Tuesday, September 28, 2010

Two weeks today

Beautiful weather
It is beautiful outside with picture perfect weather.  Fall has started and we have dropped out of the hot weather, it is definitely cooler.  The temperature is hovering in the low 80's (28 deg. C.), sunny blue skies with low humidity, a day to be outside enjoying the sunshine.

Progress report
It is two weeks since surgery and I am walking around the house for exercise and having in-home rehabilitation.  Yesterday we started using weights in rehab and that was it for the rest of the day.  I crashed and iced the knee (under instructions) then slept thanks to the pain medication.  Oh the pain was bad, this lets me know that I still need to take recovery slowly and I am not there yet.  I want to walk, I want to run, but not yet.  The pain in my right (surgical) knee is minimal and I can tell the knee is going to be fantastic to walk on when it is totally recovered.  There is pain in my left arthritic knee, the normal pain not any stronger than before, and it will be wonderful when this knee is also corrected.

Using a stick
I thought that I knew how to use a walking stick from being on the camino but I didn't.  It is a totally different motion when using a stick for an injured leg.  Because it is my right knee that is injured the stick must be in my left hand.  I am a one stick person on the camino and my stick is always in my right hand.  I wondered how much the walking stick helps the knee so I weighed myself, then weighed myself using the stick, and it takes 27 pounds (12 kilos) of weight off the knee, amazing huh.  Then it is said that each pound of weight is equal to three pounds of pressure, WOW that is 81 pounds (36 kilos) of pressure.  Lets me know that it would be good for my knees if I could get that weight off my body.  Hmm.

Friday, September 24, 2010

Ten days already

I have been approved for nine sessions of in-home physiotherapy.  Earlier today my physiotherapist (physio-torturer, Jeannette) increased my exercise repetitions from 15 to 20 and my knee feels very good.  Pain level on meds is about a one, and as I am always on meds, I do not know what the level would be without them.  Of course the left leg benefits from these drugs, so exercising is not a problem for me.  I have been warned by Jeannette that on Monday we start using weights.  My right knee is getting better.

I am so happy that Dr Parr prefers to operate on one knee at a time.  I was considering doing both together.  The PT would be so difficult working on two operated knees.  Using stairs one needs to go down on the operated knee and up on the opposite.  If both knees are done together, ouch, then stairs would be almost impossible for a long period of time.  I have made the mistake a couple of times by using the wrong knee, for the wrong step, boy it hurts!

Ten day post-operative check-up
Garry came home early this afternoon and drove me to Sugar Land for the ten day post-operative appointment.  My knee has progressed very well and Dr Parr called me a star patient making me smile.  The alignment of my hip, knee, and ankle is perfect - a dead straight line.  I was not aware that this misalignment had happened over the arthritic years (making me bow-legged) now I know.  Dr Parr http://www.tomparrmd.net/ explained to me how he uses GPS which makes this a very precise surgery.  There are antennas on poles that are screwed into the bone top and bottom of the knee, the poles hold all the equipment in place i.e. Robotic Surgery.  The surgeon cannot go less than a millimeter off the plan for the surgery, the computer/robot will not allow it.  Apparently I was a perfect candidate for the partial knee replacement.  I only had arthritis on the inside medial knee bones and a small amount on the knee cap, there is no arthritis on the outside bones.

The surgical nurse, Ashley, changed the strips holding the wound together pronouncing it a nice clean wound.

I can now increase the walking to three periods of twenty minutes each day and with every passing week increase the time.  I cannot drive until I am off the Darvocet, I must now work on that but not until Jeannette has finished with the torture.

Sunday, September 19, 2010

It happens slowly

As we age we make lifestyle, or quality of life changes, but how much do we really need to give up?  Over time I noticed that I was no longer walking the three miles every day as I had done for decades.  I no longer went for bike rides or rode my bike to the gym.  I no longer swam 50 laps of the pool (the first two summers in Houston).  Yes, I went to the gym every day but was I putting my heart into it?  I saw the daily kilometers on my Camino walks decrease with each passing year.  These changes happened slowly without my being too aware of them.  I made excuses for why I was no longer doing each activity and I believed the excuses myself.  I now see that my knees were dictating my lifestyle.  I avoided going places or doing things because it meant that I would have to walk.  When something was suggested to me I would consider what walking went into the doing or getting to what ever was on offer.

