January 2013: The End

I didn't have much to post throughout my recovery. Major milestone: election day, November 6, two days short of my 4-week anniversary. I  stood in line for at least 20 minutes and went out to lunch with friends. I felt good and quite strong.

 On November 15, I returned to work for 6 hours a day through the day before Thanksgiving the following week, when I had something of a meltdown. I arrived home on that afternoon after running a couple of errands in Highland Village after work. My left tibia was burning and the entire knee was swollen. The following week, I spent a lot of time on my feet at an all-day meeting, and my leg looked bruised below the knee. For the next 10 days or so, I went back to regular icing and began to get better again.

My 2-month appointment with Dr. Arendt was December 18. By that time I had returned to poster child status. Seems I might have "overdone" the rehab and suffered a "bleed", which explained the bruising of my leg. She removed a stitch that had worked its way through the skin, in the same area that had erupted in pain the previous month.

I've been a little more conservative since then. I walk every day during my lunch break and my endurance is increasing. I had my first pain free night at the end of December and I sometimes go several hours without thinking about my knees. I'd say ... success!

Two and a Half Weeks

At physical therapy this morning I asked Stephen to look at how long it took me to get to 110 degrees last time round. A quick glance indicated that I was at a "forced" 115 degrees 5 weeks after surgery. Today, I easily bent my knee to 110. I can do the stationary bike quite easily. All other exercises are much easier than they were 3 years ago. Still, I am quite tired now in both mind and body, though elated too.

Since we've had good, dry weather, I've been walking without a cane outside since Friday afternoon. However, I had a setback on Friday night, getting into bed. What kind of idiot would jump into bed and swing her leg over, toes pointed down? I caught my toes between the sheet and the blanket and my foot killed all the momentum in my leg. Pain shot through my entire knee -- almost unbearable, reminiscent of my dozens of injuries. However, it was only a little more painful than (the new) normal on Saturday and relatively good yesterday. This morning, it was fine.

My incision has turned into a scar that looks recent but not disgusting. Because I wear shorts to physical therapy, people quite regularly ask me about it, somewhat apologetically, but everyone has questions about my surgery and recovery. I think I'm very lucky: best surgeon, best aftercare, time to work on recovery, building strength and increasing range of motion.

Day 15

I've been surprised that one of my biggest challenges is adapting to a leg that can now be straightened to the horizontal. It had been bent (at least 10 degrees, often more)  for several years and I'd adapted walking, sitting, navigating stairs etc. to compensate for the bent leg.  My physical therapy exercises stretch the backs and sides of my legs and I'm stunned that the simplest activities, like standing on my toes, hurt! Today was better than yesterday. Although my physical therapist, Stephen Austria, has told me to hold off on doing stairs in the normal, reciprocal, way for now, I can feel that I'm almost ready to do so.

I went for a good walk yesterday but woke up to rain and snow today, so I didn't venture out except to go to lunch at Baker's Square with Bob. I'm not willing to risk slipping on leaves just for the sake putting on a few steps. I'm eager to walk a mile; maye tomorrow.

Bob and I are betting on the World Series and on the Vikings game tonight. He is risk averse, especially after I collected $1.00 last night, so I gave him 10 points on a Vikings win (Vikes favored to win by 7).

Sainted: People of UMMC

Pioneer Press, Sainted & Tainted, October 20, 2012 - My letter is the last here:

http://www.twincities.com/opinion/ci_21812456/when-your-cards-been-declined-and-youve-already

I was recently treated at the University of Minnesota Medical Center (UMMC) for total knee replacement surgery and recovery. I was in awe of the superior care I received and the expertise of those who provided it.

Ninety-seven University of Minnesota physicians were named 2012 "Top Doctors" in Mpls.St.Paul Magazine.

Orthopedic surgeon Dr. Elizabeth Arendt, a perennial "top doctor," and her team gave me a knee that worked better than the old one only a day after surgery. Everyone -- nurses, nursing assistants, technicians, occupational and physical therapists, other staff and volunteers -- treated me like their only and most important patient.

Sainted: the fine people of UMMC who serve our community with professionalism and a firm commitment to excellence in patient care.

