The Wonder of Knees

June 2020

I’ve put it off for as long as possible because replacing a knee is major surgery, and things can go sideways fast. Infection is #1 on my doctor’s list of concerns. Blood clots are #2, and I’ve heard stories of people who had clots travel to their lungs and died before they could get to an emergency room.

Pain is at the top of my list. My knee is now bone on bone, and I can’t limp all the way around a grocery store without packing it in.

Walking gingerly into OSF St. Francis Hospital with the folded-up walker I’ll need later, I’m nervous because it’s the first year of the pandemic, in the time before the vaccine, and before anyone knows whether COVID can damage your organs. Hospitals are doing only necessary surgeries on patients who are healthy enough to go home the same day.

Sitting on the hospital bed, I slip on the gown the aide gives me, as well as yellow booties and adult Depends. A nurse comes by in her mask to go over the pre-op checklist and answer my questions: “How do they know what size knee to put in?…Do they ever use knees from cadavers?” An IV port is installed in the back of my hand, and then I wait, because the previous knee surgery is taking longer than expected. The nurse won’t tell me why.

Eventually, she says it’s time and walks slowly with me as I limp down the hallway. I’m resigned to whatever fate awaits me and unconcerned about the hospital gown exposing my backside, because I am rocking the Depends.

We enter a room with half-a-dozen people in masks. Each one is introduced by their first name, and my anxiety throttles down from 7 to 3. Their smiling eyes say, Don’t worry. We’re good at this. We’ve got you.

For months, people have been wearing protective masks that hide most of their faces, and I’ve noticed how many eyes are simply beautiful. They convey emotions that I wouldn’t have seen before, from humorous to indifferent to coy. Some people glance away as if making eye contact will spread the virus. Some eyes are mischievous with secrets. A few eyes look so weary or hold such sadness that I want to ask, “Are you okay?”

Sitting on the cool, grey metal table in the middle of the room, wondering if it’s going to be THE table, I’m thankful for the warm cushion of the Depends.

A big guy comes over, puts his hands on my shoulders and says that Kris is going to give me an injection in my lower back. I will feel a prick, and the big guy will catch me if I fall over, which I apparently do a moment later, because I wake up in recovery to Grace, who inquires how I’m feeling.

“I’m amused that I woke up to grace,” I say.

Before I can go home, I’m required to walk up two steps, which is easier than I anticipated, and I have to pass urine. Standing at the toilet, I can’t get anything to happen. My midsection is numb and has apparently gone on vacation, so whether I go or not doesn’t seem to be in my control. Yet, somewhere along the line, urine has appeared in the Depends. When I point this out to the nurse, she says, “You’re good to go,” which also amuses me, because I’m not sure I can.

At home I strap my knee into a portable ice cooler that circulates cold water and wear the cooler continuously for the next three weeks. I also begin a regimen of alternating pain medications every three hours, my wife getting up throughout the night to hand me the correct pill and put more ice in the machine.

Four days later I begin physical therapy with Luke, to restore flexibility and strength. One day he uses my knee as a convenient prop to describe the surgery to a student intern—how the surgeon vertically sliced through the skin over my knee here, flipped my kneecap to the side like this, sawed off bits of my leg bones above and below the knee, finagled the artificial knee into the space between the remaining bones, glued it in, resurfaced the kneecap, flipped it back, then stitched and stapled the two flaps of skin back together over it all.

Because of the drugs, I have little appetite and lose fifteen pounds. Every couple of days I tighten my belt another notch. By the end of the third week, not wanting to become addicted to the opioids, and weirded out by the strange dreams that appear every night and swirl like something from the Twilight Zone, I swap in Tylenol and ibuprofen.

In the seventh week of Zombieland, sleep is still a problem, because the lingering dull-bladed ache in my knee keeps waking me up. I doubt that I’ve had any REM sleep since surgery. I can’t entertain a thought long enough to figure out where it’s headed. My physical therapist suggests taking Aleve, and finally I can sleep.

In retrospect, even with the thrill of thinking that I was now a cyborg or bionic, it wasn’t a miracle that a living knee could be replaced with a contraption of plastic and metal–one that works so well that I can walk without pain for the first time in a decade. That was technology and the skills of the surgeons and nurses.

The miracle was this: In the early months of the pandemic, when it wasn’t known how the virus was being transmitted, and death counts were going up at a terrifying rate, these nurses and doctors turned toward people who were suffering and put their own lives on the line. They had to be concerned about their own health, and worried that they might bring something fatal home to their families. Yet they were there in the OR with me, and they were smiling. This kind of unselfish love can’t be explained.

The courage I saw in their eyes shines bright in the night sky of my heart.