Knee Replacement Journal — Part Five

August 8, 2013 | My Jottings

July 8 – August 4, 2013 — The days have turned into weeks, and I am almost eight weeks post-op. Every day I still ice and elevate, at least four times. My six week checkup with Dr. David Palmer goes well. He says my incision has healed perfectly. He checks my range of motion and says my extension is good, my flexion a bit behind. But I already knew that, because even after all this time, I still have a hard time bending my knee past 90 degrees. I seem stuck at 95 degrees when I’m measured at Physical Therapy, and if the PT gently pushes past that, the lower quadriceps muscle which attaches to the patella begins to scream and I almost see stars. One thing I’m very grateful for, and that is I’ve finally been able to do full revolutions on the exercise bike, which is a huge milestone for a knee replacement patient. When it happens I close my eyes, put my head back and whisper, “Thank you Lord, thank you, thank you, thank you.” Perhaps I will buy myself a bicycle for Christmas after all. I wonder if they make really nice new modern bikes with tractor seats?

At the surgeon’s office they take three x-rays and I can’t wait to see them. One view is taken from the front, one view is of the knee bent slightly, from the side, and one is taken from above with my knees bent, so the placement of the resurfaced kneecap can be seen. When I’m in the consulting room and Dr. Palmer shows them to me on his computer screen, I gasp. Even my untrained eyes can see the huge difference in my tibia’s placement. I used to have a Swiftly Tilting Tibia because the lateral meniscus was virtually gone. My lower leg splayed out away from the center of my body, in what is called a valgus slant. And it hurt. Now, as you can see in the x-ray below, my right calf is straight, and matches the other one.

If you never saw the first x-ray, I’ll refresh your memory:

Dr. Palmer says my stiffness is common, the warmth of my knee is typical because of the extreme tissue trauma this surgery causes, and that it could take up to a year for me to feel okay. I’ve read and heard that before, so it’s just another reminder to be patient. To be a patient patient.

I had never had an x-ray done of my left knee, so when the double knee film comes back I am quite happy to see the good space between my tibia and femur. I plan no second knee replacement in this lifetime, and hope those bones cooperate with my plan.

As the doctor leaves the room he shakes my hand, tells me to keep icing and elevating at least four times a day, to make another appointment to come back for a recheck in six weeks, and this is his parting comment: “This is never easy.”

Ha. Understatement of the year.

Here’s Dr. Palmer, the architect of my new knee, the surgeon who has done thousands of these surgeries and is one of the top docs in the country.

Every week is much the same, with small variations to the days. I care for those in my care, while taking many breaks a day to care for myself. I do a little grocery shopping. I spend a little time with my grandchildren. I make simple meals, and order meals that are delivered. I read. I do my Gideon Bible study. I sit and do paperwork in 30 minute increments. I enjoy Instagram and post an occasional photo there. (Follow me on Instagram at JulieBalm). When discouraged at my glacial progress, I check in at bonesmart.org and see that others are progressing glacially too. Michael and I watch TV in the evenings together, and we enjoy The Closer, Mad About You, and Midsomer Murders, all delivered to our mailbox from Netflix. I make one pot of tea each day and enjoy having a cup when I’m icing and elevating and reading.

The surgical pain is gone. Now there’s a new, different kind of pain on the inside of my knee, about an inch from the kneecap. My Physical Therapist thinks it’s nerve pain and she thinks the cantankerous culprit is the saphenous nerve. My friend Su has been having saphenous pain too. I am not taking pain medication regularly anymore. I just take one 5 mg. pill at night before I sleep, and it helps me stay comfortable. When I’m out of those pills, that will be the end of my short-term friendship with narcotics.

The stiffness is ever present. It might be 5% better than it was weeks ago, but I never take a step without being aware of the vice around my joint. I am tolerating it better, and don’t feel quite as trapped as I did before. For this slight adjustment, I give thanks.

At Physical Therapy I’m working on stairs, a Pilates bench, the recumbent bike, and on flexion/bending, the latter of which is still one of the hardest physical things I’ve ever done. I think if someone gave me a choice right now between doing daily heel slides for another year in hopes of regaining knee flexion, or laboring and giving birth to a baby, I’d take the baby.

I also tend to some things that seem (sort of) important right now. I hire a highly recommended local masonry contractor to repair some mortar around our chimney, and prepare the whole thing for a gas insert. We plan to have one installed in the fall, so we can enjoy cozy fires in our dining room fireplace this winter. I call our attorney and make an appointment to update our wills, and to finally draw up a health care directive. Every time we see a doctor they ask, “Do you have a health care directive?” and we always say no. Now we’ll be able to say yes. We have spelled out what kind of heroic medical measures we want employed on us when we get old and terminal, which is mostly no heroic measures at all. We also have our attorney draw up a legal document that would make our five daughters instant 1/5 owners of our home if Michael and I were to die together. This will help them avoid probate, and many long and drawn out legal tasks.

I read on bonesmart.org that the second stage of recovery doesn’t really begin until a knee replacement patient is twelve weeks post-op. This is another comfort to me. I feel like I’m on The Knee Train. The train is moving, and I can see from my seat in the second class coach car that we are making some progress, but we’re not chugging along very fast. I feel like I need to telegraph ahead to whoever is waiting for me at The Happy and Finally Recovered Knee Resort, that my train will not be arriving when I thought it would. I might arrive at the new station in nine more months or so, or even in about a year. There are some days I’d like to get off this train. But then I see the beautiful scenery outside as we chug along at five miles per hour. If I weren’t on this train I might miss the orange Indian paintbrush waving in the meadow, the shapes in the clouds, the mama deer and her two fawns, and the curling wisps of ground fog in that distant glen.

Thank you for stopping by, dear friends and family….

Toot-toot,