Week 12 : Pre Operation Physiotherapy Helps Me

Apart from the inconveniences I encountered and still encountering though not similar, the constant fear that resurface, there is also this tough work of getting yourself to the rehab centre. Having spoken with many patients that has injuries to spine, shoulder, wrist, calves, knees and ankle ( to-date, only these patients I met ), I realized most of them finds it hassle to come for physiotherapy sessions. Some finds it a waste of time even. Some finds it costly to pay for their sessions. 

Often we hear people saying that health is important. True enough. As often as we hear people saying this, it is also often we see people neglecting their health. And I am no exception. To be frank, my condition was not good at all. Both knees had their own set of seriousness. Someday I shall share with you my condition. As of now, I prefer to focus on recovery and the journey of it. 

As a person who went through this whole journey for about 9 months now, 6 months of pre operation physiotherapy and 3 months of post operation physiotherapy and even witnessing and talking to patients who went through similar surgery but without pre operation physiotherapy, I would say there is a huge difference. What I am about to say here touches the aspect of investing time for physiotherapy sessions. Money aspect aside though. 

Take for example my own condition, I think I would not have made it this far if it was not for pre operation physiotherapy. I remember very well the very first session I had with the centre. It was painful. My muscles were so stiff and it could hardly do IRQ  (inner range quads). The exercise in the video may look easy to normal people. But, for someone with a condition like myself, it was a painful exercise. And this is just one of the basic exercises to strengthen the muscles around the knees.

 

Regardless how much pain you have to endure before the surgery, trust me, it is worth every bit of it. It made post operation physiotherapy easier. As the muscles were warmed up way before surgery, in other words, activated, the muscles are actually ready to take on the next level of tests. 

I learned that my condition did not take me 3 months to build its muscles strength. It took 6 solid months. That is how bad I was. Both therapists and doctor never objected to my target of getting the surgery within 3 months. Reason being, none of us know the amount of strength my muscles had. It was poor alright. It was like about 6 years or so that I never been to the gym or doing any real exercises.

Patients who dived straight to surgery, thinking they could handle post operation physiotherapist often gets frustrated with the fact they cannot achieve the speed and strength of doing certain exercises. They constantly complained about tremendous pain. I was told that our muscles have memory. And since you have yet to activate them and decide to move straight for surgery, this is actually the price you have pay.   

I was and still am disciplined. My ultimate goal has helped me this far and able to be as disciplined as possible to attend 3 sessions of physiotherapy in a week; whereby each session last between 2 1/2 hour to 3 hours, has so far bore me exceptionally good recovery. And I thank you God for this. 

Every patient gets to learn about their own condition and even learn a thing or two about health, correct (techniques) and targeted exercises and even our own body anatomy. What more can you possibly ask for in a rehab centre apart from getting help for your own condition? 

Talking about my goal. It is a simple goal - I would only opt for TKR ( total knee replacement ) only when I am 60 year old of age and nothing sooner. Now, I am praying for a miracle where I need not endure another surgery in future and certainly do not want to be wheelchair bound.  

Week 11th : Doctor Was Impressed

Me and doctor bumped into each other on 21 May 2015. I was there for my physiotherapy session and he was happy to see me. I, on the other hand, not really that excited. Mainly because I did not want the topic of the nursing home to be brought up. 

Doc   : Ah... Finally... I get to see you here!

Me    : Hi, doc.

Doc   : How are you progressing?

Me    : Okay.

Doc   : Tell me you can run.

Me    : And you know well that this will be like a year from now?

Doc   : This is important. You are important.

Me    : Every patient is important.

Doc  : But, you are a priced patient.

Me   : Priced as in P-R-I...what?

Doc  : C-E-D. Priced patient. Important.

Me   : All patients are. 

He walked away and told a female patient of something which I did not listen because I was in pain while a physiotherapist massaged one of my ankle.

Doc   : But, I heard somebody want to zumba ( and the conversation continues when he walked back to the end of the bed I was sitting on )

Me    : ( And how on earth he knew that? I have no idea )... ( silent )

Doc   : Unless I heard it wrongly. Or did I?

Me    : ( still keeping quiet )

Doc   : You got to walk well first.

Me    : Which reminds me of something. I will show you later since she is massaging my knees.

Moments later, before I could show him what I intend to show...

Doc   : Come. Walk for me now. Come.

Me    : Basically that is what I want to show you because last time, for the second time, you said I walked like someone who just got circumcised ( some little giggles was heard )

And I did my catwalk. I could not give it a damn if I walked like a crab or whatever.

Doc   : How long are you now ( into recovery ) from the day of surgery?

Me    : This is the 11th week after surgery.

Doc   : ( all smiling broadly )

The next day I received a Facebook message from one of the physiotherapists who treats me. And the message is...

