Recovery Day 49-50

I had great news at the PT, yesterday. My flexion was 130 degrees. Without pain, it was 125. My extension, with me trying to straighten my leg was 0, which is great. Without me making any effort, it was about +1.5. I'm not mad at that.

I went on a nice hike.

Day 50

I had a bad night last night. I woke up in the middle of the night in pain and did not get a lot of sleep. Yes, I'm still not getting full night sleeps. Today however, I feel great. By my own measurement, my flexion ROM without pain is about 130. I hiked a couple of pain-free miles tis morning, as well. All of my exercises were easier. I'm off to PT soon.

Day 36

Wednesday, July 5, 2023

 I haven't updated for a while, because it has been a wild couple of weeks. I woke up Tuesday, 6/27,  morning in tremendous pain. My stomach was cramping. My stomach had been hurting for days, and I had felt nauseous as well. I thought that the lining of my stomach was inflamed from using NAISDS. The "googler" said that the only thing to do was take antacids, stop taking ibuprofen and get on a regimen of Pepcid. I had my kid bring home some Pepcid, but the package said to take it on an empty stomach in the morning, so I asked my husband to bring home some Tums. My intent was to wait until the next morning to see how it went. When my husband got home, he said insisted that we go to the emergency room. I was in no condition to protest. I had been in pain in a fetal position all day.

When my husband called the ER, they said that it would be a short wait if we came immediately. We got there very quickly, but the wait was incredibly long. We got there at about 8:45PM, and we weren't seen until after 2AM. I was in a lot of pain. At some point I went in the car so I could curl up, while my husband waited in the ER.

The experience of waiting in the ER was horrible. People were sitting for hours, moaning, obviously in a tremendous amount of pain and no one even checked their vitals. Once I was actually in a room, everything went very quickly. The staff was attentive and made me comfortable. They gave me fluids and offered me pain medication. I told them that I had been having such a hard time with the pain medication that I'd like some other option. The doctor listened and gave me Benadryl to help me sleep. They took test after test, including at CT and came up with a definitive diagnosis. I have diverticulitis. It's an infection in the intestine. It almost certainly happened as a result of being constipated after surgery. It is very painful, but not difficult to treat if you catch it quickly enough. The doctors gave me a dose of antibiotics intravenously and sent me home with an antibiotic and anti-nausea medication. I also needed to stick to an all liquid diet for two days.

I left the hospital at about 6AM. The cramping was completely gone. I just needed to deal with weakness of lack of food. I had eaten nothing the day before and probably very little the day before that. Now I had to go two more days on very few calories. The hardest part was staying hydrated. If I drank big gulps of water, I would start to get nauseous. I could only drink sips at a time. It was just hard to remember to do it.

Thursday, 6/29, I felt better, but I had been doing too much to try and straighten my leg, so I had a set back.

Today, was the first day of my 6th week. I went to the PT and got ROM measurements. My flexion unassisted is 127. Assisted its 130. Extension is -3 1/2. I have been feeling a lot of pain the last few days, but I took yesterday off and felt much better today.

Week 4: Days 22-24 Patellofemoral Joint Replacement

 Wednesday, June 21, 2023

My PT session was earlier than usual, so I got an early start on my own PT. I always start with 5 minutes on the bike. This time I moved the seat down to its normal position. I wasn't able to get around without lifting my hip, so I basically just went back and forth. I did some upper body stuff, ab work and the hip routine before settling into the PT knee exercises. I ended with 5 minutes backward, uphill on the TM and about .75 miles forward.

PT was at noon. I like to get measured every week. I was measured at 121 & -5. -5 is a big disappointment because I have been working so hard to straighten my leg. For example, in addition to my normal PT exercises, I spent an additional 55 minutes in some kind of passive stretch yesterday. I worked very hard last week with zero improvement. It is disappointing. I spend a lot of time scouring the internet for exercises to help me with extension. I found a new one that I'm hopeful about, so I'll be adding it into the routine.

Thursday, June 22, 2023

I didn't feel good. My knee hurt and I was nauseous. I'm barely taking any medication. I can't figure out what is going on.

Friday, June 23, 2023

I've come to the conclusion that the Tylenol is making me nauseous. I did not want to take any medication at all, but my husband because everything seems to make me sick in one way or another. My husband insisted because my knee was hurting. I took ibuprofen and did not have any ill effects.

