Hey there,
100% knee talk today.
Made it through. Not gonna say I wasn't nervous, what with them digging into my body in such a violent fashion, but certainly more confident than the first go around. Surgery was on a Tuesday and it is Sunday today.
Checking in on Monday afternoon went pretty much the same as last time. Blood pressure, chest x-rays and an EKG (complete with the stickers to adhere the nodes to my hairy chest that were painful to rip off and in the room with the cot under their winter coats). There was one new wrinkle in the pre-op checklist with the nurse this time. Should preface this with the fact that the nurse was kinda cute. She went through all the items, like do I have a family history of hypertension, how much do I smoke, blah blah, but this lady seemed to focus in on my alcohol consumption. Betty had to translate my intake of booze, which isn't really regular. I'll have one with dinner many nights, and will toss 2-3 back if we are out at a party or something, but something got lost in the translation cause it came back to me via Betty as her saying that 'sometimes when people drink a lot, they get delirious after anesthesia and to prevent them from hurting themselves, she may have to tie me down.' Oh really... She then asked if I had any questions, and I said in my best sexy voice, you know the one, "does that cost extra?" I made Betty translate it to her and got zero response, so either the joke didn't land, or she is a professional dominatrix. Little tip to the kiddies out there, every nurse is a sadist to some degree.
I got a new hospital helper this time. At hospitals here, you have to have someone in the room with you at all times cause the nurses don't have the same responsibilities as they do in the States and there is no way Betty nor I want her in there taking care of business. We liked the last gal from the first knee OK, but she is choosing not to be vaccinated and can't come into the hospital. I don't know her situation and she may have a true issue with the vaccines, but good riddance to the anti-vaxxer. In retrospect, she was nice to have around, but really was a lump.
The hospital sourced a helper and then called back saying that with my size, they were gonna get a dude instead. Makes sense. These folks have no qualms in pointing out my size. The doctor said he is inserting longer posts down the femur to support my weight. I appreciate all of that, including the honesty.
The new guy was local and speaks no English, but he is well versed in what this orthopedic hospital does and how people recover from this type of surgery, so way better. And he knows all the secret spots...even took me out in the wheelchair for a puff the afternoon after the surgery. Dudes name is Bear. Love it.
A poop paragraph here. That evening after the surgery, I wasn't expecting to poop cause anesthesia is constipating, but I had to go. Bear gets the wheelchair that has the poop hole and bucket in it and I take one. It felt pretty big but got a look at it after I got up, and it was the biggest load I have ever created, and I would never kid about the size of my load. It was as big as a large ear of corn. I feel bad that Bear had to deal with that monster, but nurses are simply the best kind of humans...in addition to being sadists.
The first night is completely brutal. Pain pain pain. I took all the meds they gave me and supplemented with the oxycodone that I had squirreled away, but still ruthless. Not 'tie me up I've been a bad boy' ruthless, but close.
The next morning, the nurse came in and asked if I wanted to go home that day if the doctor approved. Absolutely. He came in around 11am and said I was good to go. I went home on day 3 last time, so figure day two was that much better, He is not too chatty but seemed extra happy with his work this time. He said this knee was in way worse condition than the first knee as there was a lot more trauma and bone degeneration. The right one was far less stable and way more painful for years and would have guessed otherwise, but dude knows his knees.
Then he told me of the unusual problem he had this time with some existing metal. Here is what it looked like pre-op.
There are a couple of pieces of metal in there from a previous ACL replacement. The one on the top was not a problem, but the one on the bottom was in the way of the replacement part stem. The screws are part of me now and could not be removed, so he had to drill a piece of them away using a diamond saw. I asked him if he had to use a hammer of some kind and he said he did. I thought I was hallucinating, but must have sorta woken up during the procedure and heard metal on metal hammering. It sounded like a movie where miners are going at a wall of copper ore with a pick-axe. In retrospect,..Fucking-A.
Hard to see the screws protrusion if you don't know where to look, but he said it was all good in the end. The procedure took at least twice as long because of the extra work. Remember looking at the clock before the lights went out and it was 8:20, and think I recall seeing it as 10:52 on the way out. It took 45 minutes the last time. He said it was physically hard to do, but that he was strong and made me feel his bicep. It was impressive. Dude is gonna be a grandfather in a few weeks.
Last thing he said was that my knee bones are small. Something about my patella measuring 29 when it should be at least 33. Probably is a contributing factor in all the problems I have had over the years. Here is what half-assed internet research said.
Patella height ranges from 22 to 38 mm with mean 31.33 So I have the patella size of a demure Asian lady? That explains a lot. Thanks genetics.
OK...scar picture time. They took off the bandage the day after the surgery and here it is.
Not too gory. This time, they sold me some compression socks. Not socks really, just covers the ankle to the bottom of the knee, so whatever you call those. Leggings? They look pretty cool...kinda like Lebron James. Supposed to wear them for 4-6 weeks. We pay in cash and the total out the door, including all the surgery/parts and hospital stay was NT$144,000, which is $5,179 bucks. Expect to get that back minus deductible from our US health insurance, who has to be delighted at the cost of the bill, so it'll be about US$1,200 for the pair. Amazing.
