Nonagenarian Sighting

   We met again, the peripatetic nonagenarian  and I, this time in the ophthalmologist's office.  The tech administering the field-of-vision test said that a 92-year-old woman patient told her that she could follow the test pattern better if the screen image pictured a half-dressed man.   I asked which half she wanted shown, but the tech couldn't answer.  Apparently that question was not covered in the class on Elderly 101---Reassuring the Patient.  

'Nother Knee

   Valerie called today to say she'd just returned from seeing "my boyfriend." I wracked my brain, thinking it must be somebody from those halcyon Cambridge days, teacher or student.  I had that effect on so many.  But she meant Dr. Congiusta; it seems she has also fallen under his spell, as have so many before her.  He was looking good today, she said, in a blue shirt, though my preference is for a white shirt.  She said she mentioned my name, and they said they knew me there, that I was a great patient.  Valerie has harked back to the days of long ago when I was someone to be known, and even acknowledged.  I suspect no one remembers me at all, and they were just being polite. 
   Val said they are here for the winter. Don has "no knee."  It was infected, probably as a result of his first TKR in Florida last year,  and Dr. C. removed all the old prosthetic parts, and inserted a space-maker, infiltrated with antibiotics, and stabilized the knee with splints.  He removed the staples, and Don is feeling better.  He has to have daily antibiotic  infusions through an IV, which last 45 minutes, and which Val takes care of.  I think she said it will be that way for 4 months.  He uses a walker, and was told he could drive if absolutely necessary; it's his left knee.  They are impressed with Dr. C's reputation, that he "is the best around" and an expert in revisions.  Don was also impressed that, like himself, he was a football player, defensive  tackle . 
    We're supposed to get together for dinner, one of these days.  There's a new Italian restaurant in Cambridge.   

Seven Degrees of Separation

     Tuesday, Nov. 12. was my four month checkup for TKR of. left knee.  Dr. Congiusta asked if it was better than before.  I said yes.  I said there had been no pain at all in the knee, only minor pain in the lower shin and foot, and some numbness in the heel which has mostly resolved.  His assessment of the ROM showed 107 degrees, which is a little short of the 115 they aim for.  At P.T.,  the therapist tested the ROM at 121 degrees, but Dr. C. said he doesn't apply any pressure, a pain-free measurement. When I asked if there was still time to improve the ROM, he said most progress usually occurs in the first few months, but it may be possible to increase it, to continue my exercises.  
    Since he had told me before that after about 15 to 20 years or so, the plastic deteriorates or melds into the bone or something, I asked if that process would be incremental, constantly progressing, and he said no, that the patient usually doesn't even know, and that's why they take  X-rays every year or two.  He said the materials  are constantly improving and last longer, and mine will probably not need replacing.  (I wonder why!)  I said what if  I come back in 20 years and he's retired.  He said he'll be here---he has kids and college to think about.  He said he was glad that I was doing so well, and to return for one-year follow up in July, 2015.  Summertime!
      ( It's been four months since anyone besides the surgeon  has looked at, or even asked about, my knee, and that's pretty cursory if you have no problem. I think my TKR has set a record for generating the least amount of attention.  I am so blessed.)

