Where Did June Go? Oh, a New Knee!

8 July 2017

I can't believe it's July already.  June sort of flew by in some kind of haze.

We flew to Bellingham, WA, which is our sort-of home base.  When we began our life of travel, my dad was still living here, and we established residency, voter registration, medical care, all those normal things one takes for granted when one lives in one place.

Anyway, that's how Bellingham became our summer stop each year.  We're at that age where the doctors want us to check in, they want to listen to things, do a quick physical, and then re-up the prescriptions.  Not a problem, we can visit my side of the family and friends while we're in this beautiful corner of the US.

But this year - this year I was scheduled for a new knee.  Not a knee that just wore down from old age, oh no, that's too mundane for me.  No, I tore out a knee by falling and having my leg go the wrong way after a hurricane in St. Thomas, USVI, way back in 1999.  Torn meniscus, torn ACL, bruised bones, the whole bit.

My doctor there thought the hurricane story was a little boring, so the better version is that Tim Duncan - from St. Croix but star basketball player for the San Antonio Spurs - Tim and I were playing one-on-one basketball and we collided.  He had meniscus surgery around the same time as I did, so that's what happened, yeah, Tim and I crashed and tore our meniscuses (meniscii?), yeah, that's it!

Anyway, knees aren't the easiest joints in the body.  They take a beating, even if one isn't a pro basketball player.  And with all the walking we do as we travel around the world, my injured knee has worn down to that bone-on-bone point.  So, time for a brand new space age bionic synthetic knee!

The first twelve days of June were spent at doctors' visits and in joint care school.  Yes, it is required that people getting new joints attend a three hour class on how to prepare for the surgery and then care for themselves post-surgery.  Which included collecting adaptive equipment to assist with the daily tasks of living as one recuperates from such surgery.

Fortunately, I have a friend in Seattle who had both knees replaced about eighteen months ago.  He drove up with a walker, crutches, huge wedge pillows to elevate the legs, a device that holds an e-reader, and best of all, a circulating ice wrap thing - really, it's like an ice chest that pumps water into wraps that you velcro around your knee!!! 

And, the Lions' Club in town has a collection of adaptive devices that they lend out for three months at a time - no questions, just bring the stuff back.  Please make a donation.  If you have other items, we'll take them too.  They were amazing!  So, a sliding bench to get in/out of the shower, and a commode that goes over a normal toilet but makes it higher up, and with a frame to hold.

I added a bed tray, since we're in a hotel.  The hotel people gave us a ton of pillows, again to elevate the legs.  Offered us a chair from the pool deck, because those are the only chairs with arms.  (Really, one needs to consider such things.  You don't realize how much you use your legs until one goes on strike.)

And we were set.  Time for surgery, and yes, I debated calling it all off.  But I was brave and went ahead with this - my surgeon verified which knee.  My anesthesiologist chatted with me and agreed to get me good and snockered before she started the spinal anesthesia.  (Really, she was talking to me, I was sitting up with a strong young woman assistant standing in front of me - the IV started up, and then I woke up in recovery.  That's the way I like my surgery!!!)

Everyone at the hospital here was wonderful.  Helpful, friendly, interested in the patients - or maybe just interested in our life of travel, since I always have trouble answering the simple question of "So where do you live?"  Pretty soon, all the staff seemed to know that we were the people who travel all the time and don't have a home.

They also let Richard come and go without really worrying about visiting hours - seems as if patient happiness is more important.  Everyone checked on my pain level, and made sure I was adequately medicated.  They kept a stash of crackers so I could take the pain meds in the middle of the night.  (They're really rough on the stomach.)

Plus you know how hospital food usually is pretty bad?  Boiled to death vegs, starchy sides, all of that?  Nope, not here.  I had fresh strawberries at every meal except breakfast!  Grilled salmon one night, grilled chicken the next day.  Fresh green salads.  It was amazing!  They even sent lunch for the day I was discharged, just so I could eat before going back to our hotel!  (And yes, my fave strawberries again!)

One of the other great things about the joint care wing is that they have single rooms.  I'm guessing all the equipment makes a difference - can't have too many people in a room when everyone has a walker, crutches, different height toilets, etc.  

I even had a view across the parking lot to the wooded area beyond, with rabbits hopping around out there every evening.

So the schedule was something like this:  surgery on Monday afternoon (12 June).  Individual physical therapy in the morning on Tuesday.  Afternoon physical therapy in a group, but with my coach (Richard), on Tuesday afternoon.  Then group physical therapy again on Wednesday morning, prior to my post-lunch discharge from the hospital.  Plus twice daily walking around the corridor - each lap around the corridor moved my marker up the side of Mount Baker by 500 feet.  (I made it about halfway to the summit.)

