Bend that knee

One guy's ongoing discussion with his left knee

Wednesday, August 31, 2005

Writing takes a while - 5 days from Surgery to departure

Well, here goes. After almost three weeks, I figured I'd finally write down all the excitement of the second surgery. Looking at my notebook, we'll see how far I get...hop in the wayback machine and we'll head with Mr. Peabody and Sherman back to August 9th...

August 9th
Headed into therapy with Kristen this morning. Steady came down a little after 10:30 and walked over to the table while doing wall slides. He had me straighen the knee and felt the back of my knee and generally around it. "Yes, I think we should give you some light anethesia tomorrow and the put fluid in, and then put in the scope if we don't like the results." His gut feeling was I had scar tissue regrowth, "We can't make it worse, but it should help". Not exactly what you want to here when you have problems with scar tissue. This was the first time he mentioned the possibility of going back in with the scope, although we had been discussing the insufflation for about a week or so since I started to have problems with the flexion.

Finished up the morning session with the typical bike, wall slides, patella mobilizations, quad sets, attempted straight leg raisees, hamstring stretches, and then ice. Passed on the JAS brace.

I headed up to the office and ducked in the back entrance. Rae actually put me in Steadman's office becuase she didn't have a room. This guy has more signed stuff that anyone I had ever seen. I took some poor cell phone pics that I'll try to upload at some point, but for example. A signed picture by Gerald Ford in the Oval, a Bruce Smith football, a collection of random arabic soccer stuff, including a trophy that had a camel on it, a picture on the broncos sideline. On his desk was a million papers, and among some other things, a model of a knee, and a sign that said "a cluttered desk is the sign of a genius mind".

He came in for a couple more comments, and I asked if maybe we didn't get it all the first time, and he said, "oh no, we got it all, this is certainly new growth. It loves it in there." I had asked about predisone, and he said give it a week if we did the scope and probably right away if not." I said I wanted to give it everything we've got.

Bounced me to an actual room after that, and I waited. Christal came in a couple times, and I guess they needed a dr to actually review with me what was going to happen 'cause Dr. Cabrerra finally came in to discuss the procedure and get some notes. We're going to try an insufflation in the joint capsule, and scope if needed. He said they'd probably use the same portals, but they ended up making new ones. He said Steadman would again do the surgery, asked about my history, and marked me at about 20-60 on the range [I suck when it's cold]

Cristal then had me sign some paperwork, and called down to have them put this surgery on the same tape as the other one (20 bucks saved, whohoo and it even came on DVD. Not that fun to watch though). She actually indicated that Steadman always does the surgery and the fellows watch, but from a few other folks seems like sometimes fellows actually do the surgery...

To insurance with Paula: She had already pre-authed it with Aetna, and didn't take a payment upfront since the insufflation is a few hundred but the scope would be a couple thousand. That was nice. Christal should be able to help with letter of medical necessity for PT.

Headed to the surgery check-in - they actually couldn't find my file at first, so I started to fill out all the paperwork, but then finally tracked it down. The pre-screening stuff was much shorter, and Richard, the same guy who shaved my knee the first time was there. The temperature things are wicked - they run it from your forehead to your ear and 'bam! - temperature done. None of this under the tongue junk. Down to hospital and then over for blood and urine.

Headed back over to Crystal for the normal 'let's go through the checkpoints' again. I wanted to ask about the roxy (ok if you need it until midnight, but I didn't take any), PT in the afternoon was ok, but I ended up not going) . Indicated I wanted to stay overnight no matter if he did the scope or not, and found there was no charge for the CPM - sure wasn't going to lug mine from the condo! They weren't sure at first, but ended up needing the lab work since I might have the scope and they couldn't re-use from 3 weeks ago.

In one of those improbably concidenses, I ran into two people from Austin that I knew! A mother daughter pair who the daughter had surgery with Steadman almost 6 months ago and did some PT with Angela. The mom was one that had given me some information about Steadman, which mentally started down the road. They were there for a follow up and to do the 'sport test' which Steadman requires before releasing someone back to competitive sports. It was definitely nice to see an old face.

Random act of silliness this evening. Needed to do some thing to relax/not think about the surgery, I bought 12 boxes of cereal to get the UPC symbols to send off for 4 cases of Disney 'Wobblers' for Kellogg's. We still haven't received them as of end of August. Bummer.

