ManKnee

I try really hard not to come down on gender lines in this space, probably because I don’t want readers thinking, “that’s a lesbian for you, she hates men.” I don’t. I may not feel any romantic or sexual attraction to them—but partially for that very reason, they make the very best of friends. But some of them…

A couple of weeks ago, I graduated from one-on-one physio to “Knee Class.” Seriously, that’s what they call it. It’s pretty much the same exercises, same measuring and same machinery (but with heavier weights and higher expectations) as the individual stuff, but there are three to six new knee recipients working out at once. At first I was a little skittish about sharing with strangers all the groaning and pushing and sweating and breathing and quiet cursing the convalescent experience demands.

But no. Knee class is great. This is the opportunity for comradeship. For voicing complaints or fears you know your friends and family are sick of hearing. For venting frustration at not being able to do something as well as you hoped or sharing the glee of making the bike pedals go all the way around (not that that’s happened for me yet.)

There are three other members in my class. One is a sweet older woman who had her knee replaced last summer, but stopped the exercises and now has to have a refresher. I let that be a warning to me. Then there is another funny, smart woman whom I call the veteran, because she’s recuperating from knee #2. Her surgery was a week before mine, so I use her progress as a guide—and her wisdom and perspective to not beat up on myself when I’m not at the point in the process where I think I should be.

We are the purest definition of community. People who have had the same experience and are learning from each other on how to deal with it. And I’ve honestly come to look forward to the time I spend with these women.

And then there is ManKnee. I call him that because 1) the only time he joins in our conversation is to rattle off a barrage of questions in a rather annoying interrogation style (i.e., so how many times have you seen the doctor? How many times did he come to your room when you were in the hospital? ) Just so happens, we had the same surgeon. And 2) despite the fact that we all had the same surgery, he’s definitely in more need and needy than the rest of us.

ManKnee: (p) MAN-nee. See “ManFlu” but for the knee.

In Ontario, you can obtain limited (and I mean, the basic, no frills stuff) free physiotherapy if you’ve been hospitalized due to surgery. Personally, I think they should put some income criteria in there, because…well, wait for it. I choose the hospital program because it was easier to get to and I figured they had more experience with post surgery situations—and as an unexpected bonus—it’s a couple of dollars cheaper than private programs. But since I can afford it—and have insurance—I would have let my leg fall off before I’d ask for the freebie stuff.

Three times now that I’ve been waiting in the crowded waiting room for the class to begin, I’ve had to listen to ManKnee browbeat the receptionist into giving him the forms for the free stuff, despite the fact that he’s also taking the paid sessions. I know he’s got insurance—and if so that, a job—because he also got nasty because they don’t direct bill.

My thinking is that the gratis goodies should be reserved for those who need them; really need them, those who can’t access anything else—not for the medically greedy. But appears he wore them down got his way—funny how that tends to happen.

ManKnee goes in early and uses the machinery before the class assistants are there, despite being told to stop. He hogs certain pieces of equipment—I had worked my way through 60 sets of leg weights, 30 sets of weighted pushes (impressed?) and most of my step exercises while he was still on the leg weights. Probably takes him so long because he’s told us all how traumatized his was to wake up during the surgery and hear the hammer like instrument that attaches the prosthetic knee in place. I’m sure they shot him another dose of “cocktail” immediately. The last thing the surgery team wants is you aware. None of us seemed overly sympathetic (everyone gets warned it’s possible) so now he has to re-tell his story every time there’s a new woman in the rehab room. He proves true the rumour that men are bad at multitasking, because clearly he can’t talk to these new victims and move his knee at the same time.

I notice he never talks to the men.

He’s come close to calling me a liar on a few occasions. He can’t believe I don’t remember a thing about the surgery. He can’t believe I was able to wiggle my toes when the doctor asked me to in recovery. He can’t believe my surgeon’s residents’ team was so attentive.

And yet I have absolutely no trouble believing that they might have avoided him.

I am not the only one who is aware of ManKnee’s tiresomeness. He openly defied one of the physiotherapist’s requests that he not get back on equipment he’d been holding up for too long. There was a snide remark from one of the staff about the class only being an hour long. I’ve seen rolling eyes and headshaking. In fact, after getting me my post session ice, one of the staff was still glaring and shaking her head. I wasn’t supposed to have noticed that exchange, but I couldn’t help myself.

“Don’t mind him,” I said. “He’s got ManKnee.”

I could still hear her giggling 10 minutes later on my way out the door.

