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Dr. Doom's Titanium Knees
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Dr. Doom's Titanium Knees
I had no idea when I went to the doctor that May afternoon that I was going to re-visit an emotional experience that I thought that I had left behind as a child.
"Well, both of your knees are totally shot," the orthopedist said in a matter of fact, I dare you NOT to react, way. I felt a wave of anxiety wash over me while he stared at my legs and the x-rays. "Do you see this? You have no cartilage between any compartments in your knees. You have tri-compartmental osteoarthritis. When you walk, you are rubbing the bones together in your legs. We need to remove them and put titanium replacements in both of your knees. I must warn you though. This is really horrible surgery. Big time surgery! So, how are you feeling?" He seemed to enjoy telling me the horrifying news. "Are you scared? What do you think about this?" I sat there defiantly determined not to break down in front of this doctor who strongly resembled John Malkovich. In light of his brusque manner, it was clear that he was enjoying the shock value, so I secretly nicknamed him Dr. Doom.
I wondered, "Well, are there any options? What about braces? Are there any that can prevent the need for surgery?"
The orthopedist insisted, "No, what is wrong with you is internal, structural. You will have to get your knees replaced, but I am warning you, this is horrible surgery!"
"So, there is nothing that can be done to delay the need for replacements? Do they work well? Is there some new technology out there that could make the surgery more manageable in the future?"
Dr. Doom said, "Well, you could wear knee braces that could stabilize your legs, but eventually we will have to operate. You will hit a wall of pain, and the joints will become too loose to support you. I do want to warn you that the procedure on someone young, like you, will be more gruesome as your muscles are tighter than they are in older people for whom the surgery was originally designed. I have to warn you that they also wear out just like your knees did. At your age, you will have to get them replaced at least one more time. The titanium knees work really well even though they do click when you walk-a small price to pay for agility, don't you think?"
I remained stoic as I listened to the surgeon describe my limited options. Somehow the thought of eight inch incisions in both knees covering titanium joints that would click when I walked did not seem like a great alternative to the pain of bone on bone. I admitted to myself that the pain was already intense and I could feel the bones rubbing together and sometimes the joints were getting stuck. Since new titanium knees would eventually wear out, I decided to choose the braces and a cane to see how far I could "get down the road" of life. I am sure that, in his mind, he thought that he was being helpful when he added that I would need to stop at the front desk and pick up the paperwork for disability license plates. "I am charting that they are to give you the forms for the license plates not the temporary disability decal. You are permanently disabled you know? You do understand that don't you? I am not getting an emotional indication that what I am saying has registered." I still did not waver with a dry eyed "Thank you for being thoughtful about the disability plates."
The orthopedist left the room to bring back several styles of braces that he thought would provide the most support. As he fit me with knee braces, I felt the restriction of the metal joints on the sides and the straps around my legs above and below the knees. They were a foot long with only my knee caps showing. I thought, "This feels too familiar" when my stomach tied in a knot as I remembered a broken leg that I had when I was six years old. I was overcome with a flood of feelings I thought had long since passed.
As a kid I was what people called, a "Tom Boy." I climbed on anything that could be mounted. I rode my bike with no hands and stood on the seat, until I fell one Sunday from the "monkey bars." I was playing on the school yard across the street from our house when my friend, Margaret, decided that she wanted me to get off of the playground equipment. She yanked my legs and I fell six feet landing like a twisted pretzel. I heard the snaps as I hit the ground and could feel the bones rubbing together when I tried to stand up. I cried out, "Margaret, I cannot walk! Please go and get my Mom." She was nearly as frightened as I was and ran toward my house. My mother was a small woman so she brought my red wagon to pull me home. I do not remember much about the drive to the hospital as I was in shock. The first thing that I recall was the doctor standing over me while a medic put a walking cast on my left leg. He told my mother, through his teeth that clenched a cigar, that I "would never walk normally again. We will have to put a pin in that leg." When I tried to stand on the leg, I could still feel the bones rubbing together. I cried, "Please Daddy, carry me. I cannot walk!" Luckily, he listened to his six year old daughter and carried me home. The rest of the night was a blur as I was in shock and spiked a high fever.
