Knee Replacement Surgery: 5 Observations at Week 4

I had my right knee replaced four weeks ago today.

1. Pain Management (NOT!) – Pain has become that relative that comes for a visit but never seems to want to leave.  For the first couple of weeks, it was just at night.  Since I started outpatient PT, it seems almost 24/7.  I have come to cherish the 40% times that the Tramadol works.  Since gettng high is not my thing, I reluctantly (but whiningly) endure the  pain during the day and take one Tramadol at night when I go to bed in hopes that I can steal a few hours of sleep.
2. Is Recovery a Mirage?– This morning the physical therapist told me that pain can last for up to two months.  (Not what I wanted to hear.)  I have heard that the stiffness can last for over a year.  I keep hoping that as the days pass, I will feel more normal.  What is normal anymore?
3. Freedom is just another word for being able to drive.  It’s been a week since I test drove my car to the local grocery store.  Each day,  I feel more confident in my ability to drive safely and defensively.  It feels wonderful to be able to go out when/where I want without having to worry whether or not I’ll inconvenience my husband.
4. The right leg is definitely stronger, even if painful.  Before the surgery, the right leg never gave out on me, but it never felt as strong going up stairs.  Now they both feel equally capable to going upstairs–sometimes even the pain level is equitable.  I am grateful to the left leg for being such a good sport under trying conditions.
5.  It is what it is.  I hate being inconvenienced so I hate to inconvenience other people.  Since fast is not yet in my vocabulary, I forgive myself for taking too long to cross the street or stepping on/off curbs.  I also realize that although I’ll have no trouble getting on/off planes, I may need to get a wheelchair while travelling from one terminal to another when changing planes at the airport. Walking longer distances is still painful for both knees and hips.  On the plus side my fit bit now records 4,000+ steps a day–up from under 1,000 when I first got home.

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Clouds

The frozen shroud of icy mist

Stings like the chill of Death’s last kiss.

Chill spring showers pierce the ground

Stinging rain the only sound

The overcast of summer haze

Barely affects the sun’s hot  blaze

Shifting fog on an Autumn’s eve

Are those real Wraithes that you percieve?

Clouds that block the warm  sunlight

Keep days cooler, but not the night

Where they are like an insolation

Trapping warmth in isolation

Water vapor trapped in place

Within a white or gray cloud face.

Mountains pierce them, planes fly through

Yet zero vis is also true

Solitary or in a crowd

How do you define a cloud?

5 Observations at 3 Weeks Past Joint Replacement Surgery

1. Pain is  part of the game.  For the past 2 weeks, my right leg has started to hurt  within 15 minutes of lying down–whether in the afternoon for a nap or at night when I’d like to fall asleep.  It  does not matter if I am lying on my back or either side.  If I’m on my back, the underside of my knee cap starts announces itself with increasing stridency.  If I lie on either side, then the sides of the knee  pulse with pain, sending it down to my ankle and big toe or up to my hip.  Most nights, Tylenol and Tramadol do not touch the pain.  Pillows of various sizes do not seem to help most of the time.  I was able to see my surgeon today. He said there was no infection or vascular problems, just part of the healing process that should go away soon.  He also recommended trying Aleve or Advil if the Tylenol was not working.
2. Knee range of movement is important. I’m bragging now.  My knee has a range from totally extended to a bend of 115 degrees.  Usually by 6 weeks they would like the knee to bend at 90 degrees of better.
3. Benefits of PT.  When I saw the doctor today, and he told me I did not have to see him for my 6 week visit , he asked if I had any questions.  “When can I drive?”  “As soon as you feel ready.”  Tomorrow I feel ready to try.  I’ve missed driving probably as much as I’ve missed anything else.   Starting with ankle rotations and in bed knee flexions, through sitting/standing exercises, and ending with resistance bands and one legged exercises, the bar keeps raising and so far I’ve been able to meet it.  I have graduated from walker to cane and now to walking without external support.  I finished at home PT on Wednesday and begin outpatient PT on Monday.
4. Social support remains important.   Visits, emails, texts, phone calls, and cards are all appreciated.  I get bored with myself, with the pain, with being  unable to do much.  Hearing from friends and acquaintances provide a welcome break in the monotony of convalescence.
5. I don’t like surgery.  I had an excellent surgeon, a wonderfully supportive husband who has been  more patient the past three weeks than I would have been if he were the patient, and a lovely visiting physical therapist.  The pain management has been wretched.  At this point the post-operative pain and limited mobility has been worse than the arthritis that made me think I wanted surgery in the first place.  The other knee will have to get MUCH worse for me to want to do this again.

