Archive | April, 2012

Knee Surgery – The Main Event

29 Apr

The hat really makes the outfit.

We’ve just passed 36 hours post-op and things are looking up! My pain has noticeably lessened since yesterday, and I am already able to put some weight on my leg. Before we get too far down my road to recovery I want to fill you in on the surgery itself. Don’t worry; I won’t get too gory or graphic!

First things first, I’ll give you a quick and dirty knee anatomy lesson: Each knee has two menisci: the lateral meniscus and the medial meniscus. The lateral meniscus is the cartilage on the outside of your knee, and the medial is the cartilage on the inside of your knee. Your medial meniscus does about 85% of the meniscal work, that is it provides 85% of the cushioning between your bones. The lateral meniscus provides the remaining 15% of support.

Once my surgeon, Dr. Carey, and I decided that surgery was the best option, we discussed the game plan. As I explained in my last post the diagnosis was a discoid lateral meniscus and meniscal tears in my lateral meniscus and possibly my medial meniscus. Dr. Carey explained that the best course of action was arthroscopic surgery. He planned to make two small incisions just below my knee, one incision would play host to a tiny camera and the other to the probe and snipping tools. The fancy unpronounceable name for this procedure is a Partial Meniscectomy (try saying that three times fast). Which is pretty much exactly what it sounds like: taking out a part of my meniscus. For the past six years Dr. Carey has been exclusively performing knee and shoulder arthroscopy, so I figured he knows what’s up.

Flash forward to surgery day, we didn’t have to report to the hospital until noon, so the morning was spent doing practical things like turning the living room into a temporary bedroom and going to the grocery store to stock up on quick, fun foods. Upon arriving at the hospital, we were introduced to a game called “hurry up and wait.” I was rushed through each step, check-in, pre-op, holding, etc. only to then sit and wait for at least an hour. At the beginning Alex got to hang with me, but as I got farther into the depths of the hospital I had to fly solo.

Of course I have no recollection of the surgery. I remember going into the operating room, and I remember asking them to cover my arms, as they were cold, other than that, I’ve got nothing. The next thing I remember was being in the recovery area where they try to convince you to wake up. Waking up was difficult, but I was determined. I knew the sooner I woke up, and convinced them that I could stay awake, the sooner I would see Alex and finally get a snack. At that point I’m guessing it had to have been at least 6:00 p.m. and I hadn’t eaten since 10:30 p.m. Thursday night.

Dr. Carey filled Alex in on the surgery itself. He showed him the pictures they took of the inside of my knee, and explained what they found and what they did to correct the situation. I was left out of the loop, because when you’re drugged up on anesthesia your chances of remembering anything the doctor tells you are pretty much zip. When Alex debriefed me afterward I learned that Dr. Carey’s projections were correct, he found significant tearing and degeneration in my lateral meniscus and slight tearing and degeneration in my medial meniscus. He removed the torn section of the lateral meniscus and then reshaped and smoothed the meniscus to give it the proper thin crescent shape. My medial meniscus was in much better shape, and required just a quick trim of the damaged area and a little smoothing.

What was projected to be a six-hour adventure turned into eight-hours and twenty minutes. We checked in to the hospital at noon and were finally allowed to head home around 8:20 p.m. On the whole our Penn Presbyterian Medical Center experience was pleasant. The nursing staff was caring and attentive, and I am still completely impressed by Dr. Carey.

Tune in next time for a journey down recovery road.

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Prelude to Pre-Op

28 Apr

One Sunday afternoon when I was in middle school I pulled a lazy teenager stunt and decided that the best way to put Snapple in the fridge was to sit on the floor in front of the refrigerator with my legs crossed yoga-style. Once all of the Snapple was loaded onto the bottom shelf I tried to get up. Tried was the word to note in that last sentence. I suddenly found that my right knee wouldn’t straighten, and quickly ended hanging on the refrigerator door whimpering in pain. In short, my knee was locked in the bent position.

A trip to the emergency room yielded no answers as to what might have caused the mysterious locking. It loosened on its own and after a few hours I was able to straighten my leg. Though my knee was only locked for about an hour, the pain lasted for about a week. Since your leg really isn’t supposed to act like it needs a can of WD40, you can imagine we were concerned.

The locking continued as I aged, happening two to three times per year. Unfortunately, despite having an x-ray and an MRI, the doctors I saw were still baffled as to what could be causing the issues. Unfortunately, I was never able to get to a doctor while my knee was still actively locked. This made for a case of “sorry, we can’t replicate the issue.” As time progressed I figured out how to live with the locking. I mostly just avoided any positions, such as squatting, that I knew were more likely to cause my knee to lock.

A new and excited symptom arose as time progressed. I needed to pop my knee back into place on a daily basis. Pressure would form in my knee and things would feel, for lack of a better term, off. In order to fix the issue I would have to plant my foot in place and then wiggle my leg until I heard a loud pop and things felt more aligned in my knee.

