3 months on...

29 April 2016: 3 months post op

It is Autumn now and three months ago I had a total replacement of my right knee. 

As I was walking into the swimming pool this morning I was greeted by a nice older man in his 80s who I chat to when we are in the gym on our exercycles. He is waiting for a knee replacement but can't get on the public waiting list for the operation and he doesn't have health insurance. He called out to me cheerily and said how well I was walking and what a difference he could see in me since the surgery. He said "your whole face looks 10 years younger without the pain you had before". 

It was a great way to start the day and a good start to reflecting on progress to date. Three months on:

- I am walking around the house without any crutches. I still use walking poles when I go out for dog walks with Lewis. I can easily walk 3-5km a day. 6km is still a bit too far.

- I am moving well except when tired I tend to limp - but the walking poles help keep me on an even keel

- the post op swelling and bruising has reduced significantly and the scar has healed well but is still creepily warm to touch

- the pain is much reduced. I get a deep kind of bone pain in my right thigh when I have overdone things. I still find it hard to stand still and chat to people - I need to keep moving rather than stand in one place 

-  my new knee hair regrowth is rampant

-  my walking and cycling in the gym is getting speedier and my I am able to do more complex and vigorous aquajogging. I can easily cycle 7km but 9 km is at present, too far  

- my cooking is improving - I have even managed to cook a couple of meals for friends. I tried less ambitious dishes that I could pre-prepare and that worked out well

- I can sleep through the night without pain

- I can get up off the toilet without having to lever myself up using the walls. (This is great progress!)

- some days I feel like I could dance!

I had a visit with my surgeon on Tuesday this week. He was also really positive about my progress. I had been feeling a bit disheartened that I am not fully able to enjoy the benefits of the new bionic knee because of the arthritis in my left knee gets sore when I get too active. He said he was expecting me to say that - given that my left knee is also very arthritic. He said that my new right knee would take another 6-12 months to get into peak condition. I should expect to still feel the bone pain and also the heat from the scar for quite a few more months. But that over time the new knee would become the dominant knee and reduce the strain on the left knee... So here's hoping!

I also really hope that my 80 year old gym buddy also gets a chance to have his knees replaced and that he has the chance to sleep through the night and to enjoy life again.

Weeks ten to eleven

15 April 2016: Eleven weeks post op.

I have returned from my brief visit to England.  Spring was in full force in London with daffodils popping up everywhere.

The meetings in England were fantastic. I feel like I am back into my work "groove". I met up with people I hadn't seen for a few years and met some really great new people. I am now on the international Board of Cochrane.org and it is great to spend time with people who are deeply committed to evidence- based healthcare and volunteer their time to demonstrate which health care services work.

http://www.cochrane.org/what-is-cochrane-evidence

The plane travel to England worked well.

I paid for an upgrade so was able to stretch out on the plane and to have  some comfort. Emirates is an ok airline - not super duper - but they have some good bargains. Their flights from Auckland to Dubai are incredibly long - 16-17 hours in the air, so it would have been torture to have had my leg compressed in economy class for such a long time.

Emirates were very considerate with their mobility assistance arrangements and I was so pleased to have wheelchair assistance in the airports. The other cool thing they offered was a free driver service to your hotel and to the airport so that meant I didn't have to lug my bags onto public transport. 

The down-side is that the trip was really physically demanding. My new right knee works well - but got tired especially during long days of meetings. My left knee has also suffered and is now very sore. 

When I left NZ I was walking pretty much unaided.  I took a crutch with me as a back up plan to give me support when I was standing. However, as I picked up the pace in Oxford and London and started walking longer distances (going to restaurants with colleagues and very slow moderate sightseeing), my left leg just got sorer and sorer and I became completely dependent on the crutch limping.  

I have been using an app on my phone for tracking my walking distances. I find it quite informative.

I was really mindful of not "overdoing" things on the trip and so I organised myself so that on my non work days I made small forays out and went back to my room for a rest or to sit quietly in a cafe.  I didn't do many of the usual things I would do on a trip (like go shopping for hours, go to museums and galleries etc). My stamina has really gone downhill. On a couple of occasions when I was out looking in shops, I got so sore and overwhelmed I just plonked myself down on stairs in order to sit for a rest. I fear I may have had a somewhat grey ashen appearance as shop attendants usually hovered around offering me glasses of water.

