Eight Reasons I'm Getting a Total Knee Replacement in Vail, Colorado.
“Why Vail?” is always the first response when I tell someone that I am going to Vail for my TKR (total knee replacement)
My reply is often in humor, "Because I want some swanky bling knees!"
But before I get to the reasons for where I am having the surgery, I should answer the why. Why is a 53-year-old is even getting a new knee to begin with?
The journey to TKR began ten years ago while playing tennis. While out on the court, I noticed that my knee pain would keep me from going after the ball as I wanted. Swelling after play was standard and eventually I started wearing a brace. I was told by doctors that I had arthritis in my knees and that it would only get worse with time. They were right.
During those ten years, I gave up most of the activities that I loved; tennis, CrossFit, 9 Round, running, hiking, and biking any distance over 20 miles. I went through physical therapy off and on throughout the entirety of those years. I tried dry needling, exercises, various creams, and had to give up Advil because of stomach ulcers. For me, the choice for surgery boiled down to one question. Do I want to live well now or wait around until some undetermined time?
Waiting would not only prolong the inevitable, but it would force me to miss out on favorite activities while becoming increasingly out of shape. I chose to live NOW knowing that there is no guarantee for tomorrow. I couldn’t imagine just being a spectator while others were being active.
The doctors I saw in Kansas City both said I needed new knees because of “terrible patella-femoral arthritis.” But when I went back to discuss that I might be ready, the Physician Assistant that I saw said he just wasn't sure how much I would like a new knee and that I should hold off as long as possible.....again. I was surprised.
Why would anyone think that I wouldn’t like being able to do the activities I love or even basic things like walking up and down stairs without pain, or chasing a blowing receipt across the parking lot?
After the appointment, I went on a solo trip to Boulder, Colorado. I wanted to get away and practice riding hills/mountains before the Copper Triangle, a 79-mile ride in the Rockies. I had signed up for the ride in the winter and was determined to get in shape so I could complete it as I had seven years prior. As I trained for the ride I noticed that instead of my speed and endurance increasing, it was actually getting worse. I was hopeful that the slow and steady grind up the mountains in Boulder would be okay. And it was! Yes, my knees hurt each night, but overall it was okay. Going at a slow pace and cadence seemed to work.
During that training, I learned that I could still ride my bike but it just wasn’t the same. I was feeling very slow on group rides. My average on our weekly ride around town dropped from about 14-15 mph to 11-12mph. If you ride, you know that’s quite a big difference. My weight is the same, my bike is even better than it was several years before, and my training hasn't changed. And yet the performance and pain was worse. And then there was the part where after a ride I could barely walk up and down stairs or get off the toilet. TMI? Let’s just say that I was ready to re-visit knee replacements.
Before I had even begun making calls to doctors in KC, things starting happening. The alignment of these events can only be described by me as “God Things.” It may be cliche, but to me, it is also true. It is more than a mere coincidence.
So here are the eight events that occurred that led me to TKR in Vail.
#1 It all started with, "Would you like me to take your picture?"
While in Boulder, I decided to head to the Rocky Mountains for the day to ride one of my favorite rides; Frisco to Copper to Vail Pass and back. On my way back from Vail Pass I stopped at the top as I always do and saw a nice couple trying to take pictures of each other in front of the map and trailhead. I asked if they would like me to take a photo of them together and they agreed. I noticed the woman had a blue piece of tape placed vertically on her knee so I inquired, “Does that help your knee?” She informed me that the tape was just there to cover an incision from a total knee replacement she had just three months ago. My jaw dropped.
Are you kidding? She had just completed a HUGE climb. We chatted for a bit and then she asked if I was on the Strava app for cyclists. I knew she would never find me with a last name like “Smith” so I vowed to remember her name so I could find her on Strava later. We connected through the app and agreed to have coffee when I came back to visit in a few weeks.
#2) An important and fun coffee date in Copper.
Paula and I met at Starbucks at Copper Mountain. I had never actually seen her without her cycling gear and even then it was only for a few minutes. I was relieved to see she wore the same kit she wore when I saw her at the top of Vail pass. We made an instant connection and discovered we had a lot in common. We talked all things knees. I learned that she was very young and very fit 71 years old. She just kept surprising me.
One thing Paula shared during our coffee was that if nothing else, I needed to have robotic-assisted surgery. I hadn’t even considered it because I didn’t know it was an option. She sent me a couple of
videos to watch as well as information on her doctor. As I watched the videos during the drive back to KC, the wheels started turning; and so did the stomach after watching a surgery.
