Log Book
August 2008
August 2008
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| August 2008 |
La Paz and El Sargento
August was dedicated to one thing: Susie’s recovery from right knee replacement.
recovery. The following are excerpts from weekly medical updates Susie wrote herself.
Medical Update August 9
This Saturday was the completion of two weeks of PT – 4 times per week. PT consists
electrical nerve stimulation (which feels good), muscle massage (the best part), moist heat
packs (also good), ice packs (not that great), and time in the CPM (continuous passive
motion) machine which is the most difficult part. The said it was not unusual for some
people to find this treatment painful and it has been so for me, at least to date. So we are
starting to break up the CPM time into 10 minutes on and 10 minutes rest; otherwise it gets
so painful that I tense up all my muscles and that doesn't help anything. We try to get 45
to 60 minutes total in the CPM machine each PT session.
I have been somewhat discouraged with what I perceive as my slow progress, but I need to
stop making comparisons with others who have had the surgery. So I will start ignoring
those reports and just listen to my doctor and my physical therapist, both of whom seem to
think I am about where I should be right now, given my weight (which is coming off slowly)
and surgical trauma.
I got the stitches out Friday night, August 8. There are still a few weepy spots, covered
with steri strips, but it is healing. I need to take blood thinners (injections that I give myself
in my stomach nightly) for 10 more days. I can shower alone and use the porta-poddy by
myself. I can do some of my exercises myself, using a large stretchy band. My leg
muscles are extremely sore and I get cramps sometimes after a long walk back from the
car or a grueling session of therapy. Sam tries to help with muscle massage, and I can do
a little of the massage myself. I am sleeping well at night. I have about 50 to 60 degrees
flexion and I need 90 to sit comfortably and eventually 120 for full flexion. I take the
maximum number of pain pills the doctor allows me to have and I don't feel guilty. Things
get worse when the pain gets out of control.
So things go for me these days. PT 4 days a week. Lots of rest and sleep. Exercise
about 20 minutes twice a day on non-PT rerst days. Get up and sit in a chair 3 times a
day for a total of about 4 or 5 hours upright. Showers every other day. Walking as I can
without causing too much swelling in my leg. Ice packs and elevation to reduce swelling.
Read a lot of books. Watch the Olympics on Canadian cable. Eat nutritious but low fat low
carb meals. Try to drink lots of liquids. Chat on the phone with my family about my
progress. Moan and groan when things hurt or when I think something might hurt - I have
a very low threshold for pain and Sam says I make more to-do about what I anticipate will
hurt than what actually happens. Oh well, I am such a wimp.
Medical Update August 12
My PT and I have found the right combination of therapy for me. First electrical stimulation
for 10 minutes to reduce the pain, then 10 minutes of moist heat packs to loosen the
muscles, and then the first 10-minute session on the CPM machine. 10 minutes out of the
machine and resting the knee. Another 10 minute CPM session and another 10 minutes
out, etc. Yesterday following this regimen I was able to tolerate 40 minutes total in the
CPM machine. After the 4th CPM session the muscles on both sides of the right knee
were getting stiff and sore, but massage relieved much of the discomfort and then ice
packs. So we will follow this routine again next PT session but increase the degrees of
flexion from 48 to 50 or more.
This past weekend of 2 days rest from PT seemed to have made a difference, too. A
surprise for me - moving my leg in and out of the bed by myself. I had been using a
rubber exercise band to lift the leg and move it around. Now I can pick up my leg without
the band to put it on a pillow or flex it over the edge of the bed before getting up. This is a
MAJOR improvement and I will feel good about it. Another note - I nearly walked away
from the porta-poddy without my walker on Sunday afternoon. I said OOPS and got the
walker, of course, but the idea that I forgot for just a moment was interesting.
Since I have been in nearly constant pain since August 2007 with bilateral knee
osteoarthritis and have walked with a cane for a year, it is hard to establish what "normal"
means for me. Certainly being pain free in the right leg and having full flexion of the right
knee is the short term goal. I have not decided when to do the left leg, but understand it is
inevitable for a return to a more active life. For me, that would be walking, moving, sailing,
and dancing, without pain.
Medical Update August 23
Well, it has been four weeks today - Saturday, August 23 - since the surgery. I saw the
surgeon last night and he is very pleased with my progress to date.
Physical therapy continues 3 times per week. We have stepped up the CPM (continuous
passive motion) aspect: now it is 15 minutes at 68 degrees (up from 10 minutes at 52
degrees) X 4 with 10 minute breaks for moist heat. I experience slightly more discomfort
each successive time but it is tolerable and not distressing. I look forward to the massage
following 60 minutes CPM.
