Surgery: Part II

Waking up from surgery is always a weird experience for anyone...

It's always the same: I'm in a deep sleep and I hear my name being called out. When I open my eyes I'm very confused - where am I and what just happened?

I wanted to just close my eyes and go back to sleep, but they won't let you - they start asking you questions, handing you stuff to eat and drink, etc.

I was also shivering... a lot. That was weird but the nurse said it was the drugs in my system causing that.

Joel then walked into the recovery room (I was in a room with a bunch of curtains where others were out of surgery) and said something like, "Well, you were in there for a while." It was 10:30. And then he said something like, "That bandage looks a lot different than what I had."

I looked down and saw my leg bandaged up and a tube coming out of it. "What the ???"

OK, so I'm very groggy but I had no idea it would look like this. I remembered him saying it would be wrapped in a bandage but I could remove it for showers. What in the world was going on?

Dr. Ramsey then appeared and explained everything. In addition to repairing the torn meniscus, removing the cyst, cutting out the scar tissue, shaving down the bone, and fixing the "problem" discussed below... he ran into something else: a permanent suture.

My previous surgeon had attached a permanent suture which attached the kneecap to the femur (I think - remember, I'm groggy). He said it was restricting the kneecap and shouldn't be in there.

I don't know if that means the previous doctor left it in there by accident or on purpose, but this may be a HUGE change in my mobility.

If you've seen me walking on stairs (especially going down), it is an extremely difficult process. When I step down, I'm always holding onto a railing because I don't feel like I have any control. While the right knee is flexible, the left knee would only go to a certain point. It was like there was a wire in there!

Well, now I know... at least I'm really really REALLY hoping that is what was causing this and that my flexibility improves. This falls right in line with my goals - walk like a normal person again!

So then he explained the tubes: It's a glorified ice pack. As you can see in the picture above, I'm attached to a machine that pumps cold water into a pack that is on my knee. Hence, why the knee looks like it's 10 sizes too big.

I have to keep this hooked up 24 hours a day while I'm stationary. If I need to get up, I have to unhook it (it's a process, believe you me) and then re-hook when I return (couch or bed).

Dr. Ramsey then said I'm not to remove the dressing - which means I'm back to trash bags for showering. I was supposed to see him next Thursday, but he wants to see me this Monday morning. I then go into physical therapy after leaving his office (that day).

My restrictions are not to bend the knee and to stay on crutches until he or my therapist releases me... and no driving. Good gravy!

After getting dressed, they wheeled me out to the front and got me into Joel's car and off we went. I was one big groggy mess - Joel was talking and I was trying to talk but was having difficulty. They had stuck a tube down my throat, so it was sore and I had a lot of drainage. Couldn't seem to clear my throat.

During the drive, Joel said "You're not going home tonight. I'll go to your house later to get your crutches." (Hair on the back of the neck perks up)

You see, I left my crutches at my house specifically because I was told I'd be going there directly after surgery. Then I reluctantly agreed the night before to stay a few hours at their house after the surgery. Now I'm being told this bit of news.

OK, I'm not trying to be stubborn, I'm just more comfortable at my house. I keep the AC very cold, I don't have bugs flying around or landing on me when I'm on the couch, and it's quiet.

We got back to their house and Joel helped me out of the car and to the couch. Immediately the IV fluids were ready to get out of the system - I went to the bathroom 3 or 4 times in the few hours I was there.

Mom arrived and I made it clear (while sitting on their couch with my shirt off sweating) that I was going home. She could see my frustration... and agreed if Carson stayed the night with me. No problem.

More to come...

Surgery: Part I

OK... here goes my attempt to bring everyone up to speed...

I agreed to stay at my parent's house Tuesday night since I knew it would be easier for us to get to the surgery center by 7 AM on Wednesday.

I also took this "no driving for a few days" as an opportunity to put my truck in the shop for it's 90k mile service.

Joel met me at the dealership around 5:30 Tuesday - his surgery was rescheduled because he had a cut on his hand. So, that was one less headache for my mom.

On the way back to the house, Joel told me he was going to be taking me to/from the surgery center tomorrow and that I would be going back to their house. (The hair on the back of my neck started to rise)

Even though I told him I thought the plan the entire time was for me to go after the surgery, he made it clear that I was going to their house. I knew it was a lost cause to argue with him, so I told my mom when I arrived - "I'm going home tomorrow."

The rest of the evening involved a dinner, 2 nephews playing their games, and me watching TV after the parents went to bed. The nephews and I went to bed around 10.

