Necie's Knees

Until July 17, 2015 both of my knees were shot.  I'd been complaining to my docs for some time. Asking them if they could hear the crunching that I heard when I bent my knees. One doc said she heard it, but it was no big deal. She blew it off. At the time my docs were rotating like crazy, in and out of Toluca Lake Medical Center.

The last one promised she would stay around a while and she took me seriously when I told her about the crunching and pain in my knees. Right away she referred me to Dr. Robert Klapper, the knee guy to the stars, who works out of Cedars Sinai.

Dr. Klapper is a busy man. It was 3 months before I was able to get in to see him. Before he entered the exam room he ordered more x-rays, because the ones I brought with me weren't clear. Dr. Klapper has every x-ray machine known to man, right there in his office.

He came into the exam room with my x-rays and said, "I hate to say 'Hello, I'm Dr. Klapper, and you need surgery', but......" He showed me the shots of my knees, that look so much thinner in the x-rays, and told me that I had no meniscus. None. My knees were bone on bone. He listened to the crunch as he moved my feet up and down while I sat on the exam table. He said you could hear the crunch from across the room. He told me not to let anyone give me shots in the knees, because there was nothing to put the shot in.

He ordered physical therapy for me while I contemplated surgery. Before I left, he said, "I can't tell, you, you can't tell you, but your knees will tell you when it's time for surgery." Hmmmmmm.

He told me to keep riding my bike but to avoid hills. And that ice is my friend.

I went ahead and scheduled my next appointment, 3 months out. When my appointment rolled around, I was more than ready. I came into the exam room and told him, "Cut me doc!" My knees were killing me. Making me a crippled old lady, I was not ready to be. I appreciated Dr. Klapper's confidence. He told me that the surgery takes and hour and a half for most surgeons, but for him only 45 minutes because, "I measure twice and cut once."

The right knee gave me the most pain and that's where we started. My surgery was scheduled quickly because someone else had canceled. I had less than 3 weeks to get all of the pre-op blood work and tests done. My blood was typed, crossed and checked for HIV/AIDS and other STDs. I donated a unit of blood for the surgery. This was a challenge as I have slow moving blood and rolly polly veins. The nurses call it a hard stick.  It's hard alright. Hard on me. Especially when there is an inexperienced nurse poking around in my arm.  The folks at Cedars are pros, though, and they made it happen.  If they had been unable to get my blood flowing, I would have had to ask someone to donate a unit of blood for my surgery. Who knew?  I also didn't know that my slow flowing blood could have lead to a clotting problem during surgery.  My blood flow speed just barely made the time cut. Whew.

Then there were teeth to clean, because after the surgery there would be no more dental visits for a year. There was a class to take. A two hour pre-surgery class. I've got to give it to the people at Cedars, they are thorough as hell. They leave no stone unturned. During my numerous trips back and forth to Cedars I saw how vast an organization it is. It's like a small city. There's a Starbucks, clothing stores, gifts shops, of course, and all manner of food shops.

Then there was a pre-op exam by my internist Dr. So. A mammogram which was already scheduled before the surgery. Then before you know it, it was the 17th. July 17th is my beloved Grandmother's birthday, so I thought it was the perfect date for the surgery. A good sign. Some nice person called the night before to let us know what time the surgery was scheduled. I was ready.

A couple days before the surgery date, the husband, Earl, was cleaning the gutters on the back of the house. I came home from running some errands. I greeted him and he asked me to spot him on the ladder. I was hungry and he'd asked me to change clothes, into"grubbies", to better help. I wanted to get something to eat first. He said go ahead.

I was eating when I heard a thump. I ran to see what happened and there he was, going down. I got there just in time to see his head hit the ottoman cushion. His arm took the brunt of the fall. He sat up in shock. I helped him up, saying to him, "No more ladders!" He'd missed the last step on the way down. He insisted on finishing the job. I spotted him. It was too late. I told him,"You can't be broke down now, you've got to help me next week!"

