving my legs and knees in 95 degree water!

I'm still sleeping erratically - maybe a total of 2 hrs at a time, then I flip and flop til I get comfortable again - and get another 2 hrs.... Went back to the Darvocet for night time - although I'm not sure how much good it actually does....

We leave for "vacation" next weekend - a 5 hr/4 hr two day drive to the OBX in NC. Not sure how this works with being on Medical leave, however, I'm sure the HR/Medical guys can help me with this one.... We're a little worried about the long drive, will be bringing the EBIce machine, and a converter for the car - and figure out a place I can stretch out and elevate my leg (the back seat?) during the icings. Sitting for a hr or so it just starts to ache...

More on that after our ride down next weekend!

Day 21 - Day by Day

I think your mind is an incredible thing - I realize that a mere 8 weeks ago, I was at the same stage for my Right knee, however, I don't remember the "bad" stuff. I keep thinking I was much further along in the healing/movement cycle, but it is not so.....

Michele tells me that this knee is much more flexible than the first - and that I'm really progressing well. However, my nights are restless, I am sleeping for more hours at a time, but am still struggling with the increased pain at night. One thing that is very different from the first knee, is that I am not sleeping as late - on the first one, I did my best and deepest sleeping from 7 to 9 or 10 each day. Now I'm waking up at 7, and laying in bed til 8, thinking should I take one more Darvocet? Deciding not to, and then getting up....

I went cold turkey off the Darvocet on Saturday, since I only had a few pills left, and knew I'd run out before I could get a refill. I decided to try Tylenol (well the Walgreen's generic) Arthritis formula, but I had a pretty rough day, I went along in the car with JD as he did errands, and by the end of the day, I was feeling nauseous, and a little car sick. My knees (yes both of them) were stiff, and swollen - and I spent the rest of the day and evening icing. I then tried the Tylenol PM formula, and it worked for about 4 hours, then restless...

Day 14 - It's passing quickly

As I look back over the last week, I'm pleased with my progress. I've graduated to a cane, and at times, can even walk without it - but I sway badly, and don't want to get into that habit of walking.... I've walked outside several times - with JD's help walked around the yard - which is a lot harder than it sounds since the ground is uneven underneath that lush green lawn - to appreciate the spring flowers that are blooming. Our Pink dogwoods. that we planted several years ago when the sour gum fell down, are in full bloom! Very exciting! The bleeding hearts are blooming around the yard in their little shady spots. It's so much nicer to see them up close, rather than thru a window. I have to admit, I'm getting rammy!

I will be starting Out PT this week on Thursday - one day early! Colleen & Barbara (my Home PT) said that I'm doing so well, that Aetna wouldn't pay for another day of Home PT.... Surprising with my rough beginnings. However, I do know the drill, and am probably pushing it a bit - since I started doing my standing exercises earlier than they said to - just cause I needed to get moving....

My final measurements with the Goniometer were 111 degrees flexion and -.5 - 0 extension. I'm pleased.

I've also got my apetite back 100%, but am doing well at portion control - and have dropped all of the weight gain, plus some, so, hopefully next time I weigh-in with Weight Watchers, I'll be at the official 30 lbs down mark. I can tell, since I tried on three pairs of shorts, and the first two were way-y to big, so ended up with the third size down.... Yeah! What a way to lose weight! And with 3-4 lbs of new knee(s) to boot!

I'm still using the meds (darvocet) at a pretty regular pace - usually no more than 4.5 hrs between them, and can definitely feel it when I go too long. It's funny, you get a false sense of the level of pain when you're on the meds.... Over the next week, I'll be trying to space it out a lot farther...

Sleeping has also been a progression - I've moved from sleeping on my back 100% of the time to switching from side to side to back, moving when my hips, knees and everything else starts to ache... I'm now sleeping about 3 - 3.5 hrs at a clip, so that is much better.... I've stopped icing at night due to the chills.

I've started pulling my own weight around the house - well, a little anyway, and now am emptying the dishwasher, pushing the swivel sweeper (very light) around, and generally trying to pickup after myself. I've got a little carry bag that I use for all of my "have to haves", like my darvocet, book, ipod, and knitting project, that I could hook onto the walker, or carry easily while using the cane.

All in all, I'm pleased with my progress!

