Alligatorob's Diary

[alligatorob]

Today was a good day, for just having had knee surgery anyway. I ate well, did about an hour of physical therapy and feel pretty good tonight. Had a birthday party today and still was able to stay close to 1200 calories, less protein and more carbs than I get when I do my own food, but not awful. No oxycodone in the last 24 hours, but am still taking Tylenol and elevating and keeping ice on the knees ~22 hours a day.

Tomorrow is my first out patient physical therapy session, I have been warned that is when the real pain begins, but not everyone says that, will have to go and see.

yes good to not try and rush the process--i imagine that could make things even slower if you overdo it!

Nice to see you back home and standing!

Thanks Liza, and I don't think there is much I can do to rush it. Most of the PT now seems to be bending and extending the knees. I guess that is necessary to keep scar tissue from forming in places that would block the motion. The really hard one is trying to force my foot to my butt, picture below is an attempt to show what I have been doing. I pull on the strap as hard as I can for a few seconds and repeat 20 times trying to get further back each time, it hurts like hell... I am told tomorrow that the therapist will put his shoulder into it and push back even further... Apparently some folks take the oxy before the PT because of that.

I think I've seen a dude (on tv) who had that done and he was unable to put any weight on his legs for A YEAR. Can you imagine not even being able to start recovery/rebuilding muscle for the first 12 months post-OP?

It sounds like a form of self-mutilation to me... After this I cannot imagine doing anything of the kind.

& now I can see your legs. They do look much straighter. How are you feeling today, Rob?

Hey Cate, I think they are straighter, not sure how much, but thanks for the complement. Makes me feel a little better. I feel good today, except for those damned knees anyway. Got my new and updated flu and covid shots yesterday, feeling that a little but not much. Have you had your shots?

 

[Cate]

I have had 4 covid shots, Rob & a flu shot & a dose of Omicron in June. Good luck tomorrow!

 

[Llama]

That's great flexion for a week post surgery! I'm not a fan of stretching that "hurts like hell" but of course stick to what your doctors says.

 

[liza3]

I pull on the strap as hard as I can for a few seconds and repeat 20 times trying to get further back each time, it hurts like hell... I am told tomorrow that the therapist will put his shoulder into it and push back even further... Apparently some folks take the oxy before the PT because of that.

Oh wow that all sounds so intense. I hope the painful parts of PT don't last too long.

 

[alligatorob]

Today was alright, I ate well went to physical therapy and am ok tonight. To be honest I am getting tired of not being very mobile and hurting all the time. The pain isn't terrible, have not taken oxycodone for a while, but its just always there... Physical therapist says I am ok to go back to the gym for upper body work only. Will try that tomorrow, just to break the boredom if nothing else.

I have had 4 covid shots, Rob & a flu shot & a dose of Omicron in June. Good luck tomorrow!

Thanks Cate, Physical Therapy was the high point of my day... This is my 5th covid shot, its supposed to be a new and improved. The flu is also something extra strength for the over 65.

That's great flexion for a week post surgery! I'm not a fan of stretching that "hurts like hell" but of course stick to what your doctors says.

That's what my physical therapist says too, pretty much. He thought my flexion was very good for a week out, extension not so good, but we are working on it. He does not seem to be of the "hurts like hell" school, but he does push for as much flexion as possible and that hurts... Today he let me decide how hard to pull, and I did inflict some pain on myself.

Oh wow that all sounds so intense. I hope the painful parts of PT don't last too long.

Thanks, and yes the "hurts like hell" phases are short lived and the pain goes away or down quickly. I actually hurt less leaving PT than going in. He did show me this machine he called the torture rack, says we will be graduating to that in a week or so...

 

[Llama]

I actually hurt less leaving PT than going in.

I like your new PT. And I think the pain would probably go down a bit in general if you took it a little easier. I understand you're bored but overdoing it now will only slow down the process. Enjoy your upper body gym time though! I wonder how many exercises you'll discover need some (stabilizing) leg function on top of upper body strength.

