Bilateral knee surgery — Five weeks and waiting for “normal”

Last Tuesday, when Mark’s physical therapist asked him how he was doing, Mark said, “I just want to be normal again.”

“If you were normal,” the therapist said, “you’d still be walking with a walker right now.”

As I’ve been pointing out all along, Mark has recovered to this point quickly. He can do most things, excepting the three prohibitions mentioned in the pre-op class. He stopped all prescription pain medicines and is back to taking only Motrin twice a day. We think the Lyrica really helped with the pain because Mark’s discomfort level has risen since he’s  been off of it.

Mark is scheduled for physical therapy twice this week and will need to go once or twice next week. After that, we don’t know. We expect he will be finished soon.

Then it is just a matter of time to heal completely. We were told initially that it takes three months, after that he is no longer prohibited from kneeling, etc.

I wanted to include a video of Mark walking down the hall, getting down on the floor and back up again, and walking down and up a flight of stairs.

I took the video over the weekend but somehow lost most of it in the transition to the computer. All I have left is Mark sitting with his legs up on his desk, sipping a Cosmopolitan, straightening up from getting off the floor, a laugh in the background, and a head shot as Mark approached me during his stroll down the hall. Since I think I was lucky to get the video in the first place, and I don’t believe my actor will be willing to do a retake, you will have to take my word for it.

All is well. And we feel lucky to have made it this far in Mark’s recovery so soon.


Bilateral knee replacement surgery—Three weeks post-op and x-rays

Three weeks after surgery, Mark is walking around the house without a cane. He has started doing minor household chores like clearing his place after a meal and emptying or loading the dishwasher. Yesterday he refilled the birdfeeders.

Although he walks well, he still walks slowly, and doesn’t like to be on his legs for very long periods at a time. Since the surgery we have gone out to lunch, dinner and breakfast. Last week he went to Macy’s at a mall with me. I parked at the Macy’s entrance so he wouldn’t have to walk a great distance. While the sales clerk was assisting me, Mark sat in a chair in the shoe department (which isn’t really all that different from what he might have done before the surgery).

Mark went for his two-week post-op check with his doctor last Wednesday where he was told he only needs the cane when he goes out in public. I don’t believe I’ve seen the cane in his hand, here or when we’ve gone out, since. He has been set free from the CPM machine and no longer needs to wear the tight hose, unless his legs begin to swell.

Mark wants to drive to his physical therapy today. His therapist has told him he probably could drive as long as he can move his foot back and forth without pain.  I plan to go with him. I’m not comfortable with him driving on expressways yet, but I think he will do fine going the short distance along primarily residential streets to physical therapy. He is pretty worn out after therapy and I suspect he will not want to drive home.

The doctor recommended he continue to take the Lyrica and Celebrex, neither of which are narcotics, until his supply runs out. The Percocet remains up to his discretion for as long as he needs it. He has not taken any for two or three days. Prior to that, he was only taking one in the middle of the night when he couldn’t sleep because of discomfort in his legs.

With the removal of the outside bandage, Mark is now allowed to take showers. This hasn’t been as big of a deal as he anticipated because he felt the sponge bathing he was able to do worked out pretty well. I shampooed his hair periodically.

The removal of the staples was a non-issue because there were no staples.  Mark’s incision had been closed with a single internal stitch that will dissolve, and steri-strips on the outside that will curl up and drop off. Overall we both think his scar looks good, much better than I, for one, had anticipated.

We didn’t actually see the surgeon at the appointment, but saw his physician assistant. Later, Mark’s physical therapist said that it was a good sign that the assistant did not think it necessary to call the surgeon into the room. The physician assistant gave us prints of the x-rays of Mark’s bionic knees.

Bilateral knee replacement - front view, Two weeks post surgery.

Right knee- side view

If you look closely at the above picture, you can see that the knee cap also looks like it was resurfaced.

Mark is experiencing a little numbness on the outside of his knees. It is noticeable, but not particularly problematic. He knew this was a possible side-effect of the surgery.

Mark continues to do the physical therapy exercises here at home: front leg lifts, side leg lifts, and bending knee lifts (not the proper name for this exercise). He does them three times a day, 50 repetitions on each leg. He’s started adding leg weights to his ankles.

