12. How far have we come?

Seven months have passed since I had revision TKR surgery and movement is afoot (pun intended)!

  • Within the medical industry itself.  Study and use of stem cells as a means to treat health care issues now has a formal name, Regenerative Medicine (see Blog 11), and is one of the fastest growing biomedical industries in the world  (Technology and business trends in regenerative medicine, Cecilia Van CauwenbergheFrost & Sullivan, USA,  November 29, 2017).

Location of Stem Cell research

Stem cells are being used to manage cardio-pulmonary issues, macular degeneration and perhaps most prominently, joint and spinal problems, suggesting the possible elimination of metal joint implant devices in the next five years (Reenita Das, Forbes, Nov. 6, 2015).

While the author made a very optimistic declaration for the entire and utterly entrenched medical industry of orthopedics, it is very true that consumers can now find and secure stem cell therapies to avoid metal implants (see Blog 11).  The same article energetically describes how:

  • Over 2500 regenerative medical trials are in progress
  • Approximately five hundred regenerative medical products are currently on the market
  • Over 5 billion dollars have been invested (worldwide) in regenerative science research and development
  • Notably, sixty thousand registered and monitored stem cell procedures now occur annually.

This is all good news despite or because of the trauma, pain and life changing demands  on patients imposed by the difficult, real, relationship between bone and metal.  Gladly, by the time our children need joint repairs, using their own stem cells will be the protocol most advised and (do we dare hope?) insured.

  •  My progress slowly but surely moves forward.  After 7 months of daily physical therapy, required rest and pain management,  I have graduated to cane-less walking most days.  While I keep a colorful collection of canes by my door, I forget to select one of them, now daily, before stepping out.  This is a tectonic change for me and one that I celebrated last night when, walking into a busy night flea market, I realized that I did not have my cane.  I had completely forgotten about it and traveled by foot, skytrain, taxi and foot again before noting its absence – which stopped me in my tracks.  I took another moment to self-congratulate and then made a beeline for a banana chocolate crepe followed by a Singha beer to celebrate.  Today, I rest.

Crepes

 

Singha

 

A few practices remain the same:

I really cannot endure a walk of more than about 500 meters (about one third of a mile) before my lower leg seizes up.  I must rest and for the remainder of the day, that night, the following day and night.  This well tested formula (500+ meters = two nights and up to two days of rest) seems pretty consistent and therefore predictable.  Consequently, my apartment has become my haven, palace,  office and detention center.

I continue to walk with a limp but if I remember to activate my core muscles, stand erect and lift the leg muscles as I walk  (a ‘walking meditation”) my stride tends to straightens out.

A few other strategies have helped along the way:  I stopped using sugar in my coffee  – a goal I never wanted to attempt but weight gain forced me to try.  My spirits are up!  I am better networked here in Bangkok, our new home.  I now regularly participate in interest groups, attend museums, and explore sections of the city I could not touch not too long ago.  Tomorrow, my son and I will visit yet another landscaped park to compare its layout to others in the city.  Our plausible goal is to see all of the parks within the Bangkok city limits by mid-April .  We look forward to meeting that goal.

Ensuring that physical therapy is a part of my everyday routine is critical.  When I think of the work I had to do for three months to attain a semblance of mobility immediately after surgery,  and then requiring an additional four more months of careful rigor to rid myself of a cane,  I shake my head in amazement at all that needs to be done to regain indispensable strength and basic mobility.  Physical therapy is here to stay in my life and in its various tailored forms.

photo pool and wieghts

In the pool, I spend about 45 minutes in constant motion including laps, and swimming the perimeter of pool with a five pound weight in my suit to demand more from me aerobically and muscularly.  Doing at least ten rounds around the pool using all sorts of strokes otherwise unacceptable to this Master’s level swimmer includes the daring dog paddle, modified breast stroke, bicycle and jogging movements, back strokes and any other movement that strikes me but does not strain my knees – all which offer a work out I need and enjoy.  In the quiet hours of the early morning the pool is cool, calm and unencumbered with humans.  Birds are discussing their issues, the sun is grazing the leaves and bouncing off the water and I am at peace despite also breathing heavily.   I end with a series of in-the-water yoga stretches and pulling the legs and arms in opposite directions to give my spine a massage followed by a period of lifeless floating, at one with the world.  It is the time of day that I most enjoy and look forward to.  Because this activity is inherently beneficial as well as enjoyable, I never think about whether or not to invest in it.  I just go – after my cup of coffee and before the rest of the world wakes up.

In contrast, I have an unenthusiastic relationship with our gym and its exercise balls every other day I am not in the pool.  My gym regime includes plank poses, large ball manipulations with twists, hip lifts and holds and plenty of stretching in between.  If it were not for the pool to jump into at the end of my gym time, my PT regime would be a bitter pill to swallow since the workout itself is, quite honestly, hard.

PT and large ball

At my age (62) and after birthing two children, I have not managed to lose weight nor the masses of noticeable material clinging to where fashionable clothing will not tolerate.  Clearly getting rid of at least ten pounds would help my joints and will be my next goal now that I can walk – more than less.  Less crepes and beer and more of everything else I can do physically is the plan.  What is yours?  Keep our blogs readers posted!