Even though I’m making progress, it’s still a slog. The big issues are physio–so much physio!–and also pain management. It feels like alternating between physio and icing and elevation is still pretty much a full-time job.
The hardest and most important exercises are focused on range of motion, making sure my knee can bend and straighten. But I’m also doing some balance work, standing one legged with the operated leg doing the work. The other focus is strength, lots of sit to stands, and leg raises.
I’m excited to say that I’m making progress. This isn’t a particularly flattering photo but it does demonstrate that I’m getting better at bending my knee. A lot of physio went into getting there!
Sam with crutches getting into the car
Also othe bright side I’m off the serious pain medication.
I feel more like myself
I can read again. Phew.
After four weeks, I can drive again. It’ll feel better not needing Sarah or my mum to take me to physio.
I’m getting around pretty well on crutches and in the house, within a room, I don’t really need them. I’m still struggling with carrying stuff. I need a coffee and book carrying robot to follow me around the house. I can do basic household chores like dealing with the dishwasher and cooking and sorting clothes but I can’t do things that require carrying stuff, like setting the table.
I also had the surgical staples removed and check in with the surgeon in London
No more staples
I think it looks pretty good. I’m impressed with their needlework/stapler skills. What I can’t do, until that heals completely, is immerse myself in water. I can shower, yes, but no swimming pools, hot tubs, or baths just yet.
I can now look forward to short outings.
This past weekend we had breakfast with a friend.
Sarah and I made also it to the farm. For me there’s no swimming, no hot tubbing, no bike riding. There’s still lots of physio and icing but with different scenery. It’s lovely.
Hoping to go out to the movies next week.
I’m also looking forward to getting back to work. Medical leave for knee replacement is 6-12 weeks and I’m hoping for the short end of that range.
Have you had a surgery with a long recovery period like this? Any advice you have to offer?
This is a reblog of a newsletter post from the Rockvale Writers’ Colony by Sandy Coomer, its founder and director. Note: I’ll be there for a two-week writing residency in mid-October! She has things to say about what happened when she had to take a pause from life as usual. I’ll let her take it from here. -catherine
Anyone who knows me well knows I’m very active and busy. That’s my natural tendency. When I rest, I’m often thinking of and planning for the next burst of energy required for the next new project or idea. It’s hard for me to slow down. In fact, I rarely stop for long . . . unless I’m forced to. Funny how that works. When it’s necessary to pause, when I’m required to stop my busy enterprises, I’m pleasantly surprised at how refreshing it is to simply “Be.”
I had a triathlon race in Wisconsin this past weekend. I had a good swim and was at mile 15 of the bike when a pedestrian/spectator ran onto the bike course and we collided. The collision made me crash head-first into a parked pickup truck. The moments that followed were interesting. I was unable to say where I was or what my name was. I didn’t feel panic – just a sort of confused wonder at what I was doing on the road. I knew I was in a race, but I had no idea where. When someone told me I was in Wisconsin, I remember thinking, “How in the world did I get to Wisconsin?” Within a few more minutes, I remembered everything, and then I was whisked away to the emergency room.
I’m not badly hurt, but I will need a few weeks to heal from my injuries. It’s a forced pause, a slow-down to allow my body to heal and my concussion-addled brain to steady. Living in the still air of patience and acceptance is a lesson in a different sort of fortitude than the one I’m used to. It wasn’t in my plans to get hurt, but the hurt came anyway, and it’s my responsibility now to see what I can learn from it. Otherwise, the experience is wasted.
Here’s what I’m discovering from my forced “Pause.”
People matter more than anything else. So many people have taken the time to check on me and see if I need anything. Am I attentive to others’ needs when I’m in “Busy” mode? Can I take a moment every day to tune into another person’s heart and say “I see you, you matter?”
Being still teaches a certain kind of balance which can lead to delight. I sat on my back porch yesterday and watched the afternoon fade into dusk. Two chipmunks were chasing each other from the porch to the grass and into the burrow under the shed. I felt like I was a crucial part of this scene. I belonged in an intricate way to the wonders of nature. I didn’t move or direct anything. I simply was there.
Letting go of perfectionism is the key to being satisfied. I was sorely disappointed I didn’t finish the race. I kept replaying the details of the wreck in my head over and over. What did I do wrong? What should I have done differently? Sometimes, stuff happens that we can’t control. Sometimes, we simply have to accept the drama of the day and move on with gratitude.
