New regime

The visit to the physio yesterday certainly gave me a jolt and I'm trying hard to do the exercises she recommended - all 10 of them. It's tough - the swelling round my knee is still restricting movement and when I try to stretch the knee bend in particular, the whole joint heats up dramatically and, as a side issue, it makes me feel sick and queasy.

We're trying to get ice on the joint as often as possible to aid the process. This morning, Jo and I did my exercises in bed together after breakfast and drugs. Jo must be knackered running around after me - she's tending to my every need, but I do need to try and do some things myself or I won't progress.

Gary and Luca came around yesterday afternoon - Gary's off all week and Luca was on an In-Service Day. I think Gary had plans to take me down to Tease for a coffee, but he caught me in one of my down moments and I just wasn't up to accepting his offer. We had scrambled eggs on toast instead. When they were gone after dinner, I had my first bath, which felt pretty pleasant - and I discovered that the bath is not too bad a place to be doing exercises.

Jo changed my dressing after the bath. This was how the leg looked last night - a lot better than the previous photo taken in the hospital over a week ago:

You can still see the blood blister from the first theatre dressing.

So that's it for today. No walking again - perhaps tomorrow. The Banchory physio reckoned it wasn't important anyway at this stage - she felt if I could walk 100 yards that was more than enough.

Jo's at swimming for a couple of hours - she needs the break.

NHS or private?

Last night wasn't too bad. I managed to stay in bed until 6:30 am, albeit still waking every hour to check the clock. The fresh supply of Tramadol must have helped.

Colin came round to see me this morning, after which I headed off for my first physio appointment with the local NHS Practice in Banchory. I could tell immediately that she wasn't too impressed - particularly with the lack of knee bend I have. She measured it at roughly 50° and said that normally they wouldn't release folk from hospital until they had at least 70°. I seem to recall that the physio at Albyn had said I was virtually at 70° - although it didn't seem that much to me at the time.

The Banchory physio understood that the swelling was restricting my movement and said that I should ditch the cool water knee collar that the surgeon preferred and instead revert to the good old-fashioned frozen peas treatment.

I have to do my exercises every day half an hour after taking my meds - that way I should be able to force more bend in my knee, which seemed to be causing her some concern. She thought that, 11 days after the op, I should have a lot more flex by now. She suggested sitting on the side of the bed (or a suitable chair) and pushing the right leg back using the left ankle and heel to force it. (This was what Scott had said too). She warned it would be very painful but I needed to get on with it - now.

An alternative way of doing it would be lying in bed and using the wall instead:

She also said that, as an alternative to using the sliding board that the hospital had shown me to slide my knee up and down, the same effect could be achieved in bed by using a cheap supermarket plastic bag on my heel.

She wasn't too impressed either with the shaped handles on the walking sticks I had got at Albyn and asked me to try out more conventional curved handles - and she was right.

On reflection, I'm glad I arranged this NHS appointment. If I hadn't, it would have been another week before I went back to see the Albyn physio.

I have arranged 2 more appointments with the NHS physio next Tuesday and Friday.

Monday knee report

I think I'm losing the plot - it appears I didn't post a blog yesterday - and when I wrote this one, it disappeared completely, so I've had to start all over again!

Yesterday was going well until about lunchtime when I took the last of the Tramadol. After that, it was a bit of a struggle - I was never settled and despite it being Super Sunday with a triple header of decent matches on TV, I felt things were going backwards again.

Eventually went upstairs at 9 pm. We watched Homeland and then I fell asleep for an hour or so, but, by midnight, I knew I needed extra painkillers - and all we had was Paracetamol. It was a long night after that, but eventually morning came and we had to get up and get dressed as today was the day the theatre dressing was coming off.

The nurse removed the dressing and cleaned up what she could, but she said a lot of the sticky stuff wouldn't come off properly until I'd had a bath - and she suggested leaving that until tomorrow. So, for now, I've got a slightly smaller, more temporary dressing on - and she supplied us with additional supplies as well.

More importantly, she prescribed more Tramadol and so I popped a couple when we got home and then sat in the front room with the sun streaming in behind me and the fire on in front of me:

As a result of my appointment with the Nurse, we missed our daily FaceTime call with Kelly. Hopefully tomorrow.

This afternoon, we've started watching the box set of the first series of Breaking Bad - I know it's 5 years old and the rest of the world has already seen it, but we thought it was time we did some catch up here. I'm also trying to write another episode of Renshaw's Chronicles whilst I'm holed up at home.

Weekend knee report

The sudden realisation when I got up to take my first drugs of the day was that they are running out! I only took one Tramadol this morning and there are just 5 of these left now, so if I have just one every 5 daytime hours, they will be finished by lunchtime tomorrow. It was always the plan that I come off the heavy meds this weekend, but it's only 24 hours since I was in severe pain again.

