As a new member of the Septuagenarian Club, I have been pretty darned blessed when it comes to going in for a medical tune-up now and again. A torn this, a pulled that, a joint ache here, an ill-advised crunch there, but, overall, not too bad.

Until now.

I’m not sure what caught up with me — the former jock in me credits years of squatting behind home plate during my teenage years — but my bone-on-bone knees finally got the best of me. These old hinge joints have been experiencing technical difficulties for at least the last five years, so, at the end of July, I bit the proverbial bullet and underwent full knee replacement surgery on my right knee.

My overall assessment: Holy Crap, KneeMan!

The Procedure

Knee replacement surgeries or total knee arthroplasty (TKA) are increasingly prevalent due to the aging population (i.e., me) and the rise of degenerative joint conditions like osteoarthritis (again, me). The procedure becomes necessary when conservative treatments (e.g., injections of a medicinal cocktail such as cortisone and steroids) no longer provide relief … and the joint’s function significantly deteriorates.

With a knee replacement, the procedure involves the removal of damaged tissue and the insertion of an artificial implant or joint, which disrupts normal knee function. Knee replacement surgery is considered challenging to recover from due to the complexity of the joint and the extensive surgery involved.

Be forewarned, candidates. Going this route, you will experience:

• Lord-Have-Mercy pain, discomfort, and soreness despite pain medications.
• Limited mobility.
• Muscle weakness, stiffness, and swelling.
• Demanding physical therapy that requires commitment, a significant amount of effort, and sticktuativeness.

I’m now three months into recovery from the surgery. I can finally understand why nearly all patients who undergo this procedure note, “I wish I had done this five years ago.”

Prep

Amongst the types of orthopedic surgeries, knee replacement is one of the most challenging. It is associated with a lengthy recovery period. Knowing this, my preparation was two-fold:

• Get my silly self to the gym 5-6 days a week for the entire year prior.
• Seek input from friends who have undergone the same operation.

The former was long overdue and a smart move. I lost a good bit of weight and became much stronger, particularly in my core and legs, which paid huge dividends during my recovery.

Getting recon from friends was also extremely helpful. Two friends, in particular, became my go-to coaches. (Thanks, Patty and Bill. I owe each of you a delectable dinner!) Both had undergone knee replacement surgery. Over the course of many chats, I received wise counsel and strategies from them with no punches pulled.

They advised me on the importance of maintaining a positive mindset, following the post-surgery exercise regimen diligently, and being patient with the recovery process.

Each also made it crystal clear that pain would be intense in the early going — far more extreme than the pain before surgery — and that the recovery process would be more challenging than expected.

Notably, I was informed that becoming a member of the Bionic Knee Club was just the first step.

They underscored that the new knee being installed was 100% perfect. Flawless. Cobalt chrome — high strength, corrosion resistance, and optimal wear properties. No aftermarket parts. How it served me would be tied solely to how hard I worked during Physical Therapy (PT) and home rehab. If I slacked off even a little bit or ever settled for “good enough,” the painful performance upgrade would be for naught — i.e., the new knee would give me forever trouble and perhaps put me back under the knife to repair scar tissue and who knows what else.

They also made it crystal clear that this was not a solo journey. NPs, PAs, PTs, doctors, and nurses aside, the #1 healthcare provider post-surgery would be one’s dedicated life partner. Turns out they were right again — my incredible wife (Debbie) stepped up bigger than big-time, adding all of my many daily responsibilities to her own for an extended period of time (including being dad and mom to our three canine children), and serving as my ever-encouraging angel, drill sergeant, dietician, chauffeur, and, most importantly, ally during this journey. Even when I knew she felt my acute pain deep inside her own mind and body, she never wavered. Such support from my sweetheart was a crucial part of my recovery.

Additionally, friends and relatives near and far reached out, pre- and post-surgery, checking on me and keeping me (and Debbie) in their thoughts and prayers. I firmly believe that behind every scar lies an untold story of survival, and in my case, the unwavering support of these life cheerleaders was paramount in keeping me focused and reassured during this challenging journey.

