[Medical trigger warning]
As today is four weeks since surgery, I thought we should have a progress report on the rehab of my left knee.
Things are now definitely getting better physically; but I’m still feeling very low mentally. Most of the bruising has gone as has almost all the swelling – ice-packs several times a day have helped (the hospital provided a specially designed cuff cooler when I had the right knee done). For some days now I’ve been walking around the house without the aid of crutches or sticks – the exception being the stairs where I still don’t feel entirely safe. I’m still taking crutches if I go out, if only for safety.
When I saw my physiotherapist this time last week I had 110° of flex on the knee, and I know it will be even more by the time of my appointment next Monday. Needless to say the physio was very happy; the flex and function of the knee are good although still painful; he even had me on an exercise bike doing gentle to and fro motion (a full cycle is not yet possible, although I did try). I was given an extra set of exercises to do, which are all about strengthening the muscles as well as improving the range of movement; and the exercises are gradually getting easier and less painful. I’m still being subjected to the torture of the green anti-DVT stockings though.
As you can see from yesterday’s photo, the scar itself is healing well and looks as if it might eventually be even less obvious than the one on my right knee. (Incidentally I don’t know if the visible flaking is dead skin, surplus glue from closing the wound or some form of plastic skin which was applied to cover the wound. But the right knee was the same and it seems to be OK.)
The pain is very definitely subsiding. Yesterday was the first day since surgery that I’ve awoken at 6 or 7 AM and not immediately thought “Bloody hell I must have some painkillers”. In fact yesterday I didn’t need to take any painkillers from midnight to lunchtime – although by then the knee was very achy. So with luck I in the next week I can start thinking about tailing off the codeine, if not the paracetamol as well.
Meanwhile I managed to screw up my lower back last week; and yes, on the left side! This entailed two trips to the osteopath. The first on the Monday helped immediately but then the muscles were going into spasm every time I tried to move. This settled down overnight with a couple of small doses of Valium as a muscle relaxant. But by Friday the lower back was giving trouble again, so Saturday saw me back at the osteopath seeing a different guy who comes to osteopathy via a sports training background. I have to say he was brilliant – not just at releasing the back but also at explaining how this was all down to the muscles and joints readjusting to different ways of moving following the operation. His prescription was to walk (do what you can and build up slowly) to get the muscles etc. used to working properly again. I came away walking well and feeling much more at peace mentally. So far I’ve concentrated on walking around the house, but our long back garden is beckoning.
I’m still feeling anxious, depressed and panicky at times but that mostly isn’t the knee but everything else I have piled up getting me down. But with the pain receding, and a more positive outlook for the knee, I am at last managing to catch up on some of the stuff I’ve ignored over the last few weeks.
So the bottom line is: keep going; keep doing what you’re doing; it does get better (even if it doesn’t always feel that way hour-to-hour or day-to-day). Onwards and upwards.
Category Archives: personal
Ten Things
Having just had my second knee transplant (sorry, total prosthetic knee replacement) I thought that for this month’s Ten Things I should maybe write a few of the important things I’ve learnt about knee replacement operations.
Ten Things I’ve Learnt about Knee Replacement
I’m taking as read all the usual stuff about operations, general anaesthetics, etc. (like anti-DVT stockings, morphine causing constipation). This is knee replacement specific things. First of all it is important to realise that no two knee operations are the same, so what follows is based on my experiences; yours may be different.
- There are three key people in a good outcome: a good surgeon, a good physiotherapist and you! Yes, you! A good surgeon and good physio are critical, but it is equally critical that you put in the work at rehab!
- If you can find out who your surgeon will be, check him (or her) out. If you have a choice, ensure you get someone who specialises in knee replacements rather than a generalist. What’s their track record? How many have they done? The more experienced they are the better.
- Anything you can do before your operation to strengthen your legs muscles, specifically the quads at the front of the thigh, is going to be helpful in rehab.
- Before you go into hospital ensure everything is ready at home, especially think about trip hazards: gangways are clear, rugs are stuck down or removed.
- Get a urinal (maybe two) with a lid – something to pee into in the middle of the night. (They’re cheap and many come with a “female funnel attachment”.) Even with a light on, you do not want to be staggering to the bathroom, on crutches, maybe in pain, barely half-awake, in the wee small hours and while trying to avoid the lurking cats and dogs.
