About this blog

"New Nees"...a term used when friends have had breast enhancement. I mean you can't go around asking "how are your new boobs?" But asking about knees? Certainly. And so it was born. As a nod to its humor, I use it here where it really does mean "new knees".

When I decided to have bilateral knee replacement, I started searching the world wide web hoping to find other blogs on how people have prepared and gotten through the recovery, physical therapy, and their end result. I found one really good blog which I will link to (Random Thoughts from Midlife), but the very few others I found were only about one knee.

So I am starting this blog, so that if someone else ever needs to go where I am going, they will have an idea about the journey on this road "less traveled".

Thursday, June 19, 2014

12 Weeks and 2 Days...

It was Tuesday evening, June 17. Mark and I were having dinner out prior to going to see Christopher Kimball (America's Test Kitchen) at the DuPont Theater. It was there that it dawned on me that it was 12 weeks since my surgery. And I started to cry. Mark and I toasted to my recovery, and I toasted him for his never wavering support.

My last PT is tomorrow and I am to wear my uniform pants, boots and duty belt to do the obstacle course. My employer loaned me old equipment and PT set up an obstacle course that included up and down stairs, stepping over differing heights, getting down on my knees, etc. while carrying about 40-50 lbs of equipment. My ROM is 130+ on my right knee and 125-130 on my left knee (it was the worst one). One of my best at home stretches is kneeling on a pillow and sitting as far back on my knees as I comfortably can do. 

Where am I truly? I am pain free, and even the spasms at night have gone away (thank GOD!!!). I walk, bike, dance a little, wear low to medium heels, and I return to work on Wednesday, June 25. Full time, full duty. I have ordered knee pads that I will keep in the medication bag to put on when I need to kneel. While the spasms are gone, I still "feel" my knees when I need to turn over in bed. My knees want to bend, then straighten out, bend, straighten out...lol. They just don't want to be in one position for very long. I take Advil every other day or so, usually when I have overdone it. Even though I am doing great, I can still overdue it...I am reminded that full healing takes about a year. 

A funny one...I have been on my church's prayer list for several weeks. 2 weeks ago, I surprised many people by kneeling at the altar rail to receive communion. As we were leaving the church, I said to Fr. Chris said "I do believe you can take me off the prayer list now", and he said "I believe we can". 

I am grateful for friends and family who have kept me in their thoughts and prayers, who have encouraged me every step of the way. I am grateful and humbled that I have been able to encourage others whether through this forum or at PT. I had several tell me that I was an inspiration to them...but one man in particular had his knee replacement in January and up until 3 weeks ago could not get past 90 degrees in ROM. He said my "cheerleading" and suggestions on how to breathe through the pain helped him over his fear and now he was 130 degrees!!! 

I'll be back to let you know how I did on my return to work. I have no doubt I will be exhausted on those first few days back.

Wednesday, May 21, 2014

8 Weeks Today

8 weeks ago today I was medicated with a Dilaudid drip due to pain from the surgery.

 TODAY I had my second followup appointment with my surgeon.  He is very pleased with my progress and again stated I am at the head of the class for his BTKR patients.  He gave me a return to work note (June 18) and said "I'll see you in 5 months".  What?

Where am I now?  Walking normally most of the time, wearing low heels, riding my bike, other assistive devices (the lift over the potty and shower chair) are no longer in use.  I still need some help whether by hand or by using the arm of the chair or sofa to pull myself out of low seating.

If I overdo it, my knees tell me at night with a variety of aches/pains.  The nurse today told me that the pain at night and the issues sleeping are the last symptoms to go away.

I am continuing PT until I use up all my visits.  I have hydrotherapy once a week, and next week they will start "functional" therapy using the equipment I have borrowed from work.

A friend's sister, who has been following my blog, had her BTKR the day before yesterday.  After a less than auspicious start (the first attempted surgery resulted in cardiac arrhythmias under anesthesia, so it was discontinued), this surgery was completed and she is on her way!   My best wishes to her!  The first two weeks are the worst, but each day is better than the day before.

Wednesday, April 30, 2014

5 weeks....

I had my one month check in with my OS last Thursday. He pronounced me "in the top 5% of his bilateral TKR patients". I am one of those who think I should always be doing better than I am; that I should be working harder, striving for more. Yet, what I am doing now is more than enough. I just have to recognize it. For those of you who have followed me from the beginning, you will remember my biggest stressor is being able to return to work between 6/17 and 25, or I lose my job. I don't want to jinx my recovery by saying I know I'll get there, or anything else. But so far, so good.

