Monday, July 16, 2012

Knee replacement countdown: One day to go

MONDAY (One day to go): Have to admit, this morning butterflies were fluttering in my stomach. I've been compartmentalizing the emotions until now and the immediacy of the moment is finally upon me. I have lots of loose ends to take care of including showing my wife how I take care of the bills electronically. I'm also dropping off my Family Medical Leave Act (FMLA) papers for the doctor's office to fill out and return to my employer. This secures my leave of absence should I run out of sick days, personal days and vacation days if I'm hospitalized longer than I expect. I am contributing to the economic comeback since with this amount of paperwork, surely it's keeping someone employed at the doctor's office.
And I'm looking to secure two witnesses for my "living will" signature who won't be creeped out by the experience.
"This is for what now?"
"You know, if I go into a coma or on life support."
"Do I have to pull a plug or something?"
"Only if you want to." Stand in line.
Over the weekend, we bought over-sized pajamas and shirts which will be easier for me to change and I settled on the footwear that's secure but easy to slip on and off. My overnight bag is already packed and I laughingly included a book to read. Let's see how pain killers affect my ability to retain an ongoing plot scheme. I'm also including an iPod which is more practical.
One last procedure before I go to bed tonight (besides fasting) - I'm to wipe down my whole body with some antibacterial wipes provided by the hospital which, according to the instructions, "leaves the body feeling sticky." As if I need another reason to not sleep well tonight.
The adventure begins in earnest tomorrow with a 6 a.m. appointment at the hospital. One difference this time compared to my last knee replacement could be the anesthesia - an epidural which will numb me from the waist to the toes. It apparently is the preferred method giving a better post-operative effect - longer lasting numbness, I suppose. And I will still be lightly asleep for the procedure so that takes care of any "tweeting" I had hoped to do during surgery. I'll try after coming out of the recovery room. Time me. See you tomorrow.
THURSDAY (Five days to go): Started on the leg exercises last night, the most important one was the "knee extension stretch," or rather the "let's see how much you can take before it really hurts" exercise. It goes like this: You prop your foot up on a chair facing you and place a towel or some sort of brace under your ankle. Then you put 5-10 lbs (that's right, five to ten POUNDS!) on top of your knee and have it sit for 15 minutes. This passively stretches the ligaments and muscles around the knee which is supposed to improve your range of motion and your balance.
I couldn't find any 10-lb bags of rice lying around so I used my wife's two 5-lb dumbbells and some towels. It wasn't too bad during the process and I actually did feel better afterwards - like fifteen minutes afterwards. That's because when I lowered my leg off the towel (remember, the bone now is ground itself into a socket) and the knee readjusted itself, there was a painful reminder why I was having the replacement surgery. The real fun starts after the surgery, however, when I have to place the weights on the operated knee. But by then I will be in the hospital's physical therapy room, sufficiently doped up and I am hopeful the comparison at that point will be moot. Although I do recall the therapists warning us ahead of time, this is the "least favorite" of the exercises. Apparently we are not doped up enough.
WEDNESDAY (Six days to go): Today, I filled out my Health Care Agent form and the directives should I be unable to direct myself. I've been putting this off for some time now for no good reason other than I didn't want to face my mortality quite yet. That's not a solid reason. I've seen what happens when you force others to second guess what they think you wanted done. It tears apart families, brings a great weight of responsibility on people you love who suffer through the guilt afterwards as they second guess what was decided. If you love the people close to you, fill out a health care directive.
Don't have anyone close? OK, then ponder this: the high cost of health care is primarily tied to keeping sick and dying people alive just a little longer, maybe weeks. I for one don't plan on adding that particular debt to the next generation especially if the quality of life just isn't there.
If you do pen your health care directive, let others know you have one and where it is stored. I filed mine with my hospital and my financial planner as well as giving a copy to my wife.
TUESDAY (Seven days to go): Early in the morning, I visited the MCHS lab to have some blood drawn. And today I stop taking all the vitamins, supplements and, my friend in pain, Aleve in prep for surgery.
Not much else to do until Monday night when fasting begins, an antibacterial wipe down occurs and a fitful night of sleep for a 6 a.m. arrival at the hospital the next day.
MONDAY (8 days to go): Attended the Mayo Clinic "Pre Op Total Joint Class" for a two-hour lecture on what to expect. About a dozen patients - the majority of whom are facing knee replacements - learned we should start doing exercises now to get the body ready, keep pets away and off the bed before and directly after the surgery to avoid infections, leave your wedding ring at home or it gets cut off and we're going to get a lot closer in "group physical therapy." Sadly, I also learned of a change from my earlier surgery: I won't have the CPM (continuous passive motion) machine waiting for me at home. It was such a relief at the end of a tough therapy day to lie down, strap your leg in and let it slowly raise and lower your knee to keep it flexible. I also felt secure at night knowing I wasn't going to twist or roll onto it while deep in sleep. Apparently research found patients did no better and no worse with the machine in recovery. Still I wished they would have asked me. I found great comfort in that slow, humming, hugging contraption.
SUNDAY (9 days to go): "So when are you going to write about how much pain you're in?" She sat staring at me, holding my cane.
"And why should I?"
"To let everyone know that delaying it doesn't make it better." My wife has little sympathy believing I put off the knee replacement far too long.
She's right, of course. I procrastinated about one month longer than needed with lame excuses about family obligations, a business conference in Iowa and some loose ends at the office.
All that did was give the pain more time to worsen and a steady diet of Aleve only slightly numbed the pain. She suffered herself, watching me grimace far too often.
Truth be told, there is never a great time. There will be at least three days in the hospital and afterwards figure on six weeks of outpatient therapy no matter what you have planned. And for you Type A personalities: Do not try to rush the process. You could end up back in surgery or at least leave you with a noticeable limp.
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  1. Makes me think twice about having knee surgery.

  2. If the pain or discomfort is affecting your quality of life, it is worth it. I had to stop snow shoeing, hiking and bicycling because I had let the knee get worse.

  3. Your wife suggested a great idea to write this experience, Jim! Sharing your experiences and the lessons you have learned throughout the process is like sharing your life to others, especially to those who have knee problems. If others like MediTouch come across your post, they’ll probably think of seeing an orthopedic surgeon to have surgery.

    Sienna Christie

    1. This comment has been removed by the author.

    2. Thanks for the kinds words, Sienna. Hopefully if people read my collective posts (by clicking on the title 'ReWrite'), I will have presented a fairly accurate picture at least of what I went through.

  4. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee. Knee Replacement Surgery