My at home program has been stepped up as well. I do 10 different exercises with 10
repetitions 2 or 3 times per non-PT day. On PT days I do them only once, in the morning,
to allow an adequate rest period before afternoon PT.
There are still a few places in the surgery wound that have not completely closed, so last
night the surgeon put me back on oral antibiotics to help in the healing process. But I am
finished with the blood thinner injections - huzzah!
I have retired the porta-poddy next to the bed and use the trips to the bathroom as further
walking and stretching exercise. It's especially great when Sam makes a pitcher of cold
jamaica or iced tea - lots of exercise on those days.
I am now participating in meal preparation. Sam still shops (while I am at PT) and washes
the dishes, but I am starting to fix most of the "big meal" myself. I fix salads sitting at the
table and we do little cooking (because of the heat).
I try to do more normal things as I would have done before the surgery - instead of asking
Sam to hand me the massage oil or get the bandaids or put away the laundry, I do it
myself. It may take me a while, but so - what else do I have to do expect get better? Doing
things for myself is part of the recovery process.
Last Wednesday we went into La Paz earlier than usual, so I could play bridge with some
of the gang at The Dock Cafe at Marina de La Paz. I was a little more tired that night when
we finally got home after the afternoon PT session, but it felt good to do something normal
and socialize.
I am almost ready to give up the walker and move to the cane. I will know when it's time for
the transition. Primarily I use the walker to alleviate the extra burden on the left (non-
surgery) leg which hurts more now than it did before the surgery. I continue to take meds
for left leg pain. There is really no pain now in the right - just tightness from swelling and
muscle soreness after exercise.
When I sit in a chair, I get close to 90 degrees flexion in the right leg for short periods of
time. In the CPM machine I am close to 70 degrees. The PT and the surgeon think this is
good, so I am happy with what I have achieved so far.
Medical Update August 31
Same routines and a few changes. I have now achieved 80 degrees flexion in the CPM
machine. My leg remains very swollen and tight but there is no pain, only discomfort. I am
trying to walk – at least around the house – with the cane instead of the walker. My wound
still has a few weepy spots, but the doctor said this might happen because of my being
overweight and I continue to take antibiotics. I see the surgeon again September 1, so I
will report next time on his assessment of my progress to date. And so it goes.
August was dedicated to one thing: Susie’s recovery from right knee replacement.
recovery. The following are excerpts from weekly medical updates Susie wrote herself.
Medical Update August 9
This Saturday was the completion of two weeks of PT – 4 times per week. PT consists
electrical nerve stimulation (which feels good), muscle massage (the best part), moist heat
packs (also good), ice packs (not that great), and time in the CPM (continuous passive
motion) machine which is the most difficult part. The said it was not unusual for some
people to find this treatment painful and it has been so for me, at least to date. So we are
starting to break up the CPM time into 10 minutes on and 10 minutes rest; otherwise it gets
so painful that I tense up all my muscles and that doesn't help anything. We try to get 45
to 60 minutes total in the CPM machine each PT session.
I have been somewhat discouraged with what I perceive as my slow progress, but I need to
stop making comparisons with others who have had the surgery. So I will start ignoring
those reports and just listen to my doctor and my physical therapist, both of whom seem to
think I am about where I should be right now, given my weight (which is coming off slowly)
and surgical trauma.
I got the stitches out Friday night, August 8. There are still a few weepy spots, covered
with steri strips, but it is healing. I need to take blood thinners (injections that I give myself
in my stomach nightly) for 10 more days. I can shower alone and use the porta-poddy by
myself. I can do some of my exercises myself, using a large stretchy band. My leg
muscles are extremely sore and I get cramps sometimes after a long walk back from the
car or a grueling session of therapy. Sam tries to help with muscle massage, and I can do
a little of the massage myself. I am sleeping well at night. I have about 50 to 60 degrees
flexion and I need 90 to sit comfortably and eventually 120 for full flexion. I take the
maximum number of pain pills the doctor allows me to have and I don't feel guilty. Things
get worse when the pain gets out of control.
So things go for me these days. PT 4 days a week. Lots of rest and sleep. Exercise
about 20 minutes twice a day on non-PT rerst days. Get up and sit in a chair 3 times a
day for a total of about 4 or 5 hours upright. Showers every other day. Walking as I can
without causing too much swelling in my leg. Ice packs and elevation to reduce swelling.
