6 month+15 month post op reports

May 2017: Six months post op Left knee replacement and 15 months post op Right knee replacement

I am feeling very pleased with my new knees. To celebrate 6 months with two new knees, I took the dog on a series of walks one Saturday and clocked up an all time record (for me). Over 18,000 steps or more than 11km.

I realise that lots of other regular folk without knee issues might think this isn't a huge distance - but it must be more than 5 years or more since I was able to walk this distance with relatively little discomfort.

In the last three months since my last blog, I have also crossed off a few other milestones. In March/April I travelled to Europe. This time I navigated my way around huge airports without the assistance of a wheelchair, wandered city streets getting lost and found - and I was even able to enjoy shopping. 

It is years since I could wander into a store and browse around. I would usually get frustrated if I had to spend more than 5 minutes in a shop or standing in a queue. This time I estimate I queued for approximately one hour to get up to the roof of Milan cathedral.

The scars are all healed and the swelling has significantly reduced. The right knee is still discoloured around the scar and I am hoping the marks will fade with time. The right knee gets more fatigued than the left - I guess it is stronger. One of the amazing things that has happened is that I no longer have flat feet. Now that my knees have been replaced, my legs are straight and my feet are normal. i no longer need orthotic inserts in my shoes (hurray!). I find that my body is still adjusting to the new ways of walking upright and without a limp, with variously my hips, ankles and back feeling sore for a day or two, then resolving.

I was looking back at the very first blog I write in January 2016. It is great to see what a change the surgery has made:

- Peter and I take the dog for a 4km walk every morning

- I still get some discomfort with knees getting tired and take panadol every so often and or a low dose anti-inflammatory but it is probably about 15% of what I was taking a year ago  

- my cycling is still a work in progress as it is winter and I am more of a warm weather biker - but it is wonderful that my feet now sit on the bike pedals. Before surgery my knees and legs were so contorted with arthritis my feet couldn't sit flat on the pedals or slot into the stirrups so it made biking painful and awkward

- I have been moving a lot of firewood (it is winter here and the cold has set in) and helping with physical tasks around the house and farm more

- travelling is a breeze and I don't feel restricted any more.

In the first blog I also said I wanted to go back to visit Venice. In April I caught a train that was going to Venice - but I got off at Milan. 😄 I had a great time there - so I am feeling that I have made great progress with my list of things I wanted to achieve.

Perhaps the main thing - the best thing - is that I am no longer defined by my knees - I don't have constant pain, I sleep well, I get out and about and I now have conversations with people without ever mentioning my knees!

For me, the surgery has allowed me to get back the enjoyment and pleasure in my life and I am feeling fit and ready for action and adventure.

One year on...

5 February 2017: One year post-op Right knee replacement - 3 months post-op Left knee replacement

What an amazing year! 

I was just looking back at my activity log on my phone.

One year ago it would have been impossible to walk 10,000 steps a day. 

Actually even four months ago it would have been an epic undertaking. It is interesting to see how after the first knee replacement I became quite active. After three months I was able to walk 3-5kms a day.  But then my left knee became harder to use - more worn out - and then my walking activity slumped.  

Since the November total knee replacement on my left knee,  I am powering up and I am now walking 5-7kms a day. I still tend to use my walking poles when I go out for a dog walk as I find that when I get a bit tired my hips tend to get sore and I go back to limping. Despite that, I sleep well, I have cut back on the pain killers and the swelling and bruising has gone. I don't have the post surgical bone pain I had with the first operation and the left knee isn't as hot to touch as the right knee used to be at 3 months post-op.

(I had to have a knee photo 😄).

Last Monday I went to visit the surgeon. He was pretty impressed that I now have full range of motion in both legs with 125 degrees bend. 

I told him that a number of people had commented that I now seemed taller - he wasn't surprised and he flicked back to the x-Ray's and showed me how much my knees were deformed and why I would have had to stoop so much. He said that it will take about a year for my ankles and hips to get used to my new upright way of walking - so using the walking poles will help retrain my body and improve my posture. 

He also encouraged me to hit the cycle paths and get out on my bike again. I can't wait until the summer heat abates a little and then it will be lovely to be out cycling. I am still finding it hard walking uphill and climbing stairs - but as my quads get back into shape from the cycling, these activities should be easier.

The best thing about the visit was he has "discharged" me - he said he doesn't need to see me again. 

