Today is knee-day-plus-six-months

Today makes six full months. SIX MONTHS. I've had a new knee for six months. And my overall experience remains positive.

Last weekend, my wife and I rode in four little airplanes (Dash 8's) from home through Philadelphia to Virginia Beach (and back) for the weekend. First of all, it was a joy to be able to stride through the airports. No need to stop and rest. No need to eat Motrin like candy.

Second, it is getting to be SOP with the TSA guys at check-in. "I've got a fake knee". "George, he's got a knee". And they wand you all over, and pat you down whereever the wand squeaks. Less than 3 minutes, max.

Third, I spent the long weekend working on a wood-turning lathe. On my feet. Standing upright in front of the lathe. For hours and hours on end. No knee pain. NONE. My legs were not even tired.

And yes, I do recognize that I am still healing. It's come a long way, and there's still more to do. But where I am today is really good, and so much better than I was before my TKR.

Changes to this blog

Knee-plus- ... well, it'll be six months next Wednesday:
Ch-ch-changes:
If you have been watching this blog evolve, you'll notice many changes in the older posts. Each day from the day before surgery until knee-plus-36 days are now posted individually, and in the archives. Knee-day for me was 29-Sep-04.

re blog frequency:
I attempt to blog on this site at least once a week. Sometimes more, sometimes less. Topics are those which I am experiencing re my TKR, although e-mail questions will trigger blogged responses at times.

re forum participation:
I drop into the Delphi joint replacement site at least once a week. I also occasionally drop by the Yahoo KneeSurgery forum and the Knee1 sites.

re best way to contact me:
E-mail should now go to greatTKR@gmail.com. I've been very happy with the Google e-mail service.

If you have questions re ANY of my postings on this blog, please e-mail me. I'll do my best to get back to you within a week.

Kneeling and crawling

There's been a continuing discussion over on Delphi about whether or not you can kneel on a TKR. I can't speak for anyone's experience but my own. And I can kneel.

It certainly feels a little strange. There are obviously no pressure sensors in the artificial joint, as there are in the natural joint, so the knees don't "match" in that sense. But I can kneel on the new one, and with increasing comfort.

The first time I tried it, I was on a bed. I turned onto my hands and knees, and sat up and back, keeping the TKR at about 90 degrees.

Now, as I approach knee-plus-six months, I can comfortably kneel on carpeted floors, and have begun to sit farther and farther back onto my heels. I'm not yet in a complete sit-on-heels position, and may never get there. But I can go a lot farther back than I ever expected to be able to do. When I hold a kneeling position for a few minutes, and then stand up, my knee feels very stretched out. A little loose. And I think that it rattles and clunks more after kneeling, but that may simply be my heightened sensitivity, looking for problems after doing something new.

That said, I knelt in bed the other day, and on that soft cushion-ey surface, was indeed able to sit back onto my heels. I could not hold this position for very long --- the muscles at the back of my thighs started to cramp up and twitch in response to the "new" experience, but I could indeed put my butt onto my heels. I am not at all sure that I could do this (yet) on a less cushioned surface. But it's a lot more flexibility than I am accustomed to having.

It's been more than a decade since I could comfortably kneel in my garden and work. I'm now looking at kneeling stools, and kneeling pads, and kneeling mats. I'm thinking about changing the garden mulch to something a little softer and thicker, just so I can kneel on it. I'm so excited about this being-able-to-kneel thing. It's such a small part of life, but it's not something I expected to regain post-TKR.

Airport security?

Yesterday, I took my first trip through an airport since knee-day. And yes, the replacement sets off the alarms.

I live in a small college town, with a relatively small airport. It was an early flight --- 0530 AM --- and I was not yet caffeinated, and only marginally awake. Nonetheless, I walked through the magnetic gate THREE TIMES, taking off more and more things each time, before I remembered that I HAD A KNEE REPLACEMENT LAST FALL. This recognition --- that I am so comfortable with the new knee that I did not even remember that it was there --- made me chuckle all day long.

Did I carry my knee-replacement card? No. But I did ask the question "Would I have to go through this if I had a card from my doctor?" The answer was "Yes". You set off the alarm, you get patted-down and wanded. It adds all of about 3 minutes to the process, and is not at all invasive. At both the small and large airports, the process is the same. Sit down. Wand each leg. Stand up, feet spread, arms raised, palms up. Wanded again all around. Repeat over the areas which "beep". Pat down those areas which "beep". The TSA employees I encountered were gentle and polite.

