The bereaved decision-maker: Getting ready for “Total Knee Replacement”

I’m blogging because I want to support other people who are going through difficult bereavements, so I try not to make this too personal. However this post is personal: Tomorrow morning I’m off to the hospital for the first of the pre-operative assessments in advance of having Total Knee Replacement (TKR).

I had my first and only other knee operation 45 years ago. Periods of inflammatory arthritis in the following years gradually left their mark. I thought I was managing it quite well, but it got worse, and it turns out there was quite a bit of damage inside the knee. About 3 years ago, on one of my twice-yearly visits to the rheumatologist, I was informed that I needed a knee replacement.

I had an appointment with a surgeon about a month or two later. It was a waste of his time, really, because this was just a year after I had lost my daughter. I was in no state to make a decision about major surgery, so I thanked him but it was “no thanks.”

A couple more years went by. Despite all my attempts at delaying the inevitable, with lots of physiotherapy, walking, healthy diet, etc, etc, my knee got dramatically worse. I was given the same advice – I needed a knee replacement. Once again an appointment was made with a surgeon. This time I was more amenable, but still in not a great hurry.

Then finally, in the past two months, my knee has deteriorated further; the joint is deformed, the centre of gravity is out of alignment, and the pain is severe enough to stop my usual activities. It has been really hard for me to make a commitment to go ahead with the surgery, but I finally called the surgeon’s secretary and said, “yes please”. Hence the appointment tomorrow.

Of course I’m nervous about surgery. Who isn’t. I’ve had quite a bit in the past though, and I know it is survivable. I’ve had second and third and even fourth opinions that this is the best thing for me to do. There isn’t a doubt on that medical, clear-thinking level.

But on another level – well it is difficult to make a decision. The newly bereaved are advised not to make major decisions for the first year, but that’s not really the issue for me. As a survivor of multiple difficult bereavements, my self-confidence isn’t exactly in good shape. But it’s not just me, of course. One of the hazards of severe grief is that it does impede your decision-making. Your confidence in “life turning out for the best” has been shaken. The regrets and guilt that are such common components of grief can also make it hard to make new decisions, as you wonder how many of the decisions and choices of the past contributed to what happened. It doesn’t matter how irrational those thoughts might be–virtually everyone who has suffered a sudden or traumatic loss will struggle in this way.

Three years back, I knew I wasn’t ready for the decision. However I felt physically – and my knee was already troublesome – I couldn’t put my mind to making a choice. Every choice has consequences. I was too afraid that I would regret any decision I made. Not making a decision about it was a better option at that time. Here I am, now, three years further along. My knee is much worse which is making me quite desperate to get it fixed, but I have an inkling that is not all that’s changed. Time, though not a healer like we’re often told (at least in my opinion!) does help us to get accustomed to circumstances. My circumstances, of being a bereaved mother with no surviving children, is a fact of my life. I hate the thought that this is my reality, but it is. Having or not having a TKR is not going to change any of that, although it could impact on how I cope with it, but that’s a story for another time.

The point I’m coming to is that we know ourselves, and we are in the best position to know if and when something is right for us. Just as nobody can tell us how to grieve, nor can anyone tell us how to live our new lives. Other people – usually with the best of intentions – may advise us, cajole us, try to steer us in what they consider the best direction, but we shouldn’t let ourselves get pressured. When we feel ready, we will make the decisions that are part of our life’s journey. At least, let’s hope we will.

(I’ll post an update when I get the date for my surgery. Let’s see if between now and then I stick with my choice!)

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