Cynthia, 69, is a newly retired grandmother. She went from having a very active lifestyle to a more sedentary one due to her job and a return to school to get a Master’s degree. After a fall, which made walking hard her surgeon recommended that she have both of her knees replaced—which she had been putting off for years. She had both knees replaced over the course of three months.
CYNTHIA: My name is Cynthia. I'm, I hate to admit it, 69 years old. I don't feel it. Sometimes my joints do however.
CYNTHIA: I am married now. I have two grown sons and I have two granddaughters. And I am newly retired. It wasn't by choice but by necessity.
CYNTHIA: A little over a year ago my manager where I worked decided he would do away with my position.
CYNTHIA: And it was interesting because I had been thinking about retiring for like six months. So I said, "Maybe it's a blessing in disguise." You know, I'm just gonna go for it.
CYNTHIA: I have three degrees. I have a bachelor's, a master's in history and a master's in library and information science.
CYNTHIA: I had been a very active adult. I had done Polynesian dancing. And that does take a little bit of pressure on the knees you might say. 'Cause your knees are constantly bent as you're dancing. And I used to ride a bicycle. I became quite sedentary when I went back to school. And unfortunately when you're sitting studying and then you have a day job where you're at your desk, it's not the best scenario for orthopedic health you might say.
CYNTHIA: In 2004 I had a slip and fall at a hospital in the parking structure. And I was really, really i-I mean it hurt terribly. A doctor gave me injections and said, "You're too young to have any knee surgery. I don't want you to have to go through that now."
CYNTHIA: I got to the point where I knew I had to have a knee replacement because I had so much pain. It was even hard to sleep at night. No matter what position I was in, I could feel the bones kind of like rubbing against each other. And then of course just to walk was getting to be problematic.
CYNTHIA: With my surgeon I tried to minimize it. I guess I did not wanna face the fact that it was gonna be major surgery. But any time you cut into the bone and you start replacing parts, it is pretty major.
CYNTHIA: As far as what he was going to be doing during the replacement, I wasn't even concerned about that because I trusted him and I knew that I did have a few issues going into the surgery that were probably not the best for a successful result.
CYNTHIA: I have had high blood pressure. But it's been under control. I have had a weight problem for years and years and years. My surgeon felt like he could work around those issues.
CYNTHIA: We had the first knee done seven months ago. And then the second one six months after that. Almost to the day actually.
CYNTHIA: When I arrived at the hospital, I was very, very nervous. And I was trying to remain as calm as I could. And the anesthesiologist came in to see me. And I said, "I don't care what you give me but when I go in there I don't wanna remember anything." I still remembered going in there and seeing all this equipment. But by that time I had enough medication that I really didn't care a lot.
CYNTHIA: And then all of a sudden I was in my room. I don't remember being in recovery at all. And I know I was. And so I just remember waking up in my room about one o'clock in the afternoon. And I wanted to eat something. Well that was not a very good idea because what went down, I had cottage cheese and fruit, came right back up again.
CYNTHIA: So shortly thereafter they had somebody come in and get me out of bed. And I knew this was gonna happen. But I was very, very nervous because I thought how can I possibly stand up? They got me up out of bed and I thought my surgeon is going to be really, really happy that I was able to accomplish this.
CYNTHIA: And then the second day was, you know, getting myself up. So the physical therapist would come by. And then take me for walks. And I was scared to death. 'Cause I did not think I could walk down the hall, even with a walker. Considering what I had done to my leg. So I was rather intimidated by that. And I remember one day when the physical therapist came by and he and I had developed a really good rapport, and I said, "We're gonna go all the way around the nurse's station to the other side. 'Cause I wanna make sure I can go home."
CYNTHIA: Coming home Friday afternoon I had a phone call from the homecare nurse who was gonna come. And she was also a physical therapist. And she was wanting to set up an appointment for that Sunday. And I thought, "Oh my goodness, already? I don't think I'm ready for this."
CYNTHIA: She arrived. Went through the normal, you know, checking my vitals which was important. Temperature, blood pressure, that sort of thing. And then she said, "Okay, we're gonna go into the bedroom and I want you to get on the bed and we're gonna do some exercises." And I thought, "No way am I gonna move this leg." But she worked with me. We started doing these exercises. And then she wanted me to do them in between her visits with me. Which was like two or three times a week.
CYNTHIA: She also advised me to ice it frequently and keep it elevated as much as I could, which I did do. I would probably ice it four or five times a day and then right before I would go to sleep at night.
CYNTHIA: So it was manageable at that point. And I was still taking the pain medications. And she emphasized to me that I needed to stay ahead of the pain. Try to manage extreme pain because that would inhibit the healing process.
CYNTHIA: The strangest thing is that with the pain medication, it caused me to become very emotional. And when my physical therapist would come by and as it got time for her to finish with me, I would start to cry. I didn't want her to leave. I wanted her to keep coming.
CYNTHIA: I have to say that I did really well managing the pain. I'd try to keep it maybe at a seven if possible.
CYNTHIA: She also checked out our condo when she started working with me. And I knew that I needed to have furniture cleared out of the way. No f-rugs on the floor where I could trip on them or slip on them. Probably the biggest obstacle is that we have two dogs. And they're small dogs. And one of them plays a lot. And she has a lot of toys. And she would scatter them throughout the house. So I would just have to be very careful when I am maneuvering around the house with my walker.
