No Left Knee Behind

Surgery is over. Stoked.

As we enjoyed our baseball foray to Las Vegas, my favorite body part remained in many of my thoughts.  I knew that after the weekend played out and as we returned home to Seattle, I was about to undertake a dramatic lifechanging event that would require patience, strength, and a little bit of humility.  My surgery for total left knee replacement was scheduled for mid-Monday morning.

After fasting the the night, I checked into Overlake Hospital in Bellevue, Washington on Monday, October 29, 2012. Esposa tres_arboles steadfastly took the reigns as partner and coach, and saw me through, from check-in to recovery room as I underwent left knee complete arthroplasty. Knee replacement. A lifetime of athletic injuries (and subsequent incidental insults, many described earlier in this blog), had rendered my knee a bone-on-bone mill of pain and lost function.

I thought about blogging the surgery and especially the entire recovery process.  A few years ago, I read this amazing piece of work on another young athlete's venture into joint replacment.  Since then, I gained the author's (Mary) friendship and support for my own bionic adventure.  Knowing the value of the utter candor and personal truth present in Mary's blog, how completely important it was for me to read, I wanted to pay forward the benefit. But the bottom line is that as lay in the hospital immediately after surgery (and then in my home those first few days after surgery), I couldn't rise to it.  To be blunt, although I worked at being a recovery super star, I had a difficult few days early in the process and didn't want to blog my complaints.

Now I am a little more than 2 months post-operative and have veered from focusing on surgical recovery to building function to last the rest of my life. Thinking this past weekend about what I experienced the past two months gave me some new energy I want to pump into this thing.  Hopefully, I have a few interesting things to pass on.

Clean site week one, sutures still in

Briefly, overall my post surgical recovery went very well.  I worked hard to at being Super-Patient. For all the therapeutic work prescribed me, I did extra sets of reps.  I dropped the walker and went straight to a cane on day one at home.  Then I dropped the cane on day three. 

Difficulty arose from not trusting my own well-though-out plan for post surgical pain management.  For four days I followed my medicinal regimen precisely.  Then, impetuously, to my chagrin, listened to the bad advice of an earnest but poorly informed in-home therapist assigned to my case.  She suggested that as a former athlete (and relatively young total knee replacement patient) I should be off narcotic pain medication after one set of doses (by day five). She also insisted I should spare my intended, intense icing regimen. She believed inflammation creates a healing environment for the surgical site and icing would impede that effect.  She was wrong in both instances and for a brief couple of days, I lost control of pain management and set my recovery back more than a week.

By skipping the oxycodone for just one dose, I allowed the pain curve to catch and pass me.  By avoiding ice for anything over 20 minutes ever couple of hours (her recommendation), I suffered  through the agony of pulsating swelling around my knee.  It all hurt so much, I was climbing the wall.

Luckily, a case manager replaced the this poorly-opined home-therapist.  My replacement was wonderful.  She pushed the renewal of the oxycodone and endorsed constant ice, elevation, and compression.  Thanks to the help of my wife, my mother-in-law, and a great neighbor, we attacked the swelling tactically.  Although I never quite got full pain relief again, restarting the narcotic stuff masked pain well enough to allow me to sleep.  And week two pushed into week three when real recovery began.

"We can rebuild him"

Although there were notable positive changes almost daily from day one (despite the hiccup), my biggest perceived improvement surged forth in the fourth week.  Although still assiduously applying ice and compression, I dropped narcotic pain medication on day 24 post-op.  I achieved greater degrees of flexion and extension almost daily.  I was released to out-patient physical therapy which I still attend twice weekly. 

At six weeks, I saw my orthopedic surgeon, a man who might be the single best care-giver I've ever had, who pronounced me very far ahead of the recovery curve.  He did not schedule another follow-up, requesting that I only come in and see him after I have some good news to bring him on tres_arbolito's impending first season of high school baseball.

At the six-week appointment, I happily snapped a photo of the x-rayed site, amazed at the length of the tibial post on this prosthetic.  I know little about the prosthetic itself, other than my surgeon choses to use this one.  According to his sampling on younger patients, this piece of hardware has the lowest incidence of revision for his patients that remain "more active" after recovery.  I'm glad to fall in that category and can only expect he's correct.  Because I have a bunch of stuff planned for this summer and intend that no left knee will be left behind.