Back in the room...again!

[tickettyboo]

Well I haven't been around much lately partly because I feel guilty writing a dieting diary when I'm currently not . I really do need to get a grip, I know what you are saying is right Tracy and I had intended to get back on track sooner but while not trying to make excuses for myself have struggled so much more with rehab from the op than I thought I would. I have come to the conclusion that most of the orthopaedic physios I've encountered are complete psychopaths. I know they have to dish out tough love, and be strict about getting you to exercise the joint, but if I am told by one more person I have to "work through the pain" I will thump somebody. My daughter is an OT in a stroke unit and sees both sides as a therapist. She says that a lot of people don't try, and it's frustrating, but surely they should differentiate between those that are trying, but not able to achieve targets, and those who don't try? I am trying so bloody hard but because I had a lot of other issues with the joint before the op my recovery is slower, my quads are wasted and it is so hard. I think the worst time was only five days after having the 40 odd clips removed, and with the wound still really sore and slightly weepy one particular physio decided without warning to start massaging the scar to break down the scar tissue by digging her thumbs into it. I was trying so hard not to cry. I normally come away from these sessions feeling a failure and utterly defeated, and promptly go home and eat everything in sight. Yesterday however I had a young bloke who was fantastic, who encouraged me and kept high-fiving me each time I achieved a target, who said he can see how hard I am trying. What a difference! I came home so much happier and positive.

Anyway, rant over. I'm going to start cutting out all the crap this week and start dieting properly next Monday as we have a big family party next weekend. It's disappointing I've put a lot of what I lost back on but I'm not going to beat myself up about it, I lost it before and I'll lose it again.

 

[Loz1986]

I used to work on a trauma and orthopaedic ward - we had no elective surgery like knee replacements, but lots of little old ladies with broken hips, men with football injuries, car crashes etc. I get what you mean about the physios. I'm glad you had a nice physio. We had a lovely one when I was a student nurse. One of the patients really fancied him and she was being transferred to where he worked for intense physio. She had me and an HCA shower her the day before she left, shave her legs etc so she was ready for him!

 

[TracyGWill]

I didn't have any physio like that, just a few fairly low-key appointments where they check my range of motion and went through a few exercises with me (although even those made me cry at first, lol). Maybe it varies from one area to another. I've been to see the consultant again today, and am being put on his list for a kneecap replacement, so hopefully that will reduce the terrible pain I currently get in my replaced knee, fingers crossed!

I suppose I'm fortunate in that I actually eat less when I'm upset or depressed, so have lost weight whilst recovering from each of the four ops I've had recently. I was so determined not to gain any, so just controlled my eating obsessively (though I did enjoy my three days of being waited on in hospital!).

I really hope you get some real improvement soon. xx

 

[Mini]

I hope you get that nice young bloke again as he sounds so positive and motivating.

Don't beat yourself up about your weight as you will lose it again when you get your head back in the diet zone...focus your energy now on getting better.

Sending big (((HUGS))) for a speedy recovery.

 

[tickettyboo]

I'm finally starting to feel in a better place four weeks on from my surgery, both physically and mentally. Mini, I have the lovely bloke for physio all the time now as I've moved on to a gym based physio class twice a week at the hospital and he's doing the class,but it's supervised by the nasty one so I just try to keep out of her way! They were both pleased with my progress last week though which was good, I managed 15 mins on the exercise bike and 15 mins on the treadmill, felt like a marathon! I'm back to work this week too, working from home as I won't be able to drive for at least a couple of weeks, but I spoke to my boss on Friday and said I'm happy to get back gradually as I can't sit at a desk for long without my leg swelling but will do what I can. He was happy just to have me back on board which was nice, he's been amazing. I feel good to be getting back to normal.

Tracy, my local NHS trust operate this programme called the Rapid Recovery Scheme for knee and hip replacements which is apparently only in place in a few areas but is seen as the "gold standard". Everyone follows the same care pathway, from the initial clinic consultation until you are completely recovered. You are involved in and take some responsibility for your own recovery including attendance at a day called "joint school" where you meet the consultant, anaesthetist, physio, OT etc learn what will happen on the day and afterwards, you are taught the exercises beforehand so are confident to do them. After discharge a structured physiotherapy programme is followed; initially 1:1 in outpatients, then progressing to the gym based classes for about 8 weeks then referral to a local authority gym at reduced cost to continue your rehab. It is a fantastic system, the only criticism I have is that there are targets at every point you are expected to achieve ( degree of flex etc) but if you can't achieve a target then sometimes I have felt it wasn't understood that it wasn't for lack of trying.

