KNEE REPLACEMENTS: A JOINT EFFORT

by Kim Marvel

During this season of ghosts, goblins, and Halloween, here is a story about skeletons – our personal skeletons. In eight months, my wife and I underwent a total of three knee replacements – one for me and two for her. As my betting friend quipped, we pulled off a “perfect trifecta!” We shared the same surgeon, surgery center, and post-operative steps to recovery. Having the identical procedure three times in close succession provided us a personal perspective on the roles as a care receiver and a care giver helpful for a successful outcome.

My procedure was scheduled first. We arrived at the surgery center in pre-dawn darkness and were back home by mid-afternoon. The first 24 hours were a breeze thanks to a nerve block. When that wore off, things got a little gnarly. Recalling my role as a patient, I’ll begin by getting several complaints off my chest. Narcotics were necessary the first few days - the pain was reduced. However, this benefit was accompanied by a couple of the seven dwarfs: Sleepy and Dopey, and by their unwelcomed cousin Constipation. So narcotics were only a brief, early phase of treatment. Then, for several weeks, life became a repeating cycle of exercise and walking, elevating and icing the knee, and repeated trips to physical therapy.

Remaining motivated to complete the routine day after day was a challenge when progress was in baby steps. And some exercises, designed to push my limits of flexibility, were unpleasant. Sleep was elusive due to leg discomfort. Finally, the role of patient required dependency on my wife for all forms of assistance and support. That’s not always easy for those of us who take pride in our independence. Okay, there, I have the complaints out of the way. The major benefit was self-evident as I gradually increased my ability to walk, bicycle, and simply move about the house without pain. We laugh at one phase of my recovery when my physical therapist, in an effort to normalize my gait, instructed me to adapt an “athlete’s swagger” when walking around the house – arms swinging, shoulders rotating, chest out, head up. My wife, snickering, started calling me “The Fonz”! Gradually, over several months my knee began to feel natural and I returned to normal activities.

Then came the role reversal. I became a care giver when my wife underwent the identical procedure three months later. Based on my firsthand experience as a patient, I prepared a detailed, hourly schedule including timing of medications, types and frequency of exercises, times for recovery (elevating and icing), and occasional humorous phrases inserted to lift her spirits. With her input we revised the schedule periodically to match her evolving condition. I temporarily moved to a different bedroom, taking my snoring and restlessness with me, to optimize her chance of improved sleep. I tried my best to fill new care taker roles: Doc, Chef, and Chauffeur. As Doc, I provided emotional support and encouragement. After several days my role as Chef was redirected from the kitchen to being a meal pick-up guy from the grocery deli or nearby restaurant. But I was successful as Chauffeur and held my own managing the laundry. I try to avoid stereotypes, but husbands likely have a steeper learning curve to fill the care giver role. I’m glad to say my wife’s recovery from her second knee replacement has gone smoothly as we both are familiar with our roles.

On the road to healing, we reflect on the experience, both as a care receiver and a care giver. First, our perspective has changed from scary Halloween to happy Thanksgiving: we are deeply grateful joint replacements are even available. Just a short generation back it was more risky and before that, not even possible. Our ancestors had to live with pain and disability. Enduring temporary discomfort pales in comparison. Indeed we are fortunate. Our experience wasn’t too spooky, even when deep purple bruises emerged or sleep was elusive. We got through it by staying calm and patient, propping up each other during the tedious phase of daily exercise routines. Now we instantly bond when we meet someone who has had a joint replacement. We have a new appreciation for surgeons and physical therapists. They know their roles well and are extremely helpful. One final thought: remember to notify airport security about your new metal body parts. I nearly set off all the bells and whistles before my wife remembered to inform the agents of our new bionic status.