When did I truly realize that my quality of life was compromised and I had to make this surgical change?  It was while I was in Paris after my pilgrimage and hospitalera stint this year.  I had pain walking around Paris.  Although I had been given a SynVisOne® shot the day before I went to Europe my knees were hurting.  I was walking around Paris slowly and with much pain.  I had walked that shot out within weeks, yet the first shot had lasted six months and now this second shot had lasted just six weeks!  I sat on the Hop On, Hop Off bus in Paris and did not want to get off because I knew if I got off then I had to walk.    I realized then that I had changed from being a person who was excited about seeing and experiencing new things to one who was trying to avoid them.  Time to admit you need help Luiza.

I have been helped by Doctor Thomas Parr and his staff at Foundation Surgical Hospital in Bellaire, Texas.  When Dr Parr asked about my pain tolerance he said, if you have walked over 1,000 kms on these knees then you have a high tolerance for pain.  I knew that I had a high tolerance for pain but it was good to have it validated by the doctor.

Because I have been active over the years I am having an easier time of this surgery.  My bone density is good and my muscles remember the workouts at the gym, so the physiotherapy is not hurting me as it would if I had been sedentary.  Jeanette, my physiotherapist, tells me that the range of motion in my knee is excellent and I believe being a walker could have helped that.

So to my fellow walkers out there, never give up walking, have the necessary surgical repairs to your body done that will keep you walking, and always, always walk. 

I cannot stress enough the value of walking.

Saturday, September 18, 2010

On the mend

There it is, my right knee all fixed.  Now to get better.  I am feeling great this morning and have been walking around the house without my stick.  So much so that I thought that I should call Jeannette, my Physiotherapist, and ask if I am allowed to walk.  I had to leave a message but I know she will return the call.  The wounds top and bottom are where the alignment supports for the robot were placed.

Jeannette returned my call and her advice is to walk as much as you can without overdoing it but please use the stick.  

Halfway ready for the next camino.

Thursday, September 16, 2010

Allergies .....

I have been kept awake tonight/this morning by itchy skin and anybody who suffers allergies knows what my night has been like.  Is it the anticoagulant-heparin (LOVENOX®) or the painkiller Vicodin (HYDROCO/APAP) that is making me itch?  It is now 0420 and I am having an allergic reaction to one of the drugs, I believe it to be the painkiller because of the timing of the reaction.  However, it is too early to call the doctor so I just sit here and scratch.  :)

I know nothing of the surgery as I was given a happy drug in the pre-operation area.  I remember looking around at all the robotic equipment that was protected with blue sheeting when I was wheeled into the operating room.  I saw a syringe coming towards me and the next thing I was in the PACU and the two hour surgery was over.

On the 1-10 scale with 10 being unbearable pain my pain at rest is 1-2, but after walking, or rehab, the pain is intense at about an 8.  The 1-2 pain level is the surgical site and not the interior arthritis, I believe that has been all scraped away. Let me tell you that my pain was always with me prior to surgery so for me to have no pain at rest tells me this has been successful.  Partial knee surgery is less restrictive and I can drive immediately except that the painkilling drugs come with the warning not to drive or drink alcohol.

Dr Parr came to see me yesterday and said he hopes to hear that I have walked 1,000 kms next year.  Thanks to Dr Parr I should be able to walk pain free next year.

Tuesday, September 14, 2010

Today's the day

The first step to being able to walk a camino free of knee pain.

I have two hours before leaving for the hospital.  I am of course on Nil By Mouth since midnight and I have to bathe in Hibiclens antibacterial soap this morning (something I have never had to do before).

I have received a telephone call from Stephen, SMS, email and fb messages from my friends and an eCard from Garry.  I thank everybody for helping me feel loved and holding my hand through all this.


I will be at Foundation Surgical Hospital which is less than a mile from our home and a first class facility with world class doctors.   I am going to be well looked after, of this I am certain.

Today our good friend Rebecca McVeigh is having surgery on her left breast.  Rebecca is having a tough time since having her breast cancer surgery so please put her in your thoughts and prayers as well.

