Progress Report, Smoke Report, Surgical Error Report, Kasha Report


Three weeks post knee replacement, I've gone from using a walker, to two crutches, to one crutch, to a trekking pole (an adjustable walking stick with a strap), to no aid at all around the house. Instead of working out three times a day for twenty minutes, I work-out almost continually throughout the day (as I write this, I'm flexing and straightening my knee. My major goals for the first six weeks are achieving a normal bend in the knee (120-degrees) and being able to completely straighten the knee. Last Friday, my bend was 105, which was good, and I was three degrees from achieving complete straightness.

Yesterday was house-cleaning day, and I excitedly anticipated being able to help, but after two and half hours on my feet, the knee started to swell (more than it is normally swollen), turn red, and feel hot. The PT said that I could expect swelling to be a problem for two or three months, and, of course, it negatively impacts my therapy goals. There's nothing I can do for it but to lie around for hours everyday with my knee elevated above my heart, and ice packs draped over my knee. It's enough to drive a person crazy. At this point ALWAYS feels like the stiffest knee that a normal person ever had in his life, and it NEVER stops hurting, but it's not pain that's through the roof. One good thing I can say about the pain of exercising is that it was many times worse when I started than it is today, and that by itself is enough to keep me motivated to work-out. 

Until a few days ago, the only outdoor walking I did was to and from the car for my physical therapy appointments. This was because the smoke from the many forest fires (I live in Oregon's Willamette Valley) has been so bad that people are advised to stay indoors. Fortunately, Peggy and I have air conditioning, something that not everyone here has because really hot days are rare--or at least they used to be. 

The smoke has been SO bad of late that there have been days when the sun never appeared; we couldn't see the nearby hills; and we could even see smoke by looking toward the shrubbery in the backyard looked smoky. Peggy taped cardboard over our bathroom vent fan; laid towels along the bottoms of doors to the outside; and avoided opening outside doors if she could help it. Picture a bad air day in Beijing, and that's what much of Oregon looks like. Peggy has had bronchitis and an ear infection from the foul air (she was prescribed steroids and is much improved), and many people are wearing masks. We get some smoke from forest fires almost every year, but this is record-breaking, and it has been going on for over two weeks. Fortunately, it has gotten some better during the last few days due to a front moving through. We even had our first rain in months, although it only lasted a few minutes. Every summer here is a drought summer, but as with the heat, the droughts are getting worst.

Once all the steri-strips fell off so that my incision was visible, my physical therapist (Kasha) pointed out that the incision was crooked (she thought this was a lot funnier than I did), and indeed it looked like what you would expect if a drunk man with palsy tried to draw a straight line seven inches long. I knew that Brian didn't have palsy, and after much reflection, I eliminated as untenable the possibility that a sex kitten of a nurse might have goosed him during surgery, and this left me with but one inescapable conclusion, namely that Brian had operated on me at 7:00 in the morning while drunker than a skunk, and that he had put my new joint in upside down and backwards. I knew this had to be the case because if the situation were otherwise, he wouldn't have been chewing gum to mask the alcohol odor, and I would be able to straighten the knee completely. Also, when I bend it, it would bend in the back like a normal knee instead of in the front like a bird's knee. I think that the best option at this point is for Brian to replace the right knee too, and to put it in upside down and backwards, so that it will match the left knee. Naturally, I would expect him to do this for free. It's a sucky situation, but I'm sure it happens all the time, and I don't hold it against him. Actually, it reminds me of a funny story.

If you've had surgery at either of the local hospitals in the last thirty years or so, you know that the surgeon will come around and put a mark on the spot where he or she is going to operate. He will do this while you're still awake, and you're expected to verify that he's marking the correct place, the goal being to avoid the embarrassment that comes when doctors operate on the wrong patient, amputate the wrong leg, perform hysterectomies on ninety year old men, do tummy-tucks on four year olds, and other fox paws (fox paw is French for fuck-up). As many of you know, Peggy spent her last 24 years as a nurse in an OB unit that was devoted exclusively to labor and delivery patients. Word came down one day that all of the doctors would be forevermore expected to mark the abdomens of all of their C-section patients in order to insure that they (the doctors) wouldn't do something embarrassing like removing a woman's ring fingers. The doctors considered the new rule too stupid for words, and the nurses backed them, so it was soon discarded.

But back to Kasha. I liked her quite well when we met, but she's an avid cyclist, and when the smoke became bad enough that biking was making her throat hurt, she became so despondent that I started to dread seeing her. She would bitch about the smoke; about not having air conditioning at home; about her gym being closed for servicing just when she needed it most; about her difficulty with getting a baby sitter; and about injuries from old bike wrecks; but especially about being unable to ride her bike. I was one appointment away from either having a serious talk with her or simply going to another therapist when she immediately turned herself around and became as good a therapist as I had thought she was when we first met. I even told her after my last session that I had enjoyed working with her, which surely isn't something she hears much from knee replacement patients because these sessions are painful. She looked like she could have cried, and I went away feeling very glad that I hadn't fired her before she could pull herself together.