- Unless you have a “slave” (aka. a partner) to fetch and carry for you, get a good bag (shopping bag size) which you can put over your shoulder or round your neck to carry things around when you’re using crutches.
- Post-op your #1 enemy is infection. Ensure no-one (and I mean no-one) touches your operated leg without having visibly washed their hands and are preferably wearing disposable gloves.
- Do as much as possible to ensure you get a good physiotherapist. Poor, or no, physio is the fastest way to ensure you don’t recover your mobility. Rehab physio will start in hospital; they’ll likely have you standing with a frame and walking a few gentle paces just 12 or so hours after your operation. You will be given exercises to do. Do them – as much as you can through the pain (but stop when it gets too painful). And keep doing them. Make sure you get as much post-op out-patient physio as you can and that your first session is within 7-10 days of leaving hospital; these sessions will help monitor your progress and adjust the exercises to your needs. The physios are not there to be sadistic (though sometimes it feels like it!) but to get you doing the right exercises, the right way, and at the right time, to ensure the best possible outcome.
- Recovery is painful! Think about what has been done – someone has done around 90 minutes serious carpentry to remove the degraded bone and replace it, very accurately, with some highly engineered metalwork; and that’s all on one of the most complex joints in the body. Discuss pain control with your clinicians; they will prescribe the right analgesics. Although the pain will recede over time, do not expect to be pain-free for several weeks. But a good outcome is well worth the pain.
- You should be provided with elbow crutches and taught to use them in the day or so after your operation. You will need them for several weeks. Go carefully and don’t get over-confident as this will lead to accidents. On the other hand you should be encouraged to dispense with the crutches as soon as you safely can.
There is a lot more I can say, and I do intend to try to write all this up for the benefit of others. But that will do for now!
Knees Up Again
[If you don’t like things medical, skip this.]
So it’s now a week and the day since I was let out of hospital after a complete left knee replacement to match the right one that was done at the beginning of the year. On the left, here’s the knee before (notice the impressively neat scar on my right knee that was prepared earlier) and on the right dressed post-op:
I suppose the knee is getting better although it doesn’t feel like that much of the time. Initially when I was in hospital it was a lot less painful than the right one had been but since I’ve been home the pain has been more like the same and at times obviously quite bad – which is very frustrating, depressing and demoralizing; but I guess that all part of healing process.
Admittedly all this is being done privately – we’re very lucky in that we can afford medical insurance – and generally I cannot fault hospital. [For anyone contemplating having knee surgery privately, don’t expect any change out of £15,000 per knee.] I had the same surgeon, the same anaesthetist, most (if not all) the same theatre team, and even the same physio on the ward – and I’m even booked in with the same guy as before for outpatient physio – that’s just one of the benefits of going private!
I had a spinal anaesthetic (so I was conscious; recovery is much nicer than a general anaesthetic) and was in theatre on the Wednesday afternoon (13 September) for about two hours. This was followed by an hour in recovery and overnight in the HDU because of my sleep apnoea. Then back in my room for lunch on Thursday.
I still don’t understand how the medics do this! They can rip you open; do 90 minutes serious carpentry; glue you back together; and have you on your feet 12 hours later. In fact the physio had me out of bed and walking few steps with a frame at 10 o’clock the following morning. Rinse and repeat twice a day. On the Friday morning the physio took the Zimmer frame away and left me with crutches; they also made me do a very small, test, staircase in their gym – this was fine although I had struggled with it back in December.
On Saturday morning my surgeon ran in about 8:20, wearing jeans and a rugby shirt, had a quick look, said yes OK you can go home, I’m now off to Portugal for a week (playing golf, needless to say!). Later that morning a physio arrived and took me to do a complete flight of stairs (down and up) and walk a corridor, which was all OK. All the boxes ticked I was allowed my freedom at lunchtime.
What annoyed me was that everyone arranged follow-up appointments according to some notional idea of what they should be and not what the surgeon had told me to do, and as I had requested. They then left me to chase around on the Monday to rearrange everything. That I was not impressed with.
By the time left hospital I had about 80° of flex on the knee; I probably now have about 90° – which is more quite a few people manage after a year; so I guess I should not be too downhearted.
