So, What Do Knee Replacement Surgery and Cancer Have in Common?

I will never forget an appointment I had at The Cleveland Clinic on Wednesday August 12, 2020, when I learned my life would never really be the same again. It was my first appointment with an Orthopedic Surgeon to discuss my aching knees. Why did I schedule the appointment? I had been taking way too much ibuprofen for years, and I was tired of people telling me I was limping terribly when I walked. I could also tell my knees were in bad shape as evidenced by how hard it was for me to get up from my living room chair after watching a good Netflix movie with Kristina. My “unique” walking capabilities have never been idolized by anyone, including me, and seeing me trying to get up last year from prolonged sitting in a chair was painful for anyone to try and take in. After numerous concerning comments from Kristina and others whom I trusted about my declining walking abilities, I figured it was time to get a professional opinion on what was going on with my knees. I did not really know what to expect that day towards the end of summer 2020, but I never expected to receive the news I was about to be given that day.

I arrived for my appointment at The Cleveland Clinic on August 12 forty-five minutes early to have X-Rays taken of both knees. I walked upstairs to the orthopedic surgery department, checked in with the receptionist, and waited for my appointment with the surgeon. Why did I pick a Cleveland Clinic surgeon for my knee appointment? First of all, God has used amazing professionals from The Clinic to save my life from two different cancers. As a result of the amazing world class care I received from them over the years, I am incredibly loyal to them. One of my golfing friends, who was President of that Cleveland Clinic hospital where the orthopedic surgeon was located, recommended the surgeon to me, and he even helped me set-up the appointment. My friend also told me the surgeon was very highly rated and would not hesitate to tell me exactly what was going on with my knees. Boy, he was not kidding when he said the surgeon would not beat around the bush. After waiting a few minutes in my appointment room, the surgeon, who I had never met before, walked in, and said to me, “What the heck took you so long to come see me?”. Yikes! I believe the actual word he used was “he**” and not “heck” by the way. I was a little shocked by his comments, but I did manage to utter an appropriate response when I answered him with, “Nice to meet you too Doctor - I can see this appointment is going to go well today”. He proceeded to tell me that my knees were a complete mess (bone on bone), my cartilage was all gone, and that I was an immediate candidate for TKR or Total Knee Replacement. After he injected a cortisone shot in both of my knees, I told him I needed to think about his TKR recommendation. I walked out of the hospital thinking I never expected to receive such news when I was 54 years old. If I am totally honest, August 12 was a humbling day for me as I suddenly felt old and I felt like my body was starting to fall apart. Since you are not allowed to run or jog post TKR surgery (there are other restrictions as well), I was a little scared too as I knew my life would never really be the same again.

On Wednesday August 19, 2020, I ended up getting a second opinion at University Hospitals (“UH”) and the surgeon, who is also a friend of mine through golf, proceeded to tell me that my knees were a mess and that I was an immediate candidate for TKR. Yep, it was the same diagnosis the first surgeon provided me with. The UH surgeon goes on to say if I were to wait by putting the two TKR’s off for a few more years, I might have bigger and more problematic issues to deal with. Gulp! He then pulled up my X-Rays and showed me all the issues which were wrong with my knees. I lost track of the number of issues he pointed out in my X-Ray’s, but it felt like it was more than 20 problem areas. However, I was grateful he took the time to show me why I needed the two TKR’s. Thankfully, Kristina was able to join me at this second UH appointment and took excellent notes, which we reviewed over the next couple of days. We prayed about the potential bi-lateral TKR’s, and then we both decided I had no choice but to move forward with these replacement procedures for my osteoarthritic knees. We decided to go with the surgeon at UH because I knew him personally, he successfully replaced one of my mother-in-law’s knees and I just felt more comfortable with him. While it was tough for me to leave my beloved Cleveland Clinic for these two important procedures, I called UH on Friday August 21, 2020 to schedule the two surgeries. Since my surgeon was booked out several months in advance, I signed up for the first two available appointments given their 8 weeks between surgeries requirements.

