Worse than Microfracture

0630 I was awake and happy with how my knee felt considering the brutality of the surgery. My ROM brace is locked out straight, swelling is incredible but somewhat masked by the Ted stocking and dressings. My toes are a familiar betadine orange.
Around 0430, the nerve block began to wear off, no increase of pain just tingling from the nerves waking up. By 0830 a new pain began not the constant ache around the osteotomy but a burning stabbing pain around the medial condyle. Soon it became unbearable and I became a slobbering, crying mess. No position of comfort could be found, so I had a phone call made to Dr Looney, within two minutes his office had returned the call and arrangements made for the hospital.
I was begging for relief, the knee felt like someone was hammering a hot poker in it. I took my alloted dose of pain medicine, then I took more. Thankfully, the ambulance came quickly, yes an ambulance! My sister was working that day and who better to come get me? Anyway, I new morphine was in my near future, what I didn't know was that 8 mg, later I would still be in agony.
Nearly, two hours later I was in Williamson medical center emergency department. Dr Looney was in surgery, so Dr Calendine met me in the ED. He is a colleague of Dr Looney and extremely nice to me.
The staff quickly unwrap my leg and check for compartment syndrome, as I was having tingling and numbness but that wasn't the cause. Soon, I received dilaudid and phenergan for my troubles and a quiet peace came over me. Except for my snoring.
I ended up staying 3 days in the hospital with high doses of potent painkillers coursing my veins.
The moral of this story: ACI with osteotomy is worse than Microfracture, its not an outpatient surgery, and make sure you get a prescription for something stronger than Percocet.

Worse than Microfracture

This is no ordinary surgery

My alarm clock went off at 0345 and I picked myself up after falling from the bed. The lack of sleep sucks and yet I'm still running late. I quickly lather up with antibacterial soap while my stomach growled. I should have ate up until midnight.
Finally, we are on our way to Vanderbilt Bone and Joint Surgery Center for my 0600 surgery time.
After checking in I waited only minutes to be called back for prep. When she said, "you again,"wasn't you here just, last month? Now I recognized her, nose ring and all. Not last month but May, I said. Then I went to deliver a urine sample.
We go through the familiar checklist, why are you here? Left knee, who's your Dr? Looney. Next, is the IV and last minute instructions with Dr Looney, while the anesthesiologist prepared the femoral nerve block. A short time later the bright lights and cold steel of the surgery room came into view. No fun and games now as I was immediately put to sleep.
I woke up several hours later in horrible pain, my postop nurse was quick to put the pain medicine to me. After, 16mg of morphine and 3 of dilaudid and a few Percocet I was able to go home.
The rest of the night was uneventful as I was able to get out of bed by myself.
That would soon change.

The Move is Complete

I have spent the last few days in a mad frenzy of boxes and wrapping newspaper around fragile items. The move is now complete and most of it, once again unpacked. The accommodations are much smaller, so finding that perfect place for each piece has took a back seat to cardboard boxes. I'm actually hoping when whoever brings the CPM(continuous Passive Motion) leaves it on the step and I avoid having to explain why I moved before a surgery.

I made the hour and a half drive to Franklin, this morning for a Pre-op exam. I'm wondering why, yes Dr Looney examined my knee but it could have waited until tomorrow. Plus, I didn't ask any of the questions I wanted too, eventhough he answered most in the usual pre-surgery chatter.

The procedure should take around two hours, not including recovery period. Its same day at Vanderbilt surgery center. My arrival time? An unbelievable 0600! I nearly fainted hearing that, I'm wondering if lack of sleep will make it harder to wake up from anesthesia?
Dr Looney, explained how the cells will be injected under the periosteum patch via arthrotomy. The camera didn't get installed so I won't get any cool video but I will get great pictures. Its the Paramedic in me, I can't resist gory pictures of my knee cut open and all that's inside.
The tibial tubercle osteotomy is what will give me the most grief. Anyone who's had a leg fracture can appreciate the pain, entailed. Right below my knee a wedge will be made in the bone to take pressure off the patella. With an 85% success rate for aci in patella defects, every effort is made to let the millions of tiny cells do their thing. Then two screws will be placed in that spot to add more discomfort and enjoyment.

