Home Health Care

A home health care agency contacted me the morning after I returned home following each surgery and I was visited by both a nurse and a PT either that day or the next. The nurse looked at my vital signs, temperature, pulse, blood pressure, and oxygen level and checked my wound’s condition. She would return several times a week for the next two weeks to monitor my condition, making sure my basic needs were being met and that I was as comfortable as possible. 

When the PT arrived, she checked my pulse and blood pressure and then began my exercise program, which took at least 40 minutes to complete. At our first meeting, she gave me an illustrated guidebook of exercises to perform. The routine included the following, see link, Prehab Exercises

•  Heel Raise
•  Knee Lift
•  Knee Push/Thigh Squeeze
•  Straight Leg Raises
•  Quad Strengthening
•  Heel Slide, Bed

•  Extension Leg Stretch,
in Chair and with Belt
•  Flexion Leg Hang
•  Knee Bend
•  Sitting Knee Bend 
•  Sitting Knee Bend Slide

Each session concluded with a measurement of my flexion using the dreaded goniometer. Despite my best efforts, my flexion did not improve much over this period and remained essentially what it had been at my discharge from the hospital.  Given that my left knee had been seized for several years prior to surgery, I had to accept that the 109 degrees reading I received at my two week post-surgery appointment (discussed below) was about as good as it would get. My right knee flexion was about 10 degrees more. It is only realistic to acknowledge that people differ in the elasticity of their muscles and other soft tissues above and below the knee joint and the hardness of their knee capsules. Because of the compromises I had made over time to accommodate the degeneration of my knees, there were other weaknesses in my legs as well. At age 72, I was not going to regain the legs I had at 32 or even at 42.

My home health care PT continued to supervise my exercise sessions, visiting three times a week for two weeks. I always enjoyed these visits and looked forward to her support.

Returning to my own PT after two weeks brought more exercises and hands-on manipulation that addressed other leg and lower back issues. Honoring the concept that new knees are not plug-and-play that they exist within the environment of the entire body, we began doing exercises that strengthened the hips, glutes and ankles. We also worked extensively on balance. Each leg presented its own unique set of problems and all of the exercises I did over the following six months are described are described and illustrated in the Rehab Exercise section. Later on, I also met with another PT who used Soft Tissue Mobilization techniques to gain a few more degrees of extension and flexion.