Be aware that your "stuff" sits in the bins on the conveyor belt, waiting for you. If you are traveling alone, you might want to keep an eye on your things. If you are traveling with a companion (and a companion who does not need to get patted down at each security checkpoint), I'd recommend that your companion watch your coat / shoes / bags / bins for you.

The other revelation of my first major travel day post-knee-day was that for the first time in years, I could walk comfortably from one end of the airport to the other, as fast as I wanted to walk, and without pain. In comparison, during one of my last business trips pre-knee-day, I had to walk 5 minutes, and then rest for 5 minutes, because my knee would no longer support me. I stubbornly refused the courtesy carts, but was to the point where I was seriously considering them.

If this blog is new to you ...

... let me tell you why I am doing this.

Last summer (2004) as I was getting ready for my total knee replacement (TKR), it was obvious to me that there was not a lot of experiential information out there. What was it like? How long did it take? What were the details of the actual process? How long did it REALLY take to get off pain killers and back to work?

Yes, there is an abundance of information from the surgical community. You can readily find pictures and video of the actual surgery, and for a geek like me (yes, I'm a scientist), that's great information. But what was it REALLY like? There's just not much of this kind of information out there.

Yes, there's a joint replacement forum on Delphi (hi, Robin!). And Delphi is great place to ask questions. If you are looking for a place to ask questions about your knee or joint replacement, and get good answers in a back-and-forth format, the Delphi joint forum is the place. There are also Q&A forums on Yahoo (KneeSurgery) and on Knee1. Both are good.

But mostly, what I found on the web last summer tended to be negative experiences. Or worse, CYA behavior by the surgical and medical community. Both are completely understandable --- negative experiences tend to get more widely shared than positive experiences (that's human nature). And CYA behavior falls into the "I have to tell you all of the worst possibilities, just in case".

But positive experiences? I heard them from friends, but found very few on the web.

Detailed experiences by someone who went through a TKR? Nope. So I decided to keep a daily diary of what happened, what I felt, how I felt, and what the actual process was on a day-by-day basis. Reverse chronological order, going all the way back to the first knee injury in 1969, which is when this whole thing started.

After five months, I consider my TKR to have been an absolutely wonderful and positive experience. I've got way more range-of-motion now than I've had in years. I've got NO PAIN at all, and it's been >20 years since I could say that. I'm taking NO pain meds --- none --- not even ibuprofen, and there were years on end when I was taking prescription-grade Motrin at doses high enough to make my ears ring almost constantly. That regime finally got to my stomach, and I cut it out cold-turkey. But then I had to learn to live with the constant chronic deep arthritis pain. And eventually, this got to me. Sleep was constantly interrupted by pain. I couldn't stand on my feet for more than 15 or 20 minutes at a time. I couldn't walk for more than a few hundred feet.

Now, I can walk for miles. I can pedal a bike for the first time in more than a decade. I take NO analgesics at all. I literally can run up and down stairs. And I am sleeping soundly.

It's truly been a wonderful experience, and one I felt that I had to find a way to share.

Unfortunately, I will probably not be able to blog on a daily basis. Please comment --- and be patient. I'll do my best to respond through this site (or the gmail address) within a week.

Swollen gland is NOT an infection

Knee-day plus 5 months: Friday, 4-Mar-2005:
Twenty-two weeks and two days.

The swollen lymph node turned out to be completely unrelated to my earlier root canal, and no risk at all to the knee [no infection]. Appears that I have a stone (yes, a stone) in the sublingual salivary gland, causing it to get irritated and swollen. Whew.

Why did it go away following my knee surgery? No idea, but there is apparently no relationship.

So how's the knee doing now? Great. My work schedule is keeping me from maintaining the exercise regimen at earlier levels, but I do what I can.

I can kneel comfortably on the new knee. It feels a little weird, since there is not the same kind of feeling in the implant (duh!). But I can kneel comfortably with the joint at 90 degrees, and can even begin to sit back on my heels, maybe to about 45 degrees (although I don't ever expect to be able to completely sit on my heels).

It's been years, and yes, I am kneeling on a carpeted surface. But it's been years ... I am looking forward to getting back into the garden.