Wednesday, January 11, 2017

The (Partially) Bionic Man

We departed Hong Kong on Dec. 30th on the United Airlines flight to San Francisco. It was an iconic flight for two reasons: 1) UAL was phasing out its Boeing 747 Jumbo aircraft and 2) our daughter is moving from Hong Kong (after living there for over 10 years) to the US, giving us little reason to make the 14-hour flight again. We enjoyed the flight on that incredible aircraft and morned it's retirement.

Meryl enjoying probably our last flight on a Boeing 747. She spent years flying around the world on 747s as a Pan Am flight attendant and loves this plane.
We landed in San Francisco and transferred to a United flight to Boise, Idaho, where we viewed miles of snow-covered hills as we did our approach for landing. Getting off the plane almost took our breath away as the temperatures where in the low 20s and we were still dressed for the tropics.

Talk about a dramatic difference from two days ago when we were sitting on the boat in Raiatea, Tahiti.
We stayed the night and then left at 5:00 a.m. the next morning when the temperature was hovering around 10 degrees and we couldn't see much on the frozen freeway because of a thick ground fog. As the day progressed the weather improved, but we were very tired when we finally pulled into our old stomping grounds in Bellevue, Washington.

The reason we came back to Bellevue in the middle of the winter was for Walter to finally have surgery on his ailing knee. It was cyclone season in Tahiti so it was a good time for us to be off the boat and finally get this surgery done.

Unlike wine, our bodies don’t get better as they age. Having always been very active and athletic, I was irritated when I had intermittent pain in my left knee starting in 2012. A friend of my wife recommended I see a guy who did wonders for her neck pain. Locally known as the “horse whisperer,” he had been a chiropractor for animals but also worked on humans. On my initial visit he had me lay on my back while he waved bottles of various pills over my belly, finally settling on a special combination of herbs, vitamins, etc. Needless to say, that didn’t work. 

Next was a neurologist who checked out the “wiring” in my leg, but to no avail. And finally a competent orthopedic surgeon, who after looking at my X-rays, said “You’ve skied a lot of moguls, haven’t you.” Well, as my skier buddy George Howe always said, your knees only have X number of turns in them and my number was up.

The good news was I had out-patient arthroscopy surgery to repair a torn meniscus about six years ago, resulting in two tiny scars on the side of my knee and a new lease on life. But as the surgeon reminded me, your meniscus doesn’t self heal or get better over time, so beware. Later I had cortisone shots which provided immediate relief but were also no long term solution.

Last year the symptoms reappeared, with intermittent pain in my left knee during long hikes, or a sharp pain if I turned the knee just right while moving around the boat. Now if you are just walking to 7-11 a couple days a week you could probably live with the pain, but when you are crossing an ocean and working on the foredeck in big waves, you want to trust your knee. And I didn’t.

On a June visit to Seattle last year I met with an orthopedic surgeon at Group Health. On a scale of 4 (worse) to 1 scale, I was almost a 4 with no cartilage left inside the knee joint. I tried to schedule surgery for around the 1st of the year, but was told that was way too far in advance, so I kept emailing them over the next several months to ensure I could get surgery around that time since we would have to store the boat, fly back to Seattle, rent a house for two months, etc. To shorten the story, when we got back to Seattle in late December we found out my surgeon had just had surgery himself and wouldn’t be able to do surgeries until the end of January. I then went into “Beast Mode” and tried everything I could to get the surgery moved up, finally settling on January 11th as the date. 

Since my surgeon was still catching up on his work, I didn’t realize all the pre-surgery appointments that I had to schedule. It seemed like we lived at Group Health for those first couple weeks in January. After a minor problem showed up on an EKG, I had to go to an internist to get clearance for the surgery. She had no problem with the EKG issue but was concerned by my chronic sinusitis issue. A particularly nasty cold/flu virus was making its way through Washington state, but when you have chronic sinusitis you never really know when you have a cold since the symptoms are almost the same (except for the flu). She put me on amoxicillin (mistakingly thinking my surgery was still scheduled for Jan 30th) and I completed the final round of appointments in preparation for the surgery.
Not exactly a four-star hotel, but still very nice given the fact you're wired into all the machines.
On January 11th at 6:00 am Meryl and I check into Overlake Hospital for the surgery. Overlake is a high-end hospital and it’s a little like being in a four-star hotel. They escorted a group of us up to the PCU (Pre Operative Care Unit) floor and we went to our respective cubicles. I met my pre-op nurse, confirmed who I am and what surgery they’re doing, and then put on the cute backless hospital gown and got into the bed. Several other nursing staff came, asking me “Now which leg are we operating on” and signed the left knee in surgical ink. 

