Total Knee Replacement
My knee problems began when I was young, around 13 and a “jock”, playing field hockey, tennis, netball as well as hiking and rock climbing. I endured bilateral MUA’s and “open” knee surgery when I was 16 long before arthroscopy and laser were available and the diagnosis confirmed bilateral cartilage damage with discoid meniscus and meniscal cysts. Hip to ankle half casts for 3.5 weeks left me with withered legs and essentially learning to walk again.
Within a few short years I was having increasing problems with pain and that’s when I first met Dr. William Bryan. My then boss who had gone through the Baylor residency program with Bill referred him to me because he was impressed. So was I.
I had a few more visits to check on my progression over the years but it wasn’t until 1992 that more surgery was necessary. By this time I had chronic pain and increasing swelling with activity, etc. Bilateral arthroscopies ensued resulting in the news there was little more that could be done to assist with the bone on bone arthritis (the clean up did help with the swelling though) and that knee replacements were definitely in my future. However, with the way my knees had eroded, the operation I needed didn’t exist. Dr. Bryan suggested I quit softball since as second base, the chance of someone running into me and wrecking my to date in tact ligaments and tendons wasn’t worth the risk. I agreed. I asked him about tennis and he said it wasn’t worth asking because he knew I wouldn’t/couldn’t. He also suggested trying to keep my quads strong, my weight down etc.
Some more years went by and things were getting worse but I really wasn’t looking for more surgery. Dr. Bryan’s office called and suggested Synvisc injections, which had been approved under limited circumstances and I qualified. These did help some, although by this time it was all relative. My knees did stop making so much noise going upstairs though!
The 6 monthly injections into both knees were very painful due to the extensive scar tissue in my knees; I routinely hobbled back to my car and could never manage to get up the stairs at home until the end of the day. The summer of 2009 we spent 3 weeks in Japan celebrating my husbands 50th birthday. We walked everywhere, all day long but when I came back and got my next round of injections my knees said, “No thanks!” They weren’t quite so polite though!
For years I’d been asking Dr. Bryan to let me know when the time was right for the replacements, but he declined saying that would be my decision. He was right. I had experienced decades of chronic pain but I was able to keep doing most of the things I loved: tennis, walking my dogs, gardening etc., but not any more. It was all I could do to stand and walk. I remember being so incredibly thankful that I had this long-standing relationship with someone I respected professionally and personally and had every confidence he was going to do everything he could to make me better.
The journey that ended October 6, 2009 was long, painful and arduous, but it really was the beginning. It was the beginning of life without chronic pain. I’m now officially in my late 50s and I am stronger and more confident in my physical abilities than I have been in a very, very long time. I finally got to work out with a trainer who was very cognizant of my medical history and frankly fear, and was very patient with me as I worked on my core strength, balance etc. Most importantly, and forgive me if I repeat this, I have no pain. I know this is very difficult for people who have not experienced chronic pain to imagine, but also for those with chronic pain who cannot see the light at the end of the tunnel. For me it is key to my new life.
There’s no denying my pain management was excellent. An epidural managed things very well while I was in the hospital. I was more concerned with my ability to manage things once I got home since I’d stopped taking NSAID’s at least 20 years earlier as they made no difference. I had no experience with anything stronger than Celebrex, which I had taken in single doses of prior to the Synvisc injections. Dr. Bryan’s office staff was always very responsive to my concerns and this continued post operatively helping me manage the medications that were available at that time as well as dealing with all the various medical supplies I needed.
Physiotherapy was challenging but not a surprise since I remembered my recovery for open knee surgery 35 years earlier. I did supplement physiotherapy with massage and regular visits to my chiropractor who kept things loose enough to manage the recovery that really started in the soles of my feet and graduated up past my ankles, through my calves into my quads, hips, lower back, shoulders and neck. Again not really a surprise but a process, which required enormous patience to work through and that, is not my forte.
For someone with, as previously mentioned, decades of pain I consider myself still recovering and mainly because my head told me for years I couldn’t or shouldn’t do certain things. Those rules don’t apply any more but re-educating your brain is harder than I thought it would be.