Journal of the Knee Year Bob Belinoff 323-804-1387 bob@digitalwkshop.

com

OCT. 17, 2012. REVIEW DRAFT ONLY

My New Knee and Me.
Feb 28 . I wake to find my right knee swollen to the size of a casaba melon. It is unable to bear hardly any weight at all, let alone a run around life I had been perfecting without incident since 1946. It could well have been a pain in my chest a heart attack or the sudden dizziness and word slurring of a stroke, but, energetically speaking, I was deeply in debt. Something wanted to give and for me it was my knee. It was, in fact, the evening of my sixty fifth birthday. In its honor Julie has taken us to a fine dinner at the exceptionally over-priced Jassbah on Gold street no matter, dinner with my wife was grand and we topped it off first with two shots too many of Hennessey and then by dancing at the El Mercado down the street. Great time. But this morning is something else. I take a double dose of fish oil and head to work. Wish I could walk. A dream last night that I was lost. March 1. My left knee barely supports me this morning, but this has happened before. I take more fish oil, limp to the car and drive the twenty miles into town. I flop into my chair at the office. Were working on three or four things, one is a docu-type film on education; projectbased learning here in New Mexico. Two are films on nutrition and obesity, for the State of California. Im a little too busy for a guy whose been doing this for so long. I am ready for a new adventure, but I wasnt expecting it to be about my knee. I call and make an appointment with Dr. Tabet one of the senior members of the premier orthopedic group in the state.

Im going to try Turmeric too, the Indian herb, they say it works best with black pepper. March 3. The waiting room at New Mexico Orthopedics is big and very full. This is the most happening place in town. Dr. Tabet looks at my X Rays.gives me a shot of Cortisone and sends me out the door as another man, about my age limps in. Ok. Im Out of action for a few days, could be more. Good I can use the break. The diagnosis, Dr. Tabet told me, is this; x-rays reveal severe osteoarthritis and a bone on bone situation in my right knee. There is no cartilage there to cushion the rubbing of thigh bone on leg bone where they meet under the knee cap. I have ground that cartilage down. How? Apparently through no end of martial art and aerobic workouts- running, stair masters, etc. all efforts designed to improve the function and prolong the life of my precious organs, superstructure and various moving parts. I am a victim of my own ambitions to attain maximum health the acquiring nature gone mad and structural capitalism at its worst. Shit. What about a knee replacement?, I had asked. Lets see what happens with the Cortisone, Dr. Tabet says. At home its more Fish oil and Turmeric, (Julie says black pepper doesnt work) ..and capsules of ginger this morning as well. I can fix this. Another dream last night about being lost.on the side of the road.

March 6 My knee is not getting better. Dr. Tabet gives me another cortisone shot but so far nothing has had any effect whatsoever. Guess it takes a while for the ginger and Turmeric to kick in. I stopped eating red meat. They say red meat is not good for the joints. Hmmm, works for cougars. What do I know? . it was easy to stop with the red meat, Julie doesnt eat meat anyway.

March 8. Basically, I am screwed. The cortisone isnt working and no more Cortisone, says Dr. T. Next up Hyaluronic Acid. A shot of this new miracle lubricant should help, Im told. The regimen calls for three shots over 3 weeks. That means I have to wait almost a month before considering other alternatives. Is this a good idea? Yes, I think. Replacing a body part with chrome and plastic should be the ultimate last resort. Who knows .the body has truly miraculous self-healing powers and, like Ive done everything else myself, I can heal this myself. Maybe. March 11. I go to work but I can barely get in and out of the car. I struggle up stairs. I dont sleep so well either. March 13. Another shot of Hyaluronic Acid. No effect so far. Dr. Tabet leaves me sitting on the edge of the exam table facing, as far as Im concerned, the end of my whole runaround world. And right there I begin to enter a tunnel of horror. I am off the playing field, all but immobile . Watching from the sidelines as my solid, dependable, trustworthy body goes on hold. March 15. At work projects move ahead without me. We shoot in Sacramento tomorrow, I wont be there. Fine. Nothing matters now but the fact that my body has failed me, and after lying around for 2 weeks I am watching myself decompose before my very eyes. We live on an acre of incredible land out side Albuquerque, New Mexico. Our fence needs fixing, branches have to be trimmed. I was in the middle of building a shed on weekends. Life has stopped. Just in time for Spring. Interesting. March 20 Another shot of Hyaluronic Acid today. Three injections, of this natural lubrication made from the combs of roosters and administered over a period of a month. The

affects for many have been nothing short of miraculous, calming the inflammation and postponing further action for years. But for me, so far, it does nothing. Maybe I should have gone directly for the knee replacement. But there are horror stories, sometimes they dont work. No? This was the right choicebut Im dying here. I wait for the Hyaluronic Acid to kick in. I Take more turmeric and fish oil capsulesand wait for my appointment next week with Dr. T. March 21. I limp into my office, actually the pain is getting worse and so is the swelling. I look at the footage from the Sacramento shoot but cant concentrate. I look around at the awards, the film editing equipment, the cameras, the tapes, the guys working in the other room. I am a veteran, a pro, an expert, that means people pay me and pay me well for endlessly repeating myself. I am a run around and make it happen guy, struck down at the peak of my profession. Cant sleep. I get in our bed at 10, by midnight Im out on the couch. I flop around for four hours, doze off about sun up. March 22. My dear departed mothers birthday. Spring. I dont even leave the house anymore.

March 23. My Life is on Pause The film projector has stopped, freezing in a single frame me stretched out horizontally. I dont say much or even think very much as I flop around the house from couch to couch. Later this afternoon the tree guys come to take down dead braches in the front and back yard. Big strapping men with muscled torsos and fine working knees. They sling power saws and machetes. The little band is led by a hulk of a man named Ivan. He sees me slouched in a lawn chair and says he has bad knees too. They want to give him shots of Hyaluronic acid. I feel helpless now but not completely alone. Real men with bad knees, in all walks and professions, there must be millions of us. 4

There are, I learn. Over half a million of them a year here in the U.S. will have their knees actually replaced with a prosthetic. Another sleepless night last night. I toss and turn on the couch for 7 hours, while the whole world sleeps. This is exhausting. April 1. While I give the accumulated Hyulauric Acid shots tome to maybe kick in I try visualization. I visualize little cells in the blood around my damaged knees scurrying around carrying off the fluid swelling my knee. The mind can create health at the cellular levelI have read this! I know this is true. Dr. Bruce Lipton did a wonderful job explaining the mechanics of this bewildering ability of the mind and body to heal in his wonderful book, The Biology of Belief. I interviewed Bruce for a film, I spent the afternoon at his house in Santa Cruz as he explained all this to me. I know this is true. April 3. This will not do. Visualization smisualzation. Rooster combs, smooster combs. The Hyaluronic acid has done nothing for me. I lie in the living room on the old couch we have come to call it the dog bed! Julie comes and goes, making me healthy food. She has contacted her doctor friends in India. They practice Ayurvedic medicine, a traditional natural healing process, very effective for maladies of the joints. They say fly right over. Dont let them cut you open.- or do one of those dreadful knee replacements the Ayurvedic doctor emails me from Coimbatore in south India. We can treat this, he says. Maybe he is right. Several years ago I spent three weeks with Julie in India at an Ayurvedic hospital. Ayurveda is the centuries old practice of healing based on the idea that given enough rest and a concerted effort to eliminate all toxins, the body can heal itself. I believe this. But I do not have time for this therapy I am an American! And it could be that in this digital age, things like dysfunctional knee joints can be more miraculously addressed with technology and science. I understand this. So I make an appointment to get Abyonga Massage. Albuquerque is a world center of Indian Medicine and one of is leading practitioners, Dr. Sunile Joshi, has an office here, where Indian trained members of his staff offer Abyonga, 5

