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Femoral chondral defect 5: tissue metabolism

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The backstory…

In October 2022, I was playing a routine tennis match when my knee went *crunch*.  This is part 4 of the story.  As a precursor to reading this post, you can read about

Tissue metabolism

Today I’m going to talk about how to optimise tissue health, as this can help with recovery from both the anaesthetic and the surgery.  This is based on my Health & Performance Pyramid, which I developed in 2014 and which I’ve used to help countless people (including me) to recover from injury and surgery ever since.

The key concept here is about optimising tissue metabolism, which is all about getting waste products out and nutrients in.  (I used to think it was the other way around – nutrients in, waste out – but when I started to study the lymphatic system, I realised that you can’t get the nutrients in properly if there are waste products clogging up the system.)

Waste products out

So the first thing I’m doing each morning is to stimulate the “big 6” lymph node clusters, following Dr Perry Nickelston’s routine: clavicles, upper neck, pecs/axillae, abdomen, groins and knees.  Vibration is good for lymphatic stimulation, so I’m using my Dr Graeme vibrating massage gun to stimulate the lymph node clusters (apart from the upper neck, where I use my fingers as using a massage gun on my neck gives me a headache!) before bouncing on my toes to create a pumping action.

The other parts of the foundation layer of the pyramid that focus on getting waste products out are sleep and stress.

I’m aiming to be in bed for at least 8 hours each night (using R5 Aminos to improve my sleep quality), and I go to bed listening to self-hypnosis tracks in a bid to control my stress levels (in practice, I suspect they just send me straight off to sleep, but hey, I’m trying!)  I’m also trying to make sure I’m on top of my prehab routine, emails and laundry, and that the rota of friends and family looking after me while I’m on crutches is as organised and as seamless as possible – so that I don’t wake in the night worrying about anything!

Nutrients in

Key to getting nutrients in are hydration and nutrition.

I’ll freely admit that hydration isn’t usually my forte but I’m really making an effort.  When I had my wisdom teeth out under general anaesthetic in my early 20s, my blood pressure dropped very low in recovery, and the resus team struggled to wake me up, which was a bit scary.  Last week I received a lovely email from my anaesthetist, Dr David Daniels, saying that dropping blood pressure isn’t a very uncommon response to anaesthetic in young, fit female patients; and that a way to influence it is to ensure that I’m well hydrated.  (I did respond to say that I’m no longer young nor especially fit, so I might be fine anyway; but I’m taking the hydration advice seriously!)  I’m using a big, brightly coloured water bottle and carrying it around with me.  That makes it more obvious so that I get triggered to drink it, and also means I can measure my intake more accurately than trying to remember to drink a glass of water every time I pass the sink!

Nutrition wise, I recently underwent blood sugar, blood fat and microbiome testing with Zoe, and I now have a list of the foods my body responds best to.  Top of the list are mushrooms, then nuts – almonds and brazil nuts in particular – plus cherries, nectarines, strawberries salmon, prawns, apples, bananas, baked beans, carrots, eggs and cheese!  So I’m giving those a good go. I’m also throwing in some extra Lean Greens to optimise my antioxidant intake, plus protein powder and vitamins. At 45 I’m probably perimenopausal, so I make sure to pick the vitamins and minerals that support bone health, namely calcium, magnesium and vitamins D3 and K2. (I use and rate Nutri Advanced supplements and can arrange discounts if you contact me.)

And what to avoid

Finally, in a bid to avoid re-clogging my system, I’m avoiding alcohol for a few days before the operation.  That’s not actually too difficult as I’m not usually a big drinker; but I figure the less I ask my liver to do, the more it can get to processing the anaesthetic! I’m also trying to cut down on my intake of sugar and highly processed foods, which is less easy as I’m an emotional eater and could quite happily mainline on ice cream and chocolate; but I’m doing my best. Sugar tends to be pro-inflammatory, and I’m quite keen to minimise inflammation when I already have an inflamed knee.

And… that’s it!  Now all I have to do is to turn up on time and trust my theatre team!  See you on the other side…!

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Many people assume that stiff or sore knees is an inevitable part of aging. 

I’m here to show you that doesn’t have to be the case!

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Many people assume that a stiff or sore neck is an inevitable part of aging. 

I’m here to show you that doesn’t have to be the case!

How To Be Your Own Physio, The New Book by Nell Mead