So intake was Monday, surgery was Tuesday AM, and I got to go home on Wednesday. Since one of the knees as been repaired, pushing off to get up after sitting down has been easier. Bear came home with us and stayed till Friday. I do not claim to be an expert in grading physical therapists, nor am I alone in thinking I have a decent bullshit detector, but I do have a decent amount of experience with PT's and my BS detector is pretty damn good. I think that now that I have quite a bit of cobalt in me, that I am receiving signals from the beyond at a much higher frequency. Here is what 56 years of experience has taught me about PT. It is an effin' scam and the practitioners are failures at real work. That is harsh as there are people that really invest in learning and adapting, but for the most part, these people learn a few exercises and then belch them out to their patients without taking into account anything about their situations. They all love that electro-pulse thing and strap that on ya for 15 minutes, then ice you down for another 15 and call it a day. That electro thing is borderline useful at best and you know it. People just like it cause they don't have to do anything but can say they went to PT. Betty is going to a place here for a shoulder thing that has been bugging her for months and she says they stick her in a machine and it pulls on her arm. I think the most egregious example I ever saw was when my mom was getting up there in age and her mobility and strength was starting to decline. Might have even been after her head injury. Anyway, she gets a guy recommended to her and she likes his energy and attitude. Sadly, having a great attitude doesn't translate into having brains. Or common sense. This guy straps my 80-something year old mom into a rowing machine of all things and her back is tweaked for months. I know I wrote that up at the time, but it pisses me off still. That dude was really a sweet guy and he came by my mom's room when she was recovering from stuff just to give her some company so feel bad about slamming him, but that's my mom.
Have a few more examples but my anecdotes really aren't fair. There are some true heroes in the industry that work with people that are truly disabled and do the Lord's work. The reason all this came back into focus was just how good Bear was and that the others pale in comparison. He obviously has experience with my particular recovery as he knows the right exercises and stretching and can explain why they are important. I was worried about bruising I had last time but he said it was not only normal, but a good thing. Little things like that.
Swelling and blood flow are a real issue and concern, but he had plans for that. First some light massage first couple of days, but then he did this move that got translated to me as releasing my bad chi. I lay down and he puts his shin on my upper thigh, where the most swelling is, and puts his entire body weight on it. For a long time..at least a minute but felt like longer cause it hurt bad. He'd roll it around a bit for max pain, but after he was done, I could feel a release of pressure in the leg and what I would call endorphins all over. He said that this isn't an every day process, and only needed to be done a few times and came back to do that only a couple times after he was done staying with us. We insisted on paying for these return visits and he said that he could not accept payment cause doing so is the right thing to do. He did add that it has to be done between the hours of 11a and noon, or at 11p and midnight cause of something to do with the Earths' axis, so that seemed a bit mystic to me but am I gonna argue? Have seen enough in my time to never scoff at this eastern medicine stuff. The thing he said that convinced me that this guy knew his stuff was when he was talking to Betty and asked if my prostate was OK as he felt I wasn't peeing enough and getting enough water. My prostate has been OK so far according to my doctor, but he was totally right in that I have not been taking in enough liquids. I monitor the color of my urine closely (you should too) and it has been dark yellow the last few days, which is a clear sign of not getting enough water. Don't think many would argue that being well hydrated is a positive and especially during a time of intense recovery, and that he picked up on that told me all I needed to know. One other thing he said was after looking at my ear lobe and said that I had wrinkles in them, which could indicate heart issues. Maybe its cause I love too much, or possibly that I eat a lot of crap and smoke/drink. Not a huge mystery for Colombo to discern, but still.
He also added that I was fortunate to have this knee doctor as his opinion was that he is in the top 5 in all of Asia. Fortunate indeed. It has been exactly 5 days since surgery and I already feel great. Still a ton of pain and aggravation at not being able to do anything, but way better than at the same stage as last time, which can be attributed to having a good doctor, wise helper, knowing what to do (like early ingestion of prune juice), and perhaps most importantly...what not to do. A common question I get asked about having new knees is if I'm gonna start running. For one, you obviously don't know me at all. Jogging across a street when the walk light is blinking red would be the ultimate for that. It's been 20 years since I could move properly, so just learning how to walk with my head up, and not scanning the ground looking for a crack in the sidewalk that would send me crashing to the ground is gonna be a process. Since I've spent a ton of time on the knee this week, here is a brief history of my leg issues.
1984, in separate incidents, I broke my left heel jumping down some stairs in front of my dorm and blew out my left ACL after an uncontested layup playing basketball. The ankle never healed properly and I did nothing with the ACL for 15 years. Those two things kept getting worse and since I was favoring the right leg, it started to show cracks, probably due to my abnormally petite knee bones. Finally went in to see a doctor about it and they were skeptical, but took a picture of the knee and sure enough, said that a new ACL was needed. Did that surgery, but the recovery aggravated the ankle to the point that the knee guy took a picture of it. Will never forget him coming back into the room after the x-ray and asked, "were you in a serious car accident?" This has to be late '90's if memory serves. The foot doctor says he has to reconstruct and fuse the ankle bone, taking some marrow from my hip to do so. That was a major surgery and have a good 18 inches of scars to prove it. All during these years, the cartilage in both knees had been compromised and had several (4-6?) procedures to "clean it up" to the point that both knees were now bone on bone. In 2008, after our best softball season where we lofted the comically large trophy, I went to the knee doc again and he said that my playing days were over and that I needed new knees, but that I had to suck it up till my 50's cause if you replace them too early, they wear out and the next set lasts half as long. So here I am, solidly on the down slope of my mid-50's and this will be the first time in 36 years where I will be somewhat normal. I really don't know what that means but am excited to find out. Not looking for any sympathy cause it is what it is and I did it to myself, just thought it might shut up anyone that thinks or says I am a whiner. Every step I've taken in at least 20 years has had some amount of pain.
Here is my goal for the end of 2022. Last weekend, was at the park where a bunch of baseball fields are to coach some kids, and on an adjacent field was our cousin's husband Lucas playing on his over 50 baseball team. He said they can always use dudes and that I would be welcome to come out with them, so getting out there, playing some third base and running out a base hit is the goal and will be working towards that in 2022.
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