Oh, hi! First let me apologize for being so silent. Second, let me explain. I thought about blogging the entire recovery process from my knee replacement surgery start to finish. I couldn’t do it. To be completely blunt, my first couple of weeks did not go well. Blogging about it just let me marinate in the negative and I couldn’t have that.
During the first week of post-op, I was in a perpetual state of being pissed off. The Pain. The almost unbearable pressure and stiffness in my leg. The worry. The inability to do jack shit. It started eating away at me and swirled around in my head like some big, dark cloud.
I found myself spiraling down into that same hole that almost buried me after I got smeared by that drunk driver. I know how my head works, and I also knew that it is just natural to be all down in the early stages of recovery, but it was startling how quickly I got to that point.
I didn’t stay there long. It wasn’t fun. Any kind of writing I did do just turned into a 7,500 word pity party. So I didn’t do much in the way of writing.
But now that I’m a little less than four months post-operative, I have made the giant leap from focusing on surgical recovery and into building function – real, no compromise function – to last the rest of my life. Hitting a bunch of milestones last week, along with a nice comment from The Patient Grappler, , got me thinking. So I thought I would try and breathe a little life into this thing. Hopefully, I have a few interesting things to catch up with.
Looking at it as a whole, my post surgical recovery went well. I was a model patient. I got bored of that pretty quickly and became The Super Patient. I used my walker once and once only. Catching my reflection in the sliding glass door as I shuffled to the crapper using that goddam walker was all it took to say “never again”. I chucked the cane into the attic on day eleven. Once the swelling went down enough to, you know, actually move my knee, I dove into therapy head first. And from there I did extra reps, time, and weight on my own.
I say the first few weeks did not go well for two reasons: 1.) I stopped taking the narcotics prescribed to me and 2.) My original physical therapist and I had a very mutual hate for each other.
I’m a happy drunk but a very mean junkie. Barbiturates and opiates turn me into a vile, mean person and I was not going to subject my family to 16+ weeks of that. It’s hard to explain but taking poppy-based pain medication is a true Jeckyl/Hyde thing for me. So I weaned myself off the smack after one cycle. All this did was allow the pain curve to catch up and pass me. I was in so much pain during therapy that I couldn’t truly push myself into recovery. I ended up getting another post-op doctor, as my original one refused to entertain anything but opiates for pain relief, and the new guy came up with a cocktail of natural and synthetic pain medications that did the trick without making me all psychotic and strung out. Once I got control of my pain management, it allowed me to push hard and fast into recovery.
My physical therapist; what can I say? Have you ever seen someone who you don’t know, have never spoken with or even know a thing about, but their very existence makes you want to walk up and just smack the shit out them? That’s how I felt about my first therapist. And the feeling was mutual on her part. This woman came to my home every day for three hours and basically knee-barred me for 2 hours, and then heel hooked me for the last one. And during this process she’d say things like “Aw, big man’s knee hurts?” She motivated through shaming and belittling. Add in the fact that she never called me by name (only by “big man”), was insulting to my family, and I actually regressed in my recovery, and I can’t tell you the satisfaction I got by loudly and publicly firing her after a couple weeks of that b.s.
Her replacement was awesome. She is/was all business, doesn’t really care about forging a personal relationship, and places her patient’s recovery above all else. Her first order of business was to attack the inflammation and stiffness. Within three days of her working with me I could bend and extend my leg fully on my own, although incredibly painfully and slowly. On the sixth day working with her I actually walked around the block (albeit with a lot of support from my daughter) later that evening. Baby steps.
A large part of therapy involves a passive motion machine. It is basically the same device used for interrogations during the Spanish Inquisition but has been updated with an electric motor and integrated circuitry. It just churns your leg through its full range of motion over and over and over. With my first therapist, I could never make it past an hour in this thing without ripping out the power cord. With the new girl, I actually sleep through the night in this thing as it just chugs along.
And before you knew it I was off and (figuratively) running.
There have been noticeable improvements and positive changes on a daily basis. Perhaps the biggest happened towards the end of week 5. I stopped taking the narcotics again. My wife took over as my pusher, and she had been secretly curbing back my dosage and before you knew it I was taking nothing but the occasional NSAID and that’s it. I was pain med free and moving around quite nicely on day 37 post-op. Two weeks after that I was released to out-patient physical therapy which I still attend three times a week.
This past Monday I saw my ortho, who said I’m so far ahead on the recovery curve that he doesn’t want to see me again for another 3 months. The device in my leg has been fully assimilated. I am it and it is me.
I’m always amazed at the length of the tibial and femoral posts on this device when I see the x-rays. My doc has told me more than once that I’ll never forget that this is an artificial knee. But I know he chose this particular design due to the fact it has the lowest rate for “adjustments” on patients twenty years my junior who define themselves as ‘athletes’ or ‘very active’. That’s cool with me. And to be honest, I really don’t want to know about the “device” in the first place. It’s my knee, not a device.
And the best part of this whole experience?
I have this TOTALLY BITCHIN’ SCAR!
The only thing that is really holding me back is that the muscle groups in my leg are nearly useless. With the device I have, the surgeons are forced to cut the quadriceps in half and detach the hamstring and calf muscle groups in order to have unencumbered access to the joint. In a word, it totally discombobulates everything and the muscle memory dies. I’ve had to learn how to walk again, although that came back relatively quickly.
It’s the lack of strength. The neural pathways are gone, I have to recreate them. And it’s a total bitch just trying to contract the quadriceps let alone trying to get the leg to work as one harmonious unit. I can’t do any kind of work with any significant weight yet, and have to be very careful just doing body-weight squats. But it’s coming. Just a tiny little bit every day, but it’s coming.
I don’t doubt that I will get on the mats again. I understand that my improvement is up to me. I understand that there might be some unforeseen problems along the way. I’m already past the pain, the nonexistent movement, the reliance on everybody. This 18-inch incision still talks to me every day. But it’s ok This too shall pass.
Before I ever had the surgery, I already regretted it.
In reality, I was scared shitless about losing my way of life as a husband, father, friend, athlete, and Jiu Jitsuka.
I have no regrets.