We are grateful that Mark’s recovery has gone so quickly. Last week the woman beside him at therapy was four weeks post-op from a single knee replacement and was still using a walker. I don’t think Mark’s recovery made her feel better. We can’t really explain it except to say that Mark had an excellent surgeon, he’s relatively young, strong, and healthy; and he prepared himself by doing the recommended exercises prior to surgery; and faithfully continues to do them now. And he is extremely hard-headed determined.

And maybe an angel or two in heaven are looking out for us.

You can find links to the entire series on Bilateral knee replacement surgery here.


Bilateral Knee Surgery – Two weeks post-op and walking with a cane

Two weeks ago today I was sitting in a hospital waiting room while Mark was having his three-hour total knee replacement surgery. Last Thursday Mark put away his walker and started using a cane. His physical therapist continues to tell him he is way ahead of schedule on his recovery. We don’t really have an explanation for that except that his surgeon did a great job with the most updated techniques and appliances, and Mark is determined and has been aggressive with following his recommended exercise routine. I’m thankful for how fast he is recovering and proud of him for how hard he is working at it with little complaint.

Last Friday at therapy he was told he could cut back even further on the CPM machine, but the therapist did not want to  make the decision to stop it, and wanted to wait until the doctor released him from it. So Mark is using the CPM 2hrs on the left leg, which is a little stiffer, and one hour on the right every day.

Mark is finished with the blood thinner shots. He still takes the Lyrica and Celebrex pain meds every day, but has cut way back on the narcotic Percocet and primarily uses it at night if he has trouble sleeping.

He will see the surgeon on Wednesday for his two-week post op appointment. After that we hope to be done with the CPM machine. Mark also hopes to be done with the tight hose he has to wear to promote blood circulation in his legs. He will undoubtedly ask the doctor when he can drive. He also wants the doctor’s advice about when he should back off the other pain medicines. On Wednesday we expect that Mark will have his staples removed and we will see his incisions for the first time. He has been wearing some kind of silver-embedded bandage on each knee since surgery that is supposed to prevent infection. And finally, Mark should be able to shower following his doctor’s appointment.

Mark has three physical therapy appointments this week and again next week. Then we will find out what comes next. The time has gone fast for me so far, but the day of surgery seems a great distance away in my mind. It’s a funny thing about time.

You can find links to the entire series on Bilateral knee replacement surgery here.


Weekly photo challenge: Ready

Arthur the healing dog is ready to do the laying on of paws hands to help heal Mark’s knees.


Now I know — a story of mothers, daughters, caregiving, and Alzheimer’s

When I was told Mark couldn’t be left alone for two weeks following his bi-lateral knee surgery, I started planning ahead, making sure I had a good grocery list, trying to foresee anything we might need—at least enough to last until the next time my daughter came or I could get my son to come home, or Mark had an hour of therapy.

I thought about my mom and how, since she’s been a full-time caregiver for my father with Alzheimer’s, she’s had to plan ahead in detail. She can’t leave Dad alone to dart out and get what she runs out of on the spur of the minute. Mom relies on my sister who brings her supplies from Sam’s Club, and periodically calls her whenever she is out shopping.  She relies on me to get those unusual and expected things like salt for her driveway or a new doorbell when the old one broke. And she knows she can always ask either of her two home health aides in a pinch, but that only works on weekdays as Mom goes it alone on the weekend. So Mom plans ahead.

I guess you might say this brief period of caring for Mark has given me a better understanding of what my mom is experiencing.

In the early days of Mark’s care when he was still in the hospital, and his first days at home, my back and arthritic knees and hips screamed out in pain every time I had to lift the CPM machine, or lift Mark’s leg into it. Every time I had to lean over the bed to pull on his therapeutic hose and it was difficult and painful, I thought of my mom and all the physical pain she endures when she has to do all the things she has to do for Dad.

You might say in this brief period of caring for Mark that I felt solidarity with my mom and the challenges she faces.

At first when Mark was recovering from the trauma of the surgery and the influence of the medicines and he had no room to be concerned about anything but his own recovery, and he wasn’t able to stay awake for more than an hour at a time, and all the decisions and responsibilities for him, and us, rested on my shoulders, I thought of Mom.

