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Voice of Experience

Voice of Experience: February 2024

A Turnabout Well Earned

Francis H Morrison

Summary

  • The poignant journey of love and healing where the roles reverse and devotion prevails in the face of medical challenges.
  • Marriages are partnerships that will encounter many opportunities to nurse and nurture each other from beginning to end.
A Turnabout Well Earned
PhotoAlto/Frederic Cirou via Getty Images

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In our partnership of more than 53 years, my wife Sally has had many opportunities to nurse and nurture me, whether or not I deserved them. But this year turnabout came to visit our marriage. This year, she elected to have a total knee replacement and my obligation to nurse and nurture her came to visit, ready or not. But, before I tell you what that included, I want to share with you the well-earned part.

After Sally contributed two C-sections to get our family started in the late 1970’s, I suffered a torn quadriceps tendon in my right knee. After a nasty surgical repair, she got to watch me pass out half way through the removal of some 50 steel clips in my incision (known as vasovagal syncope). She got to tell the PA that I was “out.” Six months followed during which I had PT three times a week (all of which she attended), one of which was usually reserved for releasing adhesions and scar tissue. I couldn’t drive, so Sally was my Sherpa, accompanying me to work at courthouses in Philadelphia and New York City. And, because I literally could not bend over and reach my posterior, Sally got to perform certain cleaning operations that my mother had done many decades before.

In 2018, I was diagnosed with prostate cancer and underwent a radical prostatectomy. For the 10 days that I was fitted with a Foley Catheter complete with a drain and bag, Sally’s duty was to empty the bag several times each day, while noting the color of the contents and being on the lookout for blood clots. And she had to witness the unceremonious, unannounced removal of the Foley—while holding my hand.

In 2022, my right knee began speaking unkindly to me, and my bone-on-bone diagnosis led to  total joint replacement major surgery. And, Sally was there again nursing and nurturing me from beginning to end.

You should understand that while 95% of total joint replacement surgeries last 20 years or more, the procedure and recovery are regarded as major surgery for good reasons. They include: preoperative injection of RECKS (anesthesia) in the front of the thigh; use of a no. 10 scalpel blade to make an 8” to 10” knee incision; turning the knee cap inside out with fat pad removal; osteophyte removal using a rongeur; release/”sacrifice” of the anterior and posterior cruciate ligaments; after careful measurements 5-10 mm of bone are removed from the ends of the femur, tibia and patella; and postoperative pain, swelling and joint stiffness which can last for weeks despite use of opioids or extra strength Tylenol.

Typical postoperative physical therapy lasts 7 to 12 weeks (there are good reasons it is not called PT “picnic”—it can include maneuvers to release scar tissue and adhesions especially where the joint has had preoperative injury). Discharge by the surgeon is commonly set for a full year after surgery—reflecting the honest assessment of total healing time. And that assumes any preoperative infections or falls causing trauma to the knee joint. Sally supervised (i.e. enforced) my home and outpatient exercises which included heel slides ( forced joint flexion assisted with a strap around the ankle) to increase knee range of motion as measured by a goniometer, deep squats, force-flattening the knee and quad muscle by standing on a triangle… and more.

Sally was nothing if not fastidious in carrying out her daily duties with my knee. Unfortunately, her patient went on to develop severe hip pain from bone on bone in the same leg—a not uncommon sequela of knee surgery (more major surgery) the incidence of which is not well understood. So six months after knee surgery I underwent a total hip replacement. As my hip surgeon promised, the surgery went much more easily than the knee surgery. Not without risk, however—I still have a dim recollection in the dark dawn after surgery hearing a figure draped in scrubs in my room saying “ whatever you do just don’t fall.” Of course, within a week of surgery, I insisted that I could complete a mile walk—resulting in sharply increased pain. Use your imaginations to conjure up the adverbs and adjectives Sally used to go with “stupid” in describing my “macho male behavior.” But she got me through it again.

There was a gratuitous cherry on top of the premium sundae Sally consumed to earn the right to turnabout from me. Between the knee and hip surgery, I had separate cataract surgery on each eye. Truly a walk in the park in contrast to knee and even hip surgery! But Sally did not escape unscathed—I proved inept at administering antibiotic drops in my right eye thrice daily for three weeks, forcing nurse Sally to come to my rescue again.

Turnabout day dawned in 2023 when Sally’s knee began talking angrily to her. And, the same surgeon who did my knee surgery examined Sally’s x-rays and said, only a little tongue-in-cheek, “Sally, this looks like Fran’s knee!” It caused me to refer thereafter to Sally’s knee as having been “a maritally transmitted defective knee joint.” Sally was not amused and expressed her fears that my nursing and nurturing skills would not be up to her very high standards. And, truth be told, I was concerned because I had to admit that I have enjoyed over 50 years of being spoiled.

So Sally had the same major surgical total joint replacement that I had. Understandably, she declined to consent to a photograph of post-op knee for this article, but the 8” scar surrounded by moderate swelling and truly majestic shades of black, purple red and yellow are eloquent testimony to her “major surgical procedure” of total knee joint replacement.

When I left her in preop just before her surgery I had an overwhelming sense of just how much Sally has meant to me.  When the surgeon came to tell me in the surgery waiting room that she was doing fine, I couldn’t stanch my tears of relief and joy. I got to give relieved, joyous reports to Sally’s sisters, a lifelong friend, our children and my 101 year old mother who, according to her, depends on Sally for nearly everything. Sally’s postop course went well: good range of knee motion; no signs of infection and no unexpected pain.

So, I was shocked and surprised when, arriving home, and while leaning on her walker and talking with me about her meds, hydration, first load of laundry and dinner, she suddenly and without warning became unresponsive. I caught her, protected her knee, and lowered her onto the floor. She was white as a sheet and clammy to the touch. Her pulse oximeter read in the mid-80’s and her rapid pulse both scared me. I kept her head down and raised her feet. Should I call 911?  She then started breathing more deeply, her saturation levels jumped into the normal mid 90’s and she said she was thirsty.  I got her into a chair and she sipped ginger ale and her color improved. When I spoke with the surgeon’s office, I was told that she was dehydrated (not unusual after major surgery) and to give her fluids and report back in a few hours.

After that scare, Sally was the ideal fastidious patient I wasn’t. She has been determined to heal and progress. My nursing and nurturing duties were a walk in the park contrasted with those she had with me detailed above. She tells people when they ask about my performance with cooking, cleaning, laundry, ice, meds—some things I have not done proficiently when I have been busy with my trial practice since 1975—that she gives me a grade of “good”—I am relieved!  And so is Sally. There has certainly been turnabout by me that Sally has more than earned!

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