Recovery and thoughts from a real life patient!!!
What I’ve Learned as an older adult from Recovering from Injury and Knee Replacement Surgeries
A Reflection from Barbara (last name withheld for Barbara's privacy)
I’d like to thank my fantastic physios, Matthew, Darren and Tomu at Urban Athlete. And of course, the lovely Maddie who keeps everything working.
“Back in 2010, I had an accident and smashed up my right ankle. I spent nearly a month in hospital having that treated and then the next 6 months, progressing from wheel-chair to moonboot and crutches to learning to walk again.
Especially learning to walk downstairs because going downstairs on crutches is completely counter-intuitive. (I wanted to say “fucking insane” but counter-intuitive is probably a better word).
What I didn’t know was that in unconsciously protecting my ankle, I over-used my knee. And, in 2019, I had knee replacement surgery. When the surgeon told me that my knee looked like the knee of a rugby-league player I couldn’t stop laughing. I am less like an athlete of any kind than you could imagine.
In the last few months before the surgery I would guess that I operated on about 30% mobility. I was constantly in pain and therefore exhausted and I was grumpy! If someone ever said, “why don’t you just…”my reaction was
“Sod off”
You meet your first physio in hospital. They come to see you the day after surgery and get you up and using crutches so that you can get yourself to the bathroom. The surgeon told me that they love physios because the patient has someone to hate who isn’t the surgeon.
I cried the first day on crutches. Everything hurt. My sister was visiting and she wanted to slap the physio for making me cry. I love my sister (and I also persuaded her that her “I want to slap you” reaction wouldn’t be well received).
So, I became re-acquainted with crutches. My GP came to visit me in hospital and I was showing off and when she left she said, “No dancing on the stairs”. I took that to mean that I was making progress!
In the first months of recovery there are lots of challenges and lots of mile-stones.
Some of my challenges were:
My first Challenge was to get down Shortland St (where I live at the top) to the physio (who is at the bottom). Initially I used an Uber both ways!!!
Thank you to the Uber Assist drivers who never complained about taking me on such a short trip.
Managing crutches was an ongoing challenge, like getting in and out of a car, going downhill or down-stairs, what happens when it rains…
Regaining confidence in your own body and in your balance…
How do you carry things when you’re on crutches? You can get into the kitchen and make a cup of tea but how do you get the cup of tea back to the chair you want to sit in?
Some of my mile-stones were:
Being able to ride a stationary bike at the gym
Being able to ride a stationary bike at the gym without crying. (It’s the first three minutes that hurt the most. It’s when your injured leg is on the up-rise and before you get to the top of the pedal, it hurts like hell). Dave, who is one of the trainers at the gym initially wouldn’t stand by me on the bike, in case people thought he was being mean to me when I cried. Then he was happy to stand by me and cheer me on. Yay!
Learning to use the leg press machine. It’s actually possible to hate a machine, I’ve discovered. I quite like it now. OK, like is a bit strong but I feel a sense of achievement when I do my leg press exercises.
The day I left the physio and forgot to collect my crutches.
Being able to walk up and down Shortland St!!!
I can get up and down off the floor (which means that I can get up and down off the grass or the beach when I’m outside).
I can put my knickers on standing up. I know, laugh away. You don’t realise that this is important until you can’t do it.
Making my way down a very steep hill on Great Barrier Island. It was an unpaved track that was only sort of formed. I only persevered because there was actually no option. Going back the way we’d come would have been disastrous. I made it with the help of my partner, Mik and by thinking, “What would Matt say?”
So, its 10 months since I had my surgery and in that first 10 months, you can measure progress really easily. It’s a bit of an adventure and you can talk to people about what you’ve learned this month. Measurable progress is a wonderful thing.
I think I’m about 70%.
And now what?
I’d like to make more progress because 70% doesn’t leave a lot of wriggle room for dropping off.
And, getting up and going to the gym isn’t exactly my favourite thing to do in the morning.
There is a hotel in Ouarzazate in Morocco which has a roof top garden and they serve the best breakfasts ever. Being teleported there would be my favourite thing to do in the morning but sadly teleporting isn’t a real thing. Yet.
So, back to the gym. When they play music that I can sing along to (always under my breath, I promise) the gym could even be my happy place. Well, nearly.
If the first year of recovery is the year of adventurous recovery, then the following years will be the time of gritty recovery. I know that I can do gritty: I had two babies, one weighing 9 pounds and the second 10 pounds and each of them took more than 24 hours to be born. That’s 3 shifts of midwives.
For people my age, 60+, we need physio as a matter of maintenance. As more of us live longer and have better access to medical treatments that make longer life better, we might want to think about what happens after the surgery.
My surgeon told me that knee and hip replacements and cataract surgery score most highly in terms of patient reaction to questions about improved quality of life. But for older people, it’s a different kind of treatment than recovery after a sporting injury when you’re young and fit. The treatment might last a long time.
What I noticed during our various COVID restrictions, is that when I couldn’t go to the physio or go to the gym, I went noticeably backwards. I was more stiff; I was in more pain more often; I was more often too tired to do things, especially in the evenings.
Managing pain is actually really tiring, it takes a lot of energy.
So my physios help me to stay on track and they keep me honest. I suspect that getting from 70% to somewhere in the 80+ percent might be more arduous that getting from 30-70% and I’ll need their help.
Physios are a major part of my green prescription. And some days, it would be soooo easy to just stop. And I don’t want to do that.
So, hero-physio, can you keep me on as a maintenance client if I promise to keep working hard?”
It may be less exciting but it may also be just as important.