Surgery

Armed with a mentality of “work hard or else” and “push through the pain,” I approached the day of surgery well-prepared, confident, and only a bit nervous.

If you’ve read this far, I won’t bore you with too many hospital details. Suffice to say that everyone at the hospital was pleasant, specialized, upbeat and on-task — clearly, a finely tuned medical team.

That morning, I eventually found myself in a large, cold room with numerous monitors and scrubs-clad professionals scurrying about. I slipped into hospital fashion-show garb (the one with the peek-a-boo back) and was wheeled into my own curtained-off area. Vitals checked. Knee shaved and marked. My surgeon and anesthesiologist came to check on me, and the latter reviewed what was in the offing. He soon came back with associates, asked me to sit up on the side of the gurney, and administered the spinal anesthesia.

I didn’t feel even a pinch, and I don’t remember them laying me back down. Peace out.

Post-Op

After surgery, I gradually regained consciousness. The surgery had lasted only 45 minutes, from incision to fully closed. I was pleasantly surprised to feel no pain. Nor could I feel my leg. My new bionic knee and the entire leg were tightly wrapped in bandages, a long compression sock, ice, and a black ankle-to-upper-thigh brace. I had a single IV in my arm. I was wheeled to my room for a one-night stay. I remember asking the medical escort who was moving me via gurney into my room if all had gone well and how much duct tape the doc had used, because, of course, almost anything can be fixed with duct tape. I believe that got a giggle, but I could be wrong about that daft recollection.

Lots of medical professionals checked on me throughout the night, adjusting the drips of pain meds and asking if I needed anything. I picked at a couple of meals and drank a lot of Gatorade.

At some point in the early morning hours, a PT person came in with a walker and got me up for my first sojourn out into the hall. It was at that point that I realized that I wouldn’t be listed as day-to-day anytime soon. Uggh and Whew and Damn and Whoa all rolled into what I’m sure was one agonizing look of pain on my face. I was beyond grateful for my attendant during this mini-meandering and for being able to return to my bed to elevate and ice my leg.

By mid-morning, I had taken another, longer walk, received a lesson on navigating the three stairs up to my home’s front door, and the IV had been removed. I was now on pain meds via pills. My wife returned to the hospital, and I was wheeled down to the entrance of the hospital and helped into the backseat of the car for the trip home.

Rehab and PT

A wise person once said that resilience is accepting your new reality, even if it’s less good than the one you had before. With high hopes, I’d traded in my old knee for a newer, upgraded model, and my 24/7 focus would now be pain management and doing precisely what I was told to do to get better.

My outpatient physical therapy sessions began 48 hours after surgery. They continued twice a week for a couple of months at the PT location, and continue to this day, both at home and at the gym. The initial PT focus, via gentle exercises and icing, was to prevent blood clots, improve circulation, and make slow but steady strides toward restoring full function to the knee joint. The pain I experienced during this early PT period was intense, and sleeping was a challenge. My right quad didn’t work, which is … well, freaking scary.

Knee replacement therapy focuses on restoring functional motion and strength through exercises such as straight-leg raises, stationary cycling, “sit-stands,” and balance drills, progressing from bodyweight exercises to using resistance bands. It also includes functional training to improve daily activities (e.g., negotiating stairs) and scar-tissue management to enhance flexibility. PT modalities, including lymphatic massages and regular icing to reduce pain and swelling, were an essential part of my therapy both at home and during my PT appointments.

In my particular case, at-home therapy also included the use of a CPM (Continuous Passive Motion) machine for the first two weeks. Once you’re strapped into what I referred to as the torture machine, the CMP gently bends and extends the knee joint at preset intervals. The patient can increase the bend. This motion, performed twice a day for an hour over the first two weeks, helps prevent stiffness and the formation of scar tissue.

Blood clots are a concern with this type of surgery. To help prevent harmful blood clots (e.g., deep vein thrombosis [DVT]) from forming or growing, I injected Lovenox (an anticoagulant or “blood thinner”) into the fatty tissue in my belly daily for two weeks. The process sounds worse than it was, and the upside of the injections was, of course, preventing clotting.

