Matt's Arthrosurface PF-wave and tibial femoral

[Hicubus]

Matt,

I'm just catching up to the forums and what a great diary you provided.  I think this puts things in perspective that it is still a surgery that you will need to work your muscles back into shape after.   I'm glad you continue to improve and I hope to keep hearing your story.  Contact me and I have something (very arthrosurface) you can show your friends and family.  X-rays look great.  Do you mind sharing who your surgeon was?

Regards,
Hicubus

[mbrugman]

I guess it's been a while since I've updated things!  Let's see, I'm at 8 and a half weeks or so post op.  I can walk around pretty well with no limp or lean unless I'm tired.

Physical therapy is going well.  I'm down to once a week.  In addition to that, I do a couple days a week in a gym and have resumed my vinyasa yoga classes.  Physio has usually been 10 minutes of warm up, some time on the leg press machine, some "Nascar" rollie chair exercises and such.  Leg press is up to 90 pounds on the operated leg compared to 180 on the other.  Getting stronger!

At the gym I usually do 20 to 30 minutes on a bike, then hit some of the other machines.  I've never been much of a gym rat, but it's a good thing for me.  I used to do a lot of biking and it feels so good to get a nice fast cadence spinning.

Vinyasa is vinyasa...  Hot room, 60 minute class of energetic flow.  There's still a lot I can't do, but then again, there's a lot I can do.  I don't have my full range of motion yet, but there's modifications for just about every pose.

Some days are still a challenge.  It can't be all sunshine and roses, eh?  I still have some swelling and can be sore at the end of the day.  The other morning I woke up pretty achy, not sure why, but some naproxen and stretching made things better.

I'm also down about 10 pounds from my post-op high, which is another really nice thing

My OS is Dr. Jon Henry (http://www.aurorahealthcare.org/find-a-doctor/dr-jonathon-c-henry-md).  I'm lucky to have had him do the surgery.  Everyone I've talked to including his staff, my physical therapist, and the people at the hospital all have a lot of respect for him.  He's done a great job of educating me along the way, answering all of my questions, etc. 

[mbrugman]

Day 66

DH and I spent the weekend visiting the daughter in Minneapolis.  It's a little over 5 hour drive from Green Bay; I drove the whole way with one pit stop, and I was reaaaalllly stiff when we got there!  Had to walk around for a few minutes to get things loosened up.

Saturday afternoon we took the dogs to the dog park.  It was a nice fenced in area on a hill overlooking a lake (go figure - a lake in Minnesota).  Got a bit scared at first - the path goes up a steep hill right away.  There's still some packed down snow & ice on that hill.  I kind of took the side where it was a combination of mud/snow, so I made it up without wiping out.  The other concern was that it was a nice day and there were a gazillion big dogs running around as happy as can be; I couldn't get the image of getting rammed by one out of my head.  (thinking of krunzer's squirrel-distracted dog!)

After a few minutes of trying to put that thought out of my mind, we started along the doggy trail.  The trail around the area was up and down with some tree stumps and roots and such.  The kind of path I used to love for mountain biking .  We did three loops with the dogs and I really didn't have any troubles with the knee.  There's something so fun about watching all the dogs running and playing; makes you forget about your problems. 

Did a Yoga class after work tonight.  It get's a little better every class.  Been doing it for about 4 years now; but right now it feels like I'm just starting again.  I know the proper alignment for the poses, but it's a challenge to try to get into them. 

Between the Yoga, therapy, and the gym I'm starting to feel the strength coming back.  I'm actually getting a little more confidence in walking and moving, which is nice.

Matt

[mbrugman]

Day 69!  Had PT yesterday.  Started with the leg press; did a bunch of reps at 135 pounds.  The therapist went to the next weight plate (which brings it up to 150); I gave it a good push, but it didn't go very far.  I must have had a pretty good "straining" face going, because he just busted out laughing  .  Of course, that just made me start laughing, too.  Gotta have fun at therapy when you can!  From there it was some other exercises, a bunch of Nascars on the wheelie chair, some time on a seated stepper machine thing.