traditional warm oil Indian massage as well as oils and tinctures and herbs and compounds of herbs in pills of brightly colored shades of turquois, ochre and blue. Meanwhile I go back to visualization, something I can do without leaving bed. Again, I visualize white cells carrying away the detritus from my knee and the swelling retreating and me playing second base, like I did as a kid. I get calls from clients. I dont call back. I have nothing to say. April 5. I limp to the car and Julie drives me to the doctors. I ask Dr. Tabet when we can do the surgery. He says he has no openings for four months. I cant wait, Im losing hope and weight and energy. I have no sense of purpose and not a trace of the spiritual connection to a vast cosmic dance that I spent so much time contemplating and meditating on. I have become a wash rag! I plop myself from bed to sofa to bed. The hell with my white blood cells. Today I dont have the battery power left to visualize anything but my own demise! I can think of nothing beyond I cant believe this is happening to me. Maybe Im dying. Yes, death must come but at such an early age 65! This cant be happening. This is not me! But, if this is not me who is me? And what am I doing here? April 6. Today I start calling other knee surgeons to see who might have a surgical opening. There are over 25 doctors in Dr. Tabets group. Some have published papers and presented at major knee replacement forums all over the world. But they of course have no openings for months. Also, there are only so many places you can do this kind of surgery in Albuquerque, and apparently only so many days in these suites reserved for knees. I hear Julie rustle papers or cook in the kitchen. I lie one the couch, where I had dumped myself and re-count my life story. Where is Lyle Manchik? What happened to Lee Word? Richard Factor? I Revisit old projects and momentous life events; old girlfriends, my fathers death, my daughters birth in a San Francisco 6

hospital, my sons birth at home.I remember eating scrambled eggs and Champaign with his mother an hour later. I remember the time as a 12 year old, steeling a basketball from the Jewish Community Center and getting caught. Making love in the moonlight, behind the stadium.I once spent an hour with Bette Midler in her closet looking for something to pose in for a publicity photo. I smoked a cigar with George Burns and at a cocktail party, at the age of 25 debated Daniel Boorstin, the acclaimed historian - and I have a picture of him and me at that partyhe looking very bored. I couldnt believe this very same person was mortal. Me. My parts were going. At some point I would die. April 8. Julie makes me eat more fiber. I double down AGAIN on fish oil. I do not want to move. But I have my Abyonga massage today. Julie drives, I limp into a warm dimly lit room, hoist myself on a padded wooden table where a kindly, burly man spends an hour plying log slow strokes of hot oil to my body, focusing on my legs and knees, my head, the bottom of my feet. Later, at home Julie takes me through a short course of restorative yoga postures. A foam block under my back stretches me out. I just lie there feeling everything go to pieces, complete release.every thing I couldnt acknowledge or describe came falling out of me and I cried and cried. Something just released. Afterwards when I stand up, I stand a little straighter. Ok. The yoga has made it so I can face the world. But by late afternoon I am back in the sack, starring at the ceiling. Here it is Spring and so far the earliest opening anyone has for surgery is Thanksgiving . Ill be dead by then for sure. .the early death option is fine with me, except for all my stuff, what happens to all my stuff? April 11. Sunrise. I wake with thoughts of death and dread. Here it is in one fell blow the sudden realization that I am assuredly headed for the end. Well, what then is all this about these last sixty years. And who in the hell am I, any way? Now these are the basic questions of a spiritual life, something I thought I was 7

living, more or lessI am astounded that I cant answer them forth width and more astounded that I find myself asking them at all!

April 13. I find a surgeon with a surgery slot, first the audition. OK. I have an appointment in three weeks, no opening before then, and if he accepts me as a candidate he actually has an opening for a knee replacement surgery in six weeks. I should have reserved a surgeon months agojust in case it came to this. I could waste away to nothing in three weeks. This isnt Canada, this is America, where is my surgeon! April 21. Bummed and dumb. I have lost another 2 pounds this week, that makes 15 pounds since this knee thing began, and I was slim to start with. I gobble pain pills, Percocet, one after another. I look gaunt and have no appetite, not that I can sit at a table and eat if I did have one, my knee wont bend. I am, if I sit at all, hunched over, like an old stuffed cat. I havent thought about work or politics or food or sex in a month. My chest has caved in, my eyes have sunk and my penis has completely disappeared. April 22. Another day slouched in the dog bed like a stuffed animal. I pick at body arts; my scalp, my nose, my ears. Ive become a monkey. April 23. I wake this morning after an hours respite and a typically fitful night -- with a debilitating pain in my wrists. My wrists! Within the hour the agony has spread to my fingers and elbow and shoulders. It feels like the osteoarthritis that had attacked my knee had advanced overnight to the other crucial joints in my body. I call the Doctor who assures me this can not be the case. There is no connection. Well then fixing my knee wont help me. I am a dead man.

Suddenly, with the pain in my neck, my wrists, my shoulders I can hardly even lift myself from the dog bed, let alone open a box of corn fakes or hold a toothbrush. How can I have surgery, I cant even brush my teeth! I will not survive five more weeks of this until my surgeryif the good Dr. indeed takes me and still has a June slot open. May 1. Now, after a life time spent running a round and getting it done the fact is, as I see it, I am looking at a long dark slouch into pain and an early death all those films and fences! The kids and books and learning and work in a few months I will be dust! The offices and cameras, 10,000 hours of precious footage and sheds full of keepsakes and journals , little pockets of money stashed in banks here and there and who knew where. What about all my stuff! May 3. Along with fish oil and turmeric I now take body builders protein powder mixed with juice to try and put on some weight. What happened? I had every base covered. I was determined to push back the encroaching affects of age. I swam every day. Took all manner of vitamins and herbs and fish oils For every day I grew older, I would grow younger by two I would at this rate not only remain young, but forever but forever starting fresh and then, of course, I would go on and live forever! Instead I am like a freight train flying off the rails into a ditch - The knee alone was enough to derail me. Now ,with this arthritis all over my body I Am surely headed off the side of the cliff. I cant move, I have no appetite, probably because of the pain killers Ive been taking for weeks Where is the yoga now that I cant even lift a butter knife? This is insane. May 4. Im thin and exhausted, you can push me over with a spoon. 9

May 5. I Google Dr. Tripuraneni; A fellowship at Stanford, Residency at George Washington University. He has done hundreds of knee replacements. Thats good enough for me. Great. Young, comfortable with technology. Hes the man! I see him tomorrow for the initial appointment and appraisal.! And still I can not sleep. May 6. Dr. Tripuraneni looks at my knee, feels it here and there. He looks at the X Rays, says I have two choices. A full knee replacement or a partial knee replacement. He recommends a full knee replacement and, as hoped, has a surgical availability in three weeks. I sign on immediately. Dr. Trip is quick and compact. He is Indian. His family is from India, excellent. I wasnt going to go back to India. Now, India has come to me. He looks like an athlete, a runner, low hurdles perhaps, not an orthopedic surgeon, who, traditionally, is large boned, not unrelated in the professional family tree to construction guys and steel workers professionals who man handle structures, cut, saw, make things work, drill and screw things together. He is very directive and in charge. Good. Even though he is an Indian he seems to harbor no special love for Ayurveda or natural healing. Good. The hell with natural healing. His job is to cut open my knee and replace the joint. He deals in chrome alloys, cement, plastic and highly precise measurements and adjustments with sophisticated state of the art digital medical equipment used under sterile conditions in incredibly close quarters. For a dying man, I am elated. Why did I wait so long? This is 2011. Get a new Fucking knee.

