Category Archives: Surgery

Day 1 of my confinement…

I didn’t sleep that well, as you can imagine getting comfortable wasn’t easy. The industrial strength painkillers work well but I stiffen up quite easily so getting out of bed was challenging. They also make me a bit spaced out so doing anything constructive while resting was also difficult. Then there is the issue of not being able to shower because I need my wound to heal for at least 5 days. My BFF ‘acquired’ some thick plastic bags & tape that is used in the OR to cover equipment & keep it sterile so I’ll try one of those tomorrow morning. This morning it was hard enough getting dressed, I think a shower would have required a 2-hour nap afterwards.

While hubby ran around dropping off elder child at camp & attending an appointment we both should have been at, younger child & I snuggled up on the sofa & watched Matilda. We have read the book but had not seen the movie. Then, although I was feeling quite tired, we built his model C3PO. By lunchtime I was done & couldn’t keep my eyes open, so hubby took him out on his new rollerblades before picking elder child up. I crashed out for that 2-hour nap.

I must confess to having had a sneaky look at the wound incision. After learning the final extent of the surgery instinct was telling me that 3cms wasn’t quite big enough for her to do what she did. I was right, it looks to be more like 2, maybe even 3, inches down the outside of my right knee. It’s fine I really don’t care as I can already walk with my foot straight which I haven’t been able to do for about 9 months now. Although, that’s only when I do load up on pain relief, when it wears off I really do feel like someone has taken a hammer & chisel to my knee & walking is not fun – especially when you need the bathroom!

Hubby is showing very little sympathy when I omit doses, which is fair enough, when you are married to a doctor you really do have to be on life support to get any sort of loving care. I’m the same in return mind you, & if the truth be known I hate being fussed over. I have had lots of thoughtful messages, texts & phone calls wishing me well so I know that I can count on some good friends if I need them, even the dog is being more attentive than usual. Hopefully by tomorrow I will not feel so battered & tired, & I can at least sit on my sofa fort & do colouring.

So, what did she find?

Well, it’s happened before, & it’s happened again. Clinically I have looked worse than my imaging suggests & the surgeon has reluctantly gone in & found it was worth taking the chance. When I saw her right before going into surgery she was taken by surprise to find my knee looked worse again & had changed in shape. When she mentioned that she would try & keep the incision small I stressed to her that a scar was the least of my worries & I would rather she did whatever she felt was necessary to make sure she had the best chance of fixing it. By this point I was starting to feel quite nervous. All credit to the hospital in Richmond they were friendly, efficient, & professional. I can honestly say the whole experience was very positive.

When I woke I was quite sore, I vaguely remember my surgeon asking me to push my foot against her hand – something she had primed me for before I went in so she could make sure she hadn’t damaged the major nerve that runs along the area she was working in. It wasn’t until I was texting hubby afterwards & waiting for him to pick me up that he briefly told me that she did have to take bone away. He then explained it in a bit more detail on the way home that she had found some extra bone formation around the fibula head where the tendons & ligaments insert. This was not something she had seen on any of the scans. She ended up stripping away a part of the tendon to get to the area & then nibbled the bone away until it looked more like it should. She can’t be sure that this will be a complete cure, but had said that it definitely looked better & I would be pretty sore afterwards.

So far I’m not too bad, but I do have some pretty serious pain meds, but I can bend it a little & at rest it feels ok. I’m sure the next few days will be a little challenging but I am relieved it’s over & if I’m honest even more relieved that she actually found something that made it all worthwhile. Fingers crossed it will only get better from now on.

Just what I needed…

We spent the afternoon at the beach (on the grassy area of course), barbequing with good friends & saying goodbye to the outgoing aneaesthetic fellow. She is flying back to the UK tonight with her two boys who are the same age as our two & have become quite friendly. They ended up in the sea & absolutely filthy afterwards, so good luck to her spending all night on a plane with them! Even the dog came along & stressed about the number in her pack. It has been good distraction for me otherwise I think I would have been dwelling on tomorrow. I also made sure I ate as much as possible & still came home & scoffed a large ice cream – I could potentially not eat at all tomorrow so I needed to stock up. Ideally I now need to chill out with a glass of wine & a movie but I’m supposed to be dry, which is the sensible thing to do. Instead we might still do the movie but first we must book the flights & car hire for next years family vacation – crazy I know but everything is getting booked up already.

