Four Month Follow up

Good Morning.  Happy Sunday.  It’s a beautiful day in New England which makes me feel a bit guilty for all the hurricane ravaged communities that are trying to bail themselves out.  Or for people who lost everything.  I can’t imagine.  I sell insurance for a living and only once did I have a claim where people lost everything and it’s heart breaking.

I thought I’d give you a run down of my final check up with my orthopedic surgeon.  It was exactly four months from the date of my second knee surgery.  He was happy that I had full range of motion in both knees.  He also said a couple of interesting things.  He said that some people with 2 replacement knees have trouble walking down the stairs normally.  Which is something I have issue with but I am not sure if my brain is holding me back or the movement itself.  I am going to try to figure that out.  He also said that most people with knee replacements don’t get on their knees.  Well I observed my father get on his knees in July and he’s had 3 sets of replacement knees (long story).  That alone gave me the desire to not be outdone by the old man.

I started training again with my personal trainer three weeks ago.  On the first day, she asked me if there was something I hadn’t done that I wanted to. When I asked her to help me get on my knees, she knew exactly what to do.  She put down a weight bench that I could use to lean on and I got on my knees next to the bench and was able to pull myself up.  While it wasn’t exactly comfortable on my knees, it wasn’t painful.  I felt accomplished and when I explained that to my surgeon he was so very impressed and stated that I must be an outlier.  And I believe that I’m an RA outlier.  I try hard to live my life with as little interruption from the chronic disease that I’ve had for 20 years.

Thanks goes out to my dad for giving me the courage to go through all of this.  It was his mother who had RA and never complained.  I also have to thank my bitchin’ personal trainer Cathy.  I love working with her so much and she gives me the courage always to keep reaching for the brass ring.  She said the day I walked back into the gym after surgery for the first time was the only time she’d seen me with a normal gait.  She said I had a confidence she hasn’t ever seen.

Music to my ears.

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Saturday musings

roomba

I’m vacuuming as I write this.  Seriously.  I purchased a Roomba earlier this summer.  We had given one to my parents at Christmas. They’re hard to buy for and my husband hit on the idea, we researched and bought it for them.  And they love it.  They talk about it regularly – I think mom called it an amazing little machine.  So I had some coupons and gift cards and I bought one.  We also love it.  My kitchen floor has never been so clean.  We dock it in the kitchen in a corner and Mr. Phat will start it up when he takes the dog for a morning walk and shuts it when they come home.  A large part of my house is one level and I can vacuum the 40 foot long great room, the bath room and the office at the same time.

I’m not sure why I started out talking about my roomba except to say that as I’ve gotten older, it makes sense to find ways to make our lives easier.  I still have a full time job and I’m not ready to give it up, so I can’t get to house and yard work like I used to.  Mr. and I know that we really need to hire landscapers to help with the yard if we are going to stay living in our home for the future.  I’ve thought about a maid service, but the roomba helps out and our house is small – I can keep the house fairly clean.

I just ordered a telescoping window cleaning set that was marked down to 1/3 the price. It hooks to the hose and helps clean the windows while you stay on the ground.  I can definitely use a tool like that.  Now if only I can find one that will clean the gutters!

I’m feeling good.  The knees are really almost pain free.  I’m walking about 7000 steps a day and haven’t had a chance to increase it.  I need to carve a little more time out of my day for walking to get to 10,000.  My RA is better, but I still ache in the shoulders, wrists and fingers each morning.  Increasing my dose of Methotrexate has definitely helped ease the RA pain.

