Another DOC visit

Another week...another doctor visit.  At just over 14 weeks post-op...I am feeling good and I was really looking forward to talking with Dr. Tarlow to see my latest progress and to ask some big questions.  Teh appointment was quick and full of exciting news.  The first news I got was that my doctor has decided to drop my health care provider.

Yes...not my fault.  And really I can't blame him for the challenge doctors have to face with providers these days.  What does that mean for me?  It means I have to go back to my old doctor that couldn't provide surgical services because the provider wouldn't cover the facility.  At least...I think I can go back as long as they haven't dropped my provider too.  Just another fun think to navigate through...

Back to the knee news...

1. The knee is still swollen but that isn't something that is totally abnormal at this point.

2. I have to wear my unloader brace for another 6 months and then for any periods of extended time on my feet.

3. Everything looks and feels like it is healing nicely.  I do have some popping and grinding still when the knee is flexed but the Doc told me that is fairly normal at this point and over time it should go away.

4. Stationary bike is a good thing as long as I don't overdo it!  Thus, I keep doing what I am doing and I actually road 5 miles yesterday.  My furthest bike ride in almost a year.

5. I asked if I could eventually Mountain bike again...while keeping my fingers crossed.  To which I couldn't believe my ears...the answer was YES!  In 18 months I can begin to mountain bike again.  That news was almost too good to hear.  I can't wait to get back on a bike soon- 18 months will not come fast enough.  (And yes, I will be allowed to single speed as long as it isn't a steady diet of it)

6. Dr. Tarlow, also felt that the cells are growing like weeds and that over the next 20 weeks they should begin to morph into a thicker substance that resembles the new cartilage that is to come.

Overall, the news was all good.  I couldn't be more excited.

Another Random Update

Today, I am at 9.5 weeks post-op.  I have been a little hesitant to post anything lately because the progress is very slow.  The knee is still a little swollen, the scar is healing nicely, my pain is manageable, and I am still in need of crutches to get around.

When it comes to the pain...I would never classify the knee as feeling awesome, but it does feel a lot better than it use to.  If I am honest, my progress seems to be moving at a glacial pace...the small increases in my ROM seems hardly enough material to write a blog about.  However, for your own boredom I will keep on keeping on!!!

Yesterday, brought some more progress.  I have slowly lowered the seat on the bike to help increase my range of motion.  I only have three more notches until my seat is all the way down.  I road for another 15 minutes yesterday.  It did take a few minutes until the knee warmed up so that I could actually make a full revolution.  Over the entire 15 minutes I set a new record for distance traveled.  I rode bike a total of .59 miles over 15 minutes.  Being a former competitive rider...It is hard to believe that I am celebrating such a small milestone on the bike...but you have to look at the little things.

I am getting more use to the brace everyday.  I did try to take a step around the car door this week with out the use of my crutches.  It was such a small distance I decided to give it a go.  Let's just say that if it wasn't for the brace and the car being so close to me I would have been flat on my face.  I am still not ready to walk unassisted yet.  Monday brings some more changes and more to share.

Stylin in my new brace!

This week has been a real test for the knee (8.5 weeks).  I attended a conference for the last three days which meant a lot of time on my feet and walking from session to session.  The time out of the house and the new routine proved to bring some great relief to the soul but a little more pain to the knee.  I also got really good at giving the short and modified story of what happened to everyone that had the nerve to ask me why I was on crutches.  Even though the extended time on my feet brought pain...it was all worth it!!!

The good news of the day is that I finally got my brace.  At least I think so...I mean, I think it is mine.  I took Aaron with me this afternoon to have a little father/son time.  As the tech assistant was opening the box holding my brace I asked Aaron what color he thought my brace would be.  He thought about for a minute and shrugged his shoulders.  With great enthusiasm in my voice and without hesitation, I told him it was black!  That was when I heard a the little voice of the tech assistant say..."Silver."

"What?" I questioned.

"It's silver.  Isn't that what you ordered?" she asked.

Evidently, the order was black, the order sheet also showed that it was suppose to be black.  But what we got...was silver.  I guess God thought I needed a little more bling in my life.  After convincing the tech to not send it back (I can't afford another week waiting for a new brace) we finally moved on to the fitting.  Here is a look at what the unloader brace looks like.

This view of the brace shows how the unloader brace actually works.  There are different numerical settings that correspond to the amount of pressure that gets placed on knee.  The pressure point is placed on the opposite side of where the relief is needed (the higher the number the greater the pressure).  In my case the pressure point is on the outside of my knee.  I will leave it in the second position because I have damage on both sides of the knee and we don't want to damage the outside of the knee trying to unload the inside of the knee.  The reason for having the brace is because the damage and the patch on the inside of my knee is so large...it should help that section of the knee have a better chance of healing.