I maybe a bit quiet for the next day or too, but watch this space to find out what the surgeon finally does to hopefully make my knee better…

A medical ordeal…

Today I had a pre-op assessment prior to surgery which is in less than 3 weeks. I wasn’t surprised they wanted to see me beforehand, I’m not as straightforward as most women my age, & as I already had an appointment to have blood work done that my rheumatologist had requested it made sense to get everything done on the same day, so I did that this morning.

So I rock up at the pre-admission clinic like I was told to do when they called to book the appointment. Of course it wasn’t that simple because I hadn’t been to registration first because I’m not a mind reader. So I then go there & take ticket number 32, the number on the electronic board was 23 – great! I’d been in the building for 10 minutes & already I could tell that 1 hour worth of parking wasn’t going to be enough. As it happens I only sat there for about 15-20 minutes before my number came up. The registration process was quick as they were expecting me & had all me paperwork there. I now had a little bit more confidence in the system…

Back at the clinic I am greeted by a nurse who takes the paperwork, & weighs me (without it, thank god, it was at least one tree), & I sit down for another nurse to take over (one nurse is obviously not capable of doing the full assessment). No sooner does the new nurse start speaking when the anaesthetist walks in, so the nurse stops & allows him to take over, but she listens in so she doesn’t ask the same questions. He apparently knows my husband from a few years back so makes some small talk in between medical questions. The main reason I am being questioned is because of the medications I take – especially my biologic (the injection). One of the other drugs I am on is a non-steroidal anti-inflammatory, but a slightly different drug to the Ibruprofen or Diclofenac that many of you might know. Normally it is advised to stop taking these drugs a few days before surgery, but I take Celebrex which is a little different & therefore I do not need to stop taking it. I am relieved about this because I will have already been without my biologic for over 5 weeks by the time surgery comes around & may be starting to feel the effects. All is well with him, he’ll see me on the day & the nurse takes over for a bit, then I think I’m done…

Not likely, the nurse then sends me off to see an internal medicine physician & I question why. Apparently it’s because of my medications that I have just discussed with the doctor that is actually going to put me to sleep, shouldn’t it be all sorted? Nope, apparently not, I must see this other guy. So off I go. I extended my parking while I wait, thinking half an hour should do it. I am called in & the guy is very polite & friendly, & very concerned I am on a biologic & I’m about to have surgery. I explain the plan I have with my rheumatologist & he is confused there is no record of this plan in my chart. No there won’t be, I see him regularly, & know him well. We discussed it very recently at my last consultation; it’s all taken care of – he’s kinda the guy in charge of me. This didn’t seem to sit well with him; a doctor I’ve never clapped eyes on in my life & probably never will again wanted to devise is own plan. I eventually manage to convince him that it was under control. Then we moved onto the Celebrex that he wanted me to stop about 6 days prior to surgery… errr no, the anaesthetist said I could still take it. For the love of all that’s medical people – make your bloody minds up!!

To cut a long consultation short, he was not happy about me taking it & was going to discuss it with his colleague – that would be the doctor who is actually going to be the one managing me on the day & frankly saw no reason to stop it, & therefore the one I’m going to listen to thank you very much. Not only that, no biologic & no Celebrex for almost a week will not give me a very good start to making a recovery. I eventually escape & return to the clinic thinking I must be done now…

NOPE! I now needed bloodwork & an ECG. They had to be kidding me; I had only just had bloodwork that morning, taken from the only place that anyone seems to be able to get any out of me. Apparently they needed more. So I have a right old rant to the nurse explaining that nobody told me any of this on the phone when I booked the appointment. I had my kids to pick up from camp, which is all the way back across town. Had I known that I was going to be 2 hours I would have requested an earlier appointment. She said I should have been told all of this when the appointment was made. Great! Thanks!

So, off I go to ECG, while adding MORE time onto my parking, & texting hubby to see if he can go for the boys. I get to ECG, wait in ANOTHER waiting area, eventually go in, & lay on the bed. The technician lays a sheet over me & asks if I can up my dress – I was wearing an all in one shorts & top romper style thing. I explain it needs to come down for him to gain access to my chest, which I was more than happy to do but he seemed embarrassed about. In the end I just got on with it – I mean really – & he got the job done not knowing where to look. Honestly you would think I was lying there completely naked (yes I had a bra on there was nothing indecent about me at all). Mind you, he was only about 16 so maybe that’s why! I then go back to the clinic AGAIN, swap the ECG for the bloodwork forms & head to the lab where the phlebotomist attacks the opposite arm from the earlier bloodwork (so both arms now very sore) & pokes around for a few minutes before finally getting what she needed… Hallelujah!! I was free to go… & face sitting in traffic for another 2 hours just to get home.

