R-6-1

The Great Recovery

It was Friday the 13th when my father went under the knife and had major knee
reconstructive surgery. He needed three ligaments in his knee replaced and one of those
ligaments would be coming from a cadaver. The procedure took about two and a half
hours but, to my family and I, it felt like a lifetime. Although my father is perfectly
healthy forty five year old man there is also the what if questions or the what would
happen. My fathers recovery would about a years worth of time, before he could even
attempt to do normal everyday things such as running. The surgeon used told my eagerly
waiting family that he did not throw just the sink at my father, but the whole kitchen. My
father would have to be on Government Disability for three months then nine months
worth of physical therapy to go along with that. For a few months, I was the one driving
my father twice a week to his appointments. It was going to be a long road to recovery
and my dad had to be physically and mentally ready and capable. I remember seeing how
mad and disappointed my father was at himself because he was not able to walk or even
do something simple like bend his knee. During my time at my fathers appointments, I
would see many other patients who were also going through various stages of their
recoveries after orthopedic surgeries or injuries. Watching these people go through these
physical obstacles is when I realized that I really wanted to get into physical therapy and
learn more rehabilitation programs.

I, myself have gone to physical therapy for various body parts. On my last soccer
game of the season I injured my ankle badly. I was going to therapy twice a week for
three months. The second time around I had a hip problem and was going twice a week
also. I have always thought that physical therapy was interesting because you are able to
do various exercises to strengthen certain parts of your body. I was going to a therapy
office that specialized only on kids. I was seeing many kids my age who were having
knee surgeries, ankle surgeries, and shoulder surgeries. When talking to these kids they
were telling me how hard the recovery is and how they would never be able to play or do
certain things again, and it was astonishing to hear how all these young kids were having
these major surgeries. In Sports Medicine class taught at Northgate, Glen Barker would
always teach us about injuries that required surgery and all the challenges that person
would go through after. It was fascinating, to learn how to rehabilitate that part of the
body with physical therapy. This led me to my question: What are the challenges
someone goes through after a major orthopedic surgery?
It is an office building and the least likely place you'd expect to find a physical therapy
facility. Once you walk in, the place itself is only about the size two to three classrooms
put together. It has three walls and one of the sides of the room made up of all windows.
The receptionists desk is on the right side of the room as soon as you enter. The other
two walls are lined with five tables that are used to evaluate patients and exercise
machines and the last wall has a sink built in and it is adorned by a large television.There
is a tiny waiting area that has only four chairs that all face each other with magazines
spread out on a table right beside the chairs. In the back of the room are all of the exercise
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machines, weights, and some yoga balls. There is a slight funky smell lingering in the
air. It smells like sweat, dust and a light aroma of the cleaning supplies that are used to
clean the tables and the machines. There are a few people in the room speaking lightly.
The sound of a physical therapist encouraging their patient to try harder and the
receptionist saying to another your co-pay will be reaches my ears. There are are a
total of three therapists working on patients and a few people are sitting in the waiting
area waiting for their name to be called. Most sessions are a minimum than forty five
minutes but no longer than an hour. There is a steady stream of patients walking in and
out of the office. I walk across the room to the therapist that I will be helping and I begin
to introduce myself to the patient.
Over million five million orthopedic surgeries are performed every year. Orthopedic
surgery is a surgery performed on the musculoskeletal system. Just like its name it is a
procedure done on either muscles, ligaments or bones. The most common orthopedic
surgeries are a joint replacements, shoulder surgeries, spine surgeries and knee surgeries,
those are only a few of the many procedures that can be done. Orthopedic surgery can
also be done on bones that have been shattered and need to be repaired. An orthopaedic
surgeon is involved with the care of patients whose musculoskeletal problems include
congenital deformities, trauma, infections, tumors, metabolic disturbances of the
musculoskeletal system, deformities, injuries, and degenerative diseases of the spine,
hands, feet, knee, hip, shoulder, and elbow (AAMC.Org).
There are many challenges that occur after someone has had surgery done such as
money issues. Many of the procedure done by orthopedic surgeons can take months to
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recover from. The surgeries themselves are very costly and if one does not have good
insurance than they will drown in medical bills. On average, surgery can cost about
$25,000 to $30,000 including consultation fees (New York Orthopaedics and Sports
Medicine). Even after the surgery there are even more things a person has to pay for.
Most patients will require about nine to twelve months and twice a week of physical
therapy after. Although many insurances cover most of the surgery there is still a good
portion that they do not pay, and every physical therapy appointment there will be a
copay ranging from fifteen to thirty dollars depending on how much your insurance pay
for. Imagine having a copay of twenty five dollars every session and twice a week for at
least nine months. That means that $1,800 will easily be coming out of a patient's pocket
directly. Most of the serious procedures will require at least two to three months of
complete rest. That means that patients who get these surgeries will not be able to work
for those eight to twelve weeks. Most companies will not pay their employees who are
not working. It can really put a financial strain on families who are dependent on that
income alone. Sure, a patients and their family can receive Social Security benefits; also
known as Disability, from the government but they will only cover about half to sixty
percent of your monthly earnings. The forty percent that is not being given can really
benefit a family who is living paycheck to paycheck. If someone is only getting paid sixty
percent of their income and yet they have many medical bills to pay it starts to take a big
financial strain on most families. Besides the surgery and therapy that one must pay for,
there also are more tests that most insurances will not cover such as X- rays, MRIs, and
Ultrasounds. The average monthly expenditure for orthopedists nationally was
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calculated to be $33,436 per physician (NCIB.gov). The average american income is