The knee still continues to be slightly swollen- Swollen enough that I still have no real contours in the knee joint.  The best part of it is that my knee no longer looks like a watermelon, but more like a grapefruit.  The outside of the knee is still quite numb, but I guess that is normal.  I am enjoying my time working on ROM on the stationary bike.  I pretty much have no problems getting full rotation.  That means tomorrow I get to lower the seat and work on getting another full circle once again.  The most time I can spend on the bike is about 15 minutes before the pain gets to be too much.  Besides the bike I do some straight leg raises and that is really about all.  I can't wait until I hit a few more weeks and can begin walking exercises.

At least it is March Madness!!!  Go Kentucky!!!

Not this week...

I was planning to update everyone with my stylish looking brace today...but there is no brace.  I have been waiting all week to hear back from the doctor that my brace had arrived.  After waiting around until Thursday afternoon I decided to give the office a call to see what was going on.  What I found out is that the brace was just ordered on Wednesday due to slow insurance approval.  That means I have to wait another week to get my unloader brace. Now, don't get me wrong.  I am not super excited to wear another brace for a few months.  However, the brace will allow me to introduce a little more weight into the joint.

The bike work (ROM) is going well.  After slowly warming up the knee I have finally made a full rotation on the bike at a speedy rate of 15sec/rotation for 15 minutes.  At fifteen minutes it is time to fall off the bike and ice.  That's about all right now.

Doctor Visit #2- 6 weeks

I received some good news today visiting the Doc.  But let me add a little drama to the blog before we get  to that part of the appointment.

The last couple of days have been great.  All I can say is, "NO CPM!"The feeling of adding 6-8 hours of time back into your day is wonderful.  I feel like I have so much time to get things done that I couldn't do or was pushed by time to get done.  I have been able to do more work from home, talk with the kids more, and even read more (actually I have read 1000 pages in the last three days).  I had some catching up to do.

Moving forward...today has been the day I have been anticipating for the last two weeks: Follow-up #2.  Before we left for my appointment I was a little nervous.  I was afraid that the doctor would be disappointed in my ROM, or the swelling around my knee, or something else that I never thought of doing.  With some small butterflies in my stomach we loaded the kids and me into the van like usual; me scooting back on my butt while Melissa slowly holds my leg until I get into place.  We first headed over to my in-laws to drop of the kids with their grandmother and then we were off to see the "Wizard."

Fairly quickly after arriving to the doctor's office we were escorted back to our holding tank.  While crutching to the back of the office I noticed the office staff all looking at me...to which I responded in my best Mr. T impression..."What you lookin' at fool?"  No, not really but I thought about it.  Anyways, as I was saying...I was crutching to my holding tank when all of a sudden I got a few comments about how cool my crutches were.  I must say they are pretty cool and it is even more impressive to receive such high praise in an orthopedic doctor's office.  Incase you missed it...here is a quick reminder of how cool my crutches really are:

Impressed aren't you???

After sitting in my holding tank just a few minutes Dr. Tarlow made his way into the room.  The moment I have been waiting for was finally here.  He asked me to remove my gargantuan brace so he could have a quick look.  He then proceeded to check my knee cap, feel around the osteotomy, look at my scar, and lastly pick up my leg to check stiffness and ROM.  To my amazement he told me everything look great and that he was impressed at how well I was doing...the swelling looked great and my ROM was awesome.  One more test...it was time to get an ex-ray to see if the Osteotomy had fully healed.  Good news...the bone had healed about 95%  The only part left was a small section at the base of the Osteotomy where the bone hadn't filled in.  Dr. Tarlow said that this was normal and that he was very pleased with my healing.

What does all that mean?  Here is basically what I was told...I no longer have to wear the immobilizer!  YEAH!  However, I was measured today for an unloader brace and will have to go pick it up next week when it arrives.  Secondly, I can bend my leg and drive again.  It was nice driving home from the doctor today.  The days of sitting in the back of the van facing the side windows are gone.  Furthermore, I can start following the PT protocol that is laid out for me in the Carticel book.  Doc told me I don't need to pay for PT unless I really want to...I have done a good enough job so far on my own that he trusts me to do what needs to be done.  I still have 5.5 week left of using my crutches but it feels nice to have made some major progress in the recovery process.  I still have lots to do and a lot of time in rehab...but progress is being made.

Glad things went well today.

I feel like I am going nuts

Am I stir crazy???  YES, yes I am!  After spending 5+ weeks sitting in a recliner or laying in the bed...I am officially stir crazy.  Several things have been recent contributors to my current condition:

• I am really tired of using the CPM machine.  I wish there was someway I could use the machine at night but the machine is too uncomfortable now that I am bending the knee to extreme measures.
• The weather has been so nice outside and it is a bummer that I can't take full use of the time outside.  I miss evening