Like a Well-Oiled Machine

My mother-in-law Mildred used to say, “What is the difference between major and minor surgery?” “Minor is everyone else and major means it is you.”

About two years ago, my husband complained of knee pain, the sensation of his “knee locking,” as well as difficulty walking and getting up and off the floor. Like many wives, particularly those of us who have worked in health care (oncology), anything short of hemorrhaging, a large mass, or chest pain was something that would “work itself out.”  But it got worse. He got injections and tried heat, ice, and physical therapy. He saw different doctors and was told that he was “bone on bone” and would “at some point” need a knee replacement. Routine, except when it is you, then not routine.

It took him six months to choose a physician and more than four months to schedule the surgery. My biggest fear was that it would be cancelled for some reason (Covid, the doctor being ill, etc.), as the timing was perfect, and if delayed, it would have affected a vacation, and time with our children and grandchildren.

The moment we booked the surgery, my husband was sent a booklet detailing what to expect for knee replacement surgery. Fifty-six pages chronicling the process and answering any possible question a patient might ask. It is written at a level that anyone could understand.

I appreciated this because, as an advocate, I am very involved with clients having surgery, reviewing, reviewing, asking regular questions, and helping clients not be “confused.”

On October 17th, my husband became one of the more than 600,000 people (give or take) who have had knee replacements this past year. It has almost become routine, except that it isn’t. And while the operation is relatively common, be sure to seek a second opinion before making the decision. Most doctors will want you to do everything possible to alleviate the pain before performing the surgery.

Knee surgery is considered “elective surgery;” although it is not elective when you are in chronic pain, and it affects your quality of life. When it appears that surgery is the only answer, ask the following questions of the surgeons you meet with:

1-How many do you perform a day?

2-Do you perform the entire procedure or have assistants or fellows? (I worked with a physician once who had three rooms going at a time. The fellows would start the procedure, and he would come in, do his part, and leave, and the fellows would finish up.)

3- What is your failure rate? (They all have some failures.) Why would someone fail?

4-What is the recuperation like? What makes it easier and gives the best chance for a full recovery? (For us, the first week was the most difficult, but taking pain meds regularly, and using the ice machine was very helpful.)

Schedule surgery when you have a caregiver in place to drive you back and forth to physical therapy, cook, and do what is needed around the house.

Four days after the surgery, my husband said, “If I knew how bad this was, I probably wouldn’t have done it”. Yes, he would, as he could barely get up and down from the floor with our grandchildren, which affected his (and our) quality of life.

If you need surgery (knee, hip, shoulder), pick a doctor with a good reputation that you feel comfortable with. Our doctor was quite honest with us; the first thing he told us was, “It is a rough recovery.” And it is, but the benefits outweigh the inconvenience and pain.

In addition to the booklet (which you have to read!), he started getting phone calls six weeks before the procedure to set up all of his follow-up appointments, schedule his pre-op physical and tests, and to set up physical therapy appointments, including a visit two weeks before his surgery to teach him exercises. I have never worked with a group as efficient.

Fortunately, the hospital where his surgery was performed had a pharmacy there, and the medical group made sure that our insurance plan was accepted at that pharmacy, so we left (the same day as the surgery) with all the necessary prescriptions.

He is now more than one month out of his procedure and gets a little better daily. No walker, no cane, no pain meds. Why was he so successful? He got into great physical condition prior to the surgery and did all the exercises recommended by the physical therapist.

We did the homework, chose the surgeon with an excellent team of professionals, and together, we prepared for the road ahead.