I hope the surgery is going to be a bit more organized!

The decision…

It wasn’t easy but it’s the only thing left. Last week after a discussion with my rheumatologist, my surgeon agreed to open up my knee. I was desperately hoping that it would happen sooner rather than later, but sadly not. I shouldn’t complain really, being married to a physician has its perks, well a perk actually, they all know someone who can help & we usually don’t have to wait as long as everyone else to be seen.

I was quite overwhelmed by the conversations we had had last week that I forgot to ask questions I would normally think of spontaneously. It wasn’t until I saw my rheumatologist the following day that it became apparent I wasn’t the kind of patient that can drop everything & have surgery. Yes, organizing the family is one thing, but my medication suppresses my immune system, therefore putting me at risk of infection, a surgical procedure means I must stop my injections before surgery. Then, once I am definitely on the mend I can start them again. As you can imagine the thought of stopping the one thing that keeps me physically active scares me, especially when it’s for a situation in which I will be temporarily less active than normal.

Today it was confirmed that hoping a cancellation would get me in sooner was not going to work really. I know a scheduled date gives me/us time to plan, but I really didn’t expect it to be August. It’s just typical that they can’t fit me in for the week my husband is on vacation. And of course it’s the same week we are supposed to be going on a big group camping trip for a friends significant birthday celebration. And the same week I am expected to do jury service, which I really wanted to do.

I know it’s great that something is finally being done, but it has screwed my life up enough, why does it have to continue to spoil my summer too?

It’s finally come to this…

I’m going to have surgery in a last attempt to fix my poor knee.

When? I’m not sure, hopefully a cancellation will make it sooner rather then later, but the problem is I have to stop my biologic injections in preparation for surgery & I hate being without them for too long.

Why? Well they suppress my immune system, & surgery puts me at high risk of infection & not healing well. It will take a month or so for the drug to stop doing it’s job, then I’ll get stiff & sore.

What is she going to do to my knee? Good question, I’m not sure she knows until she gets in there – ‘give it a bit of a tidy up’ was mentioned, whatever that involves. I guess I have to be prepared to agree to whatever she thinks is necessary & trust her judgment.

Will it fix it? That is the six million dollar question. Keep your fingers crossed for me & hope that it does!

… and then there’s Tuesday!

07.45 – Boys wait at the front of the house to be picked up by another mum. I have my appointment with the surgeon at 08.30 so she kindly offered to swing by & scoop them up.

08.25 – I arrive at the doctor’s office feeling quite nauseous & a little scared at what the outcome of this consultation will be.

09.25 – I leave the doctor’s office in tears. Not because there is nothing further to be done, but because I’m to have MORE imaging & a joint injection before she will contemplate putting me under the knife.

09.35 – Hubby is already late for a meeting, but we are driving past the post office & have a envelope to pick up which we know is our eldest new passport. Hubby reverses the car into someone which I feel is my fault – don’t ask long story – There is very little damage, the paintwork will polish up on the other car but the guy is being a complete tosser about the whole thing. I leave them to thrash it out & go to collect the passport.

09.50 – Drop hubby at work with his bike & leg it home because my rheumatologist is calling at 10.

10.05 – Emotional conversation with my doctor about the management of my knee, he is also suggesting that a joint injection is the only thing that hasn’t been done – there has also been some discussion about chopping of the head of my fibula off – I want to throw up at this point because this was also discussed with my surgeon. I suggest that he talks to her so they can agree on what pictures they want & if there will be any chopping at all.

10.20 – I’m in absolute tatters so I call hubby who I know is busy. He is & will call me back as soon as he can.

10.45 – I look like panda while talking to hubby. I am much calmer after coming off the phone.

11.00 – 14.30 – I write another chapter, do laundry, watch the rain fall & practice my guitar – which sounded better today.

14.35 – I leave early for school to pick up a few groceries on the way.

