Further adventures with recovery.

  The knee appears to be working out quite nicely.  I can now walk without any assistive devices such as a cane, and my gait, or the way I balance when I walk, is normalizing.
  I can straighten my leg to 3 degrees shy of perfectly straight, which is great considering that I wasn't able to do that before surgery.  I was walking before surgery with that leg slightly bent because of the pain.  This had been going on for more than a year, so the tendons had become a tad short.  Post-surgical physical therapy has helped me lengthen those tendons, but there is still a little more work we need to do before the leg will fully and normally straighten.
  I can also bend this new knee to 105 degrees, which is great for somebody who has only had this new knee for 8 weeks.  The goal is to bend it 130 degrees.
  In two days it will be 9 weeks.  Wow, it seems like it hasn't been that long when you say '9 weeks', but experientially it seems like it has been months since surgery.  The saying, "How time flies when you're having fun." implies that it doesn't when you aren't, and that has been true for me.
  There have been minor set backs.
  At three weeks and three days there was one incident.  It was 7-ish in the evening and I was trying to put on a pair of shoes.  We needed to go to the store for some groceries.  I needed to twist my foot to get it into the shoe.  This new knee didn't take kindly to the twisting motions that I needed to ask of it yet, so I always went slow.  I set my foot into the shoe on the floor and gently began to twist it into the shoe, but just then Henry, the dog, brushed up against me and made me lose balance just a tad so that the twisting motion occurred a little faster, and I heard a ripping, tearing noise with accompanying severe pain in the outside of the knee.  I hollered and gyrated for a few minutes.  The severe pain lasted for about 20 minutes, slowly decreasing, and the whole time I was thinking, "I've ripped something, or maybe broken something!  What am I going to do!"
  Vincent didn't even have a learner's permit yet, and I sure couldn't drive with this much pain, so I had no transportation.  My only option was to call for an ambulance, which took me to my second emergency room experience since surgery.
  They examined me, took x-rays, and conferred with my surgeon.  It was decided that I hadn't broken anything but something could have ripped, so it was back to the walker.  "Stay off the leg for a few days, and see the doctor as soon as possible."  I had an appointment for a one month check up with my surgeon, Dr. Cornelius, on Jan. 5, so I decided to just take it easy until then.  I called and cancelled two physical therapy appointments and settled down to take it easy and wait.
  After conferring with the good doctor it was decided that all I had done was tear loose some scar tissue.  This was actually a good thing and would speed my mobility.  The knee should heal better from now on.

My knee issues.

You said you did not know anything had even been wrong, so I thought I'd bring you up to date.

I have osteoarthritis.

My worst joint is my left knee where symptoms have been manifested since June of 2005. I have probably had it longer than that, but that was when the diagnosis was made.

So here I am, going to school and really enjoying the classes at Clackamas Community College, studying Horticulture since September, 2011, and just two days before Halloween, 2011, I get another arthritis flare up. I went in to my primary who sent me in to the orthopedist, the usual route, and the orthopedist says we have finally run out of options. There are no more shots we can try, no treatment options we haven't explored, and our only option left is surgery.

I kinda knew this was coming, but I didn't expect it to happen so soon. They just injected me with the Synvisc generic stuff in June and July, so I was thinking we had at least a year, but nope, those shots don't work so well on me, as evidenced by the arthritis flare up I am presently enjoying. In fact, that was our last hope before surgery would be needed. I had already undergone the cortisone shots and I had been taking larger than normal doses of ibuprofen every 6 hours for about a year, just to keep the arthritis at bay.

We discuss what can be done. He wants to do the MAKOplasty. That's a partial knee replacement done with a robot. Okay, the robot is only there to help the doctor take only 'this much' and 'no more' while he is grinding away the parts of the knee that are damaged. But, hey, it's a robot, and that has a degree of coolness there. Also, the MAKOplasty has a faster recovery time, as well. It's only 6 to 8 weeks ... says so, right here.

Of course, just in case the doctor is wrong about how much damage the arthritis has done, he wants me to sign a paper. It is a disclaimer that will give him the option to do the Total Knee Replacement if MAKO isn't going to work. However, he is leaning toward MAKO, he really thinks I am a good candidate for that. I am youngish to be getting a TKR, and I agree with him. MAKO is less invasive, quicker recovery time, and it gives the patient more time with more of the original equipment before a TKR is needed.

We set the soonest surgery date of Dec. 6.

I went to Clackamas and, because it was too late in the term to withdraw, I asked for and got incompletes from all my instructors with the proviso that I finish the coursework in 12 months.

Then began all the tests and pictures and so forth, but I sailed through all those. The only thing that would have stopped surgery would have been any kind of scratch or break in the skin on my left leg at the time of surgery.

My youngest son, Ian, who is now 13, accidentally stomped on my left big toe and cracked it 8 days before surgery, but the skin wasn't broken, so we were still good to go. I was already limping as it was. It's good that it was on the same leg so that at least I still had the one good leg to work with after surgery.

My biggest concern was the anesthesia. I didn't mind that they were going to use mild as opposed to deep sedation, but I told them that I was very sensitive to narcotics, that I had really bad reactions to them, and that if there were any other options then they might want to consider those.

Finally I went in for surgery at Legacy Salmon Creek at 0530 on Dec. 6th, 2011. Prep went as planned, the Doc came in and signed my left kneecap, and then they wheeled me in. I greeted the MAKO machine and that's the last I remember.

I awoke in the recovery room to the first of series of big shocks. They had packed my system full of morphine and other narcotics, and I was loopier than a loon.

