Discoveries through pain

I’ve had plenty of time to think during the past week — in the pre-op room waiting for surgery, in the recovery room waiting for a hospital bed, in the hospital bed waiting to go home and now, on my make-shift couch bed waiting for the day I can tackle the 18 steps up to my bedroom. It’s been a long, painful, insightful and productive journey that has included far more than my knee getting replaced, although it’s the knee that’s getting the most attention because it’s the loudest. In the trauma of my bandaged and swollen leg that is a variety of colors, the dominant being navy blue, an unexpected lens has formed that has allowed me to witness something that extends far beyond the physical. I’ve been given the honor, and yes, I say honor even though I’m still counting the hours until the next pain pill, of observing parts of my physical journey that don’t hurt when I walk, or stand, or bend my leg. I’m a week and two days out, but already am seeing the unexpected depth of the gift I’ve been given. It didn’t come without pain or tears, but it’s here and I’m accepting it. It’s me standing at the top of a difficult ski run, afraid to go down. Walking into a party where everyone is coupled up but me. Traveling alone to a developing country to volunteer, not knowing what I’ll be met with on the other side. It’s having to ask for help. It’s feeling vulnerable and afraid. It’s fear. It’s pain. It’s a fear of pain. And it’s come in unexpected doses at times I didn’t expect. It is patience, humility, surrender, compromise and the biggest of all, love. They are all gifts — the new knee and the pain that came with it, included.

Patience.
I’m learning to be patient with myself, during one of the most difficult situations I’ve ever encountered. There are physical movements that I didn’t give a thought to a week ago that I cannot do today, such as lift my leg while laying down. Even a quarter of an inch is too much. As I laid on the couch trying to follow my physical therapists directions without success, I started to cry. The therapist asked me if the pain was too much and I told her no, it wasn’t the pain. I just couldn’t do what she was asking. This, from the girl who had some of the highest kicks in drill team and up until last week, could still do the splits on both sides with ease. And now I couldn’t lift my leg even a millimeter off the couch. She touched my arm gently, told me to take a few breaths and relax. I did as she asked, while tears streamed down my cheeks. She told me that even though my leg hadn’t moved, the muscles had engaged and for now, one week post-op, that was enough. There was a lot of letting go that went on while I stared at the ceiling and cried. It was something I never would have done a week ago. Crying, that is. In front of someone I had only met a few minutes earlier. I’m good at holding in emotions that may make others uncomfortable, but not now. I’m learning that part of self care is listening to what my body needs and if that means to stop holding onto the lump in my throat and let the tears flow, then that is exactly what I’ll do.

Humility.
Two days ago, an occupational therapist sat in my living room in a chair that faced my couch bed with my large coffee table in-between us. As she was talking about the finer points of self care, I noticed that right next to the patient care folder she had sat down, were the underwear I had worn the previous day, or maybe the day before. Without apologies or explanations or attempts at reaching for the small navy and white striped heap, I redirected my attention to what she was saying about self care, which was about letting go of the need for perfection and holding onto what is, even if it happens to be a pair of yesterday’s underwear on the coffee table. Self care isn’t just about feeding myself good, nutritious food and getting rest and exercise. It’s also about finding grace in the spot where I have landed, no apologies necessary.

Surrender.
One thing about anesthesia that is difficult is that you can try as hard as you want to recall what happened while you were under, but it is impossible. The part of your brain that is in charge of remembering is temporarily shut down with the anesthesia (my boiled down, non-scientific version from what I’ve heard and read), and hard as you try, the pieces to the puzzle will not fit, because you will never have enough of them to form a clear picture. I know the urge to recall the faces, the conversations and the order of things will eventually fade, but for now, I’m still trying to establish my timeline, missing pieces and all. What I do remember was being seated at the edge of a gurney and bending over at the waist in a cold, very bright room while an attractive doctor put the needle in my spine for the spinal block. I remember seeing the unusually large gold band on his left hand and wondered if he should be wearing jewelry while putting needles in people’s backs. The next thing I heard was my doctor telling me to open my eyes and that all had gone well. He said I’d be taken to the recovery room where they’d monitor my vital signs until I could be taken to a hospital room, where I’d be reunited with my daughter and sisters. I did better this time under anesthesia than I had 18 years earlier before a procedure when I spoke out during that brief moment of feeling warm and cushy before the lights went out. I invited my doctor to my 50th birthday party and told him he was handsome (I was newly divorced). I only know this because a nurse told me, which made me laugh and want to hide at the same time. I don’t remember inviting my orthopedic surgeon to a party or telling him he’s handsome, although it would not have been a lie. Or at least as far as I know, I didn’t. I do remember talking up the Oregon Coast on my way to recovery, though, which looking back feels much safer than birthday party invitations or blatant flirting under anesthesia. After being taken into the recovery room, I remember crying, not because of pain but instead it was an emotional release. The surrender felt both freeing and comforting. Holding on is hard. Letting go felt like floating and floating feels like the best option when everything else is hard.

