Double Knee Replacement Helpful Hints

This post comes with the disclaimer that this is from my perspective only and what worked for me, may not work for you! On April 23rd I had double knee replacement surgery in Fargo, ND. The surgery was on Wednesday and I was discharged on Saturday. Arden and I decided that I should spend a week with Kirsten, Joey and Steph because therapy could come right to their house. They graciously moved a recliner to their living room, gave me Olivia's bedroom and waited on me hand and foot. So now nearly 8 weeks later, what have I learned from 1.Many people ask me why I had them both done at once. Both knees were equally bad and I wanted only one hospitalization and recovery time. My sister Kay had both knees replaced at once at about my same age and she had an excellent recovery. She is my inspiration! 2.How to decide where and when to have surgery? I originally scheduled my surgery for Minot but the surgeon was hesitant to do both knees at once so I changed to Fargo where Dr Matthys assured me he would do both at once unless there were problems with my blood pressure, heart or with the anesthesia. Two of our daughters live in Fargo and their house could accomodate me with few stairs if we decided I would stay there for some therapy. Our house at Van Hook has a lot of stairs. 3.Although it hurts, do all of the recommended therapy and more if possible! Hurting is short term and it's so important to think long term and to aim for the best function possible. I had good range of motion prior to surgery so my therapy progressed well with few glitches. I spent a week in Fargo following discharge from the hospital because the therapy group I contacted said they would come right to the house. Exercise start prior to surgery to get you used to doing them and to make sure you have as good a range of motion as possible. I did the exercises described in the information from the doctor for about a month prior to surgery and also made a pre-op visit to the therapy group. I chose them simply because their office was close to my daughters house. After I spent a week in Fargo with therapy coming to the house, I went to Stanley which was a half hour drive from our house. The therapists had very different approaches. The one in Fargo moved my knees for me...often pushing so hard that I cried. The therapist in Stanley asked me to show her what I could do and she was always amazed and didn't have to push me any further. I had some nausea from my pain medications so had to cancel a couple of sessions. In addition I continued to do exercises on my own and to work hard at being independent in walking with a walker, dressing and bathing myself. The therapist in Stanley simply asked me to bend as far as I could and it hurt but I made huge progress. My goals were to walk without a cane and to reach 120 degree bend in both knees and to also be able to have my knees flat against the mat. I reached these goals by week 4 so I was discharged from therapy. I continue to ride a stationary bike 15 minutes, twice a day and to work on balancing on one leg. I pedal the bike both forwards and backwards. I will add short walks to this regime. Whenever my knees start to feel "tight", I know I need to stretch them more. 4.Needed equipment included a toilet riser, bath stool, and a walker. They were essential for the first couple of weeks. I also needed a sock aide for putting on the compression stockings and ice for my knees. The hospital sent home ice buckets connected to pads and a pump...these worked well but someone had to fill and hook up the buckets for me. The first couple of weeks, therapy and a shower were all I accomplished and I was wiped out from those tasks. If you are a "doer", it seems odd (and somehow lazy) to only accomplish those two things and to sit the rest of the day. It's ok, it's what your body needs for healing. 5.Loneliness and boredom were huge problems. With other surgeries, all I had to do was to take the pain meds and sleep or rest. Even though I was weak, I started feeling better after 10-14 days. With joint replacement I had to work at my therapy as well as take pain meds and rest. It is best not to push yourself too much as that will cause more pain and swelling and healing needs to happen. The key is to find the right balance. Regardless, there are huge chunks of time for watching TV and playing on the computer and it gets old. My attention span was short so reading a book or even watching a movie was difficult. I had friends and relatives visit but I didn't always feel up to that either. The 30 minute trip to Stanley for therapy was difficult at times as my legs always felt best when they were elevated. The 5 hour trip home from Fargo was brutal. The truth is that I was the only one who could go thru this. Arden (and others) empathized and wanted to help but I had to do it and endure it. It was kind of like being in labor....no one else can do it for you and you just have to get thru it. Sometimes the best part of the day was bed time because I could say I made it thru another day and I knew I was another day closer to full recovery! 6.The biggest eye opener was how painful this was and how long I was in considerable pain. I wish I hadn't worried about being on pain killers. I tried to reduce them almost as soon as I got out of the hospital....BIG MISTAKE! Because I am a nurse, I have seen people who were addicted to pain meds or who were still wimping out years after surgery. I was NOT going to be that person. In hindsight I would have taken both the short and long term narcotics as often as possible for the first month. I was nauseated and had no appetite and lost 20 pounds in the first month but that was ok because I needed to lose weight too. Many narcotic pain meds also cause constipation and dry mouth and fogginess but they provide blessed relief and sleep and that's what you need. I have a high pain tolerance and found that I didn't always recognized that I was having pain. One day I found myself shivering with cold and it finally dawned on me that I was in pain. I didn't always recognize that restlessness was a big sign of pain too. 7.I did stop all narcotic pain medication at about 5 weeks and that was when I started to have trouble sleeping. This lasted about 3 weeks and led to many long nights. I tried ZZZquil with little relief. Melatonin helped me to get deeper sleep so I felt refreshed. Prior to surgery I would easily get 8-9 hours of sleep. After I stopped the narcotics, I was only getting 5-6 hours of sleep. I tried not to nap during the day because I wanted my sleep to come at night. Sometimes I had trouble falling asleep and sometimes I would fall asleep only to wake up an hour later and not be able to go back to sleep. I also seemed to have restless legs which I had had in the past for which I took iron. I had stopped taking the iron because of my nausea. The nausea went away when I didn't take the narcotics so I was able to start the iron again. I also started Magnesium supplements and took over the counter pain medications, used topical ointments such as Icy Hot and sometimes just got up and played computer games until I felt sleepy again. During this time I slept in another bed because I didn't want my restlessness to wake my husband. I tossed and turned until my bed looked like a tornado. There is lots of talk of this sleeplessness on the internet but few answers. I am now sleeping 7-8 hours a night but often wake up 6-8 times sometimes for up to an hour. At least I feel human and am able to think during the day which I couldn't do before. So if you have had knee replacement surgery or are thinking of it, just hang in there, it will get better. My surgeon said that most people don't thank him until they reach the 3 month mark so we will see if this is true. God Bless you in your journey!!

