You might be more likely to recognize Alan Helgeson from his work as a local radio personality rather than his job as principal assignment editor for Sanford Health News
Between bringing authenticity to the airwaves and coordinating stories for the health system’s marketing department, he has a lot on his shoulders. But it’s his knee that has required the most attention
Helgeson injured his right knee during a skiing accident in 2006, requiring surgery for a torn meniscus. The injury avalanche piled on from there with a series of setbacks, including a torn ACL and arthritis
“Little knee things. Not anything exceptional,” he said
The 61-year-old managed the pain for years through conservative measures like physical therapy and corticosteroid injections. The shots provided relief, but the effectiveness diminished over time
“He went from getting months of relief with an injection to weeks,” said orthopedic surgeon Kristofer Kimber, M.D. “That’s more frustrating and that’s more difficult for patients usually, and it was more difficult for him.”
Helgeson reached a point where knee replacement surgery felt like the next natural step. It’s a decision he made in conjunction with Dr. Kimber and his physician, Mark Lounsbery, D.O
“(Dr. Kimber) has been along for so much of this journey and knows every bit about me,” Helgeson said. “When we finally got to this point, he said, ‘Only you can make that decision if you want to.’”
Importance of information
The journey for joint replacement surgery starts well before the procedure ever happens
The Sanford Center for Joint Success offers a comprehensive joint class for patients undergoing total hip, knee or shoulder replacements. The class covers topics like do’s and don’ts leading up to surgery, what to expect the day of surgery, and what the days, weeks and months afterward may look like
“They know how much this matters to the overall thing that they’re doing,” Helgeson said. “They want people to heal in the proper way, in the right way. These little things make all the difference in the world.”
Patients also have a pre-op physical to minimize the risk of complications during the surgery. The appointment includes things like checking in on heart and lung function to make sure the patient will tolerate the surgery
“Your point of contact always starts at your primary care doctor,” said Dr. Lounsbery. “We evaluate Alan frequently and talk about all of his medical conditions and all of the concerns.”
The pre-op physical also serves as another chapter in the continuing conversation around the knee replacement process
“It’s important to go in with an informed decision and be able to decide what’s the best for you,” Dr. Lounsbery said. “In the end, it’s your knee, it’s your joint, it’s your health. It’s a very individualized approach from my standpoint.”
Putting off the decision can also compound the situation
“I’ve seen too many people through the years that have just ignored and ignored and ignored,” said Dr. Lounsbery. “A lot of times they can get into a situation where their ability to walk gets very difficult. When you start to lose the ability to walk and move, your life – quantity and quality – go down significantly.”
‘Never a good time to do this’
Life is motion and motion is life. It’s a philosophy among many who work in orthopedics. But sometimes life can disrupt motion
A few weeks before Helgeson was scheduled to have knee replacement surgery, his dad passed away. The emotional shakeup led to consideration for putting off the procedure
At the crossroads, Helgeson thought of his dad, who had both of his knees replaced several years prior
“He absolutely would’ve said do it. He would’ve said, ‘What are you doing?’” Helgeson said during a conversation days before his surgery
He also remembered a podcast interview he’d conducted with someone who’d lost her father to colon cancer because there was never “the right time” to get screened. It was as if Helgeson’s reflection came at the right time
“I could find all sorts of excuses to get out of it and not have this done,” he said. “I thought about that and said, ‘I need to get this done. There’s never a good time to do this and I’m gonna do it.’”
The mindset not only got him over the hump. It carried him through the rest of his knee replacement journey
“Alan’s biggest strength in the whole process,” Dr. Kimber said, “is that he’s had a very positive attitude about this since the get-go.”
‘Still unreal to me’
Helgeson walked into the Sanford surgical tower on a relatively mild December Tuesday, his last day with his troublesome knee
Amid all the thoughts leading up to surgery, his focus was drawn to the incredibly thorough preparation process – down to the way he was instructed to brush his teeth
“I’ve worked in healthcare for 20 years, but then you see these things and I was just awestruck at the attention to detail to things like this,” Helgeson said. “I had no idea the kind of care and the team that would wrap around me to do all the things to get me through that.”
Despite a screw in his knee from a previous surgery, Helgeson received a standard knee replacement. Dr. Kimber cleaned up some of the soft tissue in the area, attached metal pieces to protect the bone, and inserted a plastic piece behind the kneecap
“The bone has nerve endings. If the metal is protecting the bone, usually the bone doesn’t get irritated and you don’t have the pain,” Dr. Kimber explained. “The reason for putting the kneecap there is he did have enough arthritis behind the kneecap that I didn’t want that to continue to be a pain generator for him.”