$51,000, and if over half of that was going towards medical bills then, many people
would struggle to keep up with their expenses. If one does not have enough money to pay
all of their medical bills then it will affect their credit score and it will significantly hurt
them in the long run.
Surgery is the one thing most people hope to never have to go through. Surgery is both
mentally and physically draining. After surgery most people can expect to be in a great
deal of pain once the pain medications begin to wear out. Sean Fernald who is a
registered physical therapist assistant at Spine and Sports Physical Therapy clinic
mentions, Most patients can argue that a few hours after surgery is the worst pain they
have ever felt in their life (Fernald). Severe pain occurs in about twenty to forty percent
of patients. The most common surgeries such as shoulder and knee have been reported to
be some of the most painful procedures that one can have. Many people who have
surgery may not have someone to take care of them after the procedure which makes it
very difficult for the patient to recover. Besides the surgery, the recovery time will take
even longer. Lets say someone got a knee reconstructive surgery, it would take at least
nine months of physical therapy to be able to bend their knee fully and it would be about
a whole year later before they are allowed to even begin thinking about doing some light
jogging and activities that are not very strenuous. Many of the patients at the Spine and
Sports Physical Therapy mentioned, how difficult it is to get on with their lives since they
are unable to do the activities that they are so used to doing, and how challenging it was
to do something as run. Stephanie Kalivoda is a certified physical therapist who also
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works at Spine and Sports Physical Therapy and sees a wide range of patients a day but a
majority are recovering from orthopedic surgeries.
Many of the patients we see here at the clinic want to rush their progress so they can get
back to their normal lives. But they do not understand that recovery is a long drawn out
process (Kalivoda). Many people do not realize that orthopedic surgery is a big deal and
no one can expect to recover in a couple of months, which is why major surgeries are
physically challenging.
Orthopedic surgeries are also mentally challenging as they are physically. It is very hard
for patients to deal with the fact that they can not do the same activities they once were
able to do before the surgery. If a patient was to tear a ligament playing soccer, after
surgery many will not be able to comprehend the fact that they will never be able to play
soccer the same way after surgery even if they are allowed to play at all. A patient that I
met in the Spine and Sports Physical therapy clinic David Ortiz who is a twenty five year
old who just had undergone knee surgery. He had just been told by the surgeon to not
continue playing the sport that he injured himself in the first place. After surgery, it was
heartbreaking when the Orthopedic surgeon told me I should not play basketball ever
again (Ortiz). After surgery, patients expect to be able to get back on their feet in a few
weeks but, many are upset when their progress comes much slower than they anticipated.
A few of the times while working with Sean Fernald the physical therapist assistant,
many patients would ask when will I be able to play this sport or when do you think
this and the looks of disappointment on their faces when he would tell them, that will
not be possible or not for a while. Even before the surgery can be mentally
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challenging for people. Most patients will report getting anxiety and emotional before
they even are operated on. Many are worried about how much the procedure will hurt or
what if it goes wrong and it does not work. Depression after undergoing a major surgery
is more common than most would think. Some of the factors that can lead to depression
are decreased mobility, increased dependency on others, pain or discomfort, and side
effects of medication. The Journal of Evaluation in Clinical Practice found that 28 out of