For anyone who has gone through a major surgery, you know the feeling of helplessness as you are laying on the gurney, with an IV put in your hand, your body prepped for surgery, breathing in all those weird hospital smells, and taking that last squeeze of your loved one’s hand. The one positive thing was a new “air type” heated blanket that was almost weightless and kept me warm in the cold hospital room. 

Next the anesthesiologist came in and explained the “cocktail” of drugs he would use, including a local block (a new time release drug good for up to three days) and a spinal. He explained I would be awake as he put the needle in since he had to be careful of some nerves in the vicinity and I would let him know (I assume via my screaming) if he hit one.

Just as I was to be rolled into the surgical suite the surgeon showed up and went through some last minute questions, including if I have any infections and why I was on antibiotics. That opened a Pandora’s Box of questions with the surgeon calling the internist, and then telling me we’re going to have to reschedule the surgery to a later date due to my sinus infection. I almost lost it on the table, since I’d been planning for these dates for over six months, and now minutes away from surgery everything was being changed. About 10 minutes later the internist called back saying I’d been on the antibiotics long enough to cure the infection and gave the OK for the surgery.

It's amazing how they can fabricate a new knee from stainless steel and high tech plastic.
I had watched a YouTube video showing knee replacement surgery (not for the faint of heart) and was amazed at how they do the surgery. A seven-inch incision in made down the top of your knee. They then move the knee cap to the side and saw off a thin slice of the head of the femur using a stainless steel jig. A metal cup unit the shape of the head of the femur is then glued into place. They do the same thing to the head of the tibia, except that a plastic bearing surface is placed on top of the metal piece glued to the tibia. This serves as the meniscus surface between the top and bottom metal pieces. It’s amazing how they manhandle the leg once all the pieces are put back in place to make sure the joint has full flexibility. Some of it is just like we’d fix things back on the boat fabricating various pieces from metal, plastic, or fiberglass.

The next thing I know is I’m waking up in the PACU (Post Anesthesia Care Unit with my very own personal nurse hovering over me as I came out of the anesthesia. It’s kind of like waking up from a weird dream, except you are looking out over a sea of surgical beds in a large open room. She tells me my surgery went very well and if there is anything I want (visions of a large hot fudge sundae float through the haze of my brain). Meryl is in a special waiting room with a large computer screen showing color coded numbers, one of which is me. The colors change as you move through various stages of the system. Next I was wheeled up to 3rd Floor West, normally an orthopedics floor but now also housing patients with the flu.  I’m introduced to my nurse (a beautiful Chinese woman) and technician, a guy named Zach. The both do a great job getting me comfortable and handing me a menu so I can order lunch and dinner from the restaurant. I felt great, although my left knee was elevated, tightly bound in Ace bandages, and covered with ice packs. As with any hospital, every hour or so they take your blood pressure, give you various drugs, and ask how you are doing. All the rooms at Overlake are private and they provide comfy leather recliners for the guests. The level of care was outstanding and my only complaint was having new nurse/technician teams on every 12-hour shift. I even had a nice volunteer deliver me the local newspaper each afternoon.

With a Total Knee Replacement they want you up and walking as soon as possible so Zach rigged me with a waist belt and got me into a walker for a tour of the floor. Apart from the swelling, which made my knee feel very tight, I felt great otherwise. Whenever I told the nurses that they had this funny look in their eyes, leading me to believe at some point the wonder drugs would wear off and reality would hit home.

Everyday I’d do three sessions of in-bed physical therapy (PT) and one or two “walks” about the floor. Everyone I’ve know who has had joint replacement emphasized the key to success doing your PT religiously everyday.

We’re now back at our AirBnb in Bridal Trails Park in Bellevue. It’s run by a wonderful Chinese woman who had a trading business in Hong Kong, and her American partner.  Peter, a former Seattle attorney, makes fresh muffins for us every other day and Ester invited us up for a Chinese dinner with her son and daughter along with friends of Peter's. The unit itself is perfect in that everything is on one level and very easy for me to move from room to room. Even better is the large screen LED TV with a free Netflix subscription. So far we’ve finished The Wire, House of Cards, Selfridges, and other series we’ve missed over the last five years.

I’m doing PT three times a day with Meryl’s help and a Group Health physical therapist comes over two days a week to judge our progress. We managed a few outings to the various malls where I can walk without freezing to death (it’s cold here) and had some follow up visits to the hospital. 

I have to say we are totally pleased with the level of care from both Group Health (our health care provider) and Overlake Hospital. We have a combination Group Health/Medicare plan and so far the total cost with co-pays has been under $600. Thank God we have a good medical plan and such quality health care facilities here in Seattle.

We plan to travel to Bend, Oregon in the next few weeks to look at potential places to live, then down to the Phoenix area to see if that would work out as a retirement location.