 

[alligatorob]

Today felt a little better than yesterday, up days and down I guess. I ate well, however have to confess that I had a piece of applesauce cake last night after posting. Added it into today's log and was still under 1,500 calories so I am ok. Did an hour at the gym today, my first day back, it was a bit awkward but felt good.

I had a bit of a breakthrough. Wife took me to the gym, on the way home got her to stop at an empty parking lot and I tried driving. Felt fine, my reaction time was as good as ever and neither braking or the accelerator were hard to operate, not much pain. The to test my new skills I drove to the PT place and then home. For short trips anyway I guess I will now be driving myself. I plan to ask the doctor about it tomorrow to be sure I'm not missing something. I was told it would be 3 to 4 weeks before my feet would work well enough to drive. That doesn't seem to be the case.

No physical therapist today, but I did most of the PT exercises on my own. Seems ok. No opioids again today.

I like your new PT. And I think the pain would probably go down a bit in general if you took it a little easier. I understand you're bored but overdoing it now will only slow down the process.

Thanks, and I like him too. I have found that if I do too much sleeping is hard, residual pain, that will limit me I think. Still using a lot of ice ~20 hours a day, without it pain would be a lot worse.

Enjoy your upper body gym time though! I wonder how many exercises you'll discover need some (stabilizing) leg function on top of upper body strength.

I am limited, but I worked with the trainer I have used before. She's been doing this almost 40 years and knows muscles well. She did a pretty good job of keeping me working with bench press and a lot of seated weight things. And she has ideas for more. Hardest thing is getting up and down from the various seats, but I am figuring it out.

 

[Llama]

If all patients put this much work into prep and recovery I'd have so much less work.

 

[Cate]

You really are an amazing man! Be aware that driving just after your major knee ops could be an insurance problem.

 

[alligatorob]

Pain is up a bit, and it is making me want to eat. I guess I should not be surprised, its what I am. Tried doing PT exercises to take my mind off of it, but I've done about all I can or should do. Maybe I'll try walking...

Went to the doctor today, first pre-op, he says I can keep the knees. He also said the pain increase was normal, my nerve endings coming back to life. His assistant said my knees were amongst the worst he had seen in his 20 years assisting the doctor. That is why it took so long, 4 1/2 hours operating time. I am skeptical, I know my knees were bad and I am sure I was in some denial about how bad, but I know lots of others who have more pain that I did. Oh well, at least it reinforced my decision to get it done.

Doctor cleared me to drive, but not within 12 hours of taking an oxycodone. The gym and PT are both about 5 minute drives, that is the most I would attempt.

Now back to fighting the binge urges...

 

[Cate]

Pain is up a bit, and it is making me want to eat. I guess I should not be surprised, its what I am. Tried doing PT exercises to take my mind off of it, but I've done about all I can or should do. Maybe I'll try walking...

Eating and/or binging is not who you are. We all have to eat.

Went to the doctor today, first pre-op, he says I can keep the knees. He also said the pain increase was normal, my nerve endings coming back to life. His assistant said my knees were amongst the worst he had seen in his 20 years assisting the doctor. That is why it took so long, 4 1/2 hours operating time. I am skeptical, I know my knees were bad and I am sure I was in some denial about how bad, but I know lots of others who have more pain that I did. Oh well, at least it reinforced my decision to get it done.

Rob, maybe you have a higher threshold for pain than most people. I doubt his assistant would have just said that if he didn't think it was so. I'm glad you have had them both done. I wish I could magic mine done.

Doctor cleared me to drive, but not within 12 hours of taking an oxycodone. The gym and PT are both about 5 minute drives, that is the most I would attempt.

That's good. It's always best to have that approval. I'm glad you're being sensible about it.

Now back to fighting the binge urges...

Are you sure you are eating enough nutritious food, especially protein? If it's actual hunger maybe that's what your body is telling you. I have upped my protein & am not having sweet cravings.

 

[Emilyrose]

I mean, that wheelchair parking sign is fucking gold! Hahaha. I hope you appreciate it.

