Read about the continuing story.
This year did not go well. Those who have read the other parts of my pages know that I like to stay active. I do take some risks, but I try to minimize them. I ride a classic cycle. Though I wear a helmet when I do. I hike into the back country, but I carry the right equipment. Even for a day trip I carry first aid equipment in addition to my camera.
Sometimes none of this matters. It is the things you do every day that get you. This time it was a simple game of basketball with one of my daughters.
Kira and I were playing some one on one. We both went up for the rebound. She came down on solid feet. I came down and kept going down. I felt pain and my knee would not hold me. This ended the game. I picked myself up and hobbled off the court.
I tried treating it with hot and cold. After a couple of days it did not get any better. So I went to the family doctor. He had x-rays taken of my knee. It showed no broken bones. So after consulting with his partners they sent me to Dr. Asselmeier an Orthopedic and Sports Medicine specialist.
Dr. Asselmeier felt around the knee for a bit. Then moved my leg all over. After this he said he believed I tore my medial meniscus cartilage. He sent me to have an MRI. The results of the MRI showed he was correct as far as he went. It turns out the anterior crucial ligament (ACL) was torn as well.
At this point we started talking about my options. There were three basic options that I had to chose from.
First I could do nothing. This meant that I would run a high risk of reinjury of the cartilage. It also meant that without the correct padding I could speed the onset of arthritis. It would mean an inactive life.
Second I could have the meniscus repaired leaving the ACL torn. This would have reduced pain. It would help slow the onset of arthritis. It would mean lots of therapy to strengthen the knee for protecting the meniscus from injury again. Without the ACL the knee would be unstable. Allowing it to catch and tear the meniscus again. To become as active as I had been, I most likely would need a brace to replace the ACL during sports.
The final option was to repair the meniscus and replace the torn ACL. This would again call for lots of therapy to regain strength and flexibility in the knee. However, there would be light at the end of the tunnel. There was every chance I could get back to the activities I had done prior to the injury.
The doc and I talked about the options. He sent me home to think about it. I talked to my brother Neil. He had this the surgery before me. I was talking to my friend Kelly about the possibility of getting the surgery. She told me she had done it a few years before. It is amazing how little you know about friends sometimes. I read all the stories on the Internet I could find. I checked out Vicki's physiology text books. In the end I decided to get the repair and the replacement using arthroscopy and endoscopy. This method would reduce the size of the incision and reduce the trauma.
Once deciding this, I had to figure out where to get the replacement for my ACL. This time there were two basic choices. I could donate a tendon from elsewhere in my leg. The patellar tendon is the most often used. The other is to get the part from a dead guy. This is called an allograft. Sounds better don't it.
Neil and Kelly had acted as their own donors. So they could tell me some about recovery time. It seemed like a lot of work to recover not only from the repair site, but also from the donor site.
The allograft had the problem that there was a 1 in 1,000,000 chance that an infection could be carried from the donor. It is dead tissue and does not carry the infection itself. However, it does need to be processed correctly to remove blood and other materials that could contain infections. This meant it was important to worry about the quality of the place doing this work.
I figured I had the same chance of Vicki carrying home an infection from the dental office as I did from a well done donation of tissue. She tells me every once in a while someone forgets to tell her about a medical condition. They don't tell her they had a heart attack. Then she notices a heart medication on their chart. If they don't tell her about something that could cause them death, why not forget to tell her about something that puts her and her family at risk. A surgical mask and gloves do not mean the person cannot pass on TB or hepatis.
All and all things looked good for the allograft. The easier recovery was worth the small risk. I was putting on pounds fast in the time after the injury. I wanted to become active as quickly as possible. Therefore, I decided the best option for me was to get the allograft.
I had to get permission from my insurance. This took awhile. First they determined the procedure was necessary. Then they had to check to see if there was anyone else they could make pay for it. They wanted to know all about the accident.
The surgery was setup. I took the required tests. They made me get an EKG. The doc made sure a donor tendon was available.
