The Story of my Knees

I’m a wife and mother of 3 children, a grandmother of 1, married for 31 years and still working part-time as a Registered Nurse. I have never, in my entire life, considered myself to be athletic. I’m not a runner nor do I have any desire to become one, although people hear about my knee problems, look at my body type, and automatically presume that I run. I’ve been graced with a lean body type and a ridiculously efficient metabolism. I have always liked being outdoors, bike-riding, waterskiing, downhill skiing, gardening and dancing (just for fun) but make no mistake: I didn’t do anything out of the ordinary to damage my knees. I just inherited the unlucky knee genes from my mother and led a very active life with 3 children.

The beginning of my knee issues started at age 29 and progressed slowly over the years. Cortisone injections (many times and in both knees over the course of these many years) kept me able to perform my “ADLs” (activities of daily living) with a relative degree of comfort. But by the age of 38, I needed the first arthroscopic knee surgery to debride the patella and repair a medial meniscal tear. Afterwards, I followed up with a minimum of physiotherapy to get me moving again. I had no time to consider doing anything in the way of being proactive towards preventing recurrence of injury. By the time I was 50, I had had a total of 5 arthroscopic knee surgeries (3 on the right, 2 on the left) and continued to need cortisone injections every 3 months just to keep me relatively “comfortable”. From the age of 46-50, I had finally been afforded the time to be a gym member and do a twice/weekly gym workout. But that became an exercise in frustration as I became more and more restricted by the bilateral knee pain. At the age of 52, I asked my Orthopaedic Surgeon to please do the bilateral total knee replacement surgeries. I was told that I was “too young” and that I should “wait”. Wait for what? I was beyond frustrated.

Fast forward to July 2016 (age 53) when I was in constant pain, taking a combination of 1000 mg of acetaminophen with 400 mg ibuprofen several times daily, just to cope. Picture this: I was with my 83 year old mother in a store and had to ask her to slow down so that I could keep up with her! (My Mom’s knees had both been replaced years ago, when she was 69/70 years old.) My husband and I had a big trip planned to Scotland via Iceland in August 2016. It was going to involve a lot of walking, touring, climbing stairs, and long periods of sitting on trains, buses and planes. My knees were at their worst but I was determined to see and do everything we’d hoped to do while on our vacation. I spent every night there with ice packs on both knees and had to stop in my tracks on several occasions, as the knee joints struggled to move properly due to the severe degradation of the cartilage. My legs, which used to be straight, had become very bowed and I had been losing what precious little muscle I had due to walking improperly and using a compensatory gait for years.

At home after our trip, I was trying to carry a basket of laundry down the stairs and the pain was just too much. I stood there on the stairs, sobbing. I was a 53 year old with the knees of someone in her 80’s or 90’s. I felt REALLY OLD. A call to my surgeon’s office resulted in me having an MRI of both knees. The consultation in his office in September 2016 was one that I couldn’t face alone. My husband came with me, as support and witness of the struggles I’d faced on our trip. Again, my request for new knees was met with the same response as the previous visit: “You’re too young.” That’s when I cried, right there, across the desk from the surgeon. I had reached the point where I wouldn’t accept his answer. I recall my words exactly. “You can’t sentence me to 20 more years of this pain! Look at me! I’m 105 pounds! I’m not going to wear out the artificial joints! I just want to be active and go to the gym and get strong and NOT FEEL OLD!!!” So, after 24 years of knee issues, I got my wish: Surgeries were booked for Nov. 4, 2016 and Jan. 17, 2017. I was getting bilateral TKRs.

My goals were simple all along: the only way to stay healthy, be independent, resume the activities I’d given up and be able to enjoy life (and eventual retirement) would be to keep active, improve my mobility and build muscle strength. Goals are helpful in that they provide hope. Keeping goals attainable is so important. So, after the first TKR, I got into physiotherapy on the 4th post op day and did everything known to man (or to Carolynn, my physiotherapist) to get my right knee to bend beyond 70 degrees of flexion. I cried a lot. When it proved to be impossible, Carolynn suggested that I ask for a manipulation under anaesthesia (MUA) while in the O.R. for the next TKR. My surgeon agreed, thankfully, and the real work began after that second TKR and MUA. I was in a really rough place, with an extremely long road of recovery and rehab ahead of me. It was DAUNTING.

That’s exactly why you always have to keep hopeful and reset your goals. Set-backs happen. The weeks following that second surgery were, by far, the most challenging. I felt terrible while on the pain meds but they were necessary for me to withstand the physio regime both in the clinic and at home. As soon as I could, I got off the heavy pain meds and I did every type of therapy/treatment that was available to me and then some! It was a very long, very depressing process in which I cried daily and lost my temper with my husband (who was doing his utmost to be helpful). I thought I’d never walk properly, let alone dance or ski or hike. I had goals to reach but they had to be baby steps first and above all, I had to learn patience with myself and my body’s ability to heal. Two months post op, with the help of my son, Sean, (who was a trainer in the gym I’d attended) and in collaboration with my very dedicated and knowledgeable physiotherapist, Carolynn, I started a brand new strength program. I had lost too much weight and muscle mass. I needed to be consuming the adequate amount of calories and protein to support my attempts to rehab properly. I needed to get strong and be able to return to my job by the end of that summer, 7 months post op.

So, how is my life better since the surgeries? 8 MONTHS POST OP September 2017- I returned to doing Scottish Country Dancing once/week as a way to test my cardio and balance. 12 MONTHS POST OP January 2018- I was feeling strong and confident with walking on ice and snow, throwing sticks in the park with our dog, shovelling the snow in the driveway and loving every minute of it! I continued with my strength and conditioning program, twice a week, all alone in a more or less empty gym, just plugging away at the mundane and boring routine but knowing that everything I did was getting me further on the road to reaching my next, really challenging goal: 18 MONTHS POST OP August 2018- I was hiking up the GROUSE GRIND in North Vancouver with my husband and our daughter, Erin (whose idea it was to make this hike my first BIG GOAL post op) and I achieved it in 1 hour and 43 minutes, which is remarkable actually! Under the 2 hour mark was my goal within the goal. 20 MONTHS POST OP November 2018- I started taking horseback riding lessons once/week for 10 weeks. This goal in particular is one that I truly NEVER thought possible before the knee replacements. But I did it and loved it and plan to continue with lessons! 24 MONTHS POST OP January 17, 2019- I started working with a personal trainer twice/week. It was important to find someone knowledgeable enough to understand my particular restrictions/challenges as a bilateral TKR patient and to help me to establish reasonable new goals in the gym. 24 MONTHS POST OP January 2019- I returned to downhill skiing! I took a lesson to make sure that I remembered the basics. I hadn’t skied in about 15 years and was thrilled to be able to get on and off the chairlifts successfully and to link my turns and not even fall down once!! I bought a set of skis and went back to Mount St. Louis again in March.

My long-term goal has no end, no finish line. I just keep working at getting stronger, staying active, maintaining and improving mobility, and using any opportunity I have to do simple stretches and routines that can be done almost anywhere. I didn’t get new knees just to be pain-free and accept that as being good enough. As someone else already said, “I didn’t come this far only to come this far!” One key lesson that I’ve learned during this process can be summed up in very few words: Your own degree of mental toughness/inner drive will be the most influential aspect of your ability to get through the pain and the mundane, to reach your goals, whatever they may be. No one else can do it for you.