Thanks to her surgery, Miki can go back to enjoying hiking and other outdoor adventures. 

After six decades of banging around on dogsleds and horses, not to mention a plane crash (Julie) and a broken knee from a dogsled accident (me), our joints have taken a beating. Bush living plus a genetic tendency to arthritis equals joint-replacements.

I sport a brand-new knee in addition to a 2014 replacement hip. My twin sister initiated this, replacing in 2012 a hip damaged in a horse crash years earlier, followed by an ankle fusion and then the other hip. With several friends and neighbors facing similar challenges, this seems a fortuitous time to share some hard-gained knowledge on joint replacements.

The good news is these surgeries have improved significantly even since our mother’s 2008 hip and knee jobs, with realistic expectations of excellent results.

The bad news is a replaced joint can’t perfectly replicate the original, and I do know folks who’ve had unfortunate results. Pain in an arthritic joint can often be reduced with specialized physical therapy targeting stabilizer muscles around the joint.

Supplements such as turmeric, fish oil, Vitamin C, and others, along with techniques like acupuncture and osteopathic manipulation may help. NSAIDS such as Aspirin control pain and inflammation but, as well as being hard on your body, may actually speed joint degradation.

Stem cell injections helped mild to moderate arthritis, but were less effective for advanced stages. Steroid injections into the joint offers fairly quick relief lasting weeks, months or even a couple years.

While arthritis has slowed us down, thanks to joint replacements, we’ve managed to maintain an active Bush lifestyle. When the pain interfered with daily commitments, surgery restored function and almost completely eliminated soreness.

Timing a surgery was difficult when coming in from the Bush. In addition to pre-surgical evaluations, I needed an MRI of my knee a couple months prior because my surgeon ordered a unique personalized implant. I needed to arrive a week before the actual operation to endure endless pre-surgical medical tests and clearances.

I chose an experienced orthopedic surgeon specializing in joint replacements in Alaska. Before the procedure, I asked about expectations, complications and any long-term restrictions. Then I asked again later, because I often got a different answer.

We learned to expect bills from different people (surgeon, anesthesiologist, hospital, physical therapist etc) over many months. Thankfully, the doctor’s office obtained advance clearance from my insurer.

Each replacement surgery came with a big booklet of invaluable information. We carefully followed all advice, including pre- and post-surgical physical therapy. Targeted exercises speed recovery of the joint, and to maximize long-term potential I visited a professional physical therapist before and several times after each surgery.

I maintained a high plane of nutrition before and after surgery, especially cutting out sugar because it increases inflammation and slows healing. High-quality protein aids in healing, and because the required antibiotics disrupt gut microbes, I ate plenty of vegetables and plain yogurt daily to forestall any issues.

On the big day, I brought a paperback with a bookmark on which I wrote three reminders: “Breathe” (deep breaths maintain lung capacity and increase oxygen levels). “Drink” (to hasten removal of both medications and inflammatory elements). “Wiggle” (especially ankle pumps, to increase blood flow and reduce the possibility of blood clots). I did these every five to ten minutes while in recovery, and frequently for the next few weeks.

I was warned not to watch videos of my procedure; joint replacement is not for sissies! After my damaged knee bones were cut away, the surgeon installed the prosthetic with posts and glue. Good pain control allowed me to stand up on my new joint just a few hours afterwards. Although I had trouble with vertigo for a day, I cautiously pushed through since movement soon after surgery speeds recovery.

By that evening, I was hiking the halls using a walker or crutches. I used crutches for three weeks following the hip replacement, a walker for a couple weeks, and then crutches for another week or two after the knee replacement. Due to the previous injury, the knee replacement proved complex, slowing recovery.

I felt okay for a few days—tired and sore, but okay. Then about day four, BAM! It hit me. Appetite, gone. Attitude, bleh. Energy, zero. It took me a couple days to claw back from that.

Then I noticed my three-times-a-day 100-yard hikes didn’t leave me fatigued. I didn’t hurt as much. I came home safely three weeks after the knee replacement—keep in mind I arrived home in a canoe, my bedroom is up a flight of stairs, and the bathroom a fifty-foot outdoor hike on unimproved surfaces.

Now, four months after surgery, I am still regaining strength—full recovery can take a year—and doing half an hour of PT most days, but I can hike much more briskly than before, even over rough ground. I no longer dread the two-mile round-trip walk to our boat landing. I’d be walking farther but the other knee is now begging for new parts as well.

I’m “looking forward” to getting that done next year. In the meantime, I am sure enjoying almost zero discomfort in a knee that has pained me for over four years. I do have limitations—no full squats, no kneeling on a fragile planed-down kneecap—but the sacrifice is totally worth it to be able to hike, or even just do dog yard chores, without pain.

Trappers and lifelong Bush residents Miki and Julie Collins have written three books. They live in Lake Minchumina.

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