Mike, 71, is married with four kids and ten grandchildren. Mike played Division 1 basketball at the University of Santa Clara in the late 60’s. He continued to play basketball into his 50’s, along with tennis and golf, into his late 60’s. Mike tore his meniscus which led to other knee problems. Even by keeping himself as fit as he could, Mike could not undo the overuse of his knee after 50 years of abuse. Mike’s knee issues really only affected his ability to play sports. Mike’s surgeon told him not to wait until the last minute to have his knee replacement and advised him to build up his muscles as much as possible and then have the operation so his recovery would be easier.
MIKE: Hi, I'm Mike. I'm, uh, 71, married, uh, high school sweetheart. We have four kids, ten grandchildren. The kids are all over the world, Denver, Singapore, Tuscon, and San Francisco.
MIKE: I'd say the sports has been a central part of my life. Played college basketball, D1 basketball at Santa Clara where I was co-captain in the late sixties. Took up tennis like a lot of other aging baby boomers. In the seventies, tennis was a very popular sport. And so, I played both, uh, tennis and basketball into m-my fifties.
MIKE: The combination of basketball and tennis, and then continuing tennis on hard court, you know, led to a lot of knee problems. Basically, torn meniscus, and scopes, etc.
MIKE: [Do?] to maintain that knee. Cycle, did weight training, and, you know, tried to keep the quad and hamstring as strong as possible. But, you know, forty years of over use, you know, I don't think you can exercise enough to compensate for that. I did start playing tennis on clay which helped because less pressure on the, uh, joint. But, it just, you know, dawned on me that I would need to have a replacement.
MIKE: In terms of impact on my life? I would say outside of sports there wasn't much of an impact. I didn't have trouble sleeping at night. Maybe at a year-plus b-uh-before the surgery might, you know, be a little gimpy, bowlegged. But, I was definitely getting more pain, you know, I'd ice, but, you know, that [wouldn't?] a panacea by any means. And, eventually I wanted to get a professional opinion on what the protocol should be.
MIKE: I think the emotional toll was probably the most pronounced. Because, you know, my self-image was very wrapped up in being a, quote, stellar athlete, unquote. And, it may not have been true, but that's how I felt. As those, uh, activities diminished, people would say, “Well, gee, why don't you take up rowing,” or, you know, something like that. Well, that just didn't float my boat.
MIKE: What was interesting is the surgeon that I saw had a slight change from the prevailing view that you should wait until you are in excruciating pain, and then get it done. And, his feeling is that keeping the quad and hamstring as strong as possible before the surgery means that you don't want to wait until you are in excruciating pain and can't work out. Because then, your recovery is going to be much longer because you've gonna have to build those muscles up in addition to firing, um, up, and stretching, and being mobile. So, that was a big influence on me because that made sense to me. Because I've always worked out, weight training, and cycling, and it just made a lot of sense to me to make sure that for two to three months before the surgery the quad and hamstrings were as strong as possible.
MIKE: I want to continue to play golf and tennis, and the way to do it is to have the knee replacement.
MIKE: In terms of the hospitalization, I would say it was as expected. First of all, I had a nerve blocked during the surgery. So, I didn't have general anesthesia which is, uh, a big benefit to your recovery, and the hangover that you don't have. Once the nerve block wore off, then they had drip meds, and basically, I didn't have any pain in the hospital. You're have discomfort, but I didn't have pain.
MIKE: I was in there for two nights. Physical therapist came in. Manipulated the knee. I've learned how to do stairs when I was in the hospital the second day [LAUGH], and that, kind of, blew me away. But, I have s-a upstairs bedroom so I needed to learn how to do the stairs.
MIKE: Infection [CLEARS THROAT], you know, was a big concern to me because I had had a staph infection after a scope about 20 years ago. My doctor is known in the community as being maniacal about infection.
MIKE: At home, you know, when you're off all the really high potency painkillers in the hospital, -eft I mean, everybody warned me, “Oh my gosh, how the first ten days…” [COUGH] It was, uh, painful, but it-it wasn't excruciating. And, I was up walking, uh, every day, you know, with a walker. My personality is such that I probably would be prone to over doing rather than under doing. As long as I felt comfortable they want you to do that. They don't want scar tissue to build up. They want flexibility in the joint.
MIKE: Two weeks with physical therapists coming into the house three times a week, and that was painful because her goal was to manipulate the knee so that the scar tissue is broken. By definition that's painful, and it was. It's the goal that you have. So, you know you have to suffer a little bit along the way.
MIKE: Started walking around the block maybe ten days after the surgery. Every two or three days you could go a little further, uh, you know, building up your stamina. I just followed my surgeon's instructions to an absolute tee. I never did any more than he said. I never did any less than he said. Same with the therapist who came in to the house. She was very professional, and had done literally hundreds of, uh, knee replacements.
MIKE: If you don't have a really good connection with the therapist that comes to your house, you might want to consider, you know, getting another one. 'Cause that's very important because, you know, that's when the scar tissue builds up is that first two weeks. So, you want somebody just like a surgeon that's done a thousand of 'em. You want a physical therapist that's d-done a thousand knee replacements, and she was excellent.