At first, I was quite surprised, I thought I would have an annual check-up or something. But then, I  felt an amazing sense of freedom! 

I now feel like I have left behind so much of the pain, disability and difficulty and that my life as a regular person (a non-patient) has begun.

Happy New Knee Year!

1 January 2017: Eight weeks post op left TKR: Eleven months post op right TKR

It is nice to start the new year with two gorgeous new knees.

You will see that the scar on the left knee is healing well and the swelling is reducing. Eleven months on, the right knee is still a bit swollen and it has dark marks (hyper pigmentation) around the scar. The marks are not painful and I am hoping they will gradually fade.

In the last couple of weeks over the festive season I have made superb progress with my left knee:

- I have stopped taking tramadol. It wasn't as easy as I expected and I fear I may have been slightly edgy over Christmas (I think I may have stopped the pills a bit too early). However, I decided that I would like to have a few drinks over Christmas and tramadol and alcohol weren't a great combination for me and made me feel very unwell. So the good news is that I am not taking it any more thank goodness! 

- my walking has increased. Eight weeks after the right knee replacement I was only walking about 2 km. However today (8 weeks after my new left knee) I went for a 3.5km dog walk as well as some general rushing around.

Even better, I have also been able to walk up some gentle hills to revisit places I haven't visited in about 4 years.

I have also been able to stand for longer periods of time - which means I can get up at about 5.30am and go out and water my vegetable garden for about 30 minutes. It is such a nice meditative activity so I am pleased to be able to be in the garden.

Over Christmas, I have also been able to cook meals and have had visitors come and stay. I find I have much more stamina and ease of movement. It is a pleasure to be able to be more normal.

I have also been back to the gym and pool. I still get very tired exercising and I am working on improving my bending and cycling. My knee bends are improving but still not easy and comfortable.

It is great to think that the year ahead will be surgery-free. And my knees will continue to get stronger and more flexible. My plan over the next few weeks is to work on some realistic yet adventurous knee-oriented goals for 2017. I want the year ahead to be the "bees knees".

The road to recovery

18 December 2016: 6 weeks post op Right Knee Replacement

It seems to me that the road to recovery after knee replacement surgery is rather like my driveway - sunny in some patches, shady in others, winding and steep - but ultimately leading to somewhere interesting.

Since the surgery, I have had some gloomy patches with infections and pain (as I reported in previous blogs). But in the last few weeks there have been a lot more bright patches as I have been able to:

- push the pedals on the exercise bike a full rotation (woohoo!)

- drive the car decent distances (100km)

- stand at work and social events and chat to people 

- stand and give a presentation for 45 minutes (actually I did lean on a stool some of the time)

- prepare nice food for my friends 

- go for 2km dog walks and walk nearly 5 kms most days.

And it all feels good. I have also been recalibrating my vision of where the two knee replacements will take me. 

I had been thinking that I wanted to recover to a state that at least as good as before I had surgery. But then I realised that the destination I should be aiming for was more like aiming for a state of fitness and stamina that I had five years ago. And it was quite a change of mindset.

Peter and I were chatting about Fiordland the other night and he said, "when your legs are stronger we could walk the Milford Track". My initial reaction (based on the last five years of thinking was - really? You must be joking!! But then I began thinking about it - and it might just be a realistic possibility. It's an amazingly exciting destination that I hadn't expected or considered for such a long time.

And then last night I met a man who has had two knee replacements - the most recent operation was six months ago. He looked so well and was really pleased with his new knees. He is very active and goes off on adventures with his wife in their bus. And looking at him, I began to think of the possibilities that lie in store for me...

For my regular blog readers, I feel compelled to provide the usual photo update on the knee scar. (You will be pleased that there are no gory  shots in this post).

And the range of motion is also really good - see photo of my bent leg below.

 It is looking good. And with the scar healing well I should be able to go swimming this week.

So, as I say to myself when I am clambering up my rather steep drive way - Onwards and upwards! Let the adventures begin!

A dam strange week!

3 December 2016: One month post op Left knee replacement and ten months post op Right knee replacement

Here in New Zealand it is late spring/ early summer. A time when the temperatures are increasing but the weather is quite temperamental and we can get horrendous winds for a week at a time (100-140km an hour).

