There and Back Again

I’m baaack. Though many of you might not have noticed I was gone. 🙂 But my journey was necessary and it was, like so many sojourns we think we undertake for one reason, important in several unexpected ways.

You say Biologic, I say Bionic

I am now officially the Complete Bionic Woman. My first hip resurfacing was in 2006. My other hip was done in 2012. And two months ago I went in for double-knee partial replacement. Lots of people, including hospital nurses, told me I was brave to get both knees done at the same time. I heard the word brave all over the place, from the library to the supermarket. I didn’t feel brave, just practical. Apparently most folks who need both knees done get the worst done first, then try to recuperate while the other knee deteriorates. So until the second knee gets done (in weeks or months or even years), they’re still hobbling, crutching, caning or wheel-chairing around instead of truly healing. Made no sense to me. Doing both knees at once might add a bit of time to my recovery, I reckoned, but when I was done I’d be DONE.

You’ll read about my surgery and recovery below, but I want to say right here, upfront, to any reader thinking about having knee surgery and either being talked into putting it off or having only one knee done at a time – please don’t. Find the right surgeon who can do the right kind of surgery for you, prepare for that surgery like a person possessed (more about that below) – and get ‘er done. ASAP.

The Elephant In The Room

At 245 pounds a decade ago, that elephant might have been me. One question I heard a lot when I was hobbling around on two bone-on-bone knees was “If your Protocol is so great, and you eat so well, how come you have arthritis?” My response: “I didn’t always eat well (an understatement), and I was morbidly obese for years.”

The invariable reply: “Oh. So it was all that weight on your joints.”

Well I’m sure that didn’t help, I always say, but it wasn’t just the weight – it was mainly the inflammation. The inflammation all that visceral and adipose fat gave off 24/7, and that happily attacked my arteries and joint cartilage. By the time I got it all figured out, invented the Protocol and lost a hundred pounds (plus), the damage was done. Over time, I lost all my cartilage in both hips, and on the outer edge of both knees. Yet it is still amazing to me that no one really talks about this collateral damage of eating badly in general, and eating sugar in particular. That elephant continues to walk among us.

Surgery and Protocol

By 2006 I’d gotten down to about 165. I had the (then) new Hip Resurfacing surgery and recovery was okay, but just okay. By 2012 I was at 150 and my other hip recovery went much faster and smoother. By this June I was 140, and I’d been doing BBS, living the Protocol life and had eaten virtually no sugar for years. Although I was bone-on-bone for the last eighteen months or so, I hadn’t needed a single pain pill thanks to taking highly effective anti-inflammatories. And oh, mama! What a difference it all made.

First, the surgery. I had the new MAKO robotic arm partial knee replacement. Unavailable until just a few years ago, this arm makes partial replacements possible. Since only my outer third of each knee was damaged, only the outer third of each knee was wiped free of arthritis and only a tiny metal and plastic prosthesis was added to each. I still have my patellas and kneecaps, and no giant full knee implant. The surgery itself is fascinating. First, a computer probe attached to a sophisticated CAT scan computer is placed in your shin, about six inches below your knee. It ‘reads’ your entire leg/knee anatomy, and ‘draws’ a precise 3-D image of it all. Surgery is then ‘done’ to the image by the computer, and the Doc manipulates your 3-D knee (for future full range of motion, among other things) to make sure prosthesis placement is precisely correct. There is no room for even a centimeter of mistake in that. Once the surgeon is satisfied, the data is sent to the robotic arm, actual surgery begins, and the arm does the actual placement. No human hand or eye is good enough, even though my surgeon does ten of these a day, about four days a week.

Note to prospective patients: THIS is the type of surgeon you want if you are interested in, and eligible for, a partial. One who actually does MAKO (it’s so sophisticated, like hip resurfacing instead of hip replacement, that many surgeons don’t bother going through the long and arduous learning curve), and one who does a lot of them on a regular basis. An orthopedic surgeon who doesn’t do MAKO is unlikely to suggest or speak well of it.

