Six Months today since surgery

I am now resting watching catchup for the Barbarians against Argentina, remembering my days of refereeing, after my normal 2 plus mile dog walk in the morning and then collecting a running machine for Catharine and me to continue to improve our fitness.

Back in September racing on my yacht.

As for my left knee all I can say is that it is great thanks to Nordorthopaedics and to Jen at Anglesey Injury Clinic. I now find myself trotting downstairs and generally pain free; although the right knee is not aligned at all well with the cartilage in the natural part of the partial knee replacement from 2015 having completely failed. With the strength now in my left knee I feel it is sufficient to delay my decision for the replacement of the partial right knee for a while.

Having made that decision I was a little concerned when I twisted on the right knee this morning and I got shooting pains for a while! Hopefully this won't require a change of tactic!

A selfie of my knee at a comfortable angle today

It is very difficult to remember how things feel as your body acclimatises to its new situation but I now feel sufficiently energised to get things done which I seem to have ignored for the last 3 years. The clicking which was very noticeable after surgery has now pretty much disappeared and almost all the swelling above the knee has gone. I have now got pretty good flexion with the knee and I can kneel down although my brain still says no!

Jen has been helping me to get various muscle sets back to functioning and to retrain my walking gait stopping me from hitching my left hip when swinging the leg forward and last week I restarted pilates with one of her groups. The biggest problem I had was the retraining of my gluteus maximus which had been giving me constant pain from the lower back down to the ankle, that too has now all gone.

When I first got back to the UK I used to catch my foot on the bed covers and have significant issues with getting in and out of bed. This problem of a pull sideways on the knee has now subsided; again I am not sure when this went away but probably over the last two months.

With the yacht now being out of the water for maintenance over the winter I have to climb up ladders to get onboard and I now successfully use the car as an access to the transom ladder to get up onto the swim deck; this I would not have been able to do before the operation that is for sure..

With my regular morning walks with the dogs I have to climb and descend the face of some sand dunes, before the operation I had to reverse down and could not walk up the loose sand but that too has all changed.

I am so lucky to have been able to get to Lithuania to have the treatment at Nordorthopaedics even though my claim for this expense to Betsi Cadwaladr University Health Board under EU56 has been refused even after waiting over 4 years to have the operation. My thanks go to all involved in this process.

View of Cymyran Beach

11 Weeks since the operation

Yesterday was the 11th week since my operation. The movement in the knee is still improving although frustratingly slow progress with some days much better than others. This week I have been aware of a dull ache in the left hip after getting lower back pain when I bent over weeding in the garden. I have arranged another session with my physiotherapist for this coming Friday.

Almost every day I continue with my exercises and sessions on our home spin bike. I can now walk the dogs down the beach for a couple of miles without any problems although my fitness levels are still well below what I would like. I try to walk quickly varying the pace so that I can raise my heart rate, things are getting better.

Still finding walking downstairs at times a bit of a challenge but after exercising it does seem to be easier. The left leg swelling seem to occur if I stand and don't move very much but when I am walking it doesn't seem to swell.

8 week anniversary

Hi all

Today is 8 weeks since my operation and here is a quick update on how I am getting on.

In terms of residual pain I can say that I am able to walk downstairs with each leg normally with very little pain but it is much better after Catharine has massaged the area immediately above my knee and I have completed my exercises. The major area of residual pain is on the outside of my knee cap which changes throughout the day. I still get very tired but I am conscious that I am only 8 weeks in and that I am really very mobile.

Last week I managed to get out for my first race on my yacht! Note that I am in a leg elevated position while helming!

Yesterday I went for a 3 mile walk which included this particular challenge. The Afon Braint stones on Anglesey.

Here is the comfortable angle of movement as I drive my van
















So all in I am very content with my progress and have had an initial discussion with Jurate about the right knee replacement for the now failed partial.

5 weeks since the operation

Wow doesn't time fly... even with the recovery, pain, lack of sleep things are moving at an increasing rate.

This week has seen significant improvements in my mobility, I now walk happily without aids, although I do take a walking stick with me on longer walks but it is a prop not an essential. I am now sleeping better; we're up to about 3  to 4 hours rather than the 2 hour sessions but I am feeling less tired during the day. I notice that on getting out of bed in the morning the knee is stiff with a fair amount of pain but as I move around this decreases and the flexibility increases. After doing my exercises the I am able to walk downstairs normally without pain or support.

I have moved my bicycle on its stand onto the balcony so that I could attempt cycling. Currently I have the saddle at its highest possible position and I have been doing 10 minutes on the bike then 10 minutes of icepack.

Since the operation I have noticed clicking in the knee but when Jen has manipulated the tendons this goes away for a while so I am happy that this is purely an issue of recovery. When doing my exercises there is a noticeable pain on the lefthand side of the knee cap, or what ever is there now, this is a sharp pain when doing the extensor exercises this materialises at various times during the day but goes away if I massage the area.

