Part I: Tales of a Surprising Knee Surgery (Back from Another Brink)

Never did I think this would come to pass, me being a hearty hiker and not so terribly old: now an owner of a fantastic titanium knee. What a marvel! It may nudge me to minor super woman status, even if only in my own mind.

On second thought, not yet. Not even close. I know of many who’ve had knee replacement surgery and after a couple of months are pleased with the result. They get out and about and insist pain is minimal and they look forward to doing more than ever before. I am in awe of such unbridled optimism and growing ese.

But my story is not that story. My story has been harrowing at worst, mildly encouraging at best. A doorway that has led me into territory disturbing and amazing and not fully comprehended. I still am not sure who I was the last couple of months; it was as if I took leave of myself entirely some days. And I am putting myslef back together, still uncertain who this woman is becoming now.

I couldn’t write of it before. There were no concise words, and no will to consider it closely and put it into a structured viewpoint that made sense. It is still a complicated experience that demands new skills and not always appreciated actions of me. Recently there has been a gradual easing of difficulties. It isn’t at all over, but I feel stronger, and am able to clear mind and spirit enough for a pale brightness seep through the veils of darkness, more often than not. And writing enables me to define the path traversed since late January. It assuages a little of the grief and pain as I move through an arduous recovery.

I’m sure there are those who have had worse outcomes of knee replacement surgey. But this has been enough. To even breathe more normally again–literally, symbolically–is a fine gift. And there have been others presented recently.

It has been almost two months since I was thrust from the ordinary world intp another iteration of my life. The commonplace dawn of one early morning when I entered an outpatient surgical center gave way to a miasma of deeply foreign felings and states, then sent me through maze-like passages I had feared but hoped to never know. I am still making my way.

All this for a total knee replacement for a worn out, cranky and unstable right knee. It’s more common that I knew, especially for older persons or driven athletes or those who’ve endured accidents. Many people have confidence in their surgeons, then heal well and move on. But I wasn’t sure til the last moment I even wanted to do this. I asked myself: Why am I doing this? I don’t even want to do it. My body felt so resistant as I took daily walks, as usual, though my right knee sparked with pain off and on. Then I talked myself into it. I determined I need to enjoy many more years of outdoor adventures. As in: until truly decrepit. There has been quite a need for a stronger, more functional knee joint– that, or risk more injury and weakening. I would get it finished, be on beautiful trails by spring.

It usually is worth it for recipients of this elective but major surgery. I tamped down the fear, uncertainty. Yet how would I fare with relentless pain I’d been warned about, and some new medicines? I am known by my doctors as one who has side effects few people get, some bad enough to make me seriously ill. And I don’t do well with opioids for pain control. Plus, I am in recovery, as well.

It was to be a partial knee replacement, that was the good news, so it would be easier to heal. Surprise number one: there was much more damage to cartilage and bone than first assessed, so it became a full one as the surgical team, including a robot, poked around. This was the first thing I heard when coming out of anesthesia. I thought I had misheard the nurse but my husband, Marc, stated it was a fact, both of us stunned.

Above and below my knee are the blurred star-shaped scars left by robotic-assist with surgery. They’re still burgundy red. They carry a smudge of memory as if holding onto the violent action I blissfully missed while afloat far below normal consciousness. The knee scar itself is remarkably better that when first viewed, when the skin was heavily bunched then stapled closed under a very long bandage. Just as if a Frankenstein experiment took place and this was the evidence to be reckoned with from now on. But skin tends to heal fairly quickly. The hard ridge running over my kneecap–is it mine, still, really?–has flattened and faded already. The scar will fade but remain. Vanity is irrelevant; it is what it is.

That early morning it was as if I was yanked from the known world and set spinning away to a place I could not longer navigate. When I surfaced, the air I breathed was shaped by a rough breathlessness, my being and flesh so raw it was shocking. I was imbued with a sensation of earth having tried to pry me from gravity, that I was just hanging on at a distant blue curvature. I was not of myself, nor in myself, not fully within or outside flesh and spirit. Yet I knew my life would never be the same. I felt it hover, sink, gasp, many voices meaningless, the light too harsh, my head spinning with vertigo that would settle in for days, even with medication.

In those first hours as medical staff monitored and aided me, then helped me move from one space to another as was necessary, I just fell into their arms and expertise. My heart went into A-fib, an arrythmia that can become deadly but this time it was not. The nausea and blurriness was central to all. I thought: it is worse than I feared. I vaguely wondered: perhaps death will come, perhaps I will be free of this, but the children will be hurt irrevocably, so must live. Searing pain demanded release as anesthesia wore off despite a spinal and a knee nerve block. But how to banish it? No, it was settling in right in tissue-deep, bone-deep, mind-deep.