I Need to Walk

In long term care we must have "care plans" for all of our residents. These are the goals that are set by staff, the resident and family or significant others. They are usually related to health or care concerns but sometimes they list preferences for the resident. A recent trend is to have "I" care plans that state the goals/wishes in the first person such as "I want to keep my blood sugar within normal range." or "I want to lose weight." In cases where someone is restless, the "I" care plan may say "I want/need to walk". This is a reminder to staff that they should ensure that a resident has a place to walk that is free of obstructions and that if they need assistance in walking, that someone is there to help. If the resident cannot tell us what is important to them, we often talk to family and friends to find out what the resident enjoyed doing in the past. The point of the first paragraph is to introduce my love of walking. I just read an exercise blog today that said "do what you love" and your exercise routine will be more successful. I love to walk. I need to walk. More importantly I need to do it outside where I can see, smell and feel the outdoors!! I have been a sporadic walker for over 35 years. I started walking for stress control, not for weight management as many people do. It was also my alone, thinking time when my life was much busier than it is now. In the last 10-15 years, I have gotten in the habit of listening to books while I walk. This combines my love of reading with my love of walking. Listening to books or music can impede my hearing of nature sounds but I will occasionally turn off the book to hear geese honking or most recently to hear an elk bugle. My love of walking has returned with a vengeance after I recovered from my double knee replacement surgery in April. I have been wearing a fitness band for 10 months and am currently walking 12000 steps or about 4.5 miles a day. I love it!! I am ready to increase my walking to 14000 steps a day except for one problem....North Dakota weather. Several days this week I have had to wear my down filled coat and a scarf across my face because of the wind. When there is ice or snow, I may not be able to walk outside because of the unsure footing. Winter is coming, no doubt about it. So I am longing to be in a warmer climate or in a less rural place where I could at least walk at a mall or fitness center. The other morning I woke up to the wind howling and thought some very negative thoughts: •I won't be able to walk outside today •It's going to be so cold •I hate North Dakota wind and cold weather •I could walk on the elliptical but I would rather not •and most ridiculous of all....This has got to be Arden's fault! I had read that when you walk, you should walk with a smile because it lifts your spirits. Most days I grin for the whole hour that I walk. I love that I am stronger. I love that my knees don't hurt. I love the sights and smells of rural North Dakota....in all seasons. So I decided to go for my walk despite my negative thoughts and the wind and I discovered that my negative thoughts were SO wrong. How often does that happen---that my negative fears and worries are SO wrong. It wasn't nearly as cold as it sounded and it was a great walk!! What do you love to do? Are your negative thoughts leading you into a downward spiral and how often are they proven wrong?