Beauty exists in every situation if you stay open to it. As I was being driven from the ER back to my hotel, I noticed the light glinting off the water of the lake, little cups of sparkle and glee. I thought, “how beautiful.” Back at home, I settled into my own comfortable bed with its floral comforter and sage green pillows and I thought, “how lovely.” Do I even notice this when I’m focused on all I need to get done?
When I think about my writing, I realize that if I get too focused on the achievement aspect and forget the beauty of each moment, I can miss the whole point of writing entirely. I write because I have something valuable to say. My writing comes from my soul, not my ambition. Remembering that is what will keep me at the page.
A “Pause,” forced or chosen, can be a time of pondering and eventually, great insight. If we believe every situation has a purpose and a lesson, we’re more apt to let experiences teach us and take the lessons to heart. Yes, we learn a lot from work, but we learn equally from not working, from pausing our “Go” button, and simply allowing the universe to share its infinite wisdom. I would not have chosen to wreck in the race, but I AM choosing to ponder the Pause, the Moment, the Wonder of Being Here Right Now.
So I am the sort of person who is good at following the advice of physiotherapists. I’ve successfully rehabbed some serious injuries and I trust the professional advice of physiotherapists. I do what I’m told.
It’s also worth noting that I have exceptionally good benefits and they cover almost all of my physio costs. And yet, even for me, physio after knee replacement is tough and I thought I’d explore why.
First, advice about recovering from knee surgery can sound contradictory. The take home sheets from the hospital say to use your new knee as much as possible each day. It will help you heal faster from surgery and improve your chances of long-term success. But also it says to avoid pushing yourself too far too soon. So as much as possible but not too much. Yep.
And practically it feels like that too.
The knee feels good and so I go for a short walk. After that it swells up and is painful so it’s time for ice and elevation. I’m constantly moving between making the knee work and then helping it recover.
After I posted about going for a very short walk this morning, friends commented, great, now rest!
What’s as much as possible but not too much? There’s not really good intuitive measure at this stage since everything hurts a lot of the time.
Second, unlike other physio I’ve done this is really painful. It’s the kind of painful where you ice before and after and take pain medication around your pt sessions. Since you’ve just undergone surgery and things still hurt from that, you feel a bit like hiding on the sofa, covering yourself in blankets, and waiting until the pain goes away.
Third, it’s pretty time consuming.
Here’s a rough schedule of my days this week. Next week I’m hoping to be able to get on the bike trainer to help with my range of motion.
6 am breakfast, drugs, ice and elevation in bed
630 physio round one, basic stretching and mobility
700 more elevation and icing and getting ready for the day
Tiny walk
800 Breakfast round two, more pain meds, more elevation and icing
900 Physio round 2 mobility and stretching plus regaining strength
930 ice and elevation
10-12 free time for reading possibly napping
12-1 lunch
100 ice and elevation, more pain meds
130 Physio round 3, mobility and stretching and regaining strength
200 ice and elevation
230-4 free time for reading and napping etc
4-6 dinner etc
7 last round, 4, of basic mobility physio
Tiny walk #2
Bed with all the ice and more pain meds
That’s me on the deck post tiny walk, resting and icing, as friends and physio advised.
Like most cyclists, I have a yearly distance goal. It’s ranged over the years from 4000-7000 km. This year it’s 5500 km.
My goals and monthly activity on Strava
I’ve got 785.5 km to go. In normal times that would be perfectly reasonably even going into the fall months because of Zwift and weekend gravel rides.
But I’ve also just had total knee replacement surgery. Another friend who also had the same surgery got back on his bike at 8 weeks. It’s never reasonable though to look at someone else’s progress and make that your own standard. Isn’t there something about comparison being the thief of joy?
I started to do the math. There’s 18 weeks left in 2022.. Suppose I’m like him and riding on Zwift at 8 weeks. That gives me ten weeks to meet my annual mileage goal. That’s about 80 km a week. Say 4 easy 20 km rides a week. I could even do that slowly, just spinning, no pressure on the pedals.
Still, though it might have doable, it also might not be.. This isn’t a year for distance goals. If it works, great. If it doesn’t, fine. I have big picture goals about mobility and long term bike fitness. That matters in ways that arbitrary numbers on the bike computer just don’t.
I do have one immediate goal though–getting upstairs on crutches to the shower! I can shower if I can keep the incision covering dry with a plastic bag taped on and use a hand held shower. Sarah just bought one to install.