Of course, I did my morning exercises, including a hip routine abs and upper body. I took the dog on a short 1 mile hike. I went to PT and went on a 1.76 mile hike in the early evening. I slacked a little bit on straightening my leg. I only did exercises about 6 times. Usually, I get it about ten different times during the day. I can honestly say that all the work on this one thing doesn't seem to be making the slightest difference. I would bet if the PT measured me, I'd be -4 or -5. All I can do is what I'm doing. I am working as hard as possible.

Week 3: Days 20-21 Patellofemoral Joint Replacement

 Monday, June 19, 2022

I peeled off the last of steri strips to completely reveal the scar and I got another rash. It seems unlikely that the rash is related to any medication. I didn't take any medication at all yesterday or today.

I had a doctor's appointment, today. The doc seemed very happy with my progress and told me to keep doing what I'm doing. I did my normal exercises in the morning, but not much after I got home from the appointment.

Tuesday, June 20, 2023

I got up early and did a pretty extensive workout. I'm still trying to work on ROM every hour. About midday, my husband and I went on our first real hike. I used poles because there is a pretty steep part that I don't think that I could have done without poles. The hike was about 1.75 miles.

My second workout was something that I found on YouTube.

In the evening, I went on a .85 mile walk.

The doc gave me the OK to start using ointment on my scar, so I started using Scar Away gel today.

When I went to bed, my foot was hurting. I did a lot today. I may have over did it.

Week 3: Day 19 Patellofemoral Joint Replacement

 Sunday, June 18, 202

I got up early and did an early session workout. My husband and I went on a short midday hike, and back to the house for a little more ROM work. I ended up doing 40 minutes in total on the bike (4 minutes at a time) and 50 minutes of extension work (5 minutes at a time).Every couple of hours I tried to do some ROM work.

Week 3: Day 18 Patellofemoral Joint Replacement

 Saturday, June 17, 2023

I woke up with a headache and pretty tired, so I took some ibuprofen and Tylenol with breakfast, but besides that I didn't have any more pain medication the rest of the day.

I'm really trying to work on straightening my leg, so I decided to do a passive 5 minute stretch, 10 times during the day. Five time, I sat with my legs out in front of me on a second chair with a 15 pound weight on my thigh; and five times I laid on my stomach with my knees off the table with an ankle weight.

I did a long extensive workout in the morning, I went on a one mile hike (no elevation) in the afternoon. Normally, I would do one more workout and take a second walk, but today I just rode the bike five minutes and did a passive extension stretch.

Week 3: Day 17 Patellofemoral Joint Replacement

 Friday, 6/16/2023

I woke up way too early, but I was able to get in a workout before PT. PT was very productive, today. I had a different therapist, because mine is out of town, and she gave me some good tips. Probably the most important thing that she did was give me a different way to cue walking (in my mind). I think it allows me to create a much more normal gait. She also told me that I need to get to 0 degrees pretty quickly. I'm planning on really working on it this weekend.

I didn't take any pain medication at all, because I wanted to have wine in the evening. The pain wasn't too bad.

Week 3: Day 16 Patellofemoral Joint Replacement

 Thursday, 6/15/2023

Today is supposed to be a sort of rest day. My PT told me to only do ROM exercises and to limit my walk to 15 minutes. It ended up being a pretty weird day.

Yesterday, I didn't take the Celebrex. I took ibuprofen instead. I think the Celebrex gives me a headache, so I was experimenting. I took the Celebrex, today and promptly got a rash. The rash is near were I use the e-stem, so it could be from the drug or it could be an allergic reaction to the stick stuff on the e-stem unit. Who knows. I think that I'm going to stay away from Celebrex for a while an try to get a prescription for ibuprofen.

I got some X-rays today which gave me an up and personal look at the hardware. It's pretty interesting

Pain today was really weird. It was basically moderate with strange waves of acute pain every now and then. I did get a good night sleep last night.

I tried some new exercises. One I thought up on my own. The other, I found on the internet. The one I thought up is very hard. I lay on my back and put a strap under my hamstring and pull my thigh up to a 90 degree angle. I let gravity pull on the bottom part of my leg creating an angle. It's quite excruciating actually. I did it in the morning, and in the afternoon, I made a complete rotation on the upright bike. I thought I was so far from ever being able to do that just hours before I did it. I was so happy that I shed a tear. There were real wet eyeballs involved. I doubt that the progress on the bike was due to the new exercise but you never know.