AND yesterday was 5 weeks from the day of surgery! I will readily admit you think you will never get to "point B" or you are forever wondering when "X" will happen or in some cases, go away. However, in public I am walking with a cane, around the house I try to walk without a cane, I am driving, hydrotherapy is now an option and will start in a week or so, sleeping on my side is now possible for a few hours at a time (how many of us find THAT simple accomplishment a blessed relief?), I started cooking some meals again (short and sweet, not hours on my feet), and so much more. Simple movements, positions, accomplishments that only we or our SO recognize.

Fatigue and intolerance (lol) still haunt me and it took numerous experiences for me to realize that after late afternoon, I am just not up to company, or going out. I am hoping after 6 weeks or thereabouts, that starts to disappear.

And starting Thursday afternoon, I will be completely on my own. I had Lynn when I first came home, and my mother, who has been here for 2 weeks, will leave tomorrow. I haven't really needed much of my mom's assistance, but the fresh fruit plate while in bed will be missed in the morning...lol.

Thursday, April 17, 2014

11 days, not yet 2 weeks...But NOW it's 3 weeks (or 23 days)

Saturday, April 5

I am psyched about today...Mark is on his way to pick me up since I have been discharged from rehab! w00p! w00p!  It's hard to believe it's only been 11 days as it feels like much longer.  And because it's only been 11 days, my progress is considered fantastic!

Thursday, April 17

Confused?  Sorry...I had started the above entry but never finished it because Mark walked in the door to take me  home.

It's been 23 days since the surgery. The first few days at home were a little tough.  I went through some depression, found myself overwhelmed when around too many people, so I found myself avoiding our veranda and just staying inside.  Lynn was here during the day to help me down the stairs in the morning, keep food and water nearby and generally watch over me.  Sometimes at the end of the day I would find myself in tears...so tired, and feeling so limited.  I'm pretty sure most of the depression was due to the lack of sleep.

In the beginning I was up and down all night and couldn't get comfortable.  That is slowly changing, thank god, and I am getting 4-5 hours of sleep at a time.  I am now able to sleep on my side but it takes a great amount of effort to get there, and I can't stay in the same position all night.  I've really cut back on my meds, only taking something an hour before therapy and at night to encourage sleep.

Going up and down the stairs has become easier, and I have started trying to go up the stairs, one foot over the other, rather than one step at a time. I have also found myself abandoning my walker while in the bathroom, kitchen or bedroom.  It's not a graceful walk, but I walk nonetheless.

Every day is an improvement...I see it, Mark sees it, the physical therapist sees it.  In fact today will be my last in home PT, and I start outpatient tomorrow at 9 a.m.  Not missing a beat here!

As to the wounds themselves...my right knee looks so different than my left.  A little neater if I had to  define it, and the vast majority of scabbing is gone.  The left knee still has a lot of scabbing and just looks a little angry (there is NO infection).  Two different teams must have closed the incisions.  I'll ask when I have my follow up appointment.  I've had little swelling and the bruising is nearly all gone.  While the left leg is stronger, the knee is tighter; and it's the opposite on the right...good range of motion on the right, but not as strong.  "Not as strong" is really a "brain/muscle" connection.  I was going to the gym and working before surgery, so none of my muscles were atrophied and were stronger than most.  But it's a case of the brain and muscle connecting with each other again.  The muscles, ligaments, tendons were all traumatized during surgery and so went into "hiding"...lol.

All in all, I would say I am doing quite well (knock on wood).  I hope to be able to fully abandon the walker in another week or so, and trade it off for a "pimped out" cane...lol.


Thursday, April 3, 2014

P.S.

The staff no longer has to transfer my legs for me...I'm pretty much doing everything myself!  Well, me, my walker and I!

Second Week

One week ago at this time I was done with surgery.  I remember waking up crying, and not knowing why.  I still don't know why...lol.  The arthritic pain is definitely gone, but of course, it is replaced by the surgical pain but instead of getting worse, this will continue to get better.

I started writing this one Tuesday morning...it's Thursday morning now...lol.  I'm generally pretty active, but if you give me a little oxy, I'm down for the count.  Oh well.

PT is enjoyable; I won't say FUN, because there are many other things I would choose to do, but I don't mind going and I look forward to seeing what ROM (Range of Motion) is being accomplished.  Right now I am 0/95 on both legs.  This is good.

I have yet to "second guess" choosing to have this surgery.  I do wish I could get a better night's sleep      though.  Pain meds kicking in......

Sunday, March 30, 2014

Gentle vs Aggressive

Although I thought today was starting off "bad", it actually hasn't been too bad. I asked PT if there was "gentle" approach that we could use today. She said there was and while it wasn't completely discomfort free, I didn't need to sleep it off when I returned to my room AND I wasn't too sore for the afternoon session and so could put my all into it as well. I also iced more often today, before and after PT and a couple more times just on my own. My ROM is 90-3/4 on both legs. Straight leg lifts or partial leg lifts continue to be quite painful and near impossible. I am confident I will be much improved over this week. Interesting how different therapy encourages a different outlook.

