Day Two After Knee Replacement -- Getting Unhooked

During the night I started to feel a bit better and have more mobility.  I was able to get in and out of bed using my "good" leg to move the bad one without total fear that it was going to fall and hurt like the dickens. So I started the day with some high hopes that PT was going to be easy.

Hah!  I got assigned a PT person who worked me hard.  (Which is a good thing - I want to be worked hard.) We started off by getting up using crutches instead of a walker and took a lap around the nurses station.  Then we hit a flight of stairs going both up and down.  I thought that was pretty good but she had more in store for me.  We did ankle pumps (easy - yeah!), some heel slides (not too bad) and then she had me lay back in the bed with a roll under the knee and told me to lift my foot up, contracting my quad muscles.  Hah!  I quite firmly told my leg to do so and it completely ignored me.   She then supported my ankle some and I was able to do some lifts that she made me hold for 3 seconds and then repeat.  Next was lifting the leg with it straight out.  Same issue.  I told my leg to lift but no go.  With some assistance I was able to but wow, did it hurt!

We finished with me sitting in a chair attempting to get the leg at a 90 degree angle.  It couldn't get all the way there but got close.   Hanging it from the chair position though was quite painful.   I sat in the chair for the rest of the day though and kept stretching it back and forth and it did get better as the day continued.

My quad muscle feels like a hard rock as if I am contracting it all the time.  With some massage it loosens up some but never completely relaxes.  I remember this from my first knee replacements so I am not surprised but like childbirth, you kind of forget about it.

Still on Percocet which makes me loopy so no idea if any of this makes sense but hopefully so.   My kids came by to see me and I wasn't sure what I was saying to them.   I think I was drifting in and out and mixing what they were saying with what I was dreaming.   They thought it was quite funny to hear their Mom all nuts.

I am slowly being unhooked from items.  I no longer have the compression pad on my "good" leg and they removed the drain from my operated leg.  I anticipated that hurting but really it just felt weird -- like someone pulling a tube through my muscles.  IV is still in but not hooked up except when I am getting antibiotics.   The ice machine is hooked up when I am in bed and not doing exercises.

I should be released from the hospital tomorrow. Only thing that might hold it back is that my white blood cell count is a little elevated so that may keep me here to get additional IV antibiotics.  We shall see.

First Day After Knee Replacement

I had my full knee replacement yesterday and it went well.  The doc came by to see me today and was quite pleased.  Said that the range of motion he got was very good and  he thought the results would be good.  Its nice to see your doc excited about your surgery!

It  hurts today but that is certainly to be expected.  I have good leg extension (being able to lay your leg flat) but its hard to bend it right now.  I can get it about 40 degrees but only with the therapist moving it to that point.  I was able to make a lap around the nurse station twice today.  Woohoo!  With a walker of course.

I have a continuous ice machine attached to my operated leg.  It has a small cooler of ice and it circulates cold water around my leg.  The blue wrap is where the cool water is.

The other leg has an air pack that continuously pumps and massages my leg to help prevent blood clots.

I'm surprisingly hungry and despite the hospital food probably not really tasting all that great.... I think its delicious and have eaten it all.  I'm also very thirsty and have drunk four pitchers of water since yesterday afternoon.  Good to help build back up the blood lost during surgery and also to flush out the anestetia.

During my morning physical therapy, they started by having me sit up on the side of my bed and I felt a bit weak headed so they just helped into a chair and had me sit there for a half hour or so when my blood pressure stabilized.  Didn't want to collect me from the floor after passing out!

After my walk, we put a sheet under my foot and I used it to pull my foot in a heel slide toward me to help get that bend going in my knee.  Couldn't go very far but it got better each effort so we will get there.

So mostly I have done a bunch of heel pumps, a couple walks, and a whole lot of napping.   The tv was on today but I have no idea what I watched as I kept falling asleep during each show.   Hope tomorrow I have a bit more knee flexibility and am able to navigate some stairs.

Fun times.  I'll finish with a picture of myself... I don't like quite as good as before I looked before surgery -- still kinda weak looking.   One step at a time!

