A Journey From Knee Replacement Surgery to Recovery ‘Facing Arthritis’ Blogger Shares Her Story

Judith Lautner, a Californian who writes the blog Facing Arthritis, has dealt with significant osteoarthritis pain in both knees, her hands and hips. In these posts, she details her seven months of recovery from a second knee replacement surgery... Sept. 30, 2011 Two Days I’m going back to the hospital for a second [knee replacement] surgery, this time on my right knee. All is in order, all is lined up. All of my tests were normal, something both the nurse and surgeon said is not particularly common. Everyone who has told me about second knees assures me that the second surgery goes more easily. Not because there is less work, but because the patient knows what is ahead. This weekend, then, is mainly for tidying up. When I return home it won't be long before a nurse and physical therapist show up at the door. I want to be generally ready for them. I am excited. I have had a lot of pain in my right leg and I really hope to see improvement. Oct. 3, 2011 The Day Of And so here I am, 4:30 in the morning or so, on the day of my second [knee replacement] surgery. I got so worried last night that I would not be ready and that I would not wake up that I got pretty much everything done. I'm feeling better, ready to go, in spite of hardly sleeping at all last night. I just need to be alert enough to tell them which knee to mark. Oct. 3, 2011 In the Grip The [knee replacement] surgery went well. I woke, however, in a lot of pain. The nurses gave me all the pain relievers they could while I was in the recovery room, and then when I went into my regular room, I got still more. It's better but far from comfortable. I wish I could get up right now and walk around, but the pain makes that seem impossible. When the physical therapist arrives, I hope I will be able to stand up. That might even help, once I get past the initial pain of moving off the bed. Oh, yes. The good news is that there is no full-length brace on my leg this time! I hope this means everything will proceed a little bit more easily. Oct. 4, 2011 No Walk in the Park Oh, the misconceptions. This knee was going to be easier than the last. I was going to power through the pain. Let's just admit up front that I am as much of a wimp as ever. I lost count of the different pain meds I have been on so far. My knee is hard to move. I am managing to wiggle toes both ways now and flex my foot, sort of. I have done the pulley exercises five or six times, last night. Need to rig that up again. The nurse was in here maybe a dozen times last night. Replacing IV bags, checking meds and so on. It is a miracle I slept at all, even given all the drugs. One day at a time is my motto for now. I know that improvement will come, that I will celebrate small victories. Oct. 4, 2011 No Pain, No Gain I have to accept that old saw when it comes to the knee therapy. Again and again, nurses say one has to keep pain meds in the system so that therapy will not be very painful and therefore make progress. I used to want the pain to be blocked altogether and would be impatient when it did not happen. Of course, in a perfect world, I would get that. I have personally observed four people who have had knee or hip replacements, and all have had trouble finding pain meds that worked for them. The first days are usually the worst. I am trying to take more deep breaths and reduce my expectations in this department. Today the therapist, Ron, had me do some tiny leg lifts, then ankle bends and the pulley lift. And, finally, he struggled to get all the cables put aside so I could get up with the walker and walk down the hall and back. It got easier and much better than yesterday. Yesterday, my knee buckled when I tried to stand straight up. Little by little, I am regaining independence. Perhaps it is a good thing that I am so impatient. Oct. 6, 2011 As I Lay Thinking... When I was through [knee replacement] surgery on Monday, I awoke connected to many tubes. The gowns are now made so every kind of tube can be attached to a body, through, over, under the gown. Each had a different purpose, shape and length. And movement was difficult because I kept tangling them up. Oct. 7, 2011 First Friday My challenge for the day: Get dressed. I can get everything else on, but my right sock and shoe are a challenge. I discussed this with the occupational therapist, and she brought out a grabber and long shoehorn. Oct. 8, 2011 Alarming At the transitional care center, there are many sounds. Whenever one of us “residents” wants assistance, we press our little red button and somebody magically appears. There is a blinking light on top of our door indicating this is the one, and a beep-beep sound. Some residents need a little more monitoring, so they get a sensor clipped on their bodies. When the resident falls or otherwise causes a disruption to that sensor, an alarm goes off. People really jump at that one. Just recently a new alarm system has been installed for the building. Since I have been here, it has gone off several times. So far it has all been testing or mistakes. Televisions play a pretty big part of life here. There is a large-screen TV in each living room, and in the afternoons it tends to be quite loud. And yet, there’s no piped-in music. So I continue to be very happy at the choice of noises offered here. Oct. 15, 2011 Going Home My checkout time is 11 this morning, and I am excited about going home. There is a lot to like about the transitional care center, but seriously, any care center worth its salt is going to want its residents to get antsy eventually. I