IN LATE 2003, I had my first total knee replacement under spinal anesthesia. Soon after surgery, I was hurting. Despite substantial doses of morphine, my pain was a 10 on a scale of 1 to 10. Even at rest, I was very uncomfortable. I had to take narcotics for a month to deal with my knee pain, making me feel “fuzzy” and sleepy. The drugs definitely hindered me from focusing on the exercises I needed for recovery.

Three years later, I had my other knee replaced. I also had spinal anesthesia for this procedure, but this time I also got a little something extra. My anesthesiologist gave me a continuous femoral nerve block, which stayed in for two days after the procedure. What a difference! I was up and walking the first post-op day. My pain was zero at rest and during activity. I needed no morphine; after the procedure, I took acetaminophen plus hydrocodone for just 10 days, and I didn't take much. To be fair, my second procedure was less invasive due to a smaller, quadricepssparing incision, but I believe the peripheral nerve block prevented the pain from ever escalating in the first place. I can honestly say that I had virtually no pain the second time around, and I felt I was better equipped for rehab.

This turned out to be quite fortuitous. As luck would have it, I landed back in the operating room just one month after my second TKR to undergo open-heart surgery, and the fact that I was already functioning well with my new knee expedited my recovery. You see, the reason I received spinal anesthesia rather than general anesthesia for my two TKRs was that I had been experiencing atrial fibrillation for several years, off and on. Soon after my second knee replacement, my doctors discovered why. There was a tear in my mitral valve. In the OR, the physicians patched the tear and performed a MAZE procedure to normalize my rhythm.

Now, just four months later, I feel better than I have in a very long time. I have significantly more energy and no knee pain for the first time in decades. I am back teaching third grade. I am taking week-long trout fishing trips in California's beautiful Sierra Nevada mountains. I'm riding my bike again, and I am working around the house.

Several years ago, I thought my chronic knee pain and fatigue were simply part of getting old. Now, at 62 years young, I am very happy to be proven wrong. And while I hope I'm finished with doctors and hospitals for a while, if I ever have to do this again, I will choose a continuous peripheral nerve block in a heartbeat.