Days to Celebrate in August

Named for Ceasar Augustus (who was ceasar when Jesus was born).  From Wikipedia

August is the eighth month of the year in the Julian and Gregorian calendars, and the fifth of seven months to have a length of 31 days.^[1] It was originally named Sextilis in Latin because it was the sixth month in the original ten-month Roman calendar under Romulus in 753 BC, and March was the first month of the year. About 700 BC, it became the eighth month when January and February were added to the year before March by King Numa Pompilius, who also gave it 29 days. Julius Caesar added two days when he created the Julian calendar in 46 BC (708 AUC), giving it its modern length of 31 days. In 8 BC, it was renamed in honor of Augustus. According to a Senatus consultum quoted by Macrobius, he chose this month because it was the time of several of his great triumphs, including the conquest of Egypt

August 1 is Spider Man Day.  He made his debute in August 1962.   For more information checkout the Checkidea website. The Ramones wrote the lyrics to the popular Spiderman song.

Spiderman, Spiderman, does whatever a spider can
Spins a web any size, catches thieves just like flies
Look out, here comes the Spiderman

There are several versions of this song on YouTube, but I personally did not find any as good as the Ramones original.

National Coloring Book Day is August  2.  No longer just for children, adult coloring books have been gaining in popularity.  It can be a form of therapy, a delightful recreational pasttime, something you can do alone,  or with friends of family.

ALA recognizes August 8 as Cat Read Day.  Google did not confirm this as a day that anyone else celebrates.  From Dr. Seuss’ Cat in the Hat to T.S. Eliot’s  Old Possum’s Books of Practical Cats., there were cat books long before there were cat videos.

“The Naming of Cats is a difficult matter,
It isn’t just one of your holiday games;
You may think at first I’m as mad as a hatter
When I tell you, a cat must have THREE DIFFERENT NAMES.

 From Old Possum’s Books of Practical Cats

August 8 is National Dollar Day.  It “commemorates the day Congress established the U.S. monetary system in 1786.”  Does anyone remember the old Five and Dime stores like Woolworth?  These were the original variety stores.  Now adays they have been replaced by Dollar General and a host of its kindred.

Do you really need an excuse to read?  IF you are a bibliophile, book nerd, or a Tsunde oku, then National Book Lovers Day on August 9 is for you.  There may not be such a thing as coincidences, but I learned about Tsunde oko last night on Jeopardy when they were rerunning the first day of  the Teen Tournament and Alex Trebek asked a young lady about an unfamiliar martial art she practiced.

“What is Tsunde Oko? ”  Alex asked.

“It’s not a martial art, it’s Japanese for someone who buys books and then leaves unread and lying aroud” paraphrasing what the young  lady responded.

The dog days of summer last from July 12 to August 20. According to Wikipedia

The dog days or dog days of summer are the hot, sultry days of summer. They were historically the period following the heliacal rising of the star system Sirius, which Greek and Roman astrology connected with heat, drought, sudden thunderstorms, lethargy, fever, mad dogs, and bad luck. They are now taken to be the hottest, most uncomfortable part of summer in the Northern Hemisphere.

National Dog Day is celebrated just after that period on August 26.  Appreciate man’s best friend whether your dog came from a shelter or a breeder; is a pet, service dog, working dog or some other role.  Wisdom from a dog:

Wag more, bite less.