suspect that most people who like their independence as much as I do never go to a rehab center in the first place. But I knew from the outset that my knees would really benefit from a lot of physical therapy, and that I could never provide as much on my own as I could get here. Three times a week does not compare with twice a day. I have gotten enough of a good start here that I will continue to improve, even with my less-intense home workouts. Not only that, but I will be able to take little walks around the park, paying close attention to every step, as I did for the other knee. I will also enjoy being able to spend time with [my daughter] Elaine, just the two of us and my four cats. Oct. 20, 2011 How It’s Going I have been out of transitional care for five days. Elaine was here until yesterday, when she flew home again. She stocked up on groceries, vacuumed, washed clothes, sent spiders off on new journeys. She took me to my appointment with my surgeon Tuesday – everything looks terrific. Monday I met with the home-care nurse, Sandy, for the first time. She was impressed by my progress and my overall good health, surprised at the small number of meds I am taking. Over the weekend I just relaxed. I was not surprised when the physical therapist, Roberto, measured my flex and extension on Tuesday and found that I had lost a little of what I had gained at the transitional center. Roberto went through my packet of exercises and circled those he thought I should focus on, and filled in the number of sets and reps for each. He said, though, that he is pleased when his patients do any exercises at all on their own. I have heard this a lot. I am not so gung-ho that I do everything every day, but I believe I am more conscientious than many others. The pain seems like a lot. I wake up in pain and have trouble loosening up enough to calm it down. This morning it took over an hour to feel relief, even after I took some pain relievers. Most of this difficulty is from the swelling. It is going down but has a ways to go yet. I need to get up and move around and do a few more exercises. This is the best path to pain relief and flexibility. Oct. 30, 2011 110 Degrees and Counting My recovery from my second total knee replacement is similar to that of the first, but also different. According to all of the therapists I have seen (and that's a lot), every knee is different, even on the same person. In the case of this knee, my right, I am having more pain now than I was at five weeks with the left knee. It isn’t unusual, but it has been dissatisfying for me. I find myself wondering what I should have done differently, which is an exercise in futility. The best thing is to go forward and expect a good outcome. Today, though, after focusing more the last two days on elevating and icing, as well as on some specific flex exercises, more than before, I reached 110 degrees flex. A solid 110. I had been stuck at about 104, so this really charges me. I feel more capable and energized. Tentatively, I am scheduled to go for outpatient therapy starting next week, but if I don’t feel ready for it, I can keep the home therapy going longer. I am beginning to understand the advantages of each: Home therapy: One therapist focuses entirely on me. No distractions. I get from 45 minutes to an hour of undivided attention. Outpatient therapy: Appointment times may be more consistent, but this varies with the therapist, of course. There is a lot of equipment available which I do not have at home. I feel more capable because I am outside of my house. With outpatient therapy, the biggest disadvantage is the need for the therapist to work with more than one patient at a time. So I get stuck on a machine and left until he or she returns to me. I keep feeling I could do this sort of thing at home or at the gym. Outpatient therapy, though, is a sign of progress. So I welcome it. I also don’t need to vacuum before my appointment. Nov. 10, 2011 Some Specifics I am 5-1/2 weeks in from [knee replacement] surgery on my right knee. Today these things are true about me: It hurts to stand on my right foot for any length of time. Walking is still not pain-free. But not bad. I am still taking pain meds, day and night. And becoming sleepy often. Nighttime pain seems a little less. I have yet to have a really comfortable shower, standing up. Nov. 18, 2011 Return to Aqua Yesterday I returned to an Aqua [water exercise] class at my gym. The Thursday leader is one of the milder ones, so I felt it was a good way to get back in. However, after 20 minutes, she relinquished the class to Cindy, one of the Movement Maniacs, who finished the class with us. Cindy is a personable, highly active 50-something teacher, who knows all of us. She is famous for keeping us moving. Back and forth, up and down, high and low. A few times I felt the twinge, especially when we had to do things that called for quick high bending of the knees and bicycling-type moves. I made it through all right, but I knew it had taken a bit out of me. When I went into therapy this morning, the therapist said I was already walking better. Clearly the Aqua class didn't hurt anything, and it probably helped. Jan. 1, 2012 Inauspicious Beginning Some signs of progress: It doesn't hurt to drive anymore. It still hurts to get in and out of a car. My left knee generally does not hurt. Every now and then there is a bit of pain at night, but mostly it is just stiff. I feel discomfort when I have to stand for any length of time. My legs both feel a kind of uncomfortable tension, and often my right knee or my right hip will hurt as well. I do physical therapy three days