56 people that have gone knee surgery have claimed to be depressed before leaving the
hospital. Post-operative depression often results in changes in appetite, reduced energy,
and feelings of sadness about your state of health (Healthline.com). I had a first hand
look at that with my own father after his knee reconstructive surgery. It took a mental toll
on him and there were days when he was very sad that he still could not walk or bend his
knee too much. Major surgeries do not only affect the patient but it affect the families just
as much.
The families of people who have just gotten surgery are affected just as much as the
patient. If one is lucky enough it is going to be a family member who will be helping the
patient when they are recovering. They will be the ones driving the patient to doctors
visits, therapy, and helping them shower and use the restroom. It will take effort from
multiple people to help a person recover from a surgery.
When people hear the word surgery, most will visibly cringe because there are many
negative connotations associated with that word. Surgery is not a fun thing to go through
nor would anyone want to go through it. Until people get surgery, they do not understand
the full extent of all the challenges someone goes through. Getting Orthopedic surgery
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poses great financial problems to many people and the cost for medical attention is
steadily rising and to people are getting these through the roof medical bills that are
impossible for them to pay. The mental barriers are just a few of the many obstacles that a
patient goes through after a major surgery. One would never believe that a surgery could
cause depression but it is very possible. Any type of procedure will take a toll on people
but a major procedure will always be extremely hard to come back from. Which is why
anyone who is going through or will be getting a major operation done needs to be ready
physically because they will be going through a lot of pain. Going through a surgery can
affect the whole family or anyone who is involved with the person. But, even after all of
these major challenges someone faces after a major surgery, the best feeling in the in the
world is to see a loved one overcome these obstacles and slowly return to their normal
life.
Major orthopedic surgeries will always be hard to recover from regardless of how strong
mentally and physically that person is. Orthopedic surgeries are very costly and a person
needs to have good insurance to cover all of the incoming medical fees. After having the
surgery the recovery process can takes months or even up to a year. It requires many
hours and sessions of physical therapy. The recovery process can be physically
exhausting and many patients will become angered if they do not see any immediate
results. After any orthopedic surgery it was quite surprising to find out that many people
can get depressed after having the operations. The road to recovery although it can be
tiresome in the end it can produce life long results (Kalivoda).

Almost six months after the surgery, my father is fully capable of walking without his
crutches. He has to wear a brace for all hours of the day and he has the ability to bend his
knee. He still has a long way to go before he can even think about doing any running,
jumping or any other strenuous activities. My dad has his goals of being able to step back
out into the soccer field and play again, and he hopes to achieve that milestone by the end
of the year.

Works Cited
Books:
Baheti, Neeraj D. Physical Therapy. S.l.: Jaypee Brothers Medical P, 2016. Print.
Bennett, James P. Physical Therapy: Theory, Practices, and Benefits. New York: Nova Science,
2011. Print.
Electronics Sources:
APTA. "My Clinical Collections." Benefits of Physical Therapy. APTA, 2016. Web. 17 Feb.
2016.
Sears, Brett. "What Is Physical Therapy?" About.com Health. Brett Sears, 4 Apr. 2012. Web. 17
Feb.

2016.

Primary Sources
Kalivoda, Stephanie. Physical Therapist, Spine and Sports Physical Therapy, Concord CA.
Personal Interview. 4 March 2016

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