Weighty Matters

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All Clear!

A couple of days ago, I met with my orthopedic surgeon for my three month followup appointment. Technically, we were three months plus a week or so, but no big deal. 🙂

I walked in feeling confident and, admittedly, eager to see what the expert would have to say about my progress and recovery. In a nutshell – he was very pleased! He examined my knee, checked the extension, and we talked about the marks I reached in physical therapy.

At my last couple of P.T. appointments, I’d managed 120 degrees of flexion (bending) with my knee on my own. The doctor said that his minimum goal is 110 degrees and that the average at this point is 117 degrees. So, I surpassed the average. (I hope he wasn’t making that up.) He also said that as I continue to exercise and heal, I may achieve an additional five to ten degrees.

I told him that I’d made it as far as two degrees for extension, not quite zero degrees. I asked me to straighten my leg for him. Then he said what my therapist said, and what I’ve realized. Two degrees won’t make much difference at all and, even that may improve.

We then discussed the difference in strength between the leg with the replaced knee and the other one. He reminded me that my right knee had been compromised and weaker for several years so I needed to be patient and accept that it was going to take time and work to bet it even with my left leg. We both agreed that I’d done myself a lot of good getting as fit as possible before the surgery and that this had no doubt helped me with my recovery.

I then asked the big question on my mind. Could I return to all normal, desired activity including rowing classes and riding my bike on the street? The surgeon looked at me and said he wanted me to forget any restrictions, go out and do whatever I wanted. He was so pleased and happy with my recovery level that he decided he didn’t need to see me again for another follow up until the year anniversary of my surgery!

Then he did something kind of cute. He called up the x-ray that they took of my leg in the operating room after he installed my prosthetic knee. It’s like he was so happy with how good it looked and fit that he wanted to show it off. We spent a moment in mutual admiration before he gave me a hug and said he’d see me in nine months.

I strode out of the office feeling pretty darned good about the whole experience. Considering that as late as last October, I was still resistant to the whole idea of knee replacement and desperately hoping for another alternative, I’ve clearly come a long way – emotionally as well as physically.

So what now? I continue to do exercises at home that were recommended by my physical therapists. I also do foundation exercises from Tai Chi every day. I think the danyus, which look similar to squats, but are actually different, are great for building strength in my legs. Toryus, which I’ve now tried three times to write a description about and failed, are not only good for building strength as a weight bearing exercise, but I can really feel the stretch i my legs. So I figure they might also assist with the straightening and extension.

All of Tai Chi is good for the entire body and I’m rededicated to my practice. I can already feel improved stability because of the replaced knee and I’m gradually regaining and improving my balance on one leg or the other, standing up tall on one leg, and other movements. I had a realization when I started doing Tai Chi standing again. Previously, while learning and practicing the moves, I was always compensating in some way for the bad knee. To some extent, I need to relearn it with my new knee. No doubt I will eventually be better at than I was before. I just need to go through the process. Not only am I willing to do so, but I realize that I will enjoy it. I think it makes me a better student and practitioner to be aware of the change and the new level of ability that I didn’t have before.

Tonight I also booked myself into an early rowing class for tomorrow morning. It will be my first day back. I’m excited and looking forward to seeing crew mates from the months and months that we worked out together. At the same time, I am fully aware that I have not done a lot of cardio exercise in almost four months. I have to remember to pace myself in the morning and work my way back up to the fitness level that I had achieved before my surgery. After that, I can look forward to surpassing that level!

Now that I’m all clear, it’s going to be really fun to discover what life, activity and exercise are like without a bad knee. I’m ready for this journey into a newer, fitter future.

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Twelve Weeks, Moving On!

I knew that recovery from my total knee replacement would take work. I didn’t anticipate that it isn’t just the physical work of therapy, but the task of rolling those therapy appointments into my life. Let me start by saying that I am incredibly fortunate to work for an organization that never blinked and was nothing but supportive. All I had to do was say, “I need to leave at 2:45 p.m today for p.t.” Their answer was always along the lines of, “Okay. Hope it goes well. See you tomorrow.”

