BOTH KNEE JOINTS REPLACED

On 13 Feb 2017, at Calvary Hospital, Canberra.

In early 2016, I realized that the accumulated problems I had with both knee joints
could lead to a wheelchair existence. I was able to ride a bicycle, but walking 200M
was so painful I avoided all walking beyond limping around at home. 

Many ppl's knees are genetically determined to wear out sooner than later.
Mine sure were, and I'd spent 32 years in the building trades and I was forced
to change to the easier trade of "electronics doer" because ladders and barrows of
concrete finally crippled me. Between 38 and 44, I cycled for 6 years in a club which
seemed to make my knees better if anything.
 
In 1993, there was a bad recession in ACT, work became scarce, so I did whatever
was available. In 1993, I repaired a tiled roof on a 2 storey house over a 2 week period.
Carrying buckets of cement up a long ladder caused knee pain and swelling for a month.
The acute symptoms eased, but I could not do any building work again. Doctors told me
I may need a future knee operation, the X-rays looked terrible.
Knee joint replacement operations were a novelty, and I was considered too young and
not quite crook enough to get new knee joints.

During my time off work, I renewed an interest in hi-fi gear and began to build amps and
get serious about study of it all. By 1996, I was able to make complete amplifiers including
all the winding of transformers and building test gear. I learnt to use a PC in 2000, and
started my website in 2001. I had a good 18 years in the audio trade until I retired in 2012.

Between 1993 and 2004, my knees got worse, and by 2003, I was on Celebrex and then
VIOOX by 2004. A surgeon wanted to replace my left knee, and do a 1/2 replacement in my
right knee. But I was still a bit too young to have such operations because the titanium
+ plastic joints have a life of maybe only 15 years. So in early 2005 the surgeon did a
double knee arthroscopy to trim damaged cartilage.
This was very successful because I had not yet completely worn out the cartilage.
The pain ceased immediately, so no more drugs, I could walk better, and stand longer,
and spend more time in my workshop, and even had courage to find a GF. That search
was fruitless, but love surely isn't everything in life.
In June 2006 I got back on my bike. But between 1993 and 2006 my weight had increased
from 82Kg to 102Kg.
I increased cycling distance to about 200km a week and soon lost 19Kg in 6 months.
My BMI went under 25, waist under 100cm.
The following year my resting HR went down to 50, and all this stayed like this until 2017.

On one February morning in 2008, at age 61, I cycled a favourite highway course of 52km
with about 400M of total climbs and I averaged 32.3kph. So I had become nearly as fast
as I was at 41 when I managed 36kph on a 40km flat course. The bike was the same,
made in 1988, and even now in 2018 its only 1Kg heavier than a carbon frame bike.
But the hospital had said in 2005 that I'd be back for replacement knee joints in 2 years
because the cartilage trimming was a temporary solution. 

My return to a reformed man did not last very long. In 2009 I was diagnosed in 2009
a very bad case of prostate cancer which was inoperable. Treatment was hormone
suppression, ADT, and later I had radio therapy. I also had a kidney problem that
needed a series of 3 temporary uretic stents over 2 years. My testosterone level went
to near zero and bike speed reduced 6kph average, and I lost interest in riding with
the local Pedal Power Sunday Wanderers. But I continued to cycle when I could,
and some weeks I managed 350km.

By mid 2014 I found walking became difficult. I had MRI and X-rays, and a surgeon
at a private hospital said I needed both knee joints replaced and cost would be $30,000,
plus "extras", and I would have had to wait 9 months, and that I would soon beg for new
knees. Hmm, I have rarely ever begged for anything, and I kept cycling.

In February 2016, I found the same surgeon I'd had in 2005 for the arthroscopy. He was
at the same public hospital, Calvary, at Haydon Drive, and in fine form. This surgeon said
BOTH my knees had cartilage thickness < 1mm. The report sheets for X-rays and MRI for
each knee were full pages of of words "obliteration", "abnormal", ruptured, etc,etc.
I'd have to get both knees done together. He was pleased with my general fitness levels.
Psa levels were low enough to consider Pca was being managed OK, so I could have the
knee op. I was able to ride a bike to nearly all my medical appointments.

