November 30, 2020

Celebrating the Coolest Local Stuff

Knee Jerk Reactor

By Jay Kerner

You’re getting cut open. No getting around that one. And no matter how well you’ve psyched yourself up for it… when the time comes…it’s scary!

All through the check-in procedure, the morning of my surgery, I kept looking for the “Chicken Exit” like on amusement park rides. I’d come too far to wuss out now, but the impulse to flee was strong.

Not many of us will completely avoid hospital stays in their lives, so I’ll skip most of the low-hanging literary fruit like the gowns, the bedpans, and so on.

You will get shaved, from the top of the thigh down to the ankle.

Your Anesthesiologist will come by. Some people refer to them as “gas passers.” They love this!

Depending on various factors, you will either have general anesthesia, where they knock you out, or a Spinal Block, where you’re numb and doped to the gills with that “date rape drug,” but technically still awake. I had the latter. Went to sleep in a cold room with walls covered in giant saws like a packing plant kill floor.

Woke up in the recovery room where all I wanted to do was sleep, while everybody flitting all around me was committed to everything else. Poking, prodding. Collecting vitals. Talking like the adults on a Peanuts Holiday Special.

The wife comes in and sees my eyes open. Starts talking to me like a toddler. Or a puppy. Told me “I did so good!” as if I had more to do with it than lying there on my back, drooling into a hose. I couldn’t make out everything she was saying, but I wanted to wag my tail for some reason.

Nephew/Doc came in and they all made happy word-sounds keeping me awake.

I later learned that he was explaining to my wife why the surgery took longer than expected. Seems as the deterioration in my knee progressed, the whole joint sort of rotated toward the missing cartilage. If you saw my gimping stride anytime the last few months, it’ll make sense that it wore the bone surfaces unevenly.

Ended up using some of the advanced techniques he’d learned in Cleveland.

Let’s talk pain.

Knee replacement hurts.

I’ve seen a number of high-resolution images of my knee opened up. Reminded me of dissecting the baby pig from high school Biology.

The surgery is a precision process of laser measurement. It’s also a rough process of hammers and saws.

And while it’s light years ahead of the earliest joint replacement surgeries, they still haven’t figured out how to make it not hurt.

The only consolation, if you want to call it that, is you’re already used to pain. You’ve likely been living with it for some time. This won’t be the same pain, exactly, but at least in the same area.

You’re probably familiar with the 1-10 pain scale. You’ll be asked to rate your pain. All the damn time. This seems goofy, but pay attention. This is important stuff. Your medical team has a toolbox filled with things that can help but you have to communicate how it’s working.

Try to get a handle on that. During the first part of the process, they take care of pain management for you. You’ll be getting stuff in your IV. Somewhere in there, you’ll be offered strong pain pills. You will want them. You won’t get any rest without them, and you won’t be able to do any rehab, which starts soon after you get back to your room.

But there are all kinds of pain killers, in various strengths, and not everyone handles them all the same. For me personally, pain meds always make me puke. One of the reasons I’d put off the surgery in the first place. The doc was there when they came around the next morning asking whether I wanted one or two pills. I said one but he overrode me. He wanted two in me before therapy. Went along with him and half an hour later, my “heart healthy breakfast” was pooling in the bottom of my waste basket. Except for the morsels collected in my whiskers.

Kept asking for nausea meds. Everyone that came in said they were checking but it was several hours of puking, or trying to puke, before we got something. Once we did, it made all the difference. One anti-nausea pill, ahead of a single pain pill, turned out to be the right formula for me.

But, you’ll have to figure out your own! Your doctor can’t do it for you. All he can do is prescribe what works for most. But only you can gauge your pain.

Maybe you’re concerned about opioid addiction like I was. I told my nephew/doc that I was going to try to take as few as possible. He said, while understandable, in his experience, those that went that way couldn’t go as hard in rehab, and compromised their long-term results. He also promised to stay on top of my usage and keep me out of trouble.

Once the puking was handled, it was time for physical therapy and occupational therapy. PT is all about range of motion. I assumed the OT would be exercises to help you in certain jobs. If I got to choose, I was going to ask for either “Cowboy” or “Pirate.”

Turns out it was “how to put on your pants” and “how to go up and down stairs.” That stuff was easy-peasy. I’d been gimping around for a couple years and had workarounds for most required moves.

Finally, about 36 hours after I walked in the door, I was wheeled out for the trip north. This was the scariest part of the whole deal.

I had to let the Queen drive me home.

My wife has many wonderful qualities. I could go on and on. Driving is not one of them.

They loaded me up with pain-killers and anti-nausea meds, placed a puke bag in my lap, and tipped the seat all the way back.

I survived the 45 mile journey by clamping my eyes shut for 5 minutes or so at a time, before stirring with every sudden lane change or overly-quick braking.

But we made it. We were home.

It would be great to think the hard part is behind me. But, I know it isn’t.

The surgery is no picnic, but the rehab is the bitch. And I’m committed to making it mine.