Anyway, about the diet...tomorrow I start back properly. Today I am going to finish off the goodies left in the fridge and the there won't be anything left to tempt me. I shall weigh myself and reset my ticker as I know it's bad, I wouldn't be surprised if I've put back on all I lost before. We shall see!

 

[TracyGWill]

I'm finally starting to feel in a better place four weeks on from my surgery, both physically and mentally. Mini, I have the lovely bloke for physio all the time now as I've moved on to a gym based physio class twice a week at the hospital and he's doing the class,but it's supervised by the nasty one so I just try to keep out of her way! They were both pleased with my progress last week though which was good, I managed 15 mins on the exercise bike and 15 mins on the treadmill, felt like a marathon! I'm back to work this week too, working from home as I won't be able to drive for at least a couple of weeks, but I spoke to my boss on Friday and said I'm happy to get back gradually as I can't sit at a desk for long without my leg swelling but will do what I can. He was happy just to have me back on board which was nice, he's been amazing. I feel good to be getting back to normal.

Tracy, my local NHS trust operate this programme called the Rapid Recovery Scheme for knee and hip replacements which is apparently only in place in a few areas but is seen as the "gold standard". Everyone follows the same care pathway, from the initial clinic consultation until you are completely recovered. You are involved in and take some responsibility for your own recovery including attendance at a day called "joint school" where you meet the consultant, anaesthetist, physio, OT etc learn what will happen on the day and afterwards, you are taught the exercises beforehand so are confident to do them. After discharge a structured physiotherapy programme is followed; initially 1:1 in outpatients, then progressing to the gym based classes for about 8 weeks then referral to a local authority gym at reduced cost to continue your rehab. It is a fantastic system, the only criticism I have is that there are targets at every point you are expected to achieve ( degree of flex etc) but if you can't achieve a target then sometimes I have felt it wasn't understood that it wasn't for lack of trying.

Anyway, about the diet...tomorrow I start back properly. Today I am going to finish off the goodies left in the fridge and the there won't be anything left to tempt me. I shall weigh myself and reset my ticker as I know it's bad, I wouldn't be surprised if I've put back on all I lost before. We shall see!

Blimey, that sounds very structured, we have nothing like that round here! I just had about three or four brief visits to a physio to check on my progress in terms of range of motion, then I was discharged to get on with it! I was off work for three months, then still struggled after that. How things differ from area to area! I'm so glad you're feeling more positive and feeling human again. xx

 

[tickettyboo]

Today I have had a sort of light bulb moment. I am sixty one years old and move like a person of eighty...in fact my 87 year old mother in law is fitter and more sprightly than me. I had physio today and am doing so well, I have been so determined and motivated to recover from my tkr op as quickly as possible, I've fought through the pain of exercising the joint while it's healing, and am so proud of myself for getting to where I am now, I have never had this attitude before regarding exercise. I have always hated it, from doing anything to get out of PE in school, to being lazy enough to drive to the corner shop. And now it's come to bite me in the bum, but finally maybe I have had a wake up call that it's not too late to change things, I'll never run a 10k or swim the channel but that doesn't matter....I can be the best physically that I can be, with some determination and effort. If I can just harness the motivation I've shown over the last 6 weeks and use it I could really change my body, my mobility and health. My physio actually called me a high achiever today, I've never been described as that. From next week I graduate to the next step of rehab, the advanced knee class, which is circuit based in the gym. After that I'm taking part in the exercise referrral scheme at the gym for 16 weeks. From next Monday I'm going to get back on track weight wise (I've a suspicion I've put on all I lost before the surgery) which combined with the exercise should make a real difference. Of course I could just get all fired up and then not actually do anything (which is what I usually do) but I'm hoping this time I'll stick at it. We shall see.

 

[Loz1986]

Loving the new positive attitude. You have done really well since your surgery. Best of luck for getting back on track with the diet next week!