However since I’ve been home everything seems to have been more painful. My GP had a quick look at the knee on Thursday as she was slightly concerned I might have wound infection. However the nurses at hospital changed the dressing on Friday and were very happy everything was OK and no infection. In fact the wound was actually very good and healing well as you can see from the photograph below.
Yesterday, Saturday, I was worried because I seemed to be able to do nothing except sleep all day; totally unable to stay awake. I just could not get the knee comfortable: sitting at my desk was unbearable, lying down slightly better. It’s still not great, but a bit better today.
What more is there to say? Obviously I’m still on crutches and painkillers and will be for a while – although my surgeon says to get rid of the crutches as soon as possible. Obviously I’m also having to do exercises and I know once I see the physio in out-patients in a couple of days time they will get more and harder.
Noreen is being heroic in putting up with me – anxiety, misery, depression and all – and everyone has been sending me good wishes (thank you, one and all!). To top it all, to cheer me up, my lovely friend Katy has sent me a tasting box of various gins (below) which I shall enjoy exploring once I’m no longer on wall-to-wall codeine.
Ten Things
Here we are again with his month’s off-the-wall ten things …
Ten Concepts I Try to Live by:
- Treat others as you would wish to be treated yourself
- If it harm none, do as you will
- Nude when possible, clothed when necessary
- Gender, colour, race etc. are irrelevant to ability and worth
- Sex and nudity are normal
- Openness and honesty in all things
- Say what you mean and do what you say
- Don’t worry about things you can’t change
- Pro bono publico, nil bloody panico
- Zen Mischief
Stondon Massey
A week or so ago we had a little jaunt through SW Essex; I needed to go there on business and it seemed an opportunity not to be missed. Regrettably we didn’t do as much as we would have liked as I wasn’t feeling very brilliant – but we did visit a couple of churches.
The first church was at Stondon Massey, north of Brentwood. The church is a mile or so north of the current village, the suggestion being that the village centre moved due to the various plagues, especially the Black Death of 1349-50. The church dates back to around 1100, with several periods of extension and rebuild. The west window, shown below, appears to date from the early 15th century, and possibly earlier. The wall is of flint, which is the only local “stone” as Stondon Massey is on the southern edge of the ice from the last great glaciation. This flintwork is delightful and “rustic” – much more in keeping with the place than the dull, dark, finely worked, obviously Victorian flintwork on the north-east corner of the church. Note too the decorative use made of the lovely red (probably Roman) tiles.
Unfortunately the church was locked (fie to parishes who lock their churches!) so we could only appreciate it’s age and beauty from the outside. Not that we minded too much as the churchyard (below) was one of the most delightful I’ve seen, embroidered as it is by a multiplicity of oaks and yews with lots of dappled shade and well kept grass all paying homage to the carefully tended graves.
Those of you who know your English music will recall that the Tudor composer William Byrd (c.1540-1623) retired from the Chapel Royal in his early 50s and lived his last 30 or so years at Stondon Massey. Byrd was a recusant Catholic who was regularly heavily fined for failure to attend Anglican Sunday worship and it’s possible he chose Stondon Massey due to its proximity to his patron, Lord Petre, who lived at Ingatestone. Byrd died at Stondon Massey and may be buried there, although there is no documentary evidence for his burial.
Byrd is one of my “heroes” hence snapping up the opportunity to visit on a lovely sunny August day. I think we shall be revisiting.
I’ll keep you in suspense about church number two; watch this space for a post in (I hope) a few days time.
Click on the images for larger views on Flickr.
Extra Cat
Yesterday we acquired another kitten – a boy kitten. Well we can’t have a household of just two girlie cats! Again he came from our local animal rescue charity Guardian Angels and was being fostered by the lovely Kat in Isleworth. Kat said she hadn’t named him but was referring to him as “Boy”. By the time we got him home, it had stuck. He’s about 9 weeks old, mostly white with some tabby splotches. He’s also got noticeably, and strikingly, curly whiskers, a very triangular head and big ears – which makes us wonder if he doesn’t have some Devon Rex (or similar) in his make up; maybe a Devon Rex grandfather?
So here are the first couple of decent photos, taken at lunchtime yesterday, within an hour or so of him arriving. In the first he is offering to help with lunch. Well what self-respecting cat wouldn’t when there’s cold roast salmon on offer?
