HURTS SO GOOD Paula Watkins, RN, CNOR, (right) and her physical therapist, Mishka.

That's Mishka, my tough and unrelenting physical therapist, in the purple polo. Aside from her annoying habit of increasing the weights and doubling the reps whenever I told her that I loved a particular exercise or machine, I liked Mishka. During my thrice-weekly torture appointments after my knee replacement, she worked very hard to get me to where I am now, walking without assistance and driving, 3 months post-op.

I'm the not-so-tough one on the right with the new knee. I've got the scars from surgery and the tears from PT to prove it. I've also got a new-found appreciation for what our patients endure when they recover from surgery. We may think it's over once we've wheelchaired our patients to the front door, but oftentimes their job is just beginning.

Sweat and tears
Patients must often endure physical therapy — or pain therapy, as I call it — after surgery. The pain of PT often goes overlooked from our side of the OR table, where outpatient rehabilitation is packaged like a leisurely benefit. You get to recover in your own home! I cried doing PT in the hospital ... and when the therapist came to my house ... and on my first day at rehab.

At my first post-op visit, I told my surgeon, who's known me as long as I've worked in the OR, about this. Without a trace of sympathy, he replied, "If there weren't tears in your eyes and sweat on your brow, then you weren't working hard enough. And the therapist wasn't doing her job."

Then he told me that if contractures formed in the joint, he'd have to do a manipulation under general anesthesia and I'd be back to square one. That was the jolt I needed to endure 10 weeks of torture, 15 or 20 minutes at a time. On a machine that extended my leg one click past my usual expletive, held it there, then flexed it to my second favorite expletive and held it there. On a stationary bicycle where I had to manually pick up my leg to set my foot on the pedal before I could ride to nowhere. More forced extending and flexing, straightening and lifting. I ran out of curse words to say. I was sweating, crying, nauseated and exhausted before the PT sessions were over.

Back to work
I'm not completely free of aches and pains, but my surgeon says that I'm further along at this stage than other cases he's seen. If I'm still doing this well when I see him this month, I can head back to work, and the rigorous life of a circulator, the following week. Thank God. I never thought I'd say this, but I'm tired of time off! Chalk me up on the schedule for one of Dr. Pain-In-the-Neck's overly complicated marathon cases! (Remind me I said that a month from now.) Yes, a total knee is grueling, but it's led to a great awakening. See, for many patients the work we do while they're under anesthesia is the easy part for them. Once they awaken, that's when the hard work is just beginning. Right, Mishka? OSM