The appearance of my crutch and hobbling did have some other surprising impacts I hadn't foreseen. People I was meeting for the very first time perceived me as "disabled". Strangely, I hadn't anticipated this. In my mind, I have a temporary health situation that is going to resolve. Ok, so I have been masking the impact of arthritis in my life for the last few years - and I know that I still have arthritis in my left leg that is going to have to be addressed with surgery - but it didn't occur to me that I was dis-abled.  In most situations, people were very welcoming. I had a great meeting with the Cochrane Consumer Network people who were awesome. They have lived experience of significant health issues and they each contribute to developing reliable evidence that can inform health choices. I met a wonderful woman on the group, Anne, who also has arthritis and over the days we had together we had some fantastic talks about how arthritis affects your life. (For example, I hadn't realised how common it is for people with arthritis to have dreams about wanting to break their bones to stop the pain of having the bone pain and rigor. I had been having that dream for about a year before my surgery). 

People were also very considerate in meetings and went out of their way to help me put my leg up (we had boxes and chairs pulled into service) and they were very kind.  On the streets I found people very thoughtful - opening doors for me and being helpful. Most new people meeting me didn't mention the crutch and assumed it was a permanent feature of my life.

Since getting home I have been back exercising in the pool (which feels great). On Tuesday I started chatting with an older lady who must have been in her 70s and she had a knee replacement one week after me. We compared war stories and scars. She finds the water exercises very exhausting and is still finding walking hard. She is however delighted to be painfree.

For regular readers of this blog, here is the latest photo of my scar.

The haematomas are still quite prominent although the one above my knee is starting to soften. The lady in the pool didn't have any haematomas but does now have super hairy legs.

So - it is nice to be home. I am hoping that the sore left leg will resolve and keep pace with my lovely new right knee. I am feeling energised by my travels and the people I met. And in retrospect - I think I am still making progress and one day soon I will be able to disengage my crutch and walk unaided.

Nine weeks on - reporting in from England

3 April 2016 - 9 weeks post surgery plus a couple of days

I had expected to build-up to travel slowly. I expected that the first time I would be testing out my new knee would be travelling to a conference in England in June. So the current invitation to travel to England to attend Cochrane meetings took me by surprise.  

I can now report on how well my planning for this tour has worked:

- the graduated compression stockings were useful on the flights. My legs didn't swell and they were "good to go" when I arrived

- the wheelchair and mobility services provided in airports were well organised and reliable. It was initially a bit embarrassed to be in a wheelchair when I had spent the last two months trying to walk independently - but by being ushered through bustling airports was a massive relief. I would highly recommend this service

- I brought a crutch with me rather than a more subtle walking stick. I have been relieved to have the crutch to lean on - literally and figuratively. It has been great to use while standing up and talking to people at conferences. It has reduced my limping when I am tired. Plus it has been a useful signal to people that I need a little more space, I walk a little bit slower and that I need to take a bit of care with my mobility. People have been very kind and courteous - opening doors, finding chairs for me and being thoughtful about giving me directions with easier access.

I have tried to manage my free time carefully - taking taxis and hop-on hop-off buses so that I can get out and about and see new things but I don't waste my walking energy by getting lost and meandering around.

Yesterday after running some errands, I ran out of steam and went in search of a cab.  I was pleased to be invited into the Morse bar at one of the flashiest hotel in Oxford while the concierge hailed a cab for me.

During this trip it has been nice to meet  up again with old friends and colleagues - I had been a bit shy about telling people about the arthritis issues I was managing so now I feel no pressure to pretend I was not in pain.

I have also "knocked off" one of my big fears. I have just given a 20 minute conference presentation. I didn't use my crutch and was able to stand up and move around easily while talking. Whew!

I have significantly increased my walking. I have been now walking between 4-6km a day. In addition I have been standing around chatting (which takes a lot of energy). I was talking to Peter about this and how tired I am feeling and he pointed out that it is probably at least a year since I was able to walk 6 km - so it isn't surprising I feel tired.

I am finding ascending stairs quite hard. Last night we went to a dinner at Balliol college in their great hall. It is a huge and impressive building with a steep flight of steps. What I hadn't realised was that a trip to the bathroom involved going down and up the stairs (in the rain and darkness). And it is pretty near impossible to move quickly with crutches.

I am off to London this afternoon. It will be interesting to see how I will go in a larger city with vast differences and also larger numbers of people on the street.

My scar is coming along well although the hair is growing back quite thick and lush.

So - even though I am feeling tired, I am feeling good about getting around and managing travel. And I am pretty pleased that my capacity for distances is surely but slowly - increasing.