Knee Surgery Recovery and the X10 (Merlin’s Story Part V of V – Conclusion)
More Hurdles
There is some part of our psyche that allows us to believe in silver linings. So having “escaped” my erstwhile rehab facility one week after getting there, I felt that I was on my way to a seamless recovery because I had paid my dues. Well more fool me, I did not factor good old Murphy and his law. I arrived at my apartment, opened the door and was assailed with this awful odor of mustiness and decay.
A pipe had broken during my absence and the carpeting in my bedroom and part of the hallway was saturated. The bedroom closet was full of mold on shoes and along the walls where water had been sitting for an estimated ten days. As an asthmatic, there was no way I could inhabit that space, and the management company decided to move me into a vacant apartment.
Within a half hour, about six men arrived and began to throw things into boxes and move furniture out before I could wrap my mind around the most efficient way to manage such a move given my condition. The result was that for several days, I could find nothing while I hobbled between apartments several times a day to organize the meals I had frozen, and try to rummage through the boxes and garbage bags shoved into my daughter’s room. It took four days before I could find the crucial support hose I was required to wear to prevent life threatening blood clots. The point here is that we can make all the best plans but there are going to be unanticipated turns in the road. Whether it is mismanaged pain, a flooded apartment, or feelings of frustration and discouragement, we cannot afford to lose sight of the recovery goal. Of course this is hindsight speaking.
Getting My Real Recovery Started
Recovery coach, Ron Hoffman, had brought the X10 machine from the rehab center the day of my discharge. We agreed that it would be better to install it in my home apartment since I was only going to be relocated temporarily to facilitate drying out of the bedroom, treating for mold, and replacing the carpeting. The back and forth between apartments, and forgetting stuff that I had to go back to get was exhausting, to say the least. The rehab process never really got going to any significant degree that week in terms of the exercises I was given to do. But once the meds kicked in, and my exercise window opened up, I managed to do one, sometimes two sessions per day on the X10 to keep the knee moving and pliant. It was easier for me to work on the X10 than to do the bends and stretches on my own. This had much to do with being able to control the level of pain with the machine while still gaining mobility and strength. But my X10 usage was still erratic and I missed sessions because I was so tired.
Knee Surgery Recovery and the X10
By the time Meritus physiotherapist, Jason Smith did his first home visit while I was still out of my home, I was a jaded soul – frustrated, fearful, in pain, and not trusting anyone or any rehab process. I think he found me pleasant but watchful. And not eager to have him near my leg. He used the session to get a sense of who I was and where I was mentally and emotionally and to discover that I was not able to do too much of the recommended exercise routines on my own. On his second visit one week out of rehab, one of the first things he asked was, “Do you trust me?” My immediate response was, “No… because you are only here to achieve your target numbers and you will hurt me without a thought.” And then he said, “I will show you that is not true…you will determine how far we go, and when we stop.” And the work began as I continued to be guarded.
With words of encouragement and minimal help from Jason, I was able to bend my knee from 45° to 50° in less than a minute. I had not been able to have even that small shift in rehab. I began to feel empowered and believed that he saw me as a person. He asked if I wanted to go further. I was so pumped, I agreed. In about five minutes we were bending the knee at 55°. By then I was in the zone and was saying, “Let’s go for 60!”. He looked kind of doubtful but agreed and I gave myself to working with him to achieve a target I had set. In about 8 minutes we were up to a 60° flexion. That was one days work. Two days later, I was up to 75°. My knee surgery recovery and the X10 were now in sync.
For me the key was that sense of autonomy that was facilitated by the physiotherapist’s style and manner. In that short period, with his kind of approach, I began to trust him and by the end of the session, my trust for the process returned. I would love to say that I overcame my fear of the pain. But I think that is going to be with me for a long time. The take away here is that, as a therapist, Jason Smith addressed more than just the physical rehabilitation of my knee. He sought to understand the mental and emotional issues that could impact my recovery as well. Furthermore, once he recognized how much I relied on the X10, he began to review my numbers and incorporate my X10 usage into his rehab strategies. For me, this is the mark of a true healer.
Knee Surgery Recovery and the X10 – Getting to 125º
I have the lowest pain threshold imaginable and knee rehab is largely dependent on working through pain. Medication is a major component but there is the required discipline, and the will to make it happen. But pain remained a major demotivator for me. One of the things I discovered is that the X10 routinizes the exercises so that I was able to push through my pain endurance to the next level because I could see the numbers on the screen and commit to reaching a single degree higher. And if I did not make it in one try, I could try again and watch that needle slowly move to where I want to be. Invariably, if I didn’t make it, it was because of pain. This simple form of biofeedback generated the motivation I needed to keep improving in very small increments that added up to bigger gains.
I named my X10 machine ‘Brunhilda’ and we quickly became fast friends. She sat among my plants and books and work files like a sentinel looking out the window to the trees outside. She was strong and relentless and kind and rewarding. I could set my target, crank up the Mozart to levels that drowned the pain, pace myself, and have small victories which I would celebrate with my recovery coaches.
Brunhilda was demanding and she did not compromise on the required routines. But I remained engaged because seeing the numbers improve – for range of motion, quad strength, hamstring strength, pressure applied, and resistance times – each time I got on the machine was indeed empowering. The ready feedback presented me with a clear picture of where I was in the process and made it easy to set/adjust targets for the next session. It allowed me to project where I wanted to be and plan how to get there. Coaching sessions helped to allay fears and frustrations and helped me to strategize for the best outcomes. These were big motivators and helped me to interpret the data I was generating so I was better able to take advantage of this wonderful machine.
I was behind in my recovery but by the time the period of home therapy was over and I could go into outpatient rehab six weeks later, I was moving my knee freely at 0° extension (straight out) and a bend of 106°. Passive mobility on the X10 was 0°on extension and 120°- 125° on flexion which was my target. Thank you X10™ and Halley Orthopedics.
Thank you PJ and Ron, you guys are the most incredible recovery coaches!
Things I’ve Learned
► Talk to doctor about pain. It is to be expected but be proactive about relief. Ask to adjust meds if you think you need to.
► Find a balance between the need to step down narcotic meds and the need to rehabilitate knee with a demanding exercise regimen.
► Get enough sleep. It’s vital for the healing process.
► Eat a healthy diet that promotes bone healing.
► Exercise at least 3 times daily, both rehab work and some cardio.
► Keep stress levels down. Do some breathing exercises several times daily.
► Keep your sense of humor
Merlin, so well written. Having worked with you as your recovery coach I know so well how hard this recovery was – and all that you went through. You capture the spirit and drama and passion of your post-surgery rehab so very well Thank you for your vivid descriptions!