To knee, or not to knee

To knee, or not to knee: that is the question:
Whether 'tis nobler in the mind to suffer
The pangs and pains of injuries and arthritis
Or to take action with a surgeon against a sea of pain,
And by opposing it, end it. To lie awake: to sleep;
No more with trouble legs; and by a sleep to say we end
The leg-ache, and the thousand natural shocks
That flesh is heir to, 'tis a consummation
Devoutly to be wish'd. To lie in quiet sleep;
To sleep: perchance to dream: aye, where's the A 535 rub?
For in that sleep what dreams may come,
Why so long to wait for artificial knees and hips
Will they arrive before we have shuffled off this mortal coil?
Why does it take an 18 month pause
Where’s the respect that makes calamity of so long life;
For who would bear the aching joints of time?
The politician’s wrong, the administrator’s tardiness,
The pangs of despised joints, the hospital’s delay,
The insolence of funding and excuses
What patient merit these unworthy takes?
When he himself might his quietus make
With a bare butt in hospital gown displayed,
To grunt and sweat under a weary life,
But the dread of something after the operation,
The chance of failure undiscovered from which
No patient walks, puzzles the staff,
And makes us rather bear those pains we have
Than fly to other private clinics that we know not of.
Thus conscience does make cowards of us all,
And thus the local patient has no resolution
Is sickly with the pale cast of thought of delays.
While the New Hospital, of great pitch and moment
With this regard their current tasks turn away
And lose the name of action.

Sorry, Will, but I could not resist parodying your famous soliloquy from Hamlet. Having just undergone a total knee replacement at our local hospital, I get a number of inquiries from people suffering from knee problems.

While many people want to measure the success of the operation in terms of mobility and reduction of pain, I still cannot give a full report. Now some seven weeks after the operation I have some discomfort although it is not the same as the arthritic pain with my old knee. Hopefully the discomfort will ease as my muscles, tendons and bones get used to the metal parts in my leg.

Mobility is another question. One thing I have learned is that every patient is different. Not only do the three surgeons in North Bay who do the knees, do them in different ways – some stitch, some staple – but the results are as individual as the patients. Some people take blood thinners, some do not. Some had pulleys to move their legs after the operation, others did not. Some are up and around, walking unaided days after the operations, others need crutches or canes for weeks. A few of us even needed to go back for ‘manipulation’ after a month to get things moving.

The end result is that I expect the left knee to be almost as good as new although it will never bend as much as the original (design limits). Now the question I face is what to do with the other knee. It too, is slowly falling apart. It may last some time since I am no longer beating up the knees playing ball and hockey, but I have no idea how fast the arthritis will advance. Given that it now takes an average of 18 months to get a knee replacement in North Bay, do I reserve a space now?

Or do I wait and take a chance with Paul Martin’s promise to reduce waiting times? I am not sure whether it is a local funding decision to limit the number of knee and hip replacements or whether this dictum comes from the Province. One can book the operation at a Toronto hospital in about four months, so I have to think that either we do not have enough orthopedic surgeons or there are funding problems at North Bay General. Maybe if we were a Regional Hospital, things would be different.

For those people with financial resources there is always the option of going out of country and paying for the operation out of pocket. Waiting time is reportedly about one month at some American clinics. Of course if one is a VIP or sports celebrity, service might be faster. No matter where you have your operation, you can do your physiotherapy with the very competent NGH staff at the McLaren site.

For the record, the food at the hospital was reasonably good. The beef stew was my favourite, although I would have enjoyed a larger helping! The staff were excellent, right from administration, to the nurses, to the people who mopped our floor. I am not sure whether my surgeon, Tom, has a sense of humour because when I tried to make a little joke part way through my surgery I was promptly given a little more sleeping potion to keep me quiet.

And so the question remains: to knee or not to knee . . . .