Weekly photo challenge: Ready

Arthur the healing dog is ready to do the laying on of paws hands to help heal Mark’s knees.

Now I know — a story of mothers, daughters, caregiving, and Alzheimer’s

When I was told Mark couldn’t be left alone for two weeks following his bi-lateral knee surgery, I started planning ahead, making sure I had a good grocery list, trying to foresee anything we might need—at least enough to last until the next time my daughter came or I could get my son to come home, or Mark had an hour of therapy.

I thought about my mom and how, since she’s been a full-time caregiver for my father with Alzheimer’s, she’s had to plan ahead in detail. She can’t leave Dad alone to dart out and get what she runs out of on the spur of the minute. Mom relies on my sister who brings her supplies from Sam’s Club, and periodically calls her whenever she is out shopping.  She relies on me to get those unusual and expected things like salt for her driveway or a new doorbell when the old one broke. And she knows she can always ask either of her two home health aides in a pinch, but that only works on weekdays as Mom goes it alone on the weekend. So Mom plans ahead.

I guess you might say this brief period of caring for Mark has given me a better understanding of what my mom is experiencing.

In the early days of Mark’s care when he was still in the hospital, and his first days at home, my back and arthritic knees and hips screamed out in pain every time I had to lift the CPM machine, or lift Mark’s leg into it. Every time I had to lean over the bed to pull on his therapeutic hose and it was difficult and painful, I thought of my mom and all the physical pain she endures when she has to do all the things she has to do for Dad.

You might say in this brief period of caring for Mark that I felt solidarity with my mom and the challenges she faces.

At first when Mark was recovering from the trauma of the surgery and the influence of the medicines and he had no room to be concerned about anything but his own recovery, and he wasn’t able to stay awake for more than an hour at a time, and all the decisions and responsibilities for him, and us, rested on my shoulders, I thought of Mom.

Mom used to complain, “Your dad doesn’t care about me. He doesn’t care about how hard this is on me.”

And she might have been right. Dad might have been past the point of caring about more than himself as he struggled to survive in an Alzheimer’s world full of disability, confusion, and disorientation.

I knew how insignificance felt for one or two or a small handful of days. Only.

On Sunday when Mark had only been home from the hospital three days and I was still doing a lot of the care for him, I went into our great room for a moment. Anna, who had come home for the weekend to help, was curled up on the loveseat, covered with a soft throw, using her iPad with Arthur snuggled at her side.  The early morning light was streaking in from the windows high up on the wall near the peak of the cathedral ceiling. I could see the sycamores I love in the tree line beyond.

I wanted a moment of normalcy. I wanted to talk about, to think about, anything besides CPM machines, ice coolers, walkers, medicine or shots.

I sat down on the sofa and asked, “How is your job going, Anna?”

As she started to explain what was happening and how she was feeling about things, I thought of my mom. I thought of all the days I’ve gone to Dayton and sat at her kitchen table with her, eating lunch and talking while my Dad napped in the bedroom. I thought about all the simple conversations we’ve had about anything but walkers and lift chairs and hospital beds.

I know my situation is short term, and has already much improved. I know my mom’s situation has an uncertainty about it that I haven’t experienced. What will happen next? Will I be able to manage? Will I be able to keep him here? How long? I don’t have those questions.

I know there are many differences in our situations. They are not the same.

I also know that when I am free to go, I will visit my mom again, bring her lunch, and sit at her kitchen table talking about anything but . . .

Now I know how important that is.

A tale of determination, confidence, and the clankety clank of a walker

What in the world is he doing now? I wondered as I woke up for the second time this morning to the sound of Mark’s walker clanking down the hall to the kitchen.

The first time I woke was at 5:00 a.m. when, with the same vigilance as a new mother’s response to the cries of an infant, I heard the movement of Mark’s walker and opened my eyes to see him sitting on the side of the bed.

“What are you going to do?” I asked.

“I’m going to go sit in the recliner in the great room for a while.”

“Just be careful. You can leave the door open,” I said as he left the room to the clankety clank of his walker. I wanted to save him the trouble of trying to manuever around and close the door behind him, but I also wanted to be able to hear better what he was doing, or if he needed me.

