Meet the Surgeon

October 1, 2009
Here is the text of an e-mail sent to close friends and a few family members.

Had a good meeting with the surgeon at the Civic Hospital this morning. He says I'm in a gray area. My knees are bad enough to operate on and they could do so within a couple of months. However, he cautioned me that at only 64, I have a lot of hopefully active life ahead of me and it is likely that the artificial knees will wear out in 10 - 15 years or so. They can replace the artificial knees but the degree of success is not as high as with the primary replacement. That is to say that there is reduced mobility and the possible continuation of some pain at that time.

He spoke of other treatments. Losing weight, having physical therapy and having another kind of shot, syndisk (sp?) that frequently helps sufficiently to delay the initial operation a bit. I have had two cortisone shots now and they usually only give three. (That was surprise information - thought I could have them every month) I would say that the cortisone helps but is not the answer. It is unfortunate that I had the second cortisone shot just before the meeting with the surgeon. My knees felt very good and it was hard to insist on an operation when they weren't hurting much at the time.

The other consideration is whether to have a full or half knee replacement. They say that a half knee replacement would give me mobility and pain relief and not be so difficult a recovery. It will likely wear out in the same 10 - 15 years or so. The gray area is that with the half knee replacement there is more bone left to work with so the second operation if needed for full knee replacement is much more successful.

It is all a bit strange. I was so totally prepared for the operation on both knees. But I was surprised at my reaction last night. I didn't sleep very well and was mulling over the risks and danger of the operation. Really thought I was past that. So when the caution flag came up this morning in the meeting, I was taken by surprise but also felt a note connectng to my night of unrest.

It appears that there is only about 2 months of delay from the time I make the decision. So the decision we took this morning is to delay the final decision for a couple of months. I made an appointment to see the surgeon again on the first week of December.

In the meantime I intend to lose some weight which will make the entire process easier. I have a prescription for physiotherapy which will make my leg muscles stronger and more flexible. I will research the new injection and decide about it when the cortisone injection wears off which will be in a couple of weeks if past experience runs true to form. If the new injection works well enough to delay the operation for a year or two, then that could be good. Otherwise, I would give the go-ahead to schedule the operation which would likely be in February or March of this year.

That is the situation now. We will take another couple of months to decide whether to choose the surgery and mid-winter is not a bad time to have it. They suggest two weeks off work so that I can focus on recovery. Desk work and reduced schedule should be possible after that.

On reflection, I wonder if the Surgeon and his assistant weren't playing "Good Cop / Bad Cop?"
The assistant saw me first and presented all the cautions. The Surgeon came in and explained the practical details of the operation. It's probably a pretty good approach to make sure the patient (me) really thinks about the decision.