The Knee Saga is Now a Trilogy
I don't know what I was expecting today when I went to see this new surgeon. It wasn't what I got; that's for sure. He spent over an hour with me, going over my other surgeon's notes, asking me questions, examining my knees (both of them) like I don't think they've ever been before. When all was said and done, it boils down to several possibilities that he wants to rule out, before he said he would even think of cutting.
First, I have an MRI tomorrow. Then I have a bone scan next week at the hospital. He's thinking a bunch of different things after examining my knee:
-possible PCL sprain
-possible stress fractures
-possible bone infection from the allograft
-some cartilage deterioration under both knee caps (this is the only one that's for sure)
We barely even addressed the issue with the screw sticking out. He said he needs all the evidence before we can move forward.
He also said that the fat atrophy issue is going to require a good plastic surgeon. Maybe I will be able to get some fat from somewhere else sucked out and put there after all.
I also have to pick a 48 hour window over the next week where I put no weight on my knee at all and go back on crutches. He wants to see how I feel after that time period and report back to him.
I left there feeling like I wanted to cry. I hated getting an MRI last time. The bone scan sounds like no fun at all and is an all day affair. First an injection of isotopes and then I'll have to go back hours later to get about 30 minutes worth of scans.
In the meantime, this new surgeon who is in my insurance network, says he's going to get the operative notes from both surgeries, and the first MRI scan, so he can see what my other surgeon did and put together all the pieces.
In the meantime, no karate, no working out, no running and he'd like me to limit the amount of walking I do.
I guess if there's one thing I'm glad about, it's that this wasn't all in my head. I definitely still have problems. Here's hoping they get fixed once and for all.
Make It Go Away
Yesterday I arrived at my surgeon's office and the receptionist asked me for my insurance card.
"Oh, when you scheduled your appointment, did they tell you that we don't take your insurance anymore?" she asked.
"No," I told her, "If they had told me that, I wouldn't have scheduled my appointment."
I looked at my card, saw the 50/50 out of network numbers and figured I was just going to go through with the appointment. I once fought my insurance company over not paying for an ultrasound because I went "out of network" after I had specifically called and asked them where I could go and they told me that place. I could fight this one too.
I'm nothing if not a fighter.
A familiar face took two x-rays of my knee. It was like deja vous. This is number three.
I sat in the room waiting for my surgeon, staring at the computer screen with the picture of my knee on it, trying to figure things out myself. I don't know what I thought I was going to figure out. It's pretty obvious when there is a screw protruding from your tibia so much so that you can feel it through your skin.
My surgeon came in and held out his hands, a gesture that said, "What are you doing here?" and I pulled up my pant leg. (See that yellowish spot to the direct right of the dark purple part? That's the screw.)
He spent some time poking around at it, moving my skin around, something that makes most people want to put their head between their knees and say "stop it before I pass out."
He said what I knew he was already going to say. I need more surgery. This time, he says he will remove more of the screw. I asked him why he can't just take the whole thing out and he said he can't. Part of it has turned into bone in the middle of my tibia. The part sticking out has not.
The weird indentation I have in my leg is due to "fat atrophy," probably a side effect from the cortisone shot he gave me a while ago, back when I kept complaining I was in pain and he thought it might have just been from an abundance of scar tissue, not from the screw sheath sticking out which only became obvious after the months of swelling had gone down. Because of this fat atrophy, my body is literally skin and bones at that part of my leg. I have no cushion and that my friends, is no fun.
He talked about excising some tissue and pulling the skin over when he closes me back up so that this problem will hopefully go away. I asked him why he couldn't just take some fat from my butt, thighs or stomach and he said it doesn't work that way. Truth be told, it should work that way. That would be sweet.
As we wrapped up our conversation, I told him that his office no longer takes my insurance. He said he would call me next week, after they talked to my insurance company, to let me know how much it would cost me. I can already tell you the likely answer: too much.
I asked him about a "buy two, get one free" special, but unfortunately, surgeons are not shoe stores.
I called Mr. BBM and put him on the insurance questions I had. Which surgeons do take my insurance? Does the hospital and surgi-center take my insurance? They both do, so the out-of-pocket costs for me come with my surgeon's fees. Last surgery, I believe it cost me about $100 per minute, which is probably a drop in the bucket for a surgeon. Unfortunately, that's not the case for me.
