Dancing with Shiva

Arthroplasty

What a wonderful word. You can really get your tongue around it. Arthroplasty refers to an orthopedic medical procedure wherein joints are surgically disarticulated, bones are rearranged with power tools, bits of steel, titanium and plastic are inserted, reassembled with glue and heavy-duty staples, and followed by months of rehabilitation. Believe it or not, it is (usually) an elective procedure. Wonderful word. Fun to say; not so much fun to experience.

I've gone three rounds with arthroplasty and it has become somewhat of an obsession. Please indulge me for wanting to share my experiences.

If nothing else, arthroplasty is a great word to use every November 19.

First Dance

I had my first experience with arthroplasty in 1998 when I had my left knee replaced. The knee was completely worn out as a result of losing my ACL around 1959. In 1998 this f surgery was very invasive and caused a lot of trauma to the quadriceps muscles. In my case, the incision was about 11 inches long.

Despite the passage of time, I remember the rehab pretty clearly. The goal of rehab is to regain range of motion. After the surgery, the much abused quads tend to grow internal scars and adhesions which restrict flexibility. The rehab exercises break up the internal scars and adhesions. One of my most vivid memories was twice daily exercises to bend my knee by laying on my back on the floor with my left foot flat on a wall and letting gravity (later augmented by various tools) pull my foot toward the floor, thus bending my knee.

As you might imagine this process was be pretty painful and required a lot of codeine. I was listening to a lot of old John Coltrane recordings at the time, particularly "My Favorite Things", a classic American holiday song. Coltrane and his accomplice, McCoy Tyner had their own ideas about this tune. In my opiate addled mind, I could imagine Coltrane and Tyner as Shiva the Destroyer and Shiva the Creator, breaking down the simple melody of "My Favorite Things" and creating it anew. As I grimaced against the pain, I could imagine the same processes of destruction and creation taking place in my leg.

The other vivid memory of the rehab was France beating Brazil 3 to nil in the FIFA Word Cup final in France. Allez les bleus.

Second Dance

My second experience with arthroplasty was about a year later in 1999 when my left hip was replaced. I had broken the hip on my second skiing lesson in 1991, just as Desert Storm was unfolding. The hip (actually, knob on the head of the femur) was screwed back together, but getting the blood supply to he bone is difficult in these cases. By the time I had finished the knee replacement rehab, avascular necrosis had taken over. The surface of the bone was wearing away and shedding bone debris into the joint. 

Hip arthroplasty is a lot less invasive than the knee procedure. There was not much rehab and very few painful dances with Shiva. I sat on our lanai and wrote a paper about bigeye tuna at Cross Seamount.

The United States Women beat China in a shootout for the 1999 FIFA word cup at the Rose Bowl in California. Brandi Chastain rocks.

Third Dance 

My third experience with arthroplasty was just last month. I had my right knee replaced in December of 2013. Over 500,000 knee replacement procedures are done every year in the United States, and the procedure has evolved into what is now euphemistically called "minimally invasive surgery" (MIS). The University of Washington Orthopaedics and Sports Medicine Department serves up informative web site about MIS. My procedure was not exactly the U of W procedure, but the incision is only 7 inches long, 4 inches shorter than in 1998.

Here is what my new knee looks like from the front.

And from the side; notice the staples.

So while the procedure spares some trauma on the quads, and is therefore less invasive, it is still pretty gruesome. If you don't like graphic gore, don't click on this link to the U of W site showing someone else's knee surgery in progress.

So far, the rehab has been pretty easy. Oxycodone had replace codeine as the pain-killer of choice. After two weeks, there wasn't much pain; I gave up opiates so that I could enjoy wine with friends over the holidays. A month from the surgery, I'm walking pretty well with about 130 degrees of motion and not much pain. Coltrane now seems a bit intense for listening while doing the exercises, so I'm to listening to simpler stuff, Jimmy Reed and John Lee Hooker.

The first two dances were wonderfully successful and have given me 15 years of mobility. This third dance is not finished, but I'm making really good progress. I look forward to many more years of walking in the rain forests of Hawaii, the deserts of Utah, and the monuments of Rajasthan with Karen.

There are no epic sporting events to watch on TV at the moment so, I'm streaming  Breaking Bad on Netflix. (Walter Whites understands the medical enterprise.) I have a faint hope that the Kochi Winter Games or perhaps even the Superbowl may prove epic.

Next Dance

Creation and destruction is a classic dualism. These are the processes that drive all life, from the cells in our bodies, to the grand biogeochemical cycles on Earth, to the evolution of the Cosmos. One never stops dancing with Lord Shiva; to stop the dance is to die.

I intend to keep dancing with Shiva until I dance my prostheses into my grave.