In addition to the changeable weather, my post op recovery has had a bit of a mixed report for the last week. Monday I woke up feeling invincible - and ready to go forth and walk long distances. However, our dog Lewis had to be taken to the vet as he had got grass seeds in his eye and foot and he had to have them surgically removed. It was a wild day with gale force winds. After dropping the dog in for surgery, I was getting into the car (rather awkwardly - with my leg balanced against the door for support) when a violent gust of wind hit the door  and concertina-ed my leg into a tight bend. Not an ideal position and it hurt like crazy.  So I didn't feel invincible for long and spent much of the next few days sitting around with ice on my leg trying to get it back to its feel-good state. Lewis recovers much faster than me and he was ready to get up to mischief by Tuesday!!

By Wednesday I was beginning to feel much better and I decided to go for a walk down our drive to our dam. It is about 500m away. When I had my right knee surgery I wasn't able to walk down there until after the fifth week and it was rather an epic journey taking 45 minutes for the round trip. This week I wandered down and back, and had a chat with Peter who was down there gardening, and made the round trip in less than 25 minutes.

The trees we have planted around the dam are looking glorious and the water hole has been covered over with red weed which is great cover for all the frogs living in the water.

One of the other things that happened on Wednesday was that I noticed a suture had started to work its way through the scar tissue of my left knee. This happened with the right knee and last time the surgeon told me not to touch the suture and just let the suture make its way out naturally. So I decided this was all pretty normal. However on Thursday the area around the "piece of string" started to pinken and I went down and talked to the pharmacist about whether I should panic or whether an antiseptic cream would be useful to manage the pinkness.

He thought it would be fine with some antiseptic cream and told me that if it got any worse I should go and see a doctor. Peter was embarrassed as he thought I was making a big deal out of it and he thought I should relax about it. However, by Friday night I thought it was getting angrier and so on Saturday morning, I got Peter to drop me off at the doctors in Hastings while he took Lewis for a walk. By the time I got to the doctors it was looking nastier with pus and blood coming out.

So the doctor dug around in the scar and pulled out the suture end and cut it off with a scalpel. It was all rather gruesome. And I am back again on a higher dose of antibiotics than I took two weeks ago. He confirmed that I hadn't been over reacting and that I needed to take action to make sure the infection didn't get worse and or affect my implant.

So - in summary - I can walk further and more confidently now than I could after the previous surgery. I can sleep well. I have really needed the painkillers this week - so haven't been able to wind back on the pills - and in fact I am taking more pills - taking a second course of antibiotics that upset my stomach. Because of the risk of wound infection I can't get back swimming until the scar heals.

I am really hoping next week is more straight forward and I can get out and spend time in my vegetable garden and get back to watch frogs by the dam.

Feeling good

25 November 2016: 21 days post op Left knee and 10 months post op Right knee

We have had a lovely warm, sunny and optimistic week here in the Hawkes Bay with far less rain and drama than last week.

The garden is blooming and I have been making great progress with my new left knee. It is now more than a week since the staples were removed and the scar is looking really great.

I have been looking back at my blog from the right knee replacement and this scar is so much better when I compare it with my right knee 3 weeks post op. The left knee has far less bruising and swelling than the right one shown below.

Other comparisons between the two surgical events:

- The left knee now has 110 degrees range of motion - the right knee only had 100 degrees

- I can now walk around inside the house "crutchless" - after the previous op I was  relying on one crutch. I generally still use the crutches when I am outside so I can fend off people in the street and the crutches also give me confidence walking over undulating paddocks.

- I am doing about the same amount of walking each day - around 3 kms

- I can now sleep for 6 hours at a stretch in pretty much normal sleeping positions. With the previous right knee surgery I was barely able to sleep more than 3 hours at a stretch and wasn't able to start sleeping on my side until after one month.

- I have been to the gym and the Physio. I did some very low impact cycling and general stuff at the gym (actually it was mostly chatting if I am honest). There wasn't much the Physio could suggest I do - she just said do the same exercises as last time. She thinks that given how well the scar is healing I should go ahead and have a bath and I can also get back to the pool next week - so that is a week earlier than with the right knee replacement.

I drove home from the gym today and that seemed to go pretty well. I don't feel quite ready to drive for more than 10 minutes as it requires a lot of manoeuvring to get my left knee into the drivers seat. It was easier to get into the drivers seat last time as I installed my body first and then only needed to bend my injured knee a small distance.

In addition, I have been feeling great - better than I have felt in such a long time. The decision to have the surgery has been so positive. Hard work - but positive. 

