The next knee surgery is scheduled for next week. I’m not looking forward to it, but I can’t wait to get it over with.
I met with my knee surgeon two days before Christmas to discuss the surgery in detail. A fun little, early Christmas present to myself.
We settled on the simplest route. Hardware removal and arthroscopy. The screws are giving me trouble; the area over them is tender to touch, I can’t kneel, and I have a lot of inexplicable pain through the front of my shin when I’m doing my exercises. So those suckers are coming out. Doc said it’s a 50/50 shot of whether their removal will help, but that’s better than nothing.
He made it clear that, in contrast to some of our previous conversations, he doesn’t want to do any major reconstruction right now. My knee hasn’t responded favorably to the two previous surgeries, so there is little reason to expect that it would respond well now. Also, one of the new(er) cartilage defects is on the posterior lateral tibial plateau. Getting to it could potentially cause significant collateral damage. “You might just have to live with that one.” He did say that it depends on how far back it is and whether he thinks he could get to it without disrupting the anatomical structures too much. So, he’ll fix what he can during the scope, and we’ll see what he thinks after the scope and talk about further treatment options once he knows what we’re dealing with.
We’re not doing the general anesthesia thing this time. Nope. We’re going local (with an adductor canal block, to be specific). This part both terrifies and fascinates me. I’ve observed surgeries before (in my former life as a medical writer for a medical device manufacturer), but it fascinates me to think I’ll be able to observe my own. I’m a little terrified that I won’t be able to stand the pain because that means they’ll have to knock me out anyway. I wonder if they’ll knock me out if I start swearing. Because that’s probably going to happen, and it might not even be due to pain.
After we discussed logistics, we talked a bit about the goals of the surgery. What defines success?
Me: So, are you comfortable with this plan? Confident?
Doc: Yes. I think we’ll make your knee better. I don’t think we’re going to make it perfect, but we’ll make it better.
Me: Are we still talking about being able to ride again?
Doc: We’ll shoot for the moon because, even if we miss, you’ll land among the stars.
Me: That was kind of lame.
Doc: Yeah, it was a little lame. But it’s true. We’re going to aim to get you back to riding, but there are a lot of other things we need to work on first. (Then maybe I felt a little bad saying that was lame.)
Me: So, what are you saying?
Doc: Can you walk without pain?
Doc: Can you do the elliptical for more than five minutes? Bike without pain?
Doc: Let’s work on those things before we worry about riding again. I know that’s not what you want to hear.
Me: No, but I think it’s what I need to hear. I need realistic expectations. The last time, I had high hopes. And when things didn’t go as planned, I fell hard. I just want to know what’s realistic.
Doc: It depends on your definition of success. I think that, if we get you back to your daily activities, so that you can do the elliptical, go biking, then we’re successful. If your only definition of success is riding, then you might be disappointed.
I think this was the most honest conversation I’ve ever had with a physician. I’m thankful that he’s still “shooting for the moon,” but I’m also thankful that he’s now recognizing that there are steps that need to be taken before we can achieve liftoff. More importantly, we’re talking about it, so that I recognize there are steps I have to take to get where I want to go. I’m always going to be overly optimistic; I’m always going to push myself too hard and try to do things I shouldn’t because of this optimism. I need someone to ground me. In a way, I felt a bit of camaraderie with my surgeon. Like we’re in this together.