He asked how my other activities have been going; I told him I had a little trouble getting into balasana at Yoga the other night.  Well, okay; maybe I was whining about it a bit.  He asked me to show him, so I got down on the floor.  Another laugh from him - he said it was time to measure my ROM again.  It had been a while, and really, I'd been apprehensive about doing it.  140 degrees!!!   He's right - I shouldn't be whining about it this soon after the surgery.

[mbrugman]

Day 74 [or 2 months, 12 days ]

Met with my OS this morning.  He read my latest progress report from the therapist, checked out the slight puffiness, did some testing/manipulation, and listened to what I had to tell him.  What did I tell him?  That things are going well; I get some stiffness if I sit too long, a bit of soreness if I push it or spend too much time on my feet.

He asked how my daily activities were going, I told him that there wasn't too much that I wasn't doing.  The main issue right now is walking down stairs - the knee is a bit weak in the first few degrees of flexion when lowering the "good" leg.  He was interested in my Yoga practice; I told him the biggest thing was just getting strength back, and that it was doing a lot towards rebuilding my confidence in the knee.  Showed him my ROM, and he was pleased with that.

At the end, he told me I was doing really well; a bit ahead of schedule on recovery.  He said it was really important to keep up with the physical activities (Yoga and the gym) over the next three to six months to make sure I get the most of the surgery and recovery.  As far as the PT goes, he's leaving it up to me and the therapist to decide how much longer to go.

At the end he gave me a form for my employer that reinstates me to full duty.  My boss laughed and asked if the doctor backdated it since I've been pretty much full duty for a while now.  

Have to admit I'm pretty stoked about how well it's all going.  I'm really looking forward to the future; I'd like to get more miles on the bicycle this year.  Take care, everyone!

[mbrugman]

Day 81 (11-1/2 weeks?  Can't be!)

Had PT this morning.  Was up to 150 on the leg press with the operated leg.  Was tough, but managed a few reps of it.

Therapist feels my progress is really good with what I'm doing outside of therapy.  We made the next appointment for two weeks from today.  There's a few things I need to work on to improve before that appointment:  walking down steps, last bit of ROM, and (a personal goal) out of the saddle pedaling on a bike. 

I'm better going down the steps, it's not the "step, THUMP, step THUMP" that I was having from alternating good leg, operated leg, good leg, operated leg.  Now it's more "step, sttteeeepppp, step, sstttteeeppp" as I try to lower down with the operated leg in a more controlled manner.

If I do Hero or child's pose (both poses where you sit with your feet under your butt), I sit with my hips shifted a bit because I'm just so-close-but-not-quite-there with the operated leg.  Just a few more degrees!!!    (As a side note, I was able to get into half pigeon on the operated side last night.  Not a full-on forehead on the ground half pigeon, but a pretty good one.  Felt SO good to open the hip on that side - it's been quite a while!)

At the gym the other day I was on a bike and thought I'd try to pedal standing.  It was kind of weird, I came around until the the operated side was top dead center then stopped.  Just couldn't get that side to push the pedal down.  If I start with that side down and use my good side to start and pull up on the pedal, then it goes.  I think it may be more of a muscle memory thing than anything else.  Therapist said if that was important to me, I should really be working for it now instead of later.  The more I can do and learn or relearn now, the better off I'll be.

My routine outside of therapy has been Yoga class on Monday nights (60 minute Vinyasa), gym on 3 nights between Tuesday and Friday (kind of varies), gym on Sunday, and some home practice Yoga spread out in there.  The Yoga's nothing new for me, but the gym is definitely a new thing.  Never thought I'd say it, but I'm really starting to like it there.  Go figure 

Enough for now.  Happy knee health to y'all out there!

[captainruss]

Matt,

It is outstanding that you are healing and feeling better.  Keep up the good work!

Russ

[mbrugman]

Thanks, Russ!

Day 89 - still going along well.  Probably overdid it at the gym yesterday; was a bit sore last night.  A bit of time with some ice and a couple of ibuprofen and things were better.  Stiff this morning, but got better after moving around a little.  Still a lot better than I was before the surgery    

I have to keep beating it into my head that it was a pretty major surgery, and it was only about 13 weeks ago.  There's still a lot of work ahead, but it blows my mind how far I've come in this short time.