On Those Nights

On those nights  when bruises  bloom
Freight train whistle fills the room
Chug chug clickety clack
Signalling another pain attack

Pain meds provide no relief I sigh
As the hours trickle by
One, two.three, then four
Shadows shift across the floor

I lie awake alone at night
And wish my pain would just take flight
Through long hours of introspection
Why the pain, is this infection?

I’m relieved to see at dawn
Merely bruises to gaze upon.

Squirrelly in the Summer: Hanging By a String

The squirrels had become quite adept at feeding from the seed brick enclosed by a metal cage, even after my husband relocated  the feeder from inside the porch to the outside edge porch overhang.  The squirrels would either climb down from the gutter or a few would still jump up from the porch railing.

The three main techniques were the wrap around position:

The upside down position:

The  most impressive position (which I never got a picture of) was a squirrel hanging by one toe from the gutter above and feeding from an upside down position.  This position always ended with the one  toe slipping, an embarressed squirrel bouncing off the railing below and dashing back towards the tree.  Tell-tail evidence was a wildly rocking metal container.

Earlier this month, my husband decided to make squirrel feeding a more competitive exercise by removing the metal cage and handing the food brick from a plastic wire attached to the hook that previously held the metal cage.  Most of the bird were light enough to perch on the side of the block, while the squirrels would have to figure out how to hang  upside down from the gutter above.

It took a day before one industrious squirrel figured out how to eat by hanging down from the gutter above.  From this picture, the fellow almost looks like he has six pack abs. You can see where a corner of the block has been chewed away.

Once the squirrels had figured out how to deal with this new take-out impediment, my husband relented and restored the metal cage, making it easier for birds and squirrels alike.

Storm clouds of Pain

Storm Clouds over Cabrillo

Pain rumbled across my knee
Chasing the swollen purple bruises
Like storm clouds at sunset.
Infection not in the forecast.

 

Pain clouds ripple across the bruise

 

Paradoxes: What We Say We Want but What We Strive to Change

But well-behaved dogs don’t spring fully formed from the womb. They must be actively raised — which is not easy. The same goes for kids.–Jeff Koyen

As I returned some books to the library this morning, I drove past a straggle of four-year-olds from a nearby preschool.  The first two kids in line held the teacher or caregiver’s hands.  The rest followed in two loosely constructed lines.  Each of the approximately sixteen kids carried a colorful plastic waterbottle as he or she trudged along.  One young lady  marched virorously, swinging her waterbottle in one hand and  sucking strongly on the thumb of her other hand.   You can make me carry this waterbottle but I’ll do what I want with my other hand.  So there!

We proclaim that we like the naturalness and spontaneity of  young children and puppies.  Yet we spend a lot of time and effort teaching them appropriate manners on how to eat, when to keep quiet, how to communicate when they need to relieve themselves and the appropriate place to do that, and how to behave in public. We  teach our dogs to walk on a leash, our children to hold our hands or remain in their strollers,  not to bark or scream, not to scratch their privates or sniff another dog’s butt.  Much of this is done in the name of safety and manners that will make the child or pup more socially acceptable and less  prone to disasterous accidents.

Why do we strive to change the very behavior we swear we like?  We praise owners and/or parents with well behaved offspring.  Yet we love to look at children and puppies gamboling around, being carefree and innocent.

We spend the child’s first year waiting for her to say her first word and take her first step.  We then spend the next seventeen years telling them to sit down and be quiet.

July Pool Side

Sunshine dazzling and warming
The poolwater into shimmers
Riding lawnmower chugging
The smell of fresh-cut grass into the air
Birds song trilling
As the soft breezes blow
Soft cotton towel cushioning
My legs on the chaise lounge
Condensation off the glass dripping
Down my arms as the cool water slides down my parched throat

Flaming in the West

The West is on fire at the end of the day

It’s just the  sun setting in a breath taking way.

No need for alarums, no time for delay.