May 7. I preview the Surgery on You Tube. Big Mistake. Despite the science and engineering, there appears to be very little that is delicate about knee replacement surgery. 10

I watch a knee replacement surgery on YouTube. This I did not need. Talk about an assault to the sacred vessel! I saw curls of smoke coming out of freshly drilled holes at the ends of tortured and bloody long bones.Ever try to separate a chicken leg from the thigh bone at the dinner table something like that, I figured, would have to be done to my knee. Along with all the precision instrument work, there was a lot of pulling and twisting and stretching. I need to gain weight, Dr. Trip had told me. He gave me a handful of pre-surgery requirements, pages of things to do; dental exam, blood tests, heart, lungs. At last I have something to do! They are 350,000 knee replacements done in the world every year. Just knees, not including hips. Success rates are about 95%. This is a science, They have figured out how to do this. The operation is done in special operating theaters with specialized air filtering systems, theyre called laminar flow rooms. The surgeon and others assisting wear attire that looks like space suits. All this to help avoid infection, which at Presbyterian Hospital, where I will have this done, they have succeeded to an astonishing degree. The infection rate for this surgery at Presbyterian is .01%. This is science gone wild. They can give you the day and almost the hour when you move from walker to cane, they can tell you just when to go from 6 Percoset a day to four. Theres nothing experimental here. There is nothing mystical here. No smoke and mirrors. I am on a train, the train is moving forward.

May 8 OK. Things are looking up. Attitude is everything. I go to my Google bookmark; total knee replacements: The knee I learn is a masterpiece of structural engineering, it is not simply a hinge that goes back and forth. It is a nexus of bone and muscle, a living, it might even be said breathing, self-lubricating contraption with built-in cushioning called cartilage and a binding and suspension system of ligaments and tendons impossible to reproduce in a plastic model like you see in the doctors office, let alone in an actual in-body prosthesis. These things are made by God and attempts to replicate the product have, until recently, been clumsy at best. 11

Knees and hips have been going out forever, as all body parts eventually are wont to do. But knees and hips, I learn, bear the weight of our longer life spans especially inelegantly. Surgeons have been trying to remedy this with artificial joints starting in the 1920s with, believe it or not, molded glass. In the 30s they started experimenting with cobalt and chromium alloys. You have to pity the desperate souls on whom these experiments were such devastating failures surgeons hammering and sawing and chipping away at their innards but such was the crisis in life and motion that patients subjected themselves to unimaginable tortures with the hope of once again being able to face life squarely in the eye - or at least sit down for dinner or bend down to tie their shoes. May 9. The day is spent slouched in the dog bed looking at paperwork and filling out forms. Who pays for this stuff? Everyone apparently. Thank you everyone. Medicare will cover the whole thing. $60,000 dollars or more. At my age, I am just in under the line and between Medicare and my supplemental insurance this new knee, if I get it, will be almost completely a government job. I wonder what will happen with my sons knee, he has a cartilage problem too as will some 70% of the people over 60in ten years knee replacement will be $100,000 - out of pocket. Some people travel to China and India where technical medicine and parts replacement is state of the art and at the heart of a booming medical tourism industry low cost and, they say, all but perfected. Knee replacement in India at a top of the charts medical hospital can be done for $5000, including spa-side recovery in a resort on the South India Sea. Hmmmm. Were that I werent such a Bratwurst and Brooks Brothers kind of guy.

May 10. I have begun a journey, even though flat on my back most of the time I am moving forward. I am on track, I have a list of things to do! Life has meaning! I go where the track goes and hang on to my hat. There are the blood tests and lung function tests and clearances from my primary care doctor, as if I had one! I find one on line and make an appointment. 12

A dentist needs to check for needed dental work and do it an artificial joint, like a knee, attracts bacteria whose most likely entry point to the sacred vessel is the mouth, so any poking around in there needs to be done before the surgery. I have to write a will and find an attorney to help me shape it up in case things go badly. At Dr. Trips office the other day I was given a 20 page print-out of how best to prepare for my return from the hospital after surgery Ill need a cane and a walker and a toilet seat riser and bandages and special leotard-like tight fitting hose to lessen the chance of a blood clot in my legs, I have no idea why tight hose should prevent a clot, but I will do as I am told. Julie and I will need to attend a pre-op patient education class. I feel like Im about to join a club! Membership has its perks. Once I go to Motor Vehicles, Im told, with the paperwork the doctor provided, I can apply for a handicapped tag to hang from my rear view mirror once I am able to drive. I wonder if I get a new knee warranty or cane-side road service. Towing perhaps. As God likely said to Moses before he descended, commandments in hand; theres nothing like a to-do list to rally the troops and get ones head screwed on properly. Even the pain in my wrists and shoulders has let upmaybe its my improved mood. I can even knock on a jam jar lid with the back of a knife and open it. Life is good. May 18. Rehab class. There are fifty people here in all shapes and sizes. We are in a classroom at the new Presbyterian Rehab Hospital. Most everyone but me seems fairly mobile testifying to the elective nature of the surgery we are all about to undergo. I am one of the few sporting a cane and a grimace as I make my way to a seat in the classroom. Rehabilitation specialists take turns telling us, and those we have chosen to assist us after surgery, what to expect. We are told about post-surgery pain and how to gage it one to ten is the scale and how to manage it keep it below 4. Take as many pain pills as you need. Avoid pain. Beware of nausea and constipation, there are pills for both. We are told about Coumadin, a medication I must take to prevent blood clots. While on Coumadin Im told to avoid foods rich in vitamin K, these are dark green leafy vegetables that do naturally what this pharmaceutical, apparently does artificially 13

go figure.The drug industry is clearly in cahoots with the medical establishment to prevent the use of any treatment that would hamper the miracle of nature or threaten the growing economy. My blood will be drawn twice a week while Im on Coumadin to make sure Im getting the correct dosage.better, it seems to me, I should just eat more spinach. Whatever they say...I dont care. Onward. May 26. I continue my internet reading on knee replacements. Apparently in 1968 the first metal and plastic artificial knee met with the right kind of bone cement to make the knee replacement a real possibility. They were said to be 95% successful but horror stories abound, replacements that didnt fit, had to be re-done, infections and complications from a procedure said to be more invasive and tumultuous for the body than most heart surgeries, including quadruple by pass. The end of my femur will be removed and refitted with a metal sleeve, I learn. The end of my tibia will be replaced with a high density plastic. The hinged joint of the knee completely removed and replaced with a new Stryker Scorpio Knee with a modular rotating hinge. Stryker, I look this up, is based in Mahwah, New Jersey and they are the largest developers and manufacturers of total knee replacements in the world. One week until surgery. May 27. Four days. I go with Julie and we buy a toilet seat extender an, aluminum chair for the shower and a bed stand to hold pills, etc. Im in training for assisted living! June 1. Tomorrow is D day. Onward! Julie showers me (I long ago gave myself up to helplessness) swabs me in an antibiotic, they say put it on like a lotion before you sleep. It used to be that you go into the hospital the night before surgery where they take care of things like this on site. But new policies to cut costs mean you go in on the day of your surgery so a lot of pre-surg is done at home. Fine. Whatever. 14

