Under five weeks since my natural knees became just a joint I used to hang around in through some interesting situations, and were replaced with some contemporary combination of metal and plastics. It’s been an interesting journey.
Walking, stretching, exercise biking and then, most recently: self directed hydrotherapy, focusing on stretch and flex.
And today; after checking that the balance was going to work during the ‘throw leg over’ mount/dismount routine: back on the bike!
At surgery plus fourteen days, it is now a steady round of exercise and rest. The staples were removed on Saturday and it looks like the scars aren’t going to be as spectacular as some, as they seem to be healing really well.
I’ve hired an exercise bike to assist with regaining some joint flexibility and to complement some walking. It has been really pleasing to have enough flex in the knees to be able to complete full circles with the pedals and it’s hoped that this wil be a good way to mix up types of exercise: walking and stairs as well as interspersing with periods of time spent with legs raised
With neighbouring colourbond roof in the background, this improvised X-Ray viewer shows the bits and pieces which will no doubt excite a bit of interest the next time I have to go through airport security!
Still, they seem to be working as they should, with a successful mission downstairs to put the garbage out and back up again.
Today has been a gorgeous sunny day!
Tomorrow may well see the stairs leading to a sortie out across the footbridge to check out the creek and park.
1st August: Horses’ Birthday. – And this time last week I was posting pictures of shaved knees.
Back home Again – Sounds like another cue for a John Denver song!
After a good night last night and some planning to get a hired exercise bike etc, I’ve discussed with Doctor and by-passed the rehab hospital to have now returned home and it feels great! The stairs were always going to be a challenge but, using the techniques practiced with the physio team, I was able to make it to the top in one go.
Will now spend the week keeping up with some exercises interspersed with rest and time to get on with all sorts of things. It’s a trite old saying but: “There’s no place like home!”
Here I am sitting in a hospital ward in Lake Macquarie with limited capacity to move without the assistance of 2 walking sticks, yet I have shared ideas and messages with colleagues in Virginia and Canada, Colorado , Sydney and Newcastle as well as follow the interactions and ideas of countless others: participating vicariously in the passage of life itself.
Wireless access and some added energy and concentration facilitated by some more regular inflammation control in my knees has led to a productive night of interchange and making some potential connections which will see classes in Australia connected with classes in the USA when their school year commences in the next weeks.
Having now ticked the competency box twice for the ‘stairs’ I’m hoping to move to a rehabilitation hospital in the morning to take part in some structured gym activities and hydrotherapy before heading home to continue the process.
I can’t imagine how lonely and isolating the experience would have been without the ability to connect via social media and see this as a powerful reminder of the enabling potential of ubiquitous access.
The most difficult part of all of this is trying to get any sleep at all without being able to easily get into a position on one side as I’ve been doing ever since I remember. But, that aside, and another long night over, it was lovely to walk around the ward on sticks and sit in the sunshine of a great day, leaving the laptop off and engaging with the tactile pleasure of browsing casually through the SMH while icing legs.
Such a shame to see the front page story of a very small minority seeking to derail the very agenda of choice which has been represented by the introduction of Ethics classes in schools. I really hope that parents of children who now have this as an option, should they wish to choose it, are able to underline their belief in their right of choice within similar time spaces in our schools.
The ups and downs of machinations within decision and policy making. Then: stairs.
The final challenge in gaining confidence in using these new joints comes with learning how to get up and down stairs.
It was actually emotionally overwhelming to accomplish this goal, as we have just moved into a two story home and up and down stair mobility will be critical.
The physiotherapist has a set of practice stairs like these set up and I was overjoyed to successfully complete the up and down trip twice. Small steps, but huge lifts in confidence and a constant reminder of the ability we have to push back the horizon of possibility.
Now, more ice and stretches. Tomorrow, more stairs.
The physiotherapist today suggested that we move to the next phase and try using a couple of walking sticks to support getting about. So, that has been one of the focus areas for the day.
Experiences like this are good for reminding ourselves just how much we take for granted and reconnect with a different view of time and recommendations. It has also allowed lots of time for reflecting on the way that any of us involved in the care, and development of, others, can potentially make the experience one which more readily builds on the relationship built with the recipient. More about that some other time.
Now, stop reading or turn your head away if you’re squeamish.
On Tuesday, with the assistance of a spinal block and sedation, both knees were removed by making an incision down the middle of each knee; pushing muscles, ligaments and tendons to one side and then sawing through both femur and tibia according to exacting specifications generated from data gathered via a CT scan a few months ago. The knee prothesis is also made based on this scan data and has a part which affixes to the femur and then a plastic plate attached to the cut top of the tibia which provides the platform to take the weight and provide a surface against which the hinge like action of the joint can slide.
The new knee prostheses were then inserted and affixed to the relevant bones before everything else was put back in place, drains inserted and the incision closed with the equivalent of a large stapler.
For the first day or so the emphasis is clearly on monitoring and infection control. Both knees are tightly bandaged and ‘scuds’ attached to the lower leg which are periodically inflated to assist circulation. Fluid is introduced to the body via a cannular which also has a branch which allows the patient to provide a controlled amount of morphine via a hand held button – ‘Patient Controlled Anaesthesia’ and we are encouraged to mitigate our own pain as required, as clearly everyone has different thresholds.
Blood is drained from the joints via drains and the blood recycled via transfusion.
Regular monitoring occurs of blood pressure, temperature and any other indicators of things which may be going awry. Clearly this is intrusive surgery of significant degree and the body is obviously going to respond in different ways.
After the first 24 hours, the physiotherapist introduces some exercises which build on the pre-operative suggested exercises, and then. as described below, moves to a staged process of a bit more each day.
You can see the result below: shot in the corridor with the Flip camera at the end of day 4
Ready for the first solo mission, down off the bed and along twenty five metres or so of the corridor and back.
All catheters, cannulars and assorted tubing now removed and the main aim of the game seems to be getting everything stretching and working through psychologically convincing yourself that it’s not going to fall apart at the seams.
Judging by the row of metal staples running down the middle of each knee, there’s no intent for that to happen.
Well, according to the surgeon, the replacement went well.
Naturally I wouldn’t know, as there’s no way that I was planning on being awake for it.
You might notice a hand drawn arrow pointing downward toward the knee which I was asked to draw prior to surgery and, no doubt, a good way to ensure that everyone has common agreement about which bits are to go!
The rest of the day was all a bit of a blur with regular monitoring and checking.
Today, the physiotherapist arrived to get the legs moving with some simple exercises and then, the piece d’resistance: a standing welcome to the new joints with much trepidation and suppressed naughty words. So begins weeks of exercises and physio leading, hopefully, to the proverbial ‘walk in the park.’