#3 My physical therapist had an idea. I mentioned my coffee with Paula to my physical therapist. I asked him what he thought about going to Vail to get a third opinion. In turn, he asked me why not just go to Vail for the surgery? I had considered it, but not as a reality until he mentioned it. We discussed how doctors in the mountains of Colorado, especially in ski areas, are really in tune with younger (if you call 53 younger) people and their goals. An active lifestyle is THE lifestyle in Summit County in the Rockies. When I say I want to hike and ride bikes in the mountains, it’s really not as fancy or difficult as it sounds. But I wondered if doctors just didn’t realize how important it was to me. Both of my doctors in KC advised that I dial back my activity, and I was not willing to do that while I sit around and wait to be “old enough,”
I checked to see if either of my KC doctors did robotic-assisted TKR. Neither of them did. All of the sudden getting my knees done in Vail sounded quite appealing.
#4 “You are the 5th caller....Please hold.” I started my search for robotic-assisted TKR in the KC area and found one place. When I called I was met with a message and put on hold. While on hold for a few minutes. this gut feeling just washed over me. If I was going to have surgery, shouldn’t I be able to get in contact with the office? It just wasn’t a good sign for me so I hung up and moved on.
#5 The receptionist was from KC! I called the office in Vail thinking that I must be crazy to be even thinking of doing this, but I did it anyway because I was curious. The lady that answered was so kind. She told me that they often had patients from out of state and even out of the country. When I gave her my address she announced that she had just moved to Vail a few months ago and really missed KC. She was excited to chat all things CHIEFS. It really calmed my nerves and made me feel not quite as ridiculous for considering surgery out of state.
#6 My doctor is in-network. I forgot the importance of researching TKR surgery from an insurance standpoint so I was relieved to find out that he was in-network. A small, but important part of the decision.
#7 Meeting the doctor: Jay and I drove to Summit County and stayed in Breckenridge for the initial doctor appointment.. Vail Summit Orthopedics has several offices in Summit County and this one was in Frisco. It was a bit surreal to drive up to the hospital and offices that I had ridden my bike by so many times. The Rec Path from Breckenridge to Frisco is my absolute favorite and one that I hope to ride often without pain someday.
There I was sitting in an office surrounded by pictures of extreme athletes and Olympians. Although I am none of these, I knew I was in the right place. The subtitle of the practice is "keeping you active," which spoke volumes to me as I waited.
While waiting in the room, I clutched my X-rays and MRI in my hands and was ready to present my case. The thing is, the doctor didn’t really doubt my need for surgery. He just made sure I knew how difficult the first couple of weeks would be and then went through logistics with his surgical nurse. I made a pre-op appointment and was sent home with directions to get a physical from my doctor in KC to clear me for surgery.
This was really happening.
A few days later, I met Paula again for coffee and she gave me tons of tips, mostly revolving around the importance of PT. To have someone that has been through this and had incredible results share these things with me gave me so much peace. I felt like I had a plan. I made a PT appointment for when I came back again for the Copper Triangle. Yes, I still planned to ride this 80-mile, 6500 feet in elevation ride in the mountains.... if I could.
#8 Hailey called me from a party one night…..and asked the name of my doctor in Vail. I texted her the name and then called her inquiring why in the world she was asking. She was at a party standing next to the guy that was my doctor’s shadow student last semester! How in the world? Well, the student is from Vail which made sense, but the part where he was standing next to my daughter? Seriously. You can’t make this stuff up. I got to chat with him and he said only amazing things about my doctor. Another wave of relief!
Those are the eight defining moments that helped make the decision to have surgery in Vail. The story continues with my next trip when we got to have dinner with Paula and her husband and I got to go to my PT appointment for some pre-therapy exercises.
Several people have asked me why I can walk just fine and don't seem like someone needing new knees. I suppose they ask because many people have an obvious limp before TKR. The type of arthritis I have affects mostly the ability to load the knee when climbing stairs, getting up from sitting etc.. The other thing to note is that due to the many years of physical therapy I have had, I have learned to use many. other muscles to compensate for what my knee should be doing. I had to re-learn how to walk upstairs, and I ride my bike using more glutes and hamstrings than quads. And remember that I want to maintain my active lifestyle and NOT be in a position of being. sedentary due to my knees. As a friend said, "Get the knees and use the shit out of them." And that is exactly what I plan to do!
I head back again September 13-15 (on a plane this time) for my pre-op appointment where I will get to ask all of my questions and they will take the fancy X-rays that will design my new knee. It’s a short trip, but I plan to bring my hiking boots and hike as much and as far as my damaged knees will take me. I wish I could get both done at the same time, but I am not that crazy, Plus, this way I get to just keep returning to the Rocky Mountains:)
The surgery is at the end of September. We plan to go out for 2 weeks. My mom will be there for the first week and then it will be Jay and me for the second week. I will have my post-op appointment and head home until the next checkup. I can’t say I am sad about having to go back to check in with my doctor and have more hikes, bikes, and coffee dates with Paula who has been a tremendous support!
Stay tuned for updates as the story unfolds. Hopefully, if you find yourself needing TKR you can look back at my story and feel prepared. I always feel like if there is anyone that can benefit from something I have experience, then it's a win!