Knee Replacement X 2 Post-Op - It's Not Over Yet

After losing over 200#, I finally bit the bullet and decided to have both of my knee's replaced at the same time!  I've had several surgeries in the past so I'm no stranger to pain but I all too soon found out the bones is a whole different animal and in a league all its own.  I've always been told that I'm a tough gal and have a high pain tolerance. On lookers; general public; and those that had knee replacement, all think I'm very courageous and tough and think I've done extremely well.  They say they could never do that!  But the intense pain with 2 knee's was unexpected to me.  Everything didn't go according to MY plan.  But I very thankful to God that I had no complications and had an excellent surgeon.  I don't regret doing both knee's at the same time and would still make that same decision again. 

I had the whole plan worked out--all my ducks in a row--because I'm very organized.  But after surgery my hemoglobin and BP dropped very low so my doctor wouldn't allow me to get out of bed to do my physical therapy.  Understandable but this started a chain a events. When it came time for me to be discharged to the acute care rehab facility that "I planned" to go to, they wouldn't accept me because I wasn't ambulatory yet or could walk X # of feet.  Another facility agreed to take me that wasn't acute care.  I will spare you the bad details but after 3 days there a very dear friend came to help me advocate with the Director of Nursing about my quality of care. I still put in for a transfer to acute care. The food was so gross I could hardly tolerate it; especially being a bariatric patient.  But the food wasn't suitable for a normal healthy person to eat either.  Why is fried bologna always available in nursing homes and rehab centers? 

At 10 day post-op when I went to get my 70+ staples removed, my range of motion (ROM) in my L Leg  75, R Leg 68.  Surgeon said they should be at least 90.  I was devastated.  I thought I was doing good.  My physical therapist never told me otherwise or that I needed to push harder.  I told him about the poor care I was receiving.  He said I needed to get home ASAP.   Long story short; by the time insurance approval came through for my transfer to acute care, I was asking to be discharged.  I was there 2 weeks.
 
Then I started outpatient therapy May 25 at acute care facility.  I had PT to do at home also and I was committed to doing them faithfully every day as instructed.  June 5, L Leg 96,  R Leg 88 ROM.  Tried to get  approved for aquatic therapy but my insurance denied it saying it was not medically necessary, which is bullshit.  It would have helped me tremendously but you can't fight the system.  Insurance only approved 10 PT sessions.  My last visit July 5, L Leg 115, R Leg 105 ROM. 

Therapists said I exceeded her expectations and that I've done very well. She even said that my ROM was in the range that it should be.  (These must be "her standards" because my surgeon did not agree). She said my doctor would be happy with my progress and would not want to do knee manipulation.  Yeah right!

July 11 I had follow up with my surgeon and X rays.  He said that he would strongly advise that I consider manual manipulation because the average patients at 9 weeks has 125 ROM.  He feels that anything less than that will inhibit my quality of life and what I am able to do.  He said it's my decision but he would prefer to do it in the next 2 months. 

In manual manipulation, he takes me back into surgery and manually bends my knee's all the way back.  It doesn't take long at all.  Then I go back into PT for about 10 sessions.  I would hopefully gain 5-10 degree's ROM. (hopefully more) He says I have lots of scar tissue in there that is inhibiting my ROM.

I'm having a roller coaster of emotions about this.  No, things didn't go as I planned!  I worked very hard in my PT and did everything that I was told to do.  I feel like the system let me down and so did my insurance company.  I feel like the rehab center and physical therapists were just jerking me around.  I gave them 100% and I expected 100% from them and I don't feel like I got that.  I'm frustrated, discouraged, angry, and I feel like I let myself down.  Dare I even use the F word...failure?

I told my surgeon that I signed up for an aquatic class that is 6 wks and 2 days a week.  He also released me to go back to the gym with no restrictions.  I also have PT exercises to do at home.  I'm hoping all these things will help increase my ROM.  But I'm seriously considering the manual manipulation. 

I'm walking almost normal now.  Still have a bit of difficulty getting in and out of cars, with steps and curbs, and shopping in large stores for a long time.  I get tired.  My iron level is still low and I'm anemic.  I rarely take any pain meds anymore.

I'm discouraged and feeling like I didn't do enough.  There are no do-overs with this.  I need to get it right because these are the knee's and legs that I'm going to live with and walk on the rest of my life.  From the very beginning I was behind in my PT because of circumstances out of my control.  I could never catch up.  We thought aquatic therapy would catch me up but insurance denied it. I can't quit.  I've come to far and worked too hard to settle for a mediocre result.

          

 

My 11 Year Success Story......

published in Barb Thompson's newsletter February 2012: 
I had my RNY gastric bypass surgery over 11 years ago. My BMI was 60, I was taking 16 medications, walking with a cane, and had numerous co-morbidities. My highest weight was 353 lbs. and through surgery, I lost 225 lbs. I dropped a total of 12 dress sizes. I’ve been blessed with no complications in 11 years and have maintained my BMI.

First, God gets the glory. He’s molded me into the strong, committed, self-assured woman that I am today. My weight loss surgery may have been complication-free, but my life has not been.  My past was full of abuse and dysfunction. I finally ended my marriage, but not without suffering post traumatic stress disorder and completely losing myself. I had to lose everything, including almost losing my life twice before I decided to turn all this adversity into something positive for me.

The first step was weight loss surgery. It gave me hope when I felt hopeless. It’s not the easy way out! My life had been anything but easy, but I was ready to channel what I learned from all that adversity and pain into something positive, encouraging, and hopeful for myself. We learn nothing if we risk nothing. Risking hurt, rejection, failure, and ridicule wasn’t new to me. It's how I choose to react to that adversity that is different!

I have maintained my weight by working hard to change negative self-talk into positive self-talk; exercising; attending support group meetings; attending counseling; following the 12-step program; volunteering to help other weight loss surgery patients; having my own support group; staying accountable to people; having strict boundaries; vowing to never stop learning, growing, and changing; and never quitting. I choose to see my blessings, not my obstacles. This journey is very hard, but so was my life before weight loss surgery. This one has far better rewards.

It wasn’t my fault that I was treated so badly the first half of my life. But how I chose to react to my adversity was my responsibility. I chose food, and made other bad choices that compromised my health. I’ve learned to make better choices. Many people think that I can now eat whatever I want, just in smaller quantities. I say to them, “I didn’t have weight loss surgery so I could eat whatever I want, whenever I want. I had weight loss surgery so I could DO whatever I want, whenever I want to do it!” I could “choose” ice cream which I ate every day before weight loss surgery. Instead I choose to wear gorgeous, sexy dresses when both of my son’s got married. One son got married in Aruba, so weight loss surgery not only allowed me to fly to this tropical paradise for the wedding on the beach, but also to have an awesome vacation in my swim suit and shorts.

From the very beginning, my primary focus has been on changing my behavior and attitude that caused my morbid obesity. The number on the scale was secondary. I acknowledged the invisible wounds on the inside, and found a new way to deal with them besides eating.

I am a food addict. My success is measured one day at a time, not so much by the things I’ve done right, but by the lessons learned from the mistakes I’ve made and worked hard to not repeat. I’m very committed to stay on track but I’m not perfect. I screw up, but I don’t give up!  There is nothing I can't do if I believe in myself and have faith!