Pretty good night last night. I’ve learned a few tricks on how to sleep on my back with my leg elevated. That plus, my body reaching a bit more of a equilibrium on fluid retention/swelling means I actually first slept for 5 straight hours! This is an important aspect of my recovery process as I’m sure my body is busy trying to adjust to the radical changes that I’ve inflicted on it and needs the sleep to do its thing. I also was able to get an additional couple of hours after that so really positive on that front.
My pain level has greatly diminished at this point. I went 8 hours between meds last night and without doubt the pain is still there (and increasing as morning rolled in) and I need to stay on the pain killers for a bit longer, although at a lower level. Even with the 8 hour gap I’d say the pain only got to about a 4 or so, which frankly has been a pretty common level of pain for me over quite a few years and is not that big of a deal.
I’m settling into my PT routine which is quite basic at this point, just entailing 2 exercises designed to get my range of motion to 90-180 degrees at this point. 90 is easy, 180 a bit more difficult…I probably top out at about 170 degrees so far…still too much swelling. These exercises combined with the walking takes about 20 minutes and since I repeat hourly, it’s a bit of a time sink. It’s surprisingly challenging but since I can’t work out I’m fine with it.
We're getting ready to head back home and I'm looking forward to getting into a routine there and really rebuilding my leg!
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A final quick note on what they actually do when they replace your knee--here are the general steps:
1. They cut open your knee from above your knee cap to below it down on the upper shin--about 8 inches or so.
2. They move your kneecap to the side taking care to not strain the tendons attached to the knee cap.
3. They remove your ACL so they can get at the back of the femur and tibia. The basic design of the artificial knee mitigates the need for the stabilization normally provided by the ACL. They leave the PCL in place.
4. They remove about an inch or so from the bottom of your femur. I'm not sure how they do it because frankly when it happened I wasn't paining attention!
5. They drill a couple of holes in the bottom of the femur and then cement the cobalt (basically steel) implant in place.
6. They cut a similar amount of bone off the top of your tibia and put a couple of holes in it and cement that implant in place.
7. They insert a plastic type part on top of the tibia implant and this basically serves as my meniscus. The femur implant glides back and forth across this plastic.
8. They cut part of the back of the knee cap off and cement a plastic insert there, which also glides against the femur implant.
9. They move the knee cap back into place and make sure it all moves well.
10. They then staple your skin together with about 20-25 staples and wheel you out to recovery.
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