I’m glad I’m feeling better because Mr. has lyme disease.  Sadly his is the classic misdiagnosed case.  We live in the woods.  There are ticks everywhere.  He’s had tick bites and has found them on him, but never had a classic bulls eye.  He did have a rash last year that the doctor said was excema but we don’t think that now.   He’s felt lousy since February and we kept asking the doctor about lyme.  He had several negative lyme tests back and our primary care sent us to the cardiologist, the urologist, the neurologist and then wanted us to see a rheumatologist.  We saw a lyme specialist instead who said that the mainstream medical community is missing the boat on lyme.  According to him, it’s an epidemic and they won’t acknowledge it exists unless you get a positive lyme test.  The lyme test protocols are 40 years old.  The disease doesn’t follow the same pattern.  It’s very frustrating and debilitating.  Mr. started an antibiotic, supplement regimen and we are hoping for some improvement soon.

That’s my update for today.  It’s raining hard here so I can do some work inside and read my book about Lyme Disease.  Have a great day and weekend friends.

Mid Summer update

View from lunch yesterday in Stonington borough in CTstonington

Tomorrow is 11 weeks since my second knee replacement and 22 weeks since my first.  Feeling good.  I just went on a walk with the dog and realized that I was at a normal walking pace.  It felt good.  I’ve been doing 6000-7000 steps per day and hope to start upping that a bit.  At this point, the most uncomfortable thing I do is stand still.  When I stand still, I feel pins and prickly pinches in both knees.  But otherwise I’m moving along very well.  I went out in public the last 2 days wearing shorts.  I’ve decided I don’t care about the scars.

My RA?  I wish I could say it was better but it’s not.  I’m still very achy every day and mornings are tough.  I saw the rheumatologist this week and he suggested increasing the amount of methotrexate I inject each week.  Today was the first morning I tried that.  We shall see. The dose I was giving myself before wasn’t lasting the week so that I would dose a day or two early, which didn’t thrill my doctor.

The stomach upset that comes with restarting Xeljanz XR has mostly stopped, so I hope that I will soon feel the full effects of the medication.  The doctor said that 2 major surgeries was probably a shock to my system and my immune system is a bit out of whack.  Good point.

I’m not Wonder Woman

I’m done.  Really, that’s how I feel.  I’m totally done with sitting on my couch, being in pain, burning incisions and watching life pass me by.  I expected to rebound from last week’s setback a bit quicker than I have.  I still have major pain and stiffness in the newest knee that was doing so good until the joint filled with blood.  I have taken a couple of longer walks, but the knee is still stiff.  By yesterday I felt like I just wanted to have a good old cry, but I didn’t give in.

My return to my RA meds was delayed by a week due to the setback last week and that hasn’t helped.  I can manage three weeks off the meds, but then after that, the pain is excrutiating and it takes several weeks for the meds to kick back in when I restart them.  I started them Thursday, so they won’t reach full effect for another week and a half at least.  Which means the pain in my joints in the morning is strong.  I thought the knees were the worst of the RA joints, and replacing would rid my body of RA, but that’s not the case at all.  My shoulders, wrists and fingers hurt daily.

The weather hasn’t been conducive to someone with inflamed joints either.  It’s been raining like heck here for 2 weeks.  The morning might be sunny, but then the rain comes.  Today and tomorrow are just rain.  No sun.  I felt better when I saw two friends post on facebook last night about pain in their joints due to the weather.

Yes, I’m whining.  It’s totally not my style.  I promise this is the very last of my whining.

Three week mark

tkrimage of total knee replacement

 

I hit the three week mark from Surgery 2 days ago.  I had a setback over the weekend and wasn’t sure if I wanted to post about it, but decided I would.  Maybe someone else has had a similar issue.

I had the staples removed last Thursday and felt great.  My doctor was impressed with the range of motion and how good the scar looked.  He said I was healing really well and to keep it up – keep moving and walking.  Which I tried to do, but Saturday morning I was a bit lethargic and just didn’t feel right.  I told Mr. Phat that I was going to spend the afternoon on the couch while he spent a couple hours working.  Shortly after he left, the knee stiffened up and the pain started.  And kept coming, and coming.  Very strong pain.  Mr. got home about 90 minutes later and we decided that he would drive me to my surgical hospital.  Unfortunately I couldn’t move at all, the pain was excrutiating.  Instead we called the local town ambulance and they arrived quickly.  They loaded me, screaming in agony into the back of the truck and then before we even left they put in a IV and gave me some pain meds.  They couldn’t take me to the surgical hospital because it’s over state lines, so they took me to the local ER where I got very good care, but they wouldn’t do much beyond Xray and blood tests because they wouldn’t interfere with another doctor’s surgical sight.  The doctor in that ER suggested that it might be infected, in which case the new replacement joint would have to come out immediately.   They conferred with my doctor over the phone on Saturday evening, medicated me again, put me in Mr.’s car and we drove the hour to the other hospital.

