After spending the better part of two weeks dealing with Covid, I am finally feeling mostly like myself.
I missed two weeks of Taekwondo, missed lots of walks with Khalee (I didn’t miss two full weeks of walks, those are easier to scale to my current energy levels) and kept my yoga mat rolled in the corner.
I really missed my usual activities. Aside from my enjoyment of the movements themselves, I missed the shape that yoga and walks give my days and the shape that TKD give my weeks. Without those things, my last two weeks have had a ‘stepped out of the normal flow of time’ kind of feeling.
This time last week, I had to sit down after putting in a load of laundry (there are two flights of stairs involved) and trying to do even gentle yoga left me feeling not quite dizzy but definitely disoriented.
And aside from the physiological evidence that I needed to take it easy, I also have read (and heard evidence from friends) that pushing yourself too hard when you are recovering from Covid can lead to complications.
Today though (I am writing this on Monday), I did a little gentle yoga and my walk with Khalee, while somewhat short, didn’t leave me feeling worn.
In fact, the movement in both cases felt GOOD instead of being mostly tiring.
I’m taking that as a good sign that my recovery is on track and that I am easing back to my regular life.
I’m still going to rest when I can and pay close attention in case things get to be too much for me but I’m glad to be stepping back into *my* normal flow of time.
First, I had my six week follow up with the surgeon last week. Everything looks good. Next check up is by phone at 3 months and we’ll talk then about the schedule for my right knee.
Second, the physio recommendation from the surgeon says to focus on five things: extension and flexion (bending and straightening of the operated knee), strength training, balance, gait, and a return to the Activities of Daily Living. It actually said “return to ADL” and I had the look up what that meant.
I think that means stairs, dishes, laundry, etc. I’m walking about the house now loudly proclaiming, look at me doing an activity of daily living. The thrill will wear off I’m sure.
Third, in addition to physio and my daily living activities, I’m busy with aquafit two or three times a week. I’m also riding my bike on the trainer 15-20 minutes a day. Cheddar and I are walking again. He’s such a patient lovely dog and great walking at my speed, whatever that speed is, and not taking off after squirrels.
Fourth, I’m back at work and feeling happy to be re-engaged with the wider world outside my house, my left knee, and physio. The trick will be not over extending myself. I had the option of staying off work for 12 weeks, rather than 6, and so I am thinking of the first 6 weeks back as a chance to say no to some of the weekend and evening dean stuff and involve other people.
I’m trying not to fret about late fall, and dark November days. I’m going to all the holiday parties this year, no matter how early. I’m going to enjoy the hot tub and sauna at my fancy new gym. It also feels good to be back in my office clothes and not just wearing shorts, t-shirts, sneakers, and hoodies. I’m also very much looking forward to extending my time on the bike. Right now, I’m spinning most evenings for 20 min or so, while watching campy movies with my son Gavin. But soon I’ll back on Zwift doing some of the slow social rides.
Early in the recovery from knee replacement surgery process I blogged about what makes physio so hard. And it’s true. It’s hard, it can be painful, and it goes against our instincts–when in pain–to curl up on the sofa/bed, under a bunch of blankets, and not move.
But there are also some respects in which physio is easy for me. People note that I’m ‘good at physio’ by which they mean that I actually do it. Various physiotherapists through the years have noted it too. I’m a compliant patient. If they say to do exercise x, y times a day, then that’s what I do. They’re the experts, offering expert advice, and I follow it.
Well, everyone assumes I’m highly motivated to get back on the bike and start riding again. And that is true. But I don’t think it’s motivation that does the work on a daily basis. I am motivated. It’s true. But I don’t think that on it’s own it would be enough.
An important part of it is habit, plain and simple. I have the time available. If you normally exercise an hour or more a day, and you can’t because of injury or recovery, then physio just takes the place of the thing you would be doing if not injured. It’s why athletes are very good at physio. I’m not struggling to find time to do physio. I have the time and I’m just doing physio instead of other physically active things. In my case I was doing physio pre-surgery to get ready for surgery. And before that to help manage my condition.
