What’s the difference between undergoing joint replacement surgery versus getting hit by a moving vehicle? The answer — from the perspective of bones, ligaments, and muscles — is not a whole lot at all. Anatomically speaking, they both feel very similar to your body, except the surgical trauma is much, much cleaner, and done with the utmost precision and skill!
I mentioned in an earlier blog about my own, horrific, jaw surgery experience — and how grateful I am to that same wonderful surgeon who totally transformed my quality of life. That wasn’t quite how I was feeling coming out of surgery those first 24 to 72 hours when the swelling and bone bleeding reached its maximum, ballooning my face into orangutan-shaped cheeks... Everyone said to me, “It looks bad now, but eventually it will look better than before.” In fact, this “temporary” deformity to my face was so disturbing that most non-hospital civilians couldn’t even look at me. It was a very humbling experience that I’ll never forget.
At the time, I felt tricked and manipulated by my surgeon into going under the knife. This barbaric operation was supposedly the same “life saving procedure” that I had previously convinced myself, my friends, and my family that I desperately needed.
I remember looking at myself in the mirror, all disfigured and in pain, and seeing all the purplish bruising and caked blood inside my nose — bottom lip swollen as thick as a "Nathan’s hotdog." The only thing that got me through that first hellish week was the shear anger in my gut towards my surgeon, and the desire I had to punch him out when I saw him at my next appointment!
Ironically, when I did see my surgeon three days later, I shook his hand and thanked him for keeping me alive. He told me that some of his other patients — those with worse mouth deformities than mine — would actually break down into tears of joy, when they could see their mouth close in the mirror for the first time in their entire life.
I asked him, “Why didn’t you tell me before I went into the operating room that the recovery would be so horrible?” He replied to me, very honestly, “Because if I did tell you how bad it would be, Caesar, you would never have wanted to go through with it. And at that point there really was no turning back. You needed to have it done.”
Between you and me, “bad” actually translated into a “living nightmare” that would repeat every morning when I woke up, over and over, from one day to the next.
It seems that with a lot of surgeons, their perspectives on the recovery timeframes after surgery are a little too “light” or “easy” than they eventually wound up becoming. This is not just from my own personal surgical tribulations, but from the shared, collective experiences of many of my patients’ in rehabilitation therapy over the course of 20 years.
A good tip to go by is, “However difficult the surgeon told you the recovery process is supposed to be, just double it to be safe.”
This means, if you were told you’d need one month to go back to skiing after meniscus surgery, it’s best to assume it would be two. Actually, from a rehab medicine perspective — in order to properly engage the muscles and prevent secondary injury or inflammation to surrounding tissues — it would definitely be closer to three or four months. We discussed earlier about the different timeframes of healing for our different body parts, like muscle and bone and nerve. If I took a perfectly healthy person and cut into his or her skin and wiggled around between the knee bones with an arthroscope, it’s going to take a couple of months for that joint just to heal and restore equilibrium from all that inflammation.
As a general rule of thumb, many doctors will tell you to wait at least six months after one surgery before considering having another surgery — especially on the same area. It is usually a year after surgical “hardware” is installed in your body before you actually “forget” there’s a foreign piece of metal screwed into your bones. If you are curious enough to examine your post-op X-ray, you may be surprised to see a collection of screws that look big enough to come off of the shelf at Home Depot.
It takes time for your body to heal. It takes even more time for your mind to build up confidence in your newly repaired body.
It’s easy to imagine how the recovery process is supposed to feel like, but you really won’t understand it all until you’re there, in the thick of it, dealing with all the swelling and the pain and the stiffness of it all. Hopefully, you’ll never have to. In a more ideal world you will stay free of any serious injuries, and treat yourself only as needed with good therapeutic counsel and an active measure of prevention.
However, when an extreme intervention is truly needed, it can be foolish to avoid surgery at the cost of your future health and functioning.
Great surgeons can transform lives in a way that very few medical disciplines can do. Likewise, poor surgeons can destroy and mangle lives just as quickly and easily. And sometimes there are wildcards outside of anyone’s control, like infection or excessive scar tissue formation, that can turn an otherwise simple procedure into a really wrong direction.
Please, take your surgery seriously! When your doctor says, “Don’t lift a cup of water for two months after a massive rotator cuff repair,” then you better follow that directive like “gospel” and sip out of a straw.
It is so often that I’d hear one of my patients coming back from surgery and complaining to me that they can’t go on that trip they had been planning, because the surgeon wouldn’t allow them to fly or climb stairs. I listen to their frustrations, but I also tell them to try and remember that they will only get this one chance to recover from their surgery. This “trauma” will create a highly complex immune response that will never repeat itself again. Once scar tissue is laid down across the muscles and nerve fibers as the tissue repairs itself, it will not undo itself and reattempt a better shot after you come back from your European vacation. The inflammation that is created during the subacute phase of healing will set the future state of your body up for the rest of your life. Can you really weigh a one or two week thrill against a lifetime of potential pain, stiffness and weakness?
When I had my jaw surgery, I was given very strict precautions to not open my mouth — at all — for at least two months. To insure this from not accidentally happening, I had a plastic retainer stuck between my teeth and rubber-bands tightly placed around my metal braces at varying angles. There was no way anything — except for a trickle of water or air — was going to enter into my mouth. I couldn’t talk. I couldn’t eat. I couldn’t even take a deep breath, as if I was sucking in a tiny ounce of air through one of those goofy children's cup straws.
Believe me when I tell you that I begged many, many times to break those precautions and cut the rubber bands that were holding my mouth shut. But, the doctors and nurses simply said “Nope, we cannot cut those bands. You just have to deal with it, otherwise the surgery was done for nothing.”
So, I understand how people can feel trapped with their restrictions — but it’s temporary. Every day you will feel a little bit better, and a little bit better…
In that first month, when I couldn’t eat or speak, I would stand in the bakery aisle of the supermarket and just breathe in the sweet smell of wheat and biscuits and cookies, and just convince myself that it was worth it. I truly believed, “Some day I will be better off than before I had the surgery.”
This is something you, too, would have to ask yourself: “Is the benefit worth the risk?”
Whether it’s an accident on a city street, or a skilled “intentional” trauma at the hands of a highly distinguished surgeon, you have to appreciate that the period following your injury is a highly unusual, and highly atypical, time in the whole journey of your recovery process. You have been broken down and rebuilt up again. And remember, you only get one chance to make the best of this phase of healing, because once it passes, it never comes back around again.
If you have a concern about recovering from an old traumatic injury or a prior surgery, and you would like an expert to evaluate you, then click here to schedule an appointment with us today.