general anesthesia and post-polio syndrome
June 6, 2021 11:56 AM   Subscribe

Now in a Catch-22 Situation?

I had my second total knee replacement surgery June 1st. This surgery was star-crossed, with lots of miscommunications at several medical levels. The surgeon said he would allow me to have only local anesthesia, as I'd done with the first, but when we arrived at the outpatient Surgery Center they told us there they were equipped only for general. The anesthesiologist told me that he was on my side, that he thought general should be for torso surgery only, but he had to comply with the Surgery Center. They offered to re-schedule at another facility for sometime in July, but that meant that we would lose the current fiscal year benefit of having completely met our deductibles. So we went ahead with the procedure. It was clearly noted in all charts at all levels that I have post-polio syndrome, as a result of having a very mild three-day case of polio when I was four years old. It flares up under physical stress, and sometimes for no reason at all.
By the second day post-surgery, I knew something was seriously awry. I had extreme muscle weakness, especially in my abs, back, and arms, and severe pain when I tried to use those muscles. So I researched "general anesthesia and post-polio syndrome" --which I had not done since before the surgery since I thought I would be getting only local---and found that there are many complications, most notably, a massive flare-up of extreme weakness and neuromuscular pain. There is no treatment, only rest, and it will eventually subside, although any accumulated serious damage cannot be reversed. But time is of the essence for my new knee, and I have to be up and walking to prevent irreversible stiffness in the new joint; a Catch 22 situation. A further complication is that I am a quick healer---the previous joint replacement healed in only five weeks, and the physical therapy could not keep up with it, so to deal with the resulting scar tissue I had to continue over the next year with daily, very painful exercises at home to try to get rid of it.
I don't blame the surgeon---he is very skilled, did his residency at Mayo and is a personal friend---or the anesthesia doc. I realize that the number of polio survivors is a declining demographic now, so few doctors have experience with post-polio syndrome, which remains mysterious, poorly understood.
Hive-minders, any suggestions for how to proceed for best outcome? So much appreciated!
posted by ragtimepiano to Health & Fitness (7 answers total)
Can your rig a way to exercise your new knee while lying flat on your back to reduce stress to the rest of your body? I am thinking resistance bands. It wouldn't be the same as walking on the leg, of course, not remotely, but it would be exercise you could do without needing to stress your torso muscles and other leg and might mean that less walking would be necessary.
posted by Jane the Brown at 12:20 PM on June 6 [3 favorites]

Just brainstorming here. Something to ask a professional about would be: can you avoid as many foods high in those nutrients that help with healing for a few weeks?
posted by aniola at 12:33 PM on June 6

Can a physical therapist work the knee through its range of motion for you, while you rest?
posted by Serene Empress Dork at 12:41 PM on June 6 [5 favorites]

There are knee machines to help move the knee with little action from you - and this sounds like a situation where you clearly should have it. Good luck!
posted by leslies at 12:53 PM on June 6 [6 favorites]

But time is of the essence for my new knee, and I have to be up and walking to prevent irreversible stiffness in the new joint; a Catch 22 situation.

A combination of weight bearing in PT and a passive motion machine will go a very long way here. Talk to your physical therapist.
posted by DarlingBri at 12:54 PM on June 6

I would definitely push for a PT workup that takes the post-Polio syndrome into consideration. It should not be difficult for any good PT/rehab center to accommodate this.
posted by Lyn Never at 1:51 PM on June 6 [2 favorites]

Have you already looked into doing PT exercises while in water? Your PT person or doctor should know what this is called. It makes you less heavy in general and should take some stress off your other muscles.
posted by amtho at 10:18 PM on June 6

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