With my improved mobility I am tending to sit or stand more and this is causing swelling in the ankle so I have to take heed and sit with my leg elevated to mitigate this.

I have been keeping up with the posts on the Facebook page adding in posts or comments to support others; it is a fascinating thing to get an understanding of how other people are feeling and coping with their recovery. I am sure this is a significant factor for people in the pre and post operative periods, and a positive aspect of Social Media.

This last week I have been down to see my yacht which my crew took round to Pwllheli to be lifted out ready for some hull maintenance. I was able to climb the ladder to the gunwale and get around inside the yacht. Yachts are very good for moving around post operation as there are handrails everywhere! During the coming week I am planning to go and anti-foul the hull and prepare for Flair IV for the IRC Welsh Championships over the weekend of 17 - 19th August. I will only take part if the weather is reasonably calm though.

I am now noticing the pain in the right knee more and I am moving towards planning the next operation to remove the failed partial replacement from Feb 2015.

1 month since the operation

It doesn't seem that long but progress continues. I am still not sleeping more more than a couple of hours although the feat of lying in bed is now not painful as such, just a low constant ache. 

The wound has healed well assisted by Catharine's massage with Bio Oil and after a period of itching it is now good and flexible although the knee remains swollen especially above the knee. Most of the pain has gone from the calf although there is still residual bruising and soreness in the thigh. If I spend too long on my feet the leg does swell and it takes some time to dissipate so I have to make sure that I don't over do it. 

I have been going to Anglesey Injury Clinic on a weekly basis for her guidance, leg massage and amendments to my physiotherapy regime and today's session was good. Jen says that she is happy with progress and I now have almost the same flex as on the right leg. I asked her about elevating the leg while sleeping and she confirmed that it is good practice and that the calf should be tipped towards the heart...  

After 4 weeks the frustration of continued limitations to what I can do does become a little overbearing but generally I am keeping in a good frame of mind. I find concentrating on anything for long is a problem, my mind wanders and I find it hard to pick up my thoughts. My exercise regime does causes some grief, generally manifested by sharp pains appearing to be from the inside of the knee joint, so I limit these exercises to shorter sets and then do the next set after a rest. I am still taking painkiller tablets, aspirin, paracetamol and caffeine at 4 hourly intervals, when I remember. Jen has now suggested that I should reduce these during the daytime to increase their effectiveness overnight.

Yesterday I started discussions with a solicitor about the claim for medical negligence due to the choice of the partial replacement on the right knee and the subsequent delays in the surgery to the left knee with this contributing to the early demise of the partial replacement. Along with the refusal to send me out of area or to put me under the care of a pain clinic even though I was on the Urgent Waiting List since April 2017. 

Yesterday I could not countenance the prospect of the second operation on my right knee but today after Jen's session I am feeling much better about everything again.

Some setbacks

I thought it would be useful to maintain a less verbose diary of the rehabilitation process so I am continuing this blog, as much for my benefit for the next operation as for anyone else who might find it useful. 

Thursday 19th July. 

Over the last few days my left leg has become stiffer and more painful so I arranged to go and see my sports injury therapist here in Anglesey. She advised me that the swelling in the ankle, the calf, the back of the knee and in the thigh needed to be massaged up towards the lymph nodes in the groin area, where the body deals with the material left by the healing process.

She, like Catharine, warned me against being too glib over the rehab from this surgery and she insisted that I keep the leg elevated more than I have been doing this far. So after her, quite brutal, massage yesterday late afternoon I have been resting and elevating more and again today I have spent most of the day taking it easy. 

During the treatment yesterday she manipulated the knee and was pleased with the slightly more than 90° flexation. I have continued to do my physio exercises and the knee is still doing ok but with some odd new pains. The problem I have at the moment is knowing wether the different pains I am experiencing are problematic or just different nerve endings re-joining. As an experiment today I have gone back to wearing my support stocking to see if this would help to reduce the swelling. 

The situation is still that I have to move regularly and not sit or stand for too long in any one position as I just get stiff. 

Catharine found this link on rehab expectations which makes for interesting reading. Generally I have exceeded all these goals.

Saturday 21st July

After two days of more elevated rest the swelling is no longer evident, except just over the knee, although the bruising and localised soreness continues in both the calf and thigh. Much of the pain I was experiencing before has dissipated but the lack of pain free flexibility is still a little frustrating. I only kept the compression stocking on for an 8 hour period on the Thursday and have decided not to use it again, for now anyway, as it made my leg quite irritable. 

Today I have removed the dressing from the surgery scar and all is well, although I am still struggling to sleep through the night and get tired quite quickly. 

2 weeks since the operation

I thought I would summarise the current situation as things seem to change on a daily basis. 

Today I go to my local hospital in Holyhead to get the staples removed. It was a problem for my local GP as they didn't have the correct staple remover and could not get one. Do make sure that you bring the staple remover back with you after your operation!

Over the 7 days since my last full day in the Rehab Clinic I have had some really good times and some not so good. 