Then a week at home, hobbling around the hotel with the walker, lots of ice, and doing my PT routine from the hospital.  I have to tell you, this is not an easy surgery.  While the muscles, tendons, ligaments, etc. aren't cut, they do get moved around.  They get stressed.  They freak out.  As I said, they go on strike.  For some reason, my thigh muscles decided not to work for a week.  I truly could not pick up my foot to put on a shoe, or to get my leg up on the bed.  I had to use either the exercise elastic band to do this, or hook my good leg around the ankle to push/pull up the other leg.  Talk about frustrating and annoying!

And yes, continuing on the pain meds.  We're talking bone pain here - not to go into a lot of detail, bones do get trimmed, or a bit more than trimmed.  There is bruising.  There is swelling.  Serious meds are needed to make the pain bearable.  It never goes away 100% - it just goes down to a slight grimace instead of being screamingly excruciating.  So yes, pain meds, major narcotics, opioids or whatever - every four hours, including in the middle of the night.  I can give up a little sleep to stay on top of the meds so that the pain doesn't start up again.

And that pretty much was life for the next few weeks.  Lots of meds.  Some pain.  Learning to walk with these assistive devices.  Learning to shower while sitting on a bench.  Trying to eat plenty of protein and calcium to help the bones and muscles heal and get stronger.  

Then we add in going to physical therapy joint gym and pushing myself to do new exercises that work the muscles even more.  Try to bend the knee more and more and more - I'm currently up to 108 degrees, though the goal is 120 degrees.  Try to push the knee flat flat flat and straight straight straight - I'm at a 1 degree bend, so I'm almost there.

Practice a slow walk up and down stairs.  Try the exercise bike, and not be able to complete a full turn of the pedals.  Work work work and finally get to that full rotation - yay, a reason to celebrate.  Learn how to walk with a cane and get rid of the walker.  Go back to standing up for a shower, and get rid of the sliding shower bench.  Go back to using the normal toilet.  But, well, we have a tub and it isn't so easy to climb in, so the walker is helpful to at least have a handle to hold as needed.

Seriously, that's been the last six weeks.  Doctors, surgery, meds, physical therapy, and exercising in the room two or three times a day.

Of course, there are also the occasional breakfasts with my youngest brother who lives in town.  Phone calls with his fiancée, who recommended my surgeon (who was described as "brilliant" by another one of my doctors).  Phone calls with Seattle friends, and plans to have slow and easy get togethers.  Going out to restaurants so I can practice a little more walking around.  

The only really fun thing was going to the supermarket where I get to ride the motorized wheelchair cart - those things are fun!  Not easy to reach some of the items on the shelves, and I did nearly knock over a display on my first time around of the store.  But I've gotten much better at backing up or going around tight corners.  And I only crashed into someone once, but it was her fault, she turned her cart and pushed it into me as I was passing around her.  Totally her fault, and she knew it.

Yeah, good times, right?

So, yes, these photos are prints of the x-rays of the new knee.  Side view and what I'm guessing is a rear view from the back of the knee (since we don't see the patella).  I'll keep the photos at the very end, so if you don't want to look at them, you can just read through and then delete the page.  But if you're interested, then the photos are there for you.

My doctor told Richard I was a great patient and that the surgery went really well.  Hard for me to comment on that, I was unconscious - probably why I was such a good patient.  (Surgery took 90 minutes instead of the expected two hours.)  The doctor also gave Richard these photos, which I decided to colorize just to have some sort of graphics for this blog.

And that's the story of June.  And my new knee.  There really isn't much else to say.

I'm doing well, I can walk about 1/4 of a mile with a cane, I can easily walk up a flight of stairs but walking down isn't quite as easy.  I can pedal all the way around on a bike.  And I'm working on rebuilding strength and endurance.

Richard is doing well - he brings in take-away food and makes sure I eat well.  He encourages me to sleep, whether I need it or not.  He brings me ice for that wonderful ice circulating wrap, numerous times a day, and one day at 5 AM when my knee was aching too much for me to sleep.  He's been wonderful about this all, and even puts up with what he considers my crummy taste in television.

We're starting to make plans for travelling come September.  Well, late September.  Apparently people shouldn't fly for about three months after a joint replacement, due to increased risk of blood clots and that evil DVT that sometimes happens on long flights.  But we're looking at warm locations where I can continue to build strength and endurance - like, oh, some lovely tropical islands where we can swim and snorkel and explore exotic locations.

We'll keep you posted on that part of things.

But it's summer in the Pacific Northwest, it's sunny and sort of warm and beautiful, and I'm improving daily.  We'll enjoy being here while we're here.

And then, before it gets cold, we'll move along.

Okay, photo warning!  But in non-normal color!