Knee -1

Today is the day.  This has been a very long time in the works, but the time has finally arrived.  I check into the hospital in about 5 hours.  Tomorrow morning, I will receive a new left knee!  I do not anticipate any problems and, in a way, I am looking forward to this process.

Being able to walk without experiencing the popping and grinding of bone-on-bone will be quite a change.  I hope the right knee will be able to pick up the slack while my left knee becomes strong again.  And just think, I get to do this all over again in a few months when I trade in my right knee!

Checked in at 1500hrs to Life Wilgers Hospital in Pretoria, South Africa.  I faced the normal barrage of never-ending paperwork, only to discover that I could have (should have) come a few days earlier for pre-admission which would have avoided this process.  After being admitted I was handed a folder containing all my medical information and then sent to the second floor to the Orthopedic Ward where I was assigned a bed.  This was a six-bed ward, and I filled the last open space.  One gentleman was there for the same reason as me - LTKR; one was there for a left shoulder replacement; one young man was there with complications of a hip replacement gone bad; one man had already had a RTKR and the final one had some sort of back surgery.  We all became acquainted quickly and exchanged pleasantries.

I must have been more anxious than I realized.  When the nurse took my BP it was 197/84.  I do experience high blood pressure - even take meds for it - but it has never been 197 before to my knowledge.  They took my BP several more times before bedtime and it did recede, some.

My wife was able to stay with me in the ward past the posted visiting hours, but she left in time to return to our place of lodging prior to darkness.  After her departure I was visited by a gentleman who measured my legs and gave me a pair of the compression stockings to wear.  I was to put one on my non-surgical leg immediately, then instructed to put the other one on my surgical leg after the surgery.

Then the anesthesiologist came by to explain that he would be using a spinal block and he would put me to sleep, but it would not be general anesthesia.  In his, and the OS, words, "Recovery is much better using the spinal rather than a general". 

After visiting hours were over, I rested well throughout the night.

Putting in a line for the IV drip

Finished

Ready for surgery

The Orthopedic Ward

5 Days...

I had a meeting with a third doctor and my physiotherapist yesterday.  This doctor is acting as a liaison between my insurance carrier, the hospital, OS and myself.  He is a God-send.  I do not have to deal with a lot of issues that would normally be overwhelming. 

The physiotherapist was very nice and reassuring.  She told me that I would probably be in the hospital a day or so longer than what the OS indicated.  She will meet with me just a few hours after the surgery and begin PT almost immediately.

I feel very comfortable with all that I am facing.  Can’t wait until Sunday afternoon when I check into the hospital.  Surgery will be the following morning.

Here is a video of what is about to take place:

7 Days and Counting

In exactly one week I will be in the theater having my left leg opened at the knee.  This should be a frightening thought, but really it is not.  I am anxious to get on with this process, even though I realize it will be long and it will be difficult.  Again, I will be glad to start AND finish.

The appointment with the physiotherapist today has been changed to tomorrow.  I will meet him/her in the morning.  From most all that I read this person could be my worst nightmare, but hopefully that will not be the case.  This person could turn out to be my new best friend.  I will think like this presently, and wait until the actual rehab starts to make a final determination.

July 20, 2016

An appointment with the primary care physician is the priority of the day.  The doctor conducted a complete and thorough physical including a stress test for my heart.  With the exception of a slight infection in my nasal passage, which will be dealt with by an antibiotic ointment, everything was in order and the doctor gave his approval for the surgery.
The physiotherapist is the only remaining appointment that I have prior to the surgery.  The PT will give directions for pre-op activity as well as setting up the schedule for post-op rehab.

My wife and I are staying in a two-bedroom apartment during our time in RSA.  It is comfortable and so much better than a hotel room.  There are a few areas of concern though, such as the sofa which is fairly low to the ground and difficult for me to rise up from.  Since sitting and standing will be difficult after surgery this could be a challenge.  One of the bedrooms is furnished with a king-sized bed and the other is furnished with two twin beds.  The king-sized bed should be fine, but if it is a problem I can always move to one of the twin beds.  Another issue will be the fact that there is no shower in this apartment, only a tub with a hand-held shower wand and stepping over into the tube may prove impossible.  Considering all these issues, I am truly grateful for the accommodations, it could be so much worse!

