🎉 Happy Belated Birthday, Knees! 🎉

“Your wound is probably not your fault, but your healing is your responsibility”    Denice Frohman

Yes, I vanished again. But this time I disappeared because I’ve been out there living! Fully. Knees-first.

My knees are about one- and one-half years old and boy has life changed since the last time I wrote.  I wanted to start off with a quote from my last post:

“As bad as the pain was, I also didn’t want to forget the feeling that night of total helplessness and of not being able to stand on my own two feet. I wanted to remember those darkest moments so I could at some point later, revel in the strength of my body to heal. And that’s what got me through the night.  To keep telling myself in between the whimpering, just make it through this next hour, this next minute, even this next breath.  You got this.”  

Well, the reveling has begun…

The first three months were… let’s call them “character building.”.  I had physical therapy (PT) 2-3x a week that focused on my knees and my back. Gaining flexibility and range of motion involves your physical therapist bending your knee to the point of screaming (internally, like a polite warrior but you could hear the echoes from the brave souls across the room who let theirs out). You can also do this masochistic activity on your own with what I call “The Strap of Horror”: a simple strap with a loop you place over your foot, then pull towards you until your knee screams uncle. And if that’s not spicy enough, try it laying on your stomach, with your heel aimed skyward, and just… pullll slowly and with control, kind of like a medieval torture device. But, as painful as this was, I could feel my knee becoming increasingly flexible (I still sometimes do this when feeling a little stiff).

Would you believe me if I said that physical sensation of pain is a distant memory?  I can clearly remember the emotional suffering, but the body memory of pain is gone.  I don’t even remember what it’s like to have to climb and descend the stairs one let at a time, clinging on to the railing for dear life, or to feel the instability due to the grinding of bone on bone with even the slightest movement. I have my life back in a very profound way.  I can do things now that I haven’t been able to do in many years.  Things that we take for granted….like bending over, standing for more than a few minutes, getting in and out of a car.  And the bigger things like doing a full squat with weights, or one legged deadlift, swim, ride a bike, walk several miles (or 90, but I’ll save that for another post), or run up and down stairs (very carefully).

The first year after knee replacement surgery can be an emotional rollercoaster. It can make you question your life-choices.  While everyone’s experience is unique, here are some common emotional stages people go through as you slowly make it through the first year….one strap pull at a time:

1. 😰 Immediately After Surgery: Relief & Anxiety 

• Relief: Many feel hopeful that the worst (pain before surgery) is behind them (haha, not exactly).
• Anxiety: You might worry about pain, swelling, stiffness, complications, or whether the surgery will truly improve your mobility. You may feel like your new knee is an aberration and not part of your body.
• If you can, start physical therapy as soon as your surgeon allows it.  The first two weeks it will most likely be at home physical therapy.  I recall looking up the flight of stairs to my second floor and thinking, “I’m never going to be able to go up there again.”  My home physical therapist said, “Oh yes you will, in fact you are going to start climbing today …and by the end of the week you’ll be able to make it all the way up.”  And she was right.  I can’t even tell you how much hope that instilled in me.

2. 🫤 First Few Weeks: Frustration & Mood Swings

• Pain and discomfort from surgery can make you feel irritable, anxious, and depressed. The pain can still be intense, especially at night, and affect sleep. The sleep disturbance can lead to more depression and anxiety.
• Dependence on others can be frustrating, embarrassing, and humbling, especially if you’re used to being independent. Do what you can yourself but let people help in the same way you would help them if they needed it.

3. 🤯 1-3 Months: Progress, Impatience & Plot Twists

• Hopefulness as you regain mobility. I was so happy to ditch the walker and eventually the cane!
• Impatience because recovery feels slow, and you might still struggle with pain or stiffness. However, I can remember the first corner I rounded was week three and I noticed the pain easing up a tad bit.  The next milestone for me was the two month mark, where I noticed significantly less pain and I was able to walk more but still needed the cane if I was going outside the house.
• Doubt.  Some wonder, “Did I make the right decision?” if pain lingers longer than expected. I hear many people express doubt but just remember where you were 3 months ago and that this is a slow recovery. Remind yourself that you just experienced a major trauma to your body and you may still have mood fluctuations as your brain chemicals normalize. Also, there will be times when your new knee feels disconnected to your brain.  Your legs may not move in the same way.  Your leg muscles and ligaments are dealing with a foreign object, so they are making new connections with the part of your brain that controls motor activity.
• Fear of re-injury. I can remember being hesitant about weight-bearing exercises like dipping and touching the floor with your heel while your other leg is on a step and that might “break” my knee.  It can be so hard to believe you can do more than before surgery especially when you’re feeling a little wobbly.
• Dealing with Secondary Effects of surgery We know we should be moving from day 1 after surgery, but recovery also involves a lot of sitting.  I couldn’t stand more than a few minutes at a time, and it took several months to re-build the strength to stand and walk longer. (Breakfast for the first three months was waffles in the toaster because the time they took to toast was about the time I could stand.). But because of the sitting and resting (and focusing on your knees), you may neglect other parts of your body. For me it was my back.  It became stiff and weak and started to spasm and that really set me back in PT.  For a while in PT we had to shift focus away from the knees and focus on back, core and hip weakness, all secondary effects of surgery.  It was frustrating beyond belief.  There were weeks where my back hurt way more than my knees. WTH.

4. ☄️4-6 Months: Confidence…… & More Setbacks

• Increased independence as walking and daily activities improve. Some days you will feel like wow, life it getting to be normal again, and even better than normal if you had restricted motion for a period.
• Frustration if occasional stiffness or pain still occurs. Or if you feel you aren’t where you think you “should” be.
• Emotional dips when hitting setbacks in physical therapy. And you *will* have setbacks.  Everyone does. Sometimes you’ll push too hard in PT and it will set you back but keep fighting.

5. 🦿6-12 Months: Gratitude & New Normal (I realize this is not true for everyone)

• Renewed confidence and excitement as you return to hobbies and daily life with less pain.
• Acceptance of any lingering stiffness or minor limitations. Also, acceptance of your new knee as a part of your body.
• Gratitude for improved mobility and reduced chronic pain.

Coping Strategies Throughout Recovery

• Stay committed to physical therapy.  When you don’t want to go is the time you need to go the most.
• Talk to others who have gone through the same surgery.  It can be reassuring to know others have made it through the rough spots. However, this can be a double-edged sword because everyone’s experience and recovery can take a different path.
• Stay connected with loved ones for emotional support.
• Talk to your doctor or therapist if you feel persistently down and depressed or anxious.
• Be patient and give your body some grace. Set small, realistic goals to track progress. Remember where you were before surgery and how far you’ve come.
• Got questions or feeling stuck?  Please don’t hesitate to reach out to me at mariedonabella@outlook.com or 401-829-7527. I get it, I’ve been there.

💃🏻 Final Thoughts: 65 is the New… Unstoppable

I had my surgery just after turning 64. That year was about healing and tempering expectations. But when I hit 65, I realized I didn’t have to just survive, I could thrive. I’ll be sharing some of those adventures in the next posts, because 65 can be pretty darn fabulous.

Keep moving forward. One step, one wobble, one PT session at a time.  Til next time.