I reported to Mayo Clinic’s Methodist Hospital early the morning of May 7 for total knee replacement surgery.
I was prepared, both physically and psychologically.
Physically, all I had to do was shower using an iodine soap that I’d been given during my pre-op appointments. I had not eaten since the evening before. I really just had to show up on time and deliver myself into the hands of the Mayo team in which I put my trust.
Psychologically, I was as ready as I could be. But I wasn’t overeager. The pain I’d been living with was enough that my wife had suggested on a number of occasions that I call the Orthopedic Surgery department and ask that I be inserted into the surgical calendar ahead of schedule, in the event that another patient dropped off the calendar. I couldn’t bring myself to do that. I used the two months between my initial consult with Dr. Trousdale to brace up my courage for this rather drastic measure.
By May 7, I was there.
Faster than getting new shoes: my new left knee was installed and I was out of surgery in less than an hour. Above, the before and after.
I submitted myself to the Mayo machine. I put my well-being into the hands of a good number of people on the surgical team that I didn’t know and never would meet. My confidence in their expertise grew as I passed through the ranks of the various Mayo caregivers. The nurses that greeted me were pleasant and gracious as they took me into their care. The matter of fact demeanor in which they performed their respective responsibilities bolstered my sense of security. Everybody I encountered seemed to know their role in the process so well that my part as the patient was relegated to that of calmly sedated spectator watching the Mayo machine perform swiftly and exactly.
Occasionally, a familiar face appeared among the team members. I felt assured and happy when Peter Bas appeared hovering above me. I had met Peter first among all of Dr. Trousdale’s team. Peter is a physician’s assistance, and as I worked through the consultation process prior to surgery, I watched as he meticulously noted all the features of my knee’s deterioration and present state condition. I was intrigued with his role with Dr. Trousdale and felt a good measure of calm when I recognized his determined, confident expression wrapped in the blue surgical cap and scrubs. He looked relaxed and in perhaps his preferred element, tending to my needs just moments prior to the surgery that would repair my knee.
Another kind and happy face appeared and introduced herself as my anesthesiologist. Dr. Sandra Kopp explained how she would administer my choices for sedation, pain relief, and surgical anesthesia. She would perform a spinal block that squelched sensation and pain to my leg, and she followed that with a left leg nerve bundle block that prevented me from feeling pain in my surgical leg. About the only sensations I felt during Dr. Kopp’s procedure were the local lidocaine injections at the sites where she performed the spinal and leg nerve block. After she’d completed the pre-surgical pain controlling steps, I was ready for Dr. Trousdale and his staff to work their art.
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I was, nonetheless, sedated enough that most of the procedure was lost to sleep. I did hear the team working busily and rapidly. I never felt a twinge of pain. When my conscious level lifted and I listened in on the surgical team work, I felt like an eavesdropper to happenings across the fence line. Someone said, “Dr. Trousdale’s on his way in,” and the surgical team bustled with anticipation. I felt the excitement, but slipped deep into relaxation. I missed Dr. Trousdale’s entry. I lost track of time, and then I understood that I was well along in the procedure when I heard the deep, low pitch of grinding tool on bone. Oh, I thought, they’re already into my knee. I remember that in my thoughts, I whimsically wished them well in their work. I drifted off again, but then returned to near consciousness to observe the absolutely painless sensation of pounding as the replacement device was fitted into the seating the grinding had prepared on the lower end of my femur and top side of my tibia. Neat, I thought. The sound and sensations were enough, however. I was satisfied without seeing what was going on around my left knee joint. I settled back into my sedated rest, and presto, it was over.
Later, I’d learn that Dr. Trousdale’s surgical team completed their work in close to 45 minutes. Good deal, I thought. The shorter the time in surgery, the lower the chance of complications, and the greater the chance for infection-free recovery. I was grateful that Dr. Trousdale’s team did their art quickly.
The time I spent in the post-op recovery room, however, drew out much longer than my caregivers expected. I didn’t notice. Nor did I care. For the first span of time, I’d bob in and out of awareness before dropping back into a comfortable snooze. Occasionally, I noticed, pleasant, comforting nurses checked on me, often reminding me to take in nice deep breaths. I became aware of a digital machine at the head of my roller gurney that the nurses followed. At almost regular intervals, the instrument beeped and after several repetitions of these quiet alarms, I recognized that the digital readings that coincided with the beeping alerted the nurse that my blood oxygen levels were falling below a threshold of good.
“Keep breathing,” I’d hear a gentle voice remind me. I heard the word ‘’apnea” mentioned, and I mustered all my concentration on the effort to breath regularly and normally. I was familiar with having to remind myself to “breath in, breath out”. I’d been there before, in the remote jungles of Costa Rica when I developed a DVT that went to my lungs and formed a PE. But that was then and I’d been in jeopardy. I didn’t feel that now. I felt no real threat. I’d breathe, and I’d relax. I thought I was taking care of the situation adequately, and then the beeping buzzed out again, reminding me that I was more asleep than awake.
I noticed the shift change among the nursing crew, and occasionally Dr. Kopp visited, checking on me. How pleasant, I thought, that she’d find time to stop by in her busy day.
Over the rounds of breath taking and napping, the deep sensation of ache subtly staked claim in my surgically repaired leg, and it called me to awaken. I really wasn’t aware that I should have long ago left the post-op room and wheeled on up to my room where I’d stay for the next two nights. But I had to reach one milestone before advancing to the next. I had to keep breathing to maintain my blood oxygen levels at acceptable levels. I had to stabilize before the experts could proceed to work their pain controlling magic on me by administering additional drugs in the wake of the surgical assault on my knee.
By the time I mastered that first step, I was introduced to the pain I would become well acquainted with over the next days and weeks.
I was released from post-op and wheeled on up to the surgical recovery floor. There, I faced challenges that would occupy me for much of the next ten weeks. I would learn to control the pain of healing and recovery. I’d begin the long and never-ending task of challenging my leg to extend fully and flex to more than 105 degrees as I bent my knee and lifted my heel behind my back toward my butt. And, over time, I’d strengthen my newly repaired knee as well as the many muscles groups that had degenerated over the time my knee had deteriorated. I’d learn to walk again with no limp.