5 days post op

My apologies for not keeping this up more...pain meds do wierd things and you should have seen some of the things I wrote...once I reread them, I just couldn't post them...although they would have make for great humor!

Pain management is good here at the new rehab.  There is still pain and short of being unconscious I don't know what will relieve it. The staff still have to transfer my legs in and out of bed, a real frustration to me; and it just  hurts like a sumavitch to bend my knees. I think today I will try more ice packs.

I am on day 3 of full rehab/PT and I want to cry when I anticipate going to PT.   I think I am reach a "Val is tired, frustrated, etc." wall. A wall that might be perfectly normal.

Good news...no staples just internal stitching and dermabond. But damn it sure feels like staples when I bend my knees...lol.

Wednesday, March 26, 2014

Good News and Bad News

The good news is that I am doing great  (90 degree range of motion; able to walk down the hallway with my walker).  It's still horribly painful to get out of bed, and getting out of the recliner is excruciating.  The pain makes me lightheaded. Once I am up...not too bad.  All the medical staff have commented that my swelling is minimal (it feels very tight to me), and I found out I have no staples, just internal stitches and glue.

The bad news is that not only is Wilmington Rehab full, according to some criteria I do not qualify for an acute inpatient rehab.  In spite of the fact that I need assistance to get up rom anywhere a well as to get back down.  No Wilmington, no Magee, etc.  I am very upset about this and do not understand the criteria.  Danielle, my Discharge Planner, is trying to find something "sub-acute" meaning I am still inpatient but will only require minimal physical therapy.  It's all very confusing and upsetting, and in a word it comes down to "insurance".

I'm going to eat some chocolate ice cream.

Good Morning!

Well, the "easy" part is over and the hard part begins.

We arrived on time at 5 a.m. yesterday.  Registration, IV, review, etc .  I met the resident, the anesthesiologist, the nurses who would be in the OR. My fear of the spinal was already noted in my chart.   I was rolled to the  back (crying), I sat on the edge of the bed, slightly hunched over a pillow, leaning on a nurse and the anesthesiologist said 'I just gave you some medicine and it will take about a minute to work."  What spinal?...lol.  The next moment I remember is being woken up in recovery.

Surgery was at 7 a.m., I was done by 11 a.m., and in recovery until around 1 p.m. and then moved to my room.  I was in a lot of pain because the vicodin was not yet working, and the durned therapist shows up at 2 p.m.  That was pretty traumatic...I'll honestly admit I was sobbing in pain when he tried to get me to stand up.  I became lightheaded and on the edge of passing out, so thankfully that PT session ended.

IV Dilaudid was started, and the vicodin administration updated to every 4 hours (and not a second past it).  I tried again at 4 p.m. to get up...better but no go yet; 8 p.m. was the magic time!!!  I have been up 3-4 times since then to go to the bathroom, brush my teeth, etc.  Getting up definitely hurts, (pain level 5-6); walking hurts a little but once I get going, I would rather keep going.   When returning to bed, I have to remember to not "plop" into it as I let go of my walker.

Speaking of my walker, it's all blinged out and everyone has been commenting on it.  They love it!  In spite of MY insistence, the PT insisted I use the hospital one.  However, later when I was trying to stand with the nurses assistance, she brought me the hospital walker and I said, "I want to use mine from home; it has love and magic in it".  No problem she said, and out into the hallway went the hospital walker!  Whew!


Tuesday, March 25, 2014

It is DONE!

Some issues with pain cotntrol being worked out.

 I did get up amd walk to the door of my room with my magic  walker.

Focus is difficult so I will write more tomorrow.

Monday, March 24, 2014

Patient Navigator

I received a phone call from Maureen, who identified herself as my patient navigator and she would be seeing me tomorrow morning, but wanted to chat a bit tonight.  

Did I have questions? Not really, but in spite of that we managed to have a very interesting conversation with several bits and pieces that surprised me. 

There will be no elevated toilet seats, catheters, no CPM (continuous positive movement; a machine that makes your leg extend and retract basically in your sleep), and no ice machine (they use gel packs, etc.).  All these items I was expecting. She said Dr. Rothman doesn't like to use them, because patients come to depend on these items rather than doing things for themselves, which is P.T. in and of itself. 

I will have a large private room, they are happy for me to bring my own foods or juices and will even refrigerate them for me. Maureen is looking forward to seeing the pimped out walker...lol.

She gave me a heads up on Coumadin and Vitamin K...I love my leafy greens.  Elimination from the diet is not necessary but I have to monitor quantity. 