Regarding the actual important things in life, please allow your knees to heal properly after the surgery and do not attempt anything that might impede this. I think that's more crucial than anything else. Upper weight exercises - cool. Go for it. But give yourself time to literally get back on your feet. You need to give yourself space to just breathe and heal and all of that wonderful stuff. When I lie in bed at night sometimes, I imagine other-worldly beings coming along and speeding up whatever healing process I need. Imagine that healing light. And rest!!!

 

[alligatorob]

Not the best day, not the worst. I am in more pain, but that is apparently to be expected. I ate more than I have in a few weeks, but 1,700 calories isn't bad, and a lot of that was salmon. Did my PT exercises, but they hurt and I don't think I did them as well as I should have. Last night I took an oxycodone in the middle of the night to get to sleep. I'll try not to tonight, but if I have to for sleep I will.

Eating and/or binging is not who you are. We all have to eat.

I wish that were true, but I believe I will always be subject to the urge to binge. Just got to figure out how to live with it.

Are you sure you are eating enough nutritious food, especially protein? If it's actual hunger maybe that's what your body is telling you.

Maybe not, I had multiple helpings of salmon tonight so I should be ok with the protein. It wasn't actual hunger, I don't think it was anyway.

I'm glad you have had them both done. I wish I could magic mine done.

Be sure to ask for the anesthetic that keeps you out for several weeks... LOL Are you a possible candidate for knee surgery?

You really are an amazing man!

Thanks, I have a few people you need to call for me and explain that, ha ha. I do appreciate the praise, even if I don't believe it.

If all patients put this much work into prep and recovery I'd have so much less work.

I do think the prep helped me, but recover I am not sure. Today was a really hard day trying to do my PT exercises. Maybe I should try the oxycodone first thing, but I don't like that idea. So far I've only taken 2 oxycodone since hospital release, both at night to sleep.

I mean, that wheelchair parking sign is fucking gold! Hahaha. I hope you appreciate it.

It will be nice to have, I feel a little guilty at the idea of using it. I am not that bad, but at a big store with a full and busy parking lot I probably will. It's good for 3 months, pretty sure I won't need it anywhere near that long.

When I lie in bed at night sometimes, I imagine other-worldly beings coming along and speeding up whatever healing process I need. Imagine that healing light. And rest!!!

I'll try that, might help with sleep, thanks.

 

[Llama]

I am skeptical, I know my knees were bad and I am sure I was in some denial about how bad, but I know lots of others who have more pain that I did. Oh well, at least it reinforced my decision to get it done.

Cate is right that not everyone experiences pain in the same way but also the correlation between how bad things look and how bad they feel isn't great. Slow changes generally come fewer issues than the exact same amount of damage developed more quickly. Plus well-developed muscles (more to do with precision movement than with sheer muscle mass) can often reduce pain without improving the joint surface itself. I'd say you can believe the guy.
Apart from that your body is trying to heal 4 major fracture surfaces plus a whole bunch of soft tissue damage so quality and quantity of nutrition to support that hard work are important.

Also: no new patellae, right? I thought you were getting the full wax. Wounds are looking good as far as I can tell through the plaster.

 

[alligatorob]

It was a good day, ate a few more calories, but 1700 isn't bad, and no binge. Also went to PT and did some PT at home. I am trying to do more walking, went up the driveway and around the house. I want to get out to the street to walk, but the last bit of driveway is steep, so I'll just try it a little at a time. Drove to PT today, and it felt fine. Short easy drive. Pain is a bit less today.

Cate is right that not everyone experiences pain in the same way but also the correlation between how bad things look and how bad they feel isn't great. Slow changes generally come fewer issues than the exact same amount of damage developed more quickly. Plus well-developed muscles (more to do with precision movement than with sheer muscle mass) can often reduce pain without improving the joint surface itself. I'd say you can believe the guy.

Thanks LaMa, maybe you, Cate, and the surgical nurse are right... I was overweight putting a lot of stress on my knees for a long time, and I tend to try my best to ignore or deny pain. I can first remember the pain over 30 years ago... I am very lucky to have the opportunity to start over.

Apart from that your body is trying to heal 4 major fracture surfaces plus a whole bunch of soft tissue damage so quality and quantity of nutrition to support that hard work are important.

