Total Knee Replacement

October 9, 2004

“For I reckon that the sufferings of this present time are not worthy to be compared with the glory which shall be revealed in us.” Romans 8:18 “What man is he that fears the Lord? Him shall He teach in the way that He shall choose.” Psalm 26:12

If the Lord tarries, my total knee replacement surgery will be on Monday, November 8. I visited three rehabilitation (rehab) facilities and chose the nicest one with a private room and private bath. I have to pay $20 extra per day for a private room, but it is worth it since I am such a light sleeper. I don’t want to end up with a roommate who screams all night. This facility specializes in joint rehab and has an excellent reputation. My sister, Marsha, is flying here on November 6 and will be with me through the 15th. I am so thankful she can be with me during this time. My dad offered to give me money every month while I am out of work, so I thank God for my dad’s help also.

I thank God for all the valuable lessons He will teach me in this school of knee surgery that He has chosen for me. Here are the classes: Surgery 101, Inpatient Rehab 102, Home Rehab 103, Outpatient Rehab 104, Out of Work 3 months 105. I know He will throw in some surprise classes and pop quizzes. God encouraged me today with 2 Corinthians 1:5, For as the sufferings of Christ abound in us, so our consolation also abounds by Christ. God will not test me above what I can bear. Thank You, dear Lord, that You have it all perfectly planned out.

October 16, 2004

I went to an interesting class at the hospital to prepare me for surgery. They gave me a folder and had me watch a video by a TV actor who had both his knees replaced at the same time. He is now able to ride a horse, so maybe I can cross country ski a little next winter. Dr. S. told me not to give away my skis!

Yesterday I attended a conference for orthopedic nurses and many of the hospital nurses who will be taking care of me also attended. I learned much, but I’m not sure if it was good for me to hear about all the possible complications of knee replacement surgery. I am so thankful my two nurse friends from church will both be working the week of my surgery. It’s always nice to see familiar faces at the hospital.

October 30, 2004

I tried to donate blood to store for myself, but my veins collapsed. Two friends at church who have my blood type volunteered to donate on my behalf, so that was very generous of them. The Nurse Practitioner who was my first preceptor in graduate school now works for my primary care doctor, and she gave me my preoperative physical. It was great to see her again! I only have six days of work left. I am so ready to move onward and forward and have this surgery behind me.

November 4, 2004

“Thou hast enlarged me when I was in distress.” Psalm 4:1

I read this verse before I attended our monthly practice meeting yesterday at the hospital. Dr. E., my main boss, asked to meet with me privately after the meeting. He told me they were granting me the medical leave of absence for a maximum of 16 weeks even though they aren’t required to legally because they are such a small practice group. The hospital lost $2.5 million last year and has had to lay off a number of employees. He said he might need to decrease my hours when I return. He wants me to make rounds on all the hospital units to increase the visibility of the rehab unit and to promote the rehab unit as enthusiastically as possible. He said the workload will be difficult for Dr. S. while I am off. They are not paying me any salary while I’m off work, so at least they are saving money that way.

Many changes lie ahead at work in the next three months, but I refuse to worry about it because God isn’t worried! I praise Him for the wonderful peace He is giving me going into surgery.

November 15, 2004 – 2:40 a.m.

I had my surgery one week ago, and I’m now at the rehab facility in my pleasant private room. Marsha flew back to her home today. She was my advocate while I was in the hospital when I could not think straight from the pain and anesthesia. I am so thankful for help from her and the nurses from church. I thought I would lose my mind from the pain right after surgery. I fainted several times in the hospital from low blood pressure caused by the pain medicine, so the doctor changed to another one. They put my leg in the continuous passive motion (CPM) machine which made my leg spasm, so I refused it.

My titanium knee xray looks similar to this.

Marsha drove me from the hospital to rehab in my car, but it was agony to bend my swollen knee enough to get it in my car. I think I should have come by ambulance instead. The rehab facility couldn’t obtain my pain medicine from the pharmacy for 12 hours after I arrived, so again the pain was incredible. Mary, my friend from church, visited me and held my hand when my leg spasmed. We sang one hymn after another to try and distract me from the pain. I’m so glad I brought copies of the words of all my favorite hymns with me. Some of the brethren from church came to visit me on Sunday afternoon which was a blessing. They sang “Rejoice in the Lord” and “Isn’t He Wonderful?” I am finding singing to be very therapeutic.

Reflection

And so I began my 10 day stay in the rehab unit. The intensity of the pain after surgery surprised me. I really didn’t know a person could experience that much pain. The experts say that bone pain is the worst kind of pain, especially in the knee joint because the swelling has no where to escape. People who have had both their hip and knee replaced have told me that the knee replacement pain was significantly worse. However, everyone experiences surgical pain differently. A few people only need mild medicine, but I definitely think I was at the opposite end of the spectrum. One probable reason was my age of 49 years and having intact nerves.