 

[tickettyboo]

Thanks Loz. Just not sure yet how to approach it. Apparently you're not supposed to do a VLCD, which would be my preferred option, within 12 weeks of major surgery. I might do a partial meal replacement diet for breakfast and lunch but have a healthy high protein/low carb dinner, think that would work. Not looking forward to weighing myself, facing the prospect of having put it all back on and having to restart my ticker again! But the important thing is that I do it now, and don't slide even further back. I'm not beating myself up about it, it's been an awful couple of months where food's been my only pleasure and comfort really having been so immobile and in pain, but I've done well before, I can do this. Getting it off is relatively easy. Keeping it off is something I've never managed, that I have to learn to do.

 

[Loz1986]

You have had a couple of tough months. I can see why you shouldn't do a VLCD so soon post-op - your body needs the calories to heal itself.

Maybe if weighing yourself is the one thing stopping you from starting again, why don't you just not weigh yourself? If you know you've put on weight, do you really need to know how much? Do you have something that fitted you well when you lost all the weight pre-op which is now maybe a little more snug? Why don't you give yourself a target, a number of weeks or whatever, to get back down in to that item of clothing and then re-weigh yourself and use that as your starting point? (It might be cheating - I personally don't think it is - but so long as you lose weight, does it really matter where you started? And if you've not re-started the dieting cos you don't want to re-weigh yourself, surely this just removes that barrier).

 

[Minerva]

I completely agree with Loz, she's a lady with wisdom! Using clothes as a measure is a great idea. Weight is weight and right now you'll be carrying a bit extra water around the poor joint you've had the operation on, so any scale measurement won't even be realistic or accurate. You do need the energy right now to heal yourself, so if anything, maybe try counting calories roughly, at a maintenance level rather any kind of weight loss. Or replace a lunch or two per week with a VLCD pack so as not to strain yourself. The diet can wait, healing is the most important thing right now. x

 

[tickettyboo]

Thank you all for your encouraging, helpful replies. This forum is so good, it's lovely to share your thoughts, fears, good and bad days with lovely people that understand what your're going through. We all have our own busy lives, with our own struggles and demons, yet take the time out to support others, it's inspirational.

Loz, I'm not afraid to weigh myself, and it's not stopping me from starting. I know it sounds daft but I always start a diet on a Monday, I get geared up in my head for it. In a weird way I embrace it, it's part of getting in the zone to start again. It's like "right, now I know where I am I can start the battle again". I've done this so, so many times over the last 45 years or so, I've been at least 3 stone heavier than I am now at my biggest, so I know I can do it. I'm just not looking forward to it, any more than the root canal job I've got to look forward to at the dentist next week (just when I thought my body had had enough pain for a few weeks it throws a dental abscess at me just to keep me on my toes ) As you say Minerva, I'm still carrying a lot of fluid in the operated leg and foot, plus the metal joint itself weighs about a kg so I'm not going to get fixated on numbers but I do need a reference point. It's a good idea to try on something that fitted me nicely pre op as I'm sure it'll be snug, I've spent the last few weeks in baggy linen pants and t shirts or maxi dresses for comfort, which has been ok as the weather's been warm, but it's probably helped with the denial of the weight sliding back on as I've not been wearing fitted clothes. Anyway, this weekend I shall finish off the nice food and wine that's in the fridge ready to start again. You both make a lot of sense about how to do it, I think I will do basically a lowish calorie plan with more protein than carbs with as Minerva suggests a few vlcd packs to see how I go.

Hope you all have a lovely weekend xx

 

[Loz1986]

Good luck for starting Monday then! That's bit rubbish about needing root canal treatment - I hope you recover quickly.

(And thanks for the lovely compliment Minerva).