Also: no new patellae, right? I thought you were getting the full wax. Wounds are looking good as far as I can tell through the plaster.

In addition to the larger bones the femur and tibia they also cut off and capped the fibula, and cut the back off of the patellae and put a new back on it. The caps on the fibula and patellae are plastic so you can't see them in the x-ray. There is also a plastic plate between the metal femur and tibia ends that does show up. The doctor said he did not want to replace the part of the knee cap where the muscles attached. He said the attachments were ok. So just a refurbished patellae, not a new one. That's 2 big ones and 2 smaller ones, in both legs. Hurts just thinking about it.

 

[Cate]

I'm glad you are having less pain today & were sensible about taking a strong painkiller when you obviously needed it. I do think you are amazing & I will tell whoever you like We are our own biggest critics. I'm just as bad. We should stop. I'm getting a bit frustrated with my left knee in particular & have lost track of the plan. The last time I spoke to an orthopaedic surgeon he seemed to think my right foot was the most urgent & I'm on a waiting list to have that done. Since then my left knee has deteriorated. I really don't know what to do. We don't have private health insurance & the waiting list is so long. I'll try talking to my GP about it & see what she can find out.
1700 sounds better for you & I'm glad you're getting more protein. Well done on not binging, Rob

 

[Llama]

cut the back off of the patellae and put a new back on it.

Ah, that explains the straight edge on the one patella; thanks for the extra detail.

We are our own biggest critics. I'm just as bad. We should stop.

Hear hear!

The last time I spoke to an orthopaedic surgeon he seemed to think my right foot was the most urgent & I'm on a waiting list to have that done.

Often the "better" knee will hurt more because people subconsciously spare the more damaged one. Don't know if that's the case for you, of course.

 

[Emilyrose]

That does sound painful Rob, but I hope that in the long-run, it will be all worth it.

 

[alligatorob]

Today was ok, ups and downs on the pain, maybe a few more downs that ups, headed in the right direction but slowly. I ate reasonably, low calorie but not the most nutritious mix. Was at PT for over an hour, I do a few extra things, and it takes me longer all the other patients have only one limb to work on. Did some walking, turned on my app the second time, I did 0.55 km in 28 minutes, kind of embarrassing, but at least it was walking. First walk was shorter, so I probably did not make a km. But I'll try again tomorrow. Walked with my hiking sticks, one in each hand, felt better than the walker, and not unsafe.

The last time I spoke to an orthopaedic surgeon he seemed to think my right foot was the most urgent & I'm on a waiting list to have that done. Since then my left knee has deteriorated. I really don't know what to do.

How long is your waiting list? We have no waiting lists, and a choice of surgeons. I believe health care in the US is the best in the world, if you can afford it. Unfortunately many cannot. I have Medicare, government insurance for those over 65 who worked and contributed to it, pretty good. We have no government hospitals, doctors, or clinics, you are free to choose any that will accept your insurance, and most accept Medicare. So I am one of the fortunate ones. We also spend about twice as much for medical care as anyone in the world, not sure its worth it.

I do think you are amazing & I will tell whoever you like We are our own biggest critics. I'm just as bad.

Thanks Cate, you are very kind. And you are right we are our own worst critics...

Often the "better" knee will hurt more because people subconsciously spare the more damaged one. Don't know if that's the case for you, of course.

I have heard that, for what its worth my left hurt a little more than my right before surgery, now its reversed...

That does sound painful Rob, but I hope that in the long-run, it will be all worth it.

So do I, and given what they said about the state of my knees I am sure it will be.

 

[Llama]

Did some walking, turned on my app the second time, I did 0.55 km in 28 minutes, kind of embarrassing, but at least it was walking. First walk was shorter, so I probably did not make a km. But I'll try again tomorrow. Walked with my hiking sticks, one in each hand, felt better than the walker, and not unsafe.

Walking 550 m in one go 10 days after double knee surgery is amazing, regardless of the time it takes. Hiking sticks are great for balance if you don't need a lot of actual support.