A Road Less Traveled
The beginning of my TKR journey had interesting- and inevitable- roots of acceptance.
May, 2022
I was on my seventh doctor visit this year, with a specialist new to my lineup. At this point, I felt like I was collecting medical visits like certain children collect Pokémon cards. The doctor made me laugh quite a bit, but I’ll never forget their opening sentence when reviewing my chart: “What is a single 30 year old woman doing these days?”
As soon as the snarky answers popped into my head, with zingers such as "buying too much avocado toast and that's why I cannot afford anything," this one rolled in: What was I actually doing here? Surely, this wasn’t the same medical journey as some of my other friends, trying to get pregnant or on their second child. Surely, it feels a bit daunting and scary when you suddenly wake up to feelings and realizations hitting you like a freight train. I am my own advocate now. I have to take care of myself. We’re all getting older. Is my emergency contact info at work updated?
The road I found myself on at this particular visit was just a side street to a bigger journey that, unfortunately, has been running out of alternative routes. Picture it: Sicily, 2014 (well actually, I was 12 hours away in a little town called Sansepolcro). I was in Italy for a young artist program, and as I look back, things were really looking up (even if I couldn't see it at the time). I was 22 and about to begin my first year of teaching. I had moved in with two childhood friends, but had big emotions stemming from relationship rejection (which, as we often learn, becomes protection). However, at that time I wasn’t having it- and so began a cycle of self-deprecating thoughts about myself. His new girlfriend is skinny. This has everything to do with you. You weren't good enough.
As these thoughts orbited my head on a regular basis, I found myself spending my days after school at the Y or jogging the neighborhood. My job as an elementary music teacher kept me moving constantly. I soon found myself the thinnest I had been in recent memory. Sliding into pants from the sixth grade, I treated an old pair of Express jeans as some sort of measurement of worth. But hey, that’s a whole different set of blog posts. I’ll get to how this all ties together now.
In November 2014, I was limping around with pain throughout my knee. Recently, a friend who had a TKR described her pain prior to surgery as “lightning with each step.” Even with the most intricate of medical jargon I've learned over the years, this is my favorite way of explaining what I was feeling. I went to my PCP, who set me up for X-rays and an MRI. Abnormal femoral lateral condyle. Congenital injury with subsequent degenerative change. These were terms I did not understand and expected to hear on an episode of Grey's Anatomy before I was sitting in an office crying, trying to comprehend what they meant.
“You’ll probably need a knee replacement in 10 years,” he said as we scrolled through scans. “Try taking up biking or swimming- running isn’t something you should be doing.” I grew up knock-kneed, and he explained that this pushing out that my knees were doing was also not helpful.
A knee replacement? Respectfully, weren’t those surgeries for a retired, older generation? While this was a blow to my coping mechanism, I quickly turned to the elliptical at the gym, which eventually turned into circuit training. I also attended physical therapy and had a steroid shot here and there. As the years passed, there were seasons where I wasn’t as active and other times I was working out four times a week. I enjoyed the release working out gave me. Even as people or jobs came and went from my life, I found myself less focused on the weight loss- and more focused on the strength.
My job remained active, and I eventually got to call a three story building with the steepest of stairs (and no elevator) home. Amidst the pandemic, I found myself teaching on a cart. Going up and down these stairs room to room, my Fitbit stayed silent as the steps and flights rolled in. My body, on the other hand, was screaming at me.
In July 2021, I made a commitment to workout more, and found some of the most worthwhile exercise experiences of my life. I joined a volleyball league, and that is when I first started seeing constant swelling, no matter my use of NAISDs, ice packs, or elevation. Even through the pain, I started seeing great progress. I worked out with a knee brace most days and soon found myself six months in, 20 pounds thinner, and vitals so much better.
Shortly after the new year, the swelling was the worst it had ever been. Fancy term: bursitis. Sitting with an orthopedic surgeon, I learned I had end-stage osteoarthritis in my right knee. The pain turned into a limp I couldn’t disguise, as well as a sense of insecurity stemming from what brought me this pain. Thoughts of how I looked when completing daily tasks took mainstage in my mind. Everything from my stance to my posture changed, other parts of my body working overtime to assure I could take steps or move for a few minutes at a time. "Why did you break your leg?" my kindergarten students would ask in horror as I started wearing my knee brace everywhere. Well, little friends, I've been asking a lot of "why" myself.
Here I stood, on the edge of 30, feeling scared and insecure. Why is this my path? I want to go on long walks or stand with friends in line at a concert without pain. After months of MRIs, Cortisone shots, X-rays, and blood work, my second opinion became the doctor that would operate on my knee in the form of a total knee replacement. That didn’t come without an array of comments- from friends and family to medical professionals. “This should be a last resort.” “Who’s going to take care of you?” “You don’t want to have that surgery so young.” "You'll likely need a revision down the line, and that typically isn't as successful."
Recent trends have shown younger people opting to have knee replacements. To put it simply, it just isn’t the surgery it was even ten years ago- some patients even go home on the same day. When I weighed this decision, beyond comparison and sadness and worry, I found myself thinking of my quality of life. My current day-to-day is not cutting it. It is discouraging to find less information about this surgery in younger patients. The most comforting article I've read is by Nicole Qualtieri, and you can read it here. It is my goal to document some of my process and progress. That way, if someone finds themselves in my shoes, we can have some conversations on healing.
I write this with less than two weeks until my procedure. I have felt so much support from my friends and family. I like to consider myself an independent person, and I know I need to lean on others as I face my first surgery. This experience has been a painful yet fulfilling reminder that, beyond the pages of social media and self-imposed timelines, my journey is my own. I have a story that needs told, a reason to be thankful- as things could be much worse. As the concerns begin to fade and I am reassured by an amazing team of experts, I think back to what one of my doctors said.
What am I doing as a 30 year old single woman? Taking care of myself.