On 13 February at Calvary, I had both knees replaced. The recovery in first week was
and painful and because I lived alone the hospital gave me 2 weeks of rehabilitation where
I could rest, but where weekdays were full of gentle exercises. It was just a wonderful stay
at Calvary, I felt very well cared for. And it also reminded me that compared to so many
others at the hospital, I was having a fine old time, because most patients had far bigger
problems than myself. All the costs of the the public hospital operation, and the 3 week stay
was entirely cost free. I had had to wait 12 months for the op, but I managed that OK.

The op was planned to begin after 10am, and after fasting since midnight on day before.
I was given an epidural and then anaesthetic and I woke up later in the day. There was some
pain, but bearable, the epidural remained active with a drip feed. I had reasonable knee
movement, up to 90 degrees, but it was much less than the 135 degrees maximum in both
knees I had when I arrived.

The amount of feeling and muscle control and bend depended on the amount of morphine
being delivered to epidural cannula into spine. The drip feed rate can be increased or
decreased, and it varies the height on body where I could feel hot or cold touch.
The height of feeling determines the amount of nerve control you have. With less morphine
the height fell and pain increased, with more morphine the height rose and leg pain reduced.
If the height was too high then it could affect lung function, so while epidural pain control is
good, it needed careful monitoring.

The epidural cannula and morphine drip feed was removed on morning of day 3.
Medications for pain were fed through cannula in left arm. I am not sure what all the
medications were, but Endone was the main one to try to reduce pain to levels felt
when epidural was in place.
Unfortunately, the Endone plus whatever else they pumped in did NOT reduce pain much
and I found the side effects intolerable at 5 days after the op. I suffered hallucinations, sever
bouts of tearful depressions while having a bleeding nose. My mind became addled, I could
barely fill in the daily mean menu and I could not use a lap top.

There was a chart on wall showing supposed progress of recovery after a single knee
replacement :-
Day 1. Operation.
Day 2. Begin physical therapy to prevent "scar tissue" forming which would restrict knee bend
and knee straightness.
Day 3 + 4. Begin more intensive physical therapy,
Day 5, GO HOME.

The only thing missing on the list was :-
Day 6. Pigs will fly.

This schedule may have been possible for a perfectly fit 50yo who had only one knee
replaced, so that the other good knee could do most of the work until the other caught up.
I know a guy who said it took longer, and that it was 9 months before he could stride along
with a good walking speed without pain, clicks, and limited knee bend.

The nurses changed pain medications to be based on Targin, plus 5 others, so I had less
mental dropout and no more hallucinations.
By day 5, PT nurses did get me up on a tall walking frame with wheels and slides and knee
bend was up to 80+ degrees.
It was unpleasant. It seemed like the knee joints were full of some highly viscous material
which limited movement. The PT nurses said it Material X, or scar tissue. Methinks that
material X is the hardened matter that has come from blood which may have bled into the
joint cavity contained within the bursar, or membrane that enclosed the knee joint.
But basically, the knee surgery makes the body react the same as a major injury and fluids
collect around the joint and become a highly viscous mess to prevent the joint moving
while the business of healing cut tissues and sawn off bones.
Hospital is not a holiday, and I feel patients are not told all the truth about exactly why good
knee bend is not immediately possible after the op. 

By day 6, my progress was terribly slow with poor ability to straighten or bend either knee.
I was moved to the hospital rehab ward where there were a total of about 25 patients.
Most were older, some younger, but all had far worse medical conditions.
I was just able to clothe myself and shower, and walk with a normal walking frame.