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Ten things I didn’t know

I planned for the recovery of my knee surgery pretty much the way I approach every task—armed with a numbered and prioritized list of tasks and some clear cut goals. I love lists. I have lists of lists. I shudder to think what portion of my income gets spend on bright white neatly lined index cards and for the important, more long term lists, piles of Moleskine notebooks and calendars, in a range of sizes and colours. I am a fool for that creamy eggshell satiny Moleskine paper, beloved by writers for decades.

I tend to be a determined sort, so it’s not surprising that the only person who dared to suggest that I just might not be up to rearranging my office or finally filing all my writing samples or even dusting off a thriller I started writing a couple of years ago, was my boss. We tend to be brutally honest with each other.

Turns out she was right. It’s been six weeks since the surgery, I’m halfway through my (thankfully!) paid short-term disability period and my master list remains unchanged by a single check mark or cross off.

Truth is, I had no idea what was to come. I expected a few painful days in the hospital (which weren’t thanks to modern chemistry and residual effects from my spiral block that kept the worst at bay) followed by gradually better, more active weeks ahead. I wasn’t even close. Here are 10 things I didn’t know.

  1. I didn’t know I’d develop some problems with food. I opted for a spiral block and “cocktail” because I didn’t want to deal with the affects of anesthetic—including the loss of appetite. Nope. While I get odd food cravings at strange times—and try to eat one decent meal a day, generally dinner because I know I’m being watched—I could pretty much live on homemade smoothies and toast. As long as the world doesn’t run out of frozen strawberries and pineapple, I will survive.
  1. I didn’t expect to be an intellectual dullard. The other reason I didn’t want a general anesthetic was I knew how cloudy it could make one’s mind. None of that for me. I didn’t know that post surgery pain generally makes one temporarily confused and mentally slow. So much for the list of books I wanted to read (which were all professional development-type tomes) and pieces I wanted to write. Lately making of sense of a reality TV show is more like getting through a Ted Talk. On science.
  1. I didn’t know I’d be so tired. I take naps in the morning just to soften my entry into the day. I have to rest after exercising twice a day. A 15-minute walk, as prescribed at this point in my recovery demands an hour of lay-down afterwards. It’s ridiculous.
  1. I didn’t know the pain would bloom to its worst three days after I got home. I was drugged pretty well throughout my hospital stay. The nerve numbing qualities of the spinal lasted longer than I had expected. I was so gleeful at just being home the weekend I was released, the happy endorphins floated me on. And then Monday came—with a throbbing pain that felt like someone was smashing my knee with a hammer. Good thing that lessened a little each day.
  1. I didn’t know that for quite some time, just about everything would feel overwhelming.
  1. I didn’t know there would be setbacks. Days of gradual linear progress felled by one bleak depressing day where nothing went right, my knee wouldn’t bend and I was struck with the fact that I might never walk normally again. But I also didn’t know I’d be able to let them pass, accepting them as inevitable, then finding the strength and determination to start pushing forward the next day.
  1. I didn’t know physio was going to hurt so damn much. There, I said it.
  1. I didn’t know that so many people would be checking in, texting, writing, calling, supporting me, cheering me. That’s been a pretty wonderful discovery.
  1. I didn’t know that I would feel so proud of myself for doing a load of laundry, making a simple meal, showering without a spotter outside the door or being able to walk by myself for a whole 15 minutes. I tend to beam these days whenever I can do anything that makes me feel like me.
  1. I didn’t know that now, when the pain is more often discomfort, that I would realize how much I now appreciate simple gifts like comfy blankets and fresh sheets and pjs, the pain-easing chill of a frozen bag of peas, my favourite take-out sub—the little, but massively important parts of being cared for by someone who loves you.

Now I know. I’ll be better prepared the next time.


Not So Standard Operating Procedure

“It went beautifully Joy. I’m going to go talk to Lynn now.”

I’m peacefully foggy but recognize my surgeon despite his cap and mask and I realize the surgery–the event that my entire life has been pointed at, on hold for, for the past 18 months, is over. I feel a goofy grin spread over my face. It dawns on me that I’m wearing a paper hat. I wondered if they were short-staffed in the cafeteria.

In recovery, with a nurse admonishing me to breath deeply and cough, the events of the morning fall into order. The fistful of pills I had to down with a thimble of water. The space age inflatable blanket, powered by what it looked like a cross between a rental floor cleaner and R2D2, that wrapped me in a weightless cocoon of warm air. The catheter hooked into the back of my hand, through which a whole lot of drugs travelled into my bloodstream. The tiny bit of dread that made me ask Dr. Eva, as she checked my airways in the event of an emergency intubation, if I was going to hear or see anything—I had opted for a spinal and “cocktail” instead of a knock-out to the core general anesthetic—a choice that had friends calling me the bravest person they knew. Still, I knew some heavy equipment would be used to attach the new joint to my leg bones and the last thing I wanted to hear was workshop sounds.