Day 7 - One week after Surgery

I had a good weekend - I began to "walk" with my walker rather than step, move walker, step, move walker, etc. Good friends Rob & Deb came down on Saturday and brought dinner makings - Fish Tacos! It was really fun to be able to totally think about something else - as they related all of the decisions and milestones that they are dealing with in the rebuilding of their home.

The weather was spectacular on Saturday, and I sat on the front porch for about 1 1/2 hour - and several neighbors stopped by. The sun was out, all of the weeping cherries down the street were in full bloom, and when the wind blew - it seemed like it was snowing as the petals drifted to the ground. It reminded me of last spring when JD and I went (along with 2 million others) to Wash DC for the Cherry Blossom weekend - and walked along the Tidal Basin. I hope that I'll be able to do much longer walks than we did that weekend in the coming months and years.

One thing I found out this weekend is about my surgery day. I didn't realize how long I was in the recovery room - with JD waiting downstairs.... My surgery was 7:30am, we had to arrive at 5:30am, and I finally got to my room around 3pm. Usually you're in your room 2 - 3 hours after surgery - but in my case, my vital signs - bp, oxygen level, etc were so low that they kept me in recovery for (obviously) much longer. I don't remember any of this.

Yesterday, Sunday, I ate/drank every meal, moved a lot, did 2 rounds of my PT exercises, and generally felt much, much, much better than I have in the last week. I even started knitting again - which looking back I was doing even in the hospital last time. Boy oh Boy, was Michele right - each knee is different!

I don't feel like I have as much range of motion in this knee, but Colleen, my home PT will determine the exact measurements today on her Goniometer. My flexion measurements in the hospital were between 85 and 90 - and about 5 degrees of extension.

I took my first shower in a week today, boy did that feel good! I was glad to have the teak stool to rest on, and I even shaved my legs! Now I'm squeaky clean! It sure beats hanging over the tub holding on to the walker to wash my hair and take a sponge bath!

Thanks to everyone for their prayers, concern, caring, and comments!

Day 5 - First Home PT visit

Barb from VNA Visiting Nurses PT came this morning for my evaluation. She noted that my oxygen count is still low - 90 - 93, my blood pressure is high - 160/81, and pulse is high- over 100. But my temperature is normal - so that is good.... Not sure why, but decided to weigh myself - and yikes! I'm almost 10 lbs higher than the morning before we left for surgery.

We call Dr. Cascell's office to ask if all this was "normal". It took several hours for them to respond. Apparently this conditon is normal...for people who've had blood problems...due to a bad procedure! Eileen suggested geritol (iron) and/or dark green leafy vegetables.

Day 5 and have only eaten several bites of food in past 3 days...anyone who knows me knows that's unusual!!! Not sure why I'm not losing weight instead of gaining....

I think the extra weight it a result of all of the extra liquids I was given at the hospital, so will be keeping an eye on that. Maybe the hourly pee will take care of the water/liquid weight - that or the exercise of going up and down the stairs each time. This morning, I was so tired after I stayed upstairs at 10:30, and slept until each pee break. I didn't feel like making the hike up/down the stairs. I came back down around 2pm, and have eaten a little - I ate about 1 inch of the left over Bobbie from yesterday, and about 2/3 of a cup of chicken enchilada soup. Been trying to keep the water intake up to keep flushing the stuff in my body...

Day 4 (Thursday) - Time to go home

Day 2 in hospital was a little rough - I had to have another two units of O- blood - this makes a total of four (4)! I ate almost nothing for dinner on Wednesday night - good thing J.D. didn't make the dinner he was thinking of. All in all, this time in hospital has been vastly different - I've been exhausted, low oxygen count (low 90's) , racing heart - and his pulse (100+), and I've gotten enough lactated ringers and Red Blood Cells (via IV) to float a ship. During the night on Tuesday night, my heart was racing (also low oxygen count) - so they put me on oxygen. This really helped - it's really weird to feel your heart beating in your head and ears.

Remember the old Bill Cosby routine "What do you mean when you say 'oops'"? Most of Jan's slow and lethargic recovery has been because of a mistake made before surgery. Seems the nurse surgical team took too much blood (100cc vs. 30cc) for a new anti-coagulant mix/process during surgery. Oops. That resulted in Jan's battle in fighting low blood count, anemia, chills, exhaustion, and other symptoms not directly related to the surgery itself.