Helgeson woke up in the post-anesthesia care unit (PACU) and arrived in his hospital room a short time later. That’s when the work started. Within just a couple hours after having his knee replaced, he was up and walking with the assistance of a walker, nurses and staff
“That still is unreal to me,” he said. “I’m thinking, ‘You put something that wasn’t in there two hours ago, in between my bones, and I’m using that to help walk.’”
Joint replacement patients often have the choice to stay overnight after surgery. Some choose to go home, either for comfort or travel reasons. Others prefer to remain in professional care for a day. Helgeson stayed overnight, getting in another walking session with staff before heading home the next morning
“The physical therapy I had while I was in the hospital, like none other,” he said. “They prepared me so well for when I went home. It was just out of this world.”
Physical therapy and mental support
Physical therapy is a team sport. Both the patient and physical therapist need to be on the same page, working toward the same goals
For knee replacements, the early days set the tone for recovery, especially for range of motion. The way Dr. Kimber explains it, the curve is steeper in the beginning, with 75% to 80% of recovery taking place in the first three months. The curve flattens over the following nine months
“The initial postoperative time is a grind,” he said. “It’s that day to day where you’re not necessarily feeling like you’re always making forward progress, but just remaining diligent and consistent with your exercises.”
Consistency is something Helgeson had already found with physical therapist Brett Hudson. The two had worked together for years while Helgeson was managing his knee pain. A new knee presented new opportunities for improving mobility and quality of life
“One thing that we have to keep in mind is, yes, the patient came in and just had surgery, but they’ve been fighting with this joint for years,” Hudson said. “There are a lot of compensations there. There’s a lot of fear there.”
Helgeson continued to use a walker for the first couple weeks, then progressed to a cane. One month later, he was walking on his own. His most challenging milestone early on was a box step used to simulate walking up and down stairs
“The first time I put a four-inch step in front of him and said, ‘I want you to step up with your surgical leg,’ he looked at me like I was crazy,” said Hudson. “Our job as PTs is to coach them through that. Not only to strengthen the joint, but to strengthen their mind and say, ‘OK, I can do this. The surgeon put a new knee in there. I’m good to go.’”
The recovery process is almost never a straight line from point A to point B – there are peaks and valleys. To that end, mental support can be as important as the exercises themselves. Hudson and Helgeson added several weeks of sessions to the recovery plan, extending the physical therapy timeline by nearly two months
“He was not only a physical therapist, but he was a builder of spirit and a friend to really help get you going,” Helgeson said. “Every time I left PT with Brett, I came out always feeling better.”
Helgeson also found support and encouragement from his wife, Linda, who was there for everything from joint class to surgery day to serving as his coach at home
“She was truly the glue that held everything together from beginning to today,” he said. “I absolutely could not have done it without her.”
Getting back to normal life
Every recovery has moments where process materializes into progress
Helgeson has several of those moments, like his first time climbing back into his pickup truck and driving around the block. The next day, he drove to work for the first time in nearly six weeks
“I’m thinking, ‘How am I gonna get in this thing?’” he said. “It felt like a major accomplishment. That was a big win.”
At work, he’s been taking the stairs more often than the elevator, something that wasn’t a preferable option before his knee replacement. And when he and his wife went on a spring vacation to the Caribbean, Helgeson still brought the walking stick he’d come to rely on, but he didn’t use it
“I didn’t need to. I didn’t walk two blocks and my knee hurt or got stiff or swollen,” he said. “That’s such a great feeling. I don’t have that fear of my knee just tiring out anymore.”
Helgeson acknowledges that there is more work to be done, adding that he and his new knee are “still getting to know each other.” But overall, life is returning to normal
“It’s very rewarding to see the people that are doing well and can go on living their life,” said Dr. Kimber
“That’s what it’s all about, is getting back to what you want to do,” added Hudson
Helgeson hopes his story will speak to others who have been considering total joint replacement, especially anyone who is afraid or concerned about surgery
“I was afraid to do it, and I don’t know why I waited. I’m glad I did it,” he said. “Don’t be afraid because the Sanford Orthopedics team, they’ve got your back – or I guess they’ve got your knee.”
Learn more
- Do you need knee replacement surgery?
- What to know about total joint replacement surgery
- What is joint pain and what can you do about it?
Posted In
Internal Medicine, Orthopedics, Rehabilitation & Therapy
