Total Knee Replacement weeks 3 to 5

by | Sep 15, 2018 | Dr Andrew Redgment, Total knee replacement

Total Knee Replacement – 3rd to 5th week after operation

Saturday 25 August 2018. Day 16. First day without any crutches – just around the house. The skateboard is certainly helping to achieve more of a bend. Sitting with the leg just dangling is also very helpful. I have already achieved a straight leg while sitting with my leg extended. However, when I walk, I keep my knee bent. Why? As a result, my walking is fairly ordinary. I still cannot bend my knee enough to be able to use the stationary bike. Getting very bored.

Monday 27 August 2018. Day 18. Visit to physio Paul for more advice especially on bending and visit to GP to have the final dressing removed.

Tuesday 28 August 2018. Day 19. A very interesting visit to my surgeon, Dr Andrew Redgment, who wants me to be able to bend my knee more than 90º within two more weeks – or else he will have to bend it for me under anaesthetic. A bit of a threat. However, he did offer extremely good advice on how to get the bend happening. Viz. With the knee bent as much as possible: 1) vigorously tap that toe; 2) with the foot jammed on the floor, bring the hip forward; 3) give deep massage to all the muscles, fascia that are tight and preventing the knee bending; 4) use creams to assist massage; 5) you can do much more. Good advice. With Helen doing the massage and me squirming, we managed to get sufficient bend to do 5 revolutions of the bike (rotating backwards). For some reason, my right calf is extremely painful.

Wednesday 29 August 2018. Day 20. A day of exercise. My pattern was – on the half hour, stretch the knee back as far as possible and massage all the tight points (using Hyroid cream and Arnica) for 5 minutes, then one the bike for as many backward revolutions as possible (usually 30), then sit with legs down until the hour, then sit with legs up til the half hour when it began again. I managed 8 of these rounds and a total of 200 revolutions on the bike. My bend had increased to 98º (last measured at 115º). I may have overdone it as my knee became a little swollen and I had an uncomfortable night. But, have to know when to stop. I know that I have to push and I can understand that there is a ‘too-far’ line that I should approach but not cross. Ha.

Thursday 30 August 2018. Day 21. More exercise today – stretching and massage. At the beginning, I had lost much of the bend and could achieve only 111º. This quickly reduced (with Helen’s massage) to 95º and then 92º. Working on lifting the toe and then pushing the foot back. Not pleasant,  but bending. Despite much effort, we could not get it any further back than 92º, however, this bend is enough for me to be able to do forward rotations on my stationary bike.

Friday 31 August 2018. Day 22. The bike is becoming easier – especially with the toe pointed. 0.5 km is not difficult. However, I made the mistake of going out to a U3A event in the morning. This meant that 1) I did not do my exercises; 2) I did not rest properly. Viz, I wore myself out for no gain – except social contact with interesting people.

Saturday 1 Sep 2018. Day 23. Sleeping is still an issue. I wake up about every hour.

Monday 3 Sep 2018. Day 25. Visit to physio. Good news and bad news. Good news – the bend is looking good as is the wound. I can go into the pool. A new set of exercises. The bad news – my straightening has deteriorated. I now have to work hard to recover that. Bugger. Spent 15 minutes in the Grange pool. Walking forward was difficult as was side-step towards the ‘bad side’. Resistance of the water in the pool will certainly help build functional and sideways stability of the knee – especially as it no longer has any cruciate ligaments.

Tuesday 4 Sep 2018. Day 26. Overdid it in the pool. I did not do much and was feeling very good while doing the 5 exercises. However, the knee has stiffened up and become a little painful. Bugger. It is certainly difficult to judge the boundary between enough and too much.

Wednesday 5 Sep 2018. Day 27. Recovery from yesterday. Much the same set of exercises every hour. Five sets of exercises (total of 9 km on the bike) and a quick set of exercises in the pool. Much thought given to not overdoing it. Used a bit of heat for a while in the evening.

Thursday 6 Sep 2018. Day 28. Today is four weeks since the surgery. I woke from quite a good night’s sleep having managed to sleep on both sides and my front. Feeling very good.