My two TKR surgeries were performed on November 10, 2020 and January 4, 2021. I am grateful to report that I was blessed with two excellent surgical results. However, the two TKR recoveries were extremely difficult and painful. I have still not made a full recovery and there is no guarantee I will achieve a 100% satisfactory result as 15% of TKR’s end up with the patient feeling unsatisfied with their result. It takes up to a year to fully recover from TKR. After my first surgery, I was in so much pain that I lost over 15 pounds. Why? When you are in extreme pain, you do not want to eat so the weight comes off easier than a WW diet. For the next 4 months, even though I was on some heavy pain meds, I was fortunate if I was able to sleep 1 to 2 hours each night because the pain was so intense. Some nights I did not sleep at all. Because of the lack of flexibility in my knees at the time, I had to sleep on my recliner in our TV room for months because it was too painful to sleep in my own bed. In fact, I am still in some pain as I type this blog post all these months later, although I am taking much less intense pain medications. I also had the added blessing of bringing COVID-19 home with me from the hospital after my first surgery. Even though my first procedure was an outpatient procedure, I obviously picked it up from someone who cared for me while I was in the hospital. Unfortunately, Kristina ended up catching COVID-19 from me as well. In fact, she was the first to get diagnosed with it as I was in no shape to go and wait in a long COVID-19 testing line. I confirmed I was COVID-19 positive weeks later with a COVID-19 antibody test. Anyway, it broke my heart when she told me her COVID-19 positive news. Seeing her get COVID-19 and suffer was extremely agonizing for me because we had been living like hermits since the pandemic started in March of 2020. No one wants to see someone they love suffering, and I felt guilty because I knew she caught it from me as the result of my elective surgery. Graciously, we both survived COVID-19 but it is not something either of us ever want to experience again.

When you lay on your recliner recovering from two TKR’s for 4+ months, you have a lot of time to think about life and questions such as “Why is this happening to me at such a young age”? Only God knows the answer to this important “why me” question so I will not even try to provide my own comprehensive answer to it. However, one of the thoughts that kept popping in my head is how TKR is a reminder from God that I am getting older, and that I will not live forever. Job 14:4 (CEV) tells us:

“Our time on earth is brief; the number of our days is already decided by you (God)”

Like everyone who lives in this world, I am consistently reminded by God of my own mortality through the events which have occurred in my own life. I remember getting my first gray hair. I remember losing one of my first cousins, Sara Risk, who was a former HS Prom Queen and one of my closest friends and encourager when I was a student at Indiana University, to a heart attack when she was in her twenties. The heart attack was caused by her eating disorders. I remember when my brother, Scott Risk, was diagnosed with thyroid cancer when he was only 29 years old. I remember when I was diagnosed with cancer two times. There are plenty of other examples in my life of how God has reminded me of my own mortality, but God has used these life events as a way of reminding me that I am getting older and that I am not going to live on this earth forever. As morbid as this may sound, every day which passes is one day closer to my own eventual death. As the preceding verse in Job tells us, God does not want me or anyone else us to forget that our time on earth is brief. We need to have an exit plan, but I will get to that in a minute.

Since I was first diagnosed with cancer in 2007, I have worked with hundreds of people who have been diagnosed with cancer and I am amazed at how many of them miss this simple point that God is using their cancer diagnosis to remind them of their own mortality and their need for Him. How do I know this? For so many of the cancer patients I have spoken with over the years, their sole focus is finding a cure for their cancer because they want to keep on living. They do not want cancer to cut short their plans for their lives. For these individuals, their prayer requests focus only on their own bodies and cancerous condition and do not address much of anything else. Even though they may not realize it, these individuals are saying that they want to be in control of their own lives and masters of their own destinies. In reacting to their cancer diagnosis solely in this way, do they realize that they are saying that God’s plan for their life does not really matter? As evidenced by their prayer requests, they are missing the point that God is using their cancer trial to either get their attention or to draw them closer to Him. Charles Spurgeon, a famous evangelist, once said:

“Trials teach us what we are; they dig up the soil and let us see what we are made of.”

2 Corinthians 12:9-10 (ESV) tells us:

“But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore, I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me.”

Yes, a cancer trial will likely test your faith more than any trial you have ever faced in this world, but it is also an opportunity grow in your relationship with Christ. In a cancer trial, the preceding verse in 2 Corinthians tells us that Christ’s power is made perfect in your weakness. Sadly, I have observed many cancer patients who are so concerned about their own bodies and cancer condition that they fail to even mention their own souls when discussing their cancer trial: James 2:26 (ESV) tells us:

“For as the body apart from the spirit is dead, so also faith apart from works is dead.”

Matthew 10:28 (ESV) tells us:

“And do not fear those who kill the body but cannot kill the soul. Rather fear him who can destroy both soul and body in hell.”

