Bella  Bryce
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I got a new body part

13/12/2018

3 Comments

 
I haven't blogged since the September UK Author's Retreat because, well, whilst I was in consultation about the seemingly unnoticable (to other people) state of my knee and wasn't expecting to have surgery so soon. The backstory for how and why I was in this position at my young age is not for now - it spans three continents, starting in Hungary, involves Scotland and finally the U.S. where I lived at the time. It's also heartbreaking and I am not prepared to use this platform for the way I want to tell my whole story. However, I will share glimpses in order that the how and why I am in the position just now makes sense.
I suggest getting a cup of coffee and putting your feet up.

Janaury 2007- June 2018

The very short, not-detailed story: torn ACL required surgery, which I obtained in Hungary because as a U.S. citizen at 20 years old who was not in full time education (and therefore could not be on my parents' medical insurance) had no way of paying for it. I was on my own and the cheapest option was Sopron, Hungary. The surgery was done correctly but I contracted septicemia. Miraculously, I lived with it for three months until I saw an orthopaedic surgeon in the U.S. where I was living. To put it bluntly, he couldn't believe I was still alive and that my leg was still relatively in tact and did an emergency surgery - essentially saving my life from further disease and organ failure. I'm skipping a lot of detail that involves other people and emotions I do not want to relive right here and now, so fast forward to 2010. I'm married and living in England. We went to Guys and St. Thomas' hospital in London to see a consultant for an update, as I had been coping with arthritis and extremely limited range of motion (68 degree bend, 20 degree extension) as best a 24 year old can. He confirmed that I was doing well; walking, taking public transport, not on medication for depression due to severe life alteration, had a job, a social life, etc. He said he didn't want to consider a total knee replacement until I was 50 as I was too young, not in agony, coping well, and very high risk for repeat infection. The consultant said to carry on coping as well as I was, enjoy my life, etc. Come back when I'm either at least 50 or climbing the walls with pain. Fair enough.

My now ex-husband and I relocated to Virginia from England for his job in 2013. I wrote my first book, The Solicitation, and became a published author of now 9 novels. That became my full-time job and my knee, although bothersome at times, was easily molly-coddled as I swam and went to the gym to maintain fitness as best I could whilst being able to rest it easily since I worked from home. June 2017 my knee starts waking me up with pain in the middle of the night. I knew things got worse. My knee also gave out on me (which it never had before) and that's when I had my first appointment since London 2010, just to find out how my knee was. An urgent care doctor came in with a terrified look on her face and said, 'you need to see an orthopaedic surgeon as soon as possible.' I broke down crying and she hugged me. That's when I knew my coping days were over. 
In the throws of divorce, relocation, knee pain, floating between finishing my tenth, eleventh and twelfth books as well as doing work as a supporting artist on several BBC shows, and breaking into a lead role for a short film, my whole life was buzzing around me. I didn't want to make time to 'deal' with my knee but frankly, I was tired of the pain and after an X-Ray I was fast-tracked to see a consultant. He was blunt and repeated what I knew since 2007: my knee is bad. Really bad. Never seen one as bad. In fact, so bad, that he as an experienced ortho surgeon who does knee replacements for a living, didn't feel comfortable taking me on. I was then referred to the revision consultant, so I'm being treated as if this was my SECOND replacement even though I never had one in my life. 

August 2018

I meet my surgeon and his assistant. I adore and trust them instantly, listening to everything they said about surgery and the risk of repeat infection. The expectations were as follows:
  • Maximum expected range of motion of 70 degrees
  • High risk of infection and if that's the case, start over, hopefully get to keep the leg if it doesn't spread
  • Possibly more stiffness or less motion than the 65 I walked in with
  • Typical surgery time is 1 hour. Mine will be at least 3 hours or more

My response:
  • I'm getting at least 90, with a goal of full range of motion (Remember this detail). I'm aware this is considered impossible.
  • There will be no infection
  • There will be no scar tissue
  • There will be no stiffness
  • Where do I sign?

We signed the consent and I went home to wait for a letter assigning me a surgery date. I was supposed to have a 6-9 week heads up but due to multiple miscommunications on their end, I was given less than a week to prepare. My dear author friend, Maren Smith, set up a GoFundMe and many authors and readers poured into the fund to support me in this projected year-long recovery. Physiotherapy is going to be my full-time job or I face the outcome of the same sort of limitations I had pre-op or various other negative outcomes. Even with a somewhat miraculous recovery, I am not capable of walking on crutches to the train station and doing ad-hoc film work for up to fourteen hours, coming home and walking from the station. We nearly hit the goal within a month. There is no upper limit so should you wish to contribute the link is above. 