Ever since his appointment with out-patient therapy yesterday, Mark has started pushing his boundaries. Like the therapists in the hospital, his therapist here, whose name is Chris, was pleasantly surprised. “Does he always heal this quickly?” Chris asked me at the end of the session.

Chris told Mark that he is well ahead of schedule on his recovery, and that in fact, he is ahead of where many, if not most, single-knee replacement patients are when they come in for their first visit. We’ve been told all along that double-knee recipients lag behind in recovery. And at first in the hospital I believed it when I saw the single-knee patients trotting down the halls. I even wondered, was this a mistake?

All of this praise from the therapists feeds Mark’s ego, I’m sure, but it also feeds his determination and lack of patience I’m afraid. When Mark left the hospital his occupational therapist looked him in the eyes and said, “I want you to hear what I’m saying. You’re the type of person who comes back to the hospital. I don’t want to see you back here.”

So I listened this morning until I heard the cessation of the walker’s clankety clank followed by the squeak and click of the recliner foot rest locking into place. Then I rolled over and went back to sleep.

When I woke up the second time about an hour later to the sound of Mark and his walker moving down the hallway to the kitchen, I wondered, what is he going to try to do now? I heard the refrigerator door open. I heard the microwave door open and close and buttons being pushed. I got up and walked to the kitchen.

Mark was on his way to the refrigerator holding an empty glass in one of his hands while also holding onto the walker. “How are you going to carry that when its full?” I asked. He told me he didn’t want to wake me up.

Some of these tasks would be easier if he would have kept the basket I bought for him on his walker, but initially he didn’t like it, didn’t want it, so I took it back off. Yesterday he started carrying things like his book in his hand along with the walker.

“Why don’t you go ahead and sit down,” I said, “and I’ll take it from here.” He had an English muffin in the toaster, a stick of butter in the microwave to soften, and of course the empty glass for milk. I got him set up with his food and drink and went back to bed.

“Clankety clank,” back down the hall he came a little while later. I opened my eyes and saw him carrying his walker a few inches off the ground as he walked into our room to the bed. He was trying to be quiet.

I always knew Mark had great determination when he set his mind to something. But this surgery has provided an opportunity to display some of his finer human traits in a very visible and measurable way.

See what I’ve been up against all these years?

Now in his own defense, yesterday Chris told Mark to look for a cane and bring it back on Friday for his next appointment. So the days of the walker are numbered. He also can put the braces away; he doesn’t need to wear them at night anymore. Here’s the best news; Chris also told him he can cut back on his time in the CPM machine 50%. That means only a total of 6 hours a day instead of 12. GREAT news.

Finally, echoing the hospital O.T., Chris told him, “Don’t get over confident.”

Lord, help us all.


You can find links to the entire series on Bilateral knee replacement surgery here.

Bi-lateral knee total replacement surgery — One week later

This time last week my daughter Anna and I were waiting to see Mark in the recovery room following his knee surgery. Today Mark is sitting in the recliner beside and slightly behind me. He just this minute asked me if I knew where his wallet is. So he’s starting to perk up and re-enter life.

Mark has made incredible progress, which in turn has helped me a lot. Last week I had to lift his leg into his CPM machine in the hospital, after I carried the machine to his bed. (The nurses were not able to keep up with the schedule we were trying to keep of getting it on each leg 6 hours every day, so I often just did it myself.) I had to help him with his exercises on his right leg, because he wasn’t able to lift his leg at all. His left leg did well from the beginning. I had to attach the cooling pads to his legs. Basically, the nurses and I had to do everything for him. Everything I did for him, I did bending over his bed, which quickly took a toll on my lower back.

Today, Mark put his own legs in the CPM machine, he got up by himself to use the bathroom and give himself a sponge bath (no showers until after he sees the doctor on the 15th). He got his own clothes (from the basket I’ve left on the bench in the room). He completed all of his exercises by himself. And importantly, he put his therapeutic hose on all by himself. (Halleluia, praise the Lord).

He is taking care of his own medication needs. He is mentally alert and reliable. He’s got his care needs down and is able to perform his exercises physically. We’ve come a long way in a week. I’m basically back to just moving the CPM machine to and from the bed, keeping his ice machine stocked with frozen water bottles, preparing and serving meals, cleaning up after him, laundering his towels and clothing, and refilling his water and beverage glasses.