My horse and I are both Lame and an Update on PRP Therapy

I realized that I never gave an update on how the PRP (Platelet Rich Plasma) therapy went.   A few months ago I decided to give a fairly new therapy a try to help my arthritic knee.   Essentially the medical pros take blood from your arm, centrifuge it, extract the platelets from the blood and inject the platelets and plasma into your knee in hopes of regenerating cartilage and providing some pain relief.    Its been FDA approved but because the results are still iffy and its not been determined which patients it works for and which not, insurance usually will not cover it.

Golly enjoying his "vacation"

I decided to give it a try though and while it did help the achiness in the soft tissue, it did not make much difference in the join pain so I decided to move forward with my second knee replacement which is scheduled for tomorrow.

About the same time that I decided to go for the second knee replacement, Golly came up lame and after a vet exam, it was determined that he had a mild suspensory pull and was confined to stall rest.  He has been in his stall for the last month and is now allowed out part of the day in a small paddock part of the day.   Lest you feel sorry for him, he's living the life of luxury as my girlfriend is loaning me her big airy double stall for him and his current job is his favorite thing -- doing nothing... and eating.

Its been a bit of a struggle making sure his belly is full, he is occupied mentally and he doesn't gain weight but I'll fill you in on that in another post.

He will be starting rehab with hand walking a couple of weeks before I can ride and then once I can ride, we will start with just walking for ten minutes at a time -- perfect timing for us both as we will both have limited ability.   Only major issue is that I have to rely on GREAT friends to do the hand walking and do the first couple rides under saddle ... just in case he is a bit frisky the first time out.

Stay tuned for some recovery pics as this knee heals.

Lessons Learned from Top Eventers for an Amateur Dressage Rider

At the recent Rolex Kentucky 3 Day, I spent a lot of time observing riders both in competition and in their warmup and there are a few things that I took away that I plan to apply to my own riding.

Patience

Prepping for the fence

Of all the traits I observed, this is the one thing that set apart the winning riders from the ones at the bottom of the pack.   This applied in both their dressage and their jumping.    William Fox-Pitt, who ended up on the wining horse for the weekend, truly looked as if he had all the time in the world to complete his dressage test. Before the rein back, he paused so long I thought briefly he had forgotten what to do for the next movement.

Success!

In reality, he was setting his horse up for success.  Instead of going directly from halt to the rein back, he allowed each movement to be its own entity.   He didn't begin the rein back until he knew he was going to get a perfect one.  And he did.

The riders who took their time at the jumps were also the successful ones.    There were riders who looked as if they were more or less along for the ride.  Their horse got over the jump for the most part but it had a frantic, "Oh, wow, we got over!" look rather than a confident, "Well, of course, we nailed that baby!" look.

The ones that nailed the jump were the ones that set their horse up for success by sitting back, both slowing their horse to allow them to see the upcoming jump and getting the horses in a nice collected bouncy gait before attacking the jump.

Preparation and Focus

William Fox-Pitt in the warm up

This trait goes along with the previous one but to expand on it a bit, it wasn't just patience - the riders who succeeded did their homework.   It was clear that the riders who ended up on the podium, knew exactly what their horse needed and they had a plan.    In the dressage warmup, they were completely focused on their plan.  Despite their sometimes being hundreds of people surrounding the warm up ring, the rider paid no attention to them and focused on their plan.

Because I was reporting for a British magazine, I spent a lot of time watching William Fox-Pitt and I was truly impressed with his focus.  He spent about an hour in the dressage warm up and in that time I never saw him look up from his task, minus one quick stop to get a drink.   Watching him, you would think that he was home alone in his ring.   Complete focus on his plan.

Before the competition begins, the riders walk the cross country course.  Again, the riders who succeeded were the ones that had a clear plan of attack.  As they approached each jump, they knew exactly where they were going to turn, exactly how many strides it was going to  take to get to the jump, exactly where they were going to collect the horse and exactly where they were going to take off.    This type of planning pays off in your horse's trust.  The successful rider's horses looked confident that they were going to get over because they trusted their rider had a plan for them and was going to execute it.

What light fingers! And the expression on this horse's face
looks like this massive fence is so easy he could take a nap.