Catherine Hennessey, St. Paul

Comeuppance

I spent the first part of the week waiting for the boom to fall, and when it didn't, I redoubled my rehab efforts. Unfortunately, I couldn't get a second physical therapy slot after Tuesday's first session, even though I was waitlisted for any time, any therapist. Being experienced at this gig, I designed my own "next steps"  and was soon exceeding even my own expectations. I impressed myself with moves I haven't been able to attempt for years, including a figure skating spiral, on dry land, of course!

After repeated successes, my hips felt a little tired and sore yesterday evening, so I settled for the CPM machine instead of floot slides and leg lifts. I felt the back of my calf and thigh cramp up, so I quit and went to bed. Today I got up bright-eyed and energetic, ready to head out with Bob to put the boat and Corvette in storage.

When I was putting on my left shoe, I felt this awful pain shoot down my left thigh and calf. Like a ragged lightning bolt. Fortunately, I don't think I did any damage and was fine all day, except that I skipped the fancy moves and took a day of rest. I'm feeling quite a bit less cocky than I did a few days ago.

Not Much to Report

I'm happy to report that I don't have much to write about. Physical therapy yesterday was uneventful, but I was happy I went. I had forgotten the correct way to do leg raises and had already developed some compensatory bad habits getting up from a chair or lying down.

I was amazed to be back in the gym and so far ahead of where I was last time. I got on the bike at the end of the session and think I could have done a full rotation. However,I was a little tired by then and thought (sensibly for once) that I'd wait until next time. I set up my PT schedule through Thanksgiving, with morning appointments now and afternoon slots after I go back to work on November 15.

The Institute for Athletic Medicine is a busy place: I had to be waitlisted for 3 sessions this week and next. The day was beautiful and I enjoyed being outside for much of the afternoon. We went to a ride (in the car -- wish it could have been on my bike!) around Lake Nokomis. I walked twice as far as I did on Monday, a modest couple of blocks from our house to Prior Avenue. By this time next week my goal is to be up to a similarly modest mile.

Our neighbors, Tom and Ginger Kueppers, brought us an elegant dinner on two trays: sphaghetti casserole, bread sticks, salad, dessert. We visited with Bob's son, Scott,on the deck until late in the afternoon, when the day was beginning to cool from it unseasonable warmth. We watched the presidential debate. While I'm thrilled to say that my recovery is uneventful, even I am bored reading this blog. I won't post again until I hit some kind of milestone.

Eté des Indiens

Today`s brilliant light made me think we are enjoying early Indian summer. Leaves still cling to the trees and the colors seem even more vibrant in the sunshine. I have not had time to enjoy the beautiful days of autumn for many years so I am savoring the season.

I ditched the crutches today for my cane. Went for a walk up the block and back. Decided that my full-time job has to be rehab. I`m doing at least 6 hours a day in the CPM machine and adding stretches and other exercises, as I think of them. I start physical therapy tomorrow so I should be able to add a little more structure to my routine. No fear of ice or debilitating heat. The fall is a good time for recovery.

Just Another Sunday

Made it through the night without any Tylenol. Not too much pain, but not much sleep either. I was wired from the day's excitement, such as it was. Finally got up just after 5 and took a shower. What a great feeling! No trouble with the tub, but I'm mighty careful. I can see how people fall in the tub and ... that's it! Fortunately, I was not one of them today.

Had a little argument with Bob this morning because I insisted on going to 7:00 o'clock Mass and he thought I should stay home. I had no trouble, although I was afraid of tripping someone with a crutch when I went to communion. We had breakfast at Joseph's and I spent the morning at home with my leg in the passive motion machine and ice pack around the knee. This afternoon's visit to Fort Snelling State Park yielded only one photo op: a turtle that should have been hibernating.

My sister Marilyn and I were both a little concerned about the large amount of Tylenol I was taking (3,000 mg daily). I cut the dose by skipping last night's midnight pill popping. Today I've had 1500 mg and tomorrow I'll see what happens with 500 mg morning and evening. I suspect it will be sufficient. I'll talk with my clinic about this tomorrow morning.