I've still got Ibuprofen and Paracetamol that I can take in the event of pain, and I still have to take the Rivaroxaban (blood thinners) for another 5 days

Today has started pretty well, however - at least I was able to talk to Kelly in our regular morning FaceTime today. I was pretty sensible yesterday and didn't try any exercises or walking, but I plan to try to walk up to the village again today.

Dan Corbett came in to see me yesterday afternoon when Jo was at her swimming, so that helped distract me and while away some more time. The golf from Turkey was also pretty good and I also watched an old movie I had never seen - The Shining. Jack Nicholson at his most scary.

I had also watched another old movie featuring Jack Nicholson the day before - Tommy. I hadn't seen this since viewing the original cinema release at the Leicester Square Odeon almost 40 years ago - with Jo and Barry. Gary had just been born and Barry drove Mum down to see us and Mum babysat, whilst the three of us drove in to Central London - open-topped. There are a lot of scenes in the movie I just didn't remember. It's a bit dated as well, but there are one or two good musical sequences.

Anyway, it looks like the swelling on my leg is definitely going down - I can feel and almost see it now. We've been keeping daily measurements on a spreadsheet and whilst it's not always easy to measure exactly the same spot every day, there's no doubt this is moving in the right direction:

The readings on the left were taken on my "normal" knee on Tuesday morning and that's effectively the target for the right knee. We started with 2" to lose off the calf and thigh and 3" to lose off the knee itself, and we're now down to just 1" to lose off the calf and thigh but still 2" to lose off the knee.

That's it for today - day 20 of my real ale fast. The heavy meds are coming to an end so I could be breaking my fast early next week - just too late for the Stonehaven Real Ale Festival, which finishes today.

Knee progress

Well, yesterday was a really good day. We really thought the new meds regime had finally cracked the pain problem. I had a long (for me) walk and I was able to do all the exercises with ease. It could only get better from there surely?

I should have remembered the words of the surgeon - "you'll have good days and bad days". Today definitely started like one of the latter. I seemed to have a reasonably comfortable sleep - no pain issues, although I was sweating so profusely that my pyjamas and the duvet were absolutely wringing, and we had to change them early this morning. We even slept in a bit - although I realise now this may have caused the problem. It meant that the gap between meds was nearly 10 hours, compared with just 5 during daytime.

Anyway, the morning started very badly and I could barely talk to Kelly on our regular morning FaceTime call. It felt like I had gone back a couple of steps. I have since taken extra meds and it seems to be settling down a bit again - thank goodness.

Johanne and Colin came round this morning and whilst I was still in pain while they were here, their visit at least provided a very welcome and much needed distraction.

Our visitors have gone now - as has Jo, who has her swim and Costco shop this afternoon. I've settled down to watch some TV - particularly the golf from Turkey.

Nigel Meany sent his regards and pointed me to a web article about some new knee ligament discovery - http://www.bbc.co.uk/news/health-24826323. I'm not quite sure I understand this, nor the implications of it, but they are reporting it as a significant discovery. Perhaps somebody will explain it to me one day.

Jo took today's knee measurements early this morning when I had the most intense pain - and I wasn't wearing my compression stockings, which is not really consistent with previous days. The results are pretty confusing and I think we may have to re-measure when Jo comes back this afternoon. On the face of it, both my knee and my calf have come down a chunk - but my thigh has increased! Mmmmm

Knee & pee

This is a Thursday afternoon knee blog update. Yesterday's morning post was quite depressing and the rest of the day didn't get much better - at least not until I phoned the hospital later afternoon.

Jo had gone swimming and I decided I had to try another short walk. This time, I headed west and walked through the Tor-na-Coille Hotel car park, and out the far exit, then back along the main road to the Lodge House and back home again. It took me about 40 minutes in all.

I watched some TV and waited for Jo to come home. By that time, the pain levels were pretty high again. Jo urged me to phone the hospital and ask if I could increase the dosage, as it was pretty obvious by now that the pain and the swelling were hampering my attempts to do the required exercises.

I wasn't at all sure about this - from the various patient records and discharge papers I had, it looked like I was already on maximum daily dosage of the Opiate - Tramadol. I was taking one 50 mg pill every 5 hours - a total of 4 per day, amounting to 200 mg, which my patient record said was the maximum daily dosage.

In the end, I relented and I spoke to the room nurse, who advised me that, in fact, the maximum daily dose is 600 mg! Now obviously I didn't want to go to this level, particularly as I only have a few days left taking Tramadol - I should be winding down a bit now. However, I was fairly regularly taking two 50 mg pills at a time in the hospital and the nurse OK'd it for me to carry on with the occasional additional "breakthrough" pill, should the pain level be severe.

