“He’s more machine now than man. His mind is twisted….”

This past week, when I mentioned to one of my friends that I was going in for yet another joint replacement, he reminded me of this most appropriate of movie quotes. At first I laughed, but when I really considered what the quote said, I suddenly realized that it was strikingly appropriate. Both literally and figuratively, my body and mind are changing, becoming something different than I ever expected them to be. Just like the character to which the quote refers, I am on my own journey of self-discovery and I must suffer the tests put before me. I have ended up becoming something I never thought I’d become – and it happened so surreptitiously that I didn’t notice until it was too late.

About a year and a half ago, I began to see that my right ankle was accumulating bone at an alarming rate. This bone growth was causing my right foot to supinate so badly that I was literally walking on the edge of my heel and pinky toe, and in response, my body was protecting the soft skin underneath by forming a hardened barrier made of skin. Of course, I immediately realized the danger inherent in ignoring such a problem, and began to work on the right ankle with my physical therapist.

Over the following 18 months, my PT and I tried everything we could think of to prevent the foot from supinating further. We attempted moist and dry heat, cold therapy, electric stim pads to loosen the muscles in the ankle and lower leg, stretches and exercises designed to keep the ankle loose and movable, and even a course of treatment that utilized iontopharesis to draw acetic acid into the ankle to help breakup some of the overgrown bone that was preventing the foot from sitting level. We tried all of these procedures in different combinations in order to keep the joint moving. Unfortunately, there was just no stopping the bone from overgrowing. Because of this, I finally gave in last week and visited my orthopedic surgeon to determine the extent of the damage.

After I took x-rays, I visited with my surgeon. He pulled up the images and just about gasped. What we all saw on the screen left no room for misinterpretation. I no longer have a right ankle. In the ankle’s place I simply have a baseball-sized blob of bone – the joint was completely fused.

Normally, having my ankle fused would save me the trouble of having surgery. As an alternative to total replacement, fusing of the ankle is often performed. Unfortunately, as is always my luck when it comes to my disease, my ankle fused in exactly the wrong position. I would have a foot that is permanently tilted 45-degrees to the inside. Sitting in the exam room, all three of us looked at each other and said “so, ya. Replacement I think.” Three words and we were off again on another of our patented surgical adventures.

Ankle replacement. Oh boy. Just about one year to the day after my shoulder replacement and subsequent heart attack I was going to go under the knife once again. The right shoulder that still needed to be replaced and the left hip that needed a tune-up would have to be bumped down the list. According to just about everyone, if the ankle isn’t done as soon as possible, it can further injure my hip, my back, my other ankle, my left – just about every single joint in my body.

So here I am with another replacement just a month and a half away. As you all know, last time I attempted a joint replacement, I ended up with a myocardial infarction for my trouble. Nothin’ like a heart attack to make you feel young. Because of this, you might think that I would be frightened or at least apprehensive about this upcoming surgery. Well, I’m not feeling anything at all.

Now you see just how apropos that quote is. Anyone who can read can discern the literal meaning, as this will be my fourth total joint replacement. Add that to my metal veins and my implanted defibrillator that can download data or upload new settings wirelessly and I’m a walking “WiFi hotspot.” I’m literally becoming more machine than man. Beyond the obvious meaning, though, my mind is changing too.

I find myself able to brush this newest surgery off like it is nothing at all. Akin to when one of you stubs your toe, I plan to curse loudly, suck in a deep breath or two, and go on with my day. In and out of the hospital in three days, out of my cast in six weeks, back to “normal” in 4 months, this is going to be easy as pie. This is how my conscious mind is looking at the upcoming surgery. Even when I peer into the mirror and ask myself how my life got to the point where I can brush off a total joint replacement as status quo, I still cannot conjure feelings of fear, apprehension, or gravity – the usual emotions that this situation warrants. I truly am more machine than man at this point, both body and soul. A twisted mind indeed.

Has this sordid life I lead become such the norm that short of losing a limb, I refuse to be moved? If you told me ten years ago that I would become so numb to the horrors of my disease, I would tell you just how crazy you were. In addition I’d scold you for ever thinking that me, the emotional voice for many a patient, could be so desensitized to my own pain, and I’d be totally correct for doing so.

So, here I am, a robot in all senses of the word. Have I begun to lose that part of me that so many of you rely on for putting into words the horror that most of us face on a daily basis? Who knows. What I do know, though, is that now that I see exactly what is happening to me, I can put a stop to it. I will use the pain of the surgery to give me the shot in the ass I need to remember what it feels like for anyone to go through what I will soon. I know there are those of you out there who, like me, have become more machine than human, but fight it, I beg you. It starts with ignoring the right things, but one day you may find you can’t feel anything at all.

You are all invited to come with me again, of course. Just as I blogged about the shoulder replacement and heart attack, I’m sure CJ will join with me in running a special for the ankle replacement. So, here we go again, get ready!

P.S. Hats off to anyone who picked out where the quote was from. True fans you are.