Two Week Update

It has been 2 weeks since my ACI surgery.  I really can't say that the time has flown by.  There have been plenty of painful and grueling moments that seem to prolong the days.  There have been moments when I begin to question the reason for undergoing such a crazy and invasive surgery...only to remind myself of how bad I was before (that is one reason I started to blog pre-surgery to keep track of where I was just incase those moments came).

I still have a long ways to go...but at least I can look back over the last two weeks and know that I have made some progress.  Spending all of my time in bed and in the home (I haven't been in the kitchen in two weeks) has really jacked up my sense of time.  Thank goodness for Netflix...I have spent way too much time watching "American Pickers."

From a pure physical standpoint...I am right on schedule.  Today I measured a ROM of 73 degrees on the CPM.  I have to be at 90 degrees by week 3 and not a day early.  A few things that I am looking forward to:

- After week 4, I can sleep with no Bledsoe Brace (I do have to keep it on during the day)
- After week 3, I only have to spend 6 -8 hours on the CPM instead of the current 8-12 hours/day
- Week 5, I will graduate to using crutches
- Week 6 or 7 I begin PT

There are a lot of things that I am still looking forward to.

A few interesting things to update you on.  Today, I weighed myself for the first time post surgery and I have lost a total of 16 pounds in two weeks.  Watch out Biggest Loser!!!  Secondly...I am beginning to look like a true mountain man.  It is a little difficult to stand long enough to shave, so I have decided to not shave right now.  What do you think???

No More Staples

Yesterday was road trip day.  It was the first outing for the "million dollar knee" and it was also the first time I got to load myself into a Toyota Sienna.  Having two smaller cars we ended up trading some close friends for a vehicle that was big enough to transport my kids and me (remember I have to have my leg fully extended even in the car).  That is where the van has proven itself very worthy.

Getting in the van was quite the event.  While Melissa supported the surgical leg I sat on the floor of the van and then began to scoot, pull, and push myself to the back seat (entering from the passenger side of the vehicle) until I was in position to pick myself up into the seat.  All in all...this took about 15 minutes, if you include the time walking to the van.

Once we were fully loaded, we made our way to grandma's house to drop off the kids and then onward to the doctor's office.  Upon our arrival, the assistant walked me back to my holding tank and began to take out all 35 staples.  Here is a look at the knee without staples.

Not too bad!  Dr. Tarlow quickly made his way into my room and assessed the knee and called for me to get a couple of X-rays of the knee.  The x-ray process wasn't much fun.  I was required to get into yoga like positions with little help and no brace.  However, I must say the x-rays are crazy looking.  I now have four screws in my left leg: 2 from ACL surgery and 2 more from the Fulkerson Osteotomy.

Overall, Tarlow said that the knee looks good, the screws are holding so far, and to hold faith that the carticel will take.  I am to go back in five weeks for another post op visit to see how the bones are healing after the osteotomy.  Until then we are to keep the same schedule.

Getting the staples pulled wasn't as bad as I first was prepared for.  Each staple removal felt like a small needle poke.  Once all the staples were removed the knee was swabbed with iodine and steri-strips were placed.

Sleeping is still proving to be difficult.  The best I manage is sleeping for 3 hour intervals.  Furthermore, the CPM machine has gotten my range of motion to 64 degrees.  More to come soon.

One week at Home

Below is a quick look at my knee as it is strapped into my CPM machine.  As you might be able to tell, the swelling is going down.  Even though my knee is finally beginning to resemble a knee again, the color is still pretty extreme.

Now that I have been home for a week...the routine for Melissa and me is now in high gear.  I would go as far to say that we are professionals at getting out of bed, hooking up the the CPM machine, and getting in and our of the lazy boy.

