The Bees Knees
Do your knees make noises when going up steps? Do you devise a game plan for sitting down? Does it take a village to hoist you up from a chair? If so, you may need a new knee. And when that scenario became my reality, it was time to act.
Don’t let anyone fool you, a total knee replacement is totally traumatic. After all, this surgery involves power tools, for goodness’ sake. But unless you are willing to settle for a sedentary lifestyle, a replacement offers a return to an active one. Although this is major surgery, most patients recover fully and successfully, but not quickly. Recovery takes time, true grit, and perseverance. You may travel through Dante’s Inferno to get there, and your provider may not dwell on the unsavory aspects of the journey.
My surgical team was top-notch, and I was well prepared for replacement. I had drugs to keep the pain in check. The Iovera treatment froze the surrounding nerves in my leg. An ice machine kept the swelling and inflammation at bay. I walked up the stairs on my first day home, used a walker for a week and a cane for less than two. After eight weeks, I played a easy game of golf.
My struggle, however, was not just physical. It was the mental and emotional stress for which I was wholly unprepared. The recovery routine is a drill. For weeks, my daily regimen consists of icing, elevating, resting, and physical therapy. What can only be described as a cinder block seemed to encapsulate my knee. Adding to that, physical recovery is not linear. Some days I felt pretty good, the next day I was unbearably stiff and sore. At times, the fatigue was overwhelming. I could dissolve into tears at unlikely times for no apparent reason. Were these symptoms normal or was I losing my mind? I longed to feel like myself again.
Several studies from the National Institutes of Health suggest that depression and anxiety are common after total knee replacement surgery, while others indicate these symptoms predict poor knee replacement outcomes. And yet this risk factor is seldom addressed by surgeons prior to surgery. Medical teams focus primarily on physical and functional recovery such as pain management, blood clots, and infection, ignoring the emotional challenges.
Oftentimes, loss of independence, sleep issues, pain, or the trauma of surgery cause anxiety and depression. Because total knee replacement offers relief from debilitating knee pain, no one anticipates this reaction. And yet, the slow and demanding recovery process can be overwhelming. I was dismayed that keeping my house in order was just too much for me. Silly as it sounds, the fact that my couch pillows went unfluffed for weeks upset me. I simply had no energy to do so.
A recent National Institutes of Health study suggests providers are beginning to address the importance of discussing the emotional impact of knee replacement, thereby helping patients manage expectations and improve surgical outcomes. I was referred to my primary care group when I shared my symptoms with my team. After an initial assessment with the psychologist, I was armed with appropriate coping strategies; meditation, deep breathing, and talk therapy. My symptoms improved over time. It was reassuring to know that my reaction was not uncommon.
If you are considering knee replacement, keep in mind these helpful healing suggestions.
· Recovery is a marathon, not a sprint.
· Everyone heals differently; do not compare yourself to others.
· Sleep whenever you can, even if it is in the middle of the afternoon.
· Anxiety and depression can occur after surgery. Should symptoms arise, call your provider immediately.
· Be patient, give yourself grace. Healing will come, and with it a new lease on pain-free mobility.
I have plans to replace my right knee within the next few months. Because I understand the recovery process and know the certainty of positive outcomes, it will be worth the journey. And that, for me, is the Bees Knees! *
*The Bees Knees was a popular expression from the 1920’s, meaning the best. It originated as a name of a Prohibition era cocktail, favored by Al Capone. Lemon and honey were added to bathtub gin to make the drink more palatable.
Bit by bit, that’s all she wrote…