I have no fear whatsoever. Lets do this thing. Whatever happens, however it comes out its out of my hands, this is the way its supposed to be. I feel like Im strapped to a rocket. Great let her rip. June 2. Surgery day! I wait with Julie and my lap top in the orthopedic surgery pre-operative waiting area, its as big as an airport gate departure holding pen and just as crowded. Family and friends have come to see patients off, those patients waiting as well as those already departed so to speak can be tracked by code on any of a half dozen flat screen panels that list all of todays surgical patients along with assigned doctors and moment to moment status pre-surgical prep, in surgery, in recovery room, etc All of us headed, one at a time, on our own charter flight to the land of invasive procedures. My scheduled takeoff is apparently on time. I havent a care in the world. I hear a bing and look up to the board, my flight has been called. June 4. After surgery; Where am I, whats going on? This is my second day in the hospital. They had me walking yesterday after the surgery , slowly, with a walker fifty yards down the hall and back while I nurse held me with a strap from behind, they saidI hardly remember a thing. My newly opened and sewn back together knee now rests undercover in a continuous motion contraption that ever so slightly bends and straightens my knee continuously. I am in a high bed, single room, with a window on the parking structure. I feel no pain. Im being given morphine intravenously as well as Percocet and Hydrocodone by mouth. I am in a hazy fog. Today they again had me stand on my new knee and take a few more stepsanother 40 yards. Julie comes and goes, nurses poke their head in every hour to check on me or give me drugs or bring me a tray of food or adjust my continuous motion machine. Dr.

15

Tripuraneni came in this afternoon, looked at my leg, said I was doing fine and could head for home tomorrow. Tomorrow! No way. Between the drugs and the constant attention, I have no desire whatsoever to leave here. Just bring me drugs and chocolate pudding. Ill live here I dont want to be cast out into the busyness and insanity of a crazed world. Im movin in. June 5. Still here. Ha!! June 6. They had to pry me out of the hospital bed. They eased me into a wheel chair, Julie drove the car around, picked me up and the next thing I know weve stopped at Walgreens and were loading up on Percocet, Hydrocodone and Oxycodone. Goody. the idea is to override the pain so I can bend my new knee and move my leg before scar tissue begins to set in and restricts movement. June 7. I am lying in bed at home, my leg raised on a pillow. Under a large gauze pad are 27 steel staples holding a very swollen knee together. I photograph this obscenely grotesque site with my iPhone but dare not send it to anyone. Dr. Trip said no more continuous motion machine at home, hed rather have me up and moving whenever I can. He wants me to try and walk as much as possible. As it is I can make it to the bathroom and a couple of passes around the dining room table bent over my walker. I feel like Im in rehearsal for being 106. Were having a heat wave. It is a highly unusual, even for this time of the year, 105 degrees outside. And not much cooler inside. We are in the high desert of New Mexico and rarely need air conditioning and do not have it. So I lie in a pool of sweat. I stare at a fan and flowers my daughter sent me sit on a red stool. June 8. My first visit from a home rehab nurse today. Sybil has asked me to move my leg and its new knee. But I can not. Those muscles are on strike. There seems no connection now between my mind and that part of my 16

body. My mind is requesting my leg with its new knee to move two inches to the right, and my leg is doing hardly anything at all. It has been assaulted, invaded and tortured, probably in shock. As am I, though I wouldnt know itpain pills leave me in neutral. Sybil comes twice a week for the next few weeks, when shell sign me up for out patient rehab. For now my job is to make neurons twitch and force totally ambivalent muscles to muster - leg lifts, heel slides, hip abductions, ankle pumps, gluteal sets, hamstring sets, leg raises, knee extensions. Ten minutes or as much as I can do twice a day. I also take a walk, if you could call it that, maybe to the yard with the walker. I hate the walker. Im told to take a Percocet or Hydrocodone to facilitate the moving. June 11. I ditch the walker. Just a cane now. I walk as far as the gate and back twice, a hundred yards, maybe more. What me worry? I no longer get the Morphine I got in the hospital. But I take two Percocet every 4 hours, a hydrocodone whenever I wantand I always want, I take Ambien to sleep (actually an Ambien Percocet concoction seems to do the trick as far as sleeping goes). I also take something to counteract the constipating effect of the pain pills and of course that ever-loving Coumadin. Thank you George Bush for the Prescription Drug Benefit. But you have to wonder how many people like me, never get off this pain medication and how many others overdose themselves into oblivion. Every morning and every afternoon I sit up in bed and I go to work: leg lifts, heel slides, hip abductions, ankle pumps, gluteal sets, etc., etc. June 13. Knee is very, very stiff. My knee feels like its wrapped in 27 ACE bandages, stretched to the limit. Otherwise I feel fine in a woozy, swabbed in gauze narcotic way. Julie off shopping. I wonder what the world is like out there? No, I dont. I dont care. I keep my right foot elevated when Im lying down which is most of the time. Gotta stop flopping from bed to couch. Getting bed stores on my heels. Heart feels weak, breathing shallow. Nothing but time to kill and pain to deaden.

17

Small improvements in movement seem to take forever. June14. Dr. Trip took the stitches out today and my knee stayed together without them! One by one he used a gleaming stainless wire cutter to snap those wire staples. You Could hear them pop and ping. June 15. I am not fine. This is not fun. If I fail to take my painkiller on time I get a window into what is really going on with me. Healing was supposedly taking place under those 27 steel staples but one less Percocet and it feels like hot tar is being poured into an open wound at my knee. And above my waist I feel like Im suffocating. I have trouble holding my head up or taking a deep breath. This, I suspect is a result from an ill-advised decision I made while waiting to go into surgery. I was offered either a spinal anesthetic or gas a general anesthetic - as if I knew the difference or was in any condition to make this kind of clinical call. I didnt like the sound of a spinal (having once undergone a spinal tap) so I went for the general. It apparently saturated every fiber of my being with a kind of cellular hang-over that I have since learned can last months. I drag myself to the edge of the bed and do my exercises, walk 100 yards or so and do as much as I can. Otherwise I sleep about 16 hours a day, nap and nod in and out for fouroccasionally I circle the dining room table, walk around the garden once or twice, out to the gate and back -- otherwise Im on my back with ice on my knee. Outside its summer. I hardly notice. Meanwhile, getting up from the dog bed and moving is something that needs to be planned very carefully. Route and timing are crucial; should I go through the bedroom or through the hall for a glass of water, around the dining room table or between two chairs parked near the lamp. Its a shorter route but requires an extra turn. I have to think before I leave on this trip; what else might be needed, my glasses perhaps. Im exhausted. Its 9PM now. Fogetaboutit. Im taking two Vicodins and an Ambien. June 16. 18

Over two weeks since surgery and Im totally despondent. The arthritis is back wrists, shoulder, hands. You have to understand, I have no perspective on this thing. I am half sure I will die tomorrow.a simple surgery, nine out of ten people fully recover. But with this arthritis I cant even pull myself up with a cane. So this is how it ends after all. The knee surgery was a success but arthritis took over and turned the young film maker into a cripple and a cockroach. June 17. The thrill is gone. I have accepted death and now see whats going on. I have my fathers disease., and will now repeat his demise. He at the age I am now, suffered his first stroke. It would ultimately lead to confinement to a hospital bed moved into the den of our home where he lied in a half conscious twilight, never speaking or moving again, until after five years he finally gave up the ghost -- all that was left was a 60 pound shadow of himself, hollowed eyes and a bag of bones, a few suits in his closet, his wallet with expired credit cards - and his life long wish to die quickly in his sleep. Thats me. June 18. Today before Sybil arrived I was limping with my metal cane in the backyard, when suddenly the frustration overwhelmed me and I threw a fit. I assaulted the cat. Then I slammed my aluminum cane into the side of the house, totally bent up. I dont know if it was the pain pills or the fact of being holed up for the past three monthsbut I just lost it. flew into a rage, finally collecting myself as I heard Sybils car pull up. What happened ? She asks, looking at my newly mangled cane. Lying amidst the Spanish Broom in the yard. Dont ask. I limp inside, get back into bed and she draws some blood and we do some leg lifts. June 19. Ok so I have these tight fitting white stockings that seem to require an hour and a half of sweat and tears and three very able-bodied teamsters to pull on over my legs. Its no wonder I havent taken them off since I got home last week. Julie helps pull them off to wash them. Getting them back on is another story.

