Body Pride

I am not an active person although many people who know me ask if I ever stop and rest. What I mean is that I have never sustained any exercise program more than a month and I am “chunky” or as my daughter calls it,  “fluffy”. The Yiddish words zaftig fits.

So it is with extreme pleasure I can announce that I am healing well from my latest surgery and can see – and feel – the proverbial light at the end of the tunnel.  And it is MY flabby, fluffy undisciplined body that is reaching the benchmarks easier and faster than average.

As I sat on the bleachers at the pool where my husband and my friend were participating in what we call “geezer aquatic aerobics” I ached to be in the water with them. I have 2 more weeks to go until I reach the magical 6-week post op mark where the doctor assures me that the surgical incision will be healed enough to block infection from the outside. And since there are kids in the pool right before the low-impact exercise class, we can assume there are elements in the water that could introduce a problem. I will be patient.  

This journey through pain and repair has been over two years now. I’d like to run through the story so perhaps others can feel they too can feel better.

First of all, when I was 19 I went skiing and had a spectacular fall. I laid in the snow off to the side of the run for a while and my memory is that the ski patrol came by and asked if I was okay. My answer was “I don’t know” and they left. Unlikely, but that’s the way I remember it.  I managed to get down the mountain and went back to school and never saw anyone at the health center because hey, I was 19 and healing is pretty magical at that age.

The next time the knee was assaulted was when I was 50 and contracted bacterial meningitis  working at Vanderbilt Medical Center. To be fair, no one else who handled the piece of equipment got sick. The doctors believed that as I was in the 6th year (of what turned out to be 10) of my husband’s fight with brain cancer, my adrenal system had been under assault for some time.  Fight or flight….and since I was choosing to stick with him and fight that cancer, I was bombarded with bad news all too often. That’s when the slow weight gain happened and that’s when my immune system weakened.  

So,  there I was all of a sudden, feeling like I had a horrible case of the flu and thankfully friends who came to take care of my youngest son made me go to the hospital.  I was that woman you hear moaning when you walk down the halls of a nursing home….too unable to articulate anything except “I feel miserable”. And then I remember nothing until I woke up and the doc was drawing about a liter of fluid from my knee.

Anyway, I survived, obviously. A year later my knee started hurting and I immediately invaded the doctor’s clinic (one benefit of working in a hospital) and he assured me that the meningitis was not back, but that I had arthritis in that knee.

I controlled the aggravation with glucosamine in various combinations and topped up with Advil if I needed more help. I started acupuncture when I moved to Oregon and sometimes had relief for 10 days without any Advil.

Until June 28, 2016 when I twisted my knee and could barely walk. We were heading to the farmers’ market and poor Graham had to set up everything without much help from me. I went to my doctor a day or so later and she did got me a referral to one of the local orthopedic docs here in town. It took 6 weeks to get an appointment and he took a look at me walking and decided, without the benefit of any x-ray or other imaging that I “just have arthritis and will never need surgery.”  When I asked him why it hurt so much differently and more than before I twisted it he was too busy to answer.

It will be no surprise to you that I refused to go back to him when I asked my primary doctor for a second opinion about 3 months later.  His partner had the benefit of an x-ray at that time and a ct-scan but he said just about the same thing the first doc had said…..I would never need surgery.

And so, while I waited for this knee to magically heal itself, I asked my doctor for PT and continued with the acupuncture. The physical therapy helped some but I was always in pain and always unable to do things I had been able to do before.  A marvelous friend stepped in to help Graham close down our farmers’ market booth each week.

And a year passed. And then my opposite hip started hurting. I had been “walking wonky” for a year because of the knee and the physical therapist opined that my pelvis had tilted because of the knee being out of alignment and the pressure of the femur into the pelvis was different from the way it normally should be.

