TKA: The Last on this for a While

This is going to be the last you hear on this topic for a while. I am back at work and life is slowly returning to normal. So it’s time to put this story to rest for a while.


I’m talking about my recent knee replacement surgery. The next time you hear from me on this topic I will be telling you about a return to the bicycle. I promise.


You already know that it’s been a bit more than I would have thought. I thought I was stronger, more prepared, and ready for this thing. I even told Dr. Jones (that did the surgery) that I was not going to be his typical patient.


Well, this piece of garbage knee that I gave the good Dr. Jones to work with had something different in mind. This thing decided that I was going to pay for ignoring it for way too many years. It decided at surgery that “all right big boy, I’m going to show you who is boss.”


I’ve been humbled. I’m not superman. I’m far more normal than I ever thought. This knee replacement has been just like everybody else’s. It hurts. It’s stiff. No part of it is easy.


Oh, it seemed like it was going to go just like I planned. The morning after surgery, the wonderful physical therapist Kim Tippitt got me up and walked around the halls of the hospital. That was after Physical Therapy Technician Bill brought me coffee and my wife sweet tea, something he does for lots of folks (and another column unto itself).


Kim expertly guided me through my first few steps, coaching me along the way and then took me to the PT gym on the same floor to go through a few exercises. When she came back for another jaunt, I asked to use my own forearm crutches and she obliged.


I was off to a booming start. I went home that night and came to a screeching halt. The pain was rather significant. I was, perhaps, human after all. The next few days taught me lesson after lesson. I was most assuredly human.


Surgery was on a Wednesday. My first outpatient physical therapy visit was to be Friday at one. On Friday morning, I called and cancelled that appointment, opting instead to move it to Monday. My family could not believe it. I was definitely called out on that one. I just wasn’t ready.


Let’s jump back to the now. As I said, I’m back at work. Everyone is looking out for me but I’m where I need to be. Two weeks at home did not drive me crazy. My wife has taken incredible care of me. I’ve read a ton, watched some good movies, and caught up on a lot of writing.


Physical Therapy is going well. My knee is really stiff but that’s mainly because of the extra length of time that I had to stay in a tourniquet for the surgery and for the extent of the garbage that my knee had become. Pain is manageable. Walking isn’t too bad.


Several weeks ago, a friend said to make note of the date when I decided that this whole affair was worth it. I really can’t say I’m quite there but I know that the day is coming. I can see the light at the end of the tunnel.


And I can’t really answer the question “are you glad you did it?” I guess I am but I’m ready to be normal, pain-free and back on the bicycle.

TKA: The Saga Continues

I received some good column writing advice many years ago…some advice I’ve tried to always follow. The late great Jim Dykes told me “write where you’re at.” Works for me. For 35 years.


Well today, I’m in the middle of recuperating and rehabilitating from knee replacement surgery. I told you about all that last week. I thought I might update you later but this is pretty much my whole world right now. This is “where I’m at.”


Every moment is consumed with getting through this, getting better, and getting back to some degree of normalcy. But I have to tell you, this thing has been a bear. Dr. Jones tried to tell me that it was not going to be much fun. He tried to tell me that it was painful but I thought I was tough. And when I started whining, he reminded me that he spent an extra hour just chopping away bone and bad stuff.


I originally had thoughts of going home on the day of my surgery. THAT wasn’t happening. I had these thought I would get a new knee and be back to work in a few days. Huh-uh. Wasn’t gonna happen. So now I’m working every day on moving my leg, walking, exercising, going to physical therapy, and, yes, simply recuperating.


Simple tasks take more energy. Sleep doesn’t come easy. I’m still using crutches to get around (I was NOT going to use that walker thing). And then there’s that whole thing about “staying ahead of the pain.” I didn’t really understand that at all. Everybody told me about that. Told me how important it was.


But I was different. I was tougher than most. At least I thought I was. I learned that lesson the hard way the first night home after surgery.