What I didn’t do while recovering? Well, I’d hoped to read a lot. I thought I might even do some writing (ha!). But I did neither of those things. Twice daily physio (with ice and elevation after, plus, in the early weeks, naps) took up most of my day. I did watch a fair amount of TV while icing and elevating!
The other bit that helps is my identity as a person who can do hard things. Cate has blogged about grit and it’s a quality we share. Like Cate, it’s part of my self conception that I’m a person who can take on physical challenges. I ride in uncomfortable conditions, too hot, too cold, too hilly and so on. Knee physio isn’t as much fun as riding my bike in tough conditions but I do feel proud of being able to do it in the same way.
Today is my first day back at work and my challenge will be keeping it up with a job that can be very busy into the evenings and weekends. I need to remind myself that medical leave for knee replacement is 6-12 weeks and I’m just taking 6. I’m going to try to count the next six weeks as part of my recovery, keeping up with physio and getting help with the parts of the job that spill over into evenings and weekends. I’ve cancelled two conferences this month and while I will feel sad missing them it was the right decision.
I did round one of physio in bed this morning with icing and elevating after. Instead of TV I caught up on some much neglected email. Tonight at 7 pm I’ve got a meeting with the physiotherapist to assess progress and learn some new moves. After that, it will be an early night. Zzzzzzz!
It’s Saturday morning in late September. I’m sitting in one of my favourite coffee shops enjoying a latte and trying to get the chill out of my bones. I decided to bike here this morning, despite the thermometer reading eight degrees. I love Ottawa in the fall: it’s one of my favourite times of year. The leaves are turning on the trees, but the Parkway is still reserved for cyclists on the weekends, which makes for some breathtaking rides. The Parkway hugs the Ottawa River, so it’s not unusual to run into hordes of Canada geese as you bike down the west-bound lanes. When the cars are away, everybody gets bolder, including the wildlife.
I’ve been a cyclist most of my life and in my twenties it was my main form of transport. A friend once described cycling as the closest humans every get to actual flight, and I agree. But I had an accident on my bike about a decade ago that left me fearful of climbing back on. While I still cycled every so often, I lost the joy I had had before my accident.
Then about six years ago I took the leap and bought a new bike: a bright red electric bike modeled after the wide-handled cruisers of the fifties that appealed to both my love of two wheels and my personal aesthetic. To my deep pleasure I rediscovered the joy of pedalling along the many bike paths this city offers. I could ride to work almost exclusively on paths. The five-kilometre trip was a pleasure every time and I resisted getting back on the bus until early December.
But last year in the late fall, I had a stroke. Hospitalized for the first time in my life, I spent two weeks answering every person who asked me, “What is your goal for recovery?” that what I wanted most of all was to get back on my bike. I didn’t know that this was a very unlikely and lofty goal. When you’ve had a stroke, people treat you like you’re not entirely compos mentis (which of course you’re not) and they don’t try to nay-say you. If I wanted to get back on my bike, nobody was going to tell me it was very unlikely.
But the first week I was back home, I climbed up on my stationary bike, which I had bought just before the pandemic hit in order to keep my biking muscles in good shape over the winter. I lasted five minutes. It wasn’t just the challenge of biking – even the act of getting on and off my bike was hard. I wobbled. I tripped. I cried a little. And I persisted. By January, I was on my stationary bike three times a week for 20 minutes. By March, that was four to five times a week for 30 minutes.
Then, at the suggestion of my massage therapist, I started upping the difficulty by twisting my upper body as I pedalled. Then I added hand weights. Then I closed my eyes, which forced me to try to balance more carefully.
In April, Big Red, my beautiful bike, came up from storage in the basement. In early May, I attempted my first ride on a real bike. It was a mere six kilometres over 30 minutes, but I wept with relief at the end of it. I had not fallen. I had not had to stop.
My balance was still shaky: getting on and off Big Red was not easy for me. If it had not been for the throttle that permitted me to get started without pedalling and let me catch my balance as I took off, I do not think this would have been possible.
Since that first ride, I have probably done 600 kilometres this summer. Weekends are my big ride, when the Parkway is open and I can pedal almost all the way to my coffee joint on a wide lane meant for cars, but I am on the bike paths several times each week. My Saturday rides are over 20 km.
