A story full of heart, dedication and making the most out of a tough recovery.

Maria explains in her knee replacement recovery journey.

I was born in Cuba, and moved to Miami at the age of five, where I grew up. I have lived here all my life. I studied psychology and political science in college and became a paralegal. I was always active and athletic as a kid. Although it wasn’t my major, I was on the modern dance team in college.  Because I live near the water, I have always enjoyed all forms of water activities such as swimming, boating, snorkeling, and kayaking. During my marriage, my ex and I also used to go skiing quite frequently. In addition, I enjoy running, dancing, biking, crossfit and boot camp.

A Meniscus Tear

About 15 years ago I tore the meniscus in my right knee and had arthroscopic knee surgery to clean it out. No one ever explained to me that this surgery would ultimately have repercussions as I got older and continued an active life style. After my pregnancy I gained a significant amount of weight, and then lost it. I started running 5k’s during and after my weight loss, and continued dancing which was always my passion. The first few years my knee was fine, but after a while it started swelling up and started causing me tremendous trouble. I seemed to always be in pain. I became a regular at the orthopedic doctor’s office. I did endless therapies, took cortisone shots every 6 months, iced the knee, stretched it, did yoga, you name it. But the knee kept getting worse and worse, and the cortisone shots were no longer helping. About three years ago I practically blew out my knee during a 5K run. I had several medical opinions telling me that I would ultimately need TKR surgery, but for the time being it was just “elective” surgery. I finally met my surgeon, Dr. Carlos Alvarado, who gave me a third and final opinion. He ordered an MRI, and when he read the results, he was shocked to see that not only was I bone on bone, but I had also torn my ACL and MCL. He advised that surgery was no longer an option or elective for me; it was mandatory.

Dr. Carlos Alvarado is my guardian angel. I found him through a mutual doctor friend who advised me to see him. It was the best medical advice I ever received. Dr. Alvarado is young, extremely knowledgeable, and well-schooled in the latest technology. He has great bedside manner, and in my opinion, is a brilliant surgeon. My surgery was state of the art and used a new technique. It went very well, and in fact, Dr. Alvarado kidded with me the next morning about how I broke the blade of his saw during the surgery. I was up and walking around just hours after my surgery.

What??… Manipulation Under Anesthesia?!!

While I was physically in need of the surgery, I was not mentally prepared for what I was about to endure. I really don’t know how anyone can be prepared for this life changing event if they’ve never personally experienced total knee replacement surgery. That said, everyone and every BODY heals and recovers differently. I went to 90º flexion painfully, and sweated every minute of every therapy session. My extension wasn’t much better, as I was between -11º to -8º. I was going to therapy 3x’s a week, every week for an hour. I took five weeks off from work, so I had to take advantage of the time off to recover as quickly as possible. I made it to the 90º mark between the second and third week, and then progressed to about 113º, where I seemed to linger longer than the therapist wanted. The protocol is for a patient to reach 120º flexion and 0º extension by the 6-8 week mark, or an MUA (Manipulation Under Anesthesia) would be the next recommended step.

I didn’t know what an MUA was, let alone what it entailed, but the mere mention of the word sent me in a panic. And my therapist wanted to make sure that I knew what it was. So I got home, depressed, hopeless and frustrated, and got online to do some research. It’s what I do. In an MUA they put you under anesthesia and manipulate (aka “crack”) your knee to 120º. The goal of the MUA is to break up the scar tissue to allow the joint to move freely. With the exception of having a new surgical scar, you are basically starting at almost ground zero all over again, and with new pain and swelling. I saw my surgeon at my four week follow up and he told me he expected me to be Gumby, to which I replied I’m neither green nor made of clay. He said I was one of the youngest patients he had, and because I was in such good physical shape, he had very high expectations of me. I knew what that meant, and I saw where I was headed if I didn’t take immediate action.