That’s our weekend mission.
Next week it’s my hope to be sleeping upstairs and have the bike back on the trainer downstairs. I’ll be using the bike purely for range of motion purposes. It’s likely going to be awhile before I can make a complete rotation on the trainer.
Anyway, I’m blathering. Thanks pain drugs. The point is just to say, I’m giving up distance goals and sticking to sensible short term functional fitness while my knee heals.
Sam with crutches outside Defy physiotherapy in Guelph
So this month I both rode my bike in the Friends for Life Bike Rally and I’m having total knee replacement surgery.
I didn’t plan it this way at all–I signed up for the bike rally a long time ago and I just got the call about knee surgery a few weeks ago.
I’ve been amused at the variety of reaction I’ve gotten for this and I have some thoughts of my own.
My favorite reaction was from the massage therapist at the rally. She laughed when I told her my knee was sore but not from riding. It’s just always sore. We focused on my back and ignored the knee. “You don’t owe that knee anything, ” she said. “It’s nice that you don’t have to baby it through the bike rally. You’re just going to finish the rally and then say goodbye to it.”
My regular everyday ongoing knee physio people are impressed. They talk about the important of strengthening the muscles around the knee prior to surgery and that riding a bike is a good way to do that. We never waste time in physio sessions bike riding since I also ride my bike to get there. They’re keen to get me back at physio within days of surgery. Currently surgery is Monday and my first physio appointment is Friday. But I won’t be biking there that time. Or driving either. My mother likely will be taking me.
Lots of friends are confused about my ability to ride my bike so far. “But I thought you were having knee replacement surgery?” Yes. But it’s never been about riding my bike. It’s that once I get off the bike I can barely walk around the block and I can’t stand for very long. That’s true even if I don’t ride my bike at all. My knee actually feels better when I’ve ridden my bike.
For a few years now I’ve come to rely on cycling. Sometimes I ride around campus. I travel with my folding bike so I can get around a new place without walking. At first it was a matter of giving up on other athletic activities–soccer, running, Aikido etc. But lately it’s been a matter of giving up more everyday stuff. For example, I wait in the car while Sarah goes grocery shopping. Cheddar just gets short walks around the block. And I carefully plan my trips up and down the stairs.
The bike rally was a good example of how limited my life is outside of cycling. Yes, I could ride my bike 110 km each day. But once I got to camp I needed Sarah to put up the tent. The walking around the campsites wasn’t easy. I’m really looking forward to being able to do more, besides ride my bike, as much as I love it.
Mostly I’m looking forward to long walks, hiking, and canoe camping with long portages. But also everyday things like sleeping through the night without knee pain and being able to get groceries and put them away.
Wish me luck. Surgery on the left knee is one week! Surgery on the right is 6 months to a year after that.
I’ve written before about my one seriously arthritic toe. One! What a weirdo toe. It’s the same toe that kept losing the toe nail at even the hint of strenuous activity. It’s a toenail that sees cross country skiing in its future, turns black, and falls off. The same, of course, for running. It’s my Bad Toe, and I’ve even been prescribed toe physio for it.
I confess I haven’t been keeping up with my toe physio. And issues with my knees felt more pressing and that felt like physio enough.
Until my feet started hurting while riding my bike. Toe cramps bad enough to make me want to get off my bike. Ouch! I wear orthotics in my running shoes and in my everyday boots. But until now I thought of cycling as an activity that didn’t require orthotics. The keywords are “until now.”
So I now have orthotics for my cycling shoes, in addition to my running shoes, and they seem to help. Aging bodies and activity seem to require a bunch of extra work and resources. I’m feeling extra grateful for my benefits these days.
Cycling shoes and running shoes with socks sticking out
Mostly, these days, I don’t mourn the things my knees used to do. I’m forward looking, thinking about knee replacement and about long hikes. Also, dancing. I’m excited about having dancing in my future.
Running is a thing of the past.
Four years ago I wrote that not being able to run made me sad and I admitted that sometimes I cried about it.
Now, I am anticipating dancing. I think often about long walks. I can’t wait until I can sleep without pain. But running? Meh. I no longer cry about missing it.
Still, I’m shocked at how fast all this has happened.
A few people asked if I was doing the Pride Run this year. Nope. No more Pride Runs.
I remember getting the running reprieve from the knee surgeon when we first met. He asked how much I liked soccer and if I was okay with giving it up. I was. But running short distances fast? (Well, fast-for-me.) That could stay.
