Today was the final commitment in the knee replacement surgery countdown; one last meeting with Dr. D’Ascoli before he sees me in a very unflattering hospital gown. It was my last chance to ask questions and address any concerns and while I had been thinking about it for several days my questions were admittedly few. The Joint Class I attended did an excellent job of letting me know what to expect during the entire hospital stay and how to prepare my home for the weeks after discharge; he was curious to know how well I liked the class and asked me if I thought anything should be added.

One thing I did want to bring up with him was my concern about pain interfering with my rehabilitation; every bit of information I had read about this procedure said the same thing: aggressive physical therapy was the surest path to success but in order to put in the work you need to be comfortable enough to do so. He assured me that they have many kinds of medications available, some of which I would be getting automatically and some which will be added as needed, but it was my responsibility to monitor how I was feeling and let the nurses know if I was headed for the weeds. My normal “unobtrusive patient” model may not be a good fit in this case.

Another thing I was curious about was something called a femoral block which I had heard about from the lady on my left in Joint Class. A retired nurse and knee joint recipient, she said it helped her immensely so naturally I was curious about it. Dr. D said he has been using a newer technique which involves injecting areas in the surgical site instead of the nerves in the leg; they discovered that it is preferable to a block which wears off relatively suddenly and can make it more difficult for a patient to get ahead of the pain. A femoral block can also contribute to residual sciatic pain according to my research, which I was definitely not interested in. Since I am all about hitting it hard as soon as I can this made perfect sense to me and I decided to forego the block.

Our meeting concluded and he shook my hand; “I’ll do a good job for you”, he said. I told him I already knew that because I went to the gym with his former secretary Helen and she told me he was the best. That made him smile and I finally felt ready to face things.

I wish I had felt ready to face things a few nights ago when I awoke in the middle of the night in a sheer panic. It was the night of the Joint Class and the facts of the day crowded in on me with a vengeance obliterating reason and logic. It was blessedly brief, and I collected my thoughts by going over the list of things I was no longer doing because of my knee. No more Boot Camp. A cancelled fall trip to the UK. The constant sensation of broken glass in my knee. It was a shitty choice, but it was a choice at least. And there are a whole lot of people out there who are in worse shape than I am.

One thing I have thought about a great deal is the fact that I am extremely lucky to have an employer who gives me liberal time off and great health insurance. I have two sisters who clean houses for a living and have neither health insurance or sick time; they would be completely screwed by a diagnosis like mine. The big picture is that I have it pretty good and that my little middle-of-the-night pity party was largely unwarranted. That doesn’t mean that I won’t have another one; it’s hard for me to imagine what the night before surgery is going to be like. But hopefully I can keep it in perspective.


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