What Matters to You

Our grandchildren, Olivia who is 6 and Casey, who is 4 were visiting recently. Several adults had the discussion on whether it is appropriate to correct children who may not be your own. I am outspoken and have often done this impulsively. In hindsight, I should wait until a parent or grandparent can intervene if they are present. If they don't say anything, I will speak up, especially if the child is at my house or in my yard. I guess that when I (or anyone) does this, they assume that they have the same values and standards as the parent(s). I am amazed that some parents do not think that their child should be respectful to adults. They do not correct their child when that child calls others "stupid" or they do not correct the child when they mock the beverages that are in the fridge or the toys in the toy box. Do children behave this way because they see it modeled by someone important in their life. Does someone in their life feel superior because of education and yearly income? So I come to the question: What matters in life to you? My brother Bruce told the story of he and our cousin standing on the overpass in Epping, spitting on the bums who were riding the rails. When he told our Dad about the incident, Dad simply said "those bums are people too and deserve your respect". What a wonderful value Dad taught us!!! Thanks Dad (and Mom) for your values and standards you passed on to us. May we also convey them in kind ways to the next generations. Here are some traits, values or standards that I think matter: •Honesty •Respect for elders and peers and those younger than you •Hard work (no matter what it is)--show up when you are expected •Caring for and about the universe--not littering, recycling, caring for other creatures •Making a difference either by the way we treat others or how we do our jobs •Volunteering--not just doing our jobs but helping out in tasks where you don't get paid •Standing up for what is right, respectfully speaking up when needed. •Listening and trying to understand others •Being kind •Using humor in the right way, not in ways that are hurtful •Not feeling superior--being humble Here are some things that I think do NOT matter: •Education can help you realize your dreams and maybe get you a better job but it does not make you more valuable •Status in the community does NOT make you more valuable. A homeless person has as much value as a CEO of a company. •The house you live in--we have lived in a beautiful, big, impressive house because we wanted to be able to have foster kids not because the house looked impressive. •Age, weight, looks, sexual orientation, race --it's been hard to overcome prejudices when we have lived in such a WASP-y area but these things really do NOT make one person more valuable than another. Neither one of the above lists is all inclusive as there certainly may be other things that are important and there may be many more things that do NOT matter.

Who is your Junk Collector?

Earlier this week a friend posted a link to an article about the importance and health of talking to yourself.  I commented that my mother talked to herself all of the time and I felt that she was talking to God about the problems and joys of being a busy farmwife and mother. I often find myself doing the same thing!! 


Last evening I attended the wedding of a great niece.  It was a Catholic wedding and the priest made several important points in his homily.  He said that he believed there are three things that make for a better marriage:

1. Praying together daily. 
2. Making church attendance together weekly a priority
1. Church is where you are often "stabbed" by God's word
2. Church is where you gather with others who are on this journey
3. Going to confession regularly.  He said that he has several names for Jesus including the Good Shepherd but he said that his favorite name for Jesus is "the Junk Collector".  He stated that the devil's goal is to separate us from Jesus through our sin and when we dump our junk....our sins on Jesus in confession, we are better able to enjoy this abundant life. It is the Catholic tradition to go to confession, while I believe that we can go directly to Jesus with our junk rather than go through a priest. However there is something very comforting in having someone say that your sins are forgiven.

So what does this have to do with healthy eating?  I believe that if we have not acknowledged our sin and gotten rid of it, it can lead to overeating or unhealthy eating.  It can also lead to anger and resentment and fighting and harsh words and sleeplessness and a host of other things that are not healthy.


These are the words we most often hear in the Lutheran (ELCA) tradition:


If we say we have no sin, we deceive ourselves, and the truth is not in us.  But if we confess our sins, God who is faithful and just will forgive our sins and cleanse us from unrighteousness. 


"We confess that we are in bondage to sin and cannot free ourselves.  We have sinned against you in thought, word and deed, by what we have done and by what we have left undone.  We have not loved you with our whole heart; we have not loved our  neighbors as ourselves.  For the sake of your Son, Jesus Christ, have mercy on us.  Forgive us, renew us, and lead us, so that we may delight in your will and walk in your ways, to the glory of your holy name.  Amen


Then the Pastor pronounces the forgiveness of our sins in the name of Jesus.  I believe we can be assured of that forgiveness if we are sincere in our confession, even without someone pronouncing it. 


So do you dump your junk on Jesus? Do you tell someone else about your troubles, joys and concerns or does it come out in other ways in your life?  I am grateful for the reminders this week to talk to Jesus.  I am grateful for a mother (and father) who were comfortable bringing their troubles to Jesus. I am grateful for this opportunity to learn from others whether it is from a link shared or a sermon given at a wedding.   I am grateful for forgiveness without condemnation.


 My wish for you is that you can "dump your junk" and receive and believe in your forgiveness.   

I'm in a hurry

This song by Alabama came out 25 years ago when I was busy with kids and work and I find that at times this hurry sickness invades my retirement life as well and I have to ask myself why? 

I'm in a hurry to get things done

Oh I rush and rush until life's no fun

All I really gotta do is live and die

But I'm in a hurry and don't know why.