19

The stocking are supposed to prevent blood clots in the legsat the risk, apparently of giving us both a heart attack.

June 20. Why do I even wake up in the morning? What gets me up? The idea of going to work used to get me up. I could get going on a well turned phrase, a moving picture in my edit bay perfectly in synch with the right music, a sound effect on the right frame of a cut, my wife, a run, lunch, a friend, a challenging discussion, rock and roll a bourbon and a beer. Now there is nothing. But still I get up and lumber through these exercises. Quadriceps exercises. Leg lifts, an inch at a time. Ten minutes is exhausting but I push myself. And I can not gain weight. My daughter has sent me a book The Undefeated. Its about Lieutenant Louis Zamperini, an Olympic runner turned naval bombardier at the on set of World War 11. He was left adrift with two others in the pacific when his plane went down. They drifted for a month without food or shelter from the sun and only a few drops of water, becoming skeletal with lips so swollen they obstructed breathing through the nose.two of them survived. One gave up and died. Just giving up was enough to kill him. Zamperini went on to spend the rest of the War in a Japanese prison camp suffering unmentionable horrors. What kept him going? Will. Will. Thats what pushes me on. I have become intimately familiar lately with the concept of will. June 21. Arthritis not so bad to today, I can open a tube of toothpaste. Sybil comes at three to check on my flexion and extension, a measurement of how straight I can get my leg and how much I can bend it. Later. My extension is 4, which means I cant get it very straight. And my flexion is only 90, it needs to get to 130, otherwise Ill always walk with a limp. The exercise to get my knee to bend easily requires me to force-bend it mercilessly by pulling it towards me with my arms while lying or seated.I take enough Percocet to allow me to do this without screaming in pain. Sybil says she wants my flexion at a hundred next time she comes.

20

June 22. Meaning? There is no meaning. Will is the thing. I wake and am walking out the gate and down the road by 8AM. Amazing still there is will! Will, not meaning, is what keeps me going. Sometimes there is no Meaning and I just go on fumes. I reach a certain point inside and drag myself upwards, I just do it.its like I were an appliance with a burned out bearing but still plugged in. What kept Lieutenant Zamperini alive at sea -- and three more years of torture in a Japanese war camp? Will. Not meaning. Actually, this is the first book I have read in months. I am excited that my ability to read has returned, and, greatly encouraged by the exploits of Mr. Zamperini, I have no complaints. As I say, I dont need meaning, I have will. June 23. A Life in recovery. One could do worse. Flexion today at 105. Last night I actually slept. My knee was hurting so I took a Percocet at 10PM followed an hour later with an Oxycodone. Immediate release. I went into that unmovable perfect drug state, what a relief, and slept till 3 AM. This morning I walk to the second telephone pole down our lane and then do y exercises. Ok. Theres something very comforting about being in recovery. Drugs. No, really youre accomplishing something just by doing knee bends. I accompany Julie to the outdoor pool at the health club today. I cant go in the water until the punctures from the stitches are completely healed maybe another week, I can barely slump in a lawn chair, but looking at the blue water and sky gives me hope. June 24 Surrendering the need for an explanation, it is said, can represent a profound act of personal transformation. Why did this happen to me? Perhaps it was time for a change I could not make on my own. Or there was something I needed to learn. 21

If a transformation is taking place Ill have to wait to learn what it is. All my energy now, mental and physical is going directly to my knee, which I can now bend ever so slightly. I also can move my entire leg six inches on command. Two feet sideways across the mattress. Amazing. Ive gotten used to the home health rehab lady coming. Ive gotten used to not leaving the house or yard. Ive gotten used to being protected from the onslaught of the outside world. Im getting used to being tended to, cared for, protected -- and drugged. Its evening now Im told. Time for a Vicodin and an Ambien chaser. June 25. Over three weeks since surgery. I throw away the cane. Leg still stiff but I am alive and moving. I can drive to the health club myself. I must have cried three times today just relieved t be making progress. Im up to twenty minutes of leg lifts and my other exercises every morning. This is my new religion, leg lifts. Home visiting rehab lady watches me walk without a cane. She says Im doing great , but use the cane. She says she doesnt need to come any more, enrolls me in out patient rehab. That means Ill have to go out into the world. Scary. Julie drives me to Dr. Tripp. Doc says I need to flex my knee, walk, move my new device. Avoid pain but flex that knee. I apparently have a device. He also tells me I can lose the white tights and he takes me off Coumadin. Spinach here we come. Through the haze of the painkillers, my knee still feels like its in a cement cast. June 26. I take a Percocets and Julie drives me to out-patient rehab this morning, a new airport hangar of a building off the interstate. We find ourselves in another crowded waiting room with people waiting for their lives to take off. An exercise therapist, appropriately named Glowie, greets me with a smile and escorts me back to the workout space. It is a quarter of an acre of stationary bikes, elliptical walkers, step machines, parallel bars, inclined planes interspersed with elevated foam platforms on which patients supervised by therapists are arranged in 22

various postures and slow motion exercises. People of every color and shape and demographic but most of them older and all of them with a glazed and tentative look in their eyes, that says how did this happen to me and will I ever be the same. I will join them three days a week for the next month. My leg extension, how straight I can get my leg, is measured at 6. I have to get it to 0, straight. My flexion, degree of bend is measured at 105. Full bend four months after a knee replacement would be at least 120, probably more. My job is to hit those numbers, at least. Thats all I have to do for the next 6 weeks. Make those numbers move, through leg bends and rehab exercises with and without weights. Knee still pretty swollen. More ice and Percocet. My life revolves around my knee which can bend but not revolve at all. Got forbid it should twist. July 1. A thin red line of a scar. Little black dots where the staples were. The wounds from the stitches still prevent me from putting my knee in the water. A lot of swelling still. July 2. Today in rehab; Extension 3. Flexion 105. I am doing leg lifts with weights, Glowie has left me on my own for a minute. Next to me is a man on a stationary bicycle, turning the pedals ever so slowly, he looks to be over 100 but I will later learn that he is only 97. He too has had knee replacement surgery. How are you doing I ask? He says its tough because his age is working against him but he adds hes determined to recover. Recover to what? I wonder. To what end? I have given my business up to my partners. I no longer have editing software or cameras. Or scripts. Or clients. Im getting better, but Who am I now? Even with the best outcomes it is unlikely I will never again hop off a sound stage or fix the gutter. I could read a lot I suppose and sweep the back porch. The arthritis in my wrists, shoulder and neck comes and goes without rhyme or reason. I can not plan my future not knowing whether or not I will be able to put on socks. I am adjusting to the life of a man with a limp. Excuse me Im disabled.

