A Christmas Getaway

Today I woke up thinking about the fact that surgery is now just over two weeks away.  That idea just blows me away.  As the day nears...Melissa and I decided that it would be good to get away for a little Christmas Escape...without the kids!!!

So we traveled 30 minutes away and just lounged around and enjoyed each other's undivided attention for a couple of days.  Here are some of my thoughts coming out of our time together with perspective of surgery just a few weeks away:

• Shopping has become even more agonizing than ever before, due to the knee issues.  At least now, I have a good excuse.
• My wife amazes me time and again.  I appreciate her support and encouragement.  She has been by my side through a lot of injuries and now the biggest physical challenge is just around the corner.  I wouldn't want anyone else by my side as I prepare to walk through this surgery.
•  I really like chocolate fondue!
•  The knee seems to be getting worse.  After a little pampering (a couples massage) and just a little shopping...it is time to get the feet up for a while.  Not only that...I didn't think I would hurt so bad the next morning.
• I am really ready to move forward...let's get the surgery over so that productive pain...therapy can begin.
• The Wii we bought for Christmas has been a hidden joy.  It has allowed me to be active while not really being active.  It also helps take the mind off of the knee.  Which at this point is nice blessing.
• It has been more difficult than I ever expected to keep weight off.  I joked before that I exercised so that I could eat.  I am seeing that that statement was more true than I thought.  For the first time I actually have to watch my daily calorie intake.

17 days...

Final Approval

Late last night, while participating in my fantasy basketball draft, I received an email that my final approval for the procedure and the hospital stay has been approved.  What that means we are officially a GO!

Now Genzyme, the Carticel company, will begin cloning my cells.  In just a few weeks 50 million stem cells will show up ready to be injected into my knee (not at my house- at the hospital).  I am secretly hoping that the procedure will only take 48 million.  I wonder of they give you a doggy bag to take home the left-overs?  You just never know when you will need 2 million stem cells.  With my recent medical "luck" they will get most of the way through the procedure and realize that they actually needed 55 million.

Just a few more weeks left.

Counting the weeks

Hard to believe that I am now less than 4 weeks away from my surgery date.  I find that everyday I am waking up thinking about the procedure and counting the days.  However, there are a few things that I am trying to take care of in preparation for the big day.

1) Date night...Next week my wife and I are dropping off the kids with the grandparents so we can get out of town for a couple of days.  It will be nice to get away and do some fun things before being laid up for a while.

2) I am really trying to get as strong as I possibly can right now.  Knowing the toll of what my leg will go through I want to make sure it is as flexible and as strong as I can get it.  However, that is proving to be more difficult than expected...because of the pain.  My two main exercises are straight leg lifts and walking up to my pain limit.

3) I am also trying to get my upper body as strong as I can get it.  Knowing that I will have to pick my body up for several months and use crutches as well is good motivation.

That's all for now.

Osteotomy

One part of the procedure recently discussed was to perform an osteotomy along with the ACI procedure.  Now I do know that there are many different types of osteotomies and I am not exactly sure what type of osteotomy I will undergo.

What is an osteotomy?  Basically, an osteotomy is a surgical procedure where the bone is cut to allow a reshaping or a realignment of the bones around a joint. The good news is that my knee alignement is good. However, the reason to perform this procedure is to change the weight distribution in my knee joint.

I am hoping that we are looking at a Fulkerson osteotomy and nothing more invasive.  The Fulkerson is done to reduce the load on the patella.  The downside of a Fulkerson is that I would no longer be able to kneel.  I guess I will have to learn how to pray standing up.

Here is a x-ray of what a Fulkerson Osteotomy looks like.

Looks like fun doesn't???  Just one more thing to look forward to in January.  As I know more I will update you on what I find out and what procedure they decide to perform.  In all, I am not too worried about all of it.  I know it is going to hurt but that kind of comes with the territory!

Carticel Implantation

What is carticel?  


This term is used often for a patient getting readying to undergo ACI.  CARTICEL is a biologic product used to repair articular cartilage injuries in adults who have not responded to a prior arthroscopic or other surgical repair procedure. It uses your body's own cultured cells to form new hyaline-like cartilage in your knee following a surgical procedure called autologous chrondrocyte implantation (ACI). CARTICEL is the name of the cells that are grown from the samples (or biopsy) taken from your knee. When implanted into a cartilage injury, these cells can form new hyaline-like cartilage.

