two weeks

Today, marks two weeks out from surgery. I must say I feel much better than last week. I have almost cut out the pain meds. My appetite is back, I'm still debating whether that's a good thing or not.
Yesterday, I finished the last dose of Lovenox. That's a subcutaneous blood thinning, injection to the love handles.i I was put on that instead of Aspirin, due to spending three days in the hospital after surgery.
I also finished up the worst tasting medicine in the world, Keflex! I had to enjoy that due to a defective bone saw that superheated and caused a burn next to my incision site. It is healing quite nicely, and should he completely healed in about a week.
I felt well enough this weekend to head out to a local Arts and Crafts fair. Big Mistake! Aside, from the lack of handicap access, immense pain occured from not having my leg properly elevated.

I have my third physical therapy session, today at Top Rehabilitation we should be doing measurements on my leg to check swelling and range of motion. I've been diligent with ice and elevation and kept edema to a minimum.

I go see Dr Looney, Friday as he is keeping a close watch on the burned area. I plan on discussing the many pains my leg has and its interference with my precious sleep. I understand that having your knee cut open and your shin cut and moved over, that pain is inevitable but its interupting my time in the CPM.
Its rather strange, I never had any pain caused by the CPM after microfracture. Its cramplike pain in my foot and calf and a tightness in my knee. I can only go to 40 degrees in the CPM for another week, so I'm really at a lose other than the pain is just normal.
I am still unable to do straight leg raises. I just don't have the muscle control to do them. I can move my leg from side to side but not up.

Final Musings: with two weeks down, I do feel better. Take one day at a time and don't think about the 6 weeks until weightbearing, if you do the walls will close in.

things to lose and gain

Prior to having aci with distal realignment it's best to gain and lose a few things.
First, lose all dignity, self respect, and pride. There is no possible way to make it through this surgery and recovery alone. For the first few days the only bath you will get is a spongebath. Your bathroom now becomes a bedside commode or bedpan, neither is enjoyable. Assistance is needed for basically everything, so finding a reliable friend, family, or spousal equivalent is best.
Invest in or find a bedside commode, shower chair, bedside eating tray. Many organizations loan out these items, check with your local Masonic lodge, Lions Club, etc.
Even if your bathroom is 3 feet away from your bed, that's too far to "hop" given the amount of pain you'll be in. Since you'll be non weightbearing for 6 weeks, standing on one leg in the shower is too risky. Get a shower chair, at a week out and you start smelling like a boar hog, you'll be happy to use it. Get a shower wand as well, no use drowning while taking a shower. And yes, I forgot to buy one.
If you must be alone for any length of time, make sure all snacks and meals are close by. There's nothing better than being bedbound and hungry. Don't worry, the first week you'll go through a period of anorexia.
That's just week one. In week two keep your laptop handy. Have plenty of movies & books available.
Any important business needs to be taken care of before surgery. You won't be able to get out and you won't feel like it anyway. Also, bad idea to move the weekend before surgery. This I know from experience, I can't find anything, like my Razor!
Make a schedule of people who can help and when they can and try to make appointments during that time. Until you stop taking painkillers, driving is out and that varies from person to person.
These are just a few suggestions to make life easier after ACI but the best may be, keep your pain pills close.

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.