Happy First Birthday, Cliff, and Embracing the Pain

Cliff turned one year old on Wednesday! He's been such a blessing in our lives, and we couldn't be more proud of the job Rachel and Drew have done. They're such good parents, always so engaged with Cliff as he explores his world. He's been crawling for over a month and is developing strong leg muscles as Drew shadows him while he takes on the challenge of climbing stairs. Walking can't be far off.

I'm three weeks post-total knee replacement surgery, and to be honest, it's been a struggle. But this morning, I'm feeling the best I've felt since before surgery—markedly better. I also used a cane this morning rather than my walker for an appointment. I may be a little premature about the switch, but so far, so good. I think I'm still at least another ten days away from driving myself to appointments. 

Excessive swelling in my knee has been the main hindrance to my recovery, but it is also improving. Much of the swelling I was contending with was from blood building up in my knee joint due to an elevated INR value.

I'll try and explain. 

I'm on a blood thinner (Coumadin, aka Warfarin) for a clotting condition (Factor V Leiden). Coumadin has been used as a blood thinner for 70 years. It works well for controlling my condition, but it requires occasional tweaking to keep the level of the drug in my blood within a specified range. INR (international normalized ratio) is a blood test that measures the amount of Coumadin in my blood. The normal range should be between 2-3. I've learned over the years that the amount of the drug necessary to keep me therapeutic is dependent on how active I am. If I'm doing lots of walking and cycling, 80mg per week keeps me in range. If I change my activity levels, it will show in my INR number. The more sedentary I am, the less Coumadin I need. 

I had to come off the drug in the days before surgery to minimize the amount of bleeding during surgery and afterward. When I went back on Coumadin, I suggested to the person dosing me that we drop the amount I usually take because I'll be leading a primarily sedentary life for the foreseeable future. The person discounted my concern and advised me to keep to my usual amount. I did that, and it was a mistake. My INR reading shot up to 4.9, which Tammy said is a dangerously high value and one where a person with that high of a reading should avoid activity that could lead to an injury or head trauma. A high INR reading means it takes much longer for a wound to stop bleeding and to heal. (My INR reading this morning was 3.1—not quite therapeutic, but much better than a few days ago.) 

When we met on Monday with a member of the surgical team who worked on me, he said the excessive buildup of fluid in my knee was most likely blood from bleeding due to the high INR value. He advised me to go home and elevate my leg while icing it. He also commented that what I'm experiencing in the way of post-surgery complications isn't uncommon for someone on a blood thinner.

I've begun doing my strengthening and range-of-motion exercises again. Even though the stretching is causing me a fair amount of pain as I try to improve my range of motion, I accept the pain and see it as a necessary obstacle to recovery as I work to regain my flexibility. I imagine riding my bikes again or going for vigorous walks as motivation.

A photo of my knee with the bandages removed. 

On a positive note, we were told the new hardware in my knee is positioned very well. 

I have to say a few words about the care Tammy has been giving me, especially in the first 10 days after surgery when I was weak and unsteady. She was there checking on me frequently to make sure I was doing okay, often getting up in the middle of the night to give me pain meds. Also, she's had to take on most of the typical day-to-day tasks I usually take care of. It's been a lot on her shoulders, and I am so thankful. Thanks, love! We have the best neighbors and friends who have been there for us, too! 

I decided to jump the gun on purchasing a new replacement laptop for my 7-year-old MacBook Pro, which has been showing signs of age lately with more hesitation than usual, with some web pages taking a frustratingly long time to load. I bought another MacBook Pro, which is more than I need, except when messing with video files. My old laptop is still fine, and I'll occasionally use the Windows side of it, but it's mostly retired now. The thought of Trump's plan to start a tariff war prompted me to move on to the new laptop now rather than later when I might have to pay significantly more. 

The video below is from a little more than a year ago. I hear the conditions along the river trails are fast and fun. I'm a little bummed to not be in the mix, but I hope my day is coming again before long. 

That's all I've got.