Later that day his arm swelled up and was terribly bruised. I felt really guilty. The only good thing that came out of this is that he is absolutely through with ladders. Later I said to him, "If only I'd spotted you." He blew it off with, "That's split milk." I didn't want to keep bringing it up. He gets annoyed when I do that, so I just tried to do all I could to help him feel better.

He went to the doctor and then to a specialist. He thought the wrist was broken as it was the most painful. It wasn't broken, but he wore a brace for a while. He took muscle relaxers and stumbled around like a zombie. He was exhausted at the hospital and I felt bad to have to ask for everything after my surgery.

At the hospital I had the wonderful nurses to help me. I needed them, too. They waited on me hand and foot. Even putting in my prescription eyedrops for me. I missed them when I got home. The surgery went well.  I slept through the whole thing, of course, amazed when I awoke to a 26cm scar from above to right below my new knee. Held together with 65+ staples. I had the nurse take pix so I could post them on Face Book. I almost lost a few friends behind that post. LOL! Some people are so sensitive.

The first two nights were ass kickers. The pain brought me to tears and nearly to my knees. Dr. Klapper said my high pain tolerance is a blessing and a curse. I endured too long and that increased the damage. He said when he cut me open it looked like someone had poured battery acid in there, it was bad.

Because of the major pain, as the anesthesia and pain blockers wore off I was taking high doses of pain meds. Norco 10 - 4 x a day. There's a Norco 5 but I didn't think that would cut it the way I was hurting. Norco is hydrocodone/acetaminophen 10-325mg. I think it's what they make meth with. What I know is that it knocks down the pain and drys out my mouth and intestines. Bringing along nausea and dizziness. In hospital, I was given stool softeners and anti nausea patches. When I left I didn't get any to take with me. I felt OK. I didn't feel constipated but everyone insisted it would happen. More on that later.

In order to be released from the hospital, I had to walk the halls and take a step on the stairway to be ready for the one step we have at home. My blood pressure kept dropping when I stood so I had to stay an extra day to get my BP stabilized. I'd heard that they would have me up and walking on the same day as surgery. It was true. It hurt like hell, too. Just getting out of the bed was a supreme challenge.

The night before surgery I was to shower with Chlorhexidine Gluconcate 4% (CHG) antibiotic soap. I was instructed to shampoo my hair with regular shampoo and shower again the morning of surgery with more CHG.  Once I got to the hospital they had me wipe myself down with CHG towelettes. They're not playing with those germs! The nurses prepped me and of course my rolly polly veins held up the works. The anesthesiologist ended up getting my line in. The nurses were out in the bay describing how they'd never seen anything like them. I wanted to say "I can hear you!" I tried to tell them they would need their needle expert. Anyway, it got done and they rolled me into the biggest OR I'd ever seen. Everyone introduced themselves. One guy was named Earl. Earl the Pearl he said. We got my knee marked and that's all she wrote.

As I said before, I woke up amazed. My knee was all bundled up and nurses were asking me questions. Can't remember any of them now. My room turned out to be the very same one that our friend Richard Gant had occupied a month earlier when Dr. Klapper replaced his hip. He and his wife Jasmine sent beautiful fragrant flowers.

Brent visited. I was supposed to be in the hospital 1-2 nights. Turns out it was 2. Earl went home every night. He had done that staying overnight thing in 2007 when I had breast cancer surgery. No one offered him a cot back then and this time he was all cramped up from his injuries from the fall. He didn't take the cot they offered as he remembered what it was like in 2007.

Juanita visited the next day, after a lot of confusion about where I was.  She, like the others, insisted I not get too constipated. Another friend said that her constipation was worse than the major surgery she'd had. I was still feeling OK. I hadn't eaten much. The food was too terrible to eat. I ate less each day. My mouth was too dry to taste anything. I had never suffered from constipation in the past. Diarrhea, yes, constipation, no. Maybe that's TMI.

