Getting Around: Knee Replacement Worth the Bother
I'm getting to know my new knee.
It's been in me two weeks and a day, and it feels no different from the knee I grew up with -- the other one, that's still in my left leg, at least for awhile.
Nobody really knows what causes most osteoarthritis (OA), aside from getting older. The cartilage that cushions bones in our joints somehow goes away, or wears away -- leaving bone bumping bone. It hurts. It limits movement. It can be embarrassing to drag oneself out of a chair, or down a flight of stairs, while others many years older move briskly along.
For years it had been getting harder and harder to go down stairs, rise from a seat, or even walk easily down an incline. Going up was not so bad, but down was tough. My doctor warned me I'd need surgery someday.
For a long time the general advice was wait as long as tolerable. Now they say take action as soon as OA interferes with life. Repair parts have been vastly improved. Hip and knee joints can now be replaced with artificial joints that last and last and last. In January, my regular doc (who wouldn't want me to mention his name here) gave me good marks on a routine checkup and said, "You can get those knees done now."
He's a real doctor, so that was "nuf sed" in my book. I asked about surgeons and found we have aplenty hereabouts. I picked one from a friend's recommendation and went to let him see me. X-rays confirmed extended damage OA had done to both knees. The left one was worse than the right, but not by much. Could we do both at once?
"Hold one leg out," he said. "Now, stand up."
I pushed down on the chair arms and managed to rise and stand one-legged and wobbly. We swapped legs with an even wobblier result. It was clear one knee was in worse shape than the other.
"Now stick out both legs," he said. "And stand up."
Right. He'd made his point. You can "do" both knees at once, but recovery would be way more than twice as tough, since you literally wouldn't have a leg to stand on. He no longer does two-at-once -- greater chance of problems that way, he says.
To fix my knees, the doctor proposed screwing a sort of ceramic-topped tack onto the sawed-flat top of each lower bone and fitting a titanium swivel on each upper bone that would ride on a plastic washer between them.
That is not an exact description, just a simplified one. I've been told the new one is, in point of fact, a much better knee. It's constructed of titanium and ceramics. I like to imagine its ceramic surface has in it a bit of pyrophyllite from the "talc" mine at Robbins.
The main thing is, this new one is OA-free and will forever be unable to grow bone spurs. The muscles around it are a tad sore, but less sore every day. The 8-inch vertical scar across the top does not sting, and appears to be healing visibly.
Change in Plans
At the hospital, early on operation day a fortnight ago, I'd watched my doctor looking at the target leg, my left, and shaking his head. It had some scratches. (Apparently I'd done too good a job on the night-before iodine scrub-down.) Too much chance of infection if any skin is broken, he said. He would not operate on that leg, but I didn't want to give up and go home.
"No problem," says I. "Do the other one."
A careful examination proved the right leg unscathed and therefore operable. My wife came in to sign permission paperwork, and the surgeon swapped targets. Some of the FirstHealth staff scrubbed my right knee down properly while others stabbed me in the back to insert an epidural anesthetic device.
I'd tell you about the operation, but I slept through the whole thing. I woke up to see the smiling face of Max Muse, who works in the recovery room. We are in the same Sunday School class at First Presbyterian in Carthage, and he'd promised to look after me.
"You won't hurt, I'll see to that," Max said one Sunday morning over coffee, doughnuts and theological discussion. "All my patients are naked and drunk."
I didn't feel drunk, but felt okay, just a little woozy, a little sleepy, and Max was doing all the work. Later, I woke up a second time in a hospital room to see my dear wife's smiling face.
The surgeon stopped by to tell me that right knee had been in much worse shape than he'd thought from its X-rays, but the operation had gone well. I'd see him again in a month, he said, and breezed off down the hall to his next patient.
Three days in Moore Regional, and a week at St. Joseph's for rehab followed. The day after the operation there was a surprise visitor, our editor Steve Bouser. No, he wasn't checking to see if I were really there -- he'd stopped by to encourage me.
There were other encouragements. My son, who was completing finals in calculus at UNCW (and working almost full time at a local restaurant to pay expenses), sent me a potted orchid plant. The Rotary Club sent another plant and a nice card. I got a card from our police chief. My wife came every day.
She came every day during rehab, too. Rehab turned out not to be as tough as everybody had predicted. For somebody who'd never "taken any exercise except sleeping and resting" (as Mark Twain put it) any exercise was a learning experience for me. I couldn't do some things, I found.
Then, muscle memory returned suddenly one day, and I found it actually possible to lift my right leg in the air. Wow. Hooray. Imagine that. Now, I'm home and back on the beat. People will have to give me rides for awhile, but there is court to cover, and that won't require any driving.
Thanks to all, to everyone, and -- the real point of all this -- a hearty "Go for it!" to any of you out there who need new joints and have been holding back. You could not possibly be in a better spot on the planet Earth for something like this. Moore is truly a lucky county to live in from a medical standpoint.
In any case, I'm walking about with my cane and doing those exercises -- willingly, even.
And next? I'm going back this fall to do it all over again with my left knee. Then, next summer, back on the Appalachian Trail maybe.
Contact John Chappell at email@example.com or 783-5841.
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