Mark is using the CPM machine at 120 degrees, which is the goal. He started at 60 degrees last Monday. We’re both looking forward to removing this device from his therapy and our lives as soon as possible.

I like to stay positive and not complain, but that wouldn’t be honest or helpful. I flatter myself by imagining that some day these posts may be helpful to someone else. I would be remiss if I gave everyone the impression that this has been an easy week, although it hasn’t been as difficult as I imagined it might be.

Mark has been pleasantly surprised that he hasn’t had as much pain as he anticipated. I have been pleasantly surprised that he is able to get himself up from a sitting position, in and out of a car, and is able to walk without any kind of assistance.

Neither one of us had planned on his physical reaction to the surgery and/or medication. With the exception of the day of the surgery when he first got into his room and was ravenous, he hasn’t had an appetite, and getting him to eat the nutrition his body requires to heal has been an ongoing challenge. Initially he had severe heart burn and acid reflux, now he suffers from chronic nausea. I think the nausea is probably due to the iron supplements he is required to take to boost his hemoglobin from the blood loss.

Mark feels well enough now to be losing patience with lying on his back on the bed with his leg in the CPM machine 12 hours a day.

I hadn’t planned on him being irritable.

Mark hadn’t planned on wearing the two leg braces overnight to prevent him getting his knees in a prohibited position or twist of some sort, but that often also prevent him from actually sleeping.

I hadn’t planned on the physical stress the care-giving would place, on my knees, hips, and back.

Mostly I feel much calmer than I did last Monday, and happy that Mark is well on his way to a new set of functioning, and hopefully eventually pain-free knees.

He goes to outpatient therapy for the first time today. Wish us well.

You can find links to the entire series on Bilateral knee replacement surgery here.

Three days after bilateral total knee replacement surgery

Thursday, February 2, 2012
8:00 a.m.

What should I blog about? I’ve asked this question before in a different context.

When I started this blog I claimed I would write about whatever was on my mind in the morning. The reality is that I’ve extended that to included whatever is on my mind at some point in the previous day or two or three.

I recently had an idea to post my lifetime bird and wildlife sightings, so I made a page for that. Those posts are typically not what I’ve had in my head upon rising in the morning.

Earlier I thought it might be helpful to share my self-publishing journey, so I have a series on that. I felt the same way about Mark’s bilateral knee replacement surgery and recovery. I know it was helpful to us to talk to others who had had knee replacements.

Mark’s mom is the only person we know who had bilateral knee replacement surgery and that happened over 20 years ago. So much has changed. I remember visiting her in the hospital after her surgery. Her room was empty because she was at therapy. In those days rehab was done in a rehab room. All of Mark’s rehab has been done in his own room. Mark’s mom returned to her room sobbing from the pain. She stayed at the hospital on the rehab floor for a month.

Mark is going home today, three days after his surgery. A lot has changed in the past 20 years. The pain medicines are better; the implants, the procedures, and the therapy are all better now.

Don’t get me wrong, we still have a long road ahead of us. My biggest concern at the moment is getting Mark into and out of the car. I was going to bring the truck because it sits up higher, but I talked it over with his therapist yesterday and she thought he might try to twist himself getting into the truck since he usually swings one leg up first. I brought the car.

This morning before I left the house I removed all the throw rugs from the bathroom and the pathway to our bedroom from the front door. We usually come and go through the garage, but for now we will be using the front entry because of the step situation. I also pulled the top covers off the foot of the bed so that Mark will be able to sit down and get into the bed right away.

Although I made the best effort to obtain all the medicines he will need in advance, we are leaving the hospital with instructions for Mark to take iron pills. His hemoglobin continues to be low. Fortunately our youngest son will be helping me get Mark home today and will be able to run any errands I did not foresee.

I never intended to make this blog a family newsletter. But it feels disingenuous right now to post about the cardinals on my bird feeder or the most recent book sales numbers and promotional efforts (which have fallen completely by the wayside), when the first thing on my mind in the morning, the last thing on it at night, and what occupies it most of the time throughout the day is Mark and his needs.