I was up by 5:45 and Joel and I arrived at the center by 7 AM. After signing in (and paying my deductible... grr), they called me back. I then got changed into the "gown" and got into a bed where the nurse started more pre-op work.

This included taking the temp and blood pressure (128/78), hooking up my IV (fluids), and shaving my knee. Ahh... memories.

Joel came back and sat with me for the next 30 or so minutes. The anesthesiologist arrived and said I could keep my contacts in. He then gave me something in my IV to make me drowsy, and Dr. Ramsey then came in.

He told Joel and I that he was looking at my X-Rays Tuesday night and he thinks there is a "problem" on the left side of my knee. In previous blogs, you read that I've been having 3 areas of pain: Overall top, inner knee, and lately the outer knee. The outer part was knew to me and I thought it was because I was overcompensating because of the inner pain.

Well, remember I'm drowsy at this point... so "problem" is defined as "some name he gave it that he needs to do more cutting inside (not outer) to fix it."

He also said my recovery is going to be longer and that the surgery will be a bit longer. Well, I obviously didn't care at this point... he could have said, "And then we amputate" and I would have been find and dandy.

So they wheeled me out (Joel left to go to the gym) and I went into a room with about 5 other people (nurses/doctors) waiting for me. Probably within a minute of looking around, it was "lights out." I think this was about 8:15-8:30.

Wednesday is D-Day...

Doesn't this look like fun???

I went in to see Dr. Ramsey this morning for my pre-Op work. All I can say is it was MUCH different from the previous two surgeries.

Instead of giving me a "mini-physical," they basically wanted the general information. I told them what meds I was taking, gave them all of my contact information, and received all of their instructions for pre and post surgery.

I asked a question that led into the whole "knee replacement" possibility. Dr. Ramsey said he didn't think I'd have to undergo that at this point (or in the future), but said he'd know more when he looked inside.

Background: My previous surgeon said in 10 years I'd probably be replacing the entire knee.

My surgery is around 8AM. I have to be at the "surgery center" by 7AM. Joel will be driving me. So, instead of a hospital, it's some facility located at Preston/Frankford (for those in the Dallas area that know what I'm talking about) where he does his surgeries. Interesting.

It will last about an hour or so, and then I should be home by noon.

Dr. Ramsey said the first 24 hours it will seem like no big deal. The knee will be numb. However, once I start feeling the pain, I need to hit the Vicodin immediately and take it every 4 hours.

Thursday should be an OK day but Friday should be my worst. Then, it should start to improve.

I then went and filled my prescriptions (I start taking an antibiotic tomorrow) and prepared for the upcoming pain by buying things that I never do: ice cream, cookies, etc.

5 days after surgery, I start physical therapy. I need to go through that for the next 4 weeks, 3 times a week. At least two of those weeks I won't be going into work.

9 days after surgery, I go see him for a follow-up. I'll probably get my photos, too... the interior of the knee. I'm really looking forward to that...

I can shower the next day, and I don't have to wrap it up with a trash bag. Shocking! I will take off all of the bandages and then re-apply them when I'm finished.

Absolutely NO weight on that leg for the first 5 days - meaning, I need to stay on the crutches. And, I have plenty of exercises I have to do to avoid blood clots (that's the biggest worry).

Anyhoo, that's all I know. I'm probably going to be grumpy (or grumpier than normal) towards the end of the week, but I'll do my best to write in the blog.

Got the Green Light...

All week I've been taking my blood pressure at home... twice a day.

The numbers haven't been very impressive. Typically running around 130/90 (variations in those ranges).

Dr. Ramsey wanted me to get clearance from my regular doctor, Dr. Patel. She knows my history pretty well, and was aware of my upcoming surgery.

Well, the good news is my blood pressure was 116/76. That shocked me... but then it made sense of the disparity in numbers.

When I typically take my BP, it's in the morning right before I go to work... and right after I return.

I'm assuming that my meds haven't had a chance to kick in when I take it in the morning - and I'm probably pretty dang stressed when I return home from work each day.

Believe me - this will all be resolved once my knee has been fixed where I can exercise again. I'm a firm believer in this because I've seen the proven results before.

So Dr. Patel wrote me a note that I'm "clear" for surgery, and I'll give that to Dr. Ramsey on Monday when I go through my pre-op work.

Speaking of Dr. Ramsey, my mom ran into him yesterday while she was seeing one of her other doctors (same building). She thanked him for helping out "her guys" (Joel and me) and he said he really thinks I will see significant improvement after the surgery. He even said he's really looking forward to "fixing me up." Awesome!