Mom used to complain, “Your dad doesn’t care about me. He doesn’t care about how hard this is on me.”

And she might have been right. Dad might have been past the point of caring about more than himself as he struggled to survive in an Alzheimer’s world full of disability, confusion, and disorientation.

I knew how insignificance felt for one or two or a small handful of days. Only.

On Sunday when Mark had only been home from the hospital three days and I was still doing a lot of the care for him, I went into our great room for a moment. Anna, who had come home for the weekend to help, was curled up on the loveseat, covered with a soft throw, using her iPad with Arthur snuggled at her side.  The early morning light was streaking in from the windows high up on the wall near the peak of the cathedral ceiling. I could see the sycamores I love in the tree line beyond.

I wanted a moment of normalcy. I wanted to talk about, to think about, anything besides CPM machines, ice coolers, walkers, medicine or shots.

I sat down on the sofa and asked, “How is your job going, Anna?”

As she started to explain what was happening and how she was feeling about things, I thought of my mom. I thought of all the days I’ve gone to Dayton and sat at her kitchen table with her, eating lunch and talking while my Dad napped in the bedroom. I thought about all the simple conversations we’ve had about anything but walkers and lift chairs and hospital beds.

I know my situation is short term, and has already much improved. I know my mom’s situation has an uncertainty about it that I haven’t experienced. What will happen next? Will I be able to manage? Will I be able to keep him here? How long? I don’t have those questions.

I know there are many differences in our situations. They are not the same.

I also know that when I am free to go, I will visit my mom again, bring her lunch, and sit at her kitchen table talking about anything but . . .

Now I know how important that is.


A tale of determination, confidence, and the clankety clank of a walker

What in the world is he doing now? I wondered as I woke up for the second time this morning to the sound of Mark’s walker clanking down the hall to the kitchen.

The first time I woke was at 5:00 a.m. when, with the same vigilance as a new mother’s response to the cries of an infant, I heard the movement of Mark’s walker and opened my eyes to see him sitting on the side of the bed.

“What are you going to do?” I asked.

“I’m going to go sit in the recliner in the great room for a while.”

“Just be careful. You can leave the door open,” I said as he left the room to the clankety clank of his walker. I wanted to save him the trouble of trying to manuever around and close the door behind him, but I also wanted to be able to hear better what he was doing, or if he needed me.

Ever since his appointment with out-patient therapy yesterday, Mark has started pushing his boundaries. Like the therapists in the hospital, his therapist here, whose name is Chris, was pleasantly surprised. “Does he always heal this quickly?” Chris asked me at the end of the session.

Chris told Mark that he is well ahead of schedule on his recovery, and that in fact, he is ahead of where many, if not most, single-knee replacement patients are when they come in for their first visit. We’ve been told all along that double-knee recipients lag behind in recovery. And at first in the hospital I believed it when I saw the single-knee patients trotting down the halls. I even wondered, was this a mistake?

All of this praise from the therapists feeds Mark’s ego, I’m sure, but it also feeds his determination and lack of patience I’m afraid. When Mark left the hospital his occupational therapist looked him in the eyes and said, “I want you to hear what I’m saying. You’re the type of person who comes back to the hospital. I don’t want to see you back here.”

So I listened this morning until I heard the cessation of the walker’s clankety clank followed by the squeak and click of the recliner foot rest locking into place. Then I rolled over and went back to sleep.

When I woke up the second time about an hour later to the sound of Mark and his walker moving down the hallway to the kitchen, I wondered, what is he going to try to do now? I heard the refrigerator door open. I heard the microwave door open and close and buttons being pushed. I got up and walked to the kitchen.

Mark was on his way to the refrigerator holding an empty glass in one of his hands while also holding onto the walker. “How are you going to carry that when its full?” I asked. He told me he didn’t want to wake me up.

Some of these tasks would be easier if he would have kept the basket I bought for him on his walker, but initially he didn’t like it, didn’t want it, so I took it back off. Yesterday he started carrying things like his book in his hand along with the walker.

“Why don’t you go ahead and sit down,” I said, “and I’ll take it from here.” He had an English muffin in the toaster, a stick of butter in the microwave to soften, and of course the empty glass for milk. I got him set up with his food and drink and went back to bed.