So in some ways I’m being more true to my initial plan than ever.

4:30 p.m.

We’re home now and Mark is resting comfortably in bed with the CPM machine running on his left leg. The ice machine is cooling off his other knee. He did a great job of getting in and out of the car. Our son Joe was here to help and he also got us the items from the store we still needed. Now I’m settling in for a house-bound stay with my recovering hubby. It’s good to be home.

You can find links to the entire series on Bilateral knee replacement surgery here.

Double knee replacement surgery update — Making progress

Tuesday, January 31, 2012

2:00 p.m.

Mark is sleeping in his bed with the CPM machine working his right leg. I am sitting on the loveseat/bed with my feet up. The loveseat is in a little alcove by a very large window that affords me a panoramic view from the 8th floor where we are.  Last night the city lights below were beautiful. Mark has not been able to enjoy the view yet, but I hope he will soon.

Things are progressing very well for him, according to the physical therapist. Mark’s right leg has caused him more pain from the beginning and is not as flexible or strong as his left right now. The therapist says his right leg is typical, while his left leg is something to write home about. I am so very proud of how hard he is trying and how well he is following recommendations.

The big thing with knee replacement surgery is the angle of rotation he can achieve. The doctor measures the possibility right after surgery, and then it is up to the patient to try to achieve this maximum level. Mark’s doctor said Mark should be able to achieve 140 degrees of rotation. He will need to continue to use the CPM machine until he reaches 120 degrees. The therapist said they would like him to get to 90 degrees before he goes home.

The day of surgery, yesterday, the therapist measured 60 degrees for his right and 70 degrees for his left. Today when she left after two physical therapy sessions and 2 hours per leg on the CPM machine, he measured at 85 degrees on his right and 95 degrees on his left.  This is super.

This afternoon Mark walked out of the room and partway down the hall with a walker and the help of a therapist. You can’t imagine how good it is to see him on his feet, even though I know it is a struggle for him. He said it felt good to be up.

3:00 p.m.

Medically, the discharge or bleeding from Mark’s knees has slowed way down, which is a relief as this has been a source of concern. They removed the drains from his legs just now. His IV was removed today.  I love to see them remove the tubes and things.  I asked the nurse if he was out of the woods for needing a transfusion and she said not until after tomorrow. If there is a problem with blood counts it will be the second day after. So let’s just keep our fingers crossed on this one.

The latest thinking is that he will go home on Thursday. As scary as it is that I will be on my own taking care of him, it will be nice to be in the comfort of our own home again.

Last night I went home, primarily because I didn’t realize I could stay and I wasn’t prepared to. I felt bad leaving Mark last night and plan to spend tonight here. I hate to leave him alone when he is so dependent on others right now for every little thing. And he hasn’t been great at keeping track of his medicine schedule, so I can help make sure he stays on top of the pain.

4:00 p.m.

I started this post two hours ago and am now able to finish it with all the interruptions we’ve had. We have recycled back to 2:00 with Mark asleep in his bed; the CPM machine is on his left leg, and I am on love seat.

Anna just called to tell me she is on her way back home to Columbus with Arthur. She went to the grocery for me to get some bottles of water to freeze for use in the cooling machine for Mark’s knees. You can fill the little cooler up with ice and water, but the technician said a good tip is to freeze bottles of water and reuse them as needed. So our second freezer at home is now full of bottles of water. I have obtained the prescription for pain medicine that I will fill tomorrow. We made an appointment for physical therapy on Monday.

Last night I was afraid we might have bitten off more than we can chew by doing both knees at once. Today I feel very optimistic.

View from our 8th floor room - taken with a telephoto lens and cropped.

You can find links to the entire series on Bilateral knee replacement surgery here.

Double knee replacement surgery – part 3: On the Far Side of the Bed

Saturday, January 28, 2012

I woke up nervous this morning on the far side of the bed.

Even though Mark put up a small protest as this being an unnecessary move, I switched sides of the bed and am now on the far side from the bathroom.

Mark doesn’t think it will be a problem for him to walk around the bed and then into the bathroom after his double knee replacement surgery. Giving him the side closest to the bathroom saves him nearly half the steps for that trip, and many steps any time he leaves or returns to the room. I think at first, each step is going to count.