When looking at the bed I sleep on the left side of the bed...furthest from the bathroom.  We debated on switching sides of the bed, but that just seems unnatural.  Actually, we did debate over the idea and we found that it was easier for me to get out of bed by placing my good leg on the floor first- to help steady myself.  When getting out of bed, Melissa first places both hands GENTLY under my left leg.  She then begins to pick the leg up slowly.  As this is happening I slowly sit up, use my arms and my good leg to start pivoting my butt towards the side of the bed.  This is done usually with a couple of slides/shuffles.  We just aren't quite at the point to do it in one shot.  Eventually, I reach the side of the bed and place my right foot (the good leg) on the floor.  This is the moment that Melissa begins to lower my left leg towards the floor...I must say that my hamstrings are getting pretty flexible.  In the whole process, my left leg can never touch the floor or bear any weight.  Next, Melissa hands me my walker and begins to clear the path for me to get to the bathroom.  The entire process taking a couple of minutes and another 30 seconds to recover.  A process that use to take me just a couple of seconds.

Standing up isn't too painful as long as there are no weird tweaks in the knee.  Nevertheless, standing up does release all the blood in my body to flow to my foot in one sweeping second, creating moments of weird throbbing.

Each day I also face two things that have caught me by surprise.  One is that my body continues to have troubles regulating its body temperature.  Sometimes...I am hot and sweaty (at least that is how my wife describes me) and other times I have uncontrollable chills requiring three blankets and a yoga like focus.  Eventually, the arctic chills dissipate and the shakes turn to a normal calm demeanor.  The second challenge has been the nerve quakes.  At least that is the only way I can describe the weird pains and random quakes that roll through my bad leg.  I am sure there are two things to blame for the nerve pain...the nerve block and the large cut through my leg.  Over time these two things should leave and the leg will continue to move towards normal.

Tomorrow is going to be my first day out of the house.  I have my first post-opt visit with Dr. Tarlow.  I am looking forward to hearing what he has to say and continuing the long road to recovery.  More to share tomorrow.

One Week Down

Today marks one week post surgery.  In many ways it feels as though it has been a lot longer.  Pain is now in a manageable state.  I actually started to move down in the pain medication yesterday.  The other big highlight of the weekend was I finally had my first bowel movement following surgery (TMI...I know).  My days are kept to a pretty strict regime right now.  Here is a look at my daily schedule:

7:00    I am icing in the lazy-boy preparing to eat.

7:20    Inject my stomach with Lovenox (Nothing like giving yourself a shot in the stomach every morning)

8:00    CPM machine for two hour session

10:00    Rest/sleep and Ice

11:30    Lunch

1:00pm   CPM Machine for two hours

3:00pm   Rest and Ice

5:00pm    Dinner with family

6:00pm   CPM Machine for two hours

8:00pm    Shower

8:30pm   Snack/rest/ice

9:30pm CPM Machine for as 2-2.5 hours

Midnight   ICE and try to get some sleep


That pretty much sums up my days right now.  Another thing I have been incredibly thankful for the first week, post surgery is that we had recently bought a nice recliner.  Most nights the recliner is much more comfortable than the bed or couch.

It is called Autologous Chondrocyte Implantation +++, Just Sayin

I have been home for a couple of days and here are a few thoughts that have been running through my mind.  Remember, I am still doped up on pain meds, so please excuse any typing errors or random babbling that takes place.

1. The Walker is totally the way to go!  Using a walker to get from the bed to the bathroom has proven tons easier than using crutches.  Who would have thought?!

2.  Because ACI is such a new surgery in America...nobody knows what it is...including the nurses.  I can't tell you how many times I had to answer questions and fill the nurses in with the details of how this knee surgery is different.  Furthermore, we have begun to receive random suggestions, from people who don't even know us, about what they did to get through their total knee replacement.  Just so that it is clear....this procedure I had is totally different than a TKR.  Here is the best way for me to describe what just took place this week.

- First thing they did, was saw through my shin bone and move it an "inch" or so, to the outside of my leg.  Once placed in a new position it was screwed into its new location. This will help change the future weight distribution.
- Secondly, they prepared and implanted my own stem cells of cartilage, that were previously biopsied, into the four locations I had damaged.  (The damage was serious and not a result of osteoarthritis)
- My knee cap was taken out, flipped, and put back in.
- The basic summary...I have a broken shin bone with screws, highly sensitive patch work on the interior if my knee, a loose knee cap, and a huge scar. 


Because of the sensitivity of my leg and the work that was done, I am forced to take everything very slowly when it comes to rehab goals.  Furthermore, my knee is an extreme case even within this category and as a result, my time has been even further extended.  In simple terms...I am left to my own small category of knee procedures.