Total Knee Replacement

Some of the comments I've received over the course of my operation make it obvious that if you aren't getting a new body part, you probably don't care or understand what's happening to someone who is. The basic facts of a total knee replacement:

  • Surgeon makes a cut down the front of the knee to expose the kneecap
  • Damaged ends of thigh bone (femur) and shin bone (tibia) are cut away. The ends are precisely measured and shaped to fit the appropriately sized prosthetic replacement. A dummy joint is positioned to test that the joint is working properly. Adjustments are made, the bone ends are cleaned, and the final prosthesis is fitted.
  • The end of the femur is replaced by a curved piece of metal, and the end of the tibia is replaced by a flat metal plate. These are fixed using special bone 'cement', or are treated to encourage your bone to fuse with the replacement parts. A plastic spacer is placed between the pieces of metal. This acts like cartilage, reducing friction as the joint moves.
  • The wound is closed with either stitches or clips and a dressing is applied to the wound.

25 October 2018

This is me on the morning of surgery: absolutely over the moon excited to be getting a new knee. I underwent a 4 hour pre-op assessment back on the day I signed papers, so that morning all I had to do was giggle with the nurses (we did laugh a lot), remove my nail polish (oops) and get fitted for my Ted stockings. Stylish. Schoolgirl chic is in, dontcha know? In this photo you can see how far out my leg was in its natural position due to the arthritis. Later in the post you can see an X-Ray of my pre and post op.
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6 hours later

I woke in recovery to several jolly nurses round me. My anesthetist came over and said, 'It went really well!' I was half dazed but I will never forget that moment and how surprised even I was to hear him so genuinely express those words. My surgeon came in and told me, ''we got to 90 degrees of motion." I groggily turn over and smiled as I said, "I told you."

Him: You did.
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I was in hospital for a week

From the beginning we all knew this was not going to be a standard recovery with standard goals met as expected by a 'normal' (read: geriatric age) person going through this operation. Therefore, any milestone I hit was going to be good because the expectations were low. I was on the ward with hip and knee replacement patients and was the youngest one by 32 years. Also, the only way to get the level of motion I need for a halfway decent life was for the team to really push on my joint. You can see the bruising from where the they fought hard for me. You can also see from the hospital gallery that as the photos progress, I'm looking better everyday. Some photos show just a really lovely day of opioids.

This was the day I knew I was an overcomer

When was the last time you sat down and your legs were both 90 degrees? Probably today.
For me it was 6 January 2007.


Until this day: 26 October 2018

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Note that the above photo is taken less than 12 hours after surgery and when I still have anaestethic in my system. In the days that follow I will lose multiple degrees of motion as pain and swelling take over and eventually, scar tissue tries to build up. I have to then fight to get it back and surpass even the 90 degrees this photo shows.

Physio therapy was (and still is) painful

And for the next year it is my full-time job. I only get one chance to get this right.
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After a week in hospital, fellow author friend, Vanessa Brooks, came to look after me for the second week

Vanessa made sure I got my medication, slept (no issue there as I was exhausted), ate three good meals a day and we did exercises together in the kitchen. We worked hard for 5 minutes every hour of every day in week two, to move my knee to ensure I was gaining motion. Packages and cards started pouring in from both sides of the pond.
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The district nurses came to visit and took out 25 staples

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By week three I was home alone

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Every day I sat on the counter at the one hour mark and for a few minutes I worked on bending. I did my ankle pumps and leg lifts. During week three I also went in to meet my therapist and get an initial measurement because we couldn't start working until week 5 to give the inside of my knee continued critical healing. I was bending at 68 degrees...three degrees more than I was pre-op.

The real effort had to come from me at home, deciding whether I wanted to continue to believe I could reach full range of motion. I had between week 3 and week 5 to do my home programme before I started outpatient physio.

