Monday, January 9, 2023

Gratitude Monday: not quite the bee's knees

My knees first became problematic in 2009. Physical therapy and running shoes with a greater stability factor took care of them. Two years later I had arthroscopy to clean the arthritic debris out, which helped. Until I needed cortisone shots and then hyaluronic acid, which took me through to 2020; at that point, the injections stopped helping.

But it was a flare up last June that got my attention, because the pain was unremitting for the two weeks it took to get an appointment with an orthopedist. Cortisone and physical therapy got me through Singapore, and I got a top-up of cortisone before France, but it was clear within a week that its therapeutic effects had worn off.

I actually made some decisions about where to go while in France by asking myself, “Self, do you want to go up/down those stairs? Or that hill?” I do not fancy living like that, and I was literally limping when I got off the return flight.

So on 26 January, I’m scheduled for total knee replacement surgery. The surgeon won’t do both knees at once, which is a bummer, because both need replacing, so I’m starting with the right one; accelerator leg over clutch. It’s out-patient—isn’t that amazing? The technology and treatment for joint replacement has advanced exponentially since they started doing it, so this ought to last the rest of my life.

There will be post-op pain, which I hope will be manageable. And physical therapy—the Rx is for three months of that at twice a week. Plus, you know, doing the exercises at home. The expectation is that you get up and about right away—surgery is on a Thursday; first PT appointment is the following Monday.

You need a lot of prep work for this kind of surgery—labs, medical clearance from my PCP, dental clearance, CT scan, viewing a “you and your joint replacement” video, registering on a gazillion sites. I created a spreadsheet to keep track of it all.

(A British friend of mine thought it disgraceful that I had to do this, but this is the difference between a single healthcare supplier that dictates—literally—all your appointments and the fact that I have choices among multiple providers, and schedule appointments at, mostly, my convenience. She has to trust that all the NHS components will line everything up for her when she needs a procedure—even though it’s quite clear that many parts of the NHS do not tick along like clockwork. I am responsible for lining up all the ducks for my care myself. Because we have a for-profit medical system, this also means I have my Flexible Spending Account card out for every service. My co-pay for the CT scan was more than $300.)

Because I made the mistake of including my mobile phone number on all the forms, I’ve also had to fend off attempts by the hospital and other providers to get me to access their portals via mobile. I do not fill out forms on a tiny screen; a 14” laptop monitor is bad enough. They keep trying; I keep telling them to stop.

(They make mobile phone number a required field. What are people without mobiles supposed to do? Not have surgery?)

I know I’ve made the right decision, because every single day the pain becomes a little worse. By the time I’m done with a mere 7k steps on my morning walk, I’m gritting my teeth. It’s time to take action.

And something I find encouraging is that every single person I speak with who has had the procedure done, or knows someone who has, says, “I’m only sorry I didn’t get it done sooner.” I’m looking forward to that kind of relief.

Well, it’s Gratitude Monday, so here’s the deal. I’m grateful that there is treatment to alleviate this pain. That I have an excellent surgeon (he cleared up my rotator cuff a couple of decades ago). That this is an out-patient procedure and—barring unexpected things—I’ll be home that evening. That I have a great physical therapist who is helping me prepare for the surgery and will take me through rehab. That I have reasonably good healthcare insurance, so I can afford all of this. That I have (for the moment) a job that ensures I can pay for all the co-pays. That I have friends who can help me through all the rough bits. That I can look forward to a future of not having to make touring decisions based on avoiding hills and stairs.

That’s a lot.

 

 

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