Tag: surgery

fitness · strength training

Checking in after total knee replacement surgery, 7 weeks out: Sam is returning to her Activities of Daily Living

Sam B2 Comments

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.

Chase and Cheddar. My mum’s other dog Charlie is a little camera shy.

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.

Sam in her office

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.

The tree in my front yard that’s gloriously red in October, stick like in November.

Here’s me checking in after Week 1, Week 2, Week 3, Week Four, Week Five and Week 6.

fitness · injury

Sam is checking in three weeks after knee replacement, CW: contains photo of operated on knee after staples removed

Sam B5 Comments

Knee replacement isn’t easy. It’s been 21 days now. I checked in after one week and again after two weeks and I’m checking in again now.

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?

fitness

Sam is checking in two weeks after knee replacement surgery

Sam B4 Comments

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.

Yay for tonight body pillow

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.

She Hulk

What’s up this week? Staples removal and follow up appointment with the surgeon. Stay tuned.

cycling · fitness

First time back on the bike

Sam B1 Comment

It’s baby steps but I’ve been given the okay to get back on my bike on the trainer.

The goal isn’t some number of kilometres, a given amount of time, or to reach a certain power level

Instead, it’s something much more basic and fundamental. It’s all about regaining enough mobility so that I can make a full rotation of the pedals. It’s range of motion time, baby!

Various guides to knee replacement say to expect a 5 degree improvement in the angle possible for your new knee each week. You need 90 degrees to ride a bike. A goal is 120 if your leg size permits that. Not sure mine does. I was at 52 degrees last week, a few days after surgery, and 67 today eight days after replacement.

But all of these guides to knee replacement say don’t compare your progress to the progress of others. Different people take a different amount of time to get there.

It’s unlikely I’ll be able to that the first few times I try I’ve been told. So no expectations.

Also, even once I can I’m to use the trainer in a very spinny gear, no pressure at all on the pedals.

Whether or not you’re a cyclist the bike trainer is a basic rehab tool after knee replacement surgery. Surgeons and physiotherapists have to talk people who aren’t cyclists to give it a go. It’s easy when the patient’s first question is how soon can I get back on the bike (on the trainer to start.)

It’s all about passive range of motion. Here we go!

Sam on her trainer
accessibility · fitness · habits · injury · stretching

Recovery and why physio is so hard!

Sam B1 Comment

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.

Patience my friends is going to be key.

cycling · fitness · goals · injury · motivation

Letting go of yearly goals and focusing on smaller things

Sam B

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