I guess that's why they call it "medical practice"...

So, they let me out of the hospital around 11am - and we stopped at Capriotti's for a Bobbie - that should get the blood pressure up some (it didn't). - I settled into my comfie "stressless" chair with my legs elevated, and my new knee iced, and I proceeded to sleep away most of the afternoon.

JD made a wonderful Chicken Picata with fresh asparagus, and cheese tortellini for dinner, and I ate very little - guess I know what I'll have for lunch or dinner tomorrow.

Off to bed at 9pm

Day 3: Who knew Christiana Care was a BYO!

Tough afternoon and early evening...seems the hospital ice machine(s) broke, so Jan and her roommate Linda (as well as many other knee and hip replacement patients) didn't get any icing of her knee for 4-5 hours. Earlier in the day many of the blood pressure machines weren't working. The first evening was fraught with bleeping IV blood/Ringer's drip machine problems, Pulse/Ox machine alarms going off because nobody knew how to set it. Isn't technology, and the people who run it, wonderful?

Ironic that the new $200millon hospital expansion, including a new wing for joint replacement, starts next week. I wonder if they'll get a new ice machine...

JD went across the street to the local liquor store and bought ice for Jan.

Day 2 (Post Surgery)

Jan's holding the wonderful fiber infused jello looking oh, so pleased about the idea of eating it.

You'll notice the oxygen tubes - needed to improve the low oxygen levels in blood and racing heart (see comments later...this was probably avoidable...).

Second Day: MUCH Better!

After an on & off night of sleep and two units of blood, Jan's doing much better. She's already gone to one PT session (getting around with a walker), and has asked her home nurse (aka J.D.) to bring in Pizza by Elizabeth's for dinner.

Second Surgery: Doing Well

Just a quick note that in spite of a 4:30am wakeup call Jan's 7:30am surgery today went well; she's resting in her room at the hospital...more news soon.

Deja Vu....

It feels like I've been here before.....

I've started packing for my left Total Knee Replacement (TKR), getting everything ready for my four day stay at the Wilmington Hospital - Center for Advanced Joint Replacement. I've requested the bed by the window (experience from the first one) so I can see some natural light, as well as a little buffer from the noise and light in the hallway.

I had one of my last Out PT session(s) on Wednesday with Michele Gould (picture below)- who did my final evaluation. With a little pushing (and I mean that literally - and it does hurt) she got me to Zero extension - which means flat - back of the knee touching the table, and measured at 120 degrees flexion with the goniometer (I've included a picture of my favorite tool). She was pleased with my progress, and actually expressed surprise that Dr Chris is doing manipulation of the knee while I'm under. This is done to give a little extra extension and flexion - which I really don't need at this point - but if he can get me to zero extension without the pushing, that would be great! I asked her to measure my left knee so I can have a baseline - and it was 135 degrees. Michele set my expectations at 125 for my knees - which I'll be very happy with. She also keeps telling me that each knee is different...

Yesterday I had my actual final Out PT with Steve R - who is the manager at PT Plus at Foulkstone Plaza. He and Michele have different techniques, but both are very good. I've setup my appointments with Michele and Steve for after my next surgery, so I'll be ready, and have the appointment times that I like.

So, I'm getting excited to get this behind me, and to get to this point (eight weeks after) from my second surgery. I'm looking forward to walking with little or no pain - it's amazing that my right knee is tight, but my left really hurts when I walk - and then beginning to do other fun things like biking, and golf again! I've been told that is all possible, including skiing which I hope/plan to do next winter!

Thanks to all of my friends and colleagues for your support and encouragement over the last couple of months!

So, keep your eyes on the blog, I'll (and JD) keep you informed of my progress.

Day 38 - and 15 days and counting

OK, so I got cocky.... I had a really restless sleep without the Darvocet - tossing and turning, and thinking about the dull ache in my knee, so on Tuesday and all the nights since, I've taken one before bed, along with a Benedryl (or Waldryl - Walgreen's generic). This has helped tremendously - in fact last night I slept until 6am, got up briefly and went back to bed til 8:30am! I also found one of my travel Temperpedic pillows and used it as a cushion between my legs when I sleep on my side. This worked really well too....