Another week to my next PT session.  It'll be good to see where I'm at. 

Wow, the weather's getting nice here; we it 75 degrees F. (which is about 35 above normal).  Makes a person want to get outside and do something fun!

Hoping for all the best for all the knee peeps out there.

[mbrugman]

13 weeks. 

Funny thing today; DH and I went to the local Red Cross to give blood, something we do several times a year.  As the interview part started, the Red Cross woman looks at the scar on my knee and says "Before we start, tell me about your knee."  (Disclaimer - it's really unseasonably warm in Green Bay, I had shorts on).   So I tell her I had some surgery 13 weeks ago; explained what Arthrosurface is and that I had two pieces in the knee.  She says, "You're not actually deferred now or anything, but I would wait a while before giving blood.  Thanks for coming in, goodbye."

I guess I hadn't thought much about it.  Anyone else have a similar situation?  Are there any rough guidelines about how long to wait after this kind of surgery before giving blood?  I'll have to ask my OS when I see him next, if I don't forget about it by then  .

Happy knees to all the peeps out there!

[captainruss]

Matt,

I know that they monitor your hemoglobin when having surgery.  I actually lost so much blood in several surgeries that they wanted to do blood transfusions.  I allowed the first two, but after that my OS commented on how his blood level was that low (7) and he did not have a transfusion.  So, I did not have one on the last three procedures.  It took about 4-6 weeks for my level to come back up to normal (12).

Maybe six weeks on the last one as I had real trouble with blood loss.  This is the same as all issues I have encountered, try to obtain multiple opinions and then make your own decision as it is your body.  I have monthly lab work to keep an eye on these levels and CED rate and C-Reactive Protein levels.

I am adding my normal disclaimer (too much crap happens to me) that I am the very exception to the rule as are a small number of people who have surgery.  The severity of my case and the very small (1/10 of 1%) of all TKR's that have serious complications such as mine must be taken in context with the thousands of successful TKR's performed every year by skilled and conscientious members of the medical profession. 

Russ

[mbrugman]

What a weekend in Green Bay - 80 degrees in March?  What the heck's up with that?

So, this weekend I started by not giving blood.  Then went to Fleet Farm (the most amazing home/garden/farm store in the Wisconsin area) and bought some deck stain.  The dude in the paint department said I was crazy if I thought I was going to stain a deck this time of year - temperature shouldn't drop below 50 degrees for the first 48 hours after application.  Crazy me went home, power-washed the deck and put the first coat on.  This morning I got up and DH and I put the second coat on.  We rolled the dice on the weather, and it looks like we won - a big job out of the way before the "real" spring hits around here.

Then we went to get some ice cream and finished the day off with a nice (well, slow) 2 mile walk.  DH loves to walk and she dragged me along.  The walk was nice, knee felt really good.  Home now with my good friend the cryo-cuff.  I don't have a lot of swelling right now, but one thing I've learned through this process is that it's better to get ahead of the swelling and/or pain that might be coming.


Cap'n - wow, I feel back for your issues from your surgeries .  As you say, you're the special case when taken in context of ortho surgery in general; but it sucks to be the one in 1000.  I will take your advice and get a few opinions before I go back to donate at the Red Cross.  Thanks again for the comments; sending good will and wishes your way, sounds like you've been through quite enough.

[captainruss]

Matt,

Yea,..found out I cannot get life insurance with my current pain meds.  I have to turn off my infusion pump and come off all pain meds for two weeks....I I can pass a colonocopy and blood work I can get term life insurance.  I am so afraid I am going to check out and the kids will not get thru college and I stick my wife with finishing raising the kids.  I don't know if I can do it, but I am going to try. 

Whatever your do, anyone having major surgery should set up term insurance prior.  I cannot pass the physical with the pain meds.  I am in pretty good shape other than the OS wounds and the pain meds.

Please make sure you get multiple opinions.  If you are not absolutely sure of being comfortable with your OS, ask someone on this site.  I am taking my daughter to All Children's Hospital tomorrow, but need to take her to one of the "Giants" in patellafemoral arena.....I need her fixed once and only once.....so need to make sure I really know what to ask.  I think I am getting there with all of the help from the really smart people here on KG.....and then make sure that my OS knows what is at stake.  My angel needs no mistakes...no not knowing what the complications might be...none of this "I think or I believe or trust me...I have operated on 5000 knees.

