So now here we are up to April 1. If you missed my surgery post and need to be brought up to speed, click here. I am off bed rest and ready start physical therapy. I still have the brace on to keep my leg straight. I am using it more for support and stability. Without it my knee is weak, and my leg muscles have atrophied. My quad muscles weren't even firing. I had to lift my leg up with my hands to place them anywhere. Here in this picture of me at the Arthritis Walk (with my best friends family) in May you can see the brace. Black, bulky, from thigh to ankle.
The goal now is the break that wire in my knee through bending it slowly with therapy. Eventually it will bend enough, wear down, and snap. Then they will remove all the hardware in my knee. Here's a picture of the wire if you don't remember what it looked like.
The challenge at this point was that I had just kept my leg straight since Jan 31. At Physical Therapy they had to start forcing it to bend and then by the therapist and I working together I slowly regained the use of my muscles. I don't wish this process on anyone. My leg was pretty much frozen. Your range of motion is measured by how many degrees you can bend your knee. My first day, during my evaluation, I could bend my leg 10 degrees.
Pretty much every week I would gain more mobility and flexibility, though minimal at best. My knee was still inflamed and looked like a good size grapefruit. Compression bandages and ice packs were my new best friends. A typical day at therapy would start with the therapist massaging my incision to detach any scar tissue and where my muscles attach to the knee joint. These were very tight. They still are actually. Next I would lay out on the table, on my back, and contract my leg muscles and lift my leg up in the air and old it. It's harder than it sounds I swear. After a week of that exercise my thigh muscles were starting to fire. Small milestone reached. I could now use my leg and bend from my hip. At this point we were all stretched out we started on the manipulation. Can we say OUCH! With my trucker mouth I might as well have been cursing to a nun in church. Basically the therapist was pushing my knee bent, putting pressure on the wire, trying to get the wire to break.
In mid May I hit a plateau. My knee was stuck at 65 degrees flexion. My physical therapist, surgeon, and physicians assistant all spoke together and decided the best way to go was to start using a Dynasplint. Wearing a Dynasplint would able my leg to be in a gentle stretch 24/7. Here is a picture for you.
For a good month the splint was working great. I was gaining more degrees every day. Then I got stuck again. In mid June my therapist grew concerned and after speaking with my PA they decided it was best to be seen by the surgeon sooner than later. I was looking at possible manipulation surgery. Basically I would get knocked out, then the surgeon would force bend my knee to get the ROM. That was a tense few days leading up to my appointment. Most in my life were convinced this was a botched surgery and I needed more opinions. What no one would understand was that this surgery was cutting edge and most doctors wouldn't even touch me with my RA. This is a surgery mostly done on young athletes. One of the benefits of having access to one of the best orthopedic surgeons in the country and a teaching hospital. So with all this feedback from my family and friends (I know from love) and my physical therapists, you can imagine my emotional state and the frustration with my body.
Back to the appointment with Dr. Davis. He walked in the room, started moving my leg around, sat down, looked at me, and said "wow". My worse fear had just been confirmed. My head was spinning. Surgery was in my immediate future. I started crying. I said "I know". He looked at me and said "sweetie why are you crying?". I said "because it's bad" In my head I followed with "I've worked so hard". Dr. Davis said "No! I said wow because I am so surprised at how well you are doing! You are farther along than I thought you would be!" OMGee what was he saying? Did I hear that right? I started crying again (poor guy couldn't win). He continued "Brigid you have been through so much. You had 2 surgeries. 2! And you have RA and you stayed in remission through all of this. I can tell you have have been working so hard. I bet you are going to be at 120 degrees by the end of the summer." He explained this plateau I hit was me working the wire. It was me against metal. No wonder it was so hard! This HUGE weight was lifted off my shoulders. I left his office rejuvenated and ready to fight back some more. In the weeks since I have reached 94 degrees. I have recently been able to walk up stairs alternating my legs, and I am able to ride the stationary bike at PT getting the pedals all the way around.
Dr. Davis did have one concern. My extension. That wasn't as good as it should be. He said to try a few more weeks of therapy and if it didn't get any better we would try a Dynasplint for extension. This past week I called Dynasplint and the rep came out immediately to fit me with a new splint. Picture below.
It's a good thing I called them. My extension was measured at 25 degrees. Normal is 0 to -10. After my surgery I was at 10. Yesterday was my first day with the extension splint. So the plan is everyday I have to wear the extension splint 6-8 hours. I can't wear it to bed. I have to have my ankle up on a pillow. It puts a damper on my day, really. The splint for flexion I still need. I wear that the rest of the day, including to bed. When I'm unconscious I guess my knee relaxes and bends a bit more on it's own. When I am going to be out in public like shopping, anywhere I won't be sitting, I need to use my wheelchair so I can let the splint work. any walking I do is time taken away from the splints job.
So there you go. My journey thus far. It hasn't been easy. The end result though is so worth it. Brand new knees and more things I am able to do with my family and friends.