I had been functioning at a high level on this piece of junk knee for well over 10 years. I could do everything but run. Until this year, my wife and I had taken a big hiking trip every fall for many years. Oh, I knew it was time. There were days when the knee would ache and I would think “find Dr. Griffith and a surgical suite and we will fix this thing right now.” I knew I was taking way too much anti-inflammatory medication.


Most of that was because I could still ride my bike. It hurt occasionally but for the most part, I could ride without any trouble at all. I’ve spent a lot of years getting to a decent level of proficiency on the bike and I knew that a gap in my riding that a knee replacement would demand would mean that I wouldn’t be able to ride like I did for a long time.


That’s important to me. Not because I want to be faster than most. And I’m not really very competitive on the bike. That has nothing to do with it. A lot of my very best friends are those people I ride bikes with. Steve, Maysoun, Bob, Emil, Ken, Clay, Tim, Clark, and on. There is a friendship, a camaraderie among bikers that is like nothing else.


You’ve got to like each other. You’ve got to trust each other. You’ve got to support each other. When one person goes down, we all hurt. When one person gets a flat, we all stop. It’s a fellowship that I don’t get in many other places.


For now, that’s gone. Oh, I know I will be back. I know I will catch up. But there’s a gap in my life, in my psyche from that absence. So now I work. I don’t believe anyone can say (yet) that I’ve been anything but an exemplary patient. Despite leanings this way in the past, I am dedicated to not do anything stupid.


I want to close with some advice, both personal and professional. If you’ve been putting this thing off, reconsider. I waited ten years too long and because of that, this has been much harder than it needed to be. Although I’m not quite there yet, almost every patient I’ve ever rehabbed for this has ended up saying “if I had it to do over again, I would have had it done a long time ago.”


I’m sort of counting on that.

TKA and Down

This has been a rather eventful week for me. Last Wednesday Dr. Justin Jones of OrthoTennessee-Maryville (formerly known as Maryville Orthopedic Clinic) put a new knee in me. Yep…one of those knee replacement things.


Now this is something that I know a lot about, though not on quite so personal a level.  As Baby Boomers have hit their senior years, it is becoming more and more common.


The technology is getting better all the time too. (I’m pretty much counting on that). But this surgery was way overdue. I’ve had previous knee surgeries on this knee, dating back to college days, but none quite like this. This was the big one.


If you saw me trying to run onto the football field to check an injury this year, you knew something was up. By the end of this football season, I barely strolled out onto the field, regardless of the anticipated severity of the injury. My right knee just wouldn’t allow it.


It goes back to my football days. And farming, when we would literally tackle calves to give their shots and tags (we were football players—we thought it was cool). I had a few injuries along the way but none too bad. I played basketball until I was 59 when this same right knee told me clearly it was time to give it up.


I have rehabbed hundreds of patients with total knee replacements. A common refrain is “I wish I had done this a long time ago.” I’m not sure I feel that way yet. I probably will.


I do know that literally up to the time of the surgery, I was riding my bike. I had no trouble out of my knee on any of the group road bike rides that I take every week. And weekends on the mountain bike were my regression to a younger self, when I would zoom around sweet singletrack like I was in my 20’s (…OK…in my 30’s).


But walking became difficult and running became impossible for me. Steps were too often one at a time. My family became quite protective of me in recent months but what they didn’t see, they couldn’t change. Like climbing around doing repairs on my barn. Or like last Sunday, when I zigzagged around my lower pasture doing a final season treatment of fire ants.


But it was time. So on Wednesday, I got 90 minutes of Dr. Jones’ best work and now I’m home. Yeah, 90 minutes. Maybe three times longer than it usually takes.  There was a whole lot of chopping and chiseling. The end result will be a much better knee than I’ve had in a very, very long time.


