Post Surgery Week 8: Great Expectations and Other Good Rubbish

Tuesday, July 16

In the weeks leading up to my knee surgery, I spent a lot of time with Dr. Google.  My friend Melissa, who is going through cancer treatment, says that Google is not your friend when going through something like she’s going through.  It can feed your worst fears, and raise possibilities of horrors that you’d never otherwise imagine.  So Melissa mostly stays away from the internet these days.  I don’t blame her, not at all.

But my experience with Dr. Google came early on, and it didn’t scare me quite as much as it might have.  I was forewarned about watching the actual surgery itself, as there are, apparently, videos of the full procedure. I’m not sure I’ll ever be tough enough to sit through that.  But I did find a YouTube by a couple of guys who style themselves as the “Most Famous Physical Therapists on the Internet”.  The entry of theirs that came up in one of my searches was “Knee Replacement Rehab:  Top 5 Mistakes People Make”.

Their list included an admonition to keep pain under control;  their argument for this is that you can’t progress with therapy if you can’t work through the pain of getting mobility back.  True dat.  A little self-serving was their item (#5 on their list) warning people not to stop therapy too soon, but I’ll spot them that one.  Even with my setback (which was, by the way, deemed to be “iliotibial band tendinitis” by Dr. Miner when I saw him last week), I’m pretty sure that my therapy has helped immensely.  If nothing else, it’s definitely given my recovery a form and direction that I would have had to work hard to come up with on my own.  

Another of their five mistakes deals with range of motion:  that people tend to focus on the wrong thing, for instance, trying to build up activities like walking, when the real number one focus post-surgery should be on range of motion.  This is one that I think I have in hand.   My surgeon’s 6-week goal for me post surgery was to be at flexion of 120.  I was at 108 immediately after surgery, and at 128 last week when I saw him for my checkup.  And still improving.  Lindsey, my not-really-fired physical therapist, said last Friday:  “I can count on one hand the number of people I’ve seen who have gotten better flexion than 130 with knee replacement”.  My extension has yet to reach the perfect goal of zero, but I’ve gotten darn close:  Dr. Miner clocked me at 1 degree in that same checkup. 

Another item is about not replacing the walker too soon with a cane.  That one is water under the bridge, and was not really an issue for me.  I used a walker for the first few weeks, then when I had my two-week post-op checkup, the wonderful PA Heather told me I could ditch the walker entirely.  Which I did, very happily.

So, as far as the five mistakes go, I did okay.  For four of them.  That other item?  “Don’t compare yourself to others”.  Oh dear.  That’s the hard one.  Especially with the setback.

My first few days - no, first couple of weeks - post-surgery were right on schedule.  I was making great progress.  My PT told me I was ahead of the curve, and I loved loved loved that.  All the fitness I had going into surgery was paying off.  I hadn’t been able to run for a while, but I had stayed in pretty decent shape by walking briskly every day, and putting a lot of time on the stationary bike, as well as Pilates classes.  That’s how I got okayed by PT, early on, for increasing activities.  I started to walk further at the end of week 2, and started some stationary biking around the same time, and started walking upstairs without much help, and was just starting to be able to walk downstairs normally, too.

My only real comparison at this time was with my own expectations.  I just thought I was going to be ahead of the curve, in every way:  mobility, range of motion, ability to get back to work.  Call it vanity.  Call it hubris.  Call it years of running and thinking that the running gave me a level of fitness that would have a payoff in this - or almost any -  case.  Call it just plain being wrong.

During my first few weeks of PT, I developed another basis of comparison.  Another woman, someone I judged to be about ten years older than me, had PT appointments at the same time as mine;  she had had her knee replacement surgery three days before mine, so she was a few days ahead of me the first time I saw her in the PT office.  But I passed her in progress within the first week, and I privately took some pride in that.  She was exceptionally friendly;  she always had a big smile on her face.  She was in the office the morning I came in after my setback, and when she asked how I was doing, one of the hardest things for me was being unable to match her smile.  Later that week - when I was still suffering and very teary - I saw her one last time.  Lorraine (I finally learned her name), came up and gave me a big hug, and told me she was done with PT.  I almost cried:  partly because I truly would miss her happy smile and vibe, and partly because I felt so far behind.  (By the way, the Most Famous Physical Therapists say that when they have more than one TKR patient at the same time, they try to schedule their appointments far enough apart so that they won’t end up comparing themselves to each other.  Good advice, that.)  But for all that, I’m still glad I got to know Lorraine, even just for a little bit.

So it turns out that I’ve wasted a good deal of time and mental and emotional energy this last month on doing exactly what the Most Famous Physical Therapists on the Internet warned me about:  comparing myself to others, and coming up short. I even started to beat myself up the other day after another Dr. Google search brought me to a YouTube of Al Roker after his total knee replacement.  WTF, I wanted to scream at the computer.  Al Freaking Roker had a TKR and was back at work in two weeks, looking completely put together.  How does that work?  How is that fair?  How did I go wrong?

But my caregiver, nurse, coach, cook, and chauffeur Ed just happens to be my biggest cheerleader, too.  It makes him crazy to hear me compare myself and come up short, so I’m working very, very hard on a better outlook.  Melissa, going through cancer treatments, also tells me that she’s getting through her ordeal by practicing positive imaging and meditations.  It’s all about positive vibes, and positive attitude.  

So today’s thoughts about healing are positive ones.  I’ve got great range of motion.  I’m walking a little more every day.  I’m (mostly) sleeping better with (mostly) fewer pharmaceutical aids and (mostly) less pain.  I’m riding just a little bit more on the stationary bike every day;  yesterday I got up to 9 minutes, and today, by gum, I’m going 10 minutes.  I can walk upstairs pretty easily, and downstairs, too - just not with much grace yet.  I’m starting to get antsy to do things….travel, vacation, whatever.  I'm starting to actually live again.

I’m on my way.  Maybe not as fast as I thought I would be, but after all, who cares?  Great expectations are highly overrated.  At least sometimes.  This other way of being - taking just a little longer than I planned for recovery, being kind to myself, giving myself a break - could hardly be better timed.  Now I have a great excuse to sit on the couch with the ice machine running, watching the Tour de France.