The next morning, my parents took me back to the hospital to see an orthopedic surgeon. He was not as frightening as the first doctor and acted quickly. "It is a good thing that you listened to your little girl. She has two compound fractures in her tibia. If she had walked on that leg, it would have completed snapped and punctured her skin. All that is holding the bone together is the width of a human hair." The walking cast was removed and replaced with a full leg cast from my hip to my toes. My mother had been crying all night long about her "disabled" daughter. She wanted to know if I would ever walk properly again. The orthopedic surgeon was more tentative, yet reassuring. He said that I would have to be in the full length cast for three months. I would have the cast changed once a month so that x-rays could be taken to ensure that the bones were mending properly. The white plaster cast was so heavy that I could not even walk with crutches. It was clear that I would be housebound for three months. No more first grade for me…
Time did not go quickly. The cast was so heavy and itchy. My school friends also had better things to do than sit around with me, so I used to watch them out of my bedroom window. Since I could not maneuver with the cast and crutches, I would lower myself to the floor and scoot around the house on my bottom. I wore out a number of pairs of shorts over the course of those months. At night, I listened to my mother crying in the next room.
Since I could not go to school, a tutor came to the house. She worked on my reading and math for an hour twice a week. Other than that, I had no visitors. I just sat there looking at this huge cast trying to hear the bones knit…After a month, they took off the first cast. I was so frightened when they brought me to the table with a saw to cut it off. I was so afraid that they were going to cut my leg off. Once the cast was removed, they asked me to keep as still as possible as one wrong move and the fracture could break all of the way through. If that happened, I would have to be hospitalized in traction for three months! They lifted me gently to an x-ray table to see if progress was being made. The orthopedist cheerfully reported, "We have good news for you. The x-rays show bone growth. We can put on another full leg cast on and take more pictures in a month." The second cast felt even heavier than the first one and was a bit loose around the ankle. However, I did not know to complain.
A week after that cast was applied, I was scooting across the living room floor and bumped my leg into the stereo cabinet. I cried out, "Ouch, that really hurts!" My mother came in from the kitchen to ask me what was wrong. I told her that the pain was excruciating, so she called my father at work. He came home to take me back to the hospital. When they removed the cast, they found a huge blister that covered my heel up to my ankle. The blister had burst, so they put a topical ointment and gauze to protect the wound. Then, they put on another cast. After that, I knew the consequences of NOT complaining…
Two more casts and I would be "back in business," or so I thought. The day finally came when the last cast would be removed. I thought that I would be able to get up and walk out to the car. Little did I know that my leg had withered significantly and did not have the strength to support me. It felt like a wet noodle but was also somewhat stiff in the joints. The skin on my leg was also peeling profusely. Not only had my leg atrophied but I was terrified to put weight on it. Instead of wearing a cast, I was sent home with a full length splint. "So, this is an improvement? Crutches and a splint?"
In order to regain use of the leg, I was in physical therapy for three months lifting weights and working out on the parallel bars. Even when the leg was strong enough to walk on, I was still too afraid to put much pressure on it. One day, I was in the backyard leaning on the side of the house with my crutches. My collie dog saw me standing up and got so excited that he ran up and knocked me down. I checked myself out and shouted, "Hey, nothing broke!" After that, I started walking on the leg with a decided limp that lasted for years.
My whole life had changed. While I had been athletic before the accident, I had become a bookish gimp...or that is what I thought that people would think of me. Most people either pretended not to notice, or maybe it was not as big of a deal to other people as it was to me. My mother finally stopped crying, so things were looking up. After wearing corrective shoes for three years, the limp was eventually replaced with a normal gait. However, I never have gotten over the fear of falling.
Here I am again, trying to find a way to keep from falling down as I feel the bones in my legs grinding on top of one another. Each time I go to Dr. Doom for cortisone shots, he always wants to know "Are you ready for your new titanium knees, yet?" No, I will keep the braces for now….If I am going to creak and pop when I walk, I want to be able to take the hot and heavy metal braces off when I sleep. I am not ready for titanium creaking knees that are screwed and glued into sawed off bones. I am not eager to have metal detectors at the airport sound off and be forced to produce medical documentation to verify that the metal they are detecting is inside of my body. Not yet, anyway…I am sure that one day I will "hit the wall" as he has "promised" that I eventually will not be able to walk with my cane and braces. When that day comes, I will tell Dr. Doom to "Go Ahead. Saw, chisel, and hammer away!"
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