The preceding two verses in James and Matthew tell us the soul is more important than the body and we should not fear things like cancer because it cannot kill our souls. There is nothing wrong with prayerfully asking for healing and there are certainly plenty of examples in the bible where healing has been requested in prayers. However, what is concerning to me is when I observe cancer patients who ONLY ask for healing and nothing else. Do they not realize that the soul is more important than the body? Do they not realize that even if they are healed of their current cancer predicament they are going to die eventually anyway? Yes, being cured of cancer is wonderful when it happens, but it is only a temporary pass to avoiding death. If we should not fear cancer, then who should we fear? Proverbs 9:10 (ESV) tells us:

“The fear of the LORD is the beginning of wisdom, and the knowledge of the Holy One is insight.”

Basically, this verse in Proverbs teaches that the fear of God is foundational to true wisdom; all other types of learning are worthless unless built upon a knowledge of the Lord Himself. In order to develop a fear of the Lord, we must recognize God for who He is. He is sovereign and almighty and yet He loves us more than we can love Him so that is why He directs us in His word to develop a reverent fear of Him. Those who fear the Lord have a continual awareness of Him, a deep reverence for Him, and sincere commitment to obey Him.

While no one would hope for such a potential outcome, when was the last time you spoke with a cancer patient who at least acknowledged that they may not survive their cancer trial and openly discussed the implications of their own potential death? When was the last time you spoke to someone with cancer who told you that there have been numerous blessings which were a direct result of their cancer trial and that the circumstances of their cancer trial have caused them to start trusting in the Lord’s plan for their life more than they ever have before? When was the last time you spoke to someone with cancer who told you their eyes were opened, and their faith was reinvigorated by their cancer trial? If your life experiences are like mine, observing this type of spiritual growth does happen from time to time, but it does not happen as often as it should. Why? Death scares humans more than anything else in this world so many cancer patients, out of fear and lack of knowledge of God’s clear instructions in the bible, avoid talking about it and avoid confronting it when faced with a trial like cancer. This is a shame as there is true hope to anyone who does not survive their cancer trial. God tells us in His word that he wants us to always look to Him in everything we do and experience in this world, including cancer trials. Colossians 3:2 (ESV) tells us:

“Set your minds on things that are above, not on things that are on earth.”

I should point out the preceding verse is not a suggestion from God. He is not implying that we should pick and choose when we obey His word. Why? In https://dailyverse.knowing-jesus.com/colossians-3-2 it says:

“We are to find our sufficiency in Christ, knowing that in this world we will have tribulation – but Christ has overcome the world and we have a priceless inheritance—a beautiful inheritance that can never perish, spoil or fade away - an inheritance that is kept in heaven, especially for you.”

Since Christ has overcome this world and since we have a priceless inheritance, God wants us to always set our minds on things above and He is constantly reminding us of this fact in our daily trials here on earth. God gets our attention and reminds us of these truths through trials like TKR and cancer. When life is going well, many of us, including me, have the tendency to forget God and tout our own merits and abilities. It is in the trials of life that God reminds us that we are totally dependent on Him. I am sure there are a lot of reasons why my TKR recovery was as difficult as it was and why I am still progressing slower in my recovery than many people my age, but God has reminded me in these trials that I have an expiration date and that I am totally reliant on Him for everything. Based on my progress thus far, my surgeon and physical therapists tell me I should make a full recovery and I am hopeful that I will make a full recovery. However, God is in total control of my life and will ultimately determine if I make a full recovery or not. Regardless of my outcome, I need to set my mind on things above and trust in His plan for my life as He will not make any mistakes.

When I was recovering from my first TKR surgery, I read an article about Rebecca Luker, the Broadway star who died of complications of ALS at the age of 59 on December 23, 2020. She was an American actress, singer, and recording artist noted for her "crystal clear operatic soprano" and for maintaining long runs in Broadway musicals over the course of her three-decade long career. In a January 6, 2021 People Magazine Article (Rebecca Luker Died from ALS Complications, Says Husband: 'She Remained Positive and Kind Until the End'), here is what Rebecca Luker’s Husband said about her:

