Four months post-op

I'm gradually returning to normal activity. This past weekend was spent doing yard work--the intensive, bend-plant-pull-chop-dragstuffupthehill activity. And this went on for three days. Sure, I was sore by the end of the weekend, but the knees are doing fine. It was that feel-good-because-you-worked-too-hard hurt.

I have signed up for a cardio dance/pilates class that will start in June, meeting on Tuesdays and Thursdays. I have signed up for my Wednesday yoga class (which starts today at noon). I am walking more than 10,000 steps a day on most days, and walking for up to an hour when the mood suits me. I am working on a plan to return to spinning class at least 2 days a week, maybe by next week.

The only thing I can't do is bend the way I did before. I was one of those hyper-flexible people, so my bending looks an awful lot like Millard's bending, and he's never had his knees replaced.

All in all, I'm learning to manage the back pain so my focus has now completely shifted back to weight loss and fitness. It's been a very good journey.

I am still happy to discuss my process, or yours, if you are contemplating this surgery. Just send me an email.

--Violet

Day 100 Post-op; A Time to Move On

And here we are, 100 days since my surgery. Time for an overall update.

Range: Full on both sides
Flexion: 130 degrees on right; 122 degrees on left
Extension: 0% (full) on both sides

Steps, up: Easy
Steps, down: Easier, foot-over-foot, with some caution

Distance: Able to walk 30-60 minutes without pain.
Standing: Up to 45 minutes so far without pain
Bending: Well, no full lotus positions for me for a while. But better all the time.

Pain: Never. I have had not had pain since about 4 weeks post-op.

Scars: Still highly visible and not pretty, but I love them. They represent a tremendous amount of new-found freedom for me. I work on them with vitamin E oil, every day, and they are smoothing out nicely. But I really don't care if they don't fade. I wear them proudly, like battle scars.

Several things are going to happen now that I've reached this point. I will post less frequently; probably when things change enough to warrant updating. This blog will remain public as a source of information for people contemplating arthroplasty. I would encourage those of you to contact me with questions, I'm happy to help out.

Starting some time in the future, I will create a new Fluffy blog that will focus on my activities, travel, and fun stuff. I will post a link on this blog for those of you who want to keep up.

All in all, even with the back pain that I'm still dealing with, things are looking good.

Take care.
Violet

Day 94

Well . . . I see the back surgeon next Tuesday, until then I'm on hold. I was so frustrated yesterday that I worked out at PT. I figured that if I'm hurting I'll take the drugs. But to just be waiting . . . it's killing me. I am going to do at least some of the exercises from now on. Bring it on.

The knees continue to be amazing. I am able to walk up and down stairs, foot over foot, with no pain. As my muscles get stronger, I can do this faster and faster. I am able to walk for 30-45 minutes without tiring. I can walk the dogs. I also found out this past weekend that I can RUN for short bursts. Stella was sitting in the car, with the hatch open, while I was trying to put a bicycle on the roof of the car. She saw another dog and LAUNCHED out of the car, snarling, to attack it. I put the bike down and bolted over to her, getting her under control before she caused any damage. Then I realized that I RAN--and I smiled.

I'll post again after I see the neurosurgeon on Tuesday.

Day 87: The Challenges Continue

I have good news, and bad news. The good news is two-fold. The knees continue to amaze me. There is simply no pain, ever. The muscles around them still need strengthening, but other than a reduction in stamina, I feel like I have real knees and not huge hunks of metal. I am grateful for them every single day.

The bad news, which is also good news when you put it into perspective, is that the MRI I had last week showed a 7 cm synovial cyst on my lumbar spine. This cyst is totally benign, but large enough to pinch off the nerves and cause the pain and numbness in my left leg. That leg is getting weaker by the day. The cyst will have to be removed, so I will be having more surgery soon. Which I am NOT looking forward to doing.

The good news is that we know what is wrong with my back, after nearly a year of treatment. For many back injuries, the cause is never completely identified and as a result, surgeries fail to provide relief for nearly half of all patients. I was really worried about having surgery when we were dealing with a "pinched nerve," but now that I know I have a fluid-filled cyst causing the problem, I am anxious to get it out of there.

By the way, this condition and set-back is NOT related to the knee surgery at all. It's just a very inconvenient coincidence.

Day 73: The Problem with Balance

So, it all comes down to balance. The muscles on my left side remain weaker than the muscles on my right side, and the imbalance causes all the muscle problems on the left.

This morning in PT I discussed this revelation with Kristin, and she agreed that we needed to do more targeted work on the left side. We tested the differential on the leg press machine. While the right leg could press 95 pounds with great ease, the left struggled to press 65. I simply must bring the left leg closer to the strength in the right leg if I want my progress to continue.

The instructions for this weekend are core strengthening, hamstring strenthening on the left side, and lots of walks with Stella.

Atrophy 101

Sigh. In my heart of hearts, I knew it was coming.

When I got up this morning, the newest issue of Bicycling magazine was on the coffee table, opened to this ad. My bike sat quietly by the fireplace, casting judgment. I can't blame her. She has been more than patient.

Over the past week, as I've struggled to come to grips with the back pain, it has become pretty evident that I'm dealing with plain, old, unsexy muscle atrophy. When I'm taking the pain meds, I can push myself really well, but my back muscles are doing more of the work than I realize. The only way to deal with it, long term, is to stay off the drugs and be happy with achieving much less.

So, yesterday I rode my bike for (sigh) 20 minutes, then walked the dog for 35 minutes. Today I've been too tired and sore to do much else.

To quote my favorite Bonnie Raitt line, "I will not be broken." Humbled, yes.

Day 64

Well, I'm still dinking around with back problems. The muscles in question are the quadratus lumborum (QL), a huge, deep, vertical muscle that runs alongside the spine with the job of keeping us upright; and the iliopsoas ("psoas"), a vertical muscle that runs vertically alongside the spine deep within in the lower abdomen. The two connect somewhere around L5, which can cause sciatica and leg numbness, and the two have the ability to stress each other, thus keeping up the dynamic of the dysfunctional relationship.

I awaken in the morning feeling pretty good, until I walk a few steps. Then the muscle spasms begin. It takes a great deal of time on the heating pad, along with popping pills, to get everything settled down. On PT days I don't take the pain meds, and I suffer through the session, which involves deep pressure point massage and exercises. I am trying to pay close attention to the exercises that hurt--and there are a few of them that I can't do right now. Needless to say, I am resentful and angry because my knees are practically shouting to GO! DO STUFF!!! But the rest of me is just not strong enough. Yet.

What causes injury to these muscles? Well, sitting without lumbar support is one; habitual overuse of the muscles will cause "knots" (adhesions) that must be worked out over time. The iliopsoas becomes shortened with too much sitting, and of course, I was in bed for how many weeks? So it all makes sense. It's just frustrating.

Knees are great. They make this little "clucking" noise when I bend them, but there is no pain, no weakness, no buckling, no problems. I'm thrilled with their recovery.