I shined up the shower chair today and I have the wheelchair on standby. A ramp was built today in my honor at the homestead. An abundance of steps makes things less enjoyable. Pain medicine staging and a plethora of magazines and movies are at my disposal. I even stashed scissors close so I can give those damn Ted stockings an elasticectomy. I want get to blog as much since I have no internet or phone service in Maybery, I mean the place where I currently reside. How am I posting tonight you ask? Well I'm camped out at my sisters to make a 2 hour drive slighter shorter. I hope to post again Wednesday and quite possibly tomorrow. Depends on how medicated I am. Until next time, Blessed Be.

Pre-op take 2

I thought I should fill you in on all the Dr appointments I've been to. First, pre-op went routine, I was just there a little over a month ago. I saw Debbie Jackson, and she did the usual checking of vital signs and chit chat of the procedure. I was unable to see Dr Looney, as he was either overbooked or had hightailed it outta there for vacation. Whatever, the reason my questions are still unanswered or at least confirmed until Monday. That's right Monday, the day before surgery!
While out on a shopping trip, I happened upon, an old friend, who is a Physicians Assistant with TOA. Kim Woodlee, many of you may know her as a star basketball player for Kansas State. TOA or Tennessee Orthopedic Alliance is based in Nashville, Tn.
I was relieved to see her and wish I hadn't been in a state of manic funk and asked more questions. But I was in a clothing store and for those that know me know, shopping isn't my favorite thing to do. Actually, I was just tagging along and so was knee pain, but I digress. Kim, was very understanding, knowledgeable, and compassionate with me and answered probably, my biggest question: How bad is this shit gonna hurt? Answer: very similar to the microfracture!
Yea! Not that it was fun, hell would be a better term but at least I know what I'm up against. With the right pain medication, I should be just fine.

Now on to Dr Schweitzer, I went in Tuesday, for test results and surprisingly enough, most were normal. I have hypothyroidism and vitamin D defiency but when you stay in the house as much as I do, vitamin D is bound to be deficit.
With a little levothyroxine and vitamin D, all will be good.

I also scheduled my physical therapy post-Op exam. Still makes no sense to me why I need to go the day after surgery, but its made. I'm going to assume, they like watching me stagger in via crutches, high on pain pills and slurring my speech. I know they all have their smart phones out, streaming live footage to youtube. Just look under Loo under the influence and Loo on Physical Therapy.
No, really the team at Top Rehab is great.

I want to give a big thank you to Kim Woodlee, for your free and loving advice.
P.S. Only 4 days til ACI.

questions to ask

Tomorrow is yet another pre-op day, with the fine folks at Vanderbilt Bone and Joint. Time for me to fall into the "beast" of a car and make the 1 and a half hour drive to Franklin. Which very soon after the move will be two hours but what's thirty minutes? Of course by then I will have a chaperone in a red minivan. Awe yes, riding sideways with my unloader brace and narcotic painkillers. High roller indeed!

All week I've been thinking of questions to ask Dr Looney, they would take all day. So I figure its best to let him talk and what he doesn't cover, I will. I do wonder how long I'll be on crutches, I figure non-weightbearing for 6-8 weeks, since the plan is to have an osteotomy. I am having a bit of a shoulder issue that occurrd after the last round of crutches, worsened after a workout. I know I'm looking at a recovery of nearly two years but would like that broke down into when I'll feel "normal" again.

I received a phone call from Top Rehab today. They seem to have a knack of calling right before I have surgery. Strange, eerie? I don't know. Maybe, they wanted to see if I'm still alive, so I will send them some money? Well they found out I'm alive and no I can't send money.
In all seriousness, Fran, was really nice, as always when she calls to ask how I'm doing and just check up. I believe she was even thrilled to hear I'd be coming back in for more "pt"(pain and torture).
Andrea Turner, will be thrilled to help me sort through the 72 week rehab. See ya soon Andi!

Dr Looney won't be thrilled with how much weight I've gained but that will make two of us. I shall lose ten pounds or so after surgery, albeit, quad muscle mass, if there is any left to lose.

I haven't received my test results from my visit with Dr Schweitzer, hopefully, I will get them before pre-op tomorrow. I am definitely staying away from the EKG technician at VB&J, and any parading around like Holly Madison. Today was election day I do hope you exercised your right! Well folks, that's all I have will give further report tomorrow.