15.10 – I pick up my younger son & his field hockey buddy from the class next door. His mum is a teacher at the school, she gives me his hockey gear and we confirm the arrangements. This is the first night back at practice, I won’t bore you with the details but they changed the location, which has completely screwed up all our plans because the original location is at the end of our street – walking distance.

15.30 – Arrive home with hockey boys. They get changed, do homework & eat dinner in less than an hour.

16.45 – We arrive back to school, waiting for us in the parking lot is hubby, elder child, hockey buddy’s sister (who is the same grade as my eldest) & their mum, the teacher. I swop hockey boys for their siblings, hubby puts his bike on the back of our car, I had over school uniform & homework to mum and then drive back home again.

17.00 – 19.00 – I feed, water, & do homework with siblings, listen to guitar practice, wash gym kit after muddy track & field session, feed animals, & sort out lunches. Teacher mum drops off hubby & my younger son, both require defrosting – and they were wondering why I was offering to stay home and do the feeding & ferrying about part.

… & this will now be why I will also be drinking wine on a Tuesday!!

 

 

Crying for help…

When it all just gets too much a meltdown is the only way to go. No matter what is said, how it is said, or who says it, nothing will prevent the inevitable happening. No matter how strong you have been in the past, at the moment you give in you feel a failure, not only letting yourself down, but also those who love you. A person can only take so much before they are they just give up on him or herself.

Where to next? I need somebody to just take charge & tell me because I have no clue. No more scans or injections, or drugs, how difficult can it be, isn’t it time to just open it up & take a proper look. It’s been almost 6 months now – I just want it to get better!!!

Diary of a bump!

How does a knee look dislocated, or out of place, & mechanically doesn’t move correctly, & yet 2 x-rays, a CT, and an MRI scan suggest it isn’t?

I’ve known for sometime time that this wasn’t going to be straight forward, my gut told me that. When the MRI suggested inflammation, a shot of intra-muscular steroids worked initially, enough that I could remove my knee brace briefly at Christmas, but it still wasn’t right. Next it was oral steroids, & finally a few weeks ago the joint was injected superficially. I have been wearing an industrial knee brace for 4 months now. I don’t like the knee to bend while being loaded (up or down stairs), especially if it also rotates (getting in or out of the car). It aches most of the time, especially after walking any distance. When I sit with my knees bent at 90 degrees, you can spot the protrusion from across the room, it is that obvious. It wakes me up at night if it’s bent for too long. It doesn’t really respond to painkillers, it prefers rest – which my life does not allow, & ice numbs it temporarily.

It has been a mystery to every professional that has examined it, until today…

The appointment to see a colleague of my own rheumatologist that was scheduled for 7 weeks time was brought forward to today. This particular physician is good at ultrasound, which sounds a bit basic when you consider all the other imaging I’ve had. It was difficult to pack my full history into a 5minute conversation, but he was able to get an idea of where I was regarding my disease. Then he put the probe right on the bony prominence that is also very tender. What he clearly saw was bone, extra bone on the head of my fibula. Nothing was out of place; there wasn’t any obvious inflammation, just unusual bone growth. Lying on top of that bone is tendon, now under tension because it’s being stretched & rubbed on bone that normally wouldn’t be there– he described it as ‘runners knee’ without the running.

He has never seen before, & clearly nobody else had so that’s why it’s been difficult to diagnose.

YAY! Finally, a diagnosis. But what about treatment?

If this was a real runners knee, rest, ice, non-steriodals etc. All the usual things you would expect for a sports injury, but this is not a real runners knee, it’s disease related. The treatment will only help with symptoms, it won’t stop the bone growing. In reality, unless my orthopaedic surgeon has any bright ideas, like shaving the extra bit off, I’m stuck with it! So, if my writing doesn’t make it into the spotlight, my unique knee will! It will be presented to other professionals, hopefully on Friday, at a radiology meeting. Maybe somebody else has seen something similar, or can suggest some other management.

I succeeded in holding back the tears until I left the room. Thankfully my husband was with me. He always tries to stay positive in this situations – one of us has to. I have always had a feeling deep down that this would go under the knife, I don’t know why, I just did. Maybe because of the way everyone looked at it, curiously worried at what they were missing. The thought of someone shaving my bone makes me feel physically sick & very emotional. I can’t begin to describe how upset I am, & overwhelmed with anger at having to deal with more pain and discomfort.

At what point is it decided that I’ve suffered enough?