By day 8, I began 2 weeks of physiotherapy in 3 daily sessions, 9:30am to 10:30am,
11:00am to noon, and 3pm to 4pm.
I soon learnt to walk on a walking frame then using canadian crutches. Up to about 20
patients attended the earliest sessions, with numbers dwindling to maybe only 4 for the
late afternoon sessions. We were all expected to do repeats of stand and sit, leg bends,
leg extensions with and without weights. There were exercises of upper body with weights
or rubber stretch material.

I was the only one to attend all PT sessions and do more repeats than what was required,
and in the correct way described.
Some ppl could hardly stand from their wheelchair or move anything. 4 patients had suffered
strokes, some had dementia, some younger than me. Some had never done any exercise
during the previous 40 years, and had trouble lifting arms above their shoulders.
I witnessed the protests of many who tried every possible way to avoid doing anything
involving any physical exertion and to distract the PT instructors.

Remarkably, the PT staff persisted bravely, but did not become slave drivers, because it was
obvious 50% of those attending were never going to benefit much from the PT. Some had
been in and out of hospital many times, spending long periods in hospital wards.
Calvary did their best for me and all these other patients, and I am eternally grateful.
I tried hard to be cheerful and engaged with everyone I met in the hospital.

The exercise was good for me, and because I live alone and have few friends and no family
I can rely on. I needed to make some effort to be ready to cope OK when I was allowed to
go home. I am used to the idea of coping alone for most of my life. Being among such
wonderful caring hospital staff was the nearest thing I have ever experienced to being
happily married.

Monday 6 March. 3 weeks after the op, I was considered fit to go home. A pair of
Occupational Therapy nurses took me home for a trial run on the Monday, and brought
an over toilet seat, and shower seat, and to check if the house was in fact how I had described
it in the early admission paperwork. That visit all went OK. These young women were angels.

The food at Calvary was adequate to stop hunger. I was easy to please. In 3 weeks,
my weight reduced 3Kg, about 136 grams a day. I had irregular bowel function every days.
My shit had become dark green slimy lumps of toxic smelling junk. I asked the nurses if they
could sell it to freedom fighters in Syria in their terrible civil war. One gram of my shit sprinkled
onto Assad's bunker would have had him running out with white flag. Nurses were amused,
but stifled their laughter.

I guessed that the mix of so many chemicals killed off most of my good gut bacteria.

Pain control was by Targin, Tramadol, Panadol, Celebrex, Gabapentin, and Panadol Forte.
The Panadol Forte caused me to have a foggy mind; I would be nodding off asleep while
doing exercises during PT sessions. I suspected the Panadol Forte, and told them to stop
giving it to me. My mental brightness returned. All the other patients were being given
umpteen drugs, and some seemed permanently dulled.

Tuesday 7 March. I was allowed to go home in a taxi, and able to get about with canadian
crutches, and with 87degrees of bend in R knee, and about 105 degrees bend in L knee.
The 2 weeks of PT work had not hugely increased the amount of bend in either knee,
but had much strengthened many other muscles. I was given 5 days of medications for pain
and inflammation, but with all doses reduced by half. The Targin dose was only 2.5mg each
12 hours.

Wednesday 8 March. I had many things to do at home, so I was busy. And at 4pm I sat
in a chair and tried to measure just how much knee bend I had. I measured the same figures
as the physio therapists. My measurements were done using a builders tape
measure between centre points of rotation of Ankle Knee and Hip on the outside of each leg.
I won't bore you with the use of a biro to mark positions for measurements and the geometry.
But I was able to make a simple measurement between hip and ankle to monitor if I was
getting more knee bend.

All the physiotherapists and the surgeon insisted that I MUST bend the knee under pain, hold,
then release then repeat up to 25 times a day.