I am stronger, better balanced and more confident on my bike. I have even survived a fall with relatively minor damage. But if it hadn’t been for the help having an e-bike gave me in the early days, I am not sure I would be back biking. Doctors and nurses have met the information that yes, I did get back on my bike with polite incredulity. And being back has helped me heal not only physically but mentally from the feeling of total incapacity I experienced last fall. I’m still here. I’m still pedalling.
I’m so grateful.
DJ Brown is a performer turned government wonk living and thriving in Ottawa.
They tell you that recovery from total knee replacement is a long haul of physio and rehab.
I’m here to say it’s just dawning on me how true that is. It’s not that I didn’t believe it before. I did. But now I’m feeling it too. That knowledge is real in a way that it wasn’t before.
There were big gains in weeks one, two, and three. Not so much this week. This week I might have overdone it. Too many tiny walks? Too much mobility work? Possibly going to a Tafelmusik concert in Toronto might have been too much. But the music was beautiful and I had a lovely visit with my daughter so that was all good.
I had hoped to report that I could turn the pedals over on my bike my now, but I can’t, yet. And yes, I know there are no fixed timelines for these things and that people regain mobility as different rates. Still, in my head it seemed reasonable to be back on the trainer in a month and I’m not there yet. I mean, I’m there, but I’m not making full rotations of the pedals just yet.
Weirdly, I am so close when I do it backwards. Weirdly backwards everything is easier. I’ve been doing walking backwards without crutches drills for physio and I don’t limp walking backwards.
Why is pedaling backwards easier? Here is one explanation:
“Pedaling backwards after knee surgery is often easier because of the hamstring activation. When you pedal an exercise bike forward the quadriceps is likely more active and the hamstring is likely less active. By pedaling backward after knee replacement surgery your hamstring is pulling the lower leg back which often improves knee flexion.”
The other hard thing is simply pain. I’m surprised that a month out things still hurt this much. I take pain relief medication regularly, not the narcotic stuff–the narcotic pain meds ended more than a week ago. But I’m still waking at night with pain some of the time and by end of the day things hurt a lot.
It’s also fall of course, not my favorite season, and I’ve been brainstorming ways of coping given that my options are somewhat limited this year. My friend Todd is similarly scheming and I’m enjoying reading about his plans even if I’m jealous that they include running.
What am I up to that’s positive?
🍁Well, I’m seeing more of friends and family. I’m out and about more than I was.
🍁Today I get to start driving again. Cars aren’t my favorite things but it will be nice to be independently mobile.
🍁I’ve joined a new gym that has aquafit classes and I’m looking forward to that over the winter. Aquafit isn’t my favorite thing but it’s a thing my healing knee can do once the incision heals fully . And I do love being in the water.
🍁This week the blog’s Catherine Womack comes to visit. She’s giving a talk at Guelph’s Philosophy department called “Epidemiology Food Fight: a fat feminist takes on values in nutrition science.” That’s October 6th, 430 pm.
🍁I’ve dug out my light alarm clock.
🍁I’m very happy to be planning my return to work. I miss the university. I love fall semester even though I’m not a fan of fall overall.
🍁I’m thinking I might start my November gratitude practise early this year and make it a fall thing, beginning October 1. Gratitude is good in its own right and it makes me feel better. Right now I’m thankful that I got to have knee replacement surgery and that I have lots of support through the healing process.
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!
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
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?
After a rocky start and an additional night in the hospital, things have been progressing pretty well with the total replacement of my left knee.
Here’s a few milestones on my road to recovery:
I’m sleeping in my own bed and the stairs, with crutches, seem pretty manageable. I’m still only doing them once a day though.
I’m also going on tiny walks down the street each day.
For better or worse, lol, I can now manage basic household tasks such as unloading the dishwasher, sorting laundry, and making lunch.
Physio tells me I’m going well at both ends of the range of motion, getting the knee to lay flat and bend. Physio is so hard!
I got back on the bike on the trainer just to work on range of motion. That felt both inspirational and humbling. I know it will take time.