Mark and I don’t always see eye-to-eye about preparations and what needs to be done whether it is planning for a party or undertaking a home renovation. Mark opts for minimum and I like to be prepared.

Often I submit to what he thinks, but in this case I’m standing my ground. When he comes home from the hospital in pain, unable to fully bend his knees, needing an intensive amount of therapy and general assistance, the responsibility will lie with me.

On Thursday Mark received a FedEx package containing medicine in 10 syringes. Yes. Either he or I will have to give him, a shot of a blood thinner for 10 days after he gets home. In a way, I’m relieved that he will get this medicine because blood clots are one of the bad possible side effects of this surgery.  I hope someone will train me somewhere along the way if Mark wants me to do it for him. The possible side effects of this medicine are pretty scary. So many things to watch out for. I don’t know how I’m going to do anything but hover over him for the first two days he’s home.

CPM (continuous passive motion) device- from http://www.arthroscopy.com/sp06001.htm

On Friday his CPM (continuous passive motion) device was delivered. Mark will have to use it for 1-1/2 to 2 hours, three times a day for each leg. This adds up to a whopping 9 – 12 hours a day. The technician who brought the device and set it up with Mark’s leg measurements said it is best to use it in bed. Mark can prop his head and shoulders up on a couple of pillows, but he shouldn’t sit up while using it. Seeing Mark try out this device set off a whole new level of anxiety above and beyond what I felt when we acquired the raised toilet seat, shower chair, and walker.

The CPM device weighs about 25 pounds. The technician suggested we set it up on the bed in a guest room so that I don’t have to lift it up and down from the bed every day. That’s not likely to happen. The TV and dvd player are in our room. I don’t think Mark is going to want to lie in bed 12 hours a day with nothing to do except read or look out a window in the guest room.

I’ll just consider the lifting of the device to the bed and back resistance training.

They will deliver a cooling machine to the hospital that Mark can use as often as he wants. I will have to keep it filled with ice and water.

I anticipate he will get visits from a nurse at first.

There will be pain medicines to keep track of, meals to eat, exercises for him to do, therapy to go to. (There won’t be showers to take for the first two weeks. . .) We’re going to have a pretty regimented month or so to fit it all in.

Look for a lot of photographs and some quick from-the-archives posts from me.

I woke up nervous this morning.

I probably will again tomorrow.

Sunday, January 29, 2012

I actually and unexpectedly woke up calm this morning. Mark has been nervous all day.

By the time you read this I will probably be waiting during Mark’s surgery as it is scheduled for early tomorrow morning.

I want to thank all of you who are wishing Mark well through the surgery and recovery.

You can find links to the entire series on Bilateral knee replacement surgery here.

Double knee replacement surgery—part 2: Pre-op class

We’re moving forward on our preparations for Mark’s double knee replacement surgery. Last week Mark had an appointment with a physical therapist to get fitted for knee braces. The braces prevent the knee from bending. Mark will be wearing these for the first two days after surgery when he is not in therapy.

Post-knee surgery braces

Mark actually got two different braces. The one on the left can be adjusted to allow the knee to bend to some degree, the one on the right doesn’t allow any rotation. The therapist told Mark that usually one knee is better than the other following surgery. If that is the case, he may be allowed to bend it some to help with mobility. We have to bring these to the hospital the morning of surgery.

Last Thursday Mark and I attended a pre-operation training class at the hospital. We were in a room with seven other people who were having knee or hip replacement surgeries. Mark was the only double-knee replacement surgery patient in the class. I’m going to spare you all the details and just hit the highlights.