Week 3: Day 15 Patellofemoral Joint Replacement

 Wednesday, June 14, 2023

The day started off tough. I had trouble sleeping, as usual. Everything seemed more difficult. During my morning exercises, I usually take a measurement of my heal slide, but this time I felt a stinging along my incision, so I stopped.

I did leg extensions using my monkey feet attachment, and it was way too heavy. I won't do that again. My knee hurt all day. My physical therapist told me to take it easy tomorrow. We did some measurements today.

My flexion has improved 30 degrees. And my extension improved some as well. I would love to be at 120 by my next measurement, but that seems so far away. I was also able to make a complete revolution on the bike, today for the first. Honestly, I think that I was seated a little further away than I usually am, but I'll take it.

Week 2: Day 14 Patellofemoral Joint Replacement

 Tuesday, June 13, 2023

I did two workouts today, both including an outside walk. One walk was 1.5 miles and included 4 minutes of backward walking up a hill. The other was 1 mile followed by 4 minutes of backward, uphill walking on the TM. I found an app that measures ROM. It says that I'm at 113 degrees. I am going to have my PT measure it tomorrow, to see if the app is accurate. I think that is probably about average. I am working as hard as I can. Improvement is steady, but slow.

Week 2: Day 13 Patellofemoral Joint Replacement

 Monday, June 12

Since I had no pain medication at all yesterday, I didn't sleep very well, and I woke up in some pain. I took Celebrex and two Tylenol, in the morning. My morning exercises were difficult, but I did them. Instead of walking on the TM, I walked in the neighborhood. It was very difficult, but I got it done.

PT was fine. I was able to go backward for one complete rotation on the bike for the first time. It definitely hurt, but I did it. I am nowhere near a rotation going forward.

I walked a mile in the evening, and actually, it felt a little better than the one in the morning.

Week 2: Day 12 Patellofemoral Joint Replacement

 Sunday, 6/11/2023

Today is my anniversary! I haven't taken any medication at all including ibuprofen or Tylenol, so that I can toast with champagne this evening.

I did all of my morning exercises and increases my TM walk to .75. I also walked outside a mile. It was the first time without a walker. It was on uneven ground, too.

Week 2: Day 11 Patellofemoral Joint Replacement

 Saturday, 6/10/2023

I woke up in minimal pain. I divided my morning PT into two segments: before breakfast and after breakfast.

Before breakfast:

• 5 minute bike warm-up
• Sidelying Hip Abduction
• Sidelying Hip Adduction
• Clamshells
• Sit-to-stand
• Seated Hamstring Set
• Calf Stretch Using ProStretch
• Weighted Toe Raise
• Seated Straight Leg Raise

After breakfast:

• Weighted Toe Raise
• Seated Straight Leg Raise
• 3 minute Bike Warm-up
• Supine Heel Slide
• 15 minute Walk on TM
• Seated Knee Extension with Chair
• Supine Hamstring Strech w/ Idealstrap
• 5 min Backward Walk on TM
• Elevated Icing with E-Stimulation

After session1, I went straight to bed. I slept a couple of hours and basically did a rinse repeat, session 2, then another nap.

My second session consisted of:

• Calf Stretch Using ProStretch
• Weighted Toe Raise
• Supine Active Straight Leg Raise
• 5 minute TM warm-up
• Supine Heel Slide
• 20 minute Walk on TM
• Seated Knee Extension with Chair
• Supine Hamstring Strech w/ Idealstrap
• 5 min Backward Walk on TM
• Elevated Icing with E-Stimulation

Finally, I went for a 1 mile walk in the park. It took about 35 minutes. That was my longest walk to date.

I did not take any hard core pain medication today, but I was in a lot of pain. I took Celebrex when I woke up in the morning and two Tylenol. Before I went to bed, I took the same.

Week 2: Day 10 Patellofemoral Joint Replacement

 Friday, June 9, 2023

I opened my eyes and jumped right into morning exercises. It took forever for me to get through them. I actually stopped and had breakfast in between, and then finished up. I was moving like a snail.

In the afternoon, I went to the park to walk again. I think I really have a hand on some self talk to get me walking more naturally. "Toe off, bend-pain, heel." this means push off to my very tip toe. Then bend my knee until I feel pain,. Finally, plant the heel. I think my walking is looking pretty good, but it takes complete concentration.

