Friday, June 25, 2010
Knee Surgery - Or What Happens When You're 58 and Still Think You're 18
Yesterday, June 24, I had surgery on my right knee to repair my torn medial meniscus (as shown in the drawing above). Along with the torn meniscus the orthopedic surgeon also scraped away other things in my knee that had degenerated with age. Apparently this part of my knee has worn out and my femur was pinching down on the torn meniscus adding to the pain. What a bite this was! Furthermore the doctor told me that I never did myself any favors being a catcher in baseball so many years ago. And to think my mom wouldn't let me play football because "you'll hurt your knees." I guess mom's don't know everything!
In late February 2010 I was at the You Fit health club doing my usual every-other-day upper body and lower body work out. On the days when I was not at the club I was putting up to 21.2 miles on my bicycle as an efficient cardio exercise.
Then came that fateful day in late February when I was doing my leg extension exercise. I was going for fewer repetitions with more weight in a pyramid workout (30 reps at 120 lbs, 20 reps at 135 lbs, 10 reps at 150 lbs). Leg extensions were my last exercise of the 19 upper and lower body stations that I hit in this exercise. When I sat down for the leg extensions my legs were feeling just fine and especially my knees. On my first extension with 150 lbs, as my legs were pushing my torso back I heard and felt a loud "POP" from my right knee. Not exactly a good sign!
Wisely (a first for me) I stopped the exercise and hobbled away from the weight station. From that day onward I limped like old Walter Brennan in the old television show "The Real McCoys."
Foolishly I continued to bicycle after this injury and I did so under the guise of being male and thinking "ah, it will get better." Unfortunately over the intervening two months it didn't get better - it only got worse. My hunch was that I had probably blown out my medial meniscus - the cartilage that serves as a shock absorber between your femur and your tibia and fibia.
On April 19, 2010, I visited an orthopedic surgeon (who is personal friends with and plays golf with Johnny Bench!) who looked at the x-rays and confirmed that I had done just that - torn my medial meniscus.
He shot me up with a cortisone and two other anti-inflammatory drugs. The plan then was to see if the drugs will eliminate the inflammation that was causing all the pain in my knee. If so, then good news. If not, then it was going to be arthroscopic surgery to scrape away the torn cartilage. This knee injury is the latest in a string of issues that my body keeps using to remind me that I'm not 18 any more.
At the initial consultation with the orthopedic surgeon he said the scenario would work like this: 1) Cortisone would give me instant relief from the pain (which it did), 2) after a few days the pain would come back and it would be worse than before (which it was), then 3) the pain would go away again. If 4) the pain came back then I needed to go back to see him. Unfortunately number 4 became reality and I went back.
Over the intervening six weeks after the cortisone shot I have been limping although not as bad as before. The only relief would come from swimming in the ocean. I guess with no gravity to get in the way the knee felt fine. As soon as I was back on land however the pain came back.
I visited my orthopedic surgeon about 2 weeks ago and said that the pain was not going away. Consulting with him we concluded that surgery to fix the torn meniscus was the best alternative. By the way my orthopedic surgeon is Jeffrey Oettinger, a hell of a nice guy whom I would recommend to anyone. I think he's a Republican but I'll forgive him.
My surgery was scheduled for 8:00 a.m. yesterday and I was told to be at the Intercoastal Medical Group's Ambulatory Surgery Center by 7:00 a.m. This being the first surgery I have had since my tonsils were removed in January 1958, I was a bit more than a tad anxious and wound up not getting a second of sleep the night before.
After a brief time spent getting checked in, I was taken back to the preparation area where I was hooked up to an electrocardiogram and a blood pressure monitor. The nurse took my blood pressure four times before she got a reading that wasn't off the scale. Eventually she said "we'll give you some happy juice that will bring it down" and it did.
Before the surgery began I understood the procedure to be that I would receive a local anesthetic in my right knee and that also I would be sedated so I could be awake during the procedure. Doctor Oettinger told me I'd be able to watch the work on a screen as he scoped my knee. It didn't work that way. They started me on an IV of Propofol (the drug that killed Michael Jackson because it wasn't being monitored) to sedate me.
The last thing I remember was talking to the anesthesiologist (who was a chemistry major) and telling her how I still have nightmares about the year of Organic Chemistry I took as an undergrad. The next thing I remembered was waking up in the recovery room and asking my nurse Sue Ellen "is this the operating room?" I woke up about 9:30 and don't remember a thing about the procedure. All I know is I had (and still have) a huge bandage on my right knee.
I was given a list of information about the drugs that were administered to me, told to stay off the leg and keep my knee above my heart (damned difficult to do when you're sleeping), use a cane to get around (why do they call it a cane when its made out of metal?) and drink no alcoholic beverages.
My check out materials included a list of what I can and cannot do for the next few days. It also included a list of all the drugs I was given including:
Versed (to reduce anxiety before surgery - must have been the "happy juice" she mentioned). Information I was given says that Versed may cause amnesia which might be why I dont remember a thing about the experience.
Propofol (maintains sleep in anesthesia)
Ancef (to prevent infection) This was apparently injected directly into the joint where the surgery occurred.
Pepcid (to prevent nausea)
Reglan (to prevent nausea)
Robinul (to prevent nausea and decrease secretions - which might explain why my mouth was so incredibly dry after the procedure)
Fentanyl (an opiate used to reduce or eliminate pain - Fentanyl is also known to cause constipation which certainly seems to be true!)
Adding to this cornucopia of drugs in the surgical center I was also prescribed Hydrocodone which a note on the prescription label says was "substituted for Lortab-500). Hydrocodone is a narcotic in the opiate family used to reduce or eliminate pain. I'm supposed to take 1 tablet every 4 - 6 hours "as needed" but the nurse told me to take it before hand so I have it in my system when the Fentanyl wore off. So far so good.
When I woke up from the anesthesia my throat was very sore - as if I had gotten some sort of cold or virus while asleep. I learned later that this was from something stuck down my throat to keep my passageway open while under anesthesia. The other thing I noticed this morning was a very pungent odor to my urine, no doubt a direct affect of my kidneys and liver metabolizing and excreting the drugs I was given yesterday.
My life long friends Larry Stoffregen and Dave Bylsma who are both nurses back home in Wisconsin have been their usual wonderful and helpful selves giving me all sorts of information and support in the last 24 hours. I appreciate every bit of it.
Now that I am on the mend I have several positive things to look forward to. First and foremost I wont be hobbling around like Grandpa McCoy any longer. I can get back on a bicycle and start putting on some miles in a month or so. I can get back to working out in the gym and I can be back on a boat in a week or so. I had been thinking about making a trip to the Western Aleutian Islands in mid August to look for Short-tailed Albatross for my life list with my friend Jon Andrew and to hang out with my oldest daughter Jennifer who lives in Anchorage. However the doctor said despite me being able to be on a boat here in Florida there was no way my knee could stand the rocking and rolling of a research vessel in 20 foot seas in the Aleutians so I have to cancel the trip for this year. Hopefully in 2011.
Before falling asleep yesterday I also mentioned to the anesthesiologist that when I had my tonsils out the doctors then told me that I could "have all the ice cream you want when you wake up." Of course they lied to me - I never saw an ounce of ice cream. Reacting quickly the anesthesiologist laughed and said "Any you're not getting any here either."
So ended my knee surgery adventure.