I know it’s my employer but everyone at Blount Memorial Hospital was awesome. From Shannon in Pre-op to Carmen on 5-South and everyone in between. I was well informed through every step and treated with compassion and professionalism by everyone I encountered.


And now the rehab process starts. I’ll be in the hands of my colleagues at Total Rehabilitation-Cherokee, mostly Candy Martin. I promised many that I would be a good patient. Just don’t try and hold me back. Dr. Jones won’t. He already told me as much. He put a great knee in there. I’m not going to be stupid but I do plan on working harder at rehab than I’ve ever asked a patient to do.


I guess the best advice came from my friend David Schoeni—he said “don’t be a hero.” I don’t plan to be but you might see me back on the bicycle sooner rather than later.

Strength Coaches and Injury Prevention

We had three local teams in the football state championships this weekend. It is a huge accomplishment just to make it to this level. It is amazing that three teams within spitting distance of each other are all there.


The Total Rehabilitation Athletic Training staff was there. Shawn Davies, ATC covers Greenback. Peggy Bratt, ATC was where she always is…on Alcoa’s sideline. And I was there for Maryville High. It is a privilege we don’t take for granted.


At this point in the season, it is often the teams that are healthy that are most successful. Our athletic trainers are a part of that but probably not the most important part.


The unsung heroes in injury prevention are those in charge of strength and conditioning of our athletes. The time in the weight room and in the gym is the foundation for performance but also for injury prevention. 


Success on the field or on the court starts in the offseason. And it’s not just getting bigger, stronger, and faster. It is developing balance, coordination, agility, flexibility, and core strength. I preach the core strength sermon all the time.


Think of your core as the foundation that you build your house on. Remember the story about building your house on the sand? Same thing. Knee problems? Work on your core. Shoulder problems? Work on your core. Back problems? Definitely work on your core.


The Strength Coach at Maryville High is Brandon Waters. At Alcoa, it is Brian Nix. Coach Waters is always seeking ways to develop his athletes, particularly when it comes to preventing injuries. I’m quite sure Coach Nix does the same thing.


At the end of the season, Brandon and I will always have a long conversation about what his athletes need to do to prevent injuries. During the season, when someone gets hurt, he is always seeking answers as to why.


There is really no accident to the fact that the football teams at Alcoa, Greenback, and Maryville are in the state championships. In many respects, they are the healthiest teams. And that didn’t happen by accident.


I travel to other parts of the state often and am frequently asked what is the reason for all the athletic success that we have around here. It’s not just football. Look at the soccer teams at Maryville, Alcoa, and Greenback.


For the first time ever, I’m going to give you my opinion on that.


We have great coaches around here. We have great community support. We have kids that buy into their respective programs. We have kids that grow up playing multiple sports. Yes, we have great athletic health care.


We have kids that buy into the concept of team play. We have coaches that are more invested in developing solid, responsible adults than they are in winning championships (I just happen to believe that the two go hand in hand).


Congratulations to the many teams in this community that are out there every day, working hard, striving for success, staying coachable, and learning valuable life lessons.

Who Loved you into Being

I watched the new movie “It’s a Beautiful Day in the Neighborhood” last weekend and I find that I’m feeling quite thankful for a lot of things, not just a table full of food with family around.


In that movie, Tom Hanks, playing Mr. Rogers, turns to a reporter and asks him to “consider for 1 minute the people who loved you into being.” The really cool thing is that in the movie, Tom Hanks’ character looks straight into the camera, basically asking everyone in the audience the same question.


I don’t know about everyone else that was there but I did what he asked. I thought about my mom and dad, aunts and uncles, friends, and my wife.


My parents were a bit older when I was born. My dad liked to say he had to practice a lot to get me. He had his first heart attack when I was 5 so the dad I remember was never very active (cardiac science back then was that you essentially did nothing). But he was always there for me.


When I built a tree-house at 12, he sat at the bottom of the tree and coached me through it. When he was unable to tend to our bees, he sat in that same chair and talked me through the process.