I cannot tell you much about what happened during my surgery. I was out like a light. The general procedure was described to me in these simple terms. My cartilage was screwed back down to pad the bone. The old ACL was cut away. A hole was drilled in both my femur and tibia. Then the donor tendon was inserted in the holes and attached to the bone. Then the doc stapled me shut. You can see pictures provided by Dr. Asselmeier.
The next day was not normal for most folks getting this surgery. I should have gone home. However, my insurance company would not pay to have a physical therapist come to my house to give me my first lessons. They also would not pay to have a visit by a nurse to make the first change of my dressings. The only way they would pay for the lessons and the changing of the dressing was if I were in the hospital. Managed care is meant to save money while still getting the care required to recover. Maybe, if the manager had a brain, this would work.
I had enough problems that first day. If I had been sent home as the insurance company wanted without the visit from the nurse and therapist, it seems that I would have been in real trouble.
First the Polar Care unit did not work. The Polar Care is a device that looks like a regular ice chest with a hose running out of it. The idea is to fill the chest with ice and water. Then a submersible pump connected to a hose is placed into the ice water. At the other end is a flat pad with channels like blood veins running through it for the ice water to circulate. This allowed me place the pad on my knee and keep it cold. This felt very good. Having some there with knowledge about is use was a blessing.
Then I needed to be catheterized as I was not able to urinate. Again having access to the nurse was well worth it.
I hate to think what would have happened without the first visit from the therapist. Even with the exercises I was given a muscle still atrophied. I would have been in real trouble without the therapist's initial instructions.
After being released from the hospital with the new parts, crutches, a brace, a fresh dressing and set of exercises I was ready to start my recovery. At that time I could only bend my knee 40 and could not stand on my leg. It even hurt to sit up with my leg down. The therapist instructed me to wear the brace at all times and to use the crutches to walk. I was instructed to put about one third of my weight on the knee.
To control the pain I was given Vicodin, Toradol and a Polar Care unit. The Polar Care's only drawback was the high-pitched whine it made. There were times that got to me in the quiet of my home.
I did my exercises as directed and saw my doctor in a week. At this point I was given a prescription for physical therapy for eight weeks. The nurse then removed my staples and replaced them with tape strips. I was directed to keep adding weight until I could walk without the crutches.
I was fortunate in that the therapist had a cancellation. I got right into therapy. I think I have been very lucky with the therapy. I believe the therapist has been working with me very well. I had a student, Kristi, working under a licenced therapist, Rene. Kristi and Rene gave me a new set of exercises to do at home. They had me bending, stretching and building strength at home and in their facility. After three more weeks they had me off the crutches and my knee could flex 121. My brace was also set so I was allowed to bend 90. I also could press 80 lbs. with the newly repaired knee. I also was directed to get rid of the brace around the house. This meant it was necessary to wear it only to go out and to sleep.
At this point Dr. Asselmeier gave me my release to drive and to return to work. He also allowed me to get rid of the brace. This was the best news. I do not think between the pain and the brace I got a full night of sleep since the surgery. The pain made it very hard to get to sleep in the first place. Then the brace digging into my leg anytime I moved would wake me. This made it such that I was tired all the time. I was so glad to get the brace off.
Kristi has been reassigned to practice in a hospital. Rene has assigned me to their specialist in ACL reconstruction therapy for the last half of my prescription. However, I am scheduled to visit her once a week for at least the next few weeks.
I still have some pain. Most of it has to do with reusing muscles and tendons that have gotten lazy. In fact the current muscle I am working on is to stop my knee cap from popping over every time I bend my knee.
This brings us up to date. I am now a man with three small scars around my knee. I also have three screws and a used tendon inside the knee. Additionally my knee flexes 135.
I'll let you know if the surgery was a success.
That is, can I hike into the mountains?
Can I kick start the Triumph?
Most important for my daughter, can I play basketball?
In an aside speaking to those that donate tissues:
I wish the family of the tissue donor well. I hope they will be proud of what I do with it. I plan not to waste the chance to be active with my kids.
Read about the continuing story.
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