My left knee bent more than the right. But while doing the bends they said I should do, right
knee suddenly swelled up within 15 minutes and bend range reduced to 30 degrees. I got a
taxi back to hospital by about 4:35pm.
They said I'd done the right thing. An X-ray was taken, then compression bandage applied,
and the whole bottom of my right leg began to deflate.
I was given an ultrasound scan next morning, and they confirmed that I had no blood clots or
bleeding, but must have had sudden increase in lymph fluid escaping from its confines, or
with clear solution content from blood, and then filling up the skin bag of the leg.
I had been over zealous with stretch exercises. I was re-released back home on Friday 10 March
and with 3 more days of multiple medications. I didn't temp fate by doing many exercises.
Just getting around the house, shopping, driving, cooking etc was probably quite enough
therapy. It was technically illegal for me to drive. But when alone in life, you must cope.

Sunday 19 March. I finished taking all medications except Panadol Osteo. I tried spending time
swimming up to 30 laps of my 9 meter pool and doing stretches and water aerobics including
cycling legs in water 200 times per day to get legs moving and to extend bend range.
The water aerobics did almost nothing good at all.

Tuesday 21 March. Without medications, the effort of doing jobs around the house caused
moderate swelling and a reduction of knee movement. So since discharge from hospital I
found myself GOING BACKWARDS, with increased swelling and pain.

It seemed I had gone a hospital to get some improvement to life, but no, it was getting worse.

Before leaving hospital 7-3-17, I discussed the lack of knee bend with the assistant surgeon
at my op and he said no additional surgery was possible to extend the bend up to the
135 degrees of maximum bend mentioned in hospital brochures.
I explained how much more distance I would have to stretch the quad muscle.
It seemed to me I'd have to stretch the quad by +30mm.
I said I could not understand how the tendon, kneecap, and quad muscles worked OK
before the op, but not after the op. The surgeon smiled nervously, and I said I was a
gentleman. That meant I wouldn't hesitate suing the hospital rather than punching the bastard
so he'd have to contend with nose bend.

I thought they botched my operation. I assumed there SHOULD HAVE BEEN 135
degrees of bend possible when knee cap and tendon was refitted over top of femur metal
when knee is re-assembled before sewing up the skin. It seemed knee bend is impossible
because the joint is clogged with a mystery "substance X" and the quad muscle just will
not stretch.
The Internet tells me it is possible to force the stretch of muscle under anaesthetic,
but that seems likely to damage the muscle which may react by slowly healing to being its
former short length, and be terribly painful for months. There's a reason why doctors are
reluctant when an outcome cannot be fully predicted.

A friend whose wife had a hip replaced at Calvary during the last 3 years had a lot of trouble
with pain and dysfunction. She sued Calvary. The hospital lost because the lady's lawyers
were able to prove the pelvis insert cup was inserted facing in the wrong direction by 15
degrees, leading to her continual pains and troubles. The hospital lost their case, and were
whacked by a cost of $250,000. Most went to the lawyers and my friend's wife got $20,000.
The hospital fixed the problem. She is OK now.
But there would be no doubt the hospitals have professional malpractice insurance for
"shit outcomes", and the premiums keep the insurers wealthy, and I guess all is all paid for
by the taxpayer under Medicare, because I doubt the doctors employed by Calvary would
be able to cough up $250,000.

I wondered what % of hip & knee operations lead to permanent pain. Not all would sue a
hospital, even when they had a winning case.

Those nice amiable smiling doctors can begin to look like medical terrorists.
In one of the knee joint discussion groups online, someone had typed
"You will hate your surgeon for awhile...".

Wednesday 22 March. Calvary phoned meat 3pm to bring forward a follow-up meeting
with my main surgeon for 23-3-17, at 3pm. He would not be in town during April.

Thursday 23 March. I met my surgeon again and tried to be polite, and remained silent
about how shit happens and about legal challenges.
I wasn't very happy. The surgeon said I would ride a bike again, and that one day we'd
be laughing about it all. I had just come to the end of medications given to me when
left hospital, and I had considerable pain. I had reduced knee bend. He wrote me a script
for 20mg Targin pills, twice a day for 2 weeks, and he wanted to see me again on June 27, 2017.
I went away feeling sceptical. But at least I could drive myself around again.