My plans this weekend are to take it easy - lots of time on the couch! I know next week at this time I'll be experiencing a different type of pain, but at least I'll be one step closer to resolving all of this!

Answering Questions...

... and we all know how much I enjoy answering questions. :-)

OK... here we go...

What is your current blood pressure?

It's running around 140/95 to 130/87. My doctor said it's better to get it more normalized as it makes the anesthesia more effective.

I've been working with my regular doctor to bring it down. Prior to the knee issue, and way before I was running, I had very high blood pressure. Seriously high... like 170/110. For the past few years, I've taken medication and exercised. Well, guess what has been eliminated from that equation? So because of being stagnant due to a crappy knee, I haven't been exercising.

Now that I know why the knee is hurting, my hope/goal is to get back into "mobility" after it gets fixed up. Meaning... go back to a normal life!

I just had no idea that the high blood pressure would be an issue and could prevent me from having the surgery (see picture) next week.

I'm going to see my regular doctor on Friday. If she doesn't feel comfortable with my BP level, then I'll need to reschedule the surgery. That will really bum me out.

You're still feeling pain? I had no idea...

Yes... frustratingly, absolutely and emphatically yes! This was posed to me today after someone found out that I'm scheduled for surgery. They followed it up with, "But you must be hiding it because you don't look like you're in pain."

Well, who wants to see someone grimacing... whining... or complaining all of the time? If you've been following this blog for a while, you remember I mentioned one time that I have a "strut." That helps me to try and prepare for the pain I know is going to occur when that foot hits the floor.

Here's my "pain" description. When I stand up... walk... even bend the leg with the foot pulled in... everything tightens up. I don't have any cushion between my bones. It's worse when I'm walking... it's a compressed grind. When I put my foot down, everything goes together. This pain is the top of the knee to about the middle of the knee. From what Dr. Ramsey showed me, this will always be a part of my life. That's why I need to take glucosomene to help build up protection/shock absorption around my joints (i.e. knee).

Now, there is another area of pain: Interior. This is where the meniscus is torn... possibly shredded. Every step down feels like it's being poked. Once he goes in and mends the tear, that pain should go away.

The third area (yes, there is a third) is on the exterior. It aches. I think it's because I'm over-compensating to the outside now that I know there is a tear on the interior. Kendra, the physical therapist, thinks it may be that or it may be another tear on the lateral meniscus. Hopefully by the end of the surgery, this will be alleviated.

So, if you look at it from this perspective, I'm hoping for a 2/3 improvement. Right now, it just hurts like a mutha... all the live long day.

Oh, and one more thing: Dr. Ramsey asked me to stop taking Alleve and Advil until after the surgery. Anti-inflamatories don't work well when he's got to go in and poke around. Let's just say it hasn't been a very fun day... and this is going to be one long week.

Is this a Day Surgery?

You bet. While I don't know the time, I expect to be heading home a few hours later. Maybe this time the doctor will stick around and answer any questions my parents have. Ok, I know he will. He knows my parents...

Are you staying at your parent's house?

No. I really just want to be at my place, sleep in my own bed, and keep the A/C at a temp that is comfortable for me. Sounds selfish, but hey... that's my attitude after two surgeries.

The plan as of now is for Joel to come pick me up and take me to the hospital. He may or may not stay - he's having his own surgery (hand) the day before. (When it rains it pours... poor Mom) I think she'll be there when I get out and drive me back to my house.

Now instead of being alone, my nephew Carson will stay with me that day/night. I hope he brings something to entertain him because I know I won't be very fun to be around.

Can you put me on the list to be notified?

Sure. Send me an email if you want to be notified. I'll either send out an email at some point in the day or just update the blog... or both... not sure what my frame of mind will be.

So that's about it. Pray for my blood pressure to come down. Pray for the pain to be bearable this week before the surgery. And I guess overall, just keep me in your thoughts as I try to keep a positive attitude through all of this.

Surgery Time...

Next Wednesday, July 21st, is my scheduled surgery for the knee. Let's hope it's the last one for a while...

I met with Dr. Ramsey this morning to go over the MRI and my options. Basically, he said, "We're at the point where we need to go in and scope your knee if you're going to see any kind of improvement."

The results of the MRI were sketchy. The drill bit really caused a lot of problems, both for him and the radiologist.

Here's the good news: Both my ACL and PCL are intact. This means I don't have any tears in my ligaments.

