choosing pain

The surgery is tomorrow morning!

I’ve been running through my checklists to make sure I get everything done. I’d set aside some time today to attend to what seemed like a huge amount of prep work—like preparing ready-to-go meals for the week ahead, and laundering the bed linens and towels—and then found that I was nearly done with everything by 9 a.m. I’ve got another three rounds of physical therapy exercises to do, and I’ll also want to pack a small bag to take with me to the hospital in addition to making sure my borrowed walker is in the car, so M can bring it with him when he collects me upon release. Then there are the medicated wipes I’ll need to use on every part of my body before I go to bed tonight. But I’ve got it organized, for the most part.

That transformation of anxiety into eagerness lasted for most of this past weekend, which was a relief. I was able to relax and attend to other prep tasks without my nerves getting in the way. I’m feeling more jittery anticipation today, less than twenty-four hours out, but it’s still not bad.

When I do find myself feeling afraid, I remind myself that I am actively choosing to move forward. What’s coming up is hard, and there will be pain and unpleasantness, and monotony. But this is the road through to where I want to be. Instead of continuing to let my world get smaller as my knee joints deteriorate and become more painful to the point of uselessness, I am choosing to do the hard thing. I am choosing a better life.

I first started having trouble with my knees—specifically my right knee, which is being replaced tomorrow—around 2000. Twenty-three years ago. My GP at the time noted some extra fluid around my knee and advised me to “avoid stairs.” For how long? The rest of my life? I was thirty years old.

Following that, I had occasional knee pain, along with an increasing sense of unsteadiness, especially when descending a slope or uncertain stairs (like steps hewn from rock). For years, I had a recurring dream that I was high up in a stairwell and having real trouble making my way downward, while all around me people hurried down with no trouble. The pain in both knees became more noticeable in the aftermath of my International Reporting Project fellowship in 2011, when I was based in Washington, D.C., and in Dublin for about two months. I think the trigger there was not only lots of long plane rides in coach, but also a return to a mostly sedentary work life after having walked so much when I didn’t have access to a car.

I started hiking a little over three miles every morning, and that helped, but my knees ached badly. I was stiffer and felt unstable on my knees, with the right being more painful and more problematic than the left. I had trouble dancing and doing yoga. I started icing my knees on a regular basis. Those three miles every morning reduced by degrees, until ultimately I had trouble just getting around the block. I got a weird and very unpleasant “chunk-chunk” sensation in my right knee while doing some exercises, and I now recognize that feeling as my bones rubbing against each other as my cartilage deteriorated.

Given everything else that was going on with me health-wise, concerns about my knee were routinely dropped to the bottom of the list during medical appointments. With my daily headaches, they needed to rule out MS and tumors, for instance. It was a similar story for my persistent gut pain. And so on. No one told me my knee pain didn’t matter, but other complaints took priority, so it wasn’t until 2021 that I was able to start physical therapy.

And PT went great! For a few months, at least. I was increasing my strength and my range of motion with weight-bearing exercises. I was excited and hopeful. But then I reached a plateau, where I was making no progress, followed by a sharp decline. I could do less and less, but I kept trying. I also tried a platelet-rich plasma (PRP) injection into my right knee, which had little to no effect. A steroid shot gave me about a month of relief before my knee popped one morning, leaving me significantly worse than I had been before. A second steroid shot about six weeks later brought only about a week of mild relief before the same thing happened. By that point, surgery was inevitable.

It took a long time to get to this point, and I know that my left knee will need similar surgical attention not too long from now. But as much as I’m nervous about post-op pain and the rest of it, I’m also anxious to get back to a more active life. I’m tired of not being able to go on walks and hikes with M or my friends. I’m tired of having to choose coffee shops that don’t have any stairs to navigate. I’m tired of not being able to do household chores—honestly, I’m looking forward to cleaning the gutters! I’m tired of becoming more and more isolated as my knees deteriorated.

So I’m choosing a different pain—a temporary and constructive pain. Recovery will likely be difficult and painful (and boring), but I will be reaching and building toward something better, rather than watching my life continue to crumble away from me.

Anyway, that’s what I’m thinking about today, the day before having major surgery. Depending on how I do in the hours that follow, I hope to be released tomorrow afternoon or evening so I can spend my first night back at home again. We have a neighbor who will be in the house with Jax as I begin my journey tomorrow morning. My check-in time is 8:45 a.m. Pacific Daylight Time, in case you’d like to send some good thoughts my way.