Bone on Bone

The morn­ing of my knee replace­ment surgery, my wife and I drove along Med­ical Cen­ter Dri­ve at 5:30 a.m. When we turned into the West Hills Hos­pi­tal park­ing lot, the head­lights washed over a teenage boy wear­ing a pair of white box­er shorts, a blue bath tow­el tied around his neck, and noth­ing else, run­ning along the side­walk, laugh­ing mani­a­cal­ly, tilt­ing his out­stretched arms back and forth like a big bird bank­ing in the wind. We watched him sprint across the lot to the bus stop on Sher­man Way, his shoul­der length black hair and the tow­el fan­ning out behind him, his knees pump­ing, his bare feet slap­ping the asphalt.

“A bad omen,” I said.

“Means noth­ing,” my wife said. “If your sur­geon shows up in his under­wear, you’ll have some­thing to wor­ry about.”

Her com­ment con­jured a night­mar­ish vision I could have done with­out. I let out a long breath and pulled into the lot. As I got out of the car, I watched a city bus slow down at the bus stop, then speed up, and pull away. Box­er-shorts boy waved his fists and screamed at it. I stared at him, hollow-eyed.

“Come on,” my wife said.

I trudged inside. The ancient vol­un­teer lady at the recep­tion desk gave us vis­i­tor badges. We took the ele­va­tor to the fifth floor and walked into the pre-op room.

The anti­sep­tic smell of dis­in­fec­tant. Blind­ing bright lights. Every­thing hos­pi­tal white. Rows of beds along the win­dows. Com­put­ers and IV stands strewn around the room. 

A stern heavy­set nurse found me in her com­put­er. “Right knee replace­ment. Full.” She launched into a detailed sum­ma­ry of the hospital’s plans for me that day. 

I tuned her out. This wasn’t my first rodeo.  My right knee was sev­en­ty years old, bone on bone, but my two month old left knee was made of tita­ni­um, and I knew what lay ahead for me. Emp­ty of food from fast­ing but awash in ner­vous acid, my stom­ach rolled as I thought yet again that I could have avoid­ed all this if I’d lis­tened to my body. 

If you go by mileage, my knees last­ed a long time. I start­ed run­ning to relieve stress in col­lege. I kept it up through teach­ing, law school, prac­tic­ing law, work­ing as an exec­u­tive, and retire­ment. I wasn’t fast, but I could run a long way at a slow pace, and I fell in love with it. In my for­ties, I ran in a few 5k and 10k races. I ran my first marathon when I was fifty-two. My goal was mere­ly to fin­ish. I bare­ly made it, stag­ger­ing across the fin­ish line at five hours. Three days lat­er, I start­ed train­ing for anoth­er one.

When I was six­ty-two, I wrenched my back on a steep down­hill slope at the end of a long run. The doc­tor found inflam­ma­tion in my low­er back and advanced arthri­tis in both knees. He told me to give up running.

When the swelling went down and the pain sub­sided, I hit the road again. 

At six­ty-five, my knees and back broke down com­plete­ly. I tried every­thing to get back on the road. A doc­tor gave me a series of cor­ti­cos­teroid shots. A chi­ro­prac­tor adjust­ed my back, admin­is­tered mag­net­ic pulse treat­ments, jammed my legs in hip-boots inflat­ed with air, and turned me upside down. I made bi-week­ly vis­its to an acupunc­tur­ist. With Zen music play­ing in the back­ground, I lay face-down on a gur­ney while he stuck nee­dles in my low­er back over my tail bone. 

When I couldn’t walk fifty yards with­out pain, I came to grips with the truth: I would nev­er run again, and I would have to go under the knife just to keep walking.

I went to a train­er to build strength in my legs before the knee oper­a­tions. She start­ed with a phys­i­cal test. I couldn’t stand up straight; I leaned heav­i­ly to my right side when I walked; and I couldn’t step over a hor­i­zon­tal bar six inch­es off the ground.

Alone in the car on the dri­ve home, I cried.

One month before my sev­en­ti­eth birth­day, the sur­geon replaced my left knee. When I woke up in the hos­pi­tal bed, I expect­ed a sharp pain, like a knife cut­ting into bone, but it wasn’t like that. It was a weary-to-the-core ache in my calf and thigh, so intense it felt like I’d run ten marathons back to back. The sur­gi­cal team moves your knee-cap to the side when they install the new knee. This stretch­es all the mus­cles around the joint, and after they put the knee-cap back where it belongs, these mus­cles are rabid­ly pissed off and they do their best to make you scream, which I did. 

The nurs­es’ pro­to­col starts with a mild drug, like Tylenol, and pro­gress­es up a lad­der of more pow­er­ful pain-killers until some­thing works. My pain tol­er­ance is appar­ent­ly great­ly wimp­ish. To peel me off the ceil­ing, they had to inject mor­phine straight into my IV. The next day they weaned me off mor­phine in favor of hydrocodone, and they sent me home with a bot­tle of pills.

The rehab went well. I walked with­out assis­tance on Day 4. Three weeks after the oper­a­tion I got off the pain killers, and sev­en weeks lat­er I was strong enough to under­go my sec­ond knee replacement.

Before the first oper­a­tion, I was scared because I didn’t know what was going to hap­pen. When they wheeled me into the oper­at­ing room for the sec­ond one, I was scared because I knew exact­ly what was going to happen.

But box­er-shorts boy turned out to be a good omen instead of a bad one. The pain wasn’t as intense the sec­ond time around, and I walked with­out a cane on Day 4 again.

When the Medicare-cov­ered rehab expired, I went back to the gym where my train­er had worked. She was no longer there, hav­ing moved north to attend grad­u­ate school. I didn’t think I could find any­one as good as she was, but she referred me to a young guy who panned out to be her equal.

My new knees healed quick­ly, and mirac­u­lous­ly, a reg­i­men he devel­oped seemed to cure my back prob­lems. I could stand up straight. I could walk long dis­tances with­out pain. My bal­ance improved. My strength came back.

At the end of work­outs, my train­er some­times put me on a tread­mill, attach­ing weight by a strap around my waist, and I walked short dis­tances, pulling the weight. We usu­al­ly did six sets with breaks in between for me to catch my breath. The goal was to improve my time each session.

Four months after my sec­ond oper­a­tion, I was walk­ing on the tread­mill. After the sec­ond set, my train­er said, “Try to pick up the pace this time. If you feel good enough, see if you can jog, but stop if it hurts.”

I looked at him fear­ful­ly. My sur­geon said I could run short dis­tances on soft sur­faces, but I had been afraid to try. My train­er knew how much run­ning had meant to me. “You can do it,” he said.

I start­ed walk­ing. A few steps into it, I broke into a ragged shuf­fle. My form smoothed out a lit­tle; I found a rough rhythm; and I ran.

When I fin­ished, I looked over at him. He and two of the young train­ers, who had watched my jour­ney from the time I couldn’t step over a bar six inch­es off the ground on up to that moment, were clap­ping and grin­ning ear to ear.

I only cov­ered six­ty yards, pulling twen­ty pounds, and it took me almost thir­ty sec­onds, but I ran.

I ran.