Monday 10 Sep 2018. Day 32. Visit to physio. I am going very well. Bend in the knee is well over 90º now and we think it is about 105º. I’m now allowed to do a few strengthening exercises – wall hold and a few step ups, plus encouraged to do leg curls and hamstring stretches. I’m allowed to drive at last. First time driving the new car. Helen has done about 1,000 km running around in the last 30 days.

I’ve said this a few times. When I look from day to day, there is very little improvement and in fact many days appear to be steps backwards in that I need to just sit and recover from the efforts the day before. However, when I look from week-to-week, there is enormous improvement in what I can now do compared to what I could not do the week before.

Wednesday. 12 Sep 2018. Day 34. One day short of five weeks since surgery. Visit to surgeon Dr Andrew Redgment. Excellent progress. Keep it up. I can now take off my TED stockings. I’ve pencilled myself in to have the other knee done in early Feb next year.

Shield Shrimp

When it rains across Australia’s vast inland region, temporary pools crop up all over the arid ground, giving life to a strange desert crustacean known as the shield shrimp (Triops australiensis).

Named after the formidable carapace that shields its head and upper body, T. australiensis can grow up to 7.6 cm long, and it uses its long, segmented tail and mass of 60 or so legs to propel itself through shallow water.

It also breathes through these legs – its sub-class Branchiopoda means ‘gill-legged’ – and in the females these legs bear ovisacs for carrying their tiny eggs.

Several pix in the Photo Gallery and a movie.

Acacia peuce

A rare and endangered plant. The tree grows up to 15 to 18 metres (49 to 59 ft) high, with short horizontal branches and pendulous branchlets covered in needle-like phyllodes adapted for the arid dry climate. It has a distinctive habit more similar to a sheoak or a conifer.

Although speculated to have been widespread across central Australia during wetter climates 400,000 years ago, the population is now mostly restricted to three sites, separated by the encroaching Simpson Desert. In the Northern Territory, the species is restricted to the Mac Clark (Acacia peuce) Conservation Reserve which is surrounded by a pastoral lease, Andado Station. The other two sites are near Boulia and Birdsville in Queensland. The tree is found in open arid plains that usually receive less than 150 millimetres (5.9 in) of rain per annum. They grow on shallow sand aprons overlaying gibber or clay slopes and plains and between longitudinal dunes or on alluvial flats between ephemeral watercourses.

 

Owen Springs Reserve on Hugh River

Owen Springs was a station on the Hugh River. The Hugh River flows into the Finke (when it actually flows). Both cut through the Western MacDonnell Ranges. The image above shows Owen Springs Reserve as a dot at lower right. The river it is next to is the Hugh. Hermannsburg, our next town, is near middle left edge. Hermannsburg is almost on the Finke River. You can see both Hugh and Finke Rivers cutting through sections of MacDonnell Ranges.

Palm Valley

Palm Valley is within the Finke Gorge National Park southwest of Alice Springs. Palm Valley has a smallish population of Red Cabbage Palms (Livistona mariae). The nearest related species is 850 kilometres away in Katherine NT. The average rainfall for Palm Valley is just 200 mm per year. Small pockets of semi-permanent spring-fed pools allow the unique flora and fauna (desert fish, shield shrimps tadpoles and frogs) to survive.

It had been assumed that the cabbage palms were remnants of a prehistoric time when the climate supported tropical rainforest in what is now the arid inland of Australia. Genetic analysis published in 2012 determined that Livistona mariae at Palm Valley is actually the same species as Livistona rigida from samples collected near Katherine and Mount Isa, both around 1,000 kilometres (620 mi) away. It is now thought that aboriginal people brought the palms to here from Mataranka.

Mound Springs

Mound Springs occur around the Western edge of the Great Artesian Basin and represent a natural discharge of Artesian water that was captured many hundreds of kilometers away from rain falling along the Great Dividing Range and New Guinea. This article provides details. Dalhousie is an excellent example of a mound spring.

Great Artesian Basin map Great Artesian Basin diagram