I feel good; I can walk unassisted in the house. Not too much pain. I'm being waited on by my husband. Can't believe the surgery was Thursday afternoon. Pretty lucky.

Home!

I was ready to leave the hospital at about 2:00 p.m., when the occupational therapist gave me a "pass" after I did everything that both she and I could think of, including getting in and out of office chairs.

Fired up the CPM machine for much of the afternoon until my kneecap felt "burned". Figured I might as well be ready to spring when my discharge was complete. I was so happy to see Dr. Arendt at the end of the afternoon, when she dropped by to see her patients before leaving for Europe this evening. Our meeting was very emotional. I am so grateful to her and she was thrilled to see me walking without crutches only 48 hours after surgery.

More waiting. Physical therapist Carla Lewis came by to wish me well. My night nurse, Glenda, told me that today is her birthday. Finally, discharge. More waiting for transport until my favorite, Brandon, arrived and correctly identified Bob as the guy in the red SUV.

I hopped, literally, into the truck and we were home in 15 minutes. Set up the equipment in the living room and lined up the acetominophen, Celebrex and gabapentin (only 100 mg twice daily, for those wringing their hands).

I've been drinking caffeine free coke and water all evening. Life is good!

Gap Between 2010 and 2012

Bob's daughter, Sonia Muñoz, visited this morning while I was doing my physical therapy. She remembered that I was "out of it" the last time I had surgery. I remember that visit and, in fact, I told everyone last week that I would probably not have the mental faculties to appreciate visitors while in the hospital.

Turns out that we had a great visit and I loved hearing about the wedding yesterday of Linda Hughes and Mike Longley. My knee bends beyond 100 degrees already and I had to be told to go up and down stairs one leg at a time, for now at least, until the incision heals. I can walk up and down stairs fairly normally but I'll wait until I get the OK to do so. I walk easily between my bed and the bathroom and tolerate the CPM machine for two hours at a time, whereas in 2010 I couldn't stand using it at all.

Some of the changes I know about:

• quadriceps tendon isn't touched during surgery, as it was last time. This may explain my ability to lift my leg right away.
• joint was loaded up with pain medication and antibiotics right after surgery.
• pain medication was much lighter than the last time.
• acupuncture
• I practiced all the moves I thought I would need after surgery.
• My right knee is strong.
• I'm very lucky!

I interrupted this post to work with Katy, the occupational therapist. We tried everything either one of us could think of, including getting in and out of a tub shower which I can take as soon as tomorrow. I figured I shouldn't mention changing cat litter! I hope I can offload that task for a few days.

The chaplain intern, Matthew Dahl, prayed with me but, as hard as I tried (without asking a direct question), I couldn't find out where he is a seminary student. He made the sign of the cross with me after I told him I'm a Catholic, but I wasn't sure of his Christian denomination from the style and content of the prayer. I do know he's at the beginning of his seminary studies and he seems pretty good to me.

Nurse Anne told me I'm set to go as soon as she has my take-home drugs. There's quite a lot to load into the car, including me. I tried to put on jeans but they were uncomfortable over the dressing so I changed to my old black cotton stretch pants. A lovely look that no one will be imitating anytime soon.

Walking without Crutches

Went to bed at shortly after 10:30 and I think I would have slept all night despite being wakened from a very sound sleep at midtnight and 3:00 a.m. I can't remember the last time I slept so well.

I got up at 6:30, detached myself from the portable ice machine and walked a few feet to grab my crutches. I feel terrific. The physical therapist and the nurses expect me to be discharged today, not tomorrow -- a day early. We'll see what happens.

Feeling Good!

I had a good day. Dr. Arendt's orthopaedic resident visited me before 7:00 a.m., just before a 12-hour surgery marathon. I realized when he reviewed the non-narcotic pain medication plan with me that the care team had given a lot of thought to my unpleasant experiences with Vicodin, hydrocodone and other hard-hitting drugs..

They designed a schedule with medications consisting mainly of  Tylenol and Toradol. Miraculously, the medications worked and I felt clear-headed and healthy all day. I did leg lifts early in the morning and walked quite a bit. I can bend the knee to 90 degrees already and I think I feel less pain than I did when I was loaded up with the big stuff. I was offered, and accepted, acupuncture. I don't think it changed anything but it was an interesting experience.