Here’s my Facebook status update from May 15, 2015, “Knee surgeon appointment was uneventful. As you might wish for with a knee surgeon. I don’t, as yet, even need any of the pre-surgical options. Keep doing physio, stay pain free, ride my bike as much as I want, keep running short distances (5 km) and revisit in a year. Bye bye soccer. But we knew that. And it’s fine to work on running 5 km faster.”
And here’s Mallory and me at the Pride Run 7 years ago.
Mal and Sam post Pride run
What’s on my list of things that I can’t do now that I hope I can do in the future?
Dancing
Hiking
Walking around new places when I travel
Backpacking and back country camping
Sleep without pain… That’s a biggie
Walking around campus all day without worrying I’m doing too much
Standing up at social events and convocation
Thanks to J Williams for making this photo available freely on @unsplash
A year ago, I wrote here about an injury and dispiriting MRI results: complex and degenerative tears in both menisci. The specialist sat me down for the bad news: surgeons in my town were not going to be interested in having a look, believing that meniscus surgery puts knees at risk for joint replacement down the road. I had some questions about my injury—it didn’t fit the meniscus tear stories I had read, which included sudden pulls or twists or pops. Nor was I experiencing the usual symptoms related to meniscal injury: knee locking, clicking, giving way. But the images seemed to speak for themselves. The specialist was sorry. There you go.
As he delivered the bad news, I should have remembered that visual data is always context specific and always read through an interpretive lens. I couldn’t find my way to questioning conclusions that the MRI results seemed to underscore, but I was alert to the significance of a remark made along the way, something along the lines of, “You know, you can burn more calories riding a bike than you do running.” “Hold up,” I thought, “who said anything about calorie burning?” I didn’t run to manage my weight, nor do I talk about exercise in this way. I suddenly saw myself as, I’m guessing, the specialist saw me–a middle-aged woman who jogs to keep her weight down. I became suspicious of his quick assessments and conclusions. My family doctor also had some questions. To his mind, there was no reason not to put me in front of a surgeon rather than discounting the possibility of an intervention out of hand. He agreed that a second opinion was in order.
Fast forward past the usual long wait time and I’m in front of a specialist in another city. The conclusions he draws, looking at the MRI images, are radically different. The degenerative meniscal tears, he says, are pretty run of the mill. I have probably been running with them for years. There is no need for surgery because they aren’t the cause of the injury. He puts me through a range of tests relating to meniscal function, closely examines my gait and alignment, and then announces, “Patellar tendinopathy.” My gait, he points out, is slightly knock-kneed, and in the absence of strength training to support proper alignment, the tendon is aggravated by being dragged over the joint the wrong way. I had been sitting on my butt for months at the start of Covid, leaving the house only for easy runs and not much else—certainly not strength training at the gym. The knee trouble began when I ramped up to longer distances the fall of 2020.
These days I’m running again, shorter distances until I have time to undertake strength training with diligence and attention. Will I run a marathon again? I don’t know. But I do know that I was able reclaim running by advocating for myself. I thank the doctors who respected what running means to me.
I recently finished a sprint triathlon, my first in four years. The run felt like freedom.
Picture: AC on the podium for an AG win at the Oliver Triathlon, June 2022.
Alison Conway trains and works on the traditional and unceded territory of the Syilx Okanagan People.
I’ve been seeing physiotherapists and sports medicine doctors about knee pain and function since my mid forties. I’m 57 now. It’s been a while.
Advanced knee osteoarthritis has ended my time as a soccer player first, then running, then CrossFit, then cross country skiing, and then Aikido. My sports world has narrowed considerably. I still lift weights and do yoga and ride my bike, but I can only walk short distances and I’m in pain a lot of the time. Lately it’s started to affect my sleep. Wordle helps. Thanks Wordle.
Years of physio, injections, canes, and braces later, in 2018, a sports medicine doctor recommended me for total knee replacement and referred me to an orthopedic surgeon. It was time.
Image description: A photo of Sam just outside Central Park. I’m wearing black leggings, sandals, a sleeveless black jumper and a purse over my shoulder. Also, a knee brace. I’m smiling and the sun is shining.
In August 2019 I went into the hospital and met with the surgeon and his assistant and talked about what the surgery involved, how much recovery I would need etc. Since then pretty much radio silence. There was the usual wait. In Canada it’s a year to 18 months depending on where you live. But then there was the pandemic.