Anyway, I finally caved and purchased some stool softener and laxative and prunes. I got the works. This was after being home a couple days and seeing a doctor for dizziness and nausea. He said I should cut back on the Norco 10. The nurses had suggested cutting back when I was in the hospital. The pain wouldn't let me. In time the nausea and dizziness were too much so I relented and I cut back. The doc said to take some ibuprofen along with the Norco.

The day I saw the doc, I came home and launched a 3 prong attack on my long lost bowel movement. It had been a week. I took Senekot laxative, Myralax stool softener and ate a whole lot of prunes. The doc said I should have a movement by Sunday. It was Thursday. Happy to announce my bowels moved the same day. Now I had to remember to keep taking all of the above as long as I was taking the Norco. Who knew, I was to have this much discussion of my bowel movements?

In cutting back on the Norco I had a bad pain experience that night. Didn't make me cry. Did make me moan and reach for the iburprofen. I worried that I would run out with only 3 tabs left. The pain episode passed and I was OK for the moment.

Lance visited the next day and brought flowers. He did a few thing I didn't want to want to bother Earl with as he was exhausted handling the basics of cooking, washing dishes and making the beds all with a bum arm from his fall. Lance went to the store and got me some more ibuprofen. I could relax then, knowing I had my stash.

Every other day or so a physical therapist came by. A nurse came by regularly to take my vitals. I didn't need the nurse so much as I needed Ash the PT. I needed to get my knee stretched out so it would heal correctly. I had been doing so well with the PT that I overdid it on my own the next day.

It was time for my 3 week post-op doctor's visit. Overdoing it had set me back and I was in a lot of pain. Kathy drove me to the appointment that day because Earl had to work. My appointment was at 8am in Beverly Hills. I live in the Valley, an hour's drive during rush hour. Kathy picked me up at 6:30am. We got there early and there was nowhere to sit outside the locked office doors. There were benches in the downstairs lobby where we'd waited earlier, but we were hoping the doors would open a few minutes early. It was tough trying to stand in pain. I was using the cane then, but I probably should have used the walker that day. Kathy grabbed my sweater and purse to make it as easy as possible for me. At last the doors opened. That was a tough day, but I got a good report nonetheless. I don't have to see the doctor again for a year. Kathy made the day better by taking me to breakfast afterward. My friends are the best.

There were some rough days when it was super hot and Earl was tired, I was impatient and unwashed. I didn't want to risk an infection by getting my bandages wet. I could have put a garbage bag and duct tape over my leg to shower, but I didn't want to take a chance. I just washed up at the sink. I was on a walker and using a commode. I hated that commode at first then hardly wanted to give it up when it was time. I kinda liked having armrests on the toilet.

One thing I remembered well from the pre-op class is that when friends and family ask what they could bring, ask them to bring prepared food. Carolyn and Brittany visited and brought the veggie salads I had been craving. The Farquhars visited bringing flowers and more delicious food. I was hoping I wasn't too funky for a hug. They graciously hugged me anyway.

I lost a couple pounds. The pain subsided and I could feel the extra weight of the titanium where my meniscus used to be. I took a couple steps without the walker and Ash began talking about a cane. Soon it would be time to start water therapy. I had planned to go back to the Motion Picture Hospital where I'd gone for pre surgery therapy. I thought I would need a driver but I realized one of the exercises Ash had me doing was preparing me for driving a car. Yessssssss.

Barbara came by and washed my hair for me and rebraided it. I was so grateful. It had gotten pretty smelly. I love my friends. I can't tell you. So many people were supportive. Barbara came back by some weeks later and followed up on her promise to treat me to a mani-pedi. I didn't think I wanted one as I usually do my own nails, but it was so great to get out of the house and hang with my girl. Talking and catching up with each other .

By week seven I was walking without a cane. The knee was stiff but not too painful. I tried to cut back on my pain med dosage but it was too soon. I was taking something every 9 hours or so. I've learned to practice patience with this as Dr. Klapper said it would take a whole year to be completely healed.