Sleeping is a problem as I like to sleep on my side and this causes issues with the flexing of the knee. I tend to sleep in periods of about 2 - 3 hours and then have to move and stretch my legs. I now retain a pillow for support under my left knee when I am lying on my right side and this reduces the pain around the knee area. This morning was a very slow start... 

The temptation to do too much is an obvious issue. The stability of my left knee is so improved from before that I am forgetting to use crutches at all in getting up and moving round the house. I am not lying down with my legs raised enough as I am so keen to get on with things. I have thus noticed swelling at the ankle and subsequent stiffness behind the knee. 

I have been good at doing the physiotherapy exercises in full and this does make a significant improvement on my flexibility but then if you sit in a chair for too long without moving everything stiffens up; so I keep moving about as much as possible. I tried several chairs in the house and hound that the best was this one from the balcony! The mesh provides comfortable support without pinching on any of the painful areas from the buttocks down to the knee.

The left calf is still "tight" and slightly shiny although Catharine has made some difference here with massage.  The intense pain in the thigh muscles just above the knee is much less now and I can lift my leg from the floor onto a support without it being painful.

In terms of pain relief I am only taking the paracetamol caffeine (Tesco Extra Pain relief) twice a day once in the morning and once in the evening. Although this does not reduce all the pain it leaves me in a coherent and able condition to do other things; like driving... I have an automatic, right hand drive, so my left leg is not used in the control of the car. 

The pains that I have noted are varied and change on an hourly basis; I guess this is due to the healing process and nerves re-connecting. Of late, as well as the general stiffness and the background pain around the swollen areas of the knee,  I get sharp electrical like pains on the outside of the knee joint but these last for only a few seconds and are not associated with weight bearing. 

When I go out for a walk I do use both my crutches at the moment. However crutches are not so good in loose sand! 

Travel home

Pickup from UPA was dead on time and it is a beautiful morning with the sun shining through a light build up of cumulus mostly was shaded by the tall pine forest off to one side or the other as we head NE to Vilnius.

Every vehicle I have traveled in since my arrival has had the engine management warning light on... The driver spoke Lithuanian or German so we didn't talk much on the way to Vilnius and the back seat was a little uncomfortable as it wasn't long enough in the leg for me.

61 km to Vilnius crossed a railway line at a level crossing with very little in the way of warnings or barriers, not quite the H&S we're subject to in the UK... 

At that time in the morning there was very little traffic... Just straight roads and pine forest... By 0715 a river bridge spanned the  Vokė a left tributary of Neris. Aparently Vokė flows from Papis Lake, near Merkys and looks like a good place to go and explore. Traffic by now was beginning to build up as we passed large industrial estates with railway connection, hummm what a good idea, didn't we used to do that in the UK? As we entered the Vilnias area it was obviously getting to rush hour but we kept moving on the dual carriageways without a problem. 

We arrived at the airport around 07:30 leaving plenty of time to get through the airport processes. As it happens the plane had not arrived at the planned time and we were eventually advised that the departure would be 10:30 not 0930. It  actually took off just after 11:00

Seating on the plane: if you're traveling with crutches don't book the seat by the emergency exits. They will move you and row 1 where they put me has very little leg room!

Safely on the ground finally in Warsaw. There was a long way to walk to the baggage claim and I think crutches don't go well with a cabin bag and a long walk. Airport assistance is probably a good idea, especially for the way home after an operation!

Wizz Air are apparently famous for delays to their flights and this was certainly true of today. The flight to Liverpool was delayed for another 1.5 hours, this gave me sufficient time to have a relaxing lunch in the Restauracja Atmosphere near gate 9N. Chatted with some nice Polish people on their return to their home in the UK.

When the plane finally arrived I had texted Catharine to say we were boarding but then the pilot told us that we had around 30 minutes to wait until there was a slot due to weather conditions around Europe. 

Flight was OK but again legroom is a real problem for those who have had operations. I made efforts to manipulate my feet through to my thighs as often as I could but the plane was completely full and there was no real opportunity to move at all. 

On arrival back in Liverpool again it was a long walk from the aircraft to the border agency check and then a VERY long queue. When I finally got to the desk I was told that I should have used the wheelchair lane.... Why didn't one of the agents standing around idly chatting tell me this and save me a very long walk around those stupid taped queuing lines. 

Catharine was waiting for me having had to park in the multi-storey car park as the plane was so delayed and this cost her £10 instead of £3 for a pickup. The rest was easy, Catharine drove us home with not that much traffic as the England World Cup football game was on TV that evening. 

Home at last and time to relax after a meal cooked by Kat. 

A quick note on my visit to see my GP this morning, Thursday 12th.

I rang and got an early morning appointment with my GP as someone had just called in with a cancellation. I handed him the X-Rays and the note from the clinic in Kaunas and his words were "A beautiful Job!" and "Fantastic to have the X-Rays with the Patient for review". So full marks to the team back in Kaunas. However the nurse asked if I had the tool for extracting the staples, which I didn't so I rang Jurate and she is getting the necessary information back to me tomorrow. 