I cannot take most pain medicines due to side effects (as I would discover again fully, soon). Not even ibuprophen which my cardiologist forbids. I was lifted up and moved by my armpits, tried to walk to use the bathhoom and demonstrate I was awake and able to take steps. It seemed mad that I’d nbe commanded to get up andstep onto those legs beneath me despite the havoc wrought on my right limb only a couple hours earlier. I did not do well. I was kept there as late as possible at the outpatient surgical center, folded into the car seat.

So as darkness descended, home I went. The post-surgery experience was in earnest, and would become protracted. Unexpected. Despite understanding it was major surgery, the result was nowhere near what had been explained to me.

Then, on the ride home, my husband Marc was so distressed and worried that I had to remind him how to get there, pointing, babbling directions. And I heard my son’s voice in my mind the last time I saw him: Is this the right option for you, Mama? I’d looked at him closely. He felt it, too, the intense reluctance, his own intuition flaring. I said, “I’ll get through it.” But we both somehow knew that something very hard was soon to come.

How could I know for sure that there would be relentless nausea for the first few days and then the gastrointestinal impact of round the clock use for several days of opioid medication (causes constipation). I’d insisted on taking a milder one, tramadol rather than than oxycodone than most patients use. It eased pain just a bit but ultimately left my in great misery until resolved–real life stuff here– with emergency intervention of marathon laxative ingestion. That period the first week, still unable to walk much, was its own sort of hell. I lost 6 pounds in 10 days as I could barely eat even soft foods. I weakened, and using a necessary walker was arduous. How could I know that many events a surgeon hopes will not happen to a patient were still ahead for me? GI troubles were in the end the least of it.

We each have a visceral knowing that brings a strong sense of things. I ignored mine, which tends to lead to unhappiness. I was swept along on a medically informed trajectory that told me: this will lead to a good difference. I needed to surrender and believe it was best so I did. Like a car that is broken down enters a repair shop so it can be made anew–I had to do it. Ten more years to climb the rainforest heights and descend its root-bound paths with security and vitality–this was all I longed to happen.

I had prayed for clarity. I prayed for success of the surgeon and his team and my knee’s willingness to be remade. Body of blood and light, hold me up and carry me on. Mind, heart and spirit, surrender to big change, to even pain, to a healing process that is largely unknown.

One major insight discovered was that post-operative suffering can reach limits not imagined or understood. It can rob your sense of self, alter your perspective of many aspects of life, demand mammoth effort at a big price. It can slash hope and drive a person to anguish that cannot even be voiced. It can wake you up in the night and force you to look at yourself and what you see may be disturbing, even foreign. For powerlessness is frightening. Unless one can give up a bare semblance of control to God and whoever else can help in the smallest ways. And I can tell you my husband was there as never before, attending to me without ceasing, missing work for three weeks, coming to my side when I felt I could not bear another moment. (This sort of dependence on him, which I’d rarely if ever had to experience, strips bare and alters a relationship. More on that later.) I wanted to be braver. But there are moments that bravery is a sham. You simply hang on.

It was just a routine, major surgery. A needed bridge to a reasonably strong and secure stride back into the world–and forests, beaches, wetlands and meadows and mountains. To greater joy in movement. Does this story have a good outcome? Each hurdle has presented itself and has had to be faced. I began to believe I could not only stay alive but find ways to retrieve my own self for the cave of despair and become more whole. It was a goal that wasn’t always clear. But as long as I get through each day, it has been possible to imagine.

Because I have not been truly alone with all this: family, friends and God’s constancy have carried me, do carry me still, as ever. It’s not the first time I have had to call on others for great aid. Trauma has been no stranger to me and it leaves its imprint even as healing occurs. But this is a quite different physical event than I’ve known before. Who seeks out a physically invasive procedure that can help, yes– yet has great risks? Sometimes there seems to be no other decent choice.

Have you, dear readers, ever had a knee replacement, or other joint surgery? Was it successful or are you still struggling? Then you know it is harder than you could anticipate. And if there are surprises that take you to your knees, it is something you cannot even respond to rationally at first. I think of you as I write this. My heart opens to your suffering, wants to make things better for you even if only by saying I care. And utilizing honest words to share my own perspective as I experience this long recovery. None of it is meant to discourage others form getting knee replacements. It is only my offering up of where I’ve been, what I’ve thought over these weeks.

Stay with me and I will share how it has come to be that I can finally begin to walk, if inelegantly, the knee usually resisting, though sometimes agreeing it is time to get much better. Still, accompanied by deep aches and shooting pains of ongoing nerve regeneration. I have a long way to go. But I am making peace with this experience and even expect better times at some point; a hike in seaside forests or the Columbia Gorge; a power walk along our many beautiful rivers; normal playtimes with my twin granddaughters; laughter and love shared with family and friends without wincing or excusing myself for a long rest or quick release of private tears.

I see the daffodils, cherry blossoms, forsythia and more opening to the warmth and grace of spring’s early sunshine. My swollen knee will get better than this. Will it not? I will turn my face upward, too, and hope that my best may come forth.