Facebook message from one of my physiotherapists

Doctor was impressed. Impressed with the way I walked. Senior therapist reported to me with a serious face of how impressed doctor was. The way I walked was normal. The thing is, the fear of the sudden muscle cramps and sudden locking of the knees or failure of extension of one of the knees were there. You have no idea the possible dangers I might be at! 

For me, I am grateful for a lot of things. And I must say that I could never be where I am now if it was not for the Lord's mercy and grace on me. Truly. All praises to the Lord. 

Everyone ( as in the doctor, the physiotherapists, rehab therapists, my great cell family, my friends and colleagues, they have been fabulous. Thank you Julie for recommending me to the doctor too. Dad been cool in being my mini bodyguard throughout the last few weeks. The nursing centre played a great role too as they were there for me for 5 solid weeks, right after me being discharged from the hospital.

Consultation with Doctor....What?! You Do Not Know How Ketupat is Cooked?!

On May 2nd, 2015, my appointment with the doctor was early. Got the date set about 2 to 3 weeks ago. And last visit was the highlight of the recovery session. He found the way I walked funny. I went like " It ain't funny, doc! "

But, still... he found it funny mainly because I am still walking like a crab ( this is what I prefer to describe the way I walk as for now ). So, this round I got Julie to tag along as she also needed to see the doctor.

The first thing he did was to ask me to do the 'catwalk'. I, on the other hand showed him the x-ray that was done July last year and also in year 2011. He was disappointed that the one in year 2011 does not showed the top view of the knees. One thing learned. You need to have the top view of the knees to be x-rayed for reference.

The 'catwalk' was a mini session. The rest was a solid 20 minutes food and health educational lecture. In total, I have like a good 25 minutes consultation session with him.

Straight to the point, shall we? And this is how the consultation went between me and doctor :

Doc   : Walk for me.
Me    : Huh? Before I forgot, I brought something which you asked for weeks back. Hope not too late.
Doc  : What's that? X-ray?
Me   : Yeah. You said you want to compare.

Doctor took out the x-ray result taken in year 2011 and compare it with the current one. Only to find out that, like I mentioned before, the missing top view of the x-ray. The one taken last last year will then be compared to the one I am about to take by end of this month.

Doctor teased me again ( yes, again ) about my stay at the nursing home. Well, so long everyone was happy, as in doctor got to enjoy his session of consultation ( mini entertainment session during stressful consultation by doctor is a must. Doctor is human after all ), Julie entertained in a way and me...me... just being me basically.

Doc   : You still walk like someone been circumcised.
Me    : You did muscle release what. So, I need a bit of time to adjust to this new situation.
Doc   : Not new. Temporary.
Me    : Yeah. Temporary.
Doc   : Now... You got to cycle everyday.
Me    : Everyday?!
Doc   : Yeah. Why are you so surprised? You need to. At least an hour.
Me    : ( considering my choice of word now ) I don't have a bicycle at home.
Doc   : Then get one.
Me    : How to ride? I mean I am not even stable. And to ride at the middle of the road?!
Doc  : Get one like in the physio centre.
Me   : House too small. No space.
Doc  : There are ways.
Julie : Gym la!
Me   : ( Ahem! ' Thank you '. That is really of ' great ' help now because doctor gets to have a longer lecture with me )....
Doc   : Precisely. Just do not understand why patients are so stingy to invest in their health. Do you know what out of 100 household, 20% has bicycle at home. And out of 20%, only 1% that cycles? And where does the 1% at?
Me    : Gym?
Doc   : Right. So... get that started and start taking red meat. Helps a lot with the growth of the cartilage. How's your diet, by the way?
Me    : More on fish and chickens and vegetables.
Doc   : Not enough. You need red meat for iron. If you eat fish and chicken, then your cartilage is like fish and chicken texture. You need iron.
Me    : Hmmm...
Doc   : You see... Do you know ' ketupat '?
Me    : Uh-huh.
Doc   : Do you know how they are prepared?
Me    : ....no....
Doc   : No?! You do not know?!
Me    : I sincerely do not know. I just know how to eat them. C'mon, doc! Not a very surprising thing that females nowadays does not know how to cook! I am not you. You are passionate about cooking. Not me...yet...
Doc   : Tell me that you know how rice are cooked. ( look hard at me now )
Me    : Aiyah...that one I know la... Should have said rice not ' ketupat '.
Doc   : ( hand gestures of someone praying ) Thank you God that she actually know how to cook rice... Thank you... ( still praying hand gestures ). Now... your cartilage is still growing. And this is the best time to feed the cartilage. You do not expect the food you ate will eventually fall straight to your knees just like that. No. There are holes which I drilled and those holes need to be fed. And no other way than cycling. You need to compressed those nutrients into the holes. Make it hard. But, not too hard. Like cooking rice you see. Rice when they are cooking, you see some holes in between the rice, right?
Me    : ( nodding my head )
Doc   : And that's how it should be. You feed those holes. Cartilage needs to eat too. They need nutrients to grow become harder. But, not too hard. It has to be just nice. Density just nice you see.