Onward and upward... Been a day of catchup on all sorts of things today, plus exercise, resting and more heat treatment on my knee. 

Last day at UPA

The start of my last day at this wonderful place UPA in Druskininkai I have not slept well with a significant increase in leg pain overnight. One thing I forgot to mention in earlier blogs is that the controls of the electric beds in UPA may be well hidden under the frame of the bed. So for your comfort do get used to how the bed moves and helps with your pain levels.

The morning sky is occluded for the first time since being here and it is a lot cooler. I went down and had breakfast with Declan as he prepared to leave UPA later today. It turns out that his flight to Belfast is not much earlier than mine tomorrow morning but I am not leaving till 06:00 tomorrow.

After my polarised light treatment at 11:00 I relaxed with a cappuccino sitting outside the restaurant while waiting to go to physiotherapy and catching up with emails and messages.

Today has gone quickly and although pain levels have been a bit higher than recently I have enjoyed the sessions today. In the Physio session Karolius worked me pretty intensively. After Greta had told me to use the lift on the way down to the Gym! She and Karolius had a good bit of banter before we got

stuck into his extensive exercise regime. Cryo was a welcome session straight after physio and then after lunch the massage was a great way to end my rehab here; he worked on my back and then some very gentle manipulation of my still very bruised leg. I am now chilling with a beer having paid my bill and got my online boarding pass sent to me. All I need to do now is get this printed!

After a lengthy relax making the one beer last for ages I had no problems with paying via debit card, having notified Lloyds that I would be here and making a couple of large payments. So that was a great relief. The receptionists managed to print out both of my boarding passes; I am flying from Vilnius to Warsaw then from Warsaw to Liverpool. 

When I say chilling that was before reading lots on the BBC News site about the Brexit mess. I know people have different opinions on this but I do recommend you have a read of this article if you can spare 5 minutes and your blood pressure is not already too high! 

I believe it is high time for a radical change to how our (undemocratic) democracy operates. I am certainly hopefully of a remain outcome where we can modify our destiny from within the EU without hard borders... 

That's it off to an early bed so that the 05:30 wakeup is not too much of a strain. I hope this blog has been of use to those who will follow in this wonderful service. 

Post op Day #6

A little sore after yesterday's excesses!

In discussion with Declan over breakfast we discussed how we had found that it was important to tell the masseuse what massage you want. They will just do back massage if you don't say anything. Generally you should speak to the team and let them know what you want in all respects of your care out here. They are very receptive.

In the first few days after the operation I had used much more insulin than I had expected and it seemed that I was going to run out, even though now my sugar levels have been relatively low; so I have asked receptionist if I can see the doctor. She said that she would get in touch and let me know later.

First of today's appointments was with Agné the technician in polarized light treatment so I apologised profusely for missing my Cryo appointment but she was very about it and my 10 minutes of treatment made me feel better.

At 1200, Greta, today's physio, who is a very  funny young lady took account that I had done too much yesterday. She made me laugh a lot while doing exercises which didn't help but it was less strenuous than yesterday and I felt good after as I moved to Cryo to see Agné again. Now a short relax in the atrium before lunch.

The doctor at UPA

While chilling I saw the doctor talking to the receptionist so I walked over to talk to her, she asked me to show her the insulin I needed so that she could write out the prescription for me. Declan joined me for lunch and we were just talking about his prescription, discussed with the doctor this morning, when she came over to us and delivered our medications to us.... Service second to none.

My massage today was with a different masseur and again it was brilliant. I have had shoulder problems, restricted movement for ages, since I fell on it when I slipped and my right knee gave way while walking the dog last autumn. Jen (Anglesey Injury Clinic) has treated it several times it has been worse since the op so I explained what my problem was and he did a really great job. However this afternoon I have felt a little tired and a bit low and so have not done a great deal except rest. Maybe this is a result of being some 6 days after the operation. Declan felt the same sort of thing yesterday. 

Tomorrow is my last day here; I am being collected at 06:00 on Wednesday and flying back via Warsaw to Liverpool, a bit of a long way round but I should be home before nightfall on Wednesday. 

A walk in the park

As it's Sunday and I have no other appointments this afternoon I decided to go for a walk. The session with the physio this morning gave me the opportunity to check if it was normal to have a click or two in the new knee. I just wanted reassuring. He checked and said it was ok and  was likely to be a tendon reasserting it's position! He didn't consider it to be a problem. 

So after a very trying session using this interesting piece of kit which Penrhos Stanley Hospital in Holyhead could definitely do with... 

Karolis, the Physio made me suspend my ankle in a strap hanging from the red rope, the lower part of which is bungeecord. Then he asked me to replicate leg movements as if I were cycling. You have to push down with the leg to avoid the rope going slack, well that wasn't too bad but then he asked me to reverse the movement so in effect cycling backwards! This was more difficult in terms of brain activity than leg problems! 