 

 PT went well. I got a some normal hip stuff to add, like clam shells. After PT, my whole leg was throbbing. I decided to take something. I've got my fingers crossed that I won't regret it.

Week 2: Day 9 Patellofemoral Joint Replacement

 Thursday 6/9/2023

I woke up at about 3AM in a lot of pain, but I didn't take anything. I finally fell back to sleep, and when I woke up again, I was in a little less pain. My body reacts very badly to opioids. So I decided to just take Celebrex and Tylenol, today.

I did two rounds of my exercises and I walked 30 minutes in the park, with my walker. I don't really put weight on the walker, but I am so much more confident when I have it. I'm really afraid of falling. 

My walking is pretty terrible, but by watching a video tape, I have finally figured out what my pt meant by I'm not pushing off. On a TM, I look pretty normal, but on the street, It looks like I'm dragging around a log. It feels to me like I'm pushing off, but its more like I'm dragging around a log. I got a little better when I concentrated on feeling the pushing off in my toes and concentrated on the heel plant.

Week 2: Day 8 Patellofemoral Joint Replacement

 Week 2, Day 8 Patellofemoral Joint Replacement

The only pain reliever that I took yesterday was Celebrex. It is akin to ibuprofen. I woke up today in a little bit of pain. If I wasn't going to PT, I wouldn't have taken anything, but since I have my first PT outside my home, I took a stronger pain medication in the morning.

I didn't do any exercises at all at PT, but my therapist sent me home with some exercises and told me to do them at home. He encouraged me to do them a lot, but not to over do it. That is pretty funny.

I put in the work when I got home and my knee was really swollen. I was exhausted and took a nap, but I did the workout again when I woke up.

Day 7 Patellofemoral Joint Replacement

 6/6/2023 Tuesday

I felt incredibly clear headed when I woke up, because I didn't take pain medication last night. When I opened my eyes, I didn't feel any pain, but when I started to move around, there was a little bit pain. Nothing I couldn't handle.

Day 7 was my first follow-up appointment. The doc took off the big bandage. I thought that there would be staples or stiches to remove, but there was nothing to remove. Evidently, the wound is glued together. I still can't see it. It is covered by steri strips which will evidently peel off at some time. The Doc, also, called in another pain medication. I hope that I do better with it.

It was along drive to the doctor's office. I was little worn out by it, so I didn't do much, besides some exercises, when I got home.

Day 6 Patellofemoral Joint Replacement

Despite all my efforts, I was still constipated in the morning. I was in some pain last night, but I didn't take any pain medications this morning, because not only does it make me nauseous but obviously it is making me constipated. The quicker that I can get off of the stuff the better. I increased my dosage of Sinokot last night and I took two magnesiums on an empty stomach in the morning. Even after coffee, nothing happened. I really didn't want to have to do it, but I had to take a stimulant suppository. Nothing happened, so I called my doctor. His office suggested an enema. Ugh... In the end, everything got moving, but too much. I need to ask the Doc for a different pain medication.

The PT was supposed to show up at the house yesterday, but he didn't. No call, no nothing. I've got some questions, so its a good thing I have an appointment with the doctor tomorrow.

On Day 6 June gloom was in full effect, weatherwise, and my mood matched it. I was sick of dealing with the effects of the pain medication and annoyed that the PT didn't show up or bother to call.

I nice thing to happen was that some friends brought us a delicious dinner of pork chops, potatoes and green beans. They even included dessert. It was delicious and a welcome respite for my hubby.

I'm done dealing with the pain medication, so no medication before bed. I'll see how it goes.

Day 5 Patellofemoral Joint Replacement

I woke up at about 5:30 AM in some pain. I got up, popped a pill, and the pain subsided pretty quickly. I still haven't been able to go to the bathroom, despite taking all kinds of stuff to make it happen. I'm taking Magnesium Citrate, a prescription stool softener, and yesterday I added Senokot. Nothing is happening, and I'm getting concerned.

I was given two exercise by my PT to do. One was to tense my quad muscle. He told me that at some point, i would be able to lift my leg. When I did the tensing exercise this morning, my leg popped up. I couldn't believe it. I was pretty excited. I also did my leg bend exercise and increased the range of motion between my coins to 8 3/4 inches. I've already done these two exercises once. I plan to do them one more time before bed.