Ouch!

I’ve accomplished many notable things in my life. Done some cool stuff. Navigated numerous challenges. That being said, recovery from knee replacement surgery is one of the most badass things a person can accomplish. Recovery isn’t pretty or graceful. You just have to keep going.

It’s a painful, arduous journey. One of my wife’s besties was helping us in the early going at the house. She exclaimed one afternoon after watching me struggle to rise from my chair, “Mr. Lee, I’ve never heard you say that word before!” Sheepishly, I apologized. That’s full knee replacement surgery. Afterward, I added a new daily goal — to get from the couch to the kitchen and back without cursing. Instead, I made sounds that resembled a wounded animal.

You don’t survive it. You conquer it … with a LOT of help.

Timeline

I ran the gamut of emotional struggles during recovery — fear, anxiety, frustration, lack of sleep and, of course, pain. All that being noted, recovery time after knee replacement surgery varies depending on individual factors, such as age, overall health, and adherence to rehabilitation.

My personal timeline and related thoughts:

• 0-2 weeks: Hospital stay, pain management, anti-clot shots, physical therapy, use of a walker, and lots of elevating and icing. Be forewarned of the acute pain that occurs up until about day 10 every time your leg is lowered to the ground. Blood and fluid have to work their way back down through and around the new knee, but one day — Voila! — that excruciating pain magically (and mercifully) just stopped for me.

• 2-5 weeks: Transition from walker to cane, gradual weight-bearing, and continued physical therapy.

• 5-12 weeks: Continued home rehab and icing, walk without assistance, resume most daily activities (including driving), and start light exercises, including getting back to the gym.

Finally, from what I understand, what’s hopefully still ahead for me:

• 3-6 months: Continued improvement in strength, mobility, and range of motion.

• 6-12 months: Full recovery, with most patients able to return to their previous level of activity.

This is likely not one of my most popular blog posts. Still, I’ve provided an honest portrayal of what knee replacement truly entails for those who might be interested. My main takeaways are: 1) sourcing THE BEST in medical care; 2) having a TERRIFIC support structure in place; and 3) having complete, unwavering confidence in your ability to manage your recovery through your own efforts. That’s where hope originates, and that’s where resilience is built.

Now … About that snap, crackle and pop in my other knee …

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Addendum from LSomerbyCooke …

My first steps in preparing for knee replacement involved homework. I was determined to find the foremost surgeon and physical therapist in the High Country of North Carolina. I spent several weeks online and talking to local folks — the latter including patients who had been down this path in this area. That legwork (pun intended) paid off. If you’re in these here parts and considering orthopedic surgery and the essential PT follow-up, I highly recommend:

• Steven Anderson, MD is affiliated with UNC Health and specializes in Orthopedics and Orthopedic Surgery in Boone, NC. Dr. Anderson and his support staff were outstanding in every manner, in pre- and post-surgery consultations. The team at AppOrtho demonstrated exceptional skill, provided straightforward counsel, and offered responsive and compassionate care, all while guiding me to a positive outcome. Thanks, especially, Steven, Julie and Kayla!

• Day Watson is the lead practitioner and proprietor of Day Watson Physical Therapy & Associates in Banner Elk, NC. Day and her team have a keen focus on musculoskeletal rehabilitation and post-operative recovery, particularly in cases of joint replacements, arthroscopic surgery, and traumatic repairs. Day’s shop is a happy, upbeat, and motivating environment that focuses on helping patients return to their full capacity. Thanks, especially, Day, Pam and Aaron!

• Lastly, I’d be remiss if I didn’t give a knee-worthy shoutout to Molly Haas, DO, and the team at Watauga Medical Center and Charles A. Cannon Jr. Memorial Hospital. For the past couple of years, Dr. Haas has helped keep me moving by administering the aforementioned knee injections every six months. She has a terrific “bedside manner” and a special clinical interest in family medicine, women’s health, pediatrics, and lifestyle and preventative medicine. Thanks, especially, Molly, Caden and Heidi!