Week 7 Progress

First off I have to say Happy Holidays.  We are so very fortunate to be were we are in life.  We both have jobs, are healthy and have plenty of food on the table.  But most importantly we have each other and a clan of family and friends.  Add to that 2 dogs and a cat and life is just about as complete as it can be.  Crystal and I hope everyone will have a wonder 2012.

Next I have to say I'm sorry for not writing anything in the blog.  I had to take a bit of break for another issue that came up.  I have very fair skin and because of that I get skin surface issues.  The dermatologist found some skin cancer that he had to cut off my temple and cheek.  I won't be seeing any modeling contracts in the near future but I think I was about done with that any way.  Tom Cruise doesn't have to worry any more.

So the progress and recovery is coming along but has slowed some.  I'm too the point where I'm mainly focusing on building back up the muscles, creating better balance and reducing the swelling.  I've found that I can be working on these aspects of the recovery just about any where during my day.  Today, as an example, while at the dog park I use the benches to do step ups, work on balance and do lunges while exercising the dogs.  During the business day I meet with customers and while seated I'll bend the knee back under the chair to continue working on the flexibility.  While driving back to San Diego from LA I can do isometric exercises by tightening the quad and hamstring muscles. 

My biggest issue right now is swelling.  The knee has less and less pain but the swelling from exercise and standing for 30 minutes or more is still there.  Ice is still my best friend and something I'll be using for a while.  Pain meds are still there but I'm off Percocet and now using Vicodin.  Also, I go 6 to 8 hours between use.  Getting away from drugs as soon as possible is very important to me.  This body is a temple though I'm still not sure which religion it represents.

It's at this point that my mind starts to again say when will this end.  It's good thing I've done this before.  You want to believe at 7 weeks it's all good.  I have to keep in mind that I had pieces of plastic drilled and pounded into my bones.  That process puts a lot of stress on the muscles, nerves, and bones.  They are going to sell and complain for a while.  The more I move, the sooner these different parts of my body start to understand, adapt and over come.

Tomorrow I go out on the road and ride my bike on a flat course.  Most likely it will be 5 to 10 miles down Miramar Rd if traffic is light.  If not, then I'll take Kearney Villa Rd.  Either way, I'm just testing the waters to see how my balance is and what type of strength I have in the quads and hamstrings.  I'm looking forward to feeling that wind in my...helmet.

5th Week & Orthopedic Follow-Up

This past week was particularly exciting for me because I had my first follow up appointment with the doctor who did my knee replacement, Dr Steven Copp pictured here on the left.  He did my first replacement last year and one of the main reasons I selected him was because he took the time to listen.

I had seen several other Orthopedics over the years and all agreed that knee replacement was going to happen in the near future.  But most ran me through their offices like I was a piece of paper.  Dr Copp, on the other hand, took a great deal of time to discuss my situation and what I wanted for the outcome which was to continue to be active.

The follow-up appointment went well and he was very impressed with my progress.  Some X-Rays were taken and everything is aligning well.  He did point out that my hips have some issues...great, one more thing to deal with in the future.

He didn't want me riding on the road for a few more weeks until I have greater strength in the leg and I have 100% balance.  Dr Copp was happy with my knee flexibility at this time.  130 to 135 is far enough.

This actually brings up a point.  This blog has gotten out to a lot of people and I weekly receive emails and responses to my posting.  The subject of how far a joint can or should be bent back to the hamstring has gotten the most response.  I spoke to Dr Copp about this and he was fine with my progress in this regards and mentioned that it's going to be different for each person.  Several factors come into play but one the biggest is range of motion prior to the operation.  I've always had outstanding flexibility and stretch often to keep my muscle limber.  I do this for cycling, surfing and other activities but often just because I feel my muscle need to stretch.

The next phase of this program is going to be building strength around these muscle and putting back into balance all the different parts of my body.  Many of the exercises I currently doing have already started me down that path.  A key element of strength as we all know is our core.  The challenge many of us have is that we don't focus enough on the core but should.

Here is a listing of a few of the exercises I've been working on:

• Quadriceps -Wall Slide
• Knee Flexion Stretching/Flexibility
• Knee Extension
• Hip Abduction
• Planks
• Standing on one leg through ball (balance)
• Monster (band around ankle and slide sideways)
• Single Leg Squats
• Hamstring Curls using the Exercise Ball
• Stationary Cycling
• Side step overs (stepping up and over a box sideways)

I'm now up to 20 minutes on the bike and 150 watts of resistance.  Well, that's what the bike at the Physical Therapy places shows.  I've also been using a recumbent bike at home the PTS Turbo 1000.  I picked it up on Craig's list for $25 because I knew I wouldn't be able to ride my road bike for a while.  I had to start riding this with the seat pushed back further than normal so that I could get the full pedal stroke.  Over time I've been bringing it back down.  This recumbent makes that an easy task.  I'll start riding my road bike which is in the CycleOps trainer, PowerBeam, this week.  It has watts and other features I'm missing on the recumbent.  My goal is to go to 30 minutes and 175 watts.  I'll start ILT, Individual Leg Training, in a few weeks when I have more strength.  I like to use EpicRide and SufferFest videos...see ads in this blog on the right.