Cristal called to say my surgery was at 8:30, I believe...

August 10th
Headed into the hospital to check-in on the first floor. "Bentley? Oh yeah, Bentley." People you don't want recognizing you on sight unless they are personal friends: Hospital employees, school principals, firemen, and the Secret Service [guys, it's not a secret anymore....]

Headed upstairs to check-in and waited about a 1/2 hour. Steadman walked out to talk with another group in the waiting area after a surgery, and as he walked by, said "Kinda boring out here, huh?". Yes.

Brought me back, and I recognized many similar faces [nurses/doctors also in the 'don't recognize category]. Katie "Weren't you just here?". Why yes, and it was such a lovely time I thought I'd visit again...I had my Purdue shirt on, and some said they also went to Purdue. She also happened to stay in the exact dorm, Shreve, I did the first two years. Wacky. "Did you streak?" - referring to the '"Nude Olympics where people run around naked in the quad in the middle of another dorm on the first snow". My reply "Nope, but I might do it in here if I can't tie the back of the gown again..." After hooking me up to everything, they shaved the knee, removed the steri-strips but left the sutures in.

Ready the local Vail Daily for a while, 10M for the most expensive house. "Perfect for corporate retreats, this 14BD/13.5 bath has..." - why did they decide one bath only needed to be a 1/2?. Someone walked in and asked "Is Dr. Steadman here?" to looks of 'who the heck are you and why are you asking'. "He's in surgery." "Oh, he wanted Dr. X to fix his back". That's not quite what you want to hear....they also had the date of my last surgery on the patient wrist ID. oops. Had a little trouble finding a vein in my right wrist as well, so they did the back of the hand.

Anethesiologt arrived and asked if I wanted a general or epidural. Easy choice. Awake for this, no thanks. Although when she said "I won't go into the whole spiel then", I wondered if she preferred that one. She also mentioned I have big tonsils. And then I was out.

And then I woke up. Not quite as quick, and took a little longer to actually feel ok, but near the evening, things were ok. Jill came by for PT around 2 or 3, i think. She did some over pressure, ankle pulls with a towel to try a straight leg raise. Said she was liking extension. Steadman stopped by with a couple of his crew, and said it was a good thing we went back in. Still thought there was a long of soft tissue restrictions. He also said some other stuf, but I can't read my handwriting. Dirk swung by a little later as well - very cool of him. He also liked the extension, although my flexion was painful. He caught Steadman in his office to ask if I could go to 0-90 on the CPM, and Steady agreed.

Ali and Shirley, the same Australian gal who was there the first night. Around 7:30 pm I was going 0-to 90 with a little soreness, about a 2 on the scale. Dinner at 7ish, and a little walk on the crutches around 9 with a turkey sandwich afterwards. Didn't take any roxy, but did a percoset. In the CPM all night, woke up around 4 - actually checkd email and tried to straight the leg with some exercises. Little pain in the morning and sat it a chair for a while with the knee propped straight. They let me go without anyone with me, since I was looking so good. "Hey Alex, stop by socially sometime. You don't have to have surgery to say hi..." The ceiling was actually leaking a bit in some places - they were wondering if they were going to open that morning, although they did from what I heard.

August 11
Headed down and had breakfast in the cafeteria, and then to PT. Dirk got me started around 9 - Rae gave me the same debrief as before (although I mentioned I had sutures whereas she thought I had dissolvable ones). Dr. Atticus, one of Steadman's fellows, also came down. He was prepping the other OR (evidently Steadman bounces back and forth between two rooms over the day). Said at one point, Steady looked up like he couldn't believe the tissue growth. Got me to about 115 and 10 or 15 on the table, and that my knee looked straighter right then than on the table in the OR. Said you only needed from 110 to 10 to go up and down stairs easily.

Steady arrived. When asked, said I should stay as long as I can "You can see the benefit of staying". We might do a medrol pack in a week. Also echoed that it looked better at that moment that in surgery. He wasn't able to get anything with just the manipulation "so it's a good thing we were ready to go it". Were you suprised? "Nothing surprises me anymore...but sommtimes knees test me...a challenge even for me, and I've seen more of these than anyone in the world." Said my knee was in the upper 1% of the problem children...