In my home programme I continued to sit on the counter and cross my ankle over my operated leg and try to get it to bend until I couldn't handle the discomfort/pain. Rest. Repeat. I did that for five minutes or until I was in tears and then elevated my leg. Repeat every hour. I also concentrated on reawakening my quad muscle, which has not been operating fully since 2007.
Physio therapy, whether outpatient or a home programme, is made up of two things: breathing and attitude. If you can learn to breath through every exercise and interrupt the correlation of pain between your brain and the body part, you will have an easier time. Having been through physio four times for my knee now, I can honestly say that attitude is 90% of physio therapy. Change your attitude and it'll change your outcome.

Week 5 came and I went to my first outpatient physio.
I measured 86.

Hard work pays off, but my journey gets better.

One week later I had my 6 week post-op appointment, and it was the first time seeing my surgeon and his assistant, Sarah, whom I adore. They were with me from day one back in August and I wanted nothing more than to make them proud. I had no idea what my measurement would be when I walked in, because 86 was my last measurement on the Thursday and I went in to see the team on a Monday. I worked hard over the weekend to hopefully increase my range.

Walking into the room with my crutches and a huge smile on my face, feeling well in my body and confident in my progress, Sarah saw it. She wanted to measure me straight away and so up onto the table I went.

I measured at 95 degrees of bend

The first words out of her mouth were, "You've worked hard!" Yes, I really had worked hard and it paid off. That's 25 more than anyone thought I would ever get. Remember the detail from the bullet point list earlier in this post I said to remember? You can refer to that if you want, but I'm still not done. That isn't me relaxing now that I surpassed their goal and reached my minimum. Not even close.

My surgeon came in and measured, not entirely surprised because being stubbourn and determined are good qualities when it comes to overcoming hardship. The original consultant who saw me back in June, also came into the room to check my measurement. He gave my surgeon a thumbs up on the surgery. The whole room was a bit explosive, with smiles and just pure joy, and a little bit of shock. Even I couldn't believe I was 95. They told me that was the last time they would see me now for a year. Admittedly, I pouted. This team of complete strangers walked with me through one of the most intense moments of my life and after six weeks that was it. My surgeon also prepared me for expecting 110-115 to be my maximum range because of what they got during surgery. I smiled and assured him I was getting a full range of 150. Sarah believed me. I hugged them both and was a little emotional walking out of the room. 

The next day I went to physio and remained at 95 degrees, so I'm maintaining. I was then given permission to really push hard. So I did.

Most days, my physio at home looks like this

I do my home programme just about every hour of every day (sometimes every two hours) and it's rare to do my session without tears. I have to fight for this range of motion because my joint doesn't want to give it to me and it's painful.
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Sometimes it looks like this

Just grit and determination, and pure joy that my leg is bending even that much.
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A rare trip to the outside world on crutches with a lady who also took me swimming for the first time since surgery. I was a PROPER fish. Coffee makes me happy. Can you tell? Also, fresh air and other human beings. Being alive is good.

And this week?

Today was my second to last outpatient physio appointment. I measured at 107 degrees of motion and she put me on a set of pedals. I haven't been able ridden a bicycle since 2006 so this was more than a little surreal.

Thank you fellow authors and readers, for your patience and your love as I recover. 

Answering a few common questions I've received
  • If you want to contribute (anonymous donations available) to the fund, which also helps me keep writing as I recover, it's here on GoFundMe
  • Waldorf Manor Book 7 is at almost 60,000 words with a goal to submit to my publisher around Christmas
  • Sam's Silence and The Marriage Treaty slated to be submitted to my publisher in 2019
  • This is a projected year-long recovery with no standard, because I am not the standard aged 50+ year old patient with an otherwise healthy but worn knee. I am now cleared to go to the gym and do the things I feel I can do, but at not even eight weeks of post op with a prosthesis, I am remaining at home to focus on physio and getting stronger.  
  • If you're interested in buying any Walden School hoodies, duffel bags, hats, scarves etc (see the navy hoodie with the Walden crest I'm wearing in the photo in hospital) email me as I'm getting a supplier organised for other orders.

until next time, Bella xox

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  • Home
    • About
    • Contact
  • Blog
  • Bella's Books
    • Standalone titles
    • Waldorf Manor series >
      • book I, The Solicitation
      • book II, The Shortlist
      • book III, The Courting
      • book IV, The Glass House
      • book V, Unfailing Love
      • BOOK VI, STAY
      • Book VII, How Sweet The Sound
    • Walden School series >
      • Walden, the prequel
      • Gap Year
      • Sam's Silence
  • SIGN-UP
  • WATCH