Online Research and The X10™

During my research on MUA’s I saw the X10 machine kept popping up and without hesitation, I booked a phone conference with PJ Ewing, the developer’s son.  I was in a bad head space and was very depressed. I had so many questions and concerns.  But after talking to him for over an hour, he put me at ease and I felt like this machine was sent from heaven and would be able to get me to my end range quickly and with relatively little pain and discomfort. I really needed to get to my end range by my next post op appointment. I was terrified of getting an MUA, and to make matters worse, I had heard of two cases (friends of friends) who had to have it done. I spoke with my surgeon about the X10 and although he had not heard about it, he read the literature I brought him and he signed off on the medical consent, giving me his blessing. The only caveat is that he required me to do BOTH traditional therapy along with the X10 machine. At this point I was very far from dancing two months after knee replacement as he had promised.

I received the machine a couple of days after I sent in the paperwork. I continued doing therapy, but also started working with the X10 machine. I worked with the machine diligently 3x’s a day, seven days a week. On the days I had therapy, I would do the machine only once or twice, depending on how I felt. Every time I left therapy I was sore and my joint was super tight and I needed to ice my knee. I even used the X10 on those therapy days although I was sore, I would simply adjust it accordingly. I will elaborate below.

The X10 Protocol

I starting using the machine at intervals of anywhere from 30-45 minutes. I pushed myself both up (extension) and down (flexion) with each session. While it was not as painful as therapy, it was uncomfortable because I pushed myself sometimes 5º, 10º or more per session. But it was definitely less painful than therapy. I only told my therapist about the X10 a couple of days after I started using it, because I wasn’t sure how she would react to it. When I mentioned it, she said that Passive Action Machines had been around for decades, but none seemed to be very effective. I told her all about this machine, with its advance technology, and  its many added features to strengthen the muscles and break up the scar tissue,  and because of all the research I had done, I knew the difference between the x10  and its predecessors, so I could make a valid argument in its favor. This machine is state of the art and has a lot of built in added features that speed up the recovery process.

It Fit My House

The machine itself is comfortable and very user friendly, and it doesn’t take up a lot of room. I only had to relocate an IKEA size arm chair temporarily to fit the machine in my small two bedroom apartment. Once the set-up was complete, in the comfort of my home, I was given detailed instructions from Dave on how to use it. Then I simply sat on the chair, and pressed the ON button to get started. I had mine placed in my living room in front of my television, so that I could watch TV, read, work on the computer, answer emails, visit with friends and family, or even have a cup of coffee while the machine was doing its job. While it has many amazing features, one of my favorite features is that as the machine is going up and down in its range of motion, it slows down when you are at 10 degrees from your pre-set end range in either direction so that you can brace yourself for the final push.  (It really is a mental thing).

How it Works

It adapts and adjusts to your body accordingly. If the machine feels too much pressure is being exerted to get you to the next degree, it automatically stops at the furthest degree it could comfortably get you to, and continues the up and down movement while slowly pushing you further along. As you move the joint, it will naturally loosen up and you get a better bend. This is very different from having a therapist bend your knee while you’re in therapy and “tapping out” to no avail. And you can also manually adjust your end range in either direction while you’re in the middle of a session so that you can push yourself comfortably to the next level, or pull back if you feel any discomfort. You are given an instruction manual on how to use the X10, it has all the pertinent numbers to call, and a grid where you keep track of your own progress. Since you are always in control, it is in your best interest to push yourself forward as frequently as you can even if you feel some discomfort. Kind of like the old gym adage: “no pain, no gain.”

Six Weeks After Surgery

I began using the X10 machine at about week six. After a few sessions on the machine, my therapy sessions started getting easier and far less painful. Prior to the X10, whenever my therapist would bend my knee while I was on my stomach, I would brace for the pain, and tap out while tears streamed down my face. Within a few sessions on the X10, the therapist’s manipulation got easier and easier to bear. Even my therapist noticed that my knee was bending more easily. She saw the swelling and inflammation starting to go down, and felt the muscles waking up, while the scar tissue started to break down. My therapist mentioned how she could totally feel a huge difference in the anatomy of my knee joint and the surrounding tissues, and how impressed she was with my improvement. By the eighth week (two weeks after starting the X10) I saw and felt a remarkable improvement overall in my mobility, strength, and flexibility. I only had the machine for 2 weeks, but I achieved my end ranges, and went from a starting point of 5º extension/90º flexion to 0º extension/130º flexion within that small time frame. I never felt more than a discomfort during the entire process.

