Monday, November 22, 2010

Road To Recovery

Road To Recovery
On November 5, Citizen Ellie underwent total knee replacement surgery at the General Campus of the Ottawa Hospital.
Some 18 days later, as of this writing, Citizen Ellie is back home, walking unassisted and, having decided to upgrade her home computer system, is trying to learn the Apple MAC operating system. Who says an old dog can't learn new tricks ?
Citizen Ellie needed a new knee because back in the 80's, she suffered a sports injury and had to have the lateral miniscus (cartilege) removed. Things went well for several years, but in 2001, pain in the affected joint was starting to get to her so she consulted an orthopaedic surgeon. At that time, the prosthesis for a partial knee replacement was available (the Oxford procedure)-- provided it was the interior side of the knee which was damaged, rather than the lateral side as was Citizen Ellie's situation. The orthopaedic specialist recommended that Citizen Ellie wear an "unloader" brace to prevent the knee from collapsing inwardly while buying time until the partial prosthesis for the lateral side of the knee became available.
Earlier this year, Citizen Ellie consulted her orthopaedic surgeon again. The Avon procedure was now available-- providing a partial replacement for the lateral portion of the knee joint. At that time, about 14 of these very specialized surgeries had been performed in Ottawa, and Citizen Ellie's orthopaedic surgeon had performed one of them.
This is great, Citizen Ellie thought. One day in hospital and back on the feet within no time at all !
But it was not to be. When the cartilege was removed from Citizen Ellie's knee in the 80s, the anterior cruciate ligament (ACL) was removed as well. Without an ACL, a partial knee replacement was impossible. Back to the drawing board.
What to do ? Wearing the brace had allowed Citizen Ellie to function, but her world was getting smaller as she was finding it more and more difficult to keep up when walking nine holes of golf. Aerobics was too painful to continue. Walking around historic sites while traveling -- especially if an uphill climb was involved -- was no fun anymore. Standing for a three-hour shift in the auxiliary coffee shop at the Riverside pretty well wiped her out for the rest of the day.
After exploring all the options, she decided the time had come to have the knee replaced. It was not an easy decision. There are risks involved in any surgery. Would she come out of it worse off than she was before ? What about the pain ? Could she manage the stairs in her house, drive her car -- in other words, regain her independence.
The surgery went well. As a spinal, rather than a general anesthetic was involved, Citizen Ellie was wide awake in the OR to hear her surgeon tell her she had a nice new straight knee. During the course of the surgery, Citizen Ellie could also hear the sawing and hammering involved in the surgery -- all very interesting and to tell the truth, if the option had been offered to watch the procedure on closed circuit TV, she probably would have jumped at the chance.
Citizen Ellie's surgeon had booked her into the short-term rehabilitation unit at the General campus and this was a fantastic place to be for someone who had set the goal for herself of walking out of the hospital on a cane.
They make you work in short-term rehab, and it's painful -- no two ways about that. Citizen Ellie is one of those who can tolerate a high level of pain so she stopped taking pain medication two days after the surgery -- she's of the opinion that a clear head speeds the recovery process -- purely unscientific, but that's what she believes and it works for her.
Thanks to the physiotherapy program established in the short-term rehab unit, Citizen Ellie was able to meet her goal of walking out of the hospital on a cane nine days after the surgery.
She was told there might be a waiting period of as much as 10 to 15 days before getting a place in the rehab unit at the Riverside campus. Rehab in a hospital setting is covered under OHIP so there's a huge demand because many people who require physiotherapy following surgery do not have private insurance or otherwise cannot afford to go to a physiotherapy clinic. Citizen Ellie chose to get some private physiotherapy while waiting for an appointment at the Riverside because she did not want to lose the momentum gained in the short-term rehab unit. And it has paid off. She's walking without the cane, managing the stairs in her house, and can perform all the necessary functions of daily living.
Her recovery did not all happen by accident. Prior to the surgery, Citizen Ellie worked as hard as she could to be in good shape physically. She exercised faithfully -- following the routine prescribed at the pre-surgery joint-replacement class, went regularly to aquafit classes and took daily walks of at least 45 minutes' duration to build up muscle mass in the legs. Working with small weights to strengthen the upper body also became part of the routine.
If Citizen Ellie had advice for anyone contemplating joint replacement surgery, it would be this: get fit first. And lose some weight. Citizen Ellie wishes she'd been carrying ten fewer pounds because she probably would be doing even better.
We are lucky to have a world-class facility such as The Ottawa Hospital with its excellent staff of doctors, nurses and physiotherapists. The short-term rehab unit ? Couldn't ask for better ! And Citizen Ellie is lucky to have supportive family members and friends -- without whose help and encouragement the road to recovery would have been longer and tougher.
Regular posts on municipal affairs in Ottawa will resume next week.