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More Knee Pain

August 2, 2004

“Beloved, think it not strange concerning the fiery trial which is to test you, as though some strange thing happened unto you.” I Peter 4:12

“In every trial, there are gleams of light and relief, but full deliverance is often delayed by our anxiety to obtain it. God Himself and not the deliverance is to be the satisfaction of His servant. Consequently, the deliverance is often postponed until we are without prospect or expectation of it. Then it may happen in a manner so far beyond our conception that we must see and understand the love and interest which surrounded us during the whole period of our trial.” -None But the Hungry Heart

As I begin my second week of recuperation here at home after my knee surgery (arthroscopy), I am so thankful for this encouragement from the Lord. Dr. E., my big boss, was so kind when I talked with him this week. He said to take all the time I need to recover. He knows I’m not hanging out in the Bahamas:) He asked if I have osteoarthritis, chondromalacia (rough knee cap), or torn meniscus (cartilage). I told him that I have all three which shocked him. He said he was at a loss for words to say something to make me feel better, but God is my comfort and strength.

I spoke with one of the nurses at church who had her knee replaced. She encouraged me to have it done as soon as possible so I don’t ruin the other one. She was able to drive ten days after surgery, but said the pain is intense the first few weeks.

August 9, 2004

I tried to return to work last Thursday for four hours, but it was really difficult because I became so weak. I’m afraid the stress of surgery has made my adrenal glands crash again. It took me three hours to do one admission and see nine patients. I can only stand about 30 seconds, so I went back to work too soon. I am going to write out surgical guidelines for myself for the next surgery to help me remember. I spoke with two nurse friends at church who both work in orthopedics at the community hospital. They both recommended Dr. R. who did my first two knee arthroscopies.

I tried to go to church yesterday, but became so weak after driving two blocks that I had to turn around and come home. So I laid on my couch and listened to a good Bible message on thinking right. I keep asking God to help me to see this exercise in my life from His point of view and to help me not to wrestle, but just nestle in His loving arms today.

August 14, 2004

I saw Dr. R. for a second opinion on my knee. He needs the operative report and and photos from Dr. M. He’s not too eager to do a total knee replacement on me because it only lasts 8-10 years on someone my age. If I can wait 11 more years until I turn 60, the knee replacement will last 15-20 years. He ordered water therapy in the pool which I did yesterday and today. I am still getting weak and dizzy once or twice a day, so I’m not sure when I will be strong enough to return to work. I’m off work without pay now since I used up all my sick and vacation time. I know the Lord will provide.

Dear Lord, Carry me this day. I give it to You in all my weakness. Thank You, that this path of affliction is for Your glory and my good. Help me to trust and rest in You. In Christ’s Name, Amen

August 26, 2004

“The Lord will give strength unto His people; the Lord will bless His people with peace.” Psalm 29:11

God is so gracious in carrying me along this week. The endocrinologist and naturopath both agreed that my adrenals are my main problem causing the weakness and dizziness and have restarted the cortisone and other supplements. I am getting custom inserts for my walking shoes to try and align my knees better since my knee caps point out instead of straight ahead.

Dr. E. called me again to say hello and see how I was doing. When he worked in internal medicine, he had a patient with adrenal insufficiency and said he knew what a difficult problem it is to have and treat. He assured me that they will not replace me and not to worry about my job or come back too early. If I need to come back just 3 or 4 hours daily, that can be arranged. It was so nice of him to call and reassure me.

I thank God so much for the compassion of Dr. E. and Dr. S. and allowing me to work with these two men. They are so refreshing compared to my two previous nurse managers at the LPN school and the insurance company. But I realize that none of this will matter 100 years from now, so I’m just trying to keep the big picture. I now qualify for disability since I have been out of work for over a month. I thank God so much for His encouragement today.

September 30, 2004

“And after you have suffered for a little while the God of all grace, who called you to His eternal glory in Christ, will Himself perfect, confirm, strengthen, and establish you. ” I Peter 5:10

After taking the cortisone for 9 days, I was finally able to return to work a couple weeks ago, but the knee pain is intense. Dr. S., my boss, ordered forearm crutches for me to walk with as these give the most relief from knee pain. My patients are so sympathetic as I make rounds on them and we joke about our mutual aches and pains. I’m connecting with my rehab patients on a new level.

My knee pain was so bad that I needed to walk with forearm crutches at work.

I saw Dr. R. yesterday about my continuing knee pain. He reviewed the surgical report and photos and said I need a total knee replacement if I don’t want to end up in a wheelchair. I don’t qualify for a partial knee replacement because my bones are soft and I have triple compartment arthritis. I will need about 10 days in a rehab facility after the hospital stay since I live alone. He recommended two facilities and said I should visit both before surgery to see which one I preferred. I will need to be off work for three months after surgery. He is very comfortable dealing with people with adrenal problems, so they will give me a huge steroid dose the day of surgery to prevent my adrenals from crashing again hopefully. He is going to order the newest and most expensive titanium knee for me that is supposed to last 30 years. It costs $30,000! I sure hope it lasts until the Lord takes me home.

Dear Lord, Help me to relax with the pain right now and rest in Your everlasting arms. I just want to line up with Your plan and not my own. You plan this surgery and use it for Your glory and honor. In Christ’s Name, Amen

Reflection

And so God prepared me one step at a time for a very difficult surgery. Many days it seemed like I would never be pain free again in my life. I realized even more what a blessing health is, but many times He teaches me the most when I am so very weak and can do nothing but lean on Him. This very difficult time in my life gave me much greater compassion for the health problems of my patients.