My dizziness from narcotics is of an unusual sort. Instead of the room looking like it is spinning, going from side to side, the room looks like it is jumping, going up and down. The nurses and others who looked at my eyes said that they couldn't see any movement, but I was soo dizzy that I could not even grasp a simple cup of water. I was also nauseated, and I was confused and disoriented. I felt like I wasn't quite awake.

However, I was not presenting with any of the classic signs of allergy, such as breathing difficulties or skin rashes, so they sort of shrugged and took a wait and see approach. Have some ice, take deep breaths, turn your head and cough, and just rest. You should be just fine tomorrow morning.

My second shock was that they had not performed the MAKOplasty. They had done a Total Knee Replacement.

I wasn't prepared for that. Recovery for TKR is longer and more painful than for MAKO. TKR recovery is 3 to 6 months, with some symptoms lasting as long as a year, and it now put in jeopardy my plans for school. Besides, the doctor had been so sure that I wouldn't need anything more than MAKO, and he had been the one who had convinced me that a TKR was an outside possibility.

He actually apologized when he came in after I was awake to discuss the surgery. He explained that he would have gone ahead with the MAKO if there had been only one compartment involved, as he had thought there was, but when they got in there and actually saw the state my knee was in they realized they had no choice. All three compartments were nearly bereft of cartilage. Even the knee cap was fully involved. It was the worst of the structures affected, and they had barely enough bone to put the plastic 'button' on. However, they had been able to do the whole procedure, so I was going to recover with a full knee. It was going to take longer and be more painful, but I would recover.

They brought in lunch at the usual time, then dinner that night, but I was still so incapacitated from the crazy dizziness that I could not even feed myself. They had to do it for me.

During the night they gave me more narcotics, so the dizziness didn't dissipate, and then my next nasty symptom manifested itself.

During breakfast I actually began to suspect that there was someone trying to kill me.

It was totally weird! At first I thought, the doctor is trying to kill me with narcotics. Then I shook my head, sorta laughed, and said to myself, no, doctors are here to help people! That is absurd! Then that little voice said, well, maybe they were trying to hide something in my food to kill me with, and I found myself really looking at my eggs and toast. I have never had that happen before!

I called the nurse, who called the charge nurse, and told them both my issues. The Charge nurse said that they would immediately take me off all narcotics and call the doctor. There had to be SOMETHING else they could do for pain relief! This dizziness and strange thoughts stuff was too much. I was still so dizzy that I could not function properly.

The doctors scrambled, and conferred.

In the mean time, I was visited by the Physical Therapist. She had me get up in a walker and walk all the way down the hall to the Physical therapy room. This would have not been such a big deal except for the fact that it had now been more than 8 hours since my last dose of pain meds, and I was waaaay more than uncomfortable. And we all know how well Physical Therapists listen to you when you tell them you are in pain.

I got all the way down to PT and was sitting on one of those huge elevated mats when I started passing out from the pain.

I told the PT gal that I was feeling sorta light headed, and then that the 'tunnel' was starting to close in, and she looked at my face and called another nurse. They brought a bp cuff and took my bp, and then they had me lay down and put my feet up. My bp continued to drop, so they brought in a bed and a few more nurses and got me back to my room.

They tried a different pain med, but I guess that didn't work too good, either. I had to get up to visit the potty, see, and they wouldn't consider bed pans and so I had to get out of bed. I got as far as the toilet and pulled the cord before I lost consciousness. This time they couldn't find my pulse, even though I was still blinking. I don't remember too much from that episode except that every time I opened my eyes there were more people around me. First in the bathroom, and then in the main room, and then I was in bed in the hall going ... somewhere ... and then a different nurse was asking me to wake up. I had IVs in both arms, and they were running fluids into my arms as fast as they could. I was in a completely different section of the hospital. There were wires all sorts of places on my chest, and I felt really tired. Oh, and someone had added a swarm of bees to the audio portion of our program.

Very shortly two doctors came in who I had never seen before and introduced themselves. They then said they were going to try a combination of medications to see if they could find something that would work for me. One was something I had never even heard of before, so I said, okay, lets try this. What we have tried hasn't work so well, so let's try this new thing.

They then also told me that I had something called a vasovagal response with syncope, and that they would be watching me more closely from now on.

Well, I knew that I feinted when I saw my own blood, and they said that this was related, but they had never had this happen in this way before, but they had every reason to expect that I would be just fine.

So we started in with the new pain meds.

They gave me something, and then they would monitor me very closely for the next 8 hours to see how well it worked and what my reaction would be. They tried three combinations before they hit on something that worked sorta decent. Then they observed me for 24 hours before putting me back in the area of the hospital where I had originally been so that I could be properly discharged.

We then went through the usual procedures, and I was finally allowed to be discharged after being in the hospital for four days instead of two.

Actually, I still think they should have kept me longer, at least until I had had a bowel movement. The first time that happened I had to go to the hospital in an ambulance because I was so constipated and dizzy that I couldn't get the job done. I kept fainting again. However, once that was straightened out, as it were, then the real recovery began.

Be that as it may, I am now home, sleeping and eating like normal, getting up and getting around and getting better all the time.

I had a Constant Passive Motion machine here at my apartment for 6 weeks that I called George. It was very helpful in keeping my pain levels down. I would use him about 16 to 20 hours a day, and that kept me pretty comfy most of the time. I even slept in it.

The Physical Therapist says that I am doing nicely with my recovery, and that I have every reason to expect a normal leg inside of six months, at the least; a year at the most.