Don't know why

I have to drive so fast

My car has nothing to prove

It's not new

But it'll do 0 to 60 in 5.2.

Oh I'm in a hurry to get things done

Oh I rush and rush until life's no fun

All I really gotta do is live and die

But I'm in a hurry and don't know why.

Can't be late

I leave plenty of time

Shaking hands with the clock

I can't stop

I'm on a roll and I'm ready to rock.

Oh I'm in a hurry to get things done

Oh I rush and rush until life's no fun

All I really gotta do is live and die

But I'm in a hurry and don't know why.

I hear a voice

That say's I'm running behind

I better pick up my pace

It's a race

And there ain't no room

For someone in second place.

I'm in a hurry to get things done

Oh I rush and rush until life's no fun

All I really gotta do is live and die

But I'm in a hurry and don't know why.

I'm in a hurry to get things done

Oh I rush and rush until life's no fun

All I really gotta do is live and die

But I'm in a hurry and don't know why.

I'm in a hurry to get things done

Oh I rush and rush until life's no fun

All I really gotta do is live and die

But I'm in a hurry and don't know why.

I'm in a hurry to get things done

Oh I rush and rush until life's no fun

All I really gotta do is live and die

But I'm in a hurry and don't know why...

The music of the song has a fast tempo which adds to the anxiety of "rushing, rushing".  I have a driven, type A, task oriented personality so that is why I still find myself rushing and competing even in retirement! Now contrast that with the story of The Tortoise and the Hare. "The Tortoise and the Hare" is one of Aesop's Fables.   It is a variant of a common folktale theme in which ingenuity and trickery (rather than doggedness) are employed to overcome a stronger opponent. (wikipedia)

 We most often want a quick fix in weight loss. We are deluged with ads on TV promising quick weight loss. We may have tried them or know someone who has but the sad fact is that the weight loss often doesn't last. I am here to say s-l-o-w weight loss is agonizing but satisfying. It is  3 steps forward and 2 steps back agonizing. But I like the term "doggedness" in describing the tortoise and
 although the loss of 18# in 18 weeks seems. so. slow, the results in how I look and feel are great so I will doggedly carry on. 

Silly, Funny or Foolish

We all have different senses of humor. In the 1960's the phrase "sick" was coined in regards to humor. Sick humor is humorous but may be in bad taste. Think of the humor of Foster Brooks or Ben Colder from the 1960's where they made fun of inebriated people. In light of the fact that we now know that alcoholism is a serious disease, many of those skits now just seem sad. 

I love to laugh. I love the videos of babies laughing. Have you seen the one of the baby laughing at ripping paper? Have you ever gotten the giggles at the wrong time? Have you ever laughed so hard that the tears ran down your legs? Laughter is good for the soul. There is so much sadness in the world so it's important to take time out to laugh and be silly and foolish. Certain personalities find it easier to be foolish than others.  I have a memory of watching the movie Sister Act with friends in a hotel room while we were at a conference. One of my friends jumped up on the bed to dance during the songs. What fun! I am grateful that my family loves to laugh. I am grateful to spend time with children who love to laugh. Being silly almost always puts me in a better mood. 

When I tried a new water fitness class last week, we were asked to form a couple of circles and we did the "hokey-pokey" in the water! We were uncomfortable with new people and some had disabilities so putting our right leg in and out of the circle helped to break the ice. Then we did an exercise holding on to our neighbor's water noodle. It was fun! Seeing myself in a swimsuit or in the mirrors in the workout room could make me cry in hopelessness unless I can see the humor and joy in my life.  I hope you find opportunities to be silly and to laugh this week. 

What's the plan?

I like to make plans. Within my family, I have been asked to plan birthdays and reunions and other celebrations as well as activities while we were in Arizona. It was not a chore for me as I love planning. When we were building our house in Van Hook or buying our house in Fargo, I fell asleep easily because I was planning furniture placement and decor. So I find it interesting that I have been resistive to planning my meals while on this journey to better health!

Weight Watcher members are asked to consider "why" they want to lose weight. It might be so they can be more active or to improve their blood pressure or blood sugars or to reduce pain in their joints or to look better. Last week we were asked to consider "how" we will get to our "why".  Many members stated they plan ahead either for the week or for the day. Lately, I have been resistive to planning and to logging my food and therefore had a weight gain this week. I found myself wondering why I resist planning my meals when I generally love to plan. Do I resist planning because in the past life with work and kids was so regimented and now I love the spontaneity of retirement?  Do I resist planning because I love my independence so much that I don't want anyone (including myself)) telling me what to do? Do I resist because I'm not sure what I will be hungry for later today or later this week?  I started this journey with a plan to succeed. The reality is that my chances of succeeding are greater if I plan and certainly if I track what I eat.