So I was so exhausted by this and the other exercises against the wall frame that I forgot to go to the Cryotherpahy! Arghh! After resting and a bite to eat I set off on my walking challenge for day 5. 

Turning right out of the entry road to the centre I walked past the point where I took photographs yesterday, a sluice where the river runs under the roadway maintaining the level of the lake. From here the road climbs to another new rehab centre Eglės sanatorija, Druskininkai. I followed the path round the lake edge and then climbed up an unsurfaced vehicle track into the woods. 

Armed with my phone and google maps I had established that there was a footbridge of some kind a mile or so up the path. Soon I had returned to the banks of the river as the vehicle track disappeared. The views across the river valley were very peaceful with waterlilies and the rustle of leaves in the wind. As I left the lake further behind the valley narrowed and the forest was sufficiently dense as to not allow any view of the buildings beyond the horizon. 

Still no sign of the bridge or anyway to cross the river and checking my phone I could see it was yet some way off. So I rested for a while before continuing the challenge. The path was undulating with lots of hazards in the way, undergrowth, fallen pine trunks and general plastic litter; should have brought my litter picker not the crutches!

At last I could see the river crossing as a couple of cyclists passed on a metalled track. I sat in the shelter by the river crossing, a culvert rather than a bridge, while I watched the dragonflies flit around in their bright blue livery.

After a short stop I checked the way from the other side of the river and noted that the track continued roughly perpendicular to the river and I needed to follow the river back to UPA. The path on the southern side of the river was less visible, passable and even more undulating so it took quite a lot of careful navigation of crutches to ascend and descend the slopes where the tree roots ran into the water's edge. The further along this rough path the more wood ants I saw along with a few newts here and there. I was a little concerned about getting wood ants lodged in my compression stockings! And then yes there was a wood ants' hill. 

Because of the swelling of the left foot I had no choice but to wear my crocs as I couldn't get my new boat-shoes to fit over my left foot. So with the ants and the forest debris my feet were taking a bit of a hit...  But having checked my GPS position I could see that I was now pretty close to UPA and the buildings finally came into view. 

The end of my firth day walking challenge was in sight and I made directly to the bar to taste some Lithuanian beer! Į sveikatą!

A great afternoon here is Druskiniskai

Post Op Day #5

A reasonable night's sleep but i remember getting up for a pee twice. My thoughts have turned to why I am constipated. I am not feeling any pain just aware that I have not been since the operation. I read this article: Constipation after Surgery.

With regard to the operation itself and my recovery the swelling is far less this morning. If I lie in bed with my laptop on my thighs and my legs straight, the left knee aches; the advice is to keep the leg straight as much as possible but I have used a small cushion under my knee, giving a slight angle of flex, to avoid the pain. The alternative is to sit in the chair and use the cushion on my cabin bag as a leg rest.

It is 06:30 now and the sun is breaking through the trees outside the window of my room which is at the eastern end of the building. I will get on with my first set of exercises soon and prepare myself for the appointments of today, which are all packed into the morning. Breakfast is available from 08:00 in the restaurant and I will catch up with my colleagues then; Alan is leaving today although still in a wheelchair.

Back from breakfast having wished Alan well for his return to the UK, I've done my second set of exercises on my own and it's now an hour before massage: kind of the wrong end of the schedule.

Polarized Light Treatment

The massage lasts about 20 minutes and then my appointment for the polarized light treatment. This lasts only 10 minutes of actual light treatment but the staff take off the bandage and then a nurse comes to check on the wound, clean it and then re-dress it. IT is fantastic to see how this is all co-ordinated. 

5 day old operation scar

I then returned to my room to change from robe to shorts and loose fitting shirt required for Physiotherapy and still had time to go to the restaurant bar for a cappuccino. Unlike the coffee from the breakfast bar, or things you get at the bar like beer and speciality coffees you pay cash. Here I heard an English speaker talking to the bar staff so I butted in only to discover that he, Lars, was actually Norwegian. He spoke such good English that it was very nice to sit, drink our coffee and chat. One of the great joys of traveling to unusual places is that the people you meet are generally very interesting and hold remarkably similar views on life and the universe!

Now it was 11:55 so Lars and I finished our drinks and I went directly to the Physio room for my session which was pretty intensive. So much so that I completely forgot to go to my Cryo appointment. Will have to apologise when I go tomorrow! I had returned to my room and had a rest before going down for lunch. The cappuccino had spiked my blood sugar level a bit as it was the first milk I have had since the operation. 

I enjoyed my lunch in the open seating area, to the outside of the restaurant but then took up the physio's challenge of circumnavigating the 'pond' as he referred to it. It is actually the river valley running through a section of pine forest. See separate blog post. 