I walked on the TM for 10 minutes at .8 speed and level 1 elevation. I iced afterwards, but I did feel a tight afterwards. there were some weird, sporadic pains during the walk

Day 4 Patellofemoral Joint Replacement

I woke up this morning feeling better than I had since I had the surgery. I felt very clear headed. I had very little pain. I could walk a tiny bit better and I was able to increase the distance between my coins to 7 3/4 inches. I also took a walk down the street (about 20 feet) with my walker, and I used the muscle stimulator on my quad.

Day 3 Patellofemoral Joint Replacement

Day 3 was the first day that I was able to give my husband some relief from waiting on me hand and foot. I couldn't bend my knee, but if I could manage to get up and down if I could do it with a straight leg that I didn't need to swing. He still needed to do a lot for me, but I didn't feel like I was overwhelming him.

One of the exercise that the PT gave me was to practice bending my leg. It was extremely painful to do. I added some coins so that I could measure the distance that I was bending.

I was in a lot of pain when i went to bed. I hadn't taken a lot of pain medication during the day, but I took (2) when I went to bed. It took a long time to fall asleep because I was in pain, but I slept the entire night and woke up feeling pretty well.

Day 2 Patellofemoral Joint Replacement

I woke up in a lot of pain on the second day, because I didn't take pain medication before I went to bed and the nerve block had worn off. I took a full dose of pain medication as soon as I woke up. I was still pretty much helpless on the second day. i couldn't get up or down without help, but every 30-45 minutes, I needed to get up and walk around my pool table (with a walker). I also iced frequently, 30 minutes at a time.

The physical therapist came to the house and answered all of our questions. He also gave me a couple of exercises to do.

I kept down all of my food, but day 2 was pretty difficult.

Day 1 Patellofemoral Joint Replacement

I had a partial knee replacement of the patellofemoral joint on May 31, 2023. It took me a long time to come to the conclusion that I was going to have the surgery. I tried everything, including physical therapy, Visco shots & steroid shots. If I could have afforded it, I would have tried PRP treatments. The situation was that I could go to work without pain, but I couldn't work out, at all, without pain putting me put of commission for a day or two. I couldn't hike more than a mile or two. I couldn't do spin class. I couldn't even do water running without some pain. Over the last 2 years, I've gained about 25 pounds. 

After a lot of hoop hopping regarding insurance, I was finally able to see the orthopedic that I wanted to see. I had my first appointment about a year ago. The doctor immediately sized up the situation. He indicated that at some point, I'd need a partial knee partial knee replacement, but he wasn't keen to do the operation soon. I think he wanted me to have some time to wrap my head around all a knee replacement entails and the risks involved.

When I went back about a year later, the doctor wanted to see a current MRI. The MRI did not look good. The report indicated that there was grade 4 cartilage damage in all three compartments. That would normally lead a doctor to want to do a full knee replacement rather than a partial, but my doctor believed that most of my pain was coming from problems in the patellofemoral joint. We decided to proceed with a partial knee replacement, because it would give me the best chance to get back to the kind of lifestyle that I want. He gave me no guarantees and was upfront that I might need another compartment replaced or a full replacement at some time in the future.

The procedure was done at an outpatient surgery center. My doctor said that the surgery went well and that I made a great decision to get the partial instead of a full, because my lateral compartment was in pristine condition. He said the medial compartment was not as good, but it was not necessary to replace it. He was very optimistic. When I actually woke up from the surgery, I was in so much pain. I couldn't help tears streaming down my face. i had a nerve block but nothing was being blocked at that point. The nurse gave me some medicine and I began to feel better. I went home the same day of the procedure without any complications.

The block must have kicked in, because when I got home, I wasn't in a whole lot of knee pain, but I felt terrible. All of the medications made me sick. I ended up throwing up. The first day was very difficult. I couldn't sit or stand without help. I was completely helpless, and I felt terrible.

We actually had a lot of questions. We were given a packet of stuff when we left the surgery center, but there were no instructions. We were told that a PT would come to the house the next day, but we had heard nothing the PT situation. The surgeon's office had dropped the ball and my husband and myself had to sit on the phone getting it sorted out, but we were able to get an assurance that someone would, at least, call us to set up the appointment the next day. 

I didn't taken any pain medication when I went to bed because I was feeling so bad. I woke up the next morning in a lot of pain.