Friday, May 16, 2014

Redux (May 11)

    In three days I will have my annual knee check.  I don't anticipate any problems with the operated (right) knee.  The question will  be what about the other knee.   About seven years ago, when I first consulted an orthopedist about knee pain, I was somewhat surprised when, after viewing the X-rays, he quickly came to the conclusion that I needed bilateral total knee replacement.  I didn't do anything about it at the time for a variety of reasons, first because I was taken by surprise, and, more to the point,  I was still working and would not have been covered by insurance if I couldn't continue at my job.  I remember the surgeon said to  tell my employer that I had to be accommodated, but I didn't have that type of leverage and didn't even try to explain.  He told me to call his office when I was ready and that I needed him more than he needed me.  A heartless man, I thought. 
   So I limped along, figuratively and literally, for another six years, with varying degrees of discomfort, until the discomfort threatened to severely limit my mobility.  This led me to my second orthopedist's visit, to a more kindly doctor, but one who still had the same diagnosis, the need for bilateral knee replacement.  He suggested my thinking about it and talking it over with family, but I scheduled the procedure right there and then, with a date about six weeks away, which would have been in March.  Of course, after the early bravado wore off, I postponed the surgery, for the reason I was tutoring a student who needed help to prepare for his June graduation.  He really did need my help, but I do admit I was glad to have the excuse.  There were so many cautions about total knee replacement that I was not anxious to go through with it; I think I may have postponed it indefinitely if my son hadn't made airline reservations to come home to help me. In face of all the advice and cautions, I had no idea what to expect in terms of how much help I'd need or for how long.
    So, though not exactly forced, I felt compelled to honor my decision to have the surgery, and on May 21, old knee out, new knee in.  Much easier than anticipated and way less traumatic than I'd been told to expect.  I've never regretted it.   Indeed, the outcome was so much of an improvement that my other knee was swept along with it, no more pain on walking and more stability.  This happy state of affairs  lasted into  the fall and throughout the winter.  But with the coming of spring came the beginning of forgotten twinges.  My left knee doesn't react well to walking on uneven ground.  It could be just strained because I've been outside this year doing a lot of the raking and yard work that I'd been unable to do for the past several years.  I tell myself that.  Yesterday, I walked a city block or so in Schenectady, and I'm pretty sure I got that old familiar feeling.  Didn't  I hear that clunking noise again? 
     I'm so much better off than I was a year ago that I'm reluctant to rattle the cage, as it were, but I also am not anxious to nullify my gains by allowing the other knee to deteriorate. The crux of the issue is that the knee doesn't hurt or ache if it's not being used.  Neither did the right knee, not after the double set of cortisone injections administered by the first orthopedist.  So if I can stop walking before my knee hurts, all will be fine, no surgery needed.  I can wait to find out if pain will set in at rest.  But then, if I need surgery, I'll be even older, and maybe, as I've been told, if the knee becomes more worn, the surgery becomes more difficult.   I find myself on the horns of a dilemma.  At Wednesday's visit, I will ask the surgeon what condition my left knee is in.  Who knows, I've been using the stationary bike quite faithfully,  so some muscles must be stronger, maybe enough to overcome the need for surgery.  I don't kid myself, though, I know he'll say the decision is mine to make. 
                            (May 12) Countdown to 2 days -----Testing 1, 2, 3
    I walk across the yard to the end of the lot.  I hear no sounds, but there is soreness, almost as if there is some sort of impingement.  The pain stops when I stop.  I have to take that as a good sign, and after all, the ground is uneven and moreover I walked around in Schenectady yesterday.  I'm not sure I'll even mention my left knee at Wednesday's visit.  There's no hurry anyway.  I will be the only one affected by whatever I decide to do.  Or at least I hope so.......I'll check again tomorrow, after my bike ride
 

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