Self sufficiency.
My sisters were with me for the first week and my daughter has checked in with me at least twice a day since they left. Although I had help and many offers of help, there was an element of self sufficiency that I needed and craved. My great idea to bring hot food from the microwave to the table using my desk chair on wheels as both a transport device and a walker did not impress my occupational therapist. Instead, I got a strong “ABSOLUTELY NOT” and a solution that involved closable containers and my backpack. Mealtime has me carrying my food in a backpack while my walker takes me from one part of the kitchen to the other. I’ve inserted the tiniest bit of adventure into my meal times. Coffee and any other beverage are also carried in the pack in mason jars with lids. My daughter, Emery, is often here at mealtime, but it’s nice to know I can accomplish this task solo if need be.

I’ve been going through a lot of ice for the cooling/compression sleeve that I wear on my leg whenever I’m resting or sleeping. A couple of my friends brought over a Yeti cooler that my sisters filled with bags of ice along with a bucket that I can take the water out of the cooling device and replace it with the ice, a few times a day. Finding ice the day after a winning college football team’s home game (CU), I have learned is almost impossible and once found, quantities you can buy are limited to two bags, regardless if it’s to ice down a keg or a new knee. I hope it’s an away game next weekend. On top of the cooler I have a pair of scissors and a hammer. Everything I need. Again, I have help when I need it but self sufficiency feels good.

Love.
I think we remember what we need to remember post surgery — the stuff that matters. While the nurse put my pre-surgery IV in, I remember looking to the side of the room and seeing my two sisters and my daughter seated next to each other… my line up of love. I was scared and the trio of women just feet away could sense that because I can’t hide anything from them. They know me as well as I know myself. Emery said I’d be OK, or something to that effect, but it was what she said to me after those words that stuck and I held onto as they rolled me into surgery.
“You are one of the strongest people I know.”
When I hit the wall with the pain or felt afraid in the hospital room in the middle of the night, those words — you are one of the strongest people I know, echoed in my mind giving me comfort. My sister’s embraces before they left the prep room then my daughter’s embrace and good bye are the parts of the story I remember —the parts I want to hold on to with every fiber of my being because they are the parts that matter—that are necessary.

I remember snippets. Snippets that make me cry. Snippets that make me laugh. Emery’s hug before they wheeled me off for surgery, my sisters setting their alarms to check on me every 3 hours the first few nights after I got home and touching my cheek with their hand before leaving the room. I was asleep, but awake enough to feel their presence. Drugs are a strange thing. Robin told the occupational therapist yesterday how hard the first few nights were and she and Susan would get me tucked into my couch bed and would give me my meds then say their goodnights. Robin said when she looked back the first night she saw tears streaming down my cheeks. All those emotions, finding their way through my physical body, mingling in with my emotional body and landing on my cheeks. I felt so cared for, so loved. How could I not sob?

Susan, found the quilt my Grandma made me when I was a child with many of the blocks made from leftover fabric from dresses she made for either me or my sisters when we were young. It’s well-loved and frayed in spots, but the powers of my Grandma’s love still remain in its fibers and having it lay across my body when I sleep feels like a hug. A lot of the pain I’m feeling now is similar, but stronger, to the leg aches of growing pains I experienced as a child. For some reason, I remember having them often while staying at my Grandma and Papa’s house. Thinking about Grandma tucking me into a small bed, likely shared with a sister, while rubbing my aching legs is a thread of connection I savor. These are the tiny moments that matter and are remembered.

During the occupational therapist’s first visit, the one with my underwear on the coffee table, Emery happened to be at my house when she arrived. She stood behind the couch where I was sitting with my legs stretched out in front of me and began to gently braid my hair while we both listened to the therapist’s words regarding self care. It took me a few moments before I realized what she was doing, taking me back to the days I would French braid her hair but never with the same success she had when she did it herself. She was too young to wash her hair and hated combing it, but she could French braid it like a pro. I was often complimented on my braiding skills, but had to redirect the compliments to my young daughter who was the one with the mad hair skills. Not me. I thought about that moment later that evening while working my way through pain. Emery braided my hair.