My left knee (the one that goes next) has been acting up - I guess the Supartz is not the solution, and it's now pretty swollen on both sides (water on the knee). I was beginning to think maybe I didn't need to do the left one - oh, well....

JD has the opportunity to go on a Geezer Golf trip the last week of April cause two guys dropped out, and we've been reviewing my Blog to see what my state was during the that time period for the first TKR. It's like Day 12 thru Day 19. We're talking it thru, thinking of all of the issues - like how do we get the ice upstairs at night - but I'll have two machines then, and it would only be getting the frozen bottles up (and down) each day. Food and drugs (getting them from the drugstore) can be done in advance... One issue is Out PT on the Friday, which I'd have to get to - and I don't know if I'd be able to drive yet. All of the other PT sessions should be at home - since Aetna covers 6 visits. So, it's possible that I could do it mostly on my own - with a little help from my friends....

We'll talk about it, and make a decision later...

Day 33 - More Milestones/Accomplishments

I know it doesn't sound like much to those with two "working" knees, but the following are MAJOR milestones for me....

Yesterday, for the first time since the surgery I was able to:

1) Sit down on toilet without holding on to walls, window sills, etc.
2) Walk down the stairs one foot on a stair at a time (rather than one foot down, bring down other foot, proceed to next step). It wasn't fast, but it was something I haven't done since Feb 15th
3) I didn't take any Darvocet all day yesterday or last night.

I'm also pretty consistently going up stairs regularly - Michele (my PT) gave me a new exercise that really helps with this - you put your new (knee) foot up on the bottom stair, then (no hands), slowly bring up your other foot, then slowly put it back on the floor. I do this 10 times, take a short break, then 10 times again - twice a day. Once I've done this, I can almost run (I said almost) up the stairs!

I did wake up however with both knees swollen - my left (the one scheduled for surgery on 4/13) is swollen more than normal, and my right is really tight (the skin) - So, I've been using my little EBIce machine for both of them alternating!

My scar is getting less noticeable - I've been putting vitamin E on it every day (advice from the PT folks), and rubbing it - they said that will help break up the scar tissue. JD told me to remind Dr. Chris to make the left one symmetrical to the right - it will be like two out facing parenthesis'.

I've been working about 4 - 6 hrs a day pretty consistently for three weeks now - broken up by my morning & afternoon PT sessions at home, and M-W-F at PT Plus down the road with Michele Gould. She's been pushing me hard, adding more and more exercises, and it's paying off. Not only am I now at 116 degrees flexion, but I'm really close to zero degrees (flat) extension. And, when I weighed it at Weight Watcher's yesterday - I'd lost 2.2 lbs making a total of 4.8 lbs since I had surgery - for a total of 28.6 lbs total.

So, All in all, I'm feeling pretty good with myself. I'm still working from home so I can do the PT on my schedule, and ice when needed - even while working. I'll probably keep this up til after the second surgery, so if you're a co-worker and wondering if you can contact me, please don't hesistate - AIM works best - watsonjl28....

Day 23 - Check in with Dr Chris

Dr Casscells checked out my flexibility and my scar, and said I'm doing great! I've been to see Michele at PT Plus three times, and she's added some additional exercises to my twice daily regimen. When she measured my flexion yesterday - I was at 113 degrees - which is good. She's also been working on strengthening my left leg in preparation for my next surgery.

I was able to use the stationary bike at PT Plus - and make full revolutions with my new knee.... And my biggest achievement is that I can now go up the stairs, one foot at a time, rather than old knee up, new knee up, then on to the next step! It's slow going, but a step change, none the less! I can't do it going down yet, but maybe in the next week.....

I now can get around without my cane, JD says I'm walking quite naturally - and I've walked around our neighborhood (about 1/3 mile) earlier this week (using the cane).

I got a final shot of Supartz in the left knee, since it's started swelling and hurting again, so hopefully, this will give me some relief until the surgery.

Day 17 - I've graduated!

