Back on the Bike

I promised I wouldn’t be back to talk about my knee replacement until I was back on the bicycle. Well…I’m back. On Tuesday of this week, at 6 weeks and 6 days after having had surgery, I was back on the bike.


It was a short ride and mostly flat but it was a gorgeous day and it was glorious to be back on the bike.  My knee is still stiff but it was still a “real” ride instead of the trainer that I’ve been on for the past few weeks.


I’ll get the obvious question out of the way first. How is it that I’m this far along? First, my surgery was stellar. I’ve done everything I’ve been told since surgery. I put myself in the hands of a trusted colleague, Candy Martin, for physical therapy. And I’ve worked harder than I would ever expect my patients to work. I also have the key to the clinic so my weekends have been filled with plenty of extra rehab on my own.


Let me tell you a little bit about what I’ve learned by going through this whole thing. Keep in mind that this is my work--I’ve rehabbed hundreds of people with knee replacements. I understand that creature quite well. And I’ve always been one to be empathetic. I appreciate what my patients are going through.


But I have definitely learned a lot from being on the patient side of the equation. I’ve learned that when they say to “stay ahead of the pain,” they know what they’re talking about.


I thought I was tougher than most. I considered my pain tolerance well above average. I thought that if it hurt, I could take the pain medicine and get the pain under control quickly. Huh-uh. Wrong. Twice I waited too long to take the pain medicine. Twice I was in agony for several hours.


I’m as concerned about addiction as anybody and keenly aware that opioid use in this state is out of control, but when you’re hurting that bad, you will do just about anything. My orthopedist, Dr. Justin Jones, had warned me that the pain was going to be bad. He took one look at my X-Rays and knew that.


If you are truly in pain and taking medication as prescribed, the chances of addiction are slim. You do need to get off pain medicine as soon as you can tolerate the pain without the use of opioids.


And about those X-Rays…my knee was a mess. Dr. Jones told my wife while I was in recovery that I was at least 10 years late for having this knee replaced. The surgery took about an hour longer than normal as Dr. Jones chipped away at all the junk in my knee. I learned it doesn’t pay to put it off. I’ve known for a while that this needed to be done. When I saw those X-Rays, I knew. It was past due.


I learned to take care of the swelling. A few days after surgery, I had some pitting-type edema in my ankle. It’s called lymphedema and our Total Rehab-MEND clinic was built around it. Dr. Andi Heinemann who runs that clinic took personal care of me. I learned that this is hugely important.


I knew that early movement was important. Especially extension. You want to get your knee straight. It is the #1 determinant of good outcomes. I would lay in the hospital bed and push my knee into full extension. They didn’t have to remind me not to put a pillow behind my knee.


I knew not to be afraid of it. Early weightbearing is good for the replaced knee. I did one round on the walker with my hospital physical therapist Kim Tippitt and switched immediately to crutches.


I knew that there was a light at the end of the tunnel—that better days were coming, even when the pain was at its worst. I tell my patients that all the time. But there were times when I doubted that. Like everybody, I wanted to be well immediately.


All in all, I was humbled by it all. I’m not Superman. I’m human like everyone else. Yet while this thing was quite an ordeal, it was totally worth it. Just like my patients have been telling me for years, I wish I’d had it done a long time ago.