Not to mention, I have already spent thousands of dollars on co-pays, surgical costs, appointments and physical therapy. This has been almost three years of expenses for me. As soon as I get one paid off, I've had to go back for more surgery.
I came home and Mr. BBM encouraged me to call a different surgeon. A couple months ago, I ran into my old high school athletic trainer. He is still at the school and is a wonderful guy. I worked for him as an athletic trainer my senior year and loved it. He asked me how I was and I embarked on my ACL saga. I asked him which surgeon he recommends if a student athlete tears their ACL. He gave me a name and that's who I called yesterday afternoon.
My trainer had told me it might take me weeks or even months to get in with him, so he told me to mention his name. I did and I have an appointment on Wednesday.
I am torn though. I have a real comfort level with my current surgeon. While some of my friends and family think I should see someone else, I don't know what to think. My surgeon has a personality, one that I get along with quite well. I feel like he's always been straight-forward with me and that he has my best interests in mind. However, I'm also on my third surgery now for what should have been finished, once and done, back in December of 2007. I don't know what to think. Am I part of the 3% that has a problem with the bioscrew? Am I part of the small minority that will have an unfortunate reaction to a cortisone shot?
I don't know.
The way I see it, Wednesday's appointment will be a fact finding mission. I will gather as much information as I can this week so that I can make an educated decision about who I want to do the surgery and when. When my current surgeon calls me with the fees he would charge, I have a feeling the decision will be more obvious.
However, I don't look forward to another OR visit. I especially don't look forward to going in there with a stranger.
There is one thing I'm absolutely sure about though. I want this to be the last time; and I want this ordeal to be over.
Lucky Number Three
Last night at dinner, Lil C was swinging her legs back and forth, when the very tip of her shoe hit the very spot where I'm pretty sure the screw is backing out of my tibia. It hurt lots.
Today I called my surgeon. After watching this health care bill pass, I figured I had better do it now before I have a five year wait for surgery.
The person answering the phone asked me if I had seen him before. I explained that I was pretty much a "regular" and then she asked me about my symptoms.
"Well, I can see something round and hard coming out of the incision area. I'm pretty sure it's the screw."
And that, my friends, is how you get an appointment this week.
In advance of Friday, I'm going to need to check out my schedule to see when I can fit an actual surgery into my schedule. I can't imagine my appointment will be any other way. I doubt there's a magic cream you can rub on a screw to make it disappear. Clearly, hoping and praying hasn't worked and neither has staring at it and willing it to "be gone."
I'd really like for number three to be the lucky number and for this whole knee ordeal to be over.
I can think of few things in my life that I would actually go back and change. I don't have many regrets about things. But going to karate that night, planting that foot and throwing that roundhouse kick? That's a big regret. How I wish I had been feeling guilty about not going to class that night from the comfort of my sofa at home. This ordeal has gone on entirely too long.
Here's hoping that Friday is the beginning of the end of it.
The Good and the Ugly (No Need for the Bad)
Today was my first day back on campus and it was a good one. I'm teaching Fundamentals of Speech only this semester; and although it's at 8 a.m. I am pumped for this semester. First, I don't know how it happened, but this adjunct got one of the best rooms on campus. I have white boards. I have projector screens that automatically emerge from the ceiling at the push of a button. I have some ELMO thing that I don't even know how to use, but I have one. I also have enough computers for all my students, comfortably arranged around the perimeter of the room which is going to make a HUGE difference when we start researching speech topics. I don't know what I did to deserve it, but praying to the classroom assignment gods and maybe having done a semester of chalkboard purgatory have done me well.
In addition to the fantastic surroundings, I seem to have a great group of students. I have six students from previous semesters who are all awesome, and the new students seem to be a nice group of kids as well. My class is loaded with athletes and nursing majors. I might as well just give them all A's now. I had one eye-rolling girl (there's always one) who warmed up after about 15 minutes and they all seemed like good sports, even when I announced that they'd be giving a short speech today. I see a lot of potential in this group and am excited to go back to class on Thursday. Here's hoping this trend continues.
On another note, I had my awesome physical therapist and his wonderfully talented graphic designer wife over for dinner and fun this weekend. I whipped out my knee once again and had him take a look at it. Once again, my PT strongly recommended I go back to see the surgeon. I asked him what he thinks is going on and he mentioned the possibility of something going on with the screw in my tibia. Perhaps it's backing out. Sometimes screws need to be removed.