MIKE: The flexibility, again, probably goes back to my surgeon. Having me stretch, you know, religiously for two months, and do the weight training for two months. That's, uh, my observation anyway. I feel very fortunate. The surgeon also indicated it wouldn't be a bad idea to drop 10 or 15 pounds just to, you know, be in as good a shape as possible. I'd emphasize that that's my experience, and not everybody has the time to do that, nor the, uh, proclivity. I was fortunate from that, uh, stand point.
MIKE: In terms of physical therapy, I used the one associated with my surgeon. I had confidence in him. I think Medicare pays for [CLEARS THROAT] six weeks, and that's the normal protocol. And, they get right into it. So, uh, initially it's balance, and it's body weight exercises with no weight training. And, you graduate in three or four sessions to light weights, to more balance, uh, using the rubber sleeves that you put around your ankles. Which is a form of weight training, but not much weight. And, then we got right into the weight training. You know, 10 pounds on leg extensions. 10 pounds on leg presses. Uh. Just all sorts of things that I never even knew existed.
MIKE: There are lots of other people in there, uh, that have had knee surgery. Some are doing well. Some are not doing well. It's a huge perspective-giver. You stop feeling sorry for yourself when you see some of these other people have things a lot worse than knee surgery going on. But, I'd have to say, um, that, again, retrospectively [CLEARS THROAT] what my surgeon said would happen did happen. By week two of physical therapy, my quad was starting to show. My muscles were starting to show because the, uh, swelling was going down. So, I felt very blessed with my, uh, therapist. Basically I think I was done after five weeks. He canceled the last, you know, week because I could just do it at my gym.
MIKE: I could feel sorry for myself, and probably did a few times, but you get over that when you see what other people are dealing with. I only wear one brace now, on my left knee. I don't wear a brace on my right knee. Maybe take a Tylenol before golf or tennis, but, uh, you know, that's about it. But, I stay very dedicated to the weight training on the quads and hams, and the stretching.
MIKE: I don't think that there is any easy answer. If you want an active lifestyle you, sort of, have to earn it by doing the prep work. You know, I don't even really want to say this because it just-it's a, you know, woe is me thing, but I'd like the golf proficiency to come back faster. And yet, I can reconcile myself that, you know, just calm down and don't get too excited about it. And, tennis is an aerobic, uh, sport 'cause we just rally in the back court for exercise. That's really a lot of fun 'cause, you know, you get a good cardio. You get some endorphins goin', and I'd say that's very satisfying.
MIKE: I like to garden, and that's, eh, really contra-indicated. You know, planting and trimming stuff, and leaning over, and what have you. Uh. We're gonna downsize. We have a large yard and house. One thing this teaches you is that you're human like everybody else, and maybe it'd be a good idea to get a smaller footprint, smaller garden. And, that's all reality so, uh, I'd say it's managing the expectations and not getting out over your skis, trying to be grateful and-and thankful for, you know, where you are.
MIKE: In relation to the care-giving aspect, I feel very blessed to have, uh, wife of, you know, 45 years, soul mate, all that kind of stuff. Always been a leavening effect. I would have a tendency to get out over my skis, and then she would bring me back down to earth. High expectations, all those things that you tell your kids not to have because the down escalator isn't as much fun as the up escalator, but, you know we're wired the way we're wired. In a long term relationship you benefit from the love and care, you know, even without surgery, and so with surgery it's a positive, really.
MIKE: Well, I had ups and downs just like everybody else, uh, did. You know, why aren't I recovering faster, and that's a good thing to have the care-give to get you to calm down and have reasonable expectations. 'Cause, you know, basketball and tennis, if you got out the yellow pad and said, “Now is that really a good thing to be doing for 30 years from 25 to 55?” You'd probably conclude it isn't, yet, you know, when the ego gets involved and you're in it, and you're not having problems it's like, “Well, gee. This is great, and really I am special.” But, I'd underscore that nobody is special. Period. We're all human. That's why you listen to the surgeon. Listen to the therapist. They have your best interests at heart, and…
MIKE: In terms of how it all came together, I'd say in retro the, kind of, salient factors which led to having the surgery and a good outcome was very high confidence in my surgeon and his protocol. Not waiting until you can't walk just made all sorts of sense to me, and I talked to other people who had been through it, and they said, “Boy, I wished I'd done it earlier,” combined with what the doctor says, and that's-that's a high-motivating factor.
MIKE: The physical therapy went well because of the preparation for that, and I can't underscore that too much. They've done hundreds of these things, and they know exactly, kind of, what lane you fit in. And, our generation, the aging baby boomers, somehow we think that we're different because we were supposedly the Pepsi generation, and, you know, we weren't going to get old. And, this, and that, and the other thing. All of which is not true, of course. And then, you start thinking, you know, that you are special, and then you have to remind yourself that, you know, I mean, I'm 71. I'm damn lucky to be doing what I'm doing, and be satisfied with it.