The bad news: I have a torn meniscus (we knew that) and a cyst. He didn't seem to think this was surprising... so neither do I.

But, the rest of the results start with a phrase, "Metallic susceptibility artifact obscures..." Translation: "Drill bit prevented a good MRI of the entire knee."

Dr. Ramsey then walked me through what he believes is going on. He said with the "force" of the impact, it took tremendous energy to break that kneecap. He said it's his belief that the meniscus tore at that moment because that is a normal occurrence if the patella breaks.

He asked me again, "So did your previous surgeon scope the knee?" I said I have no idea... and told him I never heard the term "scope" or "meniscus" after my surgery (as dimly lit as my pilot light was after being under) or in subsequent office visits... including the surgery to remove the hardware.

So here's the deal...

This week I need to follow up with my regular doctor to see if the new meds she put me on brought down my blood pressure. If it hasn't come down, then I need to reschedule the surgery. (notice that I'm trying to get this over with as fast as possible)

On Monday I go in for my pre-op work. Hopefully that won't be as long as before. This time it's done in his office... if you remember my last 2 took half a day of me walking around the hospital. I know my surgery is Wednesday, but I don't have the time yet. Probably in the morning.

Wednesday's surgery will last about an hour, but I'll be there for about 3 hours. He's going to make about 5 incisions to work around the knee... arthroscopic. He's going to fill the knee with fluid so it swells up and allows him to work. That fluid will stay in my knee for about 24 hours, which will alleviate the pain when I come out. But, after 24 hours, I'm really going to be feeling the pain.

When he goes in, he's going "scope" the knee. Part of this will be to use a camera to check out everything (and take pictures for me to keep). He's going to repair the meniscus, remove any scar tissue, and "shave" down any bumpiness. He'll also check the other meniscus and remove any "loose bodies." I assume that means cysts or bone fragments. We'll see. Probably something I should have asked...

Personal Note: I hope the pics show the trauma of the break. I really want to see what my bone looks like and what I'm feeling through the skin.

After the surgery, I should be in pain for the next 2-3 days. I'll be on crutches for 5 days, and he really doesn't want me returning to work for two weeks. I can work from home, so that should be fine.

The big concern after this surgery is blood clots, so I'll have some exercises I have to do to move both my feet so that doesn't happen.

Nine days after surgery, I'll go in and see him and should start physical therapy right after that. PT will last about 4 weeks, 3 times a week.

He also reaffirmed that from what he saw on the MRI and the X-Rays, I should never run again. Or, more specifically, "I can't run." Even after hearing that multiple times, it's still not the greatest of comments.

Which means my next hobby will most likely be "biker." I know certain people reading this will say "swim," but I don't really enjoy that. I do like biking, so that is probably my next best sport.

Going back to the scheduled date: I chose this because I want to get this part of my life on the fast lane and reduce the daily pain at least somewhat. My nephews are coming to visit my parents next week, so I know it's going to be a scheduling nightmare for my mom. I'm sure Joel will help out.

Anyway, that's all I know...

Back from Vacation...

... and it was AWESOME!!!

The pics above start with Galveston. I went there for the 4th (3 nights) to spend time with my family and hang out on the beach. We typically go twice a year. The beach was great, although we had some storms on Friday/Saturday related to Hurricane Alex.

If you've never been on a cruise (like me), I've been told you fall into one of two categories: You either love it or you hate it. I was hoping I wouldn't fall into the "hate" mix... and I'm proud to say that I definitely didn't! If you're looking for "simple," then a cruise is definitely for you.

Since we stayed at the Tremont Hotel the night before, we were able to park for free throughout the week. They shuttled us over and we arrived at the terminal at noon. Would you believe we were on the ship in less than 30 minutes? (I was told it could be up to 2 hours!)

Everyone was extremely welcoming... we immediately went to the "Activity" desk and booked our 2 excursions and one ship tour. We then grabbed a drink and walked around the ship. In some ways the ship was larger than expected... and in others it was smaller (if that makes sense). There are a lot of stairs, but thankfully quite a few elevators!

We went to the back of the ship to eat lunch - it was packed. That wasn't a very good first impression for me - tons and tons of people trying to eat (including screaming kids!). But the food was good and we weren't there long.

After the safety briefing, we started moving and David and I headed up to the front of the ship to watch us go out. It was fascinating - I've been to Galveston so many times, but never out the ship channel.

We went to check out our room and our luggage was sitting outside the door. The room was actually bigger than I expected - including the bathroom. The Ecstasy is an older ship - built in 1991 - but it was refurbished a few years ago.