Granted, they know that I will always put in my time and make up work at home, but I’m sure that not every company or organization is as easily accommodating. I am grateful.

Last Wednesday was the 12 week mark. I can hardly believe that three months have passed. I am doing so well. Not perfect, but who is? Most of the time I am pain free, and when I do experience discomfort, it tends to be a little ache or an occasional twinge when I’ve been working hard. I haven’t taken an opioid pain pill of any strength in several weeks. I rarely even need to take Extra Strength Tylenol any more, even after a physical therapy session.

It used to be that if you put your hands on my knees, you could feel increased heat on the right knee and that indicated that there was still healing to be accomplished. Now, I might feel a temperature difference after physical activity, but it isn’t significant.

The improvement is real and evident. Friday was my last physical therapy appointment. I’ve been paying for them out of pocket for the last few weeks. (My insurance only authorized 20 sessions.) I would continue to do so, but the therapist feels that we’ve accomplished all that we’re going to with his help. Him pushing, pulling or otherwise manipulating the leg is not going to get it to straighten any further.

The good news is that I’m only two degrees from that full extension. Honestly, I don’t notice any difference. I don’t limp when I walk. I’m not tight and hobbling when I get out of bed or stand up from a chair. I can feel the stability in the joint that wasn’t there before.

It’s awesome as far as I’m concerned! For the flexion, I can bend my knee 120 degrees on my own, without their help. That’s a pretty good range of motion. I don’t know what it was before surgery, but I’m sure it was less.

The only issue that remains is that the right leg is still significantly weaker than the left. I have work still to do in order to build that back up and get myself even strength-wise. The therapists gave me exercises I can do at home and I’m also going to take advantage of their wellness package to go in three days a week and work with the machines that were part of my therapy routine. I don’t need their help to do the exercises they’ve taught me on the universal gym and the other equipment, so I can keep using those tools to improve.

When I first had the surgery, the senior Tai Chi instructors cautioned me to not do the moves from a standing position for three months and the therapists agreed. I needed to give the bones of my leg time to grow in around the prosthetic. In the beginning, it wasn’t difficult for me to do Tai Chi moves while seated. I couldn’t have stood and done the pivots and other moves anyway.

Only as I began to improve, did the restriction begin to chaffe. Finally about two weeks ago, I began doing danyus. (They look similar to squats, just for your frame of reference.) I knew that the move would help to strengthen and stretch my legs without twisting or putting anything at risk. Closer to the 12 week mark, I added toryus, which give me excellent leg stretch and also encourage each leg to really work. I also did the first 17 moves of the Tai Chi set, after carefully determining that if I did the moves correctly, I was not going to hurt my recovery.

Being able to return, even this much, to Tai Chi did me a world of good. Tai Chi’s benefits go beyond the physical, to the mental and emotional, too. Doing the foundations and the beginning of the set settle me and help me focus. The practice is good for reducing stress. It absolutely does help me physically, but the additional benefits matter just as much.

Yesterday, I did my first full “standing” class. I was smart about it and didn’t push myself or my knee to the risky zone. However, when we closed with a set at the end, every time I thought about stopping, I realized that I could do a little more and a little more.

I was able to do a full set for the first time since before my surgery! It felt great. Imperfect, but great. I realized that I don’t know what it feels like to do Tai Chi with a good knee. I’m sure that I’ve been compensating for the injured joint for the entire last five years. Now I have the interesting journey ahead of adjusting and practicing with the new joint. Already I know that the knee is more stable. The strength isn’t there, but it will come and I can adjust and improve as it does. I’m really enjoying this process!

My three month follow up appointment with my surgeon is coming up a week from tomorrow. I hope he’s going to be as pleased with my progress as I am. I also hope that he’ll clear me to go back to rowing class. I’ve missed that a lot, primarily for the overall strengthening, particularly my core, and the great cardio workout.

I already know that it will be a challenge to incorporate rowing back into my life if I’m also doing the machines a few times a week. That said, I’ll find a way to make it work. Maybe I won’t be able to row three times a week at first, but anything will be a good start.

The most difficult, hardest part of recovery is behind me. I’m so happy with where I am today and looking forward to continuing to move on!

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