Friday 24 March was busy. I saw my acupuncturist at 10am, and he set my anti-inflammation
abilities to maximum.
I've been seeing Douglas Godfrey since about 1994. He is the only well skilled
acupuncturist I know who was well trained in China at a time when there was a firm
socialist-communist grip on most people. Doug is not one of the typical fraudulent operators
in Canberra who applies some tingly electrical pad covering an affected part of body for
20 minutes. He knows where the "chi" points are, and easily finds them, and applies a
laser pointer to stimulate them. Needles are not used. He has fixed my neck and spine on
many occasions and within 2 days after I had been suffering for a month and while taking slow
relief morphine, and unable to work or do anything. Doctors, physiotherapists and chiropractors
had all made things worse.

Later this day at 2:30pm - 3:30pm, I begin my first supervised physical therapy at Dickson
Community Health Center, and knee bend was same as I had measured on 7-3-17.
All the patients are recovering after knee surgery. The PT instructors said it would be awhile
before I pedalled a bike again.

Sunday 26 March. A penny drops. I begin to think that unless I walk a lot, my knees just will
not get better. I realize it will not be easy because I have been a feeble walker for the last 20
years. All the PT exercises possible will not give me the knee bend I want. And walking about at
home and from car to cafe makes up a small total number of foot steps.
So, on crutches, I walk 1.5km, then various similar distances all the following week,
with about 3km around botanical gardens on Tuesday 28.

I wanted to cycle as soon as possible. But I needed more knee bend so I restored an old bike
I had and put on shorter cranks 160mm long. I put fitted "cow-horn" handlebars made by cutting
the drops off a pair of normal road bars.
The bike was only for one speed, one gear, and to be OK for local flat roads with slopes less
than 2%. The gear ratio is 44t : 18t which gives a 65.4inch gear. I raised the saddle +20mm,
pushed it 20mm rearwards, and had handle bars as high as possible.
I purchased a stationery trainer frame which could be clamped onto rear axle and I set the bike up
in my lounge room. I found I could climb on with a step and a heavy lounge chair along side, and
clip my feet to the Shimano pedals. I could barely pedal.
It took a couple of weeks to pedal slightly better, but I was not ready to ride on roads yet.

Friday 31 March. 2:30pm - 3:30pm. Second PT at DCHC. All went OK, with increased knee
bend. I get to turn small pedal machine with 125mm crank length. This was easy.
Measurement from hip to ankle had reduced from 660mm to 630mm. I had walked 11km
for previous week.
Soon after, h to a distance was 612mm. This was a considerable reduction, ie, knee bend had
increased, allowing me to do more.

Friday 7 March. 2:30pm - 3:30pm. Third PT at DCHC. Increased knee bend, h to a = 593mm,
much reduced. I was able to ride the larger stationery bike with 175mm cranks. I spent 10 minutes
on machine which was equal riding a bike the 5km from home to Dickson and return.
So it looked certain that I might cycle again during Easter Weekend. In my pile of accumulated
junk, I had a 531 frame hand crafted by Ken Evans which I'd won in a cycle race in 1988.
I decided it could be used to make a second "simple bicycle", maybe with short cranks, but with
a 3 speed Shimano hub gears in the rear wheel. I had a hub laying around. I decided I needed to
stay busy rather than go mad.

Saturday 8 March. I have one day's Targin left, but I didn't take it. I expected more pain after
the 5km walk to+from physical therapy. But I felt General Malaise, like I am just not OK.
It was the slight withdrawal effects from quitting Targin. 40mg a day was not much, but it is
enough to get some addiction and withdrawal effects. I felt low all day.

