If I could turn back time

Even after making the decision to go through with the total knee replacement, I still had many doubts. Yes, I could improve, or I could stay the same...or...I could get worse. The doctor was so confident. He was so sure I would feel better and live a "better quality of life" that I had to have some hope. I didn't believe (and still don't) that I would ever be pain free. I just wanted to feel better, to be more active. So many former patients told me how this changed their lives in a positive way. I really wanted to believe...

Post-surgical pain is never fun, but I was looking to the future. It didn't take long, however, before the problems began.

The day after the surgery, the doctor came to my room and unwrapped the bandage. There was a huge blister that covered the entire surface of my knee. Both the doctor and nurse said they had never seen anything like it. Gee, where have I heard this before? The doctor theorized that the blister developed because of all of the scar tissue from my previous surgeries. He was concerned about the possibility of infection, so I would need to see him in a week. I saw him every week over the next four weeks. The blister did gradually get smaller and then it disappeared leaving behind a rather unpleasant large red, mottled scar. This skin caused problems but more about that later.

During those same four weeks, I had home physical therapy. In retrospect, I now know that was a joke. I believe that if I had gone to outpatient physical therapy, my whole story would be happier, but until they invent a time machine, I have to live with the past and its consequences. The home physical therapist did NOTHING. She never touched me. We spent time talking about different things, and she showed me a few exercises with the instruction that I practice them several times a day. She didn't have me practice while she was there other than to have me do each one two or three times to make sure I knew how. She did not try to bend or straighten my knee. She actually spent most of her time typing onto an electronic organizer, and emailing back to her company. On her last visit, she informed me that she believed I would need a manipulation because I wasn't straightening my knee well. She also told me she had attempted to call my doctor three times over the previous two weeks to tell him I was having trouble, and to ask if she could do more aggressive therapy, but that no one returned her calls. I found this difficult to believe. If I had started this problem two weeks ago, why didn't she tell me?

On that same day, I had an appointment with the doctor.( I just realized that I will be talking about various doctors, so I will call the orthopedic surgeon who performed the total knee replacement Dr. A.) When he walked into the examining room, he said, "The good news is that your blister seems to have healed. The bad news is that you will need a manipulation to straighten your knee." I started to cry. I pleaded with him. I promised I would go to physical therapy and work really hard. He told me it was too late, and that if I did not have this manipulation soon, I would "never walk again." In addition, because he was worried that even with a manipulation my knee would re bend, he would put my leg in a cast for four to six week to keep it straight. For the uninitiated, a manipulation is a procedure, where, with the patient under anaesthesia, the doctor forcibly bends and/or straightens the leg. It is quite painful, and according to those who have witnessed it, it appears to be torture. According to Dr. A, about five percent of total knees need at least one manipulation after surgery.

I cancelled my scheduled outpatient physical therapy session, and was scheduled for the procedure in mid August, at an outpatient center. Later, Doctor A admitted this was a mistake. He should have scheduled me at a hospital. Again, hindsight is always so clear.

The manipulation was performed. The pain was so intolerable that I couldn't get up to get into the car to go home. They had to send for an ambulance to take me to the hospital, where I remained for a few days so that I could be on a pain pump. The cast covered my entire leg from ankle to the top of my thigh. It caused so much pain, pressure and blistering on my ankle, it had to be shaved down twice.

I went home and learned to adapt to this new set of circumstances. I was worried that time in a cast with my leg straight might cause me to lose all of my flexion (ability to bend.) Doctor A assured me this "shouldn't" happen. On to the next chapter of the saga.