I have a new left knee.
At four weeks after joint replacement surgery, I am sitting on a log on the north shore of Eklutna Lake, eating a sandwich and basking in the March sunshine. I am now allowed to drive a car and my picnic spot was only 70 yards with a cane for assistance.
My knee is an elegantly simple mechanical device, with four main components comprised of metal alloys and plastic (polyethylene). The components make a simple hinge that I’m told will last me 15 years if I do not try to pole vault across gorges or pack full quarters of moose down steep mountain sides.
I am extremely grateful for this 21st century technological wonder, because based on my rehabilitation progress over the past weeks, I am now firmly convinced I will again hike and climb in the mountains.
Sipping coffee and watching two skiers about a mile away out on Eklutna Lake’s white expanse, I thought about a documentary film about Tibetans and their annual pilgrimage for salt, which they sold as part of their livelihood. The trip was long and arduous, taking them over steep passes and on primitive trails along precipitous cliffs. Within minutes, weather would suddenly shift from bright sunshine to a blinding blizzard.
The story centered on an old man who had been the group’s leader for more than 30 years. After so many years of wear and tear, his knees were now failing him – and a younger man was now posturing for the position. Aside from the difficulty of the journey, the real conflict was the old man’s reluctance to relinquish his important role.
He re-gained some status within the group when he helped the aspiring new leader make a crucial navigational decision. But for all intents and purposes, the old man knew his days of leading the annual expedition were over.
The movie was produced only a few years ago – but the idea of a total knee replacement was as foreign to the aging Tibetan as the absence of iPhones and internet to America’s teenagers. He had used up his knees and it was now time for retirement.
After decades of hiking and climbing with more than 150 miles of vertical ascent, my left knee began showing signs of deterioration in 2000. I fought back with hyaluronic injections, two arthroscopic surgeries, occasional cortisone injections, glucosamine, anti-inflammatory pills and ice. I put up a pretty good fight until the end of 2016, when my knee basically stated in no certain terms: “I’m done.”
The big decision
You read about a total knee replacement and doctors and technicians tell you all about it, but you never really know until it’s done and the onus is on you to rehabilitate – to bend your knee the way a knee should bend.
After the surgery you spend a couple of days in the hospital. You suffer the requisite indignities: open gown in the back to reveal butt cheeks; white, thigh-high compression stockings (to prevent blood clots) that other patients say make you look like Nurse Ratchet from the movie “One Flew Over the Cuckoo’s Nest.”
They’ve seen it all, certainly, but you still feel like a dork. Your never-ending quest to look cooler than you feel is unceremoniously quashed.
On the day after the surgery you’re out walking the ward, aided by a wheeled walker and an ubiquitous harbinger, the nurse. They all tell you how fabulous your gait is and you know they’re all blatantly lying. But at this point, you lap it up. False encouragement is better than none at all.
They send you home on the second day after surgery and you’re still quite feeble trying to get into the car. Your wife’s face is written with worry, as if she’s thinking: “I have to take of this?” But it turns out that she’s the best nurse of all. At home, aided by what they call a passive motion machine, ice and pain pills, you begin to bend the knee a little more. In a little over a week you’re walking nimbly with a cane.
The work just begins
But you’ve just left the on ramp and merged with highway traffic on the road to recovery. It’s time for physical therapy. You’ve been to a few physical therapists in the past. You know they’re not black-hooded fiends reminiscent of torturers during the Spanish Inquisition. Actually, most of them are quite nice. But categorically, they’re all no-nonsense. They’re all about can-doism.
You look beseechingly at your physical therapist and complain: “My knee hurts and it’s so stiff.” They give you a blank look, as if to say, “What’s your point? Do your exercises.”
And so it goes. You exercise the knee and create pain to make the knee bend and eventually, conquer the pain. But the pain is manageable. From the days after surgery to four weeks down the road, the pain has seldom gone to four, with 10 being the worst. I don’t think I’ve ever experienced 10, but I can imagine it’s akin to having to attend every Municipality of Anchorage Planning and Zoning Commission meeting for the past 10 years.
And I have to confess—I am a wretched wimp when it comes to pain. It’s why I didn’t play football in high school.
Learning the rehab ropes
You gradually learn that the recovering knee has a finite amount of activity for any given day. If you squander that time walking around, especially without a cane, you find that the knee becomes too stiff and sore to do the critical exercises. So you carefully budget the activity, interspersed frequently your new-found friends: Ice, Tylenol, and occasionally, on a less frequent basis, the big gun: Hydrocodone.
It’s four weeks and the physical therapist measures “flexion” and “range of motion” and says “you are where you need to be, and I don’t blow smoke. You’re doing very well.”
You want to give him a big hug. Others in the waiting room who have a clear view would probably not think it strange, since you’re still wearing the Nurse Ratchet socks.
You walk out of his office with a renewed bounce. Someone told you that if total range of motion wasn’t achieved in six weeks, it would never come back. The therapist says “nonsense” and affirms that you have a few months to make the knee bend all the way. You are relieved.
Progress is slow
I’m finishing my coffee at Eklutna Lake and watch three young guys getting ready to head out on their fat-tire bikes. I confess to a tinge of jealousy as I rise from the log, grab my cane and walk slowly back to the car.
But friends, doctors, nurses, even strangers at the post office, have all told me I’ll be back out there soon. I hope so. One of the doctors who kept me going for more than a decade, Dr. John Frost, runs the Mt. Marathon Race every year, and he is 70. I’ve traditionally climbed to the top on July 4 to cheer for him.
My ace surgeon, Dr. Prevost, thinks I’ll be up there this year. I hope he’s right. Maybe I’ll make a style statement with the Nurse Ratchet socks. So far I think they’ve brought me good luck.
Editor’s Note: Frank E. Baker is an ECHO News columnist and an avid outdoorsman. He and wife, Rebekah, a retired school teacher, live in Eagle River.