6 Weeks After Surgery

Well, not quite; my first appointment with Dr. Wang since surgery fell three days short of the actual milestone.  Not that I cared;  it felt like a get-out of-Florida-jail-early card! Although I had to admit I would miss the opportunity to choose between swimming in either a nearly always empty outdoor Olympic-size pool ($4) or the Atlantic, free but less attractive now because of the seaweed and rapidly warming waters of the impending hurricane season. I had resumed my aquatic exercise in mid-May, swimming 20 laps the first time and working up to 40 today, just 10 short of "normal," without any problem.

Lake Lytal Aquatic Center, West Palm Beach

Dr. Wang must have viewed my "screens" before entering the examination room. He barely glanced at my exposed knee, which had healed so remarkably that the continued swelling was more visible than the scar. I'm not sure what I expected from our encounter, but he seemed to be looking for validation that going for the partial instead of full-knee replacement had been the right decision. Was he concerned about second guessing by me or another orthopedic surgeon? I acknowledged that I hadn't experienced any sharp pain in my right knee since the operation, but I also asked if the stiffness ever would go away. He assured me it would lessen with time.

My major takeaways from the five minutes we spent together were: 

• "You're no longer under any restrictions, but listen to your body."

• "Most people get what they need out of physical therapy within six to eight weeks.  If you're concerned about your extension try pressing down on your knee as hard as you can while you're resting your foot on an ottoman or another surface. You won't hurt it."

• "Mobic is a pretty benign anti-inflammatory.  Nadzeya can give you another prescription and an order for more PT in New York if you think you need it."

It's weird.  I had gone from being adamantly opposed to pain medication to fearing its loss.  And a scrip for PT felt like a security blanket.

47 Pianos here I come.  In a compression sock, which Christine had assured me was all the range among millennials.  When I told her I had lived in the same apartment since 1978 she asked me if I had a fireplace because "wasn't that how they heated homes back then?"

1 Month After Surgery

After three sessions of out-of-home physical therapy, I hit a speed bump, perhaps because I'd been working myself too hard with up to five miles of biking and three miles of walking on my off days.  After whining to Christine, the no-nonsense clinic manager, about continuing stiffness and moderate pain in my knee despite frequent icings, she suggested I try reducing my daily activities and reconsider my decision a week earlier to forego any painkillers.  "Remember," she admonished, "you just had your KNEE replaced."

It had taken me more than a week to get my first appointment at ApexNetwork Physical Therapy.  I knew the location--just over the intracoastal from the Folly--well because of its proximity to the spot where I park my bike when I swim in the ocean.  Even more importantly, the building had indoor and outdoor staircases of four flights which enabled me to practice going up and down. I'd told Christine during my preliminary evaluation that stair-climbing was my number-one priority before returning to New York City.

The actual PT began with ten minutes on a stationery bicycle, followed by exercises I'd already mostly been doing at home thanks to Ariele and Matthew. Both Christine and Summer, the other young therapist, and Ingrid, a pleasant and extremely conscientious intern from Pittsburgh, spent as much time on their computers documenting their efforts as they did providing special equipment and mostly telling me how to work my quads. They also massaged my right knee and provided range-of-motion manipulation in addition to electrical stimulation and machine icing.  

I started to realize that my expectations, shaped by the positive professional feedback I had received to date, might be a tad unrealistic, recalling what Summer had mentioned at our first session:  returning to "normal" would take months, not weeks, even though I had undergone only a partial knee replacement.  And what even constituted "normal" anymore, given the fact that I will be 72 in September, just four months from now?  Age-related fatigue the year before already had decreased my swimming distance from a mile (72 laps) to 50 laps.  Perhaps I would need to reduce my biking and walking, too.

At the same time, my attitude about the benefits of professional PT became increasingly ambivalent.  My routine didn't include any stair climbing and I wondered if the other patients--including a frail woman I called Miss Daisy because of the Black driver who picked her up in a BMW luxury sedan--were exercising at home as consistently as I was, often twice a day by the pool, avoiding the sun by switching sides from morning to afternoon.  The outdoor set-up couldn't have been sweeter.

Still, I decided to stick with professional PT for at least as long as I remained in Florida. While I'd always insisted I didn't need a personal trainer to exercise, there's no question that Summer's encouragement while measuring my flexion and extension at the end of each session DID help me push myself harder. And the location gave me a regular opportunity to climb stairs on my own both before and after therapy which, more than anything else, convinced me I was ready to return to New York.

2 Weeks After Surgery

I won't lie:  during my first post-op visit at the Hospital for Special Surgery, I couldn't wait to tell Ms. Zhylinskaya that I had stopped taking all pain medication, including meloxicam, an anti-inflammatory.  

There was other good news to report, too:  

• On her fourth and last visit, Ariele had showed me how to resume my regular morning push-ups (100) and sit-ups (300) by positioning a chair to help me get up from the ground. 

• "Thank you for making my job so easy," Chella, the home nurse, had said when she discharged me three days earlier.  

• Before releasing me from home services, Matthew, the young PT evaluator who informed me that his position required a doctorate, noted that my flexion had improved by ten degrees. "You still need to work on your extension, though," he added, eager to show me a few more exercises.  For one, he assumed a prone position on the couch in the Florida room to work his legs with the red resistance band he had given me.  The scene could have served as the opening for gerontological porn movie, at least in the mind of this Dirty Old Man.