Like all kittens he’s slightly scruffy, but that never stops them looking cute …
He’s still quite phased by everything. He was the last of the litter to find a home, so he’s been without his brothers’ company for a while. He hated the car journey home. And everything here is different, new and scary especially with two big cats around. But he’ll be fine. I’m confident they’ll all adjust.
If nothing else Boy will eat for England. He clearly wasn’t starving when we brought him home. Nevertheless between about 1pm and midnight yesterday he demolished two complete sachets of kitten food, several teaspoons worth of cold salmon, a piece of raw steak the size of a large almond, and several similar pieces of cooked steak. Oh and the piece of pasta I dropped on the floor. By the evening he was very round and drum-like in the middle; he looked as if he’d swallowed a basketball and was about to split a seam. But then it is every kitten’s ambition to be like that: most cat’s run by the motto “Eat now, lest hungry later”. As Garfield always said: “Eat and sleep. Eat and Sleep. There must be more to life but I do hope not!”
Meanwhile WPC Primrose sat and watched, ready to intervene in any indecorous behaviour:
Actually, apart from spending time out, and being pissed off because our bedroom is out of bounds at present, both Tilly and Rosie are being quite good.
Oxfordshire Photo
I don’t these days get round to posting a weekly photograph all that often, partly because I’ve not been doing so much photography recently.
But a few weeks ago we had a day out in Oxfordshire. I had a meeting in Oxford in the morning and we then meandered our way home via Islip and Brightwell Baldwin, both of which have ancestral connections for me.
This is a wonderful, clearly very old, thatched stone cottage which backs onto Islip churchyard – indeed it is the churchyard wall!
We shall be revisiting both Islip and Brightwell Baldwin.
Another Daft Meme
OK, so I spotted this meme on Facebook the other day. Although I’ve answered some of these questions before there are some here which are new. So I give you the whoel sequence, which I’ve de-Americanised.
- Person you were named after? No-one as far as I know.
- Last time you cried? A couple of weeks ago when we lost our 1-year-old boy cat.
- Do you like your own handwriting? No; at best it is produced by an arthritic spider.
- What is your favourite lunch meat? Cold sausage or garlic salami.
- Do you still have your tonsils? Yes. My parents (probably wrongly) refused to let them be removed.
- Would you bungee jump? No way – ever.
- What is your favourite cereal? Barley growing in the field ready to make malt for beer!
- Do you untie your shoes when you take them off? Only if I’m wearing them at the time.
- Do you think you’re strong? No; neither physically nor mentally.
- Favourite ice cream? Good strawberry or good chocolate.
- What is the first thing you notice about someone? Face, head, hair.
- Football or baseball? Neither really, but football if I must choose.
- What colour trousers are you wearing? The Emperor’s new ones.
- Last thing you ate? Banana.
- What are you listening to? Silence.
- If you were a crayon, what colour would you be? Lime green.
- Favourite smell? Coffee, baking bread, frying onions, spices, roses.
- Who was the last person you spoke to on the phone? Taxi company.
- Tattoo or piercing? Piercing, though I’m happy with both.
- Hair Colour? Mostly grey, going on white, but some remaining mid-brown.
- Eye colour? Blue.
- Favourite food to eat? Curry.
- Scary movies or chick flick? Neither; I can’t abide films.
- Last movie you saw? It’s so long ago I have absolutely no clue.
- What colour shirt are you wearing? Again, the Emperor’s new one.
- Favourite holiday? Sun, sea & sand to relax and do nothing (or something if I choose) but not lying around getting grilled.
- Beer or wine? Both, but beer preferred.
- Night owl or morning person? Neither.
- Favourite day of the week? Probably Saturday.
OK, so now it’s your turn. Just cut’n’paste the questions, replace my answers with yours, and post to your blog, Facebook, wherever. Enjoy!
Ten Things
Summer is here. Well at least we’ve had a few glimpses of it. So Ten Things this month has a summery theme.
Ten Summer Things To Do
- Eat ice-cream
- Watch a cricket match (in person not on TV)
- Eat strawberries (and cream, of course)
- Sit in the garden (or on the beach) drinking wine
- Swim nude
- Paddle in the sea
- Go to a garden and enjoy the roses
- Sit by the river and watch nature and the world go by
- Spend a day in the nude – in your garden or on the beach – and enjoy the feel of sun and breeze on your skin
- Visit a farm to pick your own strawberries, asparagus etc.