Patience, focus and preparation are the same traits I should take to each dressage test.   I know my horse and I should have a clear plan for warmup and should execute it with focus.
During the test I need to make sure I set up each movement for success and have the patience to do so.  If I know my horse rushes the entrance and initial halt, I need to have exercises planned in the warmup to mitigate the issue and as I turn the corner to enter the arena, I need to take my time and have a clear plan of action to help him go down centerline with confidence and a steady tempo.  A wish and a prayer aren't going to make it happen.

Kindness and Compassion
One other item I witnessed at Rolex that I have to mention is the respect and compassion for the horse.   Not once did I hear a rider say they failed because of the horse.  It was always, "I should have set him up better" or "he tried hard but it wasn't his day".    When they had success, they never took the credit but gave it to their horse with, "She was fabulous.  I couldn't love her more."

I saw the riders pat their horses on the neck infusing a bit of courage before entering the ring and I saw them clap their success on their necks after successful jumps.

Despite what must be crushing disappointment after putting so much of their lives into competing at Rolex, riders again and again made the tough decision to retire their horse from the competition - not because a judge told them to but because they knew their horse and knew it was best for them.

Riding, in any discipline, is a team effort between you and your horse and these top riders showed this amateur rider a thing or two I plan to follow.

On My Way to Rolex!!!

Sitting in the airport now waiting for my flight to Kentucky.  Woohooo!!!   I have plans to watch dressage all day tomorrow including spending some time watching the warmup ring so I can see what high level riders do with highly conditioned and energetic horses before their test.  Of course I am not sure how watching horses of that caliber and energy will apply to my warm up with my tank of horse, Golly, but you never know when that knowledge will be needed!

I will also be reporting for Eventing Worldwide so I was issued a media pass which will get me some access to the after event press conferences and some interviews.   So excited!

If there is anything you would like a report on in regards to dressage tomorrow, send it may way.  I'd be glad to include it in my report.

Till tomorrow!

Interview with Katie Frei

Katie competing at Rolex Kentucky 3 Day
Photo Courtesy of Tara Katherine Photography

Headquartered at her farm Yellow Rose Eventing in Florida, Katie Frei will be competing at the 2014 Rolex Kentucky 3 Day in April with her horse, Houdini. I caught up with Katie right after she arrived at the Fork 2014 CIC3*/CIC2* & HT and she filled me in on her background and what is keeping her up at night about the upcoming Rolex Kentucky 3 Day.

Tell me a bit about your childhood and when you started riding.

I grew up near Kalamazoo, Michigan where my parents still live. My parents were in pharmaceuticals but bred racehorses as a hobby. They sold some horses at Keeneland and raced some. None of ours made it big on the track but it did get me some good horses to ride!

At about six I started riding, I had a Shetland pony named Woody who was the most rotten pony ever. I wanted so badly to have a pony hunter with all the bling but my parents said, “no, we have thoroughbreds and that is what you will ride.” I’d go in the hunter ring and my horse would lap the others. I tried the hunter ring, dressage, even fox hunting but was not successful at any of them. Then at about 8 or 9 I tried a baby novice event and won. I finally found the discipline my horse was good at so I stuck with it.

What is your daily routine?

I have a couple of working students and we all begin our day at 7 am. We have 16 horses in work, mostly young horses that are 6 and below in age. We feed, bring in, turn out, muck stalls to start the day. I try to be on my first horse by 8 am.

When I had my business in Maryland it was more of a teaching based business. I love to teach but it didn’t give me enough time to ride so when I moved my business to Florida I shifted my business model to more of a sale based so most of the horses are for sale – some owned by me and some owned by investors. The working students have their own horses too of course.

I have some very good clients who will fly to Europe .. or send me with their checkbook … we pick out a horse and put some time into them and then we sell them. It’s a bit nerve racking spending someone else’s money but its worked out well.

The day never really ends. We ride until dark or later. Clients sometimes are here late in the day to try horses and sometimes we don’t’ get to ride our personal horses until we’re all done. It’s great, but busy. We try to do fun things when we can like go to HITS to watch the Grand Prixs, go out to eat, things like that. But really we have fun all the time – I have a great group here.

Speaking of eating, when do you get a chance?

<laughing> We don’t! Its coffee in the morning, grab something when you can and some wine or beer at night.. Pretty much a liquid diet!

What is Houdini’s daily routine?