 

[Mini]

Today I have had a sort of light bulb moment. I am sixty one years old and move like a person of eighty...in fact my 87 year old mother in law is fitter and more sprightly than me. I had physio today and am doing so well, I have been so determined and motivated to recover from my tkr op as quickly as possible, I've fought through the pain of exercising the joint while it's healing, and am so proud of myself for getting to where I am now, I have never had this attitude before regarding exercise. I have always hated it, from doing anything to get out of PE in school, to being lazy enough to drive to the corner shop. And now it's come to bite me in the bum, but finally maybe I have had a wake up call that it's not too late to change things, I'll never run a 10k or swim the channel but that doesn't matter....I can be the best physically that I can be, with some determination and effort. If I can just harness the motivation I've shown over the last 6 weeks and use it I could really change my body, my mobility and health. My physio actually called me a high achiever today, I've never been described as that. From next week I graduate to the next step of rehab, the advanced knee class, which is circuit based in the gym. After that I'm taking part in the exercise referrral scheme at the gym for 16 weeks. From next Monday I'm going to get back on track weight wise (I've a suspicion I've put on all I lost before the surgery) which combined with the exercise should make a real difference. Of course I could just get all fired up and then not actually do anything (which is what I usually do) but I'm hoping this time I'll stick at it. We shall see.

Great to hear you are doing so well and nice to get positive feed back from your physio...I bet it makes you want to try even harder?

Good luck with your new start on Monday.

 

[TracyGWill]

I'm glad your recovery's going well, hon, it's not an easy time! Is that right about the prosthetic joint weighing a kilo?! I never even thought that could be increasing my weight, lol.

Take care - I wouldn't personally advise doing any sort of VLCD just yet, you do need to give your body chance to heal. xx

 

[tickettyboo]

Thanks Tracy, yes it does weigh a kg, when I went to the Joint School presentation before the op the consultant handed one round for us to see and I was surprised how heavy it was. I suppose they have to be pretty solid to withstand the forces exerted on them. Apparently every lb weight gain is about 3-4lb effect extra pressure on the joint which is why you have to keep your weight down, the joints should last about 10 years, longer if there's less pressure on it, which is another good reason to lose weight. I don't want to have to have this redone anytime soon! x

 

[TracyGWill]

Oh yes, I definitely agree about the benefits of keeping the weight down. I truly believe that if I was still as heavy as I was when I first developed knee problems, I'd be in a wheelchair by now - I'm barely mobile at the moment as it is! I'm constantly telling people to look after their knees, lol, they must be sick of hearing it. I hope you're still improving - all the physio sounds very good; we definitely aren't offered anything like that round here. As I think I mentioned before, I was discharged very quickly, after minimal checkups by the physio, who was basically concentrating on getting the 90 degree bend. I can bend it brilliantly now, almost as far as my "human" knee, it just hurts like hell, lol.

Keep up the good work on the knee, and I hope the weight loss reboot goes well! xx

 

[tickettyboo]

Thanks Tracy, I agree this system of care for joint replacement is really good, apparently our NHS trust were one of the pioneers of it and it's rapidly becoming the "gold standard" and being rolled out nationally. From when the consultant makes the decision to operate the patient is fully involved in the process and expected to be proactive in their recovery, it's apparently reduced inpatient days post op and led to much better outcomes. The rehab part is tough as it's a bit like boot camp, I know that I hated it and the physios, and cried so much the first few weeks, but doubt if I'd be where I am now 7 weeks post op without being bullied into pushing myself through the pain, I'd have wimped out left to my own devices. I've now got 120 degree bend (85 on discharge) and am able to walk without aids, at least for short distances. Considering how deformed the joint was before ( I couldn't straighten the leg and hardly bend it as it was almost locked in position) I'm amazed.

D day again tomorrow. God how many times have I done this! Every time I say this is the last time, this time I'll stick to it blah blah...but this really is the last chance saloon, for my health's sake. So today is my Last Supper, slow cooked roast beef and home made Yorkshire puds, and the remains of a bottle of Pinot Grigio. Hope everyone is having a nice Sunday x

 

[TracyGWill]

That sounds like a brilliant system your NHS Trust has there, and I'm glad you're doing so well. It's a tough thing to recover from, and the more support you have the better. Hope you enjoy your Last Supper, lol. I always have a treat on a Sunday, invariably either cake or chocolate! xx

 

[tickettyboo]

Thanks, as you know it is a hard op to recover from and I honestly think if I knew how painful it was I might have had second thoughts about having it done, although now I'm obviously glad I did. I am surprised that North Wales has been a pioneering trust, somehow I'd always assume that it was a city like London that would lead the way! Sundays are made for treats aren't they? I nearly always cook a roast, aided by a glass or two of wine, and really enjoy it. I love a proper pud too, like apple crumble or pie. Oh well, no pain no gain. Or rather loss! xx