I’m driving!

 

I just love Dr. Fagenbaum. Today’s checkup visit was majorly encouraging. He was quite pleased with the progress I’ve made in 7 weeks. No cane. Able to bend past 100 degrees. Incision looking good. Said my knee would probably not look like a normal knee for almost a year … when puffiness and swelling are totally gone. That’s ok. Just so I know.

Shared my concern about ROM being 120 by the end of January. He explained that 120 is the tops that this knee can bend. His example was a car that can do 160 mph, but that doesn’t mean he would drive the car that fast. My knee can technically bend to 120, but he would be pleased if it gets to 115.

Next week I only have one PT appointment because of the holidays.  Week after that, no appointments. Out of town, company, etc. Dr. Fagenbaum said that would actually give my knee a chance to rest. Of course, I’ll still be diligent with my at-home exercises and stretching.

Have a last prescription for pain meds to be taken one pill every six hours as needed.

And did I mention I’m driving! When I came home, first place I drove was Chick-fil-A. Yum.

(Pic from www.mycutegrapics.com. Free for personal and educational use.)

Stiff and Achy

 

Just completed week 7. Yesterday I reached 108 ROM, but it wasn’t without PAINful effort as Drew (PT) gradually bent my knee. Today areas around knees (yeah, both of them) have been stiff and achy.

Went to bonesmart.org, Recovering From Knee Replacement. Said it’s important to remember that sometimes pain can persist in one form or another for many weeks. “This is normal.” According to this site, “the early, sharp pain gets replaced with a deeper, more achy pain. This second type of pain still needs to be treated.  In addition, your physical therapy may cause some pain in your joints. You can prepare yourself for this pain with a dose of medication about an hour before your physical therapy sessions.”

So, am wondering if I started cutting back on the pain meds too soon. Around December 1, I went to a half pain pill and a half Tylenol every 5 hours with a full pill an hour before PT. I see Dr. Fagenbaum tomorrow for a checkup. Will talk to him and get back to you.

In PT in addition to the ROM, been working on loosening, stretching muscles. Purchased the Intracell Stick, which I feel like is helping – “A Toothbrush for Muscles.”

Over 24 years of research in this stick. Function of this technology is to extinguish trigger points (contracted fibers that feel like bumps in the muscles) and allow tight, contracted muscles to relax and recover.

Can’t close this post without mentioning maybe the best article I’ve ever read about the knee and its health. In the January 2014 Reader’s Digest, page 55, “A Day in the Life of Your Knee” by Jill Provost. Unique writing. It’s worth the read.  Goodnight.

Encouraging Progress

 

This past Tuesday was the beginning of week 6. I confess I’ve been stressing out a bit about ROM (range of motion) on my replaced knee. Last week it was 97. Goal for PT completion at the end of January is 120. My daughter, Heather, reminded me that was about two months away…and each week yields better results, so I could do this.

This week in PT Drew added deep tissue massage to my thigh … and calf massage. I think that must be so my leg would limber up and he could bend it more! Thursday he told me a silly knock knock joke to get my mind off the pain of bending. But that’s ok ‘cause I’m seeing progress!

Thursday evening I noticed a change in the feeling in my knee when I walk. It doesn’t feel nearly as much like something thick in my knee. I can tell it’s on the way to feeling more like a normal knee. Part of that is related to the decrease in swelling. I can actually see the outline of my  ankle bone and of my knee – not just a swollen glob.

Drew asked me the first day in PT about my goals. The first thing I said was I wanted to be back to gardening. Well, Brenda, this picture from sunny Friday is for you. (Brenda is an AVID gardener who is having knee replacement January 2.)

Note the gardening gloves and shears (and cane propped behind the fence). I was good for about an hour of tidying the flower beds. We have a very hilly yard, so I did need the cane a couple times. Need to ask Dr. Fagenbaum about sitting on the ground and getting up using mostly my “good” leg. That has to be possible.

The journey of a thousand miles must begin with a single step. – Lao Tzu

Elevation is key!

 

This morning around 2:30 couldn’t sleep, so I was on my phone checking out my favorite go-to website bonesmart.org and what it had to say about pain and swelling control . Elevation is the key! I’m a visual learner, so the pics with X (don’t do it this way) and check marks (do it this way) were just what I needed.  The foot should be above the hip and the higher the better in order to get good drainage for the lymph and tissue fluid that is the primary cause of swelling.

At my first Trinity Wellness appointment Tuesday, PT Drew stressed elevate and ice, elevate and ice. . . once every hour is ideal. Haven’t reached the ideal, but I am upping my game. 