It is winter in South Africa.  I know, you don’t consider that Africa can have a winter season but it most certainly does.  The nights and mornings are nippy to say the least.  Temperatures hover around 37 to 40 degrees.  It does warm up in the day time, but the rooms remain cold.  All in all, it should be perfect for those short mini-walks that I will be taking throughout the day during my recovery.

July, 2016

Planning for major surgery (TKR) can be difficult anytime, but when you live in Liberia, West Africa it is even more difficult. The issues with insurance, doctors, hospitals, logistics and location are quite formidable, and communication is another major issue all its own. 

You are probably wondering why I would deal with all the obstacles, why not just travel to the States and have the surgery performed there especially since that is where our permanent residence is located. The answer to this question is the easiest part of the entire ordeal, insurance. Our medical insurance encourages us to have all of our medical issues taken care of outside the continental United States. In fact, 100% of this TKR is covered by our insurance IF we have it done outside the USA. If we go to the States our insurance covers the normal 80% of allowable charges which means the remainder of costs are out-of-pocket for me. Considering all the issues, I opted to have my TKR done in the Republic of South Africa. RSA has some of the best medical care in the world and rivals most options in the United States. My wife and I departed Liberia on July 16, and arrived in South Africa on July 17th. 

My first visit with the orthopedic surgeon was on July 19. All of medical records, including the x-rays from the orthopedic surgeon I visited in the States, were sent to my surgeon here in RSA prior to my arrival. Upon arrival at the surgeon’s office, I was directed to the radiology lab for a complete set of new x-rays. To my surprise, the radiologist handed me an envelope containing all the x-rays after they were developed, and I was instructed to carry them back to the surgeon’s office. 

The meeting with the surgeon went quite well. He is very personable, well-disposed and knowledgeable. He performed an extensive exam, viewed the x-rays and without any hesitation at all agreed with the diagnosis given me, almost a year earlier, by the orthopedic surgeon in the States. Surgery was scheduled for August 1, 2016.

The surgeon’s office staff sent me to the on-sight lab to have blood drawn and a complete analysis work-up for the primary care physician that I would see the next day.

July, 2016

If you have decided to join me there is no doubt you are facing the same journey, or you have already traveled the path, of TKR (total knee replacement).  Either way, you are welcome.  Please feel free to leave comments, words of encouragement and of course prayers.  There is an African expression that says, "If you want to travel fast, go alone.  If you want to travel far, go with others."  Together, we can travel far.

Hard work has been a way of life for most of my 63 years.  Lifting and carrying heavy loads in the West Texas oil fields certainly placed a lot of tension on my knees, and I felt that this surely was the cause of my problems today.  My doctor assures me that my condition is more probably due to genetics than the hard work.  For many years my mother endured the pain of bad knees, but it was long before TKR was even a possibility.

For longer than I would like to admit, ibuprofen and pain were my daily companions and they have finally forced me to face the inevitable, an appointment with an orthopedic surgeon.  His diagnosis was really no surprise: degenerative joint disease (osteoarthritis) with the recommendation for TKR in both knees.  I decided to wait before I made any rash decisions.  After all, I have been suffering with this for several years, why get in a hurry now?  So, after another full year of pain and limited mobility, it is time for action.

When I decided to embark on this journey I began to research TKR, and I looked for people that had walked this path before me hoping to glean from their experiences.  A lot of information was available in fact, there was enough to throw me into information overload.  But it seems that the personal stories of others were what brought me the encouragement I needed.  For this reason, I have decided to keep a blog of my own journey through TKR.  Maybe someone will find encouragement in my story, and I will find a way to express my victories, failures, bad decisions and good ones.

Come on, let's travel!