CARTICEL is the first biologic product to repair articular cartilage injuries in the knee. In 1997, it became the only FDA-approved autologous cultured chondrocyte product on the market in the United States. CARTICEL is a product of Genzyme, a company with more than a decade of experience in developing and manufacturing autologous cell therapy products. (Taken from the Carticel website)

How is CARTICEL manufactured?  Here is a quick step by step look at what it takes to clone my knee.  Pretty SCI-FI stuff.

1. A patient's cartilage is harvested by the surgeon and sent to the Genzyme manufacturing facility.
2. The biopsies are processed to isolate chondrocytes from surrounding matrix.
3. Each patient lot is maintained under strict quality control procedures.
4. After primary culturing, patient cells are cryopreserved until an order is placed. This offers flexibility for patients and surgeons to schedule implantation.
5. Once an order is received, the patient's cryopreserved cells are expanded.
6. Two to three days before surgery, CARTICEL vials are released and shipped to the surgeon.

In all it is a pretty interesting process.  If you are interested in knowing more about CARTICEL...take a quick spin around their website: CARTICEL

There are some pretty interesting video spots on the procedure as well.

Random Update

It has been a joy to spend the last 48 hours with my little daughter.  My wife's grandmother died this week and she, along with my son, traveled out to California to attend the funeral.  That left my 13 month old and me to hang out for a couple of days.

One of the things that my daughter loves to do is to go for walks.  Especially, during the Christmas light season.  However, long walks and a bad knee don't necessarily go together well.  O'well...the walk always wins out in this scenario.

Yesterday, we walked about 1.5 miles and today we walked about the same.  Tonight, as I write this I am feeling the pain.  In some ways I can't wait to get on with the surgery and knowing that the pain will be "productive pain."  Nevertheless, I know the procedure is quite extensive and will be more difficult that I presently understand.

Only 5 more weeks to go!!!

Like yogurt?

I have been doing some extra reading on what to expect after the surgery, when it comes to the actual recovery time.  Here is an interesting description of what is actually going on in the healing process and how long it takes the new cells to do their thing.

Implantation Stages:
- After 1 week...like water
- After 3 months...like yogurt
- After 6 months...like pizza dough
- After 9 months...like the cheese that goes on the pizza dough
- After 12 months...like rubber

I guess that is why crutches are a must.

Prepartions

Today I have been battling through quite a lot of pain.  Sunday's are harder on me than most days due to the extended time on my feet.  However, the day has been full of great conversations and that always keeps you going.

At six weeks out I am beginning to put a list together of items that will help my life be a little easier post surgery.  Two previous knee surgeries help the process, but I have never been down as long as I will this time.  Here are some of the things I am looking at getting:

- Shower seat...yes it will be a little difficult to get this part of the daily routine done.
- Baby wipes (helpful having a baby in the house for this one)
- Toilet Risers...you have to think of everything
- Movie list
- New Wii games
- Reading list
- Buzz Cut...will make life a little easier
- Leg Lifter
- New Shorts and sweat pants
- Comfortable/flexible ice packs
- Small back pack to carry things around the house

And I am sure there will be more to come.  Let me know if anything else comes to mind that might help the rehab.  (Movie suggestions, book suggestions, game suggestions, rehab items, etc.)  Love to hear from you.

Famous ACI

Dara Torres, a popular USA Olympic swimmer, recently went under the knife for ACI surgery. Here is a great look at her story.

Got my crutches

You know things are a little weird for you when you find yourself excited to get new crutches.  Yesterday evening I pulled up to the house to find a nice box sitting at my front door...New Crutches.  Now these aren't your average crutches- these are Smart Crutches.  You can order and read more about them here: Smart Crutch

This is what my Smart Crutches look like...

These crutches are CAMO...in other words...crutches for the real man.  These are a nice upgrade from the standard silver/armpit crutches.  These fit the entire forearm and pivot to different angles allowing your arms and hands to get some rest every now and then.  In a funny way, I am looking forward to my new fashion statement come January.

I will blog more at a later time on how well I like them. But for now, it is practice time.  Furthermore, I need to put a little thought into what I am going to wear with these new crutches...I don't want to clash.