I want to thank everyone for their support.  The hard part starts tomorrow.  I'm looking forward to being able to dance at our wedding.  


BLING MY WALKER!!!

BLING MY WALKER!!!  Or better put as "PIMP MY RIDE"...lol. 

It was great to have friends over to help bling out my walker (thanks Alison!!!), have a few drinks in front of the fire and generally bask in the comfort of friends, love and laughter.  


Thanks guys!!




Interesting to note the orbs...we've seen them in photos before, and not all on the same camera (so we can't blame the lens).  We consider them our resident spirits and they are welcome to the party!!!!  Missing from the photo is Lula, who had already left.



Homeopathic Remedies

In previous surgeries, I've used homeopathic remedies with success in terms of minimal bruising and scarring.  These will be self administered (and I need to find a pill case for them!).

I am using the following: 



Healing and recovering
Arnica 200C- better known as a homeopathic remedy for bruising, Arnica is also excellent for shocks, and can help reduce bruising and trauma that goes with deep surgery. It can also aid in preventing or reducing blood clots post surgery and help reduce soreness and reduce swelling.
Calendula 200C- known in homeopathy as the magic healer and a great homeopathic antiseptic. It keeps wounds infection and germ free when taken internally and helps wounds heal.
Hypericum 200C- known in homeopathy as another great healer with affinity for nerves, Hypericum can be used to help reduce pain after surgery and nerves to heal after being severed. A great antiviral together with calendula they help keep woulds infection free.
2 pills as soon as you are able to after surgery- take unto 6 times a day to speed up healing and help reduce risk on infection.

Scarring
Naturally one of the main side effects of surgery is scarring and there are homeopathic remedies available to help reduce and minimize scarring. The main ones are:
Silicea 30c- Silicea is a homeopathic remedy traditionally used to help reduce the appearance of keloid scars and even help prevent their formation.
Thiosinaminum 30c- A homeopathic remedy known for its ability to dissolve scar tissue.
Graphites 30c- A great skin remedy. In scarring it helps reduce scarring even old scars.
Calc Fluor 30c- Calc Flour helps keep the skin elastic and has an affinity to connective tissue.
Two pills three times a day as soon after surgery as you can. Take along with Arnica/Hypericum/ Calendula.
I was also going to use Bromelain but because it has a tendency to thin blood and I will be on Coumadin for 6 weeks post surgery, I am not using it. 
The normal post op "blood thinner" is Aspirin, twice a day.  So why Coumadin for me?  I have received bio-identical hormone replacement for several years now in the form of Sottopelle. While the amount of estrogen/estradial I receive is minimal, it was enough for concern by my surgeon in terms of blood thickening and thereby increasing the chance for blood clots, and because they are implanted, I can't stop taking it. So Coumadin is his choice. 

I started the Arnica and extra Vitamin C yesterday (every 12 hours).

Please keep in mind that I am not dispensing any medical advice and if you are considering using homeopathic remedies, please do your own research and at your own risk. You may also consult a homeopath for advice.

Saturday, March 22, 2014

72 hours from now...

...I will likely be in surgery.

I had initially planned to document my whole journey from paperwork to...whenever, but decided that who cared about paperwork?  People anticipating this surgery want to know how others feel, and what they are going through. So be it. Let if suffice to say that my company IS switching insurances one week after my surgery, and that I had to jump through a couple of hoops, and it was VERY stressful but it seems to have all worked out.

Am I nervous? Sort of...I'm more "emotional".  For example, we went out to dinner with my fiance's family tonight.  As we were leaving, his brother gathered everyone together and led everyone in prayer.  I was moved to tears.  It isn't the first time I have cried in the last week...there was a meltdown on Thursday.  A few days ago,, I  envisioned myself being able to dance in a few weeks, and I cried while singing along to "Happy" by Pharrell...lol.

I haven't slept well and so took an Ambien last night, and feel much better today.  However, the mini spa day yesterday likely helped immensely (a facial and massage).

I have made it a point to clear my desk of all paperwork and filing.

There are crockpot meal ingredients bagged and ready to go in the crockpot in the freezer, frozen chili, and a couple soups.  I plan on another prepping/freezing a bit more in the next couple of days...just maybe a soup or two but am not going to stress myself.

Up until a couple of weeks ago, I was working with a personal trainer on strengthening my muscles
around my knees and upper body.  A family emergency took us to California the week before last and this past week has been catch up.  I won't get there again before surgery.

I will be using some homeopathic remedies pre and post surgery starting Sunday.  I'll make a separate post in case anyone is interested.  I have used them for previous surgeries and found them helpful.

So for those considering any orthopedic surgery, planning and preparation is crucial. The less you have to worry about post surgery, the more you will be able to focus on your healing.