So, that sounded like the purview of a chiropractor.  The acupuncturist and my primary care physician recommended the same guy so off I went.  There was some relief but when I asked  how long I could expect the treatments to effectively readjust the pelvis I was told “it had taken a while to get to that point and it will take a while to fix.”

Admittedly I was losing patience. And expressed it. So the chiropractor tried some other kind of adjustment and it HURT!  When I went back I saw his associate and that first treatment gave me 3 days of relief. I was looking forward to the next treatment but negated the positive effect by walking six blocks to meet my eldest son for lunch.  Six blocks……and I was in deep pain again. The next treatment the chiropractor tried some other aggressive treatment and that was it. I asked for a referral to a new orthopedic doctor not in this town and went “to get information”.

The new doc ordered a few more x-rays and then showed me on the computer the actual reason for the pain. And he said, very clearly, “you have arthritis which has worn away all the tissue that protects the joint and you are now “bone-on-bone”. There is no getting around the fact that you need surgery.”

This is the x-ray AFTER the surgery and may look funny because I have porcelain and plastic as part of the appliance because of a concern about a metal allergy. 

I continued with physical therapy and went into the knee reconstruction with muscles prepared as much as possible. I was able to drive in 2.5 weeks (it was my right knee so my driving leg)  which was important because I am the driver in the house. Graham is legally blind and no longer drives. Our friends were fantastic…taking him to the grocery store and me to PT but the relief of being able to get there myself was golden.  I had been told it would take me 6 weeks to be able to drive but I worked my exercise routine at home often.

I wondered how I was going to deal with right knee pain as well as left hip pain during the recuperation. The doctor told me that the hip might be okay after the surgery and it was quiet for about a month, but then starting speaking …and yelling….again.  I was very thankful for that quiet time which permitted me to sit up and get out of bed more easily.

Taking a walk around the block 3 weeks after the knee surgery. Yes, I was in pain.

And so, the hip was replaced 4 weeks ago.  Bone on bone there also, no getting around it any more.

People who have had both surgeries told me the hip would be easier healing and it has been. Pain levels were not as high and more easily handled with the Tylenol. The issues I had related to feeling like a beached whale having trouble turning over in bed and the bowel issues caused by the anesthesia and the narcotics I took the first couple of weeks.  That issue improved after a few weeks and moving in bed has gotten easier as well.

A few days ago I realized I had not taken any Advil that day. And now I am walking without a cane with an almost normal gait.

The financial side effect of all this is that I had to take money out of my retirement funds to pay my share of the bills. Medical insurance has gotten more and more expensive in the past two years with co-pays and out of pocket requirements higher.  Once I finish paying my share of the bills I will have paid out $7300 and that does not even count my monthly insurance premiums.

The upside to all that is that any additional medical help I need is now without cost. I still need to pay my monthly premium but my prescriptions will be free and the cataract surgeries will be scheduled before the end of the calendar year to take advantage of this benefit.

So, I started with a headline called “Body Pride”. There was a time, in 1983 where I experienced a wonderful glowing sense of pride in my body: I had just given birth to my eldest and was sustaining him by breastfeeding him. This was a perfectly clear example that my body worked well.

The faster than usual healing I have had from the knee and hip surgeries is also a mark of my body responding to the work I was doing, both actively through PT and more passively through acupuncture. I was making sure my nutrition was good and my body was getting the extra fuel it required because of the stress on it.

So, for all out there who have similar aches and pains, my best advice is to seek out those things you can do to supplement what you may be doing at home for self-care.  And get yourself to a doctor who will treat you fairly and communicate well. Do not give up and do not set restrictions on where you are willing to go. Yes, it is not fun to drive an hour plus to the orthopedic doc in Portland instead of 10 minutes to the guys here in my town. But it is worth every single red light and I have discovered some beautiful back roads that take me through gorgeous countryside.

I have so much I want to do….I am too young to feel as old as the last two years of pain made me feel.  Now, if only the new joints had amazing other attributes! 