Of course, doing these things is not necessarily restricted to summer, but they’re all better in nice weather. So now we just need the sunshine!
Your Interesting Links
There’s a lot in this month’s edition so let’s get straight in …
Science & Medicine
Medics are now saying that arthroscopic surgery for degenerative knee problems (ie. essentially arthritis) does not actually do any much good.
[TRIGGER WARNING] Breaking the taboo of talking about miscarriage.
Another new study shows that, against expectation, women who source online and use abortion drugs do so with very little need for emergency medical help.
And yet another on reproductive medicine … It seems the folk contraceptive “Thunder God Vine” (Tripterygium wilfordii, above) really does prevent conception.
On the physics of having a shit.
More new research has found that daily small doses of cannabis can slow brain decline with ageing – at least in mice.
And here’s yet another instance where it seems we’ve had it all wrong … apparently eating cheese does not raise the risk of heart attack or stroke.
It has long been thought that the way we categorise colours is cultural, but surprisingly it appears to be genetic.
Sexuality
Porn is allegedly having a “terrifying impact” on men. Girl on the Net lifts the lid and finds the evidence rather thin and attitudes biased.
Is the “Dildo of Damocles” daunting? What does/will happen when sex toys connect to the internet?
Environment
It is estimated that the Fukushima accident gave everyone on the planet radiation exposure equivalent to a single X-ray – although unsurprisingly those in Fukushima received rather more it was unlikely to be more than two year’s worth of background radiation, so tiny in the overall scheme of things.
Hedges are as important for the environment as trees, at least in cities.
In another non-obvious finding, research is showing that beaver dams keep streams cool.
History, Archaeology & Anthropology
There are some amazing things happening in palaeoanthropology at the moment, not least that researchers have discovered how to extract DNA from the soil around archaeological sites.
Another of those amazing pieces of palaeoanthropology is the number and age of the Homo naledi finds in South Africa.
At the other end of Africa, a 4000-year-old funeral garden has been discovered in Egypt.
In a recent, and rather more modern, find a rare medieval text printed by William Caxton has been discovered lurking in University of Reading archives.
One of our favourite London bloggers, diamond geezer, visits the Parisian Catacombs.
Finally in this section, another of our favourite London bloggers, IanVists, explores an abandoned railway tunnel used by the BBC in WW2.
London
Which brings us nicely to London itself … Londonist suggests some of London’s more secret places to visit.
Meanwhile Time Out tells us nine things we mostly didn’t know about Euston Station.
Lifestyle & Personal Development
The Guardian magazine on Saturday 27 May featured Laura Dodsworth’s upcoming book Manhood: The Bare Reality in which 100 men talk about manhood through the lens of “me and my penis” as well as having their manhood photographed.
This a follow-on to Bare Reality: 100 Women, Their Breasts, Their Stories
Pre-order Manhood: The Bare Reality from the publishers Pinter & Martin or from Amazon.
[Full disclosure: I was interviewed for this book and there’s a little bit of me in the article, although unless you know you’ll never find it.]
Following which here’s Lee Kynaston in the Telegraph on male pubic hair grooming. My only question is “Why?”.
The key to happiness is not knowing oneself, but knowing how others see us.
But then scientists and philosophers also doubt the ancient claim that vigorous self-examination makes you a better person.
Food & Drink
WFT is alkaline water? Oh, I see, it’s no different to what comes out of the tap.
If you like sushi, you might no longer as its popularity has brought rise in parasitic infections.
People
I wasn’t quite sure where to put this next item, but it is one for the railway buffs amongst us … Geoff Marshall (no relation) and Vicki Pipe are doing All the Stations: They’re travelling to every train station in mainland UK, documenting and videoing as they go. Their videos are all on the All the Stations channel on YouTube; watch the introductory video first to see what they’re planning.
[Geoff Marshall has twice held the official record for travelling the whole London Underground in the fastest time, so he had to be up for another challenge!]
Shock, Horror, Humour
And very finally here are some stories of what happens when scientists take research specimens through airport security.
More in a month’s time.