Tricia Lahmann, My Recovery Coach

With the X10 you are assigned Tricia, your X10 coach. She is your coach, virtual therapist and a Zumba instructor all in one. She is amazing and has a great personality. We had our first virtual phone therapy a few days after I started using the machine.  And from that point on we would text each other almost on a daily basis. She was a burst of energy and super inspirational. This was especially helpful on those days when I needed the “quit feeling sorry for yourself” speech. Since the machine has readings that are recorded and automatically sent to her for monitoring, I would frequently get texts messages from her, out of the blue, cheering me on. I even got emojis, which totally made my day!!! Thanks Tricia!

She was my biggest cheerleader and motivator. She kept me grounded and hopeful.  And she always brought a huge smile to my face.  Actually, the whole team is amazing.

It’s Three Months Post Surgery

My surgery was on April 3, so I am now just over 12 weeks post-surgery. I am beyond thrilled that I was discharged from therapy almost 2 weeks ago, at almost 11 weeks. My therapist said that I was off the charts and had exceeded all my milestones. I did a total of 26 therapy sessions at just under 11 weeks. I’m walking without a limp, and I’m dancing again. I take public transportation to get to and from work, so I walk over  3-4 miles a day just commuting. I have to go up and down escalators, and many times the escalators are broken, so I end up having to walk up and down the stairs. I’m slow and careful, but I can do it.

The therapist started transitioning me to regular gym equipment at eight weeks post op, and by the time she discharged me, I was doing leg presses/extensions of over 60 lbs with my surgical leg, leg curls at 45 lbs, I am also doing 20 minutes on the stationery bicycle at a low seat level, with high resistance. I’m using the elliptical machine and I’m doing wall squats with a medicine ball on my heels and on the balls of my feet.  I’ve also been cleared to do aquatic exercises.

Dancing Two Months After Knee Replacement? Three Months? You Can Do It!

Knee replacement surgery is a long journey no matter what your age or physical ability is prior to the surgery. It is as much mental, as it is physical. You have to mentally prepare yourself for this temporary setback. You will have a new metal joint in place of where you had your knee joint, and your muscles are cut during surgery. You will have little to no strength where you once had some or alot. You have to re-learn how to walk and “wake up” the quads, glutes and hamstring muscles. You had the surgery in the hopes of a normal life going forward with your new knee joint.

My advice is as follows:

• LISTEN to your surgeon and to your therapist(s), and follow their advice to the letter.
• DO THE WORK do all your therapies no matter how painful they are.
• Do NOT lie in bed all day (unless you are advised to do so), or sit all day on the sofa or an easy chair with your leg propped up. Get up and get walking. If you don’t move your muscles will atrophy, you can get blood clots, or infections, or other complications. You must stay active in order to get your mobility back, and hopefully better than before your surgery.
• TAKE your pain meds as prescribed, especially before physical therapy and/or the X10.

If you can, get the X10 machine. For me it was a great supplement to my therapy, and it helped transition me to the next level in a short period of time and with little discomfort. I don’t think I would have gotten so far so fast without it.

Don’t give up mentally or physically. It is not an overnight process. It will take time and you have to have patience and faith in yourself and your team.  Keep working at it and you will get to your happy ending.  I’m not completely there yet, but with continued hard work I know I will get there.  I have already overcome 100% of my worst post-surgery days. For now, I’m thrilled to be walking, dancing, swimming, biking, and gymming. And I look forward to many more milestones.

Thank you X10 and Team!!!

Every day will present you with a new challenge, especially at the beginning. You will wake up with pains and stiffness, and you’ll curse the day you had the surgery. It is up to you to rise up to the challenge.  At first it will be painful, it will be difficult, but with hard work and a positive attitude, you will get through it. Just when you think you can’t go any further, you keep pushing forward and within a few days (maybe even a week), you will see your hard work pay off. Get out of your head and stop telling yourself you can’t do it.  Even baby steps are steps in the right direction. The difficult and painful moments are only temporary.