Bob and Chris visited me at lunchtime and I felt sharp enough to be engaged in the conversation. Late in the afternoon, I moved from 10th Floor (surgical\medical, used for overflow orthopaedic surgery parking), to the Orthopaedic 8th Floor. It's only about 8:30 but I feel ready for bed.

The resident came back to see me at the end of his long day. He was a little surprised and pleased that I was so well, and wondered out loud if other patients are "over-medicated".

Pain Management

Got through my first night. I watched the debate, the Daily Show and much of Jay Leno before turning off the light and I slept off and on until about 4:00 a.m., when the hospital begins to come alive.

My wonderful nurse, Ivy, who helped me get through the night. I feel a lot better than I did with my first knee replacement, mostly because Dr. Arendt took me seriously when I asked for as few narcotics as possible. The main pain control drugs are acetominophen and ibuprofen (in large doses, of course).

I was on a liquid diet until just now, so I've had only three popsicles since dinner on Wednesday, so I'm feeling a little hungry. The hospital has implemented a "room service" program that allows patients to order from a menu whenever they want.  Had breakfast (hard boiled egg, yogurt, small bran muffin and coffee (luxury!). Carla the physical therapist had me out for a walk and warned me not to "overdo" -- I've heard that several times. I'm starting to wonder whether my chart doesn't have some kind of note on it.

The morning is beautiful. I see the Mississippi River from my window, and other "points de repère" that I should know but don't. Bob will point them out to me later.

I like the constant activity and the highly effective, competent staff, Such teamwork and professionalism don't happen by accident.

Made it!

Arrived at the hospital at about 11:15 and "processing" started almost immediately -- boring for Bob, mostly interesting for me. Terri, one of  the nurses in pre-op/post-op, is a felow Nativity parishioner who goes ro Saturday evening Mass, as we do. I recognized many of staff from the last go-round and my surgeon, Dr. Arendt, mentioned to the care team that she has known both Bob and me for many years. The prep was actually very pleasant and I was in the OR shortly after two.

I first became aware of the time around 5:45 and felt a little disoriented; I was dreaming about work, I think, dealing with yesterday's very interesting problems, or at least that seems to be my memory. The two nurses, Kirk (?) and Terri, told me that we had a plan to manage pain with as few narcotics as possible. Seems to be working so far, and I am so grateful. My mind is clear, despite little sleep last night.

I'm typing this wirh the plastic sensor on my finger, and will have that until tomorrow. Feet are being squeezed  with a boot that inflfates and deflates with rhythmic regularity.Blood pressure registers every 10minutes or so. I've had a couple of popsicles and a 2 half cans of ginger ale. I'm watching the Biden Ryan debate - lookin' good!

Early Start on Game Day

I should have simply stayed up last night instead of attempting to sleep. I was wired after a busy day that included a lot of diet coke guzzled at lunch and finally gave up at about 3:45 a.m. The cat was not happy to be disturbed so early in the day.

One plus is that I was able to enjoy coffee as long as I finished it before 5:30. I'd been afraid of going the whole day without my morning caffeine fix -- something I haven't done for years, maybe decades. Now, nearly two hours later, I feel pretty good for someone coming off a sleepless night.

I'm looking forward to leaving for the hospital! I have to be at the U by11:45, for a 1:45 start, 15 minutes earlier than originally scheduled. Very grateful for all the good wishes from work colleagues and Facebook friends.

Here We Go Again ...

My right knee was replaced by Dr. Elizabeth Arendt at the University of Minnesota on January 14, 2010. Actually, the left knee was the original candidate, but a last-minute crisis with the other knee led to a change in plans. My knee problems have bored family and friends for over half a century now: I hope they will soon be behind me. I feel very hopeful because of the successful surgery on the right knee -- it is stable and painfree. I am amazed that I can step into a boat or off a ladder without worrying that I will fall down without screaming in pain from a dislocation.

Surgery is scheduled for Thursday, October 11, at 2:00 P.M. I'm superstitious enough to wish that it were 10/11/12 at 13:00!