23

However my flexion is now at 117. Major. July 4. I ease myself into the pool today at the health club. The water is the first and most exciting sensual experience I have had in months. I can feel it giving me new energy. The knee loves the water. It likes to bend in it, fully supported on all side my the gift of water. I am in love with water. July 5. Today after rehab I go down stairs to the post rehab seniors workout arena., where rehab patients who have graduated can maintain a fitness regimen. It is an enormous space, jammed wall to wall with rows of step machines and treadmills. There are so many machines it looks like a digital effect.all of them occupied and everyone in the room is over 70 some must be well into their 90s. Its the age wave come to life, rolling rhythmically going nowhere but about to overtake us all. I used to be a film maker. What am I now? To what group do I belong and what is my purpose here on earth?.... Im 67, in ages past I would have been dead by now. And if I made it this far the knee thing would have been the end of me in a few years for sure. They shoot horses dont they? Perhaps I am headed for this room of ninety year old work-out-alcoholics on the orbital elliptical machines. I see myself strapped into one, like some elder Viking slave, rowing in unison beneath the water line invisible to a run around worldthere are millions and millions of us dying down here July 8. I drive myself to rehab today, blasting the Rolling Stones , Happy. I take myself to breakfast afterward, downing pancakes at Dennys, trying to put on weight. I still do not gain weight. The body is not ready. All the energy I can muster seems to go straight to my knee. Healing just sucks up the calories. Regeneration takes, time, energy, nutrients, and Glucosamine, Zinc, Omega 3s, Vitamins A and E and Iron and lots of protein. Ive been reading about this on line. Someone discovered that as many as half of surgical patients exhibit protein malnutrition - protein helps fight inflammation and rebuilds tissue. But more than anything healing takes water 2 to 3 quarts a day. I take a half dozen pills every morning and sleep half the dayand drink as much water as I can. 24

But the good news is this: I am a part of the world again, although the world is moving considerably faster than I am, zipping by on the interstate in Pintos and Hybrids while I am in what feels like a 57 Chevy on the frontage road. At Dennys I park in a handicapped parking space, legally. Sweet. Inside I take one careful step at a time. Each step elaborately calculated to reduce impact and save energy. If the goal is to get myself into a booth for breakfast it is a distant one, every step in route has become a goal in itself. Im getting used to being on Pause. The view is not bad from here. Actually you can learn a lot. July 10. I pull weeds in the yard. I am becoming human again. Five and a half weeks since surgery. Knee still quite stiff and I want much more bend. But after meeting with Dr. Trip I see this as the end of a stage. Im getting strength back and can walk fairly well without a cane. After pulling weeds in the yard. I fix the screen door. The Percocet has been helping me to sleep. But as I try to decrease the dosage, taking little nibbles of those big yellow pills, the sleeplessness returns. I appear to be addicted to Percocet., and need it to sleep. I take Ambien or Tamulislin to sleep as well. Sometimes it works. Ami comes to visit tomorrow. July 12. Ami arrives. We pick him up at the airport. My son is something of a body builder as well as surfer and a psychologist. Actually, he is my father now. Takes time with me, helps me walk, shows me some new exercises. Talks sense. We go to the health club where I use the little boys locker room, it is empty and I dont have to worry about being knocked about by body builders. At the pool I dangle my leg in the water, feels very good, soon Ill be able to get in. Ami swims laps like the swimming machine I used to be. Back in the locker room I look at myself for the first time in a full length mirror. Horror of horrors I have shrunk. I am bent over, emaciated, a cripple outside at the pool I kept my t-shirt on, embarrassed by my sunken chest., but now looking at the complete body - bony, bent over, shrunken, my structure a host to drooping skin and nasty black patches where did those come from? I am aghast I have become Lt. Zamperini in his final prison stages before rescue. I need to put on a lot of weight 25

very fast. Julie drives us to Wendys I get a bacon double cheeseburger, fries and a chocolate shake. Im not proud of it but I panicked. Ami suggests I cant sleep because Im in post traumatic shock. Maybe hes right. I just start to repeat over and over again I am safe, I will survive, all is well. July 14. There must be a starting Over. A sense of adventure. Good health and mobility is a gift with a time limit. Honor it. Decrepitude and suffering await. Most people are lost in mindless pursuits, habit, unconsciousness, fear. Thats what body breakdowns are for to wake you up! I do things very slowly, but I do them. My will is in charge. I feel it, will. This is the life force. There it is again, Im plugged in. Its will I can feel it. July 15. Ami flew back to San Diego this morning, leaving me with all kinds of fitness equipment hand weights, elastic bands, bouncy balls - and sound advice. I drive myself to rehab. My flexion hit 125. Those water work outs are really paying off. July 17. At the club today I carefully lower myself into the shallow end of the outdoor pool, and move my knee gently back and forth cushioned by the resistance of the water. The knee loves the water. This is perfect. I am not alone, I now notice. A whole sub culture of injured fitness aficionados are there mid day, mid-week for self-treatment before the after work crowds descend. If they were there before they were below my radar, now I pick them up everywhere. The fact is, moving ever so slowly and carefully, I inhabit a different part of the human spectrum and people and situations invisible before are visible now. Leaves, light, dust. also these people sitting by the pool with cast or crutches. I am not, this summer day, the only one with a joint problem, if you look closely there are others scattered about knees, elbows..hipswe of the injured class acknowledge each other with a nod or a smile, even a few words in passing. 26

I have nowhere to go. Nothing to do, but move slowly and take care of myself. The Pause setting has become a blessing. And in it I start blessing people. A man rolling a portable respirator, I silently bless him. A little girl with a disfigured arm, I bless her, creating a puffy ball of light in my mind and sending it her way. There is a young mother poolside with her kids, she is on her third knee surgery after two failed attempts to repair a soccer injury, she tells me. As she walks away I bless her. A bull of a man with a mop of gray hair and a walrus mustache and wire rims reads the Wall Street Journal in the hot tub, hes just had a hip replacement, he says, thats gone awry. Hes suing. I bless him - and his attorney. There is the gait and stance of injury actually at every turn when you have been re-calibrated to recognize it, an opportunity to help. I start distributing smiles. Thats now my job. July 20. Another sleepless night. What a gift is sleep, you dont realize it until youve been denied. Sleep deprivation is most assuredly torture. My body is still afraid to go to sleep or is it my mind. I dont know, the fact is as my wife and half the world gets ready for bed, I am ready to go to the races. My heart beats faster, the adrenalin starts pumping and my disappearing into night is futile. July 23. This I know for sure; most of my life is lived, this last third or so can not be a matter of killing time and waiting for disaster to strike. It must be a time of growth again, like in m 20s and 30s. A time of love and insight and progress. What comes next must be an adventure I have this idea that the core of me is an embarking thing, full of newness. I was growing old in my rut, the knee thing struck to wake me up My knee will be better shortly and I must be prepared to walk off with itinto what I know not. July 25. I know now the sleeplessness is connected to the Percocet I havent been taking. I have been weaning myself off Per cost for a couple of weeks, now, and am down to about a half a Percocet a day. But if I dont take a Percocet at night, theres no way my racing heart will let me sleep. No sleep at night means Im totally wasted and stressed out the next day. August 1. The stress response. I look it up on the internet in medical and technical journals. I dont understand most of what I read, but the stress response, it seems, is a whole 27