Before I had the opportunity to share any G-rated evidence with Ms. Zhylinskaya, she marveled "Your recovery has been awesome" and directed me to the X-ray room. Fifteen minutes later, we were looking at my "screens" on the computer where the metal plate that had been attached to my right femur looked like the arbitrary borders the British had established for Iran in the Middle East.

A comparison of my knees before and after surgery showed significantly more cushion between my patella and femur.

December 2024

April 2025

Ms. Zhylinskaya then removed the bandage from my knee, exposing the six-inch vertical incision for the first time.  "It's healing well," she observed.  "The stitches will dissolve on their own and you don't have to worry about getting it wet when you shower.  Just keep it clean with a little soap and water."

"Can I resume swimming?"

"Not until four weeks, after all the scabbing disappears."

I left with a prescription for up to 24 sessions of physical therapy and assurances that booking a return flight back to New York for the day after my six-week follow-up with Dr. Wang would not be a problem.

1 Week After Surgery

Old routines die hard.  My recovery had progressed sufficiently to accompany Chris to Walmart for our weekly grocery shopping which increased my distance-walked by the end of the day to more than two miles.  AND I drove the Folly Chariot home, which came as a real relief because it meant that transportation to my first follow-up visit at the Hospital for Special Surgery and out-of-home PT visits wouldn't be a problem with both Chris and Thom gone in just a few days.  

Constipation was no longer a threat because I stopped taking oxycodone two days earlier with a literary assist from Demon Copperhead.  His descent into opiate addiction after a knee injury had been both a timely and resonant cautionary tale in spite of Ms. Zhylinskaya's pre-surgical exhortations to "stay ahead of the pain."

My energy level had increased, too:  I purchased ingredients for both tapenade and chopped liver in anticipation of a visit from Patrick and Marty Saturday night.  They were in Palm Beach for the Easter weekend.

4 Days After Surgery

When the in-home physical therapist didn't contact me on Monday, I called Pinnacle Home Health Care.  The squeaky wheel gets the oil.  Ariele got in touch almost immediately. And irritatingly, three times, to schedule my first appointment in a couple of hours.  Her flakiness didn't encourage optimism, nor did I care that she had fallen behind schedule because of a weekend trip to Aruba.  I definitely was in Grumpy Old Man mode.

But by the end of our first session, my attitude had softened.  She and her blond pony walked me through a set of more challenging exercises and she followed up with an e-mail that included video links to each of them.

I do enjoy the company of a personable, pretty woman who asks me for my chopped liver recipe.  I even felt comfortable enough to offer some unsolicited advice, after she compared me to her grandfather when I refused to consider the purchase of home PT equipment on the grounds that I probably would be using it only for a few weeks.

"You might want to hold off on comparisons to your grandfather," I teased.  "Some of your clients may be sensitive about their advancing age."

Not that Ariele would have much reason to empathize.  I would have guessed she was in her early thirties but during one of her four increasingly pleasant and productive visits, she mentioned that she had a 24-year-old son!

Thom, who had flown to New York the morning after my surgery for work, would have loved her, too.  Ariele was well-put-together in black Lululemon yoga pants and perfectly manicured nails that matched her lavender top. 

"Who's your new best friend?" Chris asked after Ariele left the second time.  He had heard us discussing the mind-expansion benefits of travel.

2 Days After Surgery

What a difference a day makes, and not in a good way.  The anesthesia administered at the hospital finally wore off and I definitely needed the walker to do several laps around the Folly pool.  

"Everybody crashes on the third day," Chris observed.

Fortunately, we had grocery-shopped just before my surgery, and he had a week of meals planned.  All I really had to do was read, nap and watch video.  North Woods, Demon Copperhead, Life After Life, Big Boys, Schindler's List, and Small Things Like These provided worthwhile diversion for the first two weeks.  In spite of a guest appearance by Sissy Spacek, my favorite actress since Carrie (and wonderful as always!), I just couldn't get through Dying for Sex.  Didn't some of us live through that already?

1 Day After Surgery

Chella, my Haitian home nurse, looked genuinely stunned, when I answered her knock at the door.

"Where's your walker?" she asked.

"I forgot to use it," I said sheepishly.

Chella took my blood pressure, a little elevated, and examined the incision, recording the results on a tablet that she also asked me to sign. After double-checking to make sure that I was taking my medicine as prescribed, she left, assuring me that "Everything is looking very good," on her way out the door.

Her entire visit lasted around 15 minutes.  

Matthew, my home physical therapy evaluator, arrived half an hour later in a vehicle considerably more modest than the Mercedes Chella had driven.  He took some baseline measurements of my "extension" (how straight I could extend my leg) and "flexion" (how far back I could bend my knee), two words I initially confused but which would become important indicators of my recovery.

"Your flexion is already at 100 degrees," he reported.  "That's pretty good for a day after surgery."

I told Matthew the exercises provided by Maddison, the virtual HSS physical therapist, weren't very challenging.  He suggested a few others, allowing me to shoot video instructions, and leaving behind a red resistance band he retrieved from his car.

"Your regular therapist will call you next week to set up some sessions," he explained.  "Would you like two visits or three?"

Gung ho, I opted for three.  It seemed recovery was going to be easier than I anticipated.