Houdini goes out for turnout each night. He’s a real wimp though and can’t go out by himself so I got him a present this year -- a mini named Spartucus who bosses him around. He comes in occasionally with tiny scrapes – at knee height! The turnout really helps with his mental health.

Each morning the girls (working students) lunge him for 20 minutes to get some of that extra energy out so he is more focused when I ride him – except for Sunday which is his day off. I am a big believer in a program. They need a program. They need a plan….. You can’t go out and say “hmmm what am I going to do today?”

Katie and Houdini

So Mondays are for fitness unless there is a show the previous Sunday and then they get the day off. We will either do trot work or hack. Tuesday is flat work. Wednesday we jump. Thursday is for fitness for some horses or we flat school. Friday we jump some smaller jumps – a grid or some poles. Saturday we gallop on my track or do cross country. Sunday is the horse’s day off but not for me! -- I have to be a farmer and fix everything that is broken on the farm. Owning your own farm is a lot of work!

How long do you work each horse?

Usually about 40 minutes for each workout. Sometimes we do two sessions a day. Because we are a sale based barn we need to be flexible – you never know when a client might show up.

What did you do in your last schooling session?

Well since we are at the Fork right now I only have two horses with me so its like a vacation! I have Hannibal who is a homebred and he is doing the young horse class and of course I have Houdini with me. His (Houdini) class isn’t until Friday so today (Wednesday) we just did a relaxed canter. We got here yesterday and I try to get on them as soon as we get someplace because I think it helps them relax and get out the tension they got while trailering. Helps them relax at night and eat better. So even if it’s a long trip I get on. Sometimes it doesn’t work out if we arrive late at night but I try.

You had a good run with your horse Sir Donovan. Where is he now? Is he still competing?

I sold him to Peter Barry who is friends with Boyd (Martin) and now Boyd has the ride on him this Spring. He is a HUGE Irish horse and was way too big for me since I’m only 5’2”. Boyd can ride him better with his long legs and they are doing very well together. <A few days after we talked, Katie filled me in on some news… “Update on this.. a friend of mine in Michigan just bought Sir Donovan! Phillipa Humphreys will now have the ride on him and I am thrilled for them.”>

What staff do you have?

I have two working students -- Vanessa has been with me since September. She graduated from Clemson and we just found her a new horse in the fall from the track. Catherine has been with me about a year and is taking a gap year away from college. She just completed her first one * and did great! They have a lesson every day and are great people. Its not a paid position but they have all their expenses paid. They share an apartment here on the farm, have a credit card to buy groceries and their horse board is paid as well as their shipping to events. We have a great time together!

How does your husband put up with all that estrogen?

Sven is gone all day managing his own family horse business near HITS Ocala. They breed about 40 foals a year. He used to ride his stallion Quebec (Quick Star) at the Grand Prix level but spends most of his time now selling horses and running his family business, EWSZ.

The horse business is not an easy one. Tell me how you are succeeding.

If you are smart and business savvy there is potential to make money in this business. Good horses sell themselves… especially when they are attractive and sensible and talented. We were able to buy our farm and have everything we need and the horses have everything they need. It does help to have great equipment and product sponsors and good owners who go in partnerships with horses.

Its nerve racking spending someone else’s money on a horse as an investment but I’ve had a good record. I like being successful for my owners and getting them a good return on their investment and work hard to make sure it happens.

How do you keep you sponsors happy and how did you get your sponsors?

You have to beat the bushes a little bit. Sometimes they contact me but I have a good friend who is smart at marketing and she put together a cd and video about a sponsorship package and that worked well. It’s something that is hard for me. I’m pretty modest so it’s a bit harder for me to get sponsors. It’s probably why you couldn’t find much about me in writing – I’m not one to say “look at me; I’m the best rider ever.”

I do have some great sponsors though. Heritage has the best gloves ever and Bob Bitzer sends me all I need. Houdini can’t function without his RevitaVet and Tom Neumann is always very supportive of us. I recently became a Devoucoux rider and I am thrilled with their saddles.

Rolex Kentucky is coming up. What is keeping you up at night worrying?

I want my horse to have a good experience. No matter what capacity that is. I don’t want my horse to walk away with less confidence than what he came with. Go there and learn something. Even if the weekend doesn’t’ go my way and doesn’t meet my expectations, I want him to take something good from it.