syndrome that permeates the body and causes all kinds of weird reactions involving hormones, proteins and various healing agents. With a surgery like this, every part of the body is affected. Harmonic and metabolic changes which encompass a wide range of endocrine and immunological effects.the entire sympathetic nervous system is thrown for a loss. Fatigue, I learn is a major bi-product of a big surgery, it is a complex and pervasive. And indeed. I am exhausted. Aug. 1. Why dont they teach you this stuff when youre young. One of the classes I had in grammar school, at the age of 11 or 12 that has proved most useful to me throughout my life was home economics. I learned there how to write a check and balance a bank book, how to sew buttons on a shirt and some rudimentary cooking skills like how to make spaghetti with meat sauce, these cooking skills actually sustained me as a single and enterprising man well into my forties. Now on my way to the age of 70 I can see that there should have been a course called Life-Span, a survey course involving a timeline and an overview, a kind of what to expect guidebook concerning warranties and guarantees (there are none) and mind body part life expectancies. It would be a primer in impermanence. Its great to know how to make spaghetti sauce, you should also know how long the leftovers will last. Aug 3. Eight weeks in. At the health club I have a nodding acquaintance now with a brut of a man in his forties, he wears an I ran the NY marathon and lived to tell about it T-shirt. He sits fully clothed in the chair by the hot tub every day, elbow resting on knee with his chin in his hand and he stares blankly at his running shoes. I know this posture well it is the universal symbol of a lower body injury. One day I see him in the locker room as he removes his shoe. He has no foot, just a stub beneath his ankle. His will be a footless recovery. I am the luckiest man on earth. I bless him and bless myself and move on, one step at a time. Noticing everything. Aug 4. Big day. Flexion at 135. Thats about as much as my device can handle. 28

The arthritis in wrists and hands still comes and goes, not too bad now. Any sleep, at all very problematic without a Percocet and a half an Ambien. Still a lot of swelling around the knee. Aug. 5. I show up for rehab this morning but they just about throw me out of the building. Glowie said, Youre doing fine, Im really busy, double booked, let me see you walk. I walked back and forth. Get those quadriceps going, youre doing great, check in next weekand give it a rest, we want that swelling to go down, youre doing great. Shit. Cast out again! This time from the only affinity group I had, the disabled. Now I am in deep trouble. Im most definitely getting better. I would not only live, like the rest of those slaves in the Senior Center Rehab program .should I ever get a full nights sleep I might live forever! I could join the kibitzers and golfers and sauna sitters at the health club, add myself to the growing list of retirees. I could volunteer for something. Probably not the fire department. I could help young drug addled boys, mentor them in film-making perhaps, or homeless old men. I could work at a Hospice and help the terminally ill to die. Is that me? I dont know who I am? Now what? Aug. 6. We go for a drive to Jemez Springs. On the way back we pick up a kid from the pueblo, a nice young man who has fought with his friends and needs a lift. He sits in the back seat as we wind through the Jamez mountains. I am aware how fearful I still am of everything, Since my knee went out, and especially early on before the surgery, I felt myself a potential victim of anyone, especially able bodied men. That fear still haunts me, I see. When we get back I do some yoga and make an appointment for acupuncture, primarily to deal with the arthritis in my hands and shoulders and wrists, not so bad now, but not so good either, flares up from day to day. Aug. 7.

29

I go to Starbucks, a frequent morning stop when I was well. Same goings on. I bump into Mary Beth an old friend and one time an editor with us. She was meeting with half dozen others in preparation for a film project. I had limped in with my cane, newspaper under my arm. I sit in the back. She comes up and hugs me as I struggle to standing. Welcome Back, she says . Welcome back, I wonder, to what? As I say, something unexpected has happened, I am going to be alright. Different, but all right. I really am not interested in picking my life up back where I left off. At Starbucks. Something had changed. Aug 10. Julie had kept up her writing assignments for yoga magazines but her principal job has been taking care of me. As I appear to be recovering she may be as much at a loss as I am as to what comes next. Ive been her ward. Now were both starting over. My body feels a bit abused, oldermy strength is returning but a toll has been taken, I need to rest a lot. I am a walking stress fracture. Healing is a full time job. My body is telling me hold on, Ive got work to do. I have to re-cooperate. Im not used to healing. Im about swashbuckling, smashing and building. Aug. 11. I go back to my bookmarked pages on healing and stress, the bodies response to trauma. Blood vessels and skin and bone need to mend - how much of this sacred vessel has been rent asunder. And God only knows what happened to my mind. My entire timing system has been blown up. Protein, I read is key. Meat fish, soy. Supplements of specific amino acids especially those that contain sulfur such as cysteine and methionine (found in eggs). Two other amino acids are key to the healing process; arginine, which helps build collagen (connective tissue) at the wound site and l-glutamine. Without glutamine there is no protein, it occurs naturally but the body cant make glutamine fast enough after major surgery like a knee replacement so it needs to be supplemented.and Zinc! Zinc, thats a magic potion if ever there was one in the body zinc concentrates itself right at the wound site and builds that ever-loving binder - collagen. And Irondont get me started! And micro-nutrients copper and manganese. Vitamins! Omega 3s and water! Again, two -three quarts of water a day, at least. Aug. 15. Got to bust things open. Bust things up. I have turned the film business over to Frank and Bryce, we worked out a business arrangement. The editing suite and computers, the cameras and lights and library of 30

tapes are now theirs. Ill serve as a consultant on some key projects. I start to unload stuff and throw myself overboard into emptiness as I promised. ..I would abandon all hope, all prospects, all projects, I would take the leap, and limp into thin air.I am well. And I have nothing to do. Last night almost a full nights sleep. What a beautiful day today. Tomorrow we drive to Los Angeles through Tucson. An adventure. Got to push myself, stop treating myself delicately. Bust things open, bust things up. Aug. 20. Who Am I? I am what survives. Nearly 3 months since the surgery. The trip through Arizona worked, couldnt sleep, but I could sit. I could walk two or three blocks. We went out to dinner in Tucson. Im returning to normal. Everyday the concrete wrap strangling by knee gets a little bit easier to handle. Every day there is a difference. If I dont overdue it then my knee seems to bend a little easier each day. If I over do it, walk too much, I spend the next day in pain and on my back. Its a delicate balance. When I feel good I am haunted by that question; if I am not a run around get it done guy at the peak of my professionwho am I? I am, I decide, what survives.if my eyes go, Im still here. If my legs go, Im still here. Even if I lose my mind Im still here. Im whatevers left, even after they burn the ashes. Somethings left. Thats who I am. so what, I ask, was all this catastrophe about? Maybe my leg failed me because I was pushing too hard or had been wounded and taken advantage of. Three months before I had been betrayed (perhaps taken in the knees) on a documentary film project ironically about the development of complex technological disease fighting strategies And there it was, a few days later, my knee the size of a Cantaloupe, the result of a professional battle and an emotional wound. Maybe it was this as much as genes or my over-strenuous workouts. All things are connected. Ghosts are about. Things happen for a reason. And events tell us things. But you know what? You dont think about this when youve been hit by a train, pain is a very here and now thing. 31