Sunday 9 March. Spoke to friends at Siam Twist cafe at lunch of vegetable laksa, green tea,
and a coffee. It rained all arvo, and I walked nowhere; I don't have many complete do-little days.
I'll be happier when I can ride a bike again.
The week ahead is full of doctors and blood tests. Sunday always feels like a day for philosophy
for me although any day can bring revelations about survival. Amidst my struggles I have moments
where I feel for all those with far greater struggles than mine. Despite the world's awfulness,
there are wonderful people who stand above as voices of goodness even while they remain
unheard in the wilderness of many. If the world gives up love, is it not certain that we will lose
our world?
We cannot continue unsustainably, but we will do too little too late to bring a better future.

Saturday 22 April. I was able to go for a nervous and careful and slow ride from my house in
Watson to the Hackett shopping centre, 2.5km each way. I was very happy with that.
On the following Sunday I went 16km from home to Hackett to Civic to home, via inner
suburban roads which had very little traffic.

Monday 24 March. I attended a total of 4 PT sessions at Dickson Community Center.
It didn't cost a cent, and PT instructors were 2 very pleasant vibrant young men, and with an
exceedingly pleasant woman of 35 during my last PT day on Friday 21-4-17.
But I could pedal the large exercise bike at the PT classroom.

After four PT sessions the PT guys thought I will handle getting
better on my own.
During the last week, I began to be able to sleep better. The effects of disturbed stomach due
to Targin finally wore off, and the pain without Targin subsided enough for more sleep.
Knee bend was still minimal.

Getting R foot to clip / unclip from pedal was too slow with now quite old single sided Shimano
road pedals and shoes.
I tried Shimano SPD and other shoes which allow walking comfortably, but that wasn't any better.

Monday 24 April. It is 70 days since my op, 10 weeks. I walked 0.5km to bus stop, visited my
dentist who gave me a clean, then returned by bus, and walked a total of 0.8km for the day,
quite enough, and all without crutches. And I never felt I might fall over.

Tuesday 25 April I spent the day building the new wheel with 3 speed gears.
I had not spoked up a wheel for many years, but I had not forgotten how.

I much like being alive, and although I face an uphill battle to reach 80, I am not persuaded
to become depressed or give up while I can turn a pedal and enjoy a few friends, I'll be OK
no matter what happens.

Monday 8 May. It is now 84 days or 12 weeks since having both knees replaced. I can walk
a lot better without crutches but I don't really know how far I could walk yet. There is less
pain sleeping with fewer wake-ups caused by pain where leg position is not just right.
But the range of knee bend has not changed for last 2 weeks. The Hip to Ankle distance
changes slightly during the day depending on how tight, or inflamed it feels. I am getting k to a
distance down to 612mm on some days but often more when the knee feels tight after
sitting down typing this. It loosens after riding a bit.

I raised the bike saddle a further 12mm, got it 15mm further rearwards, and pedalling is now
more tolerable. The first few rides inflamed the R knee, but the extra height to absolute max
has stopped that. I had to raise the handle bar height +50mm and and bring it rearwards
50mm. There is no need for the normal race position I've been riding in for last 11 years.
I am not in a hurry. I've put two layers of foam tape on handlebars because I suffer problems
with tendons giving hand pain - it is part of being 70, and having done so much with my hands
over the last 55 years.

I cannot straighten knees, and both have 10 degree bend when trying to stretch legs straight.
The maximum bend has not increased for 2 weeks, but pains have reduced. The L knee has
minimum angle between femur and tibia at about 76 degrees. The right knee has about 86
degrees, and bend has not much improved for last 2 weeks. But after a 13km ride on mainly
flat roads , I rode without the feeling of restriction of knee-bend, and when I got home the a to h
distance was 600mm, less than before the ride. I guess my legs will just have to adjust
to learning how to ride again.

Cycling from Watson to around Civic and the local suburbs between is fairly easy because
most hills are all less than 2%.
At age 41 when I was at my fittest in my life, I rode this bike with 72" gearing all over Canberra
including up Mt Stromlo with 7% inclines.