Houdini is very genuine. A little odd. A little strange. But a huge heart. He struggles a bit with his self confidence – he tries very hard. If I fall off he goes back to his stall and sulks and feels bad. Even if it’s my fault, he will come out of the ring shook up and think he did something bad.

So going into Kentucky I need him to feel like Superman, I need to build up his ego.

I ran him a at a Prelim horse trial before Jersey Fresh and he came out with a ton of confidence so I will do it again for Kentucky to make sure he feels confident. Not to place but so he feels good. If my horse feels good I do too.

He’s a good horse. I want to make it a good experience for him.

What will be your routine at Rolex? When will you get there?

We can check in on Monday. There is no point in trying to sleep the Sunday night – we are too excited – so we will drive all night Sunday and get there Monday to settle in. It’s better for the horses anyway to drive in cool of night.

In the past I have brought some sale horses with me. You’d be surprised how many people are there shopping for horses and the stabling is cheap. Lots of competitors bring other horses that need be worked with them or horses that they are moving from their winter Florida quarters to summer North quarters.

I think this year though I am going to bring Houdini alone because he is like a ‘Stage 5 Cling On’ – he attaches to his trailer mates and then can’t concentrate. Him being alone will help him get in the zone.

Where will you stay?

At events we typically stay in my living quarter trailer but at Kentucky Mom always treats us to a hotel, so why not?

Does your Mom come to the big events?

She actually comes to a lot of them. Even the smaller ones. Dad is a bit more high maintenance and likes the events that have a VIP tent where he can enjoy the free coffee to sit and read the Wall Street Journal.

Who else is coming?

Vanessa will come groom and help. She is great. My husband, Sven, will be there – he is in charge of the worrying!

Best of luck Katie at Rolex -- we will be cheering for you!

Second Knee Surgery is in my Future but trying PRP First

Those following along on my journey know that about a year and half ago I had a partial knee replacement on my left knee.  At the time of the replacement my other knee was in pain as well but not nearly as much as the one that I had replaced.   Arthritis is progressive.  You may be able to slow it down but its not ever going to get better.

May 2013 X-Ray

While its still not nearly as bad as my left knee, the right knee is getting worse and I can't walk now without limping and its starting to cause my hip, ankle and back on that side to hurt.    I had xrays taken last May and then again on March 30th and there is definite progression.   Besides the narrowing of the space, my leg is collapsing on the inside so I am getting more bowlegged which is causing some of the limping.

I'm also including an xray of a normal knee so you can see what it should look like without arthritis.

When there is this much damage there are very limited options available.  My doctor said I could try the unloader brace but I tried that on the right knee and it only caused bruising and ripped the skin off my knee and didn't improve the pain any  Not trying that again.

March 2014 X-Ray

I could also try OrthoVist again but it generally does not work well when there is so little cartilage left.

And there is knee replacement which has a fairly extensive recovery process but was very successful on my right knee.

But there is ONE other option that is fairly controversial at this point but has shown some promising results -- PRP or Platelet Rich Plasma injections.  PRP is where they remove blood from your arm, remove the platelets from the whole blood and then inject it directly into the knee with the hopes of stimulating growth and healing.  Despite it showing some decent results, its not currently covered by insurance and there are not many doctors who are using it for arthritis.  I had been reading about the studies using the technology so when my doctor mentioned it was something he would like to try, I jumped at being his first patient.

Being his guinea pig wasn't as risky as it sounds.  He has been using the process in surgery for soft tissue repair quite awhile with very good results.

Normal Knee

So last week I became his first arthritis patient to receive PRP.  He removed 30 cc of blood from my arm, centrifuged it, and then injected the resulting 7 or so cc of platelets into my knee using ultrasound to guide the needle.   The injection itself was not painful but about halfway through the pressure of all that liquid behind my knee WAS painful.  Not unbearable though and well worth it if I get good results.

Its been a few days now and it may be just having more fluid in there but I do feel there is less pain so I am hopeful.  I know my knee is pretty far gone though so the chances are lower but one can hope.  If it works then I will get another injection in about six weeks and potentially one more.

Crossing fingers and toes that it works.