My surgeon prefers a spinal to general anesthesia, and so do I. Fewer complications, quicker recovery. Mine was really quick: I woke up on the operating table. 🙂 No pain, but listening to the surgical team talk and the sound of what sounded like a buzz saw was interesting. And although I discovered that at the end of surgery patients are given an injection of a ‘temporary amnesia’ drug (so you won’t remember anything that happened during a very traumatic event), mine failed to take. I can still tell you the name of the two recovery room nurses who took care of me till I left for my room. Who were pretty startled when I sat up on the gurney and asked them for ice chips, since most of their patients were usually prone and unconscious.

Post Surgery

I was lucky on many counts, the most important of which was to be taken care of by a very dear friend (adopted daughter, really – I love you, C!), who stayed at the house to take care of the pooch (while I was in hospital), and for another two weeks after I came home. Her most important role though, was visiting me every day, and helping me break just about every rule the hospital had. The best rule-breaker was a large green cosmetic bag (great disguise) we hid in a drawer and called The Pharmacy. In it were all my supplements, including dessicated liver and wheat grass caps I’d made up myself to up my blood count (which I had no intention of turning over to the staff so they could review them and hand them back to me on their schedule if they approved) and my anti-inflammatories. Especially the two I’d researched and chosen for Post-Op recovery: Black Cumin Seed Oil with Curcumin to reduce surgical inflammation (though you can get it without the curcumin), and Bromelain (a Pineapple Extract), to reduce swelling.

Black Seed Oil

The Prophet Mohammed said this about Black Cumin Seed Oil (Nigella Sativa): It is a remedy for everything but Death. You can read more about it here and here. There are two (of many) properties to which I can personally attest. First, as an excellent anti-inflammatory. Second, and very unexpectedly, as an anti-asthmatic. According to the site, Thymoquinone, one of the main active constituents within black cumin, is superior to the drug Fluticasone in an animal model of asthma. I’m not asthmatic, but for the last three years, as summers have grown warmer, I’ve suffered from hay fever that provides lots of sneezes and a stuffy nose. A week after taking the Black Cumin Seed Oil, all symptoms were gone. Completely. Three weeks later I stopped taking it. Within two days all symptoms were back. Took it again – and again returned completely to normal. It’s August now, but as far as my nose goes, it might as well be Christmas. 🙂

Bromelain

A combination of several enzymes found in pineapple, I took Bromelain starting the afternoon of surgery in order to utilize two of its many beneficial properties: to reduce swelling, and as an anti-coagulant, so that I would not have to take medication to avoid DVT (deep vein thrombosis; always a risk after surgery that may keep you immobile). Between the curcumin, boswellia (mild anti-coagulants as well as anti-inflammatories) and the bromelain, my legs were fine.

A Stunning Recovery

So how well did my pre-surgical prep and post-surgical plans work?

Day One: A few hours after surgery, I’m starving. I ask for some Greek Gods Greek Yogurt (my fav) and a banana, as well as coffee with heavy cream. I had called the head dietician the week before, to give her a shopping list (butter, chicken thighs, etc) and recipes – like Chicken Normandy. Joan was wonderfully accommodating, as she was during my hip surgery. My friend retrieved my ‘goodie box’ from the patient fridge, and we ate the prune chocolate cake and dark chocolate-covered date, pecan and walnut truffles (all sugar-free, of course) I’d prepared a week earlier.

Day Two morning: A gaggle of nurses surround my bed, shaking their heads and murmuring over the fact that despite having surgery less than twenty-four hours ago, I have no swelling in either leg. No. Swelling. At all. They said they’d never seen anything like it.

Day Two afternoon: I’m up and cruising the floor with a walker. I wanted to use my forearm crutches (thank you, Belgium – hard to believe we’re still in the underarm crutches ‘dark ages’ here), but the nurses insisted. As I walk, the aide with me keeps pointing to me whenever a nurse or doctor passes us and says “Day two, bi-lat!” Which usually got a reaction of ‘Whoa’.

Day Three: Ace bandages come off, waterproof bandages go on, and I get to take a shower. Heaven. I can bend both knees well enough to sit and stand. Walking several times a day; eating once – though a LOT, which drove the nurses nuts. “You didn’t fill out the breakfast (or dinner) menu!” they told me, shaking their heads. They just couldn’t get why anyone wouldn’t stuff themselves multiple times a day. But the meals I did eat, made from my recipes, were delicious. They offered Colace daily, even though the goodies and the Bromelain worked wonders there, too, so I didn’t need it.