Result! I was advised that these breakthrough pills would be best taken first thing in the morning and last thing at night. If I did that, and left the lunch and teatime dosages as is, I would still only be taking a total of 300 mgs a day.

I then chanced my arm a bit further and asked about using Ibuprofen to help reduce the swelling. I hadn't been using these at all - only Paracetamol - because the statins I take for my cholesterol/heart don't mix well with Ibuprofen. The nurse again re-assured me and said that as long as I used these only occasionally, there should be no problem.

On hearing this advice, we immediately changed my daily schedule to accommodate these extra/replacement pills, and last evening, watching the football on TV was the least restless I had been and the least pain I had been in since I had left the hospital.

Today, we were getting new carpets fitted upstairs and the men started banging and bashing away from about 9 am. This encouraged me to consider a longer walk this morning - along to Tease for mid-morning coffee. I made it OK, but was pretty tired by the time I got there and I couldn't get really comfortable on the seats there, so we didn't stay all that long, and Jo eventually walked ahead and picked up the car and brought it along to take me home.

Nonetheless, a pretty successful 24 hours, which has helped pick up my spirits a bit. I can now begin to think about the light at the end of this long, dark tunnel.

My toilet habits are far from back to normal, however. I'm definitely not passing enough water, although I appear to be consuming enough. Perhaps one day, I'll just explode!

Today's leg measurements were roughly the same as yesterday, but the legs don't feel quite as "full" and tight as before. The knee bend is similar, but more bruising is coming out now:

Here's the knee from behind:

So that's the end of today's knee blog. I'm under pressure, particularly from some of our "remote" family to keep this going - I'll try my best.

Day 2 of parole

Today (Wednesday) will be my 2nd full day at home - and it's exactly 5 days since my Op. It's not getting noticeably easier yet. The name of the game is distraction - focussing on doing things that take your mind off the pain. I don't look forward to getting up in the morning, nor going to bed in the evening, knowing how uncomfortable they are going to be.

The pain only diminishes shortly after taking the drugs. Take today - I finally got up just before 7 am - quite late for me, although I had been up a couple of times during the night. I took my meds shortly after 7 am and I'm sitting here blogging (another helpful distraction) at 8:30 am and the pain is now probably at its lowest point for the day. I feel I could do with more pain-killers but I'm already on the maximum daily dose. What with all the medications I normally take, plus the additional ones for the knee, it's a real cocktail of drugs I'm pouring in to my body. This is my daily schedule:

Tramadol (50 mg)		4
Paracetamol (500 mg)		8
Aspirin (75 mg)		1
Bisoprolol (10 mg)		1
Simvastatin (40 mg)		1
Rivaroxaban (10 mg)		1
Omeprazole (20 mg)		1

Yes - that's right - 17 pills every day.

The swelling in my leg has gone down a little - about a quarter of an inch all round (a bit more in the thigh) so we are making progress, but it's really hard to be patient when you're in pain.

Today's maximum knee bend is not very good - possibly a little less than yesterday:

Knee diary

I'm starting a knee diary which will record the measurements and pictures and hopefully I'll be able to better monitor my progress this way over the next 6 weeks - but don't worry, it won't become my 10th permanent blog!

Today's measurements were:

	05-Nov	05-Nov
	R	L
Knee	18.50	15.50
Calf	16.00	14.00
Thigh	21.75	19.75

So I've basically got 3" of swelling on the knee to lose - and 2" on the calf and thigh.

As regards the knee bend, this is as far as I can get today:

My physio reckoned this was about 70° of angle but I'm not sure it's this much yet.

You can tell I've got time on my hands, can't you?

First night at home

Well, how was it? It started poorly as Colin, Gary, Ross and I watched the Jags get thumped 4-0 by the Dons, but it got a little worse when I tried to rise from my chair to head upstairs. I used one stick to help me, but Ross was in the process of telling me to use both of them when I suddenly fell. Fortunately, Ross was close enough to catch me before I hit the ground, but it shook me a up a bit.

The night was restless, awaking every 2 hours or so - it seemed interminable - a bit like it had been in the hospital. I was getting stabbing, needle point pains in my knee and arthritic pains in my ankle and hip. I finally got up not long after 6 am and went down to the kitchen for breakfast and meds. The pain was still intense and drove me to tears, but the meds are now kicking in a bit and the pain is lessening a little. I've got the ice pack on now and hopefully that will help ease the swelling and allow me to do my exercises later on. Right now, I couldn't face them.

I fear it's going to be a long day.

Home again

Monday afternoon and I'm home again. I had my X-rays, they took my bloods and I've come home with a full supply of meds, 2 walking sticks and an ice collar for my knee. I also made an appointment with the physio there on Wednesday 20th, but I may cancel that, depending on how I get on with the local Banchory NHS physio next Tuesday (12th).