His 6^th grade education meant that he could never really help me with my homework but he still demanded excellence in the classroom. My summer job in college was at a local factory, the place where my father had worked until his heart sent him home. The guys there would tell stories about how hard my dad worked. He was a little man but could outwork anybody.


My mom was this tiny lady but with strength it’s hard to fathom. When my father’s health failed him, she went to work, first in the elementary school cafeteria and then at the same factory where my father had worked. Although dementia tainted her later years, she lived 94 years and was feisty up until the very end.


I was blessed with aunts and uncles that helped mold me. Soon after my dad had to retire, my uncles took me to Knoxville to buy me a proper sport coat and pants, something I didn’t have. They were role models, maybe good and bad, but they loved me and I knew it. Most say I look like my Uncle Dood.


My Aunt Gin had style and flair and if I have either of those, it came from her. I did her eulogy where I complied with her wish that I add “my Aunt Gin was a hoot.”


I have been blessed with great friends throughout my life. Ricky Alexander and I practically grew up together. He was the kid who lived closest to me and we were always at each other’s house. Scouts, football, hunting, fishing…one adventure after another. If I ever went to battle, I would want Ricky there with me.


Ronnie McNabb and I were friends from an early age but became inseparable in high school. Countless hours on the tennis court, dated best friends, roomed together in college. We don’t see each other often enough but still consider each other brothers. If I needed anything, he would be there.


As an adult, I have had many great friendships, some lasting literally for decades. Ken Bell and I can drive across the country and enjoy each other’s company for days on end. I’ve spent thousands of miles riding bikes with Steve Bright and trust him like no one else. Danny Smith who does physical therapy the right way all the time. Others. Friends that love you like family even if they aren’t.


And then there’s my wife. Forty-three years and going strong. I look forward to getting home to her each evening. I’m gone a lot (work, volunteer stuff, bicycling, politics) but she remains my rock and my foundation.


So who loved you into being who you are today?

Medical Bankruptcy

When I first started writing this column, it was all about sports injuries. It actually started out as a question and answer thing, answering questions about athletic injuries.  Dr. Bob Haralson and I took turns answering the questions in this space. It was called “The Jock Doc.” We did it that way for about a year.


It became a column not long after and I’ve been writing it every week since then. For 34+ years.  In all these years, I have covered a wide variety of topics, often having little to do with sports. But it’s always been about helping this community be a better place because…well…I’m all about making this community a better place.


When I arrived in Maryville in 1977 (December 12^th, to be exact), there were three physical therapists in all of Blount County. Blount Memorial now has about 90 Physical Therapists and Physical Therapist Assistants and a whole host of other rehab clinicians that are Occupational Therapists, Athletic Trainers, and Speech Therapists. There are other rehab clinics and clinicians around our community providing good care.


Obviously, health care has changed. The medical community here has grown to meet the needs of our county, also reaching into surrounding communities. Our population is now over 130,000. Here’s the problem:  Every single day, I encounter someone without health insurance or someone that is terribly under-insured.


All too often, I will get a boy or girl having had surgery to repair a torn ACL, a devastating injury to a young athlete. And maybe they have no health insurance or are under-insured. The rehab following ACL reconstruction is extensive. But even if they have insurance, maybe their insurance has a hard max of 10 visits for physical therapy (that means that insurance will only pay for the first 10 visits). They need more than that to get back to their sport.


Health care costs, including the costs of providing physical therapy, are expensive. Insurance and other forms of third party-payment are important in helping us get the care we need while protecting our financial viability. Unfortunately, over 500,000 people go bankrupt because of medical bills every year. That constitutes a national crisis.


Let’s look at this from a different perspective. One of my best friends in the world just got back from M.D. Anderson Hospital in Houston. He has a rare and aggressive form of cancer. So he traveled to the best cancer treatment center in the world. The cost doesn’t matter. His life is in the balance.