Day Five: Home. Tossed the walker into a corner, grabbed a crutch and walked up two flights of stairs to get to my bedroom. Heaven.

Day Six: Using two crutches.

Day Seven: Using one crutch. Home Physical Therapist arrives. She watches me walk, amazed. We exercise, then she measures my Range of Motion. She can’t believe what she’s seeing (105 degrees on the left, 95 degrees on the right – which was the really bad knee) so she measures again. I ask if something’s wrong. “Not exactly,” she says, except that this is where someone usually is … after three months.”

Day Eight: Using a cane.

Days Nine through Twelve: Walking on my own. On the last day of PT (by this time all we’re doing is taking walks together), my ROM is measured again: 145 degrees and 140, respectively. That is close to dead normal for just about anyone who never had surgery. I tell her about Protocol, my weight loss, my lifestyle, my surgery prep. She says she wishes there was a course that could teach everyone what I know. Recovery would be so much better for them, and miles better than what she sees on a daily basis. Surely there must be classes for this already, I ask. Nope, she says, not anywhere in the state. Wow. I’m shocked.

Side note: I lost four pounds while in the hospital, and another two the following week. I went down to 134, and there I’ve remained. Most of it was my remaining belly fat, since I dropped an inch from around my waist and I’m now a size 6-8, which I never thought I’d see in this lifetime. You know – it feels nice. 🙂 I’m more convinced than ever that Protocol has a cumulative effect. If you stick with it, you just get better and better. Tests done in the hospital showed that I’m no longer hypothyroid at all. At. All. In fact, my metabolism is now running a bit fast. Haven’t seen that since I was a teen.

Week Two: Bandages/Stitches come off. Good, but … Ow!

Week Four: Wounds completely healed, which means I can now go in the water and start my true, complete recovery. Yes, I had been zooming along, but surgery really takes it out of you in terms of mental and physical stamina. I wanted to get back to 100% of everything, and I knew that only the water and my water walkers – and then, when ready, BBS – would get me there.

Week Six: See the surgeon for Post-Op checkup. He shakes his head and tells me that unless something goes wrong, I don’t need to bother with the six-month check-up. I’m already there. I have no restrictions, can exercise as I like, and leg-press however many pounds of which I’m capable. No more crunching, popping, crackling or snapping, either. If you’d poured milk over me when leg-pressing 160 pounds pre-surgery, you’d have had a bowl of living rice krispies. 🙂

He knows about my research, my lifestyle and my pre-surgical preparations. I tell him what the PT said about my teaching this in a course and ask what he thinks. He thinks it’s a terrific idea! Anything that improves the condition of the patient on the operating table and makes their recovery easier would help them, him, and the hospital nurses as well. One nurse told me that the woman in the next room had surgery the same day as me, but it took three days for them to get her out of bed because she was so obese. I asked if he would recommend the course to his patients – and he said YES.

I’m designing the course now, and looking for a place to hold it.

Week Seven through –:

Here’s where this journey got really interesting for me. Learning things about myself I didn’t know. Like… taking real time off from work. I haven’t had a vacation in years. I realized that although physically I could have returned to the blog and the Participants (a warm wave to them) a few weeks ago, I wasn’t ready for it mentally. I needed time alone, just for me. To think, to read, to just… be. I finally gave myself permission to take it, and hopefully won’t make myself wait a few more decades to do it again. 🙂

Like… learning to use a body no longer crippled. I was so bone-on-bone in my right leg, my knee had turned in and had become deformed. Knock-kneed. My surgeon promised me two straight legs after surgery, and that’s what I have. Re-learning to walk properly on them has taken some effort, and I’m not quite there yet.

Like… walking up steps without pain or effort, or doing housework easily, or just doing every-day things that most folks take for granted, but which I couldn’t do for so long.

Like… looking forward to fall, and wearing my skinniest skinny jeans. They fit last winter, but really, if there’s an uglier sight than a knock-kneed woman in really tight jeans, I don’t know what it is. I plan on wearing them and the collection of heels I kept, but haven’t been able to wear for years. Woo-hoo!

So I was there, and now I’m here and happy to be back with all of you. With hopefully lots more informative threads to come.

Have you had surgery? What were your experiences?

Thanks for listening to mine…

SugarFree