TKR at 3 months Nov. 8, 2014

  Today marks the third month since my knee replacement surgery.  I've been finished with rehab since Sept. 11.  Contrary to much of what I've read, neither of my knees feels much different than before, minus the pain.  I have no sensation of their not being a natural part of my anatomy except when I kneel on them, and I think that may be getting  less noticeable also. 
  With my right knee last May, 2013,  I did not have a lot of pain, none at first, which I attribute to lasting effects of the nerve block administered,  which I think is really effective in my case.  After I started P.T., I would wake at night with dull toothache-like pain down my leg.  It lasted for about 3 weeks, I think.  With the second surgery, I have felt no pain at all in my knee, practically none at all of any kind in the hospital, where my records show I rated it 3 out of 10, and almost no pain at all ever since.  A few times I felt transient pain when I got home, 2 days after surgery, and it was in my foot, and then later minor pain in my lower shin.  But these pains were short-lasting.  By the time I would get to the kitchen to take a Tylenol, the pain would be gone. I couldn't believe that was all the pain there was, so I kept expecting it to appear at some later time, but so far it has not, and I'm eternally grateful.  I have 2 almost full bottles of Oxycodone, and they have not been refilled.
    I had an episode of what I thought was sciatic pain a few days after I got home on July 10,  self diagnosed, I may add.  But when I went for my 2-week checkup, the P.A. suspected it was ITB instead. The Visiting Nurse was familiar with the term, and she really helped me, by finding the troublesome spot.  The next day it was gone.  At my next visit, a month later, this time with the surgeon, I asked him if that were a usual occurrence.  He said no, and that the tendon had probably been stretched.  That was the word he used, "stretched."  I said no more, but think he might be a diagnostic genius, because that reminded me of what happened only 2 days after I was home from the hospital.  People were visiting, and I was walking around as usual, no walker or cane.  I went to put some empty soda cans out in the room  outside the kitchen where we recycle.  I stepped down the one step with my operated leg---and slid!  The cat had puked up a slimy hairball at the bottom of the step, and when my left foot stepped on it, the left leg flew straight out in front, with my weight landing on my right leg, which had buckled beneath me. My fleeting thought was that I'd ruined both knees, but I was lucky to be able to get right up  and say nothing about it.   I did forget (almost) until Dr. C. used the word "stretched." That leg couldn't have stretched any further out from my body.  It was rather eerie, almost as if he knew, but he'll never hear about it from me. 

The Walk

  Today I walked  the Mechanicville Breast Cancer Walk joining two grandsons who walked with the Hoosic Valley Junior National Honor Society.  The walk started at the Elks on Park Avenue, and wound around the city, by The Ugly Rooster, and past Talmadge Park before returning to the starting line.  No one seemed to know the exact distance, but estimated at 1.5 to 2 miles.  When I finished P.T. I filled out a before and after form which asked if I could easily walk a mile.  And the next question was about easily walking 2 miles.  I knew I could walk a mile, and now I can say I could walk 2 miles.  The weather was perfect, and the course was pretty flat with only one small inclined area, so all went well. 

My P.T.

    At 3 months post-op, my P.T. is pretty much confined to 100 steps of stair climbing.  That amounts to 10 counts of climbing the steps on the deck of the pool.  There are 5 steps, so 10 steps times the 10 climbs equals 100.  The only other steps available would be the 13 steps to the cellar, and that scenario is darker and more menacing.  When I get to the deck after my climb, I practice standing on one foot.  I'm getting a little better, but my sense of  balance sucks scissors.  Pathetic routine, but all I can muster.

Flu Shot Flummery

    Choices, options, decisions---Oh, no.   When you get your flu shot this year, be prepared.  It's not that simple.  In past years, I'd request a flu shot, and that was it.
     This year, besides the offering of the REGULAR flu shot, the CDC recommends offering the option of the HIGH DOSE FLU SHOT, specifically designed for those over 65, who may not respond as well to the REGULAR flu shot. The HIGH DOSE FLU SHOT  contains 4 times more antigen than the REGULAR flu shot.  The antigen is the part of the vaccine that stimulates our bodies to create antibodies to fight off viruses. 
     The QUADRIVALENT VACCINE  is another option, containing 4 strains of the flu instead of the traditional  3 strains.  FLUZONE QUAD it is called. 
     The NASAL VACCINE is available only to those under 50, so that's off the table, reducing the choices to just 3.  The pharmacist is youngish and eager to explain his craft.  He seems to think all over 65 could benefit from the Senior form, the HIGH DOSE vaccine.  But I ask why would they make it 4 times stronger, why not start off with 2 times stronger.  Why 4?   His answer amounts to something like just because that's what they did.  I opt for the FLUZONE QUAD instead.  That way I figure I'll be protected against more strains of the flu, though probably to a lesser degree.  Hey, you can't have everything.