Yesterday, I saw Mary Beth, one of my home PT's, and she's signed off for me to begin Out PT. We've decided on PT Plus with a specific Physical Therapist - Michele Gould. JD did most of the research - to make sure that I get the best and most challenging PT available. Since I'm young (55) for this surgery, most of the people going thru PT are in their 70's or older. Their goals are mobility, getting around the house with less pain, etc. My goals are much bigger - Skiing, golf, biking, and of course getting around the house and my life with NO pain..... Our first choice was Elite PT - with Hash and Rudy, but unfortunately, Elite PT is out of Network for Aetna, and this could prove to be quite expensive over the long haul, which I'm going to need with two knees going thru TKR. So, we chose PT Plus - which is part of the Christiana Care Physical Therapy group. Michele comes very highly regarded - being one of the PT's for the Women's Olympic Soccer Team in Beijing! She also trained with Hash and Rudy when they were at PT Plus, so we think I'm in good hands! She may even think I'm a wimp compared to her Olympic athletes!

Day 15 - Putting my toe in the water......

I started doing some work today, really, I've got most of my leg in the water - but those of you who know me, know I can't just dabble.....

But, I've also got to be a realist, and know my limitations. I found myself pulled into SFDC (Salesforce.com for those who don't know), and finally had to push myself to get out of my chair and walk around. Now I've got to do my PT, then maybe a little more work...

Or maybe a nap.

JD took his day off from nursing today, he drove down to Rehobeth Beach to visit an old friend and have lunch.

I'm obviously getting around OK without him, and Colleen, my PT came this morning and told me I'm doing well or better than expected. I hit 110 degrees of flexion today, which is good, I think! Some people get to this point, and never progress beyond it - my goal is at least 115 or better. Think about that next time you've got your feet way under your chair - rather than in front of you, or straight down... Don't take it for granted!!!!

Foxy Lady!

I was taking pictures of the snow, and what did I see (and get a picture of?), our FOX! I caught a quick photo of her treking thru the snow, right before she dipped over the bank down to the creek for a drink of water.

I also thought I'd share with you a photo of snow on the whirley gig - which was actually moving with all of that snow on top!

The school's are closed, so it' wonderful to hear the screams of delight of the children as they play. JD just went out for a cross country ski at Bellevue Park - which has an old horse track and lots of great bike trails and little hills - which could make for some great skiing! Next year, I'll be able to join him!

Day 14 - A good weekend and snow to boot!

I went outside again yesterday, and walked up to Morley's - 2 doors down, yeah! It's slightly uphill, so it's more of a challenge than it sounds... I also actually put on shoes - well, one shoe - JD had to put on and tie the other.... Usually I just walk a loop thru the house every couple of hours. Being outside was really nice, and as usual, we bumped into several neighbors, so I got to say "hi!" too.

With the exception of the two walking excursions, I haven't been outside of my home for two weeks (if you don't count the hospital). Dr Casscells really doesn't want me out in the world for at least a month - due to infection - which can be devastating. I learned that I won't be able to have any kind of "procedure" for at least six months and then will need antibiotics prior to ensure that any infection does not migrate to my new joint(s).

I'm still taking Darvocet every 4 hours or so, especially before PT to be able to push myself further than I'd normally go. Nights are the worst - not sure why, but I'm toally aware of the pain, and using the ice makes me shiver and cold. Not a good combination.... cause my thigh muscles start to contract, which are connected to the knee... you get the picture. I'm actually thinking of sleeping in my chair tonight - to see if maybe it's the angle of my legs.

Just got a call from Colleen, my PT, and she's not coming today. We got about 6 inches of snow last night, and it's still coming down. The roads don't look very good - and she's got a small child. So, I won't find out if I made more progess on my flexion until tomorrow! I'll keep working it during my self PT today.

So, I've been occupying my time with listening to books and knitting. I've finished one project that has been sitting around for years - it' snow a lovely lap blanket - and I've made two hats and a scarf. Plus I've picked up several other projects that have been sitting around for years. I usually have about six projects going at once - I admit - I'm a multi-tasker - just ask anyone I work with!

Knitting works really well cause it's something to occupy my hands while I'm forced to keep my leg up and on ice (it's under the lap blanket). It also allows for more multi-tasking cause I listen to books while I knit.

I've finished a bunch of mysteries - which are kind of mindless and fun to listen to. I prepared prior to surgery by requesting audio books from the library, and ripping them to iTunes - then bringing them down to my iPod. Easy to carry around.

JD just got in from plowing the driveway, and I'm watching the snow just float down outside the den window - it's actually quite beautiful... This is the view from my chair:

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!