a week. I bike, then step (on a sitting-step machine), then leg press, then the isokinetic-leg kicks, and finally a 7-minute stretch of both knees. Finally, I land on the table, where Chuck, the therapist, pushes and pushes both knees. We’re gradually softening the muscle, working to get the legs to zero extension. What a dream! I also go to Aqua classes three days a week. I am considering doing more work in the gym either on the Aqua days or therapy days, focusing on arms and aerobic activity for now. I am no longer taking pain meds. I still wake up with my right leg in pain for hours, but not every night. Fortunately, I seem to be sleeping more hours between wakeups. Jan. 7, 2012 Stuck I am stuck. Suspended. No change, or change for the worse. I recall feeling less pain a week after [knee replacement] surgery than I do now. Of course, I was taking painkillers at the time and not feeling it all. But the memory haunts me, makes me wonder what I've done wrong. There is no percentage to thinking like this. No gain to be had from dwelling on my disappointments. My body is a cage. Let my body free. Let my spirit free. Jan. 10, 2012 A Good Day It didn't start out with a lot of promise. As usual, I caned my way to the kitchen to feed the cats early this morning, bent over and felt pressure and pain in my right leg. Each time I got up, I had to grab the cane. Finally it was time to go to Aqua. I used my cane to help myself down the steps. But it was pretty easy. By the time I got to the gym and out of the car, I knew it was a good day. I walked in, flashed my tag, walked to the locker room without limping. I did not take my cane in with me. Once ready, I walked out onto the cold concrete deck and headed to pick up the buoys and noodles, then for the water. So nice. Pressure, stiffness, but no pain. Another classmate noticed and commented on it. She assumed this was a permanent change, but I know better. Still... maybe it's a sign? Yesterday, after all, Chuck, the therapist, said, "Good!" in a way that was different, after pushing my knees down. Straighter, is what he meant. We are getting there. Jan. 18, 2012 Stretching It The focus of my work in physical therapy is stretching my leg so it will get straight and stay straight. I now sit on the modern version of the rack for 10 minutes, while it stretches both legs. It's as much as I can take. When home, I also work on stretching by placing a 5-pound weight on my knee while it is resting on a low stool, straight. The other day I did the 10 minutes and later the weights at home. When I went to bed that night, I had a bad time with spasms – restless legs. It went on and on and made a hell out of the night. My theory is that the stretching brings on the spasms later. If this is so, then there should come a time when my legs are straight and the spasms slow down and even stop. I hope this is the case. In general, I am walking better. I have been going without my cane some of the time now and I am starting to walk down stairs alternating legs, rather than stepping down with my right leg and then bringing my left down to meet it. I'm making real progress. Feb. 12, 2012 Time Flies I recently purchased a Fitbit, a monitor intended to track steps and movement in general. It is small and wireless and uploads information automatically when it’s near my computer. One of the special things it does is monitor sleep! Last night I was in bed over 10 hours and slept over seven. This was a good night, too. Even on a good night I was awakened 47 times. Feb. 26, 2012 Ups and Downs I am taking more little hikes. On one, I was almost stopped at the beginning: The start is fairly steep and the soil is clayey and, therefore, slippery. I was afraid of falling. But I grabbed some shrubs on the side of the path for a bit for more stability and made it up that part. From there there were no too-slippery parts. I went only 20 minutes in, to the second bridge, and turned around. My near-constant companion is the Fitbit. This little guy tells me that I climbed 19 floors during that hike. According to the Fitbit website, each floor is equal to about 10 feet in elevation gain. There is a clear difference in surfaces for me. Walking on the sidewalk, I feel enough hip pain to make it uncomfortable. When I hike, however, the hip pain disappears almost immediately. Clearly, hiking is a better activity for me right now, given that without the pain I can walk more consistently, more correctly. March 10, 2012 Challenges and Comparisons Recovery has not been a smooth path. When I ask others who have been through [knee replacement] surgery what it's been like, many of them say the same thing – lots of ups and downs. I asked a fellow bent-knee patient, who has finally got his legs straight, when they actually got there and how. He said they went straight on the table about a month ago. Suddenly. Out of the blue. When Chuck pushed on them, the backs of his legs touched the table. I want this for myself. April 5, 2012 Back to the Coast Yesterday I did the east-west ranch hike in Cambria again. This time I was with my grandson and it was not foggy, but it was very windy and cold. We did it in one hour, which for me is respectable and, I think, less than the last time. I did not feel the discomfort I felt the last time, although my hip acted up a bit near the end. Gives me hope. For more information and expert advice, visit Lifescript's Osteoarthritis Health Center. How Much Do You Know About the Types of Arthritis? About 46 million American adults – nearly one in five – suffer from some type of arthritis. It’s estimated that number will rise to 67 million by 2030.