The night before surgery

Returning home from our family vacation in Vermont last summer, we stopped at a rest area in Pennsylvania after a long stretch on the road. When I got out of the van, my knee nearly buckled when it found the pavement. The pain was intense and seemed to be radiating from under my kneecap. I’d long been accustomed to the aches and stiffness of balky knees, but this was something completely new. Not sure how I could have hurt myself driving, I tried to shrug it off and limped inside to use the facilities. But the pain never went away. That was August. This is February. Precisely, it is February 23.

Tomorrow, I’m headed to One of the Big Cleveland Hospitals (OBCH) to get a new left knee. I must candidly admit that I’m scared shitless.

It was late October by the time I heeded my wife’s (repeated) suggestions that I go see a doctor. The initial trip was to the family medicine clinic for what I assumed would be a referral to an orthopedic surgeon. The doctor ordered X-rays and got around to telling me about a month later that the films indicated that I had some issues with arthritis. She was ready to treat. Instead, I made an appointment to see a rheumatologist, hoping to rely on their expertise in the subject of arthritis.

A month later, a young doctor with weird hair shot cortisone into my knee and told me I could take up to 4,000 milligrams of Tylenol a day. The shot helped for a couple of days and the Tylenol not at all. The pain got worse. I decided to try for a second opinion and called another rheumatologist in our health care system. This guy’s hair was fine. He gave me another shot but provided no knew information. That injection provided no relief at all and the pain got worse, to the point where he agreed to see me that day, actually looked at my knee, ordered an MRI and prescribed some stuff called Tramadol for the pain, which work better than than the over-the-counter pain relievers but don’t make you too loopy.

It took almost a week before I got a call about the MRI results: Widespread cartilage loss in the medial (inside) compartment of the left knee. Cartilage, I learned, acts as a cushion between the shin and thigh bones. And, in my case, there was hardly any left, causing those bones to grand against one another. There was some good news. The cartilage in the outside (lateral) compartment appeared to be fine. The rheumatologist finally gave me the referral to an orthopedic surgeon that I thought I was going to get two months ago.

It was mid-January by the time I saw an orthopedic surgeon. The doctor, a very nice man, pulled up my MRI on a computer in the consultation room, showed me where the problem cartilage was and suggested that a partial knee replacement might do the trick. He explained that partials are less invasive and take less time to recover from. He said he knew of a man who was back to work within a week of getting one of these. While it sounded pretty severe, it held promise as a good outcome, far better than the prospect of a full knee replacement. There was only one problem. This guy didn’t do knee replacements. I’d have to come back to see the knee replacement guy. That took another two weeks.

Replacement Guy pulled up the MRI and quickly concluded that a partial would not suffice. He said that if he did a partial now, chances are I’d have to come back in a few years for a full replacement. The cartilage beneath my knee cap was gone as well. I found the news distressing. A complete knee replacement at the oh-so-tender agea of 49 seemed … unfair. Old people get knee replacements. I’m not old. Yet. But I didn’t have much choice. I need to get this thing fixed if I ever expected to do some of the little things in life like … walking to the bathroom in the morning without pain.

I’m not sure if he’d forgotten who he was talking to when the good doctor said, “You’ll have the knee of a 60-year-old man afterward.” The stricken look on my face prompted him to quickly add: “A healthy 60-year-old man.” Thanks you very much for that assurance.

The doctor, a guy probably in his mid to late ‘50s, did have that air of confidence – and competence -- you want to see in airline pilots and Mohels (you know, the Jewish dudes who do circumcisions). Later on I’d learn my doc is considered one of the top guys in the practice.

The anxiety level has been ratcheting upward the last month knowing what lay ahead. When it comes to things medical, especially when they involve blood and/or viscera, I’m pretty squeamish. Watching my son enter the world was awe-inspiring and miraculous. But I wanted to run from the delivery room when my daughter was born three years later. I would have preferred that I waited down the hall until they got her and my wife all cleaned up.

I’m nervous about all aspects of this: the surgery, the pain, the hospitals, the immobility, the physical therapy, the cost. I realize that knee replacements are routine. I predict they’ll be doing them someday next to the Sears Optical Center. A lot older and frailer folks have them done … two at a time. And there’s knowing that everyone I’ve talked with who has had a knee replaced or know someone who has said they were quite happy with the results.

And I have goals to motivate me. I want to be able walk pain-free again, to golf pain-free again, to be able to throw batting practice again. I’m even looking forward to getting back to work given the promising project I’d been developing in recent weeks. (I’m a reporter for The Plain Dealer in Cleveland.)

I hope to keep at this and journalize my experience through surgery, recovery and rehab. My intent is to make these missives as contemporaneous as possible so that I can provide an honest representation of my state of mind (and body) on a given day. Healing is a process. So is writing. It’s time to see if I can meld them together.

The creation of this blog is a rush job. There undoubtedly is some expositional material that failed to include here and will have to cover later. I’ve decided for various reasons not to name any of the doctors or the hospital. Anonymity, in this case, will allow me to be more forthright about the experience.

That’s it for now. It’s just past midnight. No eating or drinking allowed. I have to be at the hospital in six hours. I’ll provide at least a quick update when I return home in a few days.