CYNTHIA: My biggest concern was that I didn't want to fall. And I also did not want to get in the shower. I was terrified of getting into the shower and trying to maneuver with the water and everything. Even though I had one of these benches to use. But my physical therapist had a woman who does at home showers for e-especially for orthopedic patients. She'd get in the shower with me and do the whole thing. And it was like almost as going for a massage someplace. It was very therapeutic.
CYNTHIA: So during my at home therapy, the therapist and I went down into the garage and she assessed the car. And she said, "Okay, this is how you're gonna do it." So she adjusted the seat. And she said, "Okay, you're gonna put your derriere your, in first and then swing your legs in." And then that made perfect sense to me. You know, I said, "Oh good, now I can get out of the house. I can take a ride even just around town." And that's gonna help my outlook. You know, being out. And then going to physical therapy became routine.
CYNTHIA: So that was the end of that. And then gradually, um, I was not allowed to drive while I was on pain medication. And that was really hard on me 'cause I'm very independent. And so my goal was to wean myself off of them. And gradually maybe take them only at night or before a physical therapy session. And then throughout the next couple of months I was able to take myself off them and use something over the counter. Because I had the goal I wanted to be able to drive my car again. And I wanted to go do what I wanted to do without feeling I was dependent on somebody else.
CYNTHIA: It was about seven weeks following surgery that I was able to get into the car and drive it on my own.
CYNTHIA: When I had the second knee done and having been through it previously, I knew what to expect when the physical therapist came in to get me out of bed. And so she stood me up. And I remember thinking, "Oh, my surgeon is gonna be so happy." You know. And she said, "Do you think you could take a few steps?" And I said, "I'm gonna walk over to that window." Which was more than a few steps. Because I was determined after having the first one doe that the second one was going to be easier for me to get through basically. So she was really pleased that I walked to the window.
CYNTHIA: Even when I was discharged from the hospital, I knew exactly how to get in and out of the car. That was to me a wonderful experience [LAUGH] compared to the first time.
CYNTHIA: But the pain medication is where I have had the biggest problems. It would depress me horribly and I would have crying jags where I could just cry. You know, somebody would look at me and I'd start to cry.
CYNTHIA: I had gone to see my surgeon for my six week check up. And he came into the room and I'm crying. And he immediately dives to look to see what my knee is doing. The incision. And he does a couple of maneuvers with the leg to see my range of motion. And he says, "What's wrong?" He was so concerned. And I said, "I don't know what is wrong but I cry all the time. I am so depressed. I don't want to do anything." And he says, "Well it's time to change the medication." So he did that immediately. I had to make some changes literally.
CYNTHIA: Managing my expectations has been very, very hard. Perhaps more so this time because after having done the first one everybody said, "Oh, the second one's gonna be easy. You're gonna know what to expect. You're gonna be able to adjust and just carry on with your everyday activities."
CYNTHIA: I guess at this point I really appreciated the fact that the left knee was so good so soon with not having the pain that it had pre-surgery. The right knee I think it slowed me down because with having the left knee done first, I had this knee that became the stronger knee but yet I was feeling the pain from it. This time also I can do steps if I have to. Like if I go to s-like out here at this particular location there are steps and I'm not as intimidated by them as I was the first time because I've learned how to maneuver steps.
CYNTHIA: I never was worried about what the scars would look like. Because I felt that they were almost like a badge of courage so to speak. I really felt like so what if-if they're not-if they're unsightly. I'm not ashamed of them because this is what's giving me my mo-mobility back. And my ability to do thing and engage in a more active lifestyle than before. My surgeon has told me that eventually they'll fade. But it hasn't been an issue for me because again, I feel like it's a badge of courage and what I've accomplished. And the confidence that I had, not just in myself to get through the surgeries, but the confidence that I have in my surgeon. Which I think is more important than anything.
CYNTHIA: One of the things that I was adamant about when we scheduled the first surgery, that I was gonna straight home from the hospital. I was not gonna go to any rehabilitation, any other facility. And with my husband being with me 24/7, he really was a good caregiver. He still is. And I did not realize how difficult it was gonna be for me at home. And as an example, at night if I had to get up to go to the bathroom, I could not get out of bed by myself. He had to help me by lifting the left leg and then gently bringing it down so that I could put it on the floor. And then get on the walker and then trudge off to the bathroom. And he would stay awake the whole time. And when I would come back then he would get up again and help me back into bed.
CYNTHIA: He has been very, very attentive. I mean even bringing me my coffee in the morning. Which I was so accustomed to doing on my own. Or getting up to get a glass of water or an icepack. He's always there. And I could not have done it without him.
CYNTHIA: Facing joint replacement surgery is probably one of the most intimidating medical procedures that we have to face.
CYNTHIA: You can't take an aspirin and it won't be there tomorrow. Because when you have joint pain it stays with you until you do something about it.
CYNTHIA: I've tried to explain to a friend of mine who had surgery with another doctor how important the physical therapy is. When he goes to take measurements it's very, very painful. And you really grit your teeth but I realize myself and I try to convey this to other people, they say no pain no gain. And that's very, very true. You know and you have to also consider that the physical therapy is a temporary thing. And the-the most that you can cooperate with them and do what you're supposed to do, the sooner you're done with it and g-get on with your life.