Pain Free...finally.

Let's just say, aging just doesn't do us any favors. Agreed? Basically it sucks.

Being active and exercising has its drawbacks, at least it did for me. I have been an exercise fanatic and extremely active for most of my life. Playing sports in school included, Cross Country running, Football, Soccer, Track & Field and Baseball.

As I became an adult (I use that term loosely) I continued being active and going hard at exercise. Running was a constant. In my late 30's I began to log lots of hours in the weight room trying to fight the aging process. Hey, did I mention running?

Me completing the Stop Soldier Suicide 22 Mile Challenge in 2015.

I sustained my first significant knee injury in 2002 while running, at night in the rain. The result was a torn medial and lateral meniscus and injury to the back of the knee cap. Surgery #1 in the books.

As time progressed my knees really took a pounding from my inability to restrain my activity resulting in a total of seven surgeries on both knees. The older I grew, the more intense my work outs became, until I proclaimed a fitting motto was: "workout right up to the edge". Roughly translated this meant workout right up to the edge of puking.

Eventually, it got to the point where I was having trouble walking and in constant pain and I mean blood sucking agony, keep you up at night kind of pain. Being in chronic physical pain can cause damage to other areas of your life and it must not be ignored. Your body is telling you something is wrong and you need to get it checked out. Please don't tough it out, it will come back to bite you in more ways than one.

When I was 46, the surgeon performing surgery 4 told me both of your knees need to be replaced now, but you are too young for the procedure. What the...?  Fast forward a few year and I finally decided I couldn't stand it any more. So I sought out a local Orthopedic surgeon for help. After X-Rays on both knees and a hip he told me he was going to treat me with Pain Management. I can't even explain how low I felt. Stunned and obliterated is about as close as I can do.

So I looked for a second opinion. I was fortunate and blessed to have been able to get an appointment with reknown Orthopedic Surgeon Dr. Jeffery Rosen of Orlando Orthopedic Center. After a thorough examination, he asked me "how are you even walking"? This knee (the left one) was bone on bone in about 50% of the joint and almost no space left in the rest of the joint.  At the time, the only remedy was a total joint replacement called total knee Arthoplasty. I scheduled the surgery before leaving the office.

The day of surgery was filled with a bit of apprehension but no fear. The Anesthesiologist talked to me about the process of going under and that he also would also be performing a femoral nerve block which would last for about 24 hours and help with managing pain afterward.

The procedure itself is brutal and involves sharp knives, some chisel like tools, drills, guide rods and a hammer. All I can say is thank goodness for the drugs which keep you in dream land during the procedure. My first conscious thought some time later was being in the recovery room with about 20 other surgical patients before being moved into a room on the orthopedic floor of the hospital.

In recovery, sporting my always present Tampa Bay Lightning hat. (GO BOLTS!)

Being hooked up to a hydromorphine drip under my control every eight minutes was kind of nice. To my horror, at 0900 the following morning a physical therapist who we shall call "satan's son" came into the room. He actually expected me to get out of bed. Just moving the leg hurt like hell as he helped me up. He indicated "we" would be taking a few steps in the room. As I supported myself over the walker, I recall thinking few steps my butt,  I set my sights on walking to the nurses station-about 30 feet away. After the trip out and back, he then put this machine in the bed, straped my leg to it and said you need to do this 6 hours a day. At which point I pushed the little red button causing a bit of liquid pain relief to drip into my veins. I probably said something snarky like, realllllyyy?

The machine he placed in the bed is called a C.P.M. or Continuous Passive Motion machine. Basically it flexes the knee to a preset angle and all the way to flat in a very smooth motion. The goal is to work two hours per session, three times a day, increasing the flex angle each time.

Strapped into the CPM Machine

CPM control indicating -5 degrees flat, set at 115 degrees

The 26 with the arrow indicates the machine is bringing the leg from max preset flex

to the preset flat setting. All of this is controlled by the patient.

Blah,blah, blah, yodda, yodda, yodda, more PT and exercising before I left the hospital three days later. Rehabbing joint replacement is hard work. Physical Therapists came to the house to work me hard. Nurses came to check too make sure I didn't croak from the painful activities.

Fresh cut!

The first milestone occurred on the sixth day after surgery, when I woke up in the morning with a noticeable reduction in pain. Yippie! Three days later the staples were removed, all 22 of them. Once the staples came out progress moved a little quicker. I ditched the walker at 11 days and sat in the front seat of a car at 15 days. I walked a mile 21 days post op-it took 25 minutes, but I did it.

Walking the mile on day 21. The surgery is also a great way

to loose weight.

Rehab is NOT laying in bed popping pain pills. Rehab IS working your butt off at least six hours a day on the C.P.M. and exercises in between.....if you want to walk again without pain. We went to EPCOT 28 days after getting the new knee, we didn't stay very long but we went.

Let me talk about pain management. You will be given some heavy duty pain meds when you come home. I was given 4 mg Hydromorphine tablets. Take them for the first few days weather you are hurting or not. If you get behind the pain curve, it is difficult to catch up, as I found out the hard way. I went through two refills before transitioning to 10 mg Hydrocodon tabs. Unexpected relief came from the ice wrap which circulated ice cold water around the knee. I think this is how I was able to sleep at night as you are forced to sleep on your back for about a month.

Circulating ice water wrap brought tremendous relief.

Today, that knee is completely pain free. Total recovery time was roughly 12 weeks which included 22 out patient physical therapy sessions.

The second knee replacement, a year and a half later in December 2015, was much quicker to heal from. I went home the same day, resumed normal activities three weeks later, and went through far less narcotic pain medicine. Why was the second one easier? My frame of mind knew what to expect,  a skilled surgeon like Dr. Rosen helps but also the technique has improved to the point of there is no more cutting of the thigh muscle, less surgical trauma to the knee cap and a shorter incision.

And on the horizon is Stem Cell Therapy which could eliminate most joint replacement surgery all together. The treatment involves a Dr. withdrawing your blood and separating the white blood cells. The white blood cells are then injected back into the injured area and the repair begins naturally. No cutting, hacking, no drilling, no staples and no pain. However the treatment is expensive now and not covered by most insurance. As the science evolves, I envision this treatment becoming more common place.

Shameless plug for my incredible surgeon. The day after the first replacement, (remember both of my knees were shot) as I was in an out of the bed walking and exercising on the CPM, my right knee really got over worked. I was having trouble supporting my weight with it. During his rounds, I told Dr. Rosen about the issue with the right knee and I thought an injection of Cortisone would help. He agreed. He and his surgical assistant, Victoria, who I code named "Superstar" went back to his office to fetch me some C-juice. The injection took place about an hour after our conversation. It really calmed down the inflammation in the "good knee" and allowed me to complete my rehab with relative relief. By the way, I had an Orthoscopic surgery (#6) on the right knee four months later in an effort to buy me a little time before eventually replacing it as well.

I share this information for the purpose of encouraging you to seek proper medical advice if you are in a position similar to mine. There is no worse feeling than believing your pain can't be permanently remedied. I would not wish that on anyone.