Mr. BBM did some research on it and found me pages of people on the internet who have the same problems that I have: unreasonable pain at the tibia site, the ability to feel the screw through my skin, bruising that won't go away, pain that doesn't quit, the inability to kneel in any way, shape or form without looking like a crazy person. I felt a gush of relief when I saw the pages of people with the same issue. I also felt fresh new fear.
Many people who have the problems I have had to have another surgery to remove the screw. Almost everyone who went this route reported incision pain for a couple days, followed by relief, sweet, sweet relief. If that's the problem, and it has to be done, then it's going to get done. It would absolutely figure that I'm one of the 3% who would have this problem. The symptoms seem to match up exactly to what mine are and I'm going to make an appointment and see what I can do about it.
On one hand I'm happy to know I'm not alone and that something can be done if this is my problem. On the other hand, it's another surgery, the third one on the same knee. That, I dread. However, knowing there are options and that I won't have to just accept pain as part of my daily life is a good thing.
If surgery is required, I'll need to time it just right, probably over spring break, so that I won't need to take any time away from campus. But hopefully, if this is the path I have to take, it will be the last time I have to walk down the surgery aisle, squeezing a gown shut behind me and hoping for the best. In my wildest dreams I imagine myself doing karate without feeling any pain. That alone, would be worth it right there.
ACL Knee: Always On My Mind
Last week I finally made it into karate class for the first time in a couple weeks. Because my knee has been so incredibly cranky, I told my teacher right up front that I couldn't do the kneeling for the rei in or out. He said it wasn't a problem and that we would do it from a standing position.
I made it through class, but my knee complained much of the time. Turning and pivoting absolutely sucked. Standing in nai hanchi wasn't fun either. After class officially ended, I stayed a little longer and worked out with several other black belts. We worked on a couple black belt kata. My teacher asked what I wanted to do and I said I would do whatever he wanted to do. I was clearly out of practice and welcomed reviewing anything. But we didn't review.
He mentioned something about me needing Chinto for 2nd degree and we got right into it. To be perfectly honest, I haven't once thought about going beyond Shodan. So happy and content to wrap that black obi around my waist each time I go, I just haven't even allowed myself to consider the possibilities of moving up in rank. Simply getting into the dojo has been sufficient for me.
I miss karate immensely. Although I was stressed and tired, training four-five days a week during those months leading up to testing was fun. The testing group has a tight bond and we all get along so well. Although I'd be drenched at the end of the two-three hour night (sometimes more), I was enjoying myself and the hard work.
I absolutely hate that I have become the type of black belt I never wanted to be. I arrive and people are happy to see me because it's been a while since I've been there. We have catching up to do because I haven't been there regularly. I absolutely hate that I'm not there regularly.
I've been putting it off for months because I wanted things to magically get better, but I'm realizing that the new year is probably going to contain another visit to a surgeon. My knee is not right. Currently, half of it is blue and purple. The bruising extends out from the tibia incision area all the way up into my knee cap. I realized the other day that I'm limping a bit and that I have to really work to be able to completely straighten it sometimes. Putting any type of pressure on the knee by kneeling is through the roof painful.
Last night I sat on the sofa and did some scar tissue massage in the area where I'm so sore. It was almost unbearable. I had every intention of going to karate again last night, but I felt that it was probably best that I didn't risk making it even more sore than it already is right now. We're going to Disney World soon and I need to be able to walk and keep up with my girls.
I can honestly say that tearing my ACL is the worst thing that has ever happened to me. It has robbed me of so many things. I think about how Lil C would sit at the top of the stairs when it first happened and cry because I had to scoot down the stairs like she did; I couldn't hold her. I think about how I feel every night that I want to be training, but am instead elevating my knee on the sofa. I think about it every time I want to put on a pair of my heels and know I can't because I'm going to pay for it for a week after. I think about it every time I have a twinge of soreness or stiffness (which is pretty much every day). I think about it every second that I'm at karate and it makes me mad that it is constantly an issue. I long for the days when all I worried about was whether or not my self defense move worked or my kata looked the way it's supposed to, And I'm angry that I'm not one of the people who can just bounce right back from it and not have another problem. Next week will be two years since my original surgery and I am not where I want to be, not anywhere close.
If a visit to a surgeon in the new year brings yet another surgery, it will be three years in a row. That is three years too many.
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