Love can be straightforward, quiet, soft, beautiful and unexpected and sometimes it can unwashed hair lovingly arranged into a braid.

Left Knee, Part Two

I’m not mad at you. I just wanted to get that out ahead of the anesthesia and the power tools. Really. I’m not mad at you. You’ve gotten me through 68 years, many of them with far more miles and elevation than I would have ever predicted. The Camino (3 times), The Dingle Way (2 times), five 14ers and countless trails in Colorado, the Adirondacks, The Berkshires, Lake Tahoe, Alaska, Oregon, California, Peru, Argentina, Bhutan, Nepal and a whole lot of other places. And that’s not counting the stuff that no one cares about like bedrooms on 2nd floors, elevators that didn’t work, apartments without elevators and simply making my way from one side of the room to the other, first by crawling on hands and knees, then on wobbly legs and finally walking without thinking about it, upright and with confidence, the audience and outstretched arms gone.

You hung in there, probably longer than I should have let you, but I thought I could fix you without going under a surgeon’s knife (or power tools). I educated myself. I read about procedures, equipment, oils and potions, crossing my fingers that I’d find the solution. I didn’t want to succumb and follow what over 2 million people a year do because I didn’t want to feel like I had failed and was taking the “easy way” out, even though I’ve been forewarned that there is no “easy” in this solution that many say is over used.

I wasn’t ready to take a part out of my body that I was born with and replace it with something that was made in a factory and sold to doctors by representatives who leave shiny brochures behind for their patients. After multiple appointments with a handful of orthopedic surgeons over the course of a decade or so, I realized it was finally time and the right exercise, machine, brace or magic potion oil was not going to be my answer. Maybe I bought myself some time with these carefully researched remedies.. You, my dear old lefty, have reached the end of this trail. For the first time in my life, I have started thinking about the loss of a body part and it makes me sad in an odd sort of way. Not to steal your thunder, but you will not be my first body part to be removed. You will, however, be the first one to be replaced. My list is growing starting with my tonsils at age four then my right kidney 17 years later along with a rib that was in the way and finally my uterus. I don’t remember the date on the uterus, but watched Princess Diana’s funeral from a hospital bed. Your presence in my body will be replaced and maybe that’s why I’m feeling more of an emotional connection to the loss. Granted, I was four when the tonsils came out and knew little more than the ice cream I was promised when I woke up and with the removal of my kidney, my only concern was how awful the scar would look when I wore a bikini. The uterus, although necessary, was more emotional and left me with dreams of being pregnant but because I didn’t have a uterus, I had to carry the fetus in a basket. It wasn’t convenient because I couldn’t ever set it down and explanations were difficult. The dreams continued off and on for years then stopped. Possibly coinciding with menopause. But you… you will be replaced, unlike the tonsils, the kidney or the uterus. I will have a new left knee.

My almost four-year-old granddaughter asked me if I got to keep the old one. I told her no. I’d get a new one and the old one would be left behind. She also asked me if I got to choose what color I wanted and suggested pink because that is her favorite color. I wonder what it would be like if when leaving the hospital you got to exit with what you came in with, removed body part and all. They technically belong to you, right? I think about the nurse handing over the discharge papers and instructions along with a small bag with the removed body part inside, probably marked with the bio hazard sign. There was one body part I inquired about keeping and it was the one I didn’t know would be coming out. My rib. The pesky rib that was in the way. I asked my doctor if it had been saved. I thought it could be polished up and made into something interesting like part of a hair clip or an artifact with my own history that would sit on a shelf waiting for questions. My doctor said no. Several years later, when I was living in Alaska, I found some caribou antlers that I sawed into pieces — the larger end making napkin rings and the smaller made graduated sizes of buttons. After a lot of sanding and polishing, they looked like marble. I’m guessing my rib could have looked similar. Again, I was 21.

No offense, but I don’t want to keep you, and it’s not an option anyway, much to my granddaughter’s dismay. There was a time though, that it must have been an easy option because at age four, which seemed to be the going age for tonsil removal, my friend kept her tonsils. They floated in a jar in some sort of liquid and sat on a shelf in her room. I felt cheated, even at the tender age of four, that mine hadn’t been saved and weren’t on display. They seemed too small for something that had been causing so much trouble in our four-year-old throats. But still, I remember that mason jar with the two white floating lumps as much as I remember my sore throat and the endless bowls of ice cream.