Some friends had knee surgery during the pandemic. Why them and not me? I’m not sure. One had both knees replaced at the same time and while that sounds brutal it has a kind of economy of scale and risk that sounds attractive. Would I be eligible for double knee replacement? I have no idea.
Last summer in 2021 I reached out to the referring physician to check in. I started to have those kind of worries that arise in this sort of situation. Could they have the wrong number? Maybe they lost my file?
The sports doctor has a memorable name. It’s one of those names you can’t quite believe isn’t a joke. It’s “Getgood.” He’s Dr. Getgood at the Fowler Kennedy Clinic in London, Ontario. New xrays determined that now both knees need replacing. They can’t do any more injections because in case I do get called in for surgery that would make surgery not an option. You need to wait months between last injection and surgery.
The clinic said that the hospital kept operating on young athletes throughout the pandemic, less worries about covid I guess. Once things opened up again, there were hundreds of seniors with zero mobility who needed joint replacement. And I see why they need surgery before me. Still, being stuck in the middle and waiting isn’t much fun.
So here I am. As covid continues, the surgical backlog grows. American friends are puzzled. People keep think I’m putting off the surgery because I’m nervous. Not true. I mean, yes I’m very nervous but that’s not the issue.
I’m just waiting.
I’m learning about how waitlists are maintained.
I’m learning about Quebec’s two tier system.
I’m finding the opacity of the system frustrating. I’d like to know where am I on the current surgeon’s waiting list. I’d like to know what the criteria are. I feel like I could make better decisions about my life if I had more information.
Friends suggest I change waiting lists, change hospitals but I’m not sure. Does that mean I go back to the end of the line? Can you be on multiple surgeons’ waitlists? None of this is clear to me.
Through my family’s varied health crises, and we’ve had some dramatic ones, I’ve been proud of the Canadian health care system. But I’m not happy and I’m not proud of where we are right now.
“There are thousands of Canadians whose surgeries have been postponed because of the strain COVID-19 is putting on health-care. Matt Galloway talks about addressing this health-care issue, with Dr. Jean-François Joncas, an orthopedic surgeon and president of the Association d’orthopédie du Québec; and Dr. Danielle Martin, a family doctor and the chair of family and community medicine at the University of Toronto.”
At the moment I’m on an airplane. My first flight since the pandemic began. There’s a lot of standing and walking in airports. I’m starting to consider the mobile cart to the gate. I’m staying in the conference hotel to avoid walking too much and I’m telling friends who I’ll see here that I need to eat in or near the conference hotel or take taxis.
Update: It’s very pretty here and I’ve walked a fair bit so far.
Vancouver in bloom
There’s also a 24 hour Peloton Studio at the hotel and bike rental nearby. Don’t worry. I’ll keep moving on two wheels. There’s also a pool, a hot tub, and yoga. I’m a naturally cheerful, optimistic person but if you get the sense that this is starting to wear on me, you’d be right.
Dressed for travel 2022 style
The early mornings are nice here too.
Boats, water, and grey sky with sun just starting to rise
If you are hiking in a group and waiting for slower people to catch up, don’t start walking again when they do catch up, because then you got a rest and they didn’t. I think about this tip a lot, in many different contexts.
Thanks to severe osteoarthritis in both knees, I’ve become a slow walker. See here and here and here.
Cheddar is very patient and seems to easily adjust to whatever speed I want to walk.
Walking with Cheddar
I’m glad my friends who walk with me–hey Kim!–are patient.
On the bike, I’m sometimes the faster one and this same lesson about waiting for slower people is true there too. When waiting for slower riders at the top of the hill, never just take off when they get there. Sometimes cyclists play a game called “no rest for the wicked” where first to the top have to ride back down and ride up again with the slower riders. As a slower rider, on hills, that feels ok with some people, some of the time. I talk more about this here.
When I’m walking and people get ahead, I’m happy if they walk back to me and I’m also happy if they wait. The only bad combo is waiting and then taking off again the minute I get there. That’s lonely and it would be less pressure all round just to walk by myself.
Walked home from work!
Recently my knees have been feeling a little less painful. I’ve even been able to walk home from work and I’ve been enjoying walking alone in a way I haven’t before. It’s a nice mental break between work and home (the bike ride is too fast to count as a real break) and I like getting to have complete control of the pace without worrying about other people.