“Clankety clank,” back down the hall he came a little while later. I opened my eyes and saw him carrying his walker a few inches off the ground as he walked into our room to the bed. He was trying to be quiet.

I always knew Mark had great determination when he set his mind to something. But this surgery has provided an opportunity to display some of his finer human traits in a very visible and measurable way.

See what I’ve been up against all these years?

Now in his own defense, yesterday Chris told Mark to look for a cane and bring it back on Friday for his next appointment. So the days of the walker are numbered. He also can put the braces away; he doesn’t need to wear them at night anymore. Here’s the best news; Chris also told him he can cut back on his time in the CPM machine 50%. That means only a total of 6 hours a day instead of 12. GREAT news.

Finally, echoing the hospital O.T., Chris told him, “Don’t get over confident.”

Lord, help us all.

 

You can find links to the entire series on Bilateral knee replacement surgery here.


Bi-lateral knee total replacement surgery — One week later

This time last week my daughter Anna and I were waiting to see Mark in the recovery room following his knee surgery. Today Mark is sitting in the recliner beside and slightly behind me. He just this minute asked me if I knew where his wallet is. So he’s starting to perk up and re-enter life.

Mark has made incredible progress, which in turn has helped me a lot. Last week I had to lift his leg into his CPM machine in the hospital, after I carried the machine to his bed. (The nurses were not able to keep up with the schedule we were trying to keep of getting it on each leg 6 hours every day, so I often just did it myself.) I had to help him with his exercises on his right leg, because he wasn’t able to lift his leg at all. His left leg did well from the beginning. I had to attach the cooling pads to his legs. Basically, the nurses and I had to do everything for him. Everything I did for him, I did bending over his bed, which quickly took a toll on my lower back.

Today, Mark put his own legs in the CPM machine, he got up by himself to use the bathroom and give himself a sponge bath (no showers until after he sees the doctor on the 15th). He got his own clothes (from the basket I’ve left on the bench in the room). He completed all of his exercises by himself. And importantly, he put his therapeutic hose on all by himself. (Halleluia, praise the Lord).

He is taking care of his own medication needs. He is mentally alert and reliable. He’s got his care needs down and is able to perform his exercises physically. We’ve come a long way in a week. I’m basically back to just moving the CPM machine to and from the bed, keeping his ice machine stocked with frozen water bottles, preparing and serving meals, cleaning up after him, laundering his towels and clothing, and refilling his water and beverage glasses.

Mark is using the CPM machine at 120 degrees, which is the goal. He started at 60 degrees last Monday. We’re both looking forward to removing this device from his therapy and our lives as soon as possible.

I like to stay positive and not complain, but that wouldn’t be honest or helpful. I flatter myself by imagining that some day these posts may be helpful to someone else. I would be remiss if I gave everyone the impression that this has been an easy week, although it hasn’t been as difficult as I imagined it might be.

Mark has been pleasantly surprised that he hasn’t had as much pain as he anticipated. I have been pleasantly surprised that he is able to get himself up from a sitting position, in and out of a car, and is able to walk without any kind of assistance.

Neither one of us had planned on his physical reaction to the surgery and/or medication. With the exception of the day of the surgery when he first got into his room and was ravenous, he hasn’t had an appetite, and getting him to eat the nutrition his body requires to heal has been an ongoing challenge. Initially he had severe heart burn and acid reflux, now he suffers from chronic nausea. I think the nausea is probably due to the iron supplements he is required to take to boost his hemoglobin from the blood loss.

Mark feels well enough now to be losing patience with lying on his back on the bed with his leg in the CPM machine 12 hours a day.

I hadn’t planned on him being irritable.

Mark hadn’t planned on wearing the two leg braces overnight to prevent him getting his knees in a prohibited position or twist of some sort, but that often also prevent him from actually sleeping.

I hadn’t planned on the physical stress the care-giving would place, on my knees, hips, and back.

Mostly I feel much calmer than I did last Monday, and happy that Mark is well on his way to a new set of functioning, and hopefully eventually pain-free knees.

He goes to outpatient therapy for the first time today. Wish us well.

You can find links to the entire series on Bilateral knee replacement surgery here.


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