Naturally I focused on infection because I had started back on the RA meds that week – one injection of methotrexate and 2 Xeljanz XR pills.  Could that little bit have brought on an infection?  I had taken my temp each day and never had a temperature, so I tried to think positive.  The thought of a third knee replacement surgery in 15 weeks was more than I could handle.

My surgeon saw us by 9:30pm, aspirated some of the fluid, discovered it was mostly blood and said it was most likely a hemarthrosis, which is bleeding into joint spaces.  My surgeon had requested that I take 2 baby aspirin daily from the day of surgery until the day the staples came out.  I’ve taken 1 aspirin for many years on advice of my Primary doctor, but 2 proved to be too much and it thinned my blood too much, causing the bleeding into the joint.

I spent the night in the hospital for observation while waiting for the test results on the aspirated fluids, to be sure there was no infection present.  Thankfully, tests showed no infection.  No surgery necessary, just some ice and rest.

I’ve been home since Sunday afternoon, back on my perch in the living room on the sofa.  I’m tired of being here, but thankful that this will resolve on it’s own with time, rest, and ice.

Monday, Monday

Good morning friends.  I’m doing fine except for the itching!!! It’s driving me nuts!! I have been itchy since the second day in the hospital, right on the incision, around the incision and all over my body.  Benadryl doesn’t really help, half a pain pill helps when it’s really bad, and mindfulness works only to a point.  Naturally it’s at it’s worst when I lay down, so sleep has been elusive of late.  My fitbit says I’m sleeping about 4 hours a night.  No wonder I’m tired during the days.

Three more days and the staples come out and I cannot wait!!

Good Evening

Happy Mother’s Day.  It was a low key day here, as the week has been.  Had Total Knee Replacement of my right knee last Monday, came home from the hospital on Wednesday and have been working on healing since.

From the very beginning, the procedure and the interaction with the hospital was far better than 11 weeks ago when I had the left knee replaced.  The hospital had completed their transition to the new computer system so I could tell that everyone on the staff was less stressed.  My ortho and the  Anesthesiology team was on alert to be sure not to repeat the painful visit to the recovery room that I had last time.  They were so good with the concoction that they gave me as I left the OR, that I slept soundly for almost three hours in recovery.  And the nurses on staff made sure to medicate me before I went up to the floor.  I was in my room by 3:30pm and the PT and OT were there at 4:30 to get me up. And I got up, went to the toilet and sat in my chair for dinner.

What a difference.  One of the physical therapists said to me that all joint replacements are different and I certainly believe it.  This new replacement has had a few episodes of pain, but nothing like the prior one.  I have pretty good mobility as well, and was at about 93 degrees bend the first day.  I used the walker at home for a day and then switched to the cane.  You can’t carry a cup of coffee when you’re using a walker.

Another big difference is the bruising.  My first knee had almost no bruising.  This one has varying shades of purple, brown and yellow from my groin to my ankle, both front and back.  So while it’s fairly ugly to look at, the pain level is minimal.

I’m off all my RA meds except for one celebrex per day and unlike the prior surgery, I’m having NO RA symptoms, which I find amazing.  I’m barely taking pain meds so that’s not mitigating the RA symptoms.  I just feel pretty good.

Admittedly, I’m a little tired of my couch, and my icing machine and my pj’s.  I’m looking forward to getting a few steps beyond rehab and back to living.  I can see the weeds growing as I write this.