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Almost Normal

Almost normal! It’s been about 5.5 weeks since my total knee replacement December 4 and I will see the surgeon on Monday for a post-op appointment. I have some expectations and hopes for that visit. The primary issue is will I get permission to get back into our hot tub?

We purchased an inflatable hot tub almost 2 years ago. We discovered how helpful sitting in the hot tub could be back in 2007 when Graham was on sabbatical in Pueblo, Colorado and the apartment complex had a hot tub next to the pool. We learned that the heat eased sore muscles and joints and improved nighttime relaxation and better sleeping  Although we were in Colorado from January 1 through June 30, the hot tub was available, even in the winter when the pool was closed. It was about 200 yards from our apartment door. We’d get into our bathing suits, put on our terry cloth bathrobes and some slippers and walk over. Chilly, but bearable. Getting out and back into the warm apartment after the soak was more of a challenge. I discovered that there seemed to be an envelope of warm air around my body for a very short time when I exited the hot tub. Getting the bathrobe on during that time was mandatory! Then put the cover back on the hot tub and high tail it back inside.

Our apartment was in the building on the right side, so not too far, except when it was 5 degrees.

The photo viewpoint is from the kitchen door, so you see how much shorter the after-tub commute became.

We agreed if we ever should be lucky enough to have a hot tub it would be right by the door to the house. And so, about a year later, we found ourselves building an enclosed screen porch on the back of our house in West Virginia. The tub sat on a concrete pad on the ground and the floor of the porch was built around the tub. We stepped down into the spa and Graham installed a handicap pull bar to help any of us to climb back up and out. The walk to the kitchen door was maybe 10 feet, very easy even in the winter.

But then we moved to Oregon where we are renting a house. I was missing the evening soak time. My joints ached more and so, a friend suggested an inflatable. We bought a Coleman hot tub for about $450 the first year but after they replaced one filter/motor, when that failed within a few months, they would not replace it. We searched but could not purchase a new filter alone. So we bought another inflatable for about $250. Watch for sales!!

The inflatable works for us. It runs on 110 household current so we did not have to install a new 220 line into the house. That saved us some money but the lower wattage means the temperature control goes through a cycle which runs about 48 hours and then turns off. We need to check and restart sometimes before the shutdown happens so we can maintain the temperature. The other issue is that it will not run the heat if the jets are operating. Not a biggie for me; I don’t use the jets.

So, the last time I was in the hot tub was the morning before my knee surgery. After that I was restricted from “swimming, hot tubs, saunas” and a few other wet activities. One concern is infection through the suture site. That is well healed now, so should no  longer be a factor.

But, and this is a big issue, I need to be able to get myself out of the hot tub safely. First, I need to be able to swing my leg over the height of the wall. It is an inflatable so not rigid, and if I touch it, it will bend. Graham built me a contraption with 2 posts and a rope so I had something the proper height for practice.  That was not difficult to gain the movement I needed.

However, I need to get up off my butt. The inflatable hot tub does not have the molded seats a regular fiberglass hot tub offers; we sit on the padded bottom. So, I need to be able to stand up without the need for a block and tackle.  Simple, eh?  Well, no. As my knee issue got worse and started involving my pelvis and hips last summer, Graham installed a handicapped handrail on the post holding the roof over the tub. (You thought we sit in the hot water with the cold winter rain falling on us????? Come on!)  That rail helped me, but I was able to get on my knees before the surgery. Now, not a comfortable position.  So, after thinking and thinking about it, I tried a few times at home.

