On bended knees: It’s a prehab, rehab life

SUN Media national lifestyle and food editor Rita DeMontis recently wrote about her struggles with advanced osteoarthritis knee issues, and how she faced the toughest challenge of her life: Bilateral knee surgery. Here, in Part Three of her adventures, she talks about training for surgery, and the importance of rehabilitation.

Rita DeMontis’ legs six weeks post-surgery. Toronto Sun

Rita DeMontis, Toronto Sun October 18, 2018

Six weeks ago today I faced my fears, put my faith in the medical system and went under the knife for new knees.

Today, the scars are healing and fading, I am bending at a respectful 125 (in knee bend parlay – damn good!) Pain is surprisingly at a minimal, and… I am walking. Slowly, carefully, mindful that I don’t trip, but with a sureness to my step I haven’t had in decades.

Years ago, when I realized I had no choice but to have double knee replacement surgery, I fought it tooth and nail – partly out of fear for the unknown, partly because of the (mostly) gruesome stories I had read that gave me nightmares. Terrified, I postponed my surgery twice, hoping that some miracle would visit my knees and I’d wake up one morning cured. Of course that never happened.

Instead I found myself paralyzed with pain while going about my life – standing in lineups, hobbling around, missing out on social events. Time and again tears stung my eyes as I struggled to walk when all I wanted to do was just sit down. But all I could do was let this pain monster ravage my rapidly disintegrating knees.

Fiitness and nutrition trainer Nico Alfieri. Toronto Sun

When I postponed surgery for the second time, I realized I had to do this right: Get rid of the anxiety, and get into shape. Me, the original couch potato, embraced the idea of formally entering “prehab” – a pre-surgery healthy fitness and eating regime. A personal trainer who specialized in this was recommended to me, a gentleman named Nico Alfieri, who met with me, assessed, and immediately mapped out a plan of action.

Alfiero turned out to be a godsend – he was kind but tough, wouldn’t let me squeak by with a mediocre workout. He also helped me change my eating habits – more lean proteins, greens, cut back on the carbs and ditch the sweets, and, as the weeks went by, I started feeling better about myself, and the upcoming surgery. Thanks to his efforts and encouragement, my body limbered up and my weight dropped. I started looking at my upcoming surgery in a positive light.

The idea of getting into shape before surgery is one of the best investments a person can make, says Alfieri, of Fitutoday.com. ”Surgery is not unlike getting ready for a marathon – but you don’t just wake up one morning and decide to run one! There are many challenges to consider. Much like a marathon, surgery is an event that will put a lot of stress on your body, so it’s vital that your body and mind are ready, not just for performance but, more importantly, an easier recovery.”

And it’s true – the fitter and healthier you are before going into surgery, the better the outcome. If you’re facing similar surgery, commit to the idea of getting into shape – it can be as easy as moving around more and changing your eating habits to healthier ones. You’ll be surprised at the outcome.

The second thing I did before going into surgery was listen to my surgeon, Dr. Sebastian Rodriguez of Humber River Hospital, and rented a special accelerated recovery device called a Game Ready. It’s pricey – but worth every single penny, as this computer controlled cooling machine (considered the gold standard for many sports professionals, Olympic athletes and special military forces) immediately cuts down on any post-op swelling, heat and inflammation. In fact, the two cuffs that were wrapped around my legs coming out of surgery continuously offered the most soothing, cooling experience – and, more important, cut back on need for pain meds. This is not a big ice pack, my friends.

Rodriguez spoke about how hospitals are working on various programs (working with pain management specialists, utilizing non-opiate items like professional cooling devices) to eliminate the need for massive opiate use. I can certainly attest to the fact that, throughout my surgery experience, my pain was minimal.

Coming out of surgery wearing Game Ready cuffs. Toronto Sun

Game Ready Canada president Mark Bruno, an orthopedic trauma consultant who has worked with surgeons and athletes, says “Game Ready is a true game changer since first being introduced (in the early 2000s.) Initially, it was the device of choice for professional athletes. I later started working with surgeons and the medical community to introduce the device as part of the healing protocol – and a non-narcotic option to manage pain, which eliminates the risk of side effects.” Now, Game Ready is being made available for rental after orthopedic surgery or injury as a non-invasive treatment that works with the body’s natural healing mechanisms, and insurance companies are starting to recognize the health benefits of such a device. (Check out Game Ready Canada at HealFaster.ca for more details).

So where am I in my journey today? I am now in an out-patient rehab program at Toronto’s famous West Park hospital, where, twice a week, I join a group of fellow knee surgery survivors and push ourselves to the limits – in bikes, doing stairs, getting in and out of chairs rapidly. And having our knee bend measured.

Have I had set backs? Absolutely! There’s no such thing as clear sailing on anything – nights where my knees get a weird sensation like they’ve been sunburned, or feel too stiff and tight. A sudden tiredness in the middle of the day. My knees are still swelled and remind me of sausage rolls. I’m still trying to find my centre of gravity after having had my bow-legged knees straightened during the surgery. Pain? Some – but totally manageable. And NOTHING like what I had read online.

I’m still touched by the kindness of people, including total strangers from across North America, who have been following my adventures. I’m constantly asked – how am I doing? I tell them the truth: Good. Actually great!

All my original osteoarthritis pain is gone. I still have weeks of physiotherapy to get through, deal with tiredness… but my eternal optimism can’t be dampened.

On bended knees by Rita DeMontis
1. Preparing for surgery August 23, 2018
2. Rita DeMontis tackles surgery day September 27, 2018
3. It’s a prehab, rehab life October 18, 2018
4. Two steps forward, one step back November 8, 2018
5. The quest for new knees is complete December 23, 2018

Source Toronto Sun


  Further reading

Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised controlled trials, Bricca A, Juhl CB, Steultjens M, Wirth W, Roos EM. Br J Sports Med. 2018 Jun 22. pii: bjsports-2017-098661. doi: 10.1136/bjsports-2017-098661. [Epub ahead of print] Review.

MOMMY BRIGRADE: Mothers seeking out friendship goals. Toronto Sun. Youtube Aug 9, 2018

Also see
Should you have knee replacement surgery? The New York Times
Exercise does not harm the knee joints in those with knee OA Medwire News

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