My first official outing was to Gary and Ellie’s house for Thanksgiving dinner with Asbury friends. Could have gone out before now, but I chose not to. My job is resting and getting stronger, and I haven’t wanted to risk picking up a cold or other virus. Thankful for the recovery I’m experiencing. Happy Thanksgiving!

Do what you can, with what you have, where you are. – Theodore Roosevelt

Ahead of Schedule

 

Good week 3 post-op! I could tell Dr. Fagenbaum was surprised when I went in for my checkup Thursday. At the 11-day checkup, I was not able to lift my foot off the floor more than an inch. At this 24-day checkup, I could lift my leg straight out and hold it. He also said many of his patients use a walker for the first month, but I’ve graduated to the cane.

Instructions were to start 2 ibuprofen morning and night. That’s supposed to help with swelling and inflammation enough that I’ll notice I need pain meds very little and will stop them on my own. Am finding that to be true already. Also per Dr. Fagenbaum started applying Polysporin to incision.

Friday was my last day with my in-home PT. I’ll miss his 3x weekly visits. He was super. On “graduation day” we walked from my back deck up the hilly driveway to the mailbox. Arvin showed me how to zigzag from side to side instead of going straight up and down. Just a little helpful trick of the trade.

On to new events this coming week: outpatient PT at Trinity Wellness Center, moving back upstairs, my first “outing” other than doctor appointments (Thanksgiving dinner with friends), and back to church!

We all have a fear of the unknown. What one does with that fear will make all the difference in the world. – Lillian Russell

My Replacement at Work

 

I work at Asbury UMC on Creedmoor Road. FUN staff to work with. My husband, Dan, stopped by my office yesterday and came home with news of my replacement. The name plate on my office door now reads Snoopy Schultz. I’ll preface my comments by saying that our pastor absolutely loves Snoopy, his friends, his wisdom…. He sent an email to the staff with this photo and the caption “Faye’s Replacement” . . . which generated emails from staff. I had fun composing the reply below with thoughts on my replacement.

Dear Terry and Sharon,

I was almost up to turning cartwheels when I learned of my replacement.

What a brilliant idea! Snoopy appears to be a relaxed and happy worker surrounded by friends, which should lead to high productivity. (I heard he is on the ball...already got out the signup sheet for the office Christmas party. He's no slacker.)

Undoubtedly the happy aura from Snoopy's office is drifting into Terry's office. Such a high energy emanating from Snoopy that Terry will probably be turning out a year's worth of work in December. Good move.

I know Sharon must be beaming after learning that Snoopy and his assistants will work for cookies. Quite a substantial savings there. Fran can probably get volunteers to bring in the cookies so there's no drain at all on the budget. May I suggest that the money saved be set aside as seed money for "screened-in porch" type offices downstairs. The fresh air would keep us all awake following lunch.

Ryan, I understand your concern about Snoopy's Thanksgiving fiasco but firmly believe that working next door to Beth can't help but be a positive step. And, Scott, I see this as a ministry to Snoopy and his friends. I heard that Linus would like to play some Sunday for the choir, and Lucy wants to sing a solo for the cantata. Could you work her in? If all else fails, I'm sure Mark would love to showcase the new talent in an announcement video.

Well, I can certainly rest peacefully now knowing who’s in charge. All in all, I figure this replacement situation is good job security for me. 

Love to all, Faye

Movin’ On Up

 

This morning I felt like the little doggie on this Hallmark card—his tail between his legs, dreading those ominous looking stairs. I knew today in PT we were going up and down the stairs to second floor. When I thought about climbing stairs, my point of reference was struggling to get up the front porch steps 11 days ago. But in those 11 days I’ve done some serious leg muscle strengthening and learned to balance walking with a cane. Today’s climb was a piece of cake! Whoohoo!

In case you can’t tell, that’s a thumbs up!

Glad I’m gaining some independence. I’m ready to venture beyond these downstairs walls. Miss my family who was here the first two weeks. Bring on the company.

I am not afraid of storms for I am learning how to sail my ship. – Louisa May Alcott

Week 2 Post-Op: Progress!!

 

Monday I was worried that these quad muscles weren’t getting stronger fast enough. Four additional days have made a huge difference! This morning in PT I was doing the straight leg raises, still using the belt for assistance lifting and lowering my leg. Arvin (PT) asked if I had tried the leg raises without the belt. OMG. I was soooo surprised that I could do 10 leg raises just using that quad muscle!