At 62, and fairly fit, I found I could just do Mt Stromlo on 72" gear, but it was difficult and knees
ached after for a day. Many fear that having no gears means they may damage their knees
because they end up using too much force too slowly. I've got artificial knee joints, and they
cannot be damaged the way aged cartilage can be further damaged, so all I have to worry
about is getting my muscles fit. I had about 9 weeks with no cycling, and many cut bones and
tissues have had to heal, and cycling has come back to me, and my knee motions are natural
without wobbles side to side as I saw in some of the older cyclists with whom I raced many
years ago. I seem to be able to pull up during pedal strokes OK and its possible a lot more km
will assist my recovery, and stretch the right quad muscles.

I returned the shower seat and toilet chair to hospital which were lent to me without cost.
The nurses said I was getting along real good.
The Community Health Services do have a team of ppl helping older citizens by installing
hand rails around stairs and in bathrooms to prevent the many falls which clog the hospital
system and which cost enormous sums of taxpayer dollars. I am registered within system,
and I qualify at 70 to get my house fitted out with rails and grab handles in wet areas in
bathroom. The cost is partially funded by the ACT Government.
I shall believe it when I see any home improvements to prevent me falling over. There is a
waiting list of hundreds if not thousands of old ppl in far worse condition than I am.

The work of handrails and stair rails should have been done BEFORE I went to hospital
for the new knees.

Maybe one day someone will turn up to install stair rails and bathroom grab handles etc. 

Monday 15 May. Last week saw little knee improvement. I probably cycled about 40km
last week.

I have done much work trying to complete re-editing my whole website and I keep thinking I
am nearly finished but then find more to edit. But sitting at a PC typing intelligently does not
do my knees any good, but I am getting used to sitting for 3 hours with a short walk hourly.

My walking was never ever to be wonderful. I broke a left ankle at 19 and now and over 51
years the bone size has increased and I have a permanent limp, but pain is not at all severe.
I thought of joining a walking club but the ones I have seen walking the other way around
Lake Burley Griffin get along at a pace I could not achieve. So I won't be walking socially
with anyone it seems. The number of ppl aged 70 on bicycles is dismally low, so no socials
from that activity either. I just gotta be alone.
I finished building a second old bike with 3 speed Shimano gears. This worked out OK with
170mm crank length. I slowly increased the weekly distance.

Thursday 14 July. I worked up to doing 150km a week easily on the 3 speed bike.
But for last 2 weeks I have been riding my 20 gear Cannondale and I did 200km for both weeks,
and at over 22kph average speed. My doctors say I am doing very well at 5 months after the op,
and they like seeing me arrive in lycra for consultations.
I noticed the change from 160mm cranks to 170mm cranks. The longer the cranks, the more knee
bend you need.
The move to Cannondale with 175mm cranks was easy. I began doing 200km a week.

Walking has improved. Ankle is still a slight problem, but I can live with it, and can work outside
cutting hedges and mowing lawns OK. I think I am about OK for awhile, and when I talked to my
knee surgeon on 27 June, I had no harsh words; I had ridden 12km to see him, and it seemed that
I could only improve further.........

Thursday 22 March 2018. My knees feel fine, and I don't feel like I have had them repaired by
a surgeon and his mate.
Between last July 2017 and March 2018, I became so strong on the bike during spring that I
re-joined a cycle group I had not ridden with since 2012, and I found I was able to keep up with
most of them. Their Sunday rides are typically about 80km on country roads with plenty of hills
and I managed to average over 25kph, and nobody my age was faster.
But I did find that on steep long hills I could not keep up with a few of the super fit oldies but then
found I'd easily catch up down the hills and they could not keep up to me on flat roads.
So I got to the cafe stop first, and I seemed to have stamina to get home first.

Summer brought heat, and I had no interest in cycling after 10:30am so I went back to riding alone
from 6am onwards. I have other health issues that are now beginning to slow my cycling speed,
but getting my knees replaced has worked out very well for me.

April 2018. A couple of guys turned up to fix handrails and bathroom rails and re-lay all the paving
around my pool. Wonders eventually happen sometimes, even when about 2 years late.

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