The trainer told us we will need:

a walker without wheels
a raised toilet seat
shower chair

Mark was given a booklet with information on:

what to expect and do the day before and the day of surgery
a list of personal items he may want to have with him at the hospital
hospital care
home care
and exercises (to do starting right now, 3x/day until the surgery)

According to the booklet Joint Replacement at Good Samaritan Hospital, “Very little bone is removed during a total knee replacement — usually less than a half inch on all sides of the joint. For the most part, the patient’s tendons and ligaments are preserved to allow the new artificial surfaces to glide and rotate much like a normal knee joint. [...] Your orthopaedic surgeon will enter your arthritic knee through an eight to ten inch midline incision. After opening the knee, ligament balancing and deforming bone spurs will be addressed. Bone cutting jigs will be secured to the knee bones so that precise shaping can occur. [...] Realigning your knee so that it is properly positioned between your hip and ankle is critically important for proper function and long-term durability. The actual implants will then be secured to your knee bones with cement or through a press-fit technique. [...]After the implants are secured to your knee bones, your orthopaedic surgeon will test the new knee for balance and tracking of the kneecap. [...] Final adjustments can be done to maximize the range of motion and stability of your knee. Then deep and surface tissue layers are securely reattached to allow early motion and purposeful physical therapy.”

Mark’s surgery should take about three hours.

Following the surgery Mark will have precautions, or moves or positions he is not allowed to do, until he is completely healed after 2 to 3 months. Precautions for knee-replacement surgery are:

No forceful twisting or torquing at the knee (like when you twist your foot back and forth to try to get a shoe on).
No crossing the foot over the other knee to put a shoe on.
No deep squatting.
No kneeling directly onto surgical knee/s

All knee replacement patients will be full weight-bearing after surgery, which is a good thing since Mark will not have a non-surgerical knee to rely upon.

For the first 24 hours Mark will have pain relief through a nerve block or IV pain meds. After that the medicine is PRN, which means, prescribed, but not allowed to be given unless Mark asks for it. It is designed to bring pain down to a level of 4 or less on a scale of 1-10. Pain gives the body feedback and some level of pain is needed to keep the patient from overworking or injuring the joint.

The trainer told us to ask the doctor:

What pain medicine has been prescribe?
How often is it allowed?
When is the next time he is allowed to take it?

We were advised to keep track of the pain med schedule (which I always do anyway), and ask for meds about 30 minutes before it is due to give the nurse time to work it in.

Therapy will start the day of surgery for Mark since his surgery is scheduled first thing in the morning. This is a good thing. The sooner he starts moving his legs around the better, we were told.

Starting the second day, Mark will have two physical therapy sessions and two occupational therapy sessions—both will be held in his room. If he does really well with the occupational therapy he might “graduate” early. When he leaves the hospital on day 3, Mark will be able to get in and out of bed, stand up, sit down, walk with a walker, go to the bathroom, get dressed and climb stairs.

Mark will be going to physical therapy 2 or 3 times a week, probably starting the day after he gets home.

Mark’s particular doctor prohibits showering for 14 days following surgery. He will not be allowed to drive for 4 to 8 weeks and will need a doctor’s release.

Following the training, Mark went for some basic pre-op testing where he was given this breathing device. I don’t know exactly what it is used for, except to keep the lungs clear following surgery.

He was also given these surgical wipes to use over his entire body the night before the surgery to help prevent staff infections.

The braces and  the breathing device need to arrive with Mark at the hospital before surgery.

The booklet, a walker if we have one (if not, we will get one there), and his bag with clothes and personal items all need to be brought to the hospital, but I was advised to leave those in the car until Mark has a room so that I won’t be dragging them around the hospital with me.

Our daughter Anna has offered to wait with me at the hospital during the five hours it will take for the surgery (3 hours) and recovery (2 hours). I found out Thursday that the hospital does have free wifi, so hopefully I will be able to keep myself occupied by blogging and reading. I have three books on my Kindle that I’m trying to read by the end of February.

As we learn more of the details, the surgery becomes more real, which is frightening for me. But it is also comforting to find out the details and doing so mostly reassures me that we can do this.

Since I wrote this last Friday, we have acquired a walker and a raised toilet seat that we borrowed from Mark’s mother. Yesterday I bought a shower chair, so we should be good to go. As more and more of these appliances and devices come into our home, Mark gets more and more disconcerted or anxious. We had to put the toilet chair and shower seat in the spare bedroom so that he wouldn’t have to look at them.

For me it is a relief because I feel like we are getting prepared.

Mark is also in more pain with his knees since he is not allowed to take his pain medicine for two weeks before the surgery.

