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Knee Surgery 101: Getting There

HS CHEERLEADING SQUAD. ME, UPPER LEFT. NOTE, LOWER RIGHT, BANDAGE ON KNEE (because, all that leaping!)

All on their own knees don't go bad overnight. With the exception of serious injury, it is simply a matter of wear and tear. Could I dial back and make different choices, my path of fitness would have been to stick to to swimming and yoga. But while I was a lifelong swimmer and also a daily practitioner of yoga, I also liked more aggressive activities, especially running. To be more specific, road running, and my body could handle it well (or so I thought). A good run lifted up my spirits, my mind, ameliorated stress and had the added benefit of being a load bearing exercise and thus beneficial for the bones. Plus it is how I woke up each day to my own world and also explored new places: cities, towns, rural areas, beaches. I ran in sunshine, rain, snow. 

Without running I don't think I could have survived Nathans or written a book. Especially the latter. Whole chapters got formulated as I pounded along the Potomac River.

So with all this physical activity in my adult life it may come as a surprise to learn my knees started to bother me in high school. From ages 16-18 I had knee surgery twice on my right knee and once on my left. My left has a pin in it. This was all due to the rigors of cheerleading--leaping high in the air and, a few times, landing badly, ending up in the hospital, wearing a cast for a weeks. After a course of PT I'd be back, leaping in the air! The medical advice going forward was to give up the leaping and maybe also avoid skiing and tennis. Done, done and done. 

The simple truth is time takes a toll. I had my first episode of a torn meniscus in one knee in 2011. A cortisone shot fixed me up for a year or more before I needed another. Then the other knee had the same problem. And so it would go like that for about 6 years. Cortisone shots, spaced widely apart, bought me relief and time. Then they became closer together. In early 2017 a doctor first mentioned that I was a good candidate for knee replacement. I had maxed out on cortisone shots -- you can get only so many before that treatment has to stop. 

Then, feeling very good and following the workout of a favorite exercise app, and doing lunges, I hurt both knees. For three weeks I limped. For a few months both knees were swollen. I took Celebrex and had physical therapy. The healing process took a long time.

I started to meet with knee surgeons, arriving with my x-rays and my story. Each, to one degree or another, said the same thing: new knees. I hated to hear that. In the first months, I searched for any medical person who would tell me I did not need to get new knees. I found this, but usually from doctors who weren't in the bone or joint end of the biz. My shrink. My dentist. My gyno. The knee doctors countered logically: I could definitely opt out of knee replacement, but would likely have to accept limited mobility, possibly even disability. 

Two friends stand out. Both had both knees done. One, a woman, wanted to play tennis again. She's now playing tennis again. The other, a man, wanted to play golf again. He's now golfing. What I want is to be able to walk, to take long walks, to walk on beaches (with bad knees that becomes a no-no), to walk on errands, to walk when visiting walkable cities, to possibly even revisit the Billy Goat Trail, which is a favorite local Washington hiking path that does demand strong knees. It would also be nice to again wear a feminine shoe with a heel. I know stilettos are in my past, but even a one or two inch heel would be a treat. 

I still can't believe I've set a date. My attitude about that date swings from excited anticipation to full on dread. I imagine the best, and the worst. I've been preparing my body and more about that in my next post. I'll write about insurance, too, and short term work disability leave. Choosing my new knees.  And so much more ...

 

Knee Surgery 101: Going Bionic

Growing up, my knees were put through every kind of challenge--enthusiastic participation in sports, all the leaping, twirling and high kicking of cheerleading, and dancing dancing dancing. In my 20s, 30s, 40s, 50s, there was hiking, swimming, rowing, running, boot camping, and more dancing. But, now here in my 60s, the bill has come due, the knees seem to have come to the end of their workability. The prescription is to have them replaced, which I'm told is today a nearly routine medical procedure. Trust me, I'm a skeptic, and I don't take the prescription easily or comfortably. I resist any medical procedure that isn't absolutely necessary. 

The first time a doctor told me my knees should be replaced was two years ago. Initially I flat out rejected the idea. But my knees didn't. They kept reminding me they were tired. The pain is most pronounced when I try to do the long-distance walking that is my passion. Two years ago, 20,000 steps a day were easy. Then it became 10,000. Today the average is down to 5,000. I've begun to drive on errands that once were an easy walk. If I've been sitting for a while and get up, the first few steps can be painful. That said, I don't have pain when I sit or sleep, I can easily go up and down stairs. I'm lucky. For now. I know that in time the deterioration will advance. 

A year ago I began to do research. This involved the interwebs and talking to as many people as possible, from doctors to friends and strangers who had undergone what's known among aficionados as TKR -- total knee replacement. The most amazing part of this research was discovering that in any group of adults it seemed there always was at least one who had a new knee or knees, or at least knew someone -- loved one, friend -- who had done TKR. Honestly, this stunned me. I discovered I had a close friend who had done both. I was at a dinner party with a former rugby player who had done both.  A man with whom I do some business told me when he was about to go in to do both. In the gym locker room a friend said she had done one partial. At the grocery store, a friend said her husband had done it. Another friend said she was off to Chicago to get it done (an option I learned is available if extravagant). Colleagues mentioned friends and parents. And on and on. In this casual canvassing it seemed for most, if not all, the procedure had gone well and they were glad they made the choice. What I heard most often was "I should have done it earlier."

Which is why I've opted to do it while I still get around fairly well and without a daily dose of Advil. (I try to achieve pain management through acupuncture). I'm trying to be sensibly pre-emptive. I interviewed as many as six doctors, even the Chicago option, and while they were mostly knee surgeons they were not all knee surgeons. None tried to talk me out of it. All said I was a good candidate for the procedure. All also said it was a "lifestyle" decision, in my case, and that I could do now or wait until my 70s or 80s. But, hey, how do I know I'll have those years and, besides, I want to walk NOW. The most encouraging words were that at this stage I am a fairly standard case without too much damage to repair. 

My surgery is in August with Dr. Marc Connell, at Sibley Hospital. Between now and then, and hopefully after -- assuming I can get to the computer!! -- I hope to tell the story here. Its the kind of information I've searched the web for without much success: a narrative of knee surgery. Please come along with me.