Now, in order to do a task that is difficult, the easiest way to figure out how to manage the move is to figure out the physics of it to maximize the strength while minimizing effort. I didn’t take physics in high school and until now, I figured the computer science class I took instead was an excellent substitute.  But now,  more than 45 years after that class decision in high school,  I was trying to figure how to fulcrum me up and out…..hmmmmm

Physical therapists are special people. Maybe a tad masochistic as they push their patients through pain to improvement, generally they are upbeat, optimistic and very much enjoy challenges like this. So this morning at Physical Therapy I sat on the floor next to a table that had been lowered to the height I needed and it only took two times to conquer the move. I know I can get up now! No block and tackle needs to be ordered. LOL

On Monday I will go to the surgeon’s appointment prepared to show him I have the safety issue covered. And if I need to wait, I will wait……but I am betting on hot tub Monday evening!!!

 

 

The Magic of Having Cheerleaders

On Monday, December 4, 2017 my right knee went missing.  It had provided 63 years of walking, hiking, skiing, whatevering and it was not functioning as it should because of damage caused by a fall and by illness. The knee was replaced with a modern medical miracle, one that has become so hohum that you probably know at least five people who have had knee replacements.

It really helped to talk to all those people prior to my surgery, to hear their advice and learn of tricks they used. The one thing I heard over and over and over was “do the exercises”.  One other comment, made quietly, also was handy, “You will not always get to the bathroom on time.”

When I’ve gone through SOMETHING, whether it is a physical activity like this surgery, or an emotional voyage, like a divorce, it can be very helpful to hear first person experiences. It has let me know that what I was feeling was pretty typical….or not.

It was during one of those discussions with a friend that the idea of an allergy to the implant hit me! I can’t wear pierced earrings of any kind. Sterling silver, 24k gold, surgical steel, platinum, titanium, even plastic coated, all have caused my ears to start itching and I end up removing the earrings within 15 minutes.  So, I read and then I talked to the surgeon at the pre-op appointment and I am wearing low-nickel metal with ceramic and plastic pieces. All fingers and toes crossed.

The first few days after the surgery was spent discovering that the pain meds and I do not get along. This experience made it very clear to me just how different our body chemistries are. I was nauseated and just felt overall horrible.  I had none of the “highs” users addicted to oxycontin enjoy. They obviously do not experience all the “yuks” I had or they would move on to some other drug of choice.  (This lightbulb moment made me realize that “addiction” is a horrible thing and we need a multi-prong attack to help people get off the drugs but also help them learn coping mechanisms for the issues in life that have made them (all of us to some extent) reach for help after a hard day.)

Once we moved me down a notch in the pain medical pharmacopeia, my overall body feelings were healthier and I could get on with the business of healing.

One thing that has made this experience easier is the time people have taken to drive me to my appointments (Graham can’t drive because he is legally blind), take him to the grocery store, run to the drug store for the replacement pain medicine, and just those who stop in for a few minutes with a smile to help distract me from focusing on the knee which is yelling “OW” most of the time.

And then, there is the physical therapist. Most knee patients have love-hate relationships with the love coming much later in the time table. Mine earned it on Day One when he exclaimed enthusiastically how well I was doing. He was so effusive that I started tearing up.  “No,” he said, “It’s good, really!”

So, I explained. Anyone who knows me knows “body perfect” is not now nor has ever been a goal of mine. I try to eat healthy food and not overindulge with the “fun” things but taking the time others do to firm up and have their body parts move better has not been my thing.

Here I am, 63-years-old, and this is the SECOND time in my life where I experienced BODY PRIDE. The first was after my first baby was born and I was able to nurse him. The idea that this body had produced that miracle and could sustain it nutritionally. Amazingly powerful feeling.

And now, in pain and hobbling, I am ahead of benchmarks. Me….the “couch potato” (well, maybe desk sitter is more like it). 

Altogether, the friends giving their time and sharing their good wishes and this professional who sees a lot of people like me are my cheerleaders. They have assumed the role to help me get better. And while their time investment may only 30 minutes or a couple of hours a week, they are a component in my healing that will no doubt get me to the finish line easier.

So, thank you, each of you, who send a joke, a funny picture, a phone call, a visit, a drive in the car. To all of you who are my cheerleaders, I salute you.