This assault, Im convinced, was all about a course correction. The geological plates of my very foundation shifted. Now I have graduated. Entered a new phase. I have gone to school on age and disability. I have had a dress rehearsal for my demise. Im ready onward. Aug. 23. Its been almost four months. I can walk well enough, even up stairs as long as I dont walk too far or up too many stairs. The knee feels remarkably solid. Foreign its plastic and metal and feels like it.its not real, one knee feels unfettered completely - the other, the other is actually a contraption. But it also feels tightly bound and strangely solid. My workouts keep adding muscle. I imagine that chrome and plastic starting to be coated with living cells, like moss covering rock. This is interesting. Im alive and mobile. What do the living do? I need to do something done by living mobile people, something dramatic. Sept. 3 I went online today transferred money out of savings and bought two one way tickets to Berlin. A first step had to be taken. Figure out the rest, one step at a time. I got used to doing things like that one step at a time. Still tire easily, need to watch the walking, no twistingneed to put on weight, build stamina, but, throwing myself overboard into nothing has, apparently, landed me in Eastern Europe. We leave next week. I will take very little, change of underwear, socks, a few sweaters. No journal. No books even. Nothing will upstage the emergence of me and my new device. Julie and I will each take a knapsack and will share a new iPad. We have no plans other than to land in Berlin, spend time in East Berlin, train down to Prague and see what happens. I feel light and airy and gifted and blessed. Sept. 13. It will be four and half months, we leave tomorrow for Berlin. We leave tomorrow. It will be 4 and half months. I have Ambien and pain pills and a complete set of exercise bands for those times the arthritis in my wrists and shoulders arent cramping .they too seem to get a little better each day. 32

I wake this morning singing Im as corny as Kansas in August, Im as normal as Blueberry pie Oct. 5. We were gone nearly three weeks. We got back Saturday but I really can't talk to anyone or leave the house. The colors here are psychedelic with brilliant orange trees against crystalline skies and The Sandia mountains turning pink.... Here's my report. The new knee tired after a half a day of walking. But no limp. I used the exercise bands every morning, could feel my leg muscles growing. We rented bikes in East Berlin, much better than walking. There was rarely a tub in the hotels we stayed at but always a hot shower, which I trained on my knee. Otherwise I simply forgot about it. Started sleeping without sleeping pills. And the neck, shoulder and wrist arthritis subsided enough for me to almost forget about it as well. We rented a car and drove for a week through Austria and Northern Italy. We spent three days on a Lake we stumbled onto in the Alps, and then hiked in the Alps. I hiked in the Alps, not far, but I hiked in the Alps One trip highlight had to be the tea room in Linsk Austria we bumbled into. I had been searching for these folks all my life; solitary older men in tweed and bow ties, bankers and bums, sipping wine in red plush booths, eating pastry, reading the paper, smoking, quiet clatter, big open space, great light. People just sitting, being - an ancient Linsk practice. I put myself on Pause, it comes now naturally, and I fit right in. It was not all whoppe do and wowser, travel is hard work. We had no predetermined agenda, it was not all a vacation on the beach - in that laid back sense of the word....there was a lot of wear and tear but the new knee loved the workout, lapped up the strengthening and even the uphill walks. It was a wonderful trip, especially after this summer of injury and loss, for Julie and I to be together and on a strange road and figure stuff out on the fly...and prove that you can just about do anything in life - if you know how to get lost, play to your strengths have will and a way. An I Pad also helps, we would look up cities on the map to see what they offered as we drove in their direction and then oversaw our progress with a Satellite view of the road and the country side wherever we went. Nov. 15

33

I have rented a small office in downtown Albuquerque and ordered from B&H in New York a SONY HD NEX VG10. It has only three buttons and I can operate it myself, and an interchangeable lens. It comes with a zoom with incredible depth of field. I sing at some point every morning. And I have started to gain weight. Forty percent of 40 year olds, Im told, will have osteoarthritis of the knee and half of these will require some kind of medical intervention. ..wonder if theyll learn to sing. Dec. 15. About two inches of snow last night..and I can shovel it from the walk. In the paper this morning I read about Mr. Edward Moore, a retired chemist from Woodbury New Jersey who at 91 decided to have a total knee replacement better that, he said, than limp around for the rest of his life. Three years after his surgery, on his 94th birthday, he took his wind surfer and his wife to Lakes Bay near Atlantic City and went wind surfing. In a sweeping study of 135,000 patients with osteoarthritis after three years those that elected to have a knee replacement, I learned, had an 11 percent lower risk of heart failure, after 7 years their risk of dying for any reason was 50% lower. Without knee surgery I could have lived another five years, maybe -- as a gimp. Dec. 16. In the end, heres what I learned. And its not even the end. Bodies age, stuff happens, life is a work around. Everything I did was probably helpful, perhaps a few less pain pills, though I may have gotten Tinnitus anyway. The yoga, the abyonga, the herbs, acupuncture. What we ate every night especially in recovery mode absolutely crucial. Even visualization, visualization for sure But nothing was going to re-build cartilage. The cartilage was gone. Without a new knee, my body would have been thrown into a different alignment - with compensations I would have grown used to but which would have diminished me greatly. I learned they can do amazing stuff with chromium and glue.

34

My body is quiet the healing machine, it took the slicing and sawing and drilling -the substantial opening of the sacred vessel right down past sinew and body and then it healed itself! Its almost Christmas. Julie is always in such good cheer. Acupuncture tomorrowand a massage. I am going to teach myself to edit video, I always worked with an editor I never had the patience, or dare I say the will, to learn how to edit a movie by myself. Jan 3. The debilitating arthritis must have been connected to my battered knee and the subsequent surgery for it has gone as mysteriously as it appeared. I sleep like a baby. I cant do deep squats and dont want to kneel. I have gained a very healthy 20 pounds. When my body was ready it just put on the weight, almost overnight. I work out every day. Jan 21. I sit at my desk downtown, in front of my Final Cut Pro 9.2 editing system. I set up an editing bay in one corner. In the center I have put a round teak table. I want to see who comes to sit at the round teak table. While I wait I continue teaching myself Final Cut Pro. I sit and I knit. I knit digits. March 1. A Lady from the Appleseed Foundation called a few weeks ago and has hardly any money but wants to make a video about breakfast at school for poor kids. Sure, I said, I have a camera and can edit. I have an office with a swivel chair. A round teak table. An incredible little high def camera. I can read, write, think and use the web. Im an International Film Conglomerate. I dont keep a journal anymore. No more reflection, enough! Im surprised to even be here writing. End.

35

Afterwards. One morning ten months after my surgery I woke with a ringing in my ears. It stayed with me all day and it never went away. It grew louder day by day. I had heard of ringing in the ears, now I went to the internet and I learned everything I could. Its called Tinnitus, millions of people have it, it can be mild , it can be debilitating, you can learn to live with it or it can drive you mad. But it can not be cured and it never goes away. Tinnitus, I had learned -- from web sites, bloggers and Tinnitus chat rooms -- is caused by many things, noise abuse for sure but also by pain killers, by a sleep disorder or by a traumatic bodily event like knee replacement surgery. Hmmmm. Somehow the tiny fine hair like organs of the inner ear called the cilia get damaged. There is no such thing as cilia replacement. Bu there are things that work. It took me three months, just when I was getting used to my new knee, to wrestle my Tinnitus to the ground, but I finally got it to a manageable state. Thank you acupuncture, cranial sacral therapy, valium as well as Glenn Harold and his Australian Hypnosis tapes, Barry Keate, and his Arches Tinnitus Formula, a special bled of Gingko Biloba and other things which, I believe, saved the day. My bum knee shut me down and changed my life. The knee replacement surgery, though not without its subsidiary issues, saved my life. I work out every day. I move slower now but I feel stronger. Strong like bull. I travel all over the West Coast and Mountain region and am working on a backpack video journalism project I dont want to talk about yet.

###

36

My New Knee and Me

A journal of my knee year 37 pages. Bob Belinoff 323-804-1387 bob@digitalwkshop.com

OCT. 17, 2012. REVIEW DRAFT ONLY

Bob Belinoff Bob is a nationally recognized documentary film-maker whose films on and about health issues have won national and international awards. He is currently the chief documentary film-maker on nutrition and health issues of the California Dept. of Health. In 2011 he underwent a knee replacement procedure.

37