The Moulin Rouge actor (Husband) said Luker, whom he married in 2000, experienced a "steady decline" in health after she was diagnosed. "Her hips, her diaphragm, her shoulders, her elbows, forearms," Burstein said of the loss of mobility Luker experienced. "When her hands stopped working, she screamed in frustration. She fought so hard and held onto every muscle for as long as her body would allow," he wrote. "And despite her body failing so obviously, she was still hopeful. The doctors told us that she "had the slow-moving kind of ALS." But they'd obviously been mistaken. She was progressing so ridiculously fast that it took everyone by surprise." He added, "But still she was hopeful for some new trial medication to come along and save her life. She kept saying, 'I see myself growing old, being an old woman. I just know it.' “Burstein said Luker accepted the possibility she might die two weeks before her death, rejecting her doctor's offer of a tracheotomy that — while it would have helped her breathe — would have prevented her from speaking or swallowing. He recalled Luker said of the decision, "'If I don't have my voice, I don't know who I am. My voice is everything I am. I'll take my chances.' " The actor said Luker inevitably lost "two things that she loved more than anything: her ability to speak and taste food." "And so, in a way, she lived and died on her terms. If she couldn't do the things she loved the most, then she was ready to go," he wrote. "She'd fought so hard for so long. And she didn't complain, she remained positive and kind until the end."

What I just quoted in the preceding People Magazine article breaks my heart. First of all, the Lukers were married the same year (2000) Kristina and I were married, and I cannot begin to imagine what it is like to lose your wife after only being married for 20 short years. I cannot even begin to fathom what it would be like to lose control of your hips, your diaphragm, your shoulders, your elbows, and your forearms. How incredibly humiliating and depressing that must have been for her to experience. Like so many cancer patients who have a terminal condition, Rebecca Luker was hopeful for something to save her – a new trial or medication or something to prolong her life. The article seems to suggest that fighting for her life on her own terms was her primary focus at the end of her life. I am not sure what dying on her own terms means, and I am not sure she did either. When she was losing control of different parts of her body, did see not realize that her original ALS plan of fighting so hard was not working, and, since God designed each of our souls us to yearn for Him, didn’t she wonder what would happen to her soul if she did not survive her medical trial? While I compliment her for not complaining about her deteriorating terminal condition, how in the world can you possibly remain hopeful when death is staring you in the face in the form of terminal ALS? Thankfully, the bible provides an answer to this thought-provoking question. There is only one way we can remain hopeful and that is by trusting in the eternal promises which only Christ provides. 1 John 2:25 tells us eternal life is a promise for all who believe in Christ:

“And this is the promise that he made to us—eternal life.”

Only God knows the condition of Rebecca Luker’s heart, but I could not find anything written which speaks of her faith and her husband certainly did not mention her faith in any of the articles which I read. She had 13 months to ponder her terminal condition and it does not appear, based on published accounts which I read, that she was able to find the eternal hope which only Christ provides. ALS and terminal cancer are similar in that there is no cure for either condition. I call these terminal conditions “trials with a deadline”. With ALS, your body starts to fall apart but your mind remains sharp, meaning there is time to still ponder your eternal destiny and what will happen to your soul if you die from it. It is a horrible way to die. Unless you have terminal brain cancer, terminal cancer also allows you to ponder your eternal destiny and to think about what will happen to you should you succumb to it. Rebecca Luker faced a trial with a deadline for 13 months and only God knows if her heart was ever changed.

When I think of Rebecca Luker’s story, I am also reminded of a few cancer patients I have encountered in 14 years of cancer ministry who came to faith in Christ because of their cancer trial. Yes, God used the circumstances of cancer to humble these individuals to the point that they were receptive to the Gospel. These individuals will tell you that the circumstances of cancer made them aware of their own mortality and their hopeless condition. They were all looking for something to save them from their cancerous condition, but just did not know where or how to find such salvation. For many of these individuals, a friend or someone they trusted witnessed to them about their need for a relationship with God. Ultimately, the circumstances of their cancer trials caused them to start seeking God by praying to Him, by studying His word (bible) and by hearing His word preached. Eventually, they repented of their sins and put their faith in Christ as savior and Lord. What a contrast in stories I am referring to here! On the one hand, Rebecca Luker was looking for a medical savior and she never found it. On the other hand, these individuals I am referring to were also looking for a savior and found that savior in Jesus Christ. It was not the savior they were looking for when they were first diagnosed with cancer, but the circumstances of cancer caused them to finally realize that Christ was the only one who could provide them with true hope by trusting in His eternal promises.

Why are so many cancer patients unable to find Christ during their cancer trial? Thankfully, the bible provides answers to this important question as well. Matthew 7:13-14 ESV tells us:

“Enter by the narrow gate. For the gate is wide and the way is easy[a] that leads to destruction, and those who enter by it are many. For the gate is narrow and the way is hard that leads to life, and those who find it are few."