Seems Real Now

Last Friday, Dan Gates, the surgery scheduler, called me from Vanderbilt Bone and Joint, to officially schedule my surgery & post-op dates. My pre-op appointment is Friday, yes I know I have already been through pre-op but their policy is only good for thirty days and it is just beyond that, so I'm going again. Dr Looney, wants to consult and prep a little more about the aci, as I still have many questions. You must be thinking, how many more answers does she need? Well detail oriented as I am, I can never have enough answers. Even simple things like, how soon can I shower? Will I need a bed pan? Who's going to change it? Right on up to the bigger ones, how long of a recovery? How much pain? What type of osteotomy? I'm not necessarily a creature of habit just one who plans a lot.
I even emailed my Genzyme liasion to confirm they received all required paperwork. I got a prompt reply from Mr Brooks and all is set and final phase of cell growth is underway.

I am on fire this week! Feeling better than I have in months & taking care of business. I even found a new primary care physician named, Dr Meredith Schwietzer. She is really great, we got along well and we seem to share the same ideals, as far as, natural, alternative styles. I made the appointment for a couple of reasons, 1 its been years since I've had a good primary care physician and 2. To tell someone other than my family about my depression and insomnia. Frankly, they're tired of hearing about it and I'm tired of talking to them. Lol!

Dr Schwietzer, not only listened but was very compassionate and offered great advice. I chose not to take any antidepressants or other medication. I hate taking medicine of any kind, even though sometimes it is appropriate. I have had a different mindset this past week and just hope it continues.
Via her scales my weight gain is 65 pounds not 50, I'm going with mine. I also had the standard blood & urine tests to give everything a good once over. Especially, my thyroid, I would like to blame my weight issues on it being under active, over my stuffing food in my mouth.

I also wanted to get a good wellness check before surgery, incase anything is out of whack. Like say a thyroid. Lol my bloodwork should be back before pre-op. She also wanted to do an Ekg but I was quick to point out I recently had one. Remember, I was exposed like I was preparing for a playboy photoshoot. Somebody is still having nightmares I'm sure! On well learn how to perform a 12 lead, while leaving a person their dignity. I'm almost certain that nurse used to work at an obstetrician & gynecologist office.
Enough about that, with all the hustle and bustle of Dr visits, the aci surgery seems real now, as do the challenges I will face over the next 18 months.

Insurance advice

Let me say a few things about insurance companies. First, the percentage is high that they will deny a procedure the first and even second time. (My ACI was denied three times before approval). Let's face it, they make money by ripping you off. I was offered a job, selling insurance once, I turned it down. After listening to a con artist trying to con me, I realized I could never play that game.
If denied, go through the appeals process and request a "peer to peer" with your physician and your insurance medical director. That's were they discuss your case, hopefully leading to an approval.

Second, don't give up!
Start a letter campaign to your insurance provider, not just one but multiple letters. Request another appeal by the carriers medical board. Seek multiple "second" opinions from qualified physicians. Call your carrier at least twice a week, if not everyday to check on the progress. Don't let them forget you.

Third, Use your state Representatives
They are there to represent their constitutes and are happy to help. Healthcare Reform is always a hot topic issue.

Finally,(Which should be the first thing you do). Be sure to read your insurance policy and see what items are covered and how much is covered. Be familiar with the pre-certification and appeals process. Save all EOB's and record all contact made with your insurance. Who you talked to, what department, what date and time, what assistance, if any, they provided. Don't be fooled into paying upfront costs, if someone from your insurance carrier requests that, direct them to your surgeons and Genzymes insurance liasions.
That didn't happen to me but I have heard about cases, were it did. Don't aggravate your Dr to death. I'm sure Dr Looney was about to go, well looney, getting my approval. Cigna would tell me to call him,that they needed him to call and they needed to talk to a health care professional. What the hell am I? Dr Looney would be waiting on them to call, then they didn't. All while I was crying(not literally) in his ear or rather email. So in my case Cigna was real good at giving me the run around But persistence paid off.
I am going to give a huge shout out to Dr Looney and his staff for fighting the insurance giant and getting me one step closer to healing.