I was so looking forward to driving. Earl was doing everything including driving me everywhere and cleaning up my bathroom accidents in addition to his regular stuff. Plus his arm was still healing. He said that if I could walk, then I could drive. I decided to take his word for it.

At the beginning of September I drove our car! I was sooooo excited. OK, I only drove it from the driveway to the street. But then I knew I could do it. I didn't think about my knee at all. Only driving. And it didn't hurt. Now I would be able to drive myself to physical therapy. Three times a week was a lot to ask of poor Earl. I dismantled the commode, too. As much as I liked the comfort of an armchair toilet, I was sick of looking at it. Tired of being an invalid. I thought of putting the area rugs back down, too. They had to be removed while I was on the walker and cane. I was still kind of dragging my right foot and the last thing I wanted to do was to trip and fall.

Good thing my recovery was moving along well, because in October the hubby got a job that took him out of state for a month. By then I was pretty darned independent. I was on Earl-cation. No making the beds and washing dishes. I stayed up as late as I wanted. Watched what I wanted on TV. Did laundry when I felt like it. And ate my favorite foods from restaurants he's not interested in. Yum. Oh, and listened to all of the music I want, really loud!

Earl left me a honey-do list. Can you believe that? Not easy stuff either. One item was taking one of the cars to the dealership for work that would take a week. Not too bad. I dropped off the car and they brought me home. They would come get me the next week so I could retrieve the car.

Item number two was replacing the front door. This was more than a notion, as my Grandmother used to say. I have an inch of paper work to show for it. We had been talking about getting a new front door for at least 5 years. He picks now to actually do it. So before he left town we went to Home Depot and made our selection. Home Depot doesn't tell you until it's too late to refuse, that you'll need a permit and an inspection. The installer didn't tell me until he was done that I would need to paint the wood door frame within 2 weeks to avoid water damage. That meant right away because it was supposed to rain in a couple days.

After inventorying our painting supplies and 3 trips to Home Depot, limping along on my new knee, the door installation was complete. It was not a pretty sight, limping up and down a step stool trying to prep and paint the door frame without getting paint on the rubber seal. The neighbors walking their dogs looked on curiously. None offered to help.

Physical therapy was going well. I may have lost a couple pounds without feeling like I worked very hard. It was an hour and 20 minutes of non-stop activity in the nice warm pool. The first few times I was exhausted afterwards. Soon my stamina built up enough to do more after therapy.

By the end of October I was able to get back on my bike.  It had been over 3 months and it felt really good to have the wind blowing in my face as I coasted along. The 18 sessions of pool therapy were a huge help. It almost made me want to take swimming lessons. Almost. Each day my muscles and ligaments felt more connected to my bones.

A friend who'd had her knee replaced a month after me said she watched a knee replacement surgery video on You Tube. I thought that was a good idea for me, too. I like watching that kind of stuff, anyway. It turned out to be surprisingly helpful. I understood why my knee and leg felt the way they did. The muscles had been cut away from the bone and now they were reattaching. I could feel it happening. A healing pain. Sometimes I can't even call it a pain. The medical people say that the swelling is part of the healing. I think the swelling kind of holds things together until they are reattached.

It's now 6 months of recovery and I can do just about everything I used to do. I learned the hard way not to skip the daily stretching exercises. The pain and stiffness comes back like gangbusters. I'm picking up speed on my bike. I don't know if I'll ever ride the distances of the past, but I'm just happy to ride again. Dr. Klapper said that the best thing I could do for my left knee was to get my right knee fixed. That's pretty true. Now my poor left knee has to try to keep up with the new titanium knee.

During the first 3 weeks of recovery, I thought I would never let anyone cut on me again, I was in so much pain. I thought, forget about the left knee, that's just it! I'm going to go ahead and get my left knee done, too. I'll wait until the right knee has had plenty time to heal and go ahead and get 'er done. I know what to expect and I'm going to go for it.