I made it back but I don't recommend anyone having surgery to take on this challenge so soon after their op! I was pretty knackered by the time I got back so I sat down with a beer and was shortly joined by Lars who had driven to a local cafe near the river about 5km away for lunch. He thought it was well worth a visit. He is here having a break and visiting friends in Vilnius.

Some more thoughts on things to do before travelling: 

• Make sure you have European roaming data; I did this as I had learned from ages ago that you can get charged lots extra. The coverage of 4G+ is very good unlike what we have in the rural areas of the UK. 
• Have an amount of small change/5€ notes etc for coffee, beer etc.. 

I rested again before dinner and then sat with Lars before he went of to ride a local cable car to view the sunset while I returned to my room to complete my blog of the day.. 

And as a final note my constipation ended this evening.... So that was a 5 day situation and all is well now. Hope that is not a TMI moment... Lol

Post op Day #4

Yesterday's entertainment had sucked the energy out of me and I had fallen asleep but woke at around 0330 with the swelling in my thigh being quite uncomfortable. 

So I did some early exercises then returned to bed and read the latest emails and messages from the UK. This encouraged me to do some work until the internet went slow at around 0630... 

Back to Spotify on the headphones until 0800 when, as arranged, I called the nurse to fit my compression stockings.
This I hate as I have very ticklish feet! Still success without too much wriggling and down to the restaurant for breakfast. Breakfast here is pretty continental and mostly the options, of which there are many, are labelled in English for us non Lithuanian punters.


I haven't met anyone else from an English speaking area and I have been listening to try and locate any. I guess I'll ask at the desk later. This morning's schedule is 11:00 Polarised Light Therapy in room 116 so that's on the ground floor followed by Physio in 111 at 12:00 then back to 116 for Cryotherapy at 12:40 and finally Massage at 15:00...

Even after the medication for constipation last night I am still having problems but maybe this is because I haven't eaten much fruit since the op, this morning I have had some plumbs and a peach...

Some things that might help people coming here are:

1. Useful Lithuanian phrases
2. When in rehab to wear your gown rather than clothes
3. How to find other english speaking people in the rehab centre
4. Suggested walks and their difficulty, distance
5. What to expect from the restaurant
6. Avoid confusion over where the clinics are

I'm now in the polarised light treatment having been complimented by a very good English speaking nurse. I have 10 minutes under the lamp and then a change of the dressing. I put my door card in my gown pocket but as I got up to go it cracked in half. Arghhhh. It wasn't a problem I just went to the main reception desk and they programmed another one for me. Now I have a short wait before the physiotherapy appointment.

The physiotherapy department is on the ground (1) floor and the young therapist called Karolis also spoke very good english but was surprised that I was walking so well and advised using at least 1 crutch for now. We went through a number of exercises most of which are the moves Jen has taught me in Pilates although he thought the exercise of lifting the knee, then bringing the heel up to the same level before straightening it was overboard and felt I would be better with two separate exercises, heel slides and straight leg lifting. After about half an hour of individual discussion and treatment he let me go so then off to Cryo treatment again on the ground floor. This was with the same "lady of the lamp" from earlier and she advised keeping my robe on for this session. So Cryo is being blasted with cold air over the area around the operation. It reminded me of sailing in the Baltic in the winter! Actually though it was great and made the swollen area a lot less uncomfortable.

Now I made for the reception desk and asked if there were other inmates from the UK. It appears that there are two both in rooms very close to mine so I called in to have a chat with Declan who has had a hip replacement and comes from Northern Ireland before I took a bit of a break prior to going for lunch where I met up with the other UK  national from Scotland, I Alan. We had a lively chat over lunch and then went for a wander round the facility, Alan had also had a hip replacement but his had proved more complex and he was in a wheelchair. Both these guys are scheduled to go home tomorrow but Declan may be delayed due to his pain levels.

It was hot outside but the shade from the tall trees encouraged me to go a little further and I took a 360 view on my Google StreetView app of the facility.

At 15:00 I was due to be back in for a back massage but I had misread the timetable which indicated 111-IV where the other schedules had 111 or 116. The Massage parlour is on the 3rd floor not the ground floor! So by the time I had discovered my error I was about 10minutes late arriving. Not a problem though and I was treated without further delay.

The efficiency of how this whole thing operates with a seemingly low level of staff is quite amazing. Each staff member seems to be working consistently, checking in on one patient, doing a specific task with another and so on.. There are no queues of people waiting to be treated and it all feels good.

I joined up with the other two Brits for dinner and watched the second half of the football, there were some disgruntled faces in the restaurant workforce who were obviously rooting for Sweden. Still there was considerable interest in the game and the restaurant was pretty full. I tucked into the salad and the pickled fish again avoiding eating a great deal but my sugar levels are stying down now at around 6.7 so something is working. Back in my roof after another walk around the building, on my perambulation I saw a Saab with a UK registration plate!

Post Op Day #3

Gosh it was humid overnight and there seemed to be a motor bike festival going on! Some very loud racing about! Anyway with the help of headphones and Netflix I managed to make myself sleepy enough to doze off.