Read a lot of books. Watch the Olympics on Canadian cable. Eat nutritious but low fat low
carb meals. Try to drink lots of liquids. Chat on the phone with my family about my
progress. Moan and groan when things hurt or when I think something might hurt - I have
a very low threshold for pain and Sam says I make more to-do about what I anticipate will
hurt than what actually happens. Oh well, I am such a wimp.
Medical Update August 12
My PT and I have found the right combination of therapy for me. First electrical stimulation
for 10 minutes to reduce the pain, then 10 minutes of moist heat packs to loosen the
muscles, and then the first 10-minute session on the CPM machine. 10 minutes out of the
machine and resting the knee. Another 10 minute CPM session and another 10 minutes
out, etc. Yesterday following this regimen I was able to tolerate 40 minutes total in the
CPM machine. After the 4th CPM session the muscles on both sides of the right knee
were getting stiff and sore, but massage relieved much of the discomfort and then ice
packs. So we will follow this routine again next PT session but increase the degrees of
flexion from 48 to 50 or more.
This past weekend of 2 days rest from PT seemed to have made a difference, too. A
surprise for me - moving my leg in and out of the bed by myself. I had been using a
rubber exercise band to lift the leg and move it around. Now I can pick up my leg without
the band to put it on a pillow or flex it over the edge of the bed before getting up. This is a
MAJOR improvement and I will feel good about it. Another note - I nearly walked away
from the porta-poddy without my walker on Sunday afternoon. I said OOPS and got the
walker, of course, but the idea that I forgot for just a moment was interesting.
Since I have been in nearly constant pain since August 2007 with bilateral knee
osteoarthritis and have walked with a cane for a year, it is hard to establish what "normal"
means for me. Certainly being pain free in the right leg and having full flexion of the right
knee is the short term goal. I have not decided when to do the left leg, but understand it is
inevitable for a return to a more active life. For me, that would be walking, moving, sailing,
and dancing, without pain.
Medical Update August 23
Well, it has been four weeks today - Saturday, August 23 - since the surgery. I saw the
surgeon last night and he is very pleased with my progress to date.
Physical therapy continues 3 times per week. We have stepped up the CPM (continuous
passive motion) aspect: now it is 15 minutes at 68 degrees (up from 10 minutes at 52
degrees) X 4 with 10 minute breaks for moist heat. I experience slightly more discomfort
each successive time but it is tolerable and not distressing. I look forward to the massage
following 60 minutes CPM.
My at home program has been stepped up as well. I do 10 different exercises with 10
repetitions 2 or 3 times per non-PT day. On PT days I do them only once, in the morning,
to allow an adequate rest period before afternoon PT.
There are still a few places in the surgery wound that have not completely closed, so last
night the surgeon put me back on oral antibiotics to help in the healing process. But I am
finished with the blood thinner injections - huzzah!
I have retired the porta-poddy next to the bed and use the trips to the bathroom as further
walking and stretching exercise. It's especially great when Sam makes a pitcher of cold
jamaica or iced tea - lots of exercise on those days.
I am now participating in meal preparation. Sam still shops (while I am at PT) and washes
the dishes, but I am starting to fix most of the "big meal" myself. I fix salads sitting at the
table and we do little cooking (because of the heat).
I try to do more normal things as I would have done before the surgery - instead of asking
Sam to hand me the massage oil or get the bandaids or put away the laundry, I do it
myself. It may take me a while, but so - what else do I have to do expect get better? Doing
things for myself is part of the recovery process.
Last Wednesday we went into La Paz earlier than usual, so I could play bridge with some
of the gang at The Dock Cafe at Marina de La Paz. I was a little more tired that night when
we finally got home after the afternoon PT session, but it felt good to do something normal
and socialize.
I am almost ready to give up the walker and move to the cane. I will know when it's time for
the transition. Primarily I use the walker to alleviate the extra burden on the left (non-
surgery) leg which hurts more now than it did before the surgery. I continue to take meds
for left leg pain. There is really no pain now in the right - just tightness from swelling and
muscle soreness after exercise.
When I sit in a chair, I get close to 90 degrees flexion in the right leg for short periods of
time. In the CPM machine I am close to 70 degrees. The PT and the surgeon think this is
good, so I am happy with what I have achieved so far.
Medical Update August 31
Same routines and a few changes. I have now achieved 80 degrees flexion in the CPM
machine. My leg remains very swollen and tight but there is no pain, only discomfort. I am
trying to walk – at least around the house – with the cane instead of the walker. My wound
still has a few weepy spots, but the doctor said this might happen because of my being
overweight and I continue to take antibiotics. I see the surgeon again September 1, so I
will report next time on his assessment of my progress to date. And so it goes.
| No Photos for August 2008 |