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.