I woke at around 5:45 with the sun bursting through the window and decided to make a series of video clips of my exercises for prospective TKR patients to see how I am getting on. I haven't done any video work for ages and quite honestly I don't think I am cut out for the media industry! Maybe that is why my attempt at becoming an MP failed!

So I video'd my pilates leg exercise and then got up and added in the exercises required by the physiotherapist and finally, especially for Jen at Anglesey Injury Clinic, a freestanding pilates exercise. Now came the interesting bit the video editing.... how this has changed over the years!

With iMovie and QuickTime I managed to get something passable so I am now waiting for it to upload to YouTube. Quite a way to spend the early morning while I had some of my pizza from last night as breakfast! Still only managed to get through half even with help from the night nurse!

Here is a video I have made for those who are considering coming to Lithuania for treatment with Nordorthopaedics.

 


My blood sugars are still monstrously high at 15.4 this morning and I am still constipated, which I experienced last time I had knee surgery with the spinal block. Having asked the new day nurse for some meds to help me out in this regard she has just brought a MicroLax container to me but I the instructions are not in english! I will have a quick look on the internet!

I had forgotten to bring extra insulin with me so I am going to be short on Lantus and Novo Rapid. I will try and resolve this through Jurate via email.

Juozas called in to check on me for the last time before I go off to the rehab centre. I said he can expect to see me back in November for the right knee... He is off playing golf today as it is a Bank Holiday here, the anniversary of Lithuania's only King on July 6 of 1253, Mindaugas was crowned as king which gained Lithuania its worldwide recognition. My dressing was then changed and I was introduced to the driver who helped me with my luggage down to his car ready for the drive to Druskininkai.

11:30 I am now in the UPA Spa Hotel my room is not yet ready so I am having to wait in the atrium for about 20 minutes which gives me enough time to get re-connected and sort out various bits and pieces.

Had a great drive down here with a very nice young man, it was my first trip in a hybrid car too. The countryside is just the same from start to finish of the drive, open fields with no fences, sections of woodland interspersed between the fields and rivers.

Very rich agricultural land with a few grazing animals here and there with the odd stork's nest on electricity poles or tall chimneys. Of course after I had seen several and failed to capture the pictures I saw the nest on the top of this chimney.

The driver dropped me off at UPA Rehabilitation Spa and helped me in with my bag to reception. There were some forms to complete at the desk and like all these first arrival times you need your passport number. Of course I had packed mine this morning... My room was not quite ready so I was asked to sit in the large atrium area until it had been prepared. This gave me the opportunity to get my internet connection sorted out and to let Catharine know that I had arrived.

The building is very impressive and the atrium is a lovely area to sit and chill but I didn't have to wait long before I was escorted to my room, at the end of the corridor on the second floor.  With views over the courtyard down to a stream.

For my 16:30 appointment with the Massage I got kitted up in the robe and the slippers and with the piece of paper which has my schedule on it I walked up one flight of steps and across the atrium bridge to get to the Massage Room. It was a great 20 minute massage and the young man providing the service was effective in relaxing my back. From there I went back to my room and fell asleep for a while. Now I am up and about and going for a walk in the grounds to have a look around, maybe pop in to the restaurant and check out the menu.

Back from dinner in the restaurant, I sat outside in the lean-to. It is a sort of help yourself layout and the food is good and varied with everything from steamed vag to salad and pickled fish, which I had.With all the entertainment today my leg has swollen a bit more so I am now resting with an icepack but given strict instructions to take it off after half an hour...

Post Op Day #2

Had a good night's sleep and woke up at around 06:30 feeling ready for the second full day of recovery. The night staff nurse was called Diver which apparently is a common name here. Anyway like all the staff here she was really nice and efficient at keeping me comfortable with ice packs and pills and before she left her night shift she brought me my first coffee of the morning. 

Next excitement was to deal with the Holyhead Sailing Club results from last night's offshore race; the results had been input by Cogger Jones and some photos posted by Sue Powney which enabled me to put an article together on the website before I was treated to my now normal breakfast of sausages in crepes, with the second cup of really good coffee. While I was having breakfast the fire alarm went off but just a test I guess as no one made any move to do anything. 

I went looking for a shower room but have not found one yet. I will ask in a bit as my bed is just being changed and the room cleaned while I was having my dressing changed. It turns out that the cleaning lady's name was Diver too! So there are no showers in this unit so I will just have a wash now and then shower at the Rehab centre tomorrow. Next I am expecting the physiotherapist to drop in.

12:30 and the physio has just been checking on my exercise regime. She's pretty happy with how my movement is getting better. Right now I am feeling a bit tired, not sure if it was reading about the disastrous EU Copyright Legislation or my physical state but I am now lying down for a bit of a rest; although lunch will be along soon. Throughout this period my blood sugar levels have been high, probably caused by the lack of exercise or the medication or a combination of all of these and the sausages and crepes that I had for breakfast. I have increased my insulin (bolus) over the period but I am still seeing figures well over 10 which I am uncomfortable about.