The gate is narrow because we must continuously submit the wellspring of pride and legalism rising in us because of the curse of sin and lay down our lives in exchange for God’s will for our lives. Jesus came to seek and save the lost, but unfortunately, not all of the lost want to be found because faith in Christ requires us to swallow our pride, repent of our sins and put our faith and trust in Him and Him alone. For people who want to exit this life on their own terms, these individuals are unable, unwilling, or unaware that they need to swallow their pride and put their faith in Christ to obtain eternal salvation.

In my cancer ministry, I have the unique and humbling privilege of working with a lot of people who come to our support group and some who do not. It amazes me how many people I am currently ministering to that seem to miss what I am discussing here in this blog post. Many of these people consider themselves to be Christians, yet they are extremely uncomfortable discussing their cancer trial or the implications of their diagnosis. We all know we are going to die so why is it such a surprise to someone who is given a terminal cancer diagnosis? For all of us, it is not a question of “if” we will die but “when”. Therefore, if death comes calling in the form of a terminal diagnosis, it is something we all need to be prepared for, so it is not a complete shock and so that it does not leave us hopeless. Thankfully, only God knows the conditions of each of these hearts I am currently ministering to and referring to here, and thankfully it is only His job to judge them. However, when Christians are extremely uncomfortable discussing the implications of their cancer diagnosis, it makes me wonder what they believe now that their faith is being tested in the form of a cancer trial. Are they doubting their faith altogether or did they not genuinely believe in the promises of the Gospel in the first place? Why are they so uncomfortable discussing their exit plan should they not survive their cancer trial? Does their uncomfortableness mean they are not truly trusting in God’s plan for their lives? Dr. Charles Stanley, a noted preacher and author, says: “We are either in the process of resisting God’s truth or in the process of being shaped and molded by his truth.” As Dr. Stanley said, it is an “either or” condition to describe your relationship with God. There is no in-between as you cannot just tread water with your faith. You are either swimming towards God or you are swimming away from Him, but you cannot just tread water with Him even during a cancer trial. Thankfully, God is always seeking us and is always desiring to have a relationship with us through His son, Jesus Christ. 2 Peter 3:9 tells us:

“The Lord is not slow to fulfill his promise as some count slowness, but is patient toward you, not wishing that any should perish, but that all should reach repentance.”

My favorite song on Pandora these days is “Worship you Again” by The Taylors. If you ask Kristina, she will tell you that when I get hooked on a song, I tend to listen to it repeatedly. On Pandora, you can even set up your favorite song to repeat over and over for 30 minutes. Since the song encourages me, I often set-up “Worship you Again” to repeat in this way on Pandora when I am on the elliptical, which is part of my 2 hours of daily PT to recover from my TKR. Here is what the lyrics say:

We have gathered in your house and I confess that I'm so tired The burdens of this life are heavy on my mind But I don't mean to complain when these problems cloud my view For you deserve my highest praise so Lord this is what I'll do.

I will lift my hands and worship you again I can't lift you high enough for all you have been Oh for a thousand tongues to sing Hallelujah to the Lamb So I will lift my hands and worship you again.

You are Wonderful and Mighty, King of kings and Lord of all When I magnify your name, all my problems seem so small So I will lay aside my pain, and I will lift my hands to you For I know it makes you smile every time I worship you.

If you study what the preceding lyrics say, you will learn the song writer says that the burdens of this life can be heavy on my mind and cloud my world view, but God deserves the highest praise so that is what I will do. When I magnify your name, all my problems seem so small. So, I will lay aside my pain and worship You.

If you are facing Cancer, TKS, ALS or any sort of other medical trial, do you realize that God is using the circumstances of your medical trial to remind you of your own mortality, and your need for Him? All of us, including me, want to be cured of our medical conditions, but a cure is not always part of God’s plan for our lives. Even if we are cured of our medical conditions, we still have an expiration date and we still must come up with an exit plan for our souls once our time on earth is done. If you are trusting in Christ as savior and Lord, God directs us in His word to focus on things above and trust Him, no matter the outcome of your medical trial.

“Set your minds on things that are above, not on things that are on earth.” (Colossians 3:2 ESV)

Jim Risk, a two-time cancer survivor, is the volunteer Ministry Coordinator for the Cancer Support Group (CSG) at a non-denominational church in NE Ohio. Jim and his wife, Kristina, have participated and served in CSG, a Christian ministry, since 2007.