When Richard and I found out that he had sustained enough damage to his right knee that he was going to require knee replacement surgery, we were bummed, of course. At the same time, we were deeply relieved that something as amazing as knee replacement surgery existed, something that could give him his mobility back and take away his constant pain. But when we talked to friends and family who work in the medical field, they all told us that, while it was indeed a near-miraculous medical technology with an impressive track record, it was “major.” The rehab was not for the faint of heart, they told us, and his planned recovery at home was going to test both of us.

 

I remember thinking: Well, how hard could it be? I once had a wound stitched up with no anesthetic but a slug of rum and a towel to bite on. I took care of my mother for six years while she died slowly from dementia. One time I got lost on my bike and had to ride forty miles over a mountain range to get home after I’d already ridden that far or farther.  

 

 

First, you’re emotionally freaked out because your loved one has just undergone major surgery, which carries the risk of a fatal or disabling blood clot. There is also the possibility of infection. In addition, if the patient isn’t careful to breathe deeply and actively (something that both the pain medications and the incapacitation from the surgery discourage), pneumonia is a possible complication. You need to be careful that your loved one doesn’t fall and damage the new joint, but they need to be somewhat active in order for the knee to stay flexible, as well as to prevent blood clots. These concerns can add to the stress of the physical rehab.

 

Interestingly, even though I knew that Richard had undergone knee surgery, the first time I glimpsed the leg that had been operated on, with its deep, puckered, Frankenstein-like incision held together by sturdy metal staples, I totally freaked. My reptilian brain wanted to find who had done this to him and beat him to a pulp—even though my cerebral cortex knew that Richard’s surgeon had painstakingly taken extra time to fit Richard with the least invasive prosthesis and conscientiously taken into account his nickel allergy. That reptilian brain is something, isn’t it?

 

At any rate, Richard was discharged after two-and-a-half days in the hospital. When he came home, this is what we needed to do:

 

In order to keep the joint flexible while it healed—keep too much scar tissue from forming around the operated-on area—Richard needed to spend time on the Continuous Passive Motion (CPM) machine. Or as Richard called it, “the rack.” The patient’s leg is strapped into this device that moves the knee throughout an increasingly extreme range of motion. It hurts like hell. And the machine would creep around little by little on the bed while it was in use. Since the angle of the CPM was very important—using it at the wrong angle could have caused injury—I needed to keep an eye on it the whole time. And for some reason, Richard’s temperature would always shoot up afterward. This concerned us at first. We worried that he had contracted an infection, but it turns out that this was just the way he reacted to that physical stress. The machine weighed about twenty-five lbs. and since we couldn’t keep it on the bed all the time, I had to lug it onto the bed and get it all situated, then take it off the bed and stow it three times a day. Richard needed to spend about an hour each session, which completely wore him out.

 

After spending time on the machine, Richard needed his leg to be iced (this would have been true whether or not he used the CPM), in order to keep the swelling and pain under control. Since we don’t have an ice maker, that meant I had to ask a friend to bring us ice or have someone babysit Richard while I went to get it (we have a very small freezer that was filled with food prepared for the week). The possibility that he might fall off the bed or get confused and try to get up on his own in a narcotic stupor made me unwilling to leave him alone. We opted to use a machine that would circulate icy water in a cuff around Richard’s knee, which would eliminate the risk of damaging the tissue in that area. It worked well but used a lot of ice.

 

We had to re-dress Richard’s incision each day and take scrupulous care that we didn’t introduce any infection while doing so. I had to keep track of Richard’s medications and make sure he took them properly. He needed to give himself an injection of a blood thinner once a day. We had to be very careful with his pain meds both in managing his pain and not overdoing it. Once he stopped needing to take them as regularly for the pain, he had to gradually wean himself off. He tried to cold turkey and experienced serious withdrawals.

 

Richard needed to walk around several times a day, and he needed to do that with my assistance just to make sure he didn’t fall. He had leg exercises he needed to do. And he needed to spend some time with his leg elevated, too, to cut down on swelling.

 

 

While in the hospital, Richard developed a rash on his back because the mattress was covered with a vinyl mattress cover and he perspired a lot in reaction to the surgery and post-operative pain. It was imperative that he avoid getting an infection, given his new joint, so I needed to make sure that we kept his back clean and dry. He couldn’t shower by himself, so I helped him when his incision had healed enough that we could get it wet. There were a number of daily personal activities that he needed help with, none of which took much time in and of themselves, but they all added up. I was genuinely happy to do every single one of these things and thankful I was able to. But on top of all of this, I also needed to eat, shower, wash dishes, do laundry, replenish supplies, and keep the household running. By the end of the week, I was exhausted and wrung out, wondering how on earth I had ever been able to juggle a number of freelance jobs, let alone make art and write. I barely had the time or energy to brush my teeth.

 

So, for anyone who will be serving as the caregiver for a loved one undergoing knee replacement surgery, be sure to get as rested beforehand as you can. Preparing and freezing meals ahead of time would be a good idea as well. If you live in a city where you can have meals delivered, that is a nice convenience to take advantage of during this time; where we live, we didn’t have that option. If you have good friends or family you can ask to help you out with some meals, you might want to get that lined up ahead of time so you can plan the meals you’ll need to fix. It was also very helpful to have some good friends stop by and stay with Richard that first week when I needed to go into town to buy more wound dressings, get ice, or restock groceries.

 

Other people might not have as intense a recovery period as we experienced—everyone’s experience will be different, of course, based on a number of factors. You always hear stories about some eighty-seven-year-old woman who had this operation and was out pole vaulting ten days later. But it’s a good idea to be prepared, both physically and psychologically. It’s a true blessing to be able to have a new knee, but the rehab is not a walk in the park, for either the patient or the caregiver. The good news is, a year-and-a-half later, Richard’s knee is strong and flexible and he’s no longer in pain. It was definitely worth it!

 

But we’re both hoping that we won’t have to go through this again.