3. Stretchy socks make all the difference.  My leg continued to swell for five days following the surgery.  All of that swelling has to go somewhere and much of it has traveled to my foot.  As a result, the normal socks I would wear when my feet are cold...don't even fit over my toes.  So...we have had to find "special socks" that fit the part.  One suggestion, the socks they give you for surgery at the hospital work great.  They grow with you!  Consider asking for another pair before you leave the hospital.

4. 23.5 hours lying down is no fun at all.  Right now the only time I get up out of our lazy boy or my bed is to get to the bathroom.  There were days when I was in college that would have sounded fun.  Now that I am living it...not much fun.  Therefore, make sure you have a comfy mattress.  We are actually going to replace ours this week because it is beginning to be problematic.


5.  I have been able to take a couple of showers at this point, and it is EXHAUSTING.  Keeping all of my balance on one leg without being able to bend my bad leg is not only tricky, it takes all of my strength, even with my wife's help.

Home Sweet Home

First thoughts...this surgery is very painful.  I mean really, really painful.  My two other knee surgeries put together don't even come close to the pain I have been feeling.

Ok now that is clear...let me share some of the details from the last few days.  Monday morning Melissa and I got up early and headed off to the hospital.  We arrived at the hospital on time (6:00am) and got checked in.  After a few minutes, I was called back and had the opportunity to up-grade my clothing to one of those stylish hospital gowns with nothing in the back.  (I will spare you the pictures)  After going through the normal protocol for surgery, the doctors began making their way to my bed side.  Dr. Tarlow, my orthopedists, and the anesthesiologists explained to me that I would be getting a nerve block to help with the pain coming out of surgery.

The next thing I new is that a bunch of people gathered around me to help do the femoral nerve block and I was out.  Never even got to see the OR.  The surgery lasted for 3 hours and come to find out...my legions had gotten larger since the August surgery.  The largest being 6cmx3cm.  In the end, Dr. Tarlow said the surgery went perfectly and now we will see.

While at the hospital I set new records for eating the most citrus jello in hospital history.  Furthermore, I also started my PT and the CPM machine.

Here is a quick picture of me doing one quick round on the walker.  Don't let it fool you, I only traveled about 15 feet and still no weight allowed on the surgery leg.  Jean, my PT was awesome to work with and even gave me a commemorative t-shirt to remember my experience.

The CPM machine, or better known as a continuos passive motion machine requires me to be locked into it for 8-12 hours a day.  It is the next major part of the rehab.  We will see how well I sleep with my leg moving all night.

And yes...it hurts too!

We finally made it home Wednesday afternoon after a long ride in the back seat of my toyota corolla.  After the 45 minute ride home and the waiting to get my pain meds filled I was ready to go back to the hospital.  Luckily, once the pain meds set in...I was good for the time being.  Feel free to ask Melissa about this experience.

Our home right now looks like a NORAD Command center...that is if a NORAD command center had baby wipes, shower chairs, walkers, coolers...you get the picture.

Today, I was able to take my first shower....finally!  That is a quote of Melissa.  After a hard drawn out experience we finally got it done.  And it felt great.

Most of my days are still spent lying flat on my back without any ability to do even the most rudimentary things.  To the outsider I probably look like a war veteran with my shaved head, cammo crutches, and braced leg.

None of this would have been possible if it wasn't for my incredible wife.  She deserves to win the wife of the year award and the year isn't even 20 days old.  Secondly, my parents have been a huge help this week too.  They flew out from Florida to help their son, to watch their grand kids, and to even stay up late with me so Melissa could get some rest.  I am forever grateful for their sacrifice.

Now...I know some of you want to see the damage so here it is!  If you don't like graphic pictures this is your warning to look away.  I haven't placed a tape to it yet, but the scar is somewhere in the range of 12-14 inches.

From my understanding...and remember I am on pain meds right now, so none of this may make any sense.  My shin bone was moved, the four legions were implanted, and my knee cap was put in backwards.  I will find out exactly at my first post opt.  Thanks again to everyone for your help, prayers, and concern.

