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.

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.

My Old Self

I have had two great days! Monday, I spent with family and had a little family outing. Tuesday, I woke up feeling like my "old self." Something I really haven't posted on here but I'm sure has been apparent to everyone, is that I've had a case of the "blues." Okay, maybe depression that's my own diagnosis and not that of a trained professional. I'm a paramedic, doesn't that automatically give us a minor in psychology? Maybe not, anyone crazy enough to be in EMS needs a good shrink. Wonder, if Dr Phil is available?
I came to that conclusion from one of those anti-depression medication commercials, the ones that say, have you lost interest? Oh wait, that was Cialis, Nevermind.

Now that I'm lucid, I would say I have been down in the dumps, since the first surgery nearly a year ago and it didn't help when I was "released" from work. You know, I always wondered what a Kentucky race horse feels like when its put out to pasture, when their racing days are done. Probably like this, walking with a limp and at least a 50 pound weight gain.

I mailed the Carticel package today and now let the final cell growing phase begin. I must also make an appointment to see Dr. Looney to discuss the particulars of the procedure. After reading this he may have me put into the Centennial Psych Ward. At least I won't be in there for addiction, assuming food addiction doesn't count.

The knee has been on the tender side this week, but I have been working it very hard to build up muscle tone. And like any cartilage free knee increased activity equals increased pain. That must ring true for AC joints in shoulders since I have had to critically limit overhead weight lifting. Again, my own diagnosis but should certainly be interesting on crutches.

I may only be having a "manic moment" here by sharing this but the blog is about How Knee Surgery Changed My Life and I feel emotional difficulties or triumphs should be included. I am not the only one who suffers from them and feel others may benefit from my airings. There are worst things in the world than knee surgery and financial ruin, as anybody in the business of life and death knows but while you're dealing with it you tend to lose sight of the bigger picture.

The Date is Set

I had an excitement filled Independence Day Holiday. I spent a few days with the family without the knee acting up too much. I viewed a holiday airshow and fireworks display, never have I heard Independence themed music, along with Johnny Cash and the Beach Boys, followed by Rocky Top.All while fireworks lit up the night sky. I caught a couple of fire truck filled parades. I thought parades consisted of floats, bands and pride of our country, not atv's and sirens. Not that I'm opposed to hearing sirens, it has been awhile since I have listened to the scream of one while driving through rush hour traffic only to get trapped by one SOB that refuses to move over.

I digress, come on people, get a little patriotic.My rant is over, I did enjoy myself just merely making a point. I fired up the grill and burned some corn, squash and various meat products. I never claimed to be a chef! When I push the plate away from me, BEWARE.

When I returned home, I had a FED EX package waiting. It was from the Carticel group confirming my surgery date for August 17th. I am ecstatic that its all come together. I was hoping for a July surgery but that gives me a month to lose the 20lbs, I've been losing for the past 4 months.
Where is Jillian Michaels, when I need her?

While on my holiday, I neglected my knee exercises, slightly. Well maybe more than that and it's mildly stiff and increased in pain. I predict with a couple days of normal routine it will be back to its, postop normal.

In closing, I want to thank Dr. Looney for his good works and listening to my bitching and getting Cigna inline. And wish good luck to Teri during her knee surgery scheduled for Monday.

when

I went for my preop and to see Dr. Looney today. Not much to do considering nothing has changed in a month. Good news to report on the lateral release, my kneecap has loosened up tremendously. For a kneecap that is a good thing. I still have swelling, pain, and heat but is easily managed with rest, ice, and elevation.
Carticel is still being ridiculous or Cigna, not for sure which one exactly. Carticel is saying they need pre- authorization before they can start growing the cells and Cigna has already sent me a pre-authorization letter. Plus, the surgery center says they scheduled the surgery when the hot the pre-auth. Such fun, I'm fairly sure nothing is simple with me.
We are shooting for surgery on June 22nd but myself and Dr Looney feel it will be the first part of July before everything is in place.
Until then I will be sitting on the couch, watching the womens college world series, waiting to be called up to play. Tn actually has a pro fastpitch softball team, currently based in Nashville. Eight bucks a ticket behind home plate! Next year, season tickets for me!
I also am done with physical therapy. Yahoo! I've been in pain since the last session.
With that said, I will continue pt at home and focus on weightloss. Its extremely important to be in decent shape before surgery, to help yourself out. I mean damn, I have gained over the last 2 surgeries, leg dimples. Gack! And back tits. Double gack!
Just forget about that last sentence, don't close your eyes just call your shrink.
I didn't really ask many questions today, seeing as we are in holding mode right now. So Carticel, Cigna we are waiting and ready to go. I would like to not have the knee of a 70 year old anymore.

Zombie Walking

Today's post-op visit was unremarkable. I basically drove a hour and twenty minutes, to have my stitches removed. Which I could have performed at home, oops! Maybe I shouldn't say that? My appointment was at 1340, yes I use military time, I've been doing that for ten years and see no reason to stop, for those of you wondering, if you just add twelve to whatever time it is, say 1 o'clock, you get 1300. Anyway, I borrowed my sisters SUV, due to not being able to fit in mine wearing the ROM brace. A big bulky exoskeleton, that extends from hip to ankle, combine that with a Ted stocking and crutches and that's what I call a party!
The parking lot at Vanderbilt Bone and Joint Clinic is all uphill, not very smart considering most patients coming there are crippled. The three handicapped spots were taken, so the only thing left for Loo, was the top of the hill were patients are loaded and unloaded. Before you go all bluehair on me, I went alone, sister is still recovering from sinus surgery and I was on crutches, so there!
I made it inside without incident and waited 40 minutes to be called back. It wasn't a bad wait, I found an empty couch to sit and prop my leg in and started my observations.
Waiting rooms aren't the best places for medical personnel. A people watcher by nature, I analyze the reasons for peoples injuries. Like, she was probably doing a herkey and tore her menisci or his midlife crisis motorcycle was just a bit to heavy for him to hold up. I look at all the braces and grimaces each person has and for just a moment I wonder why I'm here, until that pain rips through my knee.
I don't have an incredible story about how I injured my knee. It remains a mystery as to what caused the problems but let me just say lifting 300 plus pound patients 24 hours a day couldn't have helped.
Back to the visit, I was lead to a room about a quarter of a mile from the waiting room. Huffing and puffing I made it to my chair with cyanotic lips. Where I deblinged and waited for the stitch removal. Five minutes later, six stitches gone, steri strips placed and Dr Looney was twisting my knee around.
Everything looked great, still swelling from the lateral release, bruising minimal. I am off the crutches and out of the brace and stocking until the next surgery anyway. I do have to wear a knee-o-tracker, which is a small brace that wraps around the patella (kneecap)to keep it tracking correctly. Since that was a problem before and the reason for the lateral release. I now walk like a Zombie, arms outstretched and legs wildly taking whatever path they choose. Not as controlled as a mummy, its worse after I have been sitting awhile and my knee has gotten stiff. As my pal, Chuck says Zombies Don't Run, that is true in my case. Hopefully, physical therapy will strengthen up my leg before June.
I have another appointment to see Dr Looney in three weeks to discuss the ACI procedure and do pre-op stuff.
I have lists of questions to ask, two of which are how many people do I need to change my bedpan and how good are the pain meds? If any of you have been through this, I welcome comments and any questions.