I managed to persuade them to change my dressing which was heavily soiled with dark, dried out blood. They were initially a little reluctant to do this as the dressing was waterproof and fully sealed. They thought there might be a risk of letting infection get in if they were to replace the dressing. This gave me a chance to have a look at the wound:

Some of my visitors at the hospital brought along home-made cards. See if you can guess which of the following was drawn by a 56 year old Architect and which by a 6 year old boy?:

Tonight the Aberdeen - Thistle match is on TV and our Gary and pal Colin are coming round to ours to watch it - possibly Ross too.

Monday morning

Yes - it's been confirmed that I'm getting home this morning - looking forward to it. I've to wear the compression stockings on both legs for another 6 weeks to minimise the possibility of DVT, and I've to use both walking sticks for the same period. The hardest bit is going to be learning to walk properly again. I've had this bad knee for so long that I've got used to "swinging" my right leg rather than bending it.

Didn't have a good night last night. I cut down on the pain killers and it wasn't enough to see me through the night, so I had to call for more to help me sleep - even if only for an hour or two.

I had dozed a lot on Friday after the op and also a bit on Saturday, but I awoke early yesterday and never managed to get another 40 winks until I went to sleep at 8 pm, which meant, of course, that I awoke again early this morning and couldn't get back to sleep until I called for the extra pain killers.

Finally managed to speak to Kelly and Chris on Face Time this morning - and see (not so) little Miller - he's a big boy alright.

That's me for now - breakfast arriving soon, then shower and change and hopefully see the physiotherapist before I leave. I believe I have to have an X-ray and they also take my bloods as well.

Albyn

It's Sunday morning and I managed to get up and shower today. I'm still using the zimmer frame but hope to get on sticks when the physio comes to see me.

My leg is still very stiff and swollen and there's blood seeping from the wound - but it's contained within the waterproof plaster. On Friday, I was able to do some of the exercises the physio asked me to do - bend my knee a bit and straight leg lift - but yesterday it was too painful and stiff. We suspect this was due to the heavy dose of local anaesthetic that the surgeon put in the knee wearing off.

Had a fairly decent sleep last night - although I had to get up 3 times for a pee, which was a bit of a relief actually as they were threatening to put a catheter in if I didn't pass enough water. I also had a fairly hearty breakfast this morning, which must be a good sign.

Gary and Luca were in again yesterday and this time Luca was in fine form. He had come along on Friday and was still exhausted from his Hallowe'en night. Ken Page also popped in, as did Gary Grant. Jo has been here virtually all day Friday and most of Saturday, and she'll be in again after church today.

Spoke to Lucy, Cade and Braeden on Face Time yesterday and tried to do the same with Kelly this morning, but we've been playing telephone tennis and keep missing each other.

No news yet of when I might get out but I'm still hoping they'll let me go tomorrow (Monday).

Pre-op

So here I sit, about to have the last supper - or so it seems. My bag is packed and the alarm is set for the early morning start. I was quite relaxed about it all until everyone started wishing me all the best for my knee replacement operation tomorrow - it's suddenly made me feel nervous.

I got to thinking about all the "lasts" - I've played my last ever game of squash; my last game of golf this year was last Saturday; my last drive this year was on the way home from Fraserburgh this afternoon.

One way of cheering me up was seeing this photo of Miller:

Sorry it's sideways - but you can still see what a lump of a lad he is - and what a lovely, cheeky smile.

We're up to date with Homeland now - and Corrie. I also managed to view the last episodes of the last series of Mad Men on the plane back from Tenerife on Sunday. So just Tremé and The Sopranos to finish off now. I've got lots of reading to catch up on as well - tons of magazines - Mojo (now 20 years old), Q, Golf World and CAMRA's quarterly Beer magazine to start with, plus the book I started in Tenerife - Sleepyhead by Mark Billingham. Probably first up, however, will be the Thistle fanzine that Gary picked up when at Firhill on Sunday (with Kieran) to see the Celtic match. Bet I barely make a dent in this lot.

Back in the UK

Got back from a terrific week's golf in Tenerife late last night - Jo came to pick us up at the airport and we both headed off early this morning in to Aberdeen for my pre-op medical assessment. It was the usual round of blood pressure, ECG, urine and blood samples etc plus some instruction on the procedures for this Friday's operation. We also got to meet the physiotherapist who talked us through the post operation recovery.

The only real surprise - to me at least - was them screening for MRSA - by nose and groin swabs. It's been 6 months since my last X-rays when I decided to see through another summer before having the knee replaced, so it's possible I may be called back before Friday for updated X-rays.

After that, I had to rush off to Fraserburgh to meet up with some Danish visitors, so it's been a pretty full day. I drove home tonight in a bit of a dwam - I was on autopilot. Hopefully I'll sleep well tonight.

My golf was great last week, incidentally - all the details on the golf blog.