Friday, September 10, 2010

I will glow in the dark

Stress Test doughnut
I fasted before arrival as per instructions.  The tech gave me a shot in the arm then leaving the needle in he taped it down for another shot later.  Then he said, you can have your breakfast now, I was flummoxed.   What!  I have been here five minutes and now I can eat and drinkYes, I had to inject you first.  Now you can eat.  He had shot me with nuclear stuff, now tonight my heart will glow in the dark.  Thirty minutes later, after a Vegemite sandwich and pineapple juice, I rejoined the friendly tech and was ready for the first stage of the test.  While I rested in the doughnut, the machine goes to work taking multiple x-rays of the heart.  I laid there looking at the clouds for twelve minutes.

A walk 24 floors up
I walked on the treadmill to get my heart rate to 130 and was shot with more nuclear stuff and given another break.  I went to Starbucks for my morning coffee.  Yep, then it was back in the doughnut for another twelve minute rest.  Stress Test done!

It was four hours of waiting and testing but once again I will be reassured that my heart is fine.  I await the result which will be sent to my Internist this afternoon.  All being well, and there is no reason to suspect it will be a bad result,  the surgery will go ahead as per schedule next Tuesday, September 14.

So how do I feel?  It has been one week that I am without pain gel and drugs.  Today the pain is at times unbearable.  All my doctors have a question on their forms: Rate your pain between 0-10 with 0 being no pain at all and 10 being unbearable pain.  I have been at about a 6 or 7 since my return from Europe but this week I have jumped up to a 9 with moments bordering on 10.  Now another question on the forms is that the doctors ask you to rate your tolerance to pain.  I will tell you that I have a high tolerance and admitting to pain is not usually my game.

All systems go
The cardiology nurse called late today and I have been given the all clear by the cardiologist for the surgery.  My Internist and Orthopedist have been notified.  I am now relieved of stress knowing that I will be given the chance to walk again without pain.  Maybe by Thanksgiving and our visit to San Francisco for AGU I should be walking like I did before arthritis struck.  Oh the joy!

Now I can continue my daydreams ..... in 2011 I would like to walk from Santiago de Compostela to Saint Jean Pied de Port (SJPP).  This way has been in my dreams since I first walked Camino Francés in 2002.  Oh, and maybe, just maybe the cold weather will not affect the knees as it does now so I could walk in the Fall.  That would be different for me.

Thursday, September 09, 2010

A doughnut but no caffeine

The doughnut - CT Scanner
I faced my fears knowing that having this scan is necessary for the MAKOplasty® surgery.  However, I should not have worried as the scanner is a doughnut (see photo) and was not a noisy claustrophobic barrel like an MRI.  The scan for the knees is feet first so my head never entered the hole.  It was a smooth ride back and forward while my right knee was scanned.  All is now ready for the robot which will be used for the surgery on Tuesday.  I said a cheerful farewell to the technician and .... I will see you soon for the left knee.   Suddenly I was very brave.

No caffeine (not even decaf)
I had a pre-op exam on Tuesday with my Internist.  There was a blip on the EKG, there is always a blip on my EKG, and there has been for thirty years.  You need to see a cardiologist, I protested, but no she told me, you must as no surgeon wants a surprise on the operating table.  So OK off to a cardiologist.

Yesterday I saw the cardiologist and had an ultrasound of the heart and tomorrow I have a Stress Test.  I hate having Stress Tests to be told that basically nothing is wrong with my heart - your heart just misses a beat now and then.  Well that's me, I can never stick to the beat, one reason why I don't dance.  Hence, I am now on twenty-fours no caffeine, well okay then that doesn't matter because I drink decaf.

Oops, read a little further, NO DECAF.

The next 24 hours sucks.

Saturday, September 04, 2010

OUCH, OUCh, OUch, Ouch ouch .....

From today I am not permitted to take painkiller drugs or rub my beloved Voltaren gel on my knees. I can feel the pain escalating as I walk around and know that by September 14 I will be asking for an amputation let alone partial knee surgery.

This Tuesday I have a pre-op exam with my Internist for blood work and a chest x-ray to hopefully be given the all clear for surgery.

On Thursday I have the CAT scan for the MAKOplasty® robotic surgery. This is really facing my fears as I do not like enclosed spaces. I have been told it is the MRI that is not for folks with claustrophobia and that the CAT scan is like a large doughnut, we will see.