Published: Jan 22, 2012 02:00 AM
Modified: Jan 20, 2012 06:25 PM
I now have a Zimmer, gender-specific, high flex artificial right knee. I've never met Zimmer. I hope they got the gender right. It doesn't yet feel like "high-flex" yet, but each day hurts a bit less.
Joint replacement is one of those phenomena that no one talks a lot about, thankfully, but once you mention that you're having one, it seems that everyone you speak to knows someone who has at least one artificial part. Thing is, most of them are a good 10 to 30 years older than I am. So that felt like one of those things that isn't supposed to happen "yet."
I love to walk and have ambled all over roads, woods and trails in southern Orange County mostly. A couple of years ago though, the ability to walk long distances without pain diminished. Then the ability to walk even a mile with the dogs or with two-legged friends became an ordeal. Last February, it took all I had including walking sticks, knee braces, Ibuprofen, ice both before and after, and a snail's pacing to complete a hike I'd always wanted to do - the relatively short but dramatic trip to the top of one of the Santa Monica Mountains to a vantage point in Will Rogers Park overlooking the Santa Monica Bay at the edge of Los Angeles. The climb was worth it, but it was the last such effort for a time.
By March it was obvious that something had to be done. I'd tried exercises, alternative therapy and just toughing it out. But two different orthopedic surgeons reconfirmed the diagnosis given by a specialist sports surgeon seven years ago: "Mr. Pollock, you're a candidate for total knee replacement, just not yet." This time however they both left off that critical last phrase.
Last August one more confirming MRI showed even more damage. I was already using a cane to creep slowly along the roads along north edge of Blackwood Mountain to walk my now-arthritic 12-year-old large dog and my 17-year-old blind, deaf tiny dog; I finally scheduled the surgery. The one thing I did wrong was look at YouTube video of the surgery, my advice - don't ever view your surgery!
One thing about our area is the embarrassment of medical riches. I could have by my similarly afflicted friend's count, seen nine different joint replacement surgeons in Chapel Hill and Durham, not even straying as far as Raleigh. I saw two, chose one affiliated with Duke Hospitals and went under the knife six weeks ago. This little procedure did cause me to get my affairs in order. The hospital demanded a health care power of attorney before they would admit me. A good thing to have under any circumstances.
Aside from my relatively modest co-pays for various pre-operative visits, no one volunteered any information about the cost of the surgery. When I asked one of the surgeons I consulted, he said "about twenty-five to thirty" and didn't put the zeroes on the end of that phrase. I figured it out when he broke it down, "I'll make about $1,600, the anesthesiologist will get $1,000, the knee is about $6,400 and the hospital gets the remainder. I learned from my health insurance and the billing agent at Duke that I would be on the hook for about $1,000 out of pocket when it was all done; that was what remained for my annual deductible.
Thankful and grateful for a good health plan, saved up sick time and a very supportive work environment, I took the plunge.
Duke Hospital's joint replacement center does about 1,000 knee replacements, so they have this down. It's quite an assembly line and everyone I saw said "the right knee, correct?" and they wrote on my surgery leg during pre-op, very comforting indeed. By the time I went under the knife at 10 a.m., the team that worked on me had already completed one. A junior surgeon told me, "Some days we do four, some days six and some days eight."
I remember little beforehand and nothing afterward. My sister-in-law, also a candidate for knee replacement, says I told her ecstatically in my post-operative narcotic haze, "Go ahead Libba, you won't feel a thing!" And truly between the modern approach to pain abatement putting certain anesthetics right at the joint and a plunger filled with Dilaudid in my hand to use on demand, I didn't feel much for the first day. Then they took away my drugs and made me get up. My declamations cleared the hall. I came to dread the daily visit of the physical therapist but they demand that one begin to mobilize immediately to keep scar tissue from building up. The surgeon assured me, "You don't want me breaking up that scar tissue."
Six weeks on, I again walk the north slope of Blackwood Mountain, or rather learn to walk. I repeat the mantra given me by my physical therapist, "push and swing" gradually remobilizing my knee from the stiff-legged gait that led one co-worker to dub me "Chester" after the old Gunsmoke TV character. Now another coworker helpfully repeats my mantra aloud when he sees me limping down the hall.
As the New Year arrives, I am grateful for all the healing hands and skills that have helped me through this ordeal. I thank foremost my patient and profoundly helpful wife Rebekah who endured a lot of sleepless nights and had to listen to me struggle through the very painful exercise routines. I extol the high-quality care I received at Duke Medical Center and afterward from Comprehensive Physical Therapy here in Chapel Hill. To all the family, friends and coworkers who helped me, covered for me, supported me, walked my dogs, ferried me to doctor's appointments - my gratitude. Those were my best holiday gifts. Wishing all a bright and hopeful holiday season and 2012.