One other subject I wanted to touch on this week has to do with the others who are supporting me during this process.  The main person in my life is Crystal my wife.  She has seen all the ups and down times and been a wonderful mate to have on this journey.  When I have greater amounts of pain she can see that and knows I'm frustrated.  But on the good days I've tried to do my part around the house and not let everything fall to her.  This is extremely important in our marriage I believe and one of the reasons we've been married 25 years.  I appreciate everything she does and we both take the few seconds to say, "thank you", each time we do those little things like take out the trash, do the dishes, wash the clothes, etc.  But I've tried to work harder and saying thank you for her support.  There are still times when I need to rest and can't go to the store or take the dogs to the park.  Thanks Crystal for understanding.

My boss at work has also been supportive.  I can't fly for another 3 or 4 weeks and see customers. I cover 13 states here in the west and you can image that's a great deal of the time on the road.  I can start driving longer distances and this week I have my first appointment up in LA which will be a minimum of 2 hours one way.

I'm looking forward to this next phase of the process.  I've seen huge progress so far and it will be slower but I like the fact that I can now start sweating and coming away with the feeling I had a good hard workout.

TKR Week 4...hows it going?

I'm sure we all have good, better and best days in our daily lives.  Recovery from an operation like Total Knee Replacement will be no different in that regards.  Some days are good, some great and others suck.  Over the last 3 weeks my progress has been stellar and the days have been good.  This past week it was a challenge with pain management and resting so it was sucky but that’s part of the process.

I have to keep in mind that my body is trying to repair itself and just like when you have a cold you need to rest as resources are being used to fight that battle.  I've jumped back into my daily work and activities pretty quickly without putting aside a more time for rest and recovery.  This is talked about a lot in the pre TKR info and should be paid attention to much more as I am learning.

After my first PT session on Monday last week I was very sore especially when the therapist took my bend to 130 degrees.  I always come away from those sessions with a lot of swelling even though we take 15 minutes after and ice it down and use electronics to massage the muscles. 

I took Thursday, non PT day, totally off and even backed down from my office work by spending 90 percent of the day in bed icing the knee and sleeping.  I was just tired and needed to catch up.  That helped.  Friday PT session went very well and we saw 137 degree in the bend.  Keep in mind that this is when my therapist bends and holds the joint.  Bending it on my own I can take it to 125 with little agitation.

My therapist, Todd, added a new exercise to my regiment that was fun.  While balancing on my TKR leg I threw a 5 pound ball at a standing trampoline.  The point is to stay balanced while throwing and catching the ball.  I had little problem with this because I've been brushing my teeth standing on that leg to improve balance.

My favorite strength drill is called monsters.  A band is put around my ankle and I spread my legs out to shoulder width.  I then squat down and take little side steps while still facing forward.  I move the length of the exercise room and back 3 times.  It burns the butt and thigh muscles.

After exercises we stretch and then ice.  At home for stretching I use my body weight  as a way to create force hanging off the bed and the stairs.  I also have a strap to pull the leg/ankle with.  I acquired a balance circle and made a balance board. The circle has half a semi-hard ball attached to it in the center on the underside.  I use this to stretch the ankles and calf's and work on balance.  The balance board is  3 foot long board that I put on a foam roller.  Surfers and skateboards use these to work on balance the strength.

Saturday I went out shopping with my wife to help with some of the things she's been doing while I've been resting.  I over did it some and came home with a pained expression on my face and a swollen knee.  I had get that knee up for the rest of the day, ice it and take the meds.  Sunday I got out and around some but a lot less than the day before. Again, need to remember to let it rest and repair.

I'm proud to announce that I have been asked to help coach the Leukemia & Lymphoma Society Team in Training program that will start in January.  We will take a team of participants to Tahoe for Americas Most Beautiful Bike Ride (AMBBR) for a 100 mile ride around the like and a side route out to Truckee to complete the Century course in the early part of June.   It's a beautiful ride and I feel privileged to be asked to assist.  As a Cancer Survivor I know the importance of these types of program.  Plus, this helps me work on my recovery goals.