Friday, January 4, 2008

Surgery: Let me introduce you to my good friend, Annie...

Folks, let me tell you. When having ACL reconstruction, you've got to meet Annie.

Her full name is Anne S. Tease-Ya, and she loves playing mind games! (Annie is a man actually, but humor me for the sake of word-play.)

I met Annie the morning of surgery, and she wore many labels that day:
- Femoral Nerve block
- Spinal block
- Monitored sedation

I was firmly against meeting her military aspect, the General, having seen the aftereffects in my daughter G-Shaft many times over the years.

The fun began with the Femoral Nerve block. Annie gave me a shot of something to bend all the straight lines on the ceiling. While I admired the interesting patterns forming overhead, Annie got busy with a probe making my right thigh jump in various ways. One location made my patella jump quite uncomfortably, so I warned Annie not to go there again with the probe! After a short time, she was satisfied with the location and shot me up with a long-term agent to shut down feeling in my thigh and knee for the next 12 hours.

Next was the Spinal Block. This one I remember nothing about after sitting up and leaning forward on a pillow in the operating room, so Annie must've slipped me a Mickey to make me forget those 10 minutes.

From that point on I was nicely mellowed out as I watched the team set up for surgery.

I felt just fine, no anxiety or anything while watching video of the procedure on a nice flat screen monitor. Once the scope portion was done, the nurse asked me if I wanted to watch the rest. I agreed, and she angled the monitor like a mirror for me to watch in fascination as the crew closed things up.

Rolling into recovery I felt just great, and was SO glad not to have general anesthesia when they shortly offered me coffee and a granola bar to snack on while Mrs. Shaft and I discussed lunch.
Once the tingling in my legs went away and I could differentiate between a rub and a scratch from the nurse's fingernail, I checked out and we headed for home.

For cryotherapy options, I went with the gold standard of a Cryo/Cuff Cooler. However, the system offered by my orthopaedic clinic was a manually cycled system, as opposed to the AutoChill system that many other people mention in their blogs about ACL reconstruction. The manual cycle isn't bad, just far less convenient than the autochill system (and only 50% of the price.) For a manual cycle, you connect the cuff around the leg to the cooler with a hose, open the air valve, and let gravity drain the warm water out of the cuff. Then you close the valve, swish the water to mix it with ice water in the cooler, open the valve, and hold the cooler above the level of the cuff. Gravity pushes chilled water into the cuff.

As you might imagine, this is a PITA to keep doing, and the chilled water in the cuff only stays effectively cold for perhaps 5 minutes, requiring another manual drain/chill/fill cycle.

So Mrs. Shaft and I did some digging and found a local sales rep to order the AutoChill add-on. It's a simple air compressor that connects to the top of the cooler, creating alternating vacuum and pressure to force chilled water in and out of the cuff automatically. It should arrive Monday.

So if you're reading this for research, my advice is to plan for the extra cost and get a cryo cuff with the auto chiller system, or plan to do a lot of 10 pound arm raises to cycle your chilled water manually.

Back to our story...once arriving home, I was blissfully pain-free and enjoyed my lunch and a couple of Vicodin, relaxing with the Mrs. and generally enjoying the afternoon.

In the evening, young G-Shaft went to her first sparring class--reluctantly--and I was very proud to hear she survived intact, winning two of three rounds against her fellow students. I heard one other student really wanted to wail on her and was reprimanded several times for swinging wildly. G-Shaft scored all her points with punches, which is pretty cool considering her slender build doesn't look like it packs much of a punch. However, the night before surgery I had her put on her gear and throw a few punches at my palms with sparring gloves on--that kid has a lot more power than I thought!!!

About 10pm, the femoral nerve block began wearing off, as evidenced by my leg broadcasting a moderate burning sensation to any nerves that were tuned in. Fortunately it was just in time for my next dose of Vicodin, so things settled down about an hour later.

That first night I tried just a half dose to keep my stomach settled, realizing that I'll need a full dose for a while longer and will just need to tolerate the slight nausea that accompanies it. Toughest challenge was finding a comfortable position that didn't push, pull, twist, or squeeze the leg in its immobilizer brace. I didn't really find a good position.


The second day was filled with me tackling the near impossible task of finding a comfortable position to recline in, along with a post-up visit with the surgeon and a bit of running around at the local Target store for some odds-n-ends.

Dr. K was very happy with surgery results, and the good news is that I have no tears in the meniscus. Yay!!! I'd been using a walking stick regularly until surgery to avoid further injury to the soft tissues, looks like my vigilance paid off. I'll post a picture of the good and reconstructed knees once I download them from Mrs. Shaft's cell phone.

Target was fun as I toodled around in one of those electric shopping carts they make available to customers. That thing had the most obnoxious backup alarm, people must've thought I was a semi trailer backing up in the aisles!

A side note here to BobSpar--I bought a urinal at a local store, but haven't needed it yet since I'm currently recuperating on the couch within 20 feet of the bathroom. However, based on the sound of my voice this morning, I need to push fluids a bit more, so we'll see if anything "urgent" comes up! The urinal comes with a cap, and is probably a bit easier to use than a pickle jar. Also doesn't flavor the pickles...


So we finally arrive to today, day number 3 post-op. The good sign I had this morning was that my leg had no pain in it while lying passively, so that's a major improvement. I go to my first PT session in about 2 hours, we'll see just what's what at that time and report back tomorrow.


I think I'll stop here, grab a quick bite to eat, and nap until PT.

Thanks to everyone for their advice, positive thoughts, and prayers. They're helping me tremendously!!!


BobSpar said...

Welcome to the land of post-ACL! Wow, you are in amazing shape at this point. I hope your good condition continues. I couldn't imagine leaving home for anything except physical therapy or a doctor follow-up the first week.

Sounds like you've outfitted yourself with some excellent survival tools.

And congrats to G-Shaft on her awesome performance sparring.

Blackbeltmama said...

Wow, you are in good shape. Are they still giving you that sedation drip? This is why you stay ahead of your pain and not get behind it like I did. I swear it took days to catch up. There is no way in hell I would have been able to be on a scooter in Target on Day 2. Here I was worrying about you-I'll be worrying no longer. ;-)

Glad it went well. I can't believe you WATCHED!

Michele said...

Excellent news!

It sounds like you are doing great. I think my jaw dropped open when I read that you watched the surgery. I am impressed.

Wishing you a speedy recovery!

Hack Shaft said...

Folks, thanks to all of you for your advice and kind words. Big thanks to Mrs. Shaft for continually nagging me to keep icing the knee!

BBM, I'm checking for an invisible I.V. sedative here at home, but don't see anything poking me. I'm so sorry you had the horrible pain you did, guess I got extremely lucky.

Surgery was done in under 45 minutes. I even remember asking the surgeon specifically about the meniscus when I saw him inspecting it, quite cool to get his answer right on the spot!

As of right now, I'm 8 hours OFF of any narcotics, and strictly using ibuprofen. Still got plenty if I need 'em, but right now I'm doing just grand. I've been tired this afternoon, guess all the energy burned is catching up with me.

First PT details tomorrow.