AND I started practicing with a cane. The cane is my operated leg’s “best friend.” They work together stepping forward. Then the left leg “swings through.” I was hesitant to put weight on that right leg, but practice will make perfect. I get to practice when someone is here with me. Otherwise, I still use the walker. We’re gearing up for the stairs next week.

Have enjoyed hanging out with my mom this week. Couldn’t have managed at home without the personal help from family.

Time for pain meds, lunch, and the CPM machine.

“Spirit has fifty times the strength and staying power of brawn and muscle.” – Mark Twain

Quadriceps Femoris Muscle

 

It’s 1:13am. Just ate a yummy chocolate from Escazu Artisan Chocolates in downtown Raleigh. Their chocolates are handmade using fresh, local ingredients, no preservatives. (Thanks, Ginger and Jay!) Eating chocolate is probably why I’m awake.

One thing I’ve learned the last few days is the huge role the quadriceps femoris muscle  - quads – plays in recovery. This large muscle group includes the four prevailing muscles on the front of the thigh.  They help provide the strength needed for locomotion and stability of the knee. Several people said prior to surgery to strengthen those quads. I did halfheartedly, occasionally. If you’re anticipating knee replacement, strengthen those quads!!!!

It’s been discouraging to not be able to do two of my PT  exercises because I cannot make that quad move my leg. Then Dr. Fajgenbaum said I was several days behind most of his patients (and I thought I was doing fabulously well) because I can’t lift my recovering leg with my quads alone. Called two people who’ve had knee replacement within the last year, but neither could remember when they were able to accomplish this task. Saw a tad improvement over weekend. Was able yesterday afternoon to lift foot about 3” off floor. I’ll keep you posted. This is NOT going to get me down!

“If there is no struggle, there is no progress.”  - Frederick Douglass

One Week Post-Op

 

Up good. Down bad. Up good. Down bad. Trying to remember how to get up the porch steps and into the house. Opened the door to my lovely little downstairs bedroom suite, i.e., corner of living room. Have a half bath. That’ll work.

 

Ok, I’ll try to concisely recap the last five days at home. Nursing assistant, Ann, arrived Friday from Hendersonville, NC. Thanks, Sis, for taking time away from being a wife and doggie mom to help.

Home health nurse, Debbie, and PT guy, Arvin, came  by Saturday to check in with the patient. Everything looked good. Arvin left a daily routine for me to follow. Exercises. Walk. Ice Machine 20 minutes. Rest. CPM Machine 1-2 hours. Rest. Repeat.

Surprises? The first week has been way better than I anticipated. Less pain. More energy. An appetite! Swollen foot with tinges of blue. Care Journal compliments of BCBSNC. Compression hose are actually comfortable. Can navigate easily with my hot wheels (walker) on loan from Carol. 28 cards and notes of encouragement. Why am I surprised when so many people have prayed?

“There is nothing the body suffers which the soul may not profit by.” – George Meredith

Wake Tech Student Nurse

 

(written Friday, November 1)

Slept like a log last night. Lying in bed looking at adorable Elizabeth “Snow White” pictures and waiting on the student nurse from Wake Tech to arrive. I was waiting because I’m not supposed to be up and around without a nurse or nursing assistant with me.

Wednesday afternoon Rachel’s supervisor, Gina, dropped by my room to ask if I’d mind having a student nurse from Wake  Tech Thursday and Friday. I was thinking student nurse shadowing my Duke Raleigh nurse. Sure. Why not?

What a delightful surprise. Rachel was competent, caring, attentive. Friday morning, under Gina’s supervision, she administered my meds and an injection. I was very impressed with Duke Raleigh’s checks and balances for meds administration. Glad Rachel was gaining experience at this clinical site while I was here.

Check out the plan below for 11/1/13 posted on my white board.

My hospital bed is one thing I will NOT miss! OMG. It constantly … I mean CONSTANTLY … is noisily readjusting, something to do with pressure points.

Next post – Home, Sweet Home.

It’s 4:15 a.m.

 

(Note that even though this entry is posted November 2, it was written October 31, two days post surgery.)

It’s 4:15am. I’m sitting up in bed eating saltine crackers and sipping water. Woke up at 3:30. Pain meds were two hours overdue, and, boy, could I tell it. Started physical therapy (PT) yesterday. First time we slowly lifted my leg over the side of the bed … OMG … on a pain scale of 1 to 10, it was a 10. But I hear PT is 90% of recovery. I can do this. It will be worth it.