I feel like I should name you, but it seems like a thin gesture to name something a few days before you’re going to get rid of it. But, if I did have to give you a name, it would have to be a word that means resilient and strong, which of course are the adjectives that the rest of my physical self became in dealing with you, no offense intended. My sister, Susan, would say the knee issues started long before I’ve admitting now — as far back as 15 years ago when we were hiking a trail in Patagonia with four other women when our guide, James, asked me if I’d like to use a hiking pole?
“A hiking pole? Why?” I asked.
He told me it looked like I was protecting my left knee. I had no idea. And so I used the pole and realized that maybe he was right and taking the weight off that knee (40 pounds per pole he told me) did seem to help. On day one of a big week of hiking, I was reluctant to admit that it hurt. Maybe that was your first whisper to me that things were starting to go south.

You’ve given me a good run, both literally and figuratively and if the joint wasn’t covered up with skin, maybe I’d take my granddaughter, Muna’s suggestion and ask for pink. Pink is one of those colors that looks pretty but is secretly stronger than people realize.

You’re not coming home with me — in a bag or a box or floating in a jar of liquid.  Instead,  I’ll say my goodbyes  and offer my thanks.  You’ve served me well, Lefty.

September 12th, again, but different…

My left knee.

Last year, on September 12th, I began walking the Dingle Way in Ireland with my sister, Susan.  It was the same route we walked in 2019, also starting on September 12th.  On the same day in 2021, I was hiking in Eldorado Canyon with my Boulder friends and the year before that, I was shoveling six inches of snow from a “this rarely happens”  snow storm in Boulder.  September 12th has unintentionally become an important date for me.  All three of the Camino walks I did started on September 12th, as well as a trip to Bhutan and Nepal and a 2020 trip to walk in the Burgundy region of France, which was cancelled due to Covid.   This September 12th,  I won’t be getting on a plane.  I won’t be walking new trails or revisiting familiar ones.  Instead, my adventure will be replacing one of my body parts.   I will be getting a new left knee.  I’d rather be headed out for a 500-mile Camino walk or even a 3-mile walk to anywhere at this point, but I suppose it’s all the walks that started on this auspicious date that have played a role in wearing old lefty out.  She’s shot.  And I’m replacing her with a new and improved model.  

It’s not the experience I thought I’d be writing about this fall, but I decided it would be remiss of me to skip over thisjourney because that is exactly what it is, a journey.  It was hardly what I expected and I’d choose packing bags and making reservations over poring over pages of information about “what I can expect,” but the process of this is upheaval of plans has become my teacher. I’ve learned that adventures don’t always involve airplane flights, packing bags or new trails.  This adventure has become an unplanned journey into parts of myself that go beyond the hinge in the center of my leg that allows it to bend.  It also put into place a sad list of cancellations, including a volunteer trip in Tanzania and a wedding in Utah.  I can reschedule Tanzania, but am sad I won’t be able to attend the wedding of the daughter of dear friends of mine.

September 12th is still a few days away, but the adventure began in mid June while I was on the east coast visiting my sister, Susan.  We hiked in the Adirondacks and lefty was strong enough that I was able to revisit Rooster Comb, which I’ve wanted to do since I last hiked it ten years ago. I needed to know if it was as hard as I recalled.  Was it?  Yes, it was challenging, but my memories have painted a much more difficult hike over the years.  Or maybe, (and this is the explanation I prefer to go with),   I’ve gotten stronger.  When we got back to Susan’s home in the Berkshires, I had to cancel the hike we were going on the next day because in my heart of hearts I knew I wouldn’t be able to keep up the pace of her fellow hikers.  My knee hurt.  I had dealt with a little pain here and a little there for years, but was always able to work around it and hike to my heart’s content.  This felt different.  With all the  “a little pain here and a little pain there” that’s been going on for over a decade, I’ve slowly been inching my way to the edge and the cancellation of a relatively easy hike was me hitting the proverbial wall with my left knee leading the charge.  Time was up.  I visited a recommended orthopedic surgeon when I got home, knowing what he’d say, only this time I lingered on his words “bone on bone, it won’t get better.” Having tried several remedies that included stem cell and hyaluronic acid injections, acupuncture, physical therapy, massage therapy and a few potions and lotions out of desperation,  I knew it was time to get out my calendar and book a date.  My last hope was a cortisone injection, which I was told could give me up to nine months of relief or possibly not work at all.  I hung onto the nine months of relief  and waited hopefully until a week had passed and I called the doctor and asked how long it would be before the shot would begin to work?   I got my answer.  It hadn’t worked.  Unfortunately, I was one of the unlucky few.  Before I was given the injection, my doctor told me there was one caveat.  If it didn’t work, I wouldn’t be able to have surgery for twelve weeks.  I didn’t give the twelve weeks a second thought as I knew it would work, but I did ask if it would hurt.  He gave me a curious look and responded,


“You are dealing with bone on bone pain with your knee and you’re asking if the shot will hurt??  No.  It won’t hurt.”