That night we had dinner (3 courses) and then headed over to the karaoke bar. All I can say is people do the funniest things when they know they won't be seen by those around them ever again! It was hilarious! One big fat white guy got up there and sang "Baby Got Back" and brought the house down!

Oh, one thing on the dinner - they seated us at a table for 2. You're assigned a table throughout the cruise, so this was ours. It was a little surprising... we really thought we'd be sitting with others. But, there were A LOT of families on this cruise...

Tuesday was a sea day - we had no idea of the time when we woke up because it was so dark in the room (no window) - it was 10:3o AM! That day we lounged around a lot, went to the Casino, enjoyed the bars, and got dressed up for dinner.

One night on the cruise is a "dressy" night. David wore a suit and I put on a sport coat. Well, our little "table for two" table finally sought revenge/embarrassment. When the dinner was almost over, our waiter asked (in all seriousness) if we were celebrating an anniversary. Uugh... right then it felt like the spotlight was directed on us! Good gravy!

Wednesday we arrived at Progresso, Mexico, in a blinding rainstorm! A tropical depression was sitting right on top of us when we docked... and we had to be on the bus by 7:00... so we headed out into it. Everyone was running except me... oh well. David hung with me, though. He's a good friend. We were soaked from head to toe. Thankfully, the rain ended before we got to the ruins.

We drove 2.5 hours to Chichen Itza, the largest Mayan ruin site. It was very impressive, very large, and very touristy. It was interesting to learn about the culture (Mayans are of Mongolian ancestry). I was told by my fam that it would be a lot of walking, and they weren't lying. My knee was speaking to me! We drove back in order to make it back on the ship by 2:30... we arrived at 2:45 and the ship took off at 3:30.

That night we had another nice dinner in the dining room (I started asking the waiter what he recommended and it was always the right choice), then went back to the room. My knee was killing me, and I needed an ice pack in the biggest way.

Thursday we arrived at Cozumel - that island is incredibly beautiful. The water is very blue, the sand is very white, and believe it or not, most of the locals we ran into spoke very good English. We had signed up (on the ship) for a "Snorkel/Beach Party" excursion. Basically, it's a "Booze Cruise" that takes you snorkeling and to a beach.

Jumping into the water was awesome - we were on a reef where there were tons of fish in about 25 feet of water. Immediately these little tiger fish were swimming all around us thinking we were going to feed them. I saw all colors of fish... but the most impressive was a HUGE school moving beneath us... thousands of fish! It looked like a large black cloud.

Oh yeah, we also saw a barracuda. It was about 3 feet long... and it was very cool! Plus, the coral was purple and blue... As you can see, I really enjoyed it. We snorkeled for about 45 minutes, and then they called us up. I took pics with an underwater camera (future blog), but need to get them developed.

Then we headed to a beach - it was great. Very relaxing... drank beers and margaritas, swam in the water (floated on my back!), and hung out for about an hour... then headed back to the dock.

We had one mission: Buy watches. After about an hour of browsing and haggling in a recommended shop (by the cruise), we emerged with some nice watches. We then had lunch at a great little restaurant where we met the waitress who promised to show us more of Cozumel if we ever came back.

Friday was another sea day - but we did something really cool. We signed up on the first day to have a "ship tour." For the next 3 hours, we got a tour of the control room (engines), laundry, galley (kitchen), trash, storage, stage (performances), crew quarters, crew break room/galley/gym, and the bridge. Up there we met the captain (got a picture with him), saw the navigational equipment, and asked them a bunch of questions. It was freakin' awesome!

That night we ate at the sushi bar (we ate A LOT of sushi on this trip!), went to a show, went to the karaoke bar, listened to a very R-rated comedian (he was funny, though), and then went to a dance club (yes, we met some chiquitas to hang out with because if you know me, I don't dance!) It was a late night (and don't ask me any questions!)

Overall, the trip was just what the doctor ordered. I enjoyed the conveniences, the staff, and all of the excursions. The food was good, the drinks were plentiful, and I'd definitely recommend it to anyone who is looking for a fun and easy vacation.

What would I do differently? Don't go in the summertime - too many kids/families. Make sure the boat has an "adult" pool because the main pool was a bit too small and crowded (never got in). We hung out in an adult area, but it only had 2 very hot jacuzzis. Oh, and make sure you break your twenties down so that you have money to tip with. Let's just say some locals got very nice tips.

Now, back to reality... I go see my surgeon in the morning. I'm pretty sure we're going to schedule the surgery.

More later...