Jokes aside. On a serious note.

Questions and answers for easy understanding.

1.   Can I still take calcium tablets even when I am fully recovered?
      Yes. But, I do encourage you to take natural resources of both calcium and glucosamine. Try not         to pamper your body with tablets or pills.
      My view : Great point. If not, why does God bother to create all these for us human to consume?

2.   Can I play basketball after full recovery?
      Advisable, no. Basketball is a rough sport. Too many fast and rough movements which involve the knees. Twisting especially.

Meanwhile, the hunt for the full length photo of myself is quite daunting. Manage to find this one which is really a disappointment. Taken in April 2011.

9th Week of Recovery & Progressing

Maybe this is the only best full length shot I have of myself that reveals my knees

My recovery has so far been more of a surprise than an anticipated one. At least for me. 

For the very first time, I fell asleep during my physiotherapy session while doing hamstring curl. Half way through, with the cooling air-conditioned space and a clean and comfortable bed ( is that what you call it anyway? ), I doze-off in no time. I was caught red-handed by the rehab centre's receptionist, whom then related it to the therapist who treated me. Gosh...

As I walked around at home often without any clutches at all, but, still near to the wall or some heavy furnitures for support, I can sense that my muscles are really working. There are some muscles tightness on the side of the thighs, slight pain on the knees and ticklish pain on my calves when they are swelling badly. All these are normal challenges I need to go through with.

While talking to my therapist during one fine physiotherapy session, I realized that I forgot to take down a photo of my knees before the surgery. Goodness! I went through my stack of photos in my phone and I really could not find any photo of it. How sad! And most of my photos are photos of me wearing long pants. And mind you, this is the secret of me having smooth skin for my calves, my dear therapists! Lesser sun exposure to skin, the more wonder to it!

Maybe I do have one. Somewhere. I would not know until I dig out all those old photos in my portable hardisk. The thing about having one as record is that to remind myself not to pull any more stunts that could damage my dear knees. The only thing I might be able to show in near future may probably the X-ray I took in July 2014 and one some time this month. It would be a comparison of my previous and current condition. By then, I would describe the condition of my knees before the surgery. 

The journey, though physically painful, it is still, as what Boon said, a memorable one. She had been through it with one of her knees and she knows what it is like. As for me, having two knees to be repaired at one go, no words can describe the feeling I have. Not that I am proud of the courage I had and the perseverance to grit through this. I am not. Basically, I am amazed even to this very moment with a lot of things. And for this I got to say that, all glory to God.

Today, my colleagues realized that I was walking much much better than last week. I felt so too. Hope this is not too early to say. Touch wood! Touch wood! But, seriously. Last week, I walked much crab-by than today. The muscles reaction is much quicker too. 

How did I know that it is quicker? It is because I nearly tripped and fell that it comes to my realization that it has improved. Nowadays, the chances of me enduring muscle cramps and sudden knee-lock are much frequent. I took extra precaution as I walk and always need to remember that I still need the clutches to walk to further distance and uneven ground. There are mornings where my dad needs to remind me to bring my clutches ( now you can imagine how eager I was to fully recover and be able to do normal things again ).

Apart from pains, cramps and muscle tightness around my legs, I also suffer these to other part of my body. Like today, I accidentally twisted my left arm ( between the elbow and shoulder. But, nearer to the shoulder ). And that does not help with stairs and slopes as I rely mostly on the strength of my arms and hands with the clutches to support myself around.

Whenever my knees are tired or in pain, I will transfer the strength to my hands and arms and to the clutches. Now with a twisted left arm, I need to have my legs more mobile and handle the situation the best of the knees ability.

Returning Back to Office

Yesterday was a very tiring day for me. Not at work. Not mentally. But, physically. 

I was glad to be back to work and at the same time dreaded the fact that I am back doing what I was doing. Making this as honest as possible, I am looking forward for a change of career path. That also mean sacrifices needed to be done. At this point, I suppose that is not possible. God has better plan than mine. 

Keeping this post as short as possible, before heading to bed for a good night sleep, I shall say that adapting to the busy work life is no fun when you are armed with elbow clutches and easily tired muscles.

I battled with bad calves swelling and also tiredness around the knees and thighs. The luxury of time I had in controlling the swelling is no longer available. The agony of not able to join your colleagues for lunch and catch up with the news happening in the office is not there neither. 

Though doctor been really optimistic of me holding a single clutch, I suppose no one knows this better than I do. I really thought I was strong enough to walk with one single clutch. Maybe I was wrong. I almost tripped and fell while walking from my car to home. Both knees suddenly could not bend when I was walking. 

My left foot hit the ground hard and my right stood still while I used both clutches to balance myself. For a split moment I thought my face was going to hit the ground. Praise the Lord that it did not. Or else I would not be able to type this post.

I will be asking my therapist soon about this. 

Hangout with Mindy

Tosei at Hor Spring Village, Setapak