TKA jitters: a matter of perspective

With major surgery coming up next week, I’m taking a stab here at documenting my experience in case it helps someone else.

Anxiety and excitement share the same physical characteristics: increased heart rate, butterflies in the stomach, singular mental focus, and so on.

Years ago, I was on the eve of a skydiving adventure with some friends, and I was scared out of my mind. I’d never been skydiving before, but it was something that was on my mental bucket list. When a friend organized a group to go, I knew I had to do it—because skydiving wasn’t something I would ever seek out on my own. But with less than twenty-four hours to go, I was so nervous that I was having trouble thinking or eating.

But something made me examine my physical symptoms, including my nervous stomach and the feeling that my entire body was vibrating. I realized that my experience in that moment was a matter of interpretation. I decided that instead of fear, my body was showing signs of anticipation instead. A switch flipped, and from that point forward I was eager and happy about the coming jump.

Side note: It turns out I hate skydiving, but I’m not sorry I gave it a try. Also, despite multiple attempts, I wasn’t able to flip that switch from anxiety to excitement in other situations. Not consciously, anyway.

So why am I bringing this up now? Because I’m having a similar experience of nerves around an upcoming surgery. I have a total knee replacement scheduled for next Tuesday (July 18), and I’ve been feeling really anxious about it. I have three primary concerns, and they’re big ones: I’m afraid of the post-op pain, which could be intense and long-lasting; I’m worried about prescription pain pill addiction; and I’m intimidated by a long and potentially difficult (and painful) recovery.

The good news was that I had a lot of prep work to do, and that distracted me from my anxiety. I even assigned myself extra homework, like starting my six-times-per-day, 20-30 minutes per round post-op physical therapy a couple of weeks before surgery, so I could build muscle memory and find my daily rhythms with the exercises. I found a Greg Polar Care Cube (cryotherapy/compression machine) on Craigslist and learned how to use it. I borrowed a walker and practiced with it. I read many articles about surgery and recovery, and I started preparing my home and gathering supplies long before anyone in my surgeon’s office asked me to. Several members of the surgical and rehab teams boggled at my efforts and told me they’d never seen a patient so prepared. One even said, “Yeah, I have no worries about you post-op. You’re going to rock this.”

But I couldn’t seem to flip that switch in perspective from anxiety to excitement. Yes, I’m looking forward to being able to go on long walks and short hikes again. Maybe long hikes, too. Maybe even dancing and yoga. The osteoarthritis has eaten away the cartilage in my knees. I walk with a painful limp, I can’t go very far, and I struggle with stairs. My already small world has gotten so much smaller. This coming surgery is a much-needed miracle that could give me back so much of my life. There’s no question that I want this. But I’m still anxious.

Or, I was, until this morning. Something shifted overnight. Maybe it was the few minutes I spent outside last night stargazing, or perhaps it was something else. When I awoke this morning, the anxiety wasn’t as sharp, and I noticed a keen eagerness on the rise. That’s deeply reassuring. I’m still having “adrenaline pangs” and other anxious symptoms. No doubt these will continue and will increase over the coming weekend. I’m less than four full days out now, and the coming surgery is getting realer by the minute. When the scheduler called this afternoon to give me my pre-surgery check-in time, she closed by saying, “Well, enjoy your last good weekend!” That didn’t help. But I’ll step outside every night between now and Tuesday morning, in hopes that the stars will work their calming magick again.

My hope is to blog about my experience and my recovery. The truth is, I have no idea how my body will respond until I’m it. I don’t know how bad the pain will be, or whether I’ll have uncomfortable or intolerable side effects to the nerve block or the pain meds. I can’t predict if my recovery will be fast or slow until I start hitting those initial milestones. But it has been encouraging to me to read about other people’s experiences with this surgery and recovery—and with their return to activity afterward. If I have the bandwidth to provide the same in this space, I’d like to do what I can to inform and reassure someone else.

Posted in thoughts from the spiral.

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