Lunch arrived and it was tasty but I think maybe the salad dressing was too sweet. Feeling even more tired now so will go for a sleep... 
Been dozing for ages but still feeling very tired. Enjoying my Spotify reminiscing of favourite old music. 

This afternoon the physio checked on me again but I was sleeping so she left me till around 16:00 and then she marched me round the clinic down to the ground floor and back. She was giving me stick as my left foot was too straight and she wanted it to turn outwards a little. 

At the end of her shift the day nurse gave me a hug and wished me well as she won't be in tomorrow, it's a bank holiday here! Lovely lady and I've told her I will be back soon for the right knee. 

As I said earlier my blood sugars have been a bit high so it was a bit of a shock when the evening meal arrived. I had ordered a small pizza in the hope that it would not be so full of carbs and sugar.... but this is what arrived. I've had to invite the whole clinic to come and join in! Well maybe I can have some for breakfast!
I checked with the night nurse where it was that I was going tomorrow for rehab and she showed me on Google Maps: Liskiava Country House, Vilkiautinis Liskiavos 15, Ricieliai Druskininkai, which looks really posh!

More tomorrow... 

Post Operation Day #1

Labas Rytas!


Didn't manage a great deal of sleep due to cramp like pains in left leg but after intervention of one of the night staff and another pill I got a short but good sleep. The surgeon came to see me at just before 08:00; they work long hours here! He was very pleased with my posture on the new knee. I have asked him to bring me his business card so that I know how to spell and say his name.

It is another grey day but dry this morning, it rained most of yesterday and overnight but now it is dry and brighter skies to the east. My window faces NNE with views over the rooftops to some large retail outlets. I found out today that my MOTO G5 does not have a magnetometer so all the compass apps are useless. I was checking which direction I was facing to wite about this so had to rely on the fact that on Google Maps the McDonald's that I could see was to the north of my geographic location. With this change in the weather I note that my hay-fever has dissipated!

Breakfast was fun, again a Lithuanian favourite sausages in a crepe. 

The coffee was PROPER stuff, an espresso and very tasty so I asked for a second cup... Not a problem out here. Now at 11:00 on my third cup!

My blood pressure was tested and it was again well within range as was my temperature. All seems to be going well. 





After enjoying my breakfast I did some research on Rosenthal and Barbanell, the original name I believe the family had, in Lithuania; there are some very poignant similarities to the problems of radical religion with today's events. More of that another day. 

I had a good long chat on the phone with Catharine and that was reassuring; her efforts  on dog walking early in the mornings while I am away are good to hear about. The call was interrupted by the nurse who came in at around 10:30 to remove the dressing and check over the incision. She seemed pleased with the look of the operation area, cleaned it and put a new simple dressing on. 

Next a cleaning lady arrived and was very thorough at cleaning the room. I am expecting the physiotherapist shortly. 

Adjustable Walking Frame

11:30 just finished my first session with a charming physiotherapist, she made me walk the length of the unit and out into the main corridor. She was pleased with my handling of the crutches and explained about many things which I will no doubt forget before she comes back this afternoon. Back in the room she got me to use the adjustable walking frame to step up and down first on one leg then on the other. Then to stretch one and then the other leg forward and then backwards to stretch the calf muscles. Then to lift up onto my toes and then back on to the heals. Thanks to Jen and her Pilates classes this was pretty easy for me. The pain levels are nothing to do with the knee now just mainly the thigh muscles and she showed me to self massage the thighs from the knee up to the hip. 






Labas Diena

My Surgeon, Juozas Belickas called in again this afternoon shortly after I had, under the scrutiny of the physiotherapist, circumnavigated the building, down one flight of stairs and up another and along the corridors. He was very please to see how I was progressing and he gave me his card. I asked him how long I should use the crutches and he said it was down to me but he would expect me to use them for up to a week or so; whereas the physio had suggested 1 to 2 months... A bit of a variation. 

!7:15 I have just been for another short walk and done my regular exercises. On the way out from my room I was introduced to the nurse's 3 daughters who spoke very good english. They had come to see their mum at work after school. Next excitement will be dinner. I am expecting the menu soon. 

The menu is obviously from a local Italian restaurant full of pictures of pizzas but it also has pictures of local Lithuanian food which I will be choosing soon. 

So I chose the pasta with prawns apparently another Lithuanian favourite... 

The meal arrived at around 19:30 and was very tasty so now I have retired to bed as I felt my leg was getting a bit swollen from standing and walking too much. 

Juozas Belickas popped in before finishing work at 19:45, an early night for him! He informed me that I would not be going to the rehab clinic tomorrow but on Friday, not sure why but I am quite happy here. He then organised the new night shift nurse to get me an ice pack. So its back to Netflix now to get on with La Forêt... gripping!

Talk to you all tomorrow.