Friends warned me about out of character things they’ve said and done, wild emails sent, while on pain medication for knee replacement.. So far so good for me. Except I might have gone on a middle of the night pillow shopping spree after googling “best pillows for sleeping after knee replacement.” They keep arriving.
And speaking of pain medication, I’m just taking the heavy duty stuff now for night time and after physio.
We also went to the wedding of dear friends on the weekend. So much joy! I wasn’t sure if I’d be able to do it and I wasn’t sure how I’d feel just being there for the ceremony, but thanks to pain medication, ice, and Sarah’s help it went perfectly. It was lovely to see friends and to be there to celebrate with Jenn and Annada and their friends and families. I promised them we’ll dance next year for their anniversary.
What’s not going as well as I’d hoped? I’m still struggling with attention span and reading. I was hoping to enjoy having time to read but it turns out physio and recovery is pretty much a full-time job. So far I’m sticking mostly to tv and audiobooks.
Enjoying She-Hulk, for example, but the Booker prize winning novels will have to wait.
What’s up this week? Staples removal and follow up appointment with the surgeon. Stay tuned.
I was frustrated at myself in Taekwondo class last week.
This problem with my heel/toe/calf is making it extremely hard to properly execute my patters because I can hold my leg in the right position. And because I can’t put my leg in the right spot, my hands for get what to do. And then I end up facing the wrong direction and…so on.
I was feeling especially annoyed because I wanted to be preparing for my next belt test but this injury is really slowing my progress.
I’m the midst of all that annoyance, I had a flash of insight.
My physical practice is pretty limited right now but I could be studying my TKD theory. I could be practicing how to describe my patterns and how to teach them. I could be watching videos and observing technique.
But, instead of doing all of that work that is freely available to me, I had been focusing on the one thing that wasn’t available to me right now.
Once I had broken that spell, I started to see all the other ways I had been letting my toe/heel/calf pain get in my way.
I’ve been able to walk each day but a lot of other cardio exercises aggravate my heel so I have been largely avoiding them.
When I started thinking in terms of what I *could* do instead of what I couldn’t, I remembered the seated cardio I did after an injury a few years back. I did a quick search on YouTube and have the one below a try – I really enjoyed it.
I haven’t turned into Merry Sunshine. I’m still annoyed about my toe/heel/calf but I feel good about this change in focus. it better for my brain and for my body.
Have you benefitted from a chance in focus like this?
For both of us it’s the end of our research leaves too.
We’re back in the classroom. (Hi, Western students who’ve found our blog!)
I don’t know about Tracy but me, I’m extra tired. My household contains one very serious high school athlete whose alarm goes off during the school year at 5 am for practice of one sort or another. We’re the morning people in our house. Also, we’re the people yelling “Turn down the music it’s 9:30 pm, I’m trying to sleep. But other family members like their late nights and sometimes it seems sleep is lost at both ends of the day.
There is a much earlier start to my days usually during the school term. Partly too it’s saying goodbye to midafternoon naps (perfect when you’re up early running/biking/Crossfitting etc and rowing or doing Aikido in the evening.)
I love this infographic How to Nap and my favourite nap is the caffeine nap. Basically drink coffee, nap before it takes effect, sleep for 20 min and wake up extra bright eyed and busy tailed. The coffee nap is perfect for when lots more work beckons.
I haven’t yet worked out how office napping might go. I’ve got a comfy chair so perhaps I should just bring in a blanket.
More than ever I need my rest day. Saturday I did the Gran Fondo, rowing practice Sunday morning, Crossfit Monday, rowing practice Tuesday, Crossfit and Aikido on Wednesday. Thursday was more rowing practice and then today NOTHING. Thank God. I do find that recovery time matters more as I get older and that time between efforts matters a lot. I’m going to blog about the science of recovery and my experiences later, I think.
One advantage of my new Friday rest day is that there’s no teaching either! Yes, yes, lots of work to do. Grant application due, chapters to finish, drafts to write, papers to read, letters of recommendation to write. But no exercise until biking with friends (hi Tracy!) and Aikido on Saturday.