Therapy was light, with biking, patella mobes, overpressure and quad sets. In the afternoon, Dirk recomended the same schedule, but said how long I stay had more to do with how much I trust me PT's at home. Biked for 20, 93 degrees on the wall slides, various manual things by Megan, and 30 minutes on the jas brace.

August 12, Friday
Morning: Bike, manual work, quad sets and overpressure, and JAS brace. Afternoon: Slides to 90 with pain, bike, manual work (warm knee), quad sets, hamstring stretches, and JAS brace.

August 13, Saturday
Found out my boss was let go yesterday; have to return to give a presentation on Wed. Steady said a quick hello - reconfirmed partial weight bearing, maybe think of the medrol pack. Said it looks better and said they'd set me up in Austin when told him I was leaving on Tuesday.

Bike, wall slides, JAS brace (then measured at 7 with overpressure), quad sets, hanging off the edge of table, flexion to 90. With significant overpressure, pushed down to 1 degree, and then iced. Afternoon I have only bike, wall slides and JAS brace written down.

August 14, Sunday
Bike, wall slides, quad sets, JAS brace (0-1) right after mobs. Massaging back of knee and heard a pop, as did Kim (who worked with me on Sat too). Ball flexion, bridges and hamstring. 20 minutes of GameReady. Kim also suggested I work on terminal knee extensions as well.

Monday, August 15th
I left Rae a message letting her know I was leaving a little quicker than normal and headed in for morning therapy with Dirk. Bike, wall slides to 80ish, mobs, quad sets, hamstring stretch, JAS for 10 and then another 5 minutes due to pain. 20 minutes GameReady.

I was late coming back in the afternoon becuase I had to ship some things and I was really tired. Rae was actually looking for me - she evidently got my voice mail. Headed upstairs and snuck in the back door from Cristal - once again, back to Steady's office. Gotta figure out how to get those pictures off! Steady walked in again [still not sure if he was warned or not this time either, seemed like not ;)

He reiternated that he was glad he went back in. Touched the knee a bit and stressed patella mobs again. Said there was lots of scar tissue both times. I shared that Sat/Sun we had 15 degrees of differentce between active and passive. Glad Kim was aggresive and said the difference was due to the lack of mobility in the soft ttssue - the tissue wants to be at 30 degrees (maybe a bit much). Remembered, surprisingly, that Burns had recommended me, and said I should keep seeing him in Austin. Goal is to get above a 100; back in 6-8 weeks if so. I assume he was thinking faster if I wasn't there, but that might be tough to do! Other than the PT's up here, there's nothing else he would do if I stayed.

Said I could call Rae with updates, or email, and I could even have Rae set up a phone call if I had more questions. Amazing (of course, I actually have to try it :) Headed back and said thanks to Laura, the insurance coordinator, and then Rae found me. Gave me a generic letter about the importance of PT for the insurance, but I think I'll need a little more than that. Said to also stay in touch with Dirk. "He's good at following up and keeping us informed." Dirk said the same thing when I went downstairs, "Rae and Steady sometimes forget, and I can ping them..."

And that's the last time at PT and Steady's office.

Tuesday, August 15
Alarm at 5:45, snooze until 6:05, out the door at 6:45. Drove the 30 minutes or so to the airport. Enjoyed the scenary for the last time. As I turned into the airport drive, heard a 'ping'! Fuel light appears. And I pre-paid for the full tank of gas! Awesome! Pulled up curbside and did the curb check-in. Guy there suggested I park closer than the normal drop-off point, which is a quarter mile away. That would've sucked. Grabbed my backpack and x-rays and hobbled in myself on crutches. Right inside was a couple wheelchairs and someone came out quickly to help; she zipped me through security to the gate.

On the way, she mentioned I had two choices for getting up the stairs to the plane. Crutch the equivalent of 3 flights of stairs, or let 3 big guys carry me up in a special chair. Looking out the window in the sprinkling rain, I chose number 2. But I got lucky - they were able to get a contraption that automatically raised me up to the door. But it got stuck 1/2 up, with a nice drizzle. "Yeah, too bad, somebody ripped off the canopy last week..." Thanks.

Flight to Dallas fine. Flight to Austin fine. Landing in Austin. Priceless. It was very nice to be home.


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