“No way,” she grinned. “We let you see what’s going on and next thing you know, you’ll be wanting to give all your friends new knees at home. We couldn’t risk letting you cut into our business that way.”

I liked this woman. She had kind eyes and I could tell she was going to light me up good.

Once we got into the operating room, the team asked me to crawl over on to the operating table and I did just that. I rolled over and crawled across the table, exposing all that wasn’t covered by my tiny little gown to those assembled. “No, no, sweetheart,” someone said, “We need you on your back.” The sedatives must have been working because I was rather amused that I’d mooned the room. I also vaguely remember being held up by someone, whom I may or may not have been hugging back. Took me a day or two to connect that encounter with the faint bruise on my lower back from the spinal.

Yes, I was that out of it. Gratefully I still couldn’t feel anything below my waist. And I would continue to slug back a cupful of pills every few hours and ignore the morning ritual of a heparin shot to the stomach. During my stay, I didn’t mention the hallucinations the pain pills were creating, neither the multitude of cats I thought were walking around my room, nor the fact that a gift basket brought by a friend kept turning into a Carmen Miranda-like figure. I wiggled my toes every hour as prescribed. I gained the appreciation of the nurses because I wasn’t afraid of needles (we’re a small group apparently) and I didn’t flinch, whine or ask unnecessary questions. Even when the interest in my health moved north. Around dinnertime on the day following my surgery, a porter showed up to take me to x-ray. I had already been there in the morning to check my leg, but this time they did some chest shots.

That’s the beauty of heavy post-op drugs.  I knew something was wrong—but I could’t work up the effort to ask about it.

The following day, one of my surgeon’s residents showed up to explain that my blood oxygen factor was too low and my heart beat too fast—and there was a slight effusion (scary doctor talk for a bit of fluid) on my lung. That explained the chest x-ray. There was a fear that I’d developed a blood clot, which could be really dangerous. An ECG later, I learn I’m scheduled for a CT scan sometime later that day. That’s when the real adventure begins.

CT scans are wider than MRI machines, so I avoided the claustrophobic sense of panic I was expecting. But despite the technician’s warning, I wasn’t prepared for the effects of the dye they shot into my veins through yet another new catheter on my arm. A smoky, metal taste exploded in the back of my throat, I went hot all over and an intense headache crept in immediately. By the time I got back to my room, I was shaky, my blood oxygen was way too low and my blood pressure was scary high. I could feel my heart bumping in my chest. My night nurse, funny and refreshingly heavy on the profanity, told me I was having a mild allergic reaction to the CT dye. The doctor on call was called. The only thing to be done was flush the dye from my system.

For the next three hours—the duration of the final episode of Survivor I was watching on my iPad—I alternated between sips of water and watered-down Coke, using a spare gown to swing my stapled up knee to the floor so I could steer my walker and my overfilled bladder into the bathroom. Eight trips later, past midnight—and just after the winner of the series was announced—my vitals were in an acceptable range. As my nurse tucked me in and made sure my call button was handy, he leaned over and whispered, “Now go the f#*% to sleep.”

I did. And just after my sort of French toast arrived in the morning, another resident showed up to tell me all the tests had cleared. The problem was that a small portion of my lungs had collapsed just a little during surgery—a fairly common event if you aren’t intubated and something that would work itself out with enough deep breaths. I’m surprised he bothered to tell me the good news—at first I didn’t realize he was a doctor and asked him to help me clean up the dirty cups and mess that had accumulated on my tray. Good sport that he was, he followed me and my flapping gown to the garbage pail outside the room.

He also decided it was safe to release me.

“You tend to run a little hot,” he said. “You’re in fine health, but your vitals are just a touch higher than most people.” I smiled. One of those times I’d have preferred to be struck with the status quo.

A wheelchair ride down to the car, a cup of good MacDonald’s coffee from the drive-thru and a shower later, I was wearing my own pjs and lying on my own couch, drinking a decent Coke. Plenty of pills and pain and physiotherapy were still ahead. Along with the same operation on my right leg, to be scheduled once my left fully healed—but now I knew what to expect.

Thanks to all the tests, all that we had learned and all the mysteries that had been dispelled, the second time around would be standard operating procedure.