Russ

[mbrugman]

Wow - 15 weeks!

Had my last PT session.  I'm about 85% strength on the knee.  That's comparing single side leg press from left (unoperated) to right (operated) side.  He said there isn't much he's adding to the process that I'm not already doing between the time in the gym and Yoga class.  I had some apprehension at first, I felt like I'll miss the objective measurements and evaluation.  Therapist told me that I should find different equipment in the gym, keep track of the setup and weight and do my own evaluation with it over time.  Sounds good to me .  He also said I should keep working towards my other goals.

I still can't quite get out-of-the-saddle cycling.  Just can't get the circle going on the pedals, but still trying.  It'll happen.  I did get into full pigeon at Yoga last night.  Wasn't the prettiest, or 100% Yoga Journal model material, but I did have my shins stacked and was leaning forward.  Felt great to get that hip open

Still making progress, but I think I'm moving into the slow long road segment of the process.  My OS and therapist both emphasize that it'll be another 6 to 12 months, and that I should keep that in mind.  Gotta keep up with the exercise routines, and I can keep looking forward getting the most out of this.  That's my motivator

[mbrugman]

138 days - darn near 20 weeks ago! Can't believe April went by so fast. 

Saw my OS last week. 

First of all, why wait a week to report?  'Cause my first grandchild was born on the same day, and that was more important!!!

Ok, back to knee stuff....   I saw my OS last week.  It always impresses me when I see him; there's always extra peeps with him.  Usually a student, a therapist, a PA, or someone.  To me, it means he has the skills and ability (and desire) to teach others. 

Took a couple of X-rays, did an examination.  He says all looks good.  I asked about the occasional pain I have on the lateral part of knee.  He said that it's normal at this stage; it's not too bad, just comes after a long day.

Still keeping up with the gym and Yoga.  Strength is still increasing, just not as quickly as before.  Just as long as things are still moving in the right direction. 

Spent a week traveling for work; 7 days at a customer's site standing most of the day.  Nothing too major for that.  I packed a couple of large ziplock bags for ice packs, but really only needed it one night towards the end.

Not much else to report.  It's coming up on two years since the original injury, never thought it would be such a long road.  I'm really glad I went with the Arthrosurface, I think I'm doing much better (feeling better, more mobile, etc.) than I would without it.

Oh yeah - OS said he didn't need to see me until next December; basically a year from the surgery date.  He reminded me that I have his cell number and that I should call him directly if there's anything happening or if I have any questions before then.

[mbrugman]

6 Months post-op!  Time surely flies

Things are still going well.  With summer here, I have to admit I haven't been to the gym as often.  There's time I spend outside working and playing outstide, but it's really not the same as working out in the gym.   I still hit the Yoga studio regularly, though.  That's too good to give up

I still have some days where I'm sore and sometimes have some swelling when I do too much, like the day I shovel-and-wheelbarrow-ed a couple of yards of gravel from my driveway around the house to the backyard landscaping project.  I fully expect that; it's only been six months and my OS told me that I really shouldn't expect full recovery until 9 to 12 months post-op.  The thing that still amazes me is that I'm so much better off than I was a year ago, or even 6 and a half months ago. 

I'm still really pleased with my decision to do this, and I'd recommend it to others in a similar situation.  I think it's a process like any other; the surgery is really the beginning.  As the patient, you've got to be willing to put in the work and be, well, patient. 

Thinking back to the the time in physical therapy, the gym, Yoga class, and just walking and moving, I don't think I'd be where I am at this point.  I remember not being able to do an SLR at the beginning, and the time it took to get my leg muscles to where they are now.  My quads are pretty well defined like they were before this all started (I've been a bicyclist and Yoga practitioner for a while before the injury).  I'm also about 25 pounds lighter than I was after the surgery, which is a big help.

That's all for now, knee peeps.  Good luck to all, and happy father's day to all you daddy knee peeps!

Matt