When I was at the gym I caught up with an older gent in his 70s who has been waiting for knee replacements for more than two years. A few months ago I helped him get his GP to refer him for a specialist assessment. The surgeon thought he needed bilateral knee replacement and he was booked in to have the first operation about three weeks ago. A day before the operation, the public hospital phoned him to say he was no longer eligible for surgery and he now has no expectation of getting replacement knees. I felt so disapponted for him - he lives by himself and is unable to get out and he can't sleep because of his knee pain and he has no insurance nor the funds to pay the $27,000 per knee replacement. Now that I know what a change the surgery can make to your life, I really question why there isn't more public access to this surgery.

As you will see from my recent X-rays - it is very invasive surgery and there are considerable risks - but the potential for positive impact on your life is huge.

A bruising week

19 November 2016: 14 days post surgery on my left knee

At the start of this week, my leg was a blue and purple haze of bruising.

As the week as progressed, the hues of colours have changed, and reduced and the swelling has receded. So today, my leg looks like this.

I was supposed to have the staples removed from my scar 10-12 days after the surgery - so I booked into have them removed by my Wellington based GP on 14 November. However, in the very early hours of that morning, we were awoken by a massive 7.8 earthquake and this was followed by a cascade of significant aftershocks. Being rather slow moving at the moment, I dressed as fast as possible in case we had to evacuate to higher ground because of the tsunami threat. But luckily the threat to our area in Kapiti was downgraded. I am also please that our house was unscathed by the movement. However, the central business district of Wellington was closed for the day while buildings (including the GPs premises) were checked for damage. (If you want to know more about the earthquake - here is a link https://en.m.wikipedia.org/wiki/2016_Kaikoura_earthquake)

Ordinarily, there would be no problem rescheduling the staple removal by a day, however over the weekend, I had developed a red lump under my bra strap and I wanted to get the doctor to check it out as I was concerned it was developing into a red and inflamed boil. So I sent an email and photo off to my GP and asked if she thought it could wait til she saw me. We agreed that it should be ok until the next day. However, Tuesday was a day of torrential rain. So much rain and flooding that all the roads and transport options into Wellington were closed.

I sent an update photo to the GP who said she thought I needed some antibiotics as she was concerned that the boil was getting bigger and she didn't want to risk any chance of infection transferring to my prosthetic. (This is one of the rare but severe risks associated with joint replacement).

I tried to phone a local GP but they didn't answer any of the four calls I made to their clinic. So in the end, I phoned my friendly neighbour Colin (he is a doctor) and asked him for a script for antibiotics. He kindly provided one and then we set off in the pouring rain to get the medicines. Even though we were travelling away from Wellington, what should have been a 20 minute round trip turned into a 2.5 hour trip. Later that evening my GP phoned and said that she had looked at the photo again and thought I should lance the boil with a sterilised needle. Yik. Well - I tried but wasn't very successful at getting the pus out. So decided that I would just have to hope and pray I could get to the doctor the next day.

On Wednesday the roads were still blocked but luckily we were able to get through the road blocks to Wellington to see the GP for our third rescheduled appointment. After a rather brutal encounter with a scalpel, the GP lanced the boil. Overall she was very impressed with the progress with the knee replacement and thought that I was moving well and that the leg wasn't too inflamed or swollen.  Then it was off to see the nurse to have the staples removed. I was again surprised at what a long and painful process it is - it took over half an hour. Thankfully this time the scar was well healed and the nurse didn't have to dig into the flesh to pull out bits of metal (like she had to with the right knee).

The scar is dry and isn't as oozy as the right knee scar was.  The scar has been covered in steri-strips and a bandage which has to stay on for five days... And then I can have a bath 😄 

My sleeping is progressing well. I have tentatively tried sleeping on both sides and I can now creep to the toilet in the middle of the night without clomping around on my crutches.

I am getting more confident walking around the house unaided for very short periods of time and the rest of the time I am just using one crutch. I still use both crutches outside. Yesterday I wandered around for 2.5kms

The knee and leg are still painful so I haven't started to reduce my pain meds yet. But it is tolerable.

We came back home on Thursday and I was not too uncomfortable managing the 2.5 hour trip in the car. It is great to be home and to be out of the earthquake zone and perpetual aftershocks - and also out of the unending rain.

Overall, I would say that this surgery feels quite different from the first knee replacement. To date, the recovery is much speedier, the bruising is resolving faster and wasn't as extensive. I am able to sleep well and I have a greater range of motion in my leg. So - despite the small glitch with the boil - things are looking very promising.