My biggest concern at the moment is being able to get out to get medicines, food, or other items that we may need during the two weeks I am supposed to be with Mark 24/7. I am trying to plan ahead. For example, yesterday I noticed we are running short of stamps. I will have to make a trip to the Post Office before Monday. After Mark’s surgery, I will have to use the time he is at therapy to run necessary errands. Our daughter will be back the first weekend Mark is home, and our son is a student at the college in town about a half hour away. I hope he will be able to take time away from his classes to help me on the day Mark comes home. I am expecting there will be items and medicines I will need to pick up that day, unless someone can give me the discharge instructions early.

You can find links to the entire series on Bilateral knee replacement surgery here.

Double knee replacement surgery – Part 1: Planning ahead

My husband Mark has been suffering from knee pain for several years now. Osteoarthritis runs rampant in his family. His mother had double knee replacement surgery about 20 years ago. Three of his older sisters have all had one knee replacement surgery. It’s Mark’s turn.

The symptoms Mark has are severe pain in his knee joints whenever he stands up or walks. He is able to walk for brief periods of time, but Christmas shopping was a challenge. While we were at Barnes and Noble picking up a few gifts, Mark sat on the floor when he couldn’t find an empty seat and I walked back and forth bringing him the items I picked out to purchase. Mark’s knees also make very loud crunching noises when he bends them. And finally, his legs have become quite bowed. I remember his mom’s legs looking that that before her surgery and how afterwards they were straight again.

Mark visited an orthopedic doctor last year and had laparoscopic meniscus repair surgery on one knee. That didn’t provide any long-term relief for his pain. We decided in the fall that it was time to seek medical help. Our orthopedic doctor sent us to a knee replacement specialist and Mark’s surgery was scheduled for January 30th. He will have both knees done at the same time if all goes well.

“During knee replacement, a surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.” (www.mayoclinic.com)

So far we have only visited the doctor and read information as a way of preparing for the surgery. Yesterday Mark visited our family practitioner for a pre-op clearance. We know that as he gets closer to the surgery he will have to stop taking the pain medicine he currently takes (nsaids). His doctor also wants him to start on a special nerve-affecting pain medicine some number of days before the surgery so that it has time to start taking effect.

I have visited a medical supply store to see what kind of mobility aids we might want to acquire. We have a pair of crutches in the basement that I need to retrieve. I think I will also get a chair with arms that fits over the toilet and raises the seat. I don’t know if we will need a walker. I think a shower chair might be good to have around, although Mark has been told he won’t be able to take a shower or get his incisions wet for 10 – 14 days. We go to a pre-op “What to expect” training session next week, so I should know more after that.

I want to switch sides of the bed we sleep in. Mark sleeps on the far side and has to walk around the bed to get in and out. It will save him a lot of steps if we switch.

When our sons were here at Christmas I asked them to move the recumbent cycle up from the basement and put it in our bedroom. I think cycling is good exercise for knees, and I don’t know how long it will take before Mark can walk a flight of stairs.

Meanwhile, I’m trying to think through all the tasks Mark typically does around the house that will be left up to me. Mark and I have very different ways of doing things. For example, right now the bird seed for the feeders is in three or four bags piled on the floor in the corner of our garage. This will not work for me. I don’t lift, move, or touch anything piled in the corner of a garage, basement, or any dark and dank location—spider phobia rule #1. We need to move the seed to my garden bench or his work bench on the other side of the garage if I am going to be able to feed the birds.

I haven’t made coffee in over 10 years, ever since I couldn’t drink it any more because of stomach trouble. Mark drinks it every morning. So I need to find out how he likes to make it.

Small things, I know, but there are a house full and life full of small things through which we will have to navigate for the first days and perhaps weeks with Mark not being able to walk or stand on his own.

I’m still trying to figure out what to do about the garbage. When our kids were little and conversations about gender roles came up, I told them, “There’s only one thing that girls can’t do.” This of course peaked their interest. “Girls can’t take out the trash,” I’d say. They’d energetically respond, “Yes they can!”

So, I suppose I can.

You can find links to the entire series on Bilateral knee replacement surgery here.

For more information about osteoarthritis and knee replacement surgery, visit www.mayclinic.com.



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