Earlier in 2012, I did my little wiggle action to pop my knee back into place, and something pinched. Every step I took made me wince, so I stayed home from work for a day, rested and iced my knee and unfortunately felt little relief. I decided that I should test the situation myself, so I went to the gym and ran on the treadmill to see if that caused any pain. Low and behold, not only did it not hurt to run, my knee felt better after running.

Not being a complete idiot (I must be at least somewhat of an idiot if I though running on an injured leg was a good call) I addressed the issue with my doctor. She fiddled with my knee and gave it a good poke and prod, and then diagnosed me with Patella Femoral Syndrome. Which is aptly known as “Runner’s Knee.” Happy with a diagnosis that sounded logical, and that meant that I wasn’t crazy; I went on my way.

Two weeks after that visit my knee locked again. So I consulted the digital doctor known as Web MD, and did some research on patella femoral syndrome. Nowhere in the description did it describe locking, so I figured it was time for a second opinion. I was also set on seeing a doctor while my knee was actively in pain, so I made an emergency appointment at my doctor’s practice. The doctor I saw didn’t touch my knee, just asked a bunch of questions and made a referral to the Sports Medicine doctor on staff. While I was displeased with her lack of assessment, it seems like the co-pay was well spent, because Dr. Kapur, the Sports Med Doc knew what was up.

 

Dr. Kapur made a guess that I had a discoid meniscus, which was catching inside my leg and causing the locking and popping. Go figure that the layman’s term for “discoid meniscus” is “Locking Popping Knee Syndrome.” It seemed to me like we were on to something. To confirm his guess I went for an MRI. Not only did the MRI show that I have a discoid meniscus, it also showed tears on both meniscuses (or in the Latin way: menisci!) in my right knee. Go, Dr. Kapur!

Since you’re probably wondering what the heck a discoid meniscus is, I will fill you in. Normally, the meniscus is a thin crescent shaped piece of cartilage that sits between your thigh bones and you calf bones. When you have a discoid meniscus, the meniscus is not thin and crescent shaped, it’s fuller and fat. What this means is that instead of sitting nicely between the bones, it only sometimes sits nicely between the bones, other times it shoots around inside the knee. This can predispose you to meniscal tears.

You menisci won’t heal on their own, which is evidenced by the fact that I had these issues for over a decade with no relief. So unluckily, the only recourse we had was surgery. I did a lot of debating on whether or not to have the surgery, as on a daily basis my pain level was quite low, and came to the conclusion after meeting with the surgeon, that if I skipped surgery now I could end up damaging the good parts of my meniscus as the tears spread. I donned the surgery a “search and rescue mission.”

Since my friends the painkillers are kicking in, I think I will stop here for now. I will follow up next time with the details of the surgery itself, and where we go from here.

Not So Mainly Running

22 Apr

The point of this blog will be to mainly talk about running.  Unfortunately, I am having knee surgery on Friday, so for the time being the blog will be mainly about jonesing to start running again and the major overhaul I’ve made in my diet lately. 

I have converted to an entirely plant based-diet by cutting out all animal products (flesh and dairy). In addition to that change, I’ve cut out processed foods, foods that contain things I can’t pronounce, or that I can pronounce but wouldn’t eat by itself (i.e. Red #40). Oh, and alcohol. And coffee.  A positive side effect to all of those changes is that my fat, sugar and caffeine intake will drop significantly as well. 

I don’t consider myself a vegan.  While I do eat vegan food, I feel that veganism is bigger than that.  I am following a plant-based diet for my health and wellbeing, not for the ethical motivations that fuel most vegans diet.  Don’t get me wrong, I’m happy that another positive side effect of this diet is that more animals get to live; it’s just not my motivation.  I’ve always been more of a human person than an animal person. That being said, I recently read a quote by Peter Dinklage (I hear he plays an awesome part on Game of Thrones), “I like animals, all animals. I wouldn’t hurt a cat or a dog – or a chicken or a cow. And I wouldn’t ask someone else to hurt them for me. That’s why I’m a vegetarian.”  While I can’t say that I like all animals, I know that I wouldn’t kill one, so why would I ask someone else to do it for me?  Which reminds me of the unethical treatment of slaughterhouse employees, now that is an ethical motivation I can get behind, but that is a story for another day. 

So this is how I am choosing to live my life, and while I imagine that I might engage in some mild activism surrounding my new lifestyle choice, my goal here (and in general) is not to be preachy or try and push people to “do things my way.” You eat how you want to eat, and I’ll eat how I want to eat.  We do have free will after all. 

Unfortunately, I cannot put off those grad school papers any longer, so this is where I will leave you for today.  Tune in next time for more ponderings on my path to full on hippie-hood.  

Coming Soon!

18 Apr

A fresh new blog mainly about running is in the works. Check back soon for updated content.

Thank you for stopping by!