In the United States, we have the best medical professionals, the best technology, the best hospitals, the best medical care in the world. Twenty years ago, my friend would not have had a chance. Now, he does. And he will pay whatever it takes to beat this thing.


I’m not going to get political on you and offer my opinion about what we should do as a country. I don’t think there is a single best solution. But I can tell you my opinion about what you and I can do.


We can get healthier. We can take better care of ourselves. We can eat better. We can control our weight. We can exercise daily.


We can get an annual physical, not because we’re sick but because we’re making sure that we stay healthy by controlling our blood pressure, managing our diabetes, and by discovering medical problems early, before they turn into catastrophic events and diseases.


We can stay away alternative forms of “health” care that claim to treat everything from glaucoma to asthma to bedwetting. We have research that tells us what the best course of action to treat injury and disease is. Insist on evidence that what any provider is suggesting will really work.


We can prioritize our health and take ownership of our personal wellbeing at a level that will drastically decrease what we spend on health care. And be healthier and happier because of it.

More on Simply Moving

I want to talk about movement again today. I listened to a podcast this week about movement and it had some really great points. We just really don’t move much anymore. Modern conveniences have created a sedentary culture.


I see tons of patients with shoulder problems. A lot of those are related to their posture and a lot of that is from spending too much time in front of computers and digital devices. Neck, shoulders, upper back…all pay the price for sitting too long.


Lots and lots of jobs consist of sitting in front of a computer all day long. Even my job requires me to sit at a computer for long periods of time (hello, medical documentation). We even advise people who work at computers to set an alarm to tell them to get up and move around every so often.


Modern conveniences have been built around not moving. Drive up for fast food. Eat in your car. Drive up to the pharmacy to pick up your medicine. Drive up to the bank to handle transactions. We don’t even get out of the car.


We can call in our grocery order, pull into a designated spot and someone will bring everything we ordered and put it in our vehicle. I realize that can be a great blessing for those with limited mobility but I still advocate for getting out and going inside to do your shopping, even if it is in one of those motorized wheelchair-type things.


Even when we get the stuff home from the grocery store, we don’t have to do anything to it. We don’t have to wash it. We don’t have to chop it, peel it, or dice it. It’s already in a bag ready to eat. Instead of planning, assembling, and preparing dinner, you can get a complete meal at the grocery store that requires only that you heat it up.


And ordering things online. First, you sit in front of a computer, making your choices. You wait a couple of days and then it is delivered to your door. It couldn’t be easier. And it couldn’t require less movement unless somebody carried from the porch into your house.


You can order take-out from lots of restaurants and don’t even have to go pick it up. Someone will pick it up and bring it to you. You could conceivably exist in today’s world without ever leaving the house.


Even the rear facing cameras on our cars can be seen as a deterrent to movement. You don’t even have to turn around to look behind you. (But don’t take mine away—it’s a blessing for senior citizens like me.)


When I was a child, we had three TV channels. And those channels signed off about midnight. Heavens forbid that the President was talking—it would occupy all three channels. And the remote was my Dad telling me to get up and change the channels. You actually had to touch the TV!


Today we have an almost infinite number of shows to watch, 24 hours a day. That means that you have the potential to sit for hours on a time, completely captivated by what is on the TV screen. For goodness sake, we had to suffer through the Lawrence Welk Show when I was growing up!


We need to move, not just when we exercise. We need to move throughout the day. Don’t drive around looking for the closest parking spot. Don’t take the elevator up one floor. Never surf channels just trying to find something you might like to watch. Walk. Meander. Shop. Move!


You might find this hard to believe, coming from me, but exercise is not the solution. Exercise without a life of movement is like taking vitamins and supplements to provide you with what you’re not getting from what you eat. If you are sedentary much of the day but spend an hour in the gym exercising, you just aren’t getting the movement that your body needs. You’ve got to move all day.