Surgery Day

Today is the day!!!  I didn't sleep all that great last night, but what can you expect.  We are now loading the car and about to make the 45 minute drive to the hospital.  More to come on the other side of surgery.  : )

My Top Ten Things that have Made Me Laugh Pre-surgery

10. Brought home a shower seat to find out that it doesn't fit in the bottom of my tub.

9. Having 5 different conversations with medical personnel in the last 24 hours in preparation for Monday's surgery.

8. Telling a tattoo artist that I wanted to get a tattoo of a zipper on top of my huge scar when all of this is behind me.

7. Borrowing a wheelchair from my wife's grandmother.

6. Playing the Wii from the couch because I was too sore to stand up.

5. Having a doctor ask me if I was going home the same day as the procedure.  Once I told him that I would probably be in the hospital for 2-3 nights he replied..."It must be vey painful."

4. Hearing my new doctor...the one performing the surgery, say "Holy Crap!" after looking at my surgery pics and reading my chart.

3. Watching people at church have a heart attack while I climb a ladder as part of an illustration.

2. Telling my Chiropractor I was about to have surgery on my neck before an adjustment.  I quickly realized I better tell him the truth.  (Forgive me TY!)

1. Listening to the nurse on the phone read to me the name of my procedure...all 15 words of it.  Once I confirmed, that is what I was having done, she thanked me that I understood what it was that she just said...because she had no idea.

Last Minute Package

We are now very close to surgery day and every moment that I can spend playing with the kids is a blessing.  Yesterday was absolutely gorgeous...one of the many benefits of living in Arizona in January.  Because it was so nice we decided to spend the evening outside on our cul-de-sac letting the kids play.  And let's be honest, most of the reason to be outside was to get them to burn some energy off.  Here are a few pics from our time outside.

At the time it seemed like a great idea to help my little 14 month old girl ride the scooter.  Actually, it was a great idea...i just payed a higher price then expected.  The little 12 foot circle I walked her in was much more painful than I could imagine.  The angle and the movement required to hold her on the scooter was a quick reminder of why I need to have this surgery done.  Furthermore, tonight I am going to pick up my wheelchair to help me get around next week.

That is not all that happened yesterday.  I got a package from FedEx.  To some of you I recognize that isn't too big of a deal.  But for me to receive an unannounced package in the mail when Christmas is behind us is almost worth celebrating.  It just never happens.  As I opened up my package with great excitement this is what I found...

I have had several surgeries at this point in my life and I have never received a package in the mail providing detailed information about the surgery and rehab required to be successful.  I didn't know whether I should laugh or cry.  The last picture is a picture of a rehab journal so that I can keep close track of my daily progress.  Is that really necessary?  I guess when you are looking at 18 months of rehab you want to remember where you began.

At this point we have only a few more days.  I promise I will post pictures of the scar as soon as I possible. Hasta Luego!!!

One More Week!!!

Just one more week left.  The waiting is almost behind me and the productive pain begins.  Over the last few weeks I have answered a lot of questions concerning the surgery and the shape of my knee.  I thought I would share a few of pictures taken in my last surgery to help explain.

I think the evidence speaks for itself...

It really doesn't take too much of a trained eye to tell this is not what your cartilage is suppose to look like.  More to come soon.

Geriatric Lee

Today I got some of my surgery goodies.  And yes, I know that Christmas has already come and gone.  Here is what I am talking about:

I am lucky or blessed enough to have a good friend that had a total hip replacement at the age of 25 and already had some of the "luxury" items I need for my recovery.  I am talking luxury too...did you notice that the toilet riser is also a shower chair?  I call that the deluxe version!!!  However, I am a little saddened that I will miss out on the experience of shopping at the local geriatric store.  Now I only need to add some tennis balls to my walker.

The last few days have been spent finalizing a few details for the procedure.  I spent some time on the phone yesterday talking with the insurance company making sure everything was set and approved.  I don't like 11th hour surprises, especially when it comes to my finances.  All went pretty well until I noticed that they had the wrong doctor listed performing the surgery.  After a lengthy explanation that I was in AZ and that the doctor listed was in MN they recognized their error and made it all right.

I also began answering the long list of surgical prep questions from the hospital.  I just have one final call to answer the last of the questions next Thursday.  Now it is time to make sure the shower chair actually fits my tub.  Cross your fingers!!!

11 Days...