I was lucky to have my friend, Jane, along for that appointment.  She’s been through  knee replacement surgery before and worked as a medical attorney before retiring a few years ago.  She asked questions I hadn’t even considered.  All I could think to ask was how long before I can hike, how long before I can get on an airplane and how much will it hurt?  I was also wondering about the scar, but kept the vanity questions to myself.  

According to the calendar, twelve weeks after the injection fell on September 12th, which also happened to be the day after my two sisters would be coming out for a visit.  I hated to trade in hikes in Rocky Mountain National Park and a week-long road trip through my beautiful state for surgery and post surgery care, but it seemed to be a lucky coincidence.  My travel companions would become my home health care providers. 

A few days ago,  I was sorting out final plans on FaceTime with my sisters when Susan burst into laughter for no apparent reason.  Robin and I both asked her what was so funny and she said,

“I just had a vision…Robin and I in her Honda driving across western Kansas and eastern Colorado with a walker, a cane and a raised toilet seat in the back seat and wedged in between the equipment, our knitting.”  (Robin happens to have a friend who has a garage filled with much needed post surgery equipment and is a generous lender). 

She was right to burst out into laughter.  My how times have changed.  Normally, there would have been hiking boots and poles or snow shoes in the winter, and way back in the day, when it was legal in some states, a cooler of beers to enjoy along the way.  My two sisters, hauling equipment in the back seat of the car that will help me move across the room and trading in their Colorado vacation to come to my aid, makes me smile.  They might as well speed on their journey west.  No highway patrol officer, after seeing what they’re carrying in the back seat, would dare give them a speeding ticket.

During the time in June when I made my first hiking cancellation due to pain up until last week, my life has looked very different.  I’m not hiking and because of that, I’m not seeing my hiking friends, or at least not as often as I used to.  Instead, I have made it my summer of travel and discovery.  I drove to Santa Fe for a few nights, ate dinner alone (as noted in a previous post) and meandered my way home with an impromptu stop in Taos for a night.  I liked being in my car with little to no plans, making up my route as I went along.  It felt good.  It felt free.  I savored the “out on the open road” mentality,  although I doubt Jack Kerouac would use those words, but still… 

A few weeks later,  I traveled to Kansas City to celebrate my Dad’s 95th birthday then to LA to see my LA kids, followed by a trip to up the west coast to see my Portland kids, which included a few nights at the moody Oregon coast that fills my soul.  I rounded off the summer with a trip to Rhode Island to celebrate my birthday with Susie,  the girl I’ve called my best friend since I was 15-years-old.  It’s been a good summer.  I’ve missed the hiking and seeing my friends on the trails a few times a week, but these past few months have reminded me that the journey needs to hold as much weight as the destination.  Often, that’s where the jewels are found, but you have to be going slow enough to catch their sparkle.

This four inch area in the middle of my leg has become my teacher these past few months. I’ve learned humility, vulnerability and honesty with my impaired abilities and am working on patience.  Recently,  I’ve become strangely in search of vertical scars that run the length of a stranger’s knee cap,  because I’m both curious and nosey.  I never noticed or gave a thought to this before.  If I note a scar, my attention is then is redirected to their gait.  Is the owner of the scar limping?  Do they appear to be in pain?  In a town as physically active as Boulder, the amount of vertical scars running down knee caps is far more common than I would have predicted and not all of them have silver hair.  So far, all have had a healthy gait and none seem to be writhing in pain.  I’m holding on to that as a good sign.  

Along with the travel this summer, I’ve been “pre-habbing” my knee with daily trips to my rec center for the stationary bike and weight machines along with daily exercises to strengthen my legs.  I’ve been told all the work on the front end will make for an easier and faster recovery.   Those words alone have off set some of the “it’s not going to be easy” remarks from not only my doctor, but everyone I know who has had a knee replacement or knows someone who has.  

My 50 year high school reunion is one month and a few days post op so have a goal.  When I say 50 year reunion, it is with a gasp followed by a shake of my head because seriously, how in the world could it have been that long since I graduated from high school?  When we’re all together after so many years, we will, without planning, become 17-year-olds again and the roles will come back like it was yesterday.   Goals.  I certainly wouldn’t have guessed three months ago they would include going to my 50th high school reunion without a walker.

This is phase one of my journey and chapter one of sharing my adventure.  Somehow adding the word “adventure” makes it seem less awful.  There will be more of this to follow.