Hmm, it’s 4:30am, and I think the pain meds are kicking in. A word about pain meds, i.e., narcotics. In a recent conversation with Mark W, who has had both hips replaced, he stressed take the pain meds! First hip he had replaced, he tried recovery with little narcotics. Feared addiction. I’d had the same thoughts. He assured me the doc would make sure I weaned off them. (After coming home, got a card from Jeanette, who wrote Praying for an easy recovery from  your knee surgery – Follow directions and take the pain pills as needed. [That’s the old nurse part of me!] So I put the fear of addiction behind me. Back to the early morning entry.

Am doing ankle exercises. Wish I had my list of exercises to do in bed, but they’re on the couch. Maybe I’ll read Rick Warren’s book What  on Earth Am I Here For? Kept falling asleep. So much for reading.

Text came from Heather Thursday night 8:01pm.

 

Happy Halloween from Snow White!

Headed to OR

 

Dan dropped me off at the patient registration/same day surgery entrance around 5:40am before he parked. Never been to Duke Raleigh as a patient. I’ve just walked into the lobby area. Been to the patient pre op class. My initial thought back then was this place feels old. But if you have to be a patient, I’d recommend it. The folks  at Duke Raleigh were just so dang nice.

As we sat in the waiting room, I may have felt an intestinal flutter or two but mainly just calmness. My party hat was a gift from this young woman, who helped me dress for the party. Well, that’s what she called it.

 

One of the main guests was my super efficient, caring surgeon – Dr. Michael Fajgenbaum. For State fans, he has been an orthopaedic surgeon for NC State University Wolfpack football team for 21 years.   

Terry arrived and prayed with us before I was wheeled away. I remember being lifted onto the operating table and being asked to turn over onto my left side. Next thing I heard was “Mrs. Biffert, it’s time to wake up.” I slept through the party. That’s a good thing.

Two “Patient Friendly” Devices

 

Lamont called around 8:45am. Never met him but ended up spending about two hours with him. He’s a patient service rep with T & T Technology. Brought by a CPM machine for use after surgery. That would be Continuous Passive Motion machine. (I’ll use one at Duke Raleigh Hospital too.)

Lamont was thorough with setup, instructions, encouragement, and paperwork. According to my Plan of Care he left, this device will increase range of motion/enhance rehabilitation, decrease pain and swelling, increase nutrient flow to the joint for healing and increase regeneration of soft tissue cells. Sounds like a little miracle worker. Susan V, who had her knee done a year ago, vouches for its “wonderfulness.”

Practicing at home with my sweet caregiver

And then there’s the “Polar Care” device. Looks like a little cooler you’d take on a picnic. It sends a cold signal to the brain to help with pain management. Helps with swelling too, and I get to bring it home.

(This is the polar care device … pic being added after I came home.)

Am I nervous? No. Will I be tomorrow morning 4:30-5:30ish? Probably. Surgery starts at 7:30. Doubt that I’ll post tomorrow. Maybe I can jot a note or two on my bedside pad for sharing later.

Thanks for your prayers. Let the journey begin.

Ready, Set, Go!

Work wrapped up at Asbury through December. Check. House cleaned. Check. Food for Dan while I’m in the hospital. Check. (Thanks Ed and Carol!) Pre-op class materials reviewed so I’ll basically know what to expect. I’ll do that tonight. Lunch with Gloria H who had both knees replaced this year (and is doing great). Check. Now I know even more what to expect.

Bedroom set up downstairs. Not yet. Bags packed. Nope. Only in my head. Located Living Will and Power of Attorney. Another item for tonight.

Help lined up for week one after hospital. Check. My sweet sis is coming from  Hendersonville. Week two my energetic mom is coming from Columbia. Week three Care Corps at Asbury helping with meals. Thanks Mandy and other CC volunteers. Check.

Blog up and running. Check. Only because of the hour and a half  Ginger B spent helping me set it up. And she didn’t seem to mind when I called her with questions this afternoon. Thanks, Ginger.

Friends and family praying. Check. Most important. Asbury staff member Mark B led a prayer time Thursday afternoon in the sanctuary for me and others who needed prayer. Many, many Asbury folks and family/friends wanted me to know they will be praying. Maybe that’s why I feel so calm. I want to see this as an adventure in wholeness and healing.

When I pray for this “adventure,” I pray that the light of Jesus will shine through to caregivers and that his presence will be a felt presence in the midst of a painful knee. I don’t do pain well, but it is what it is and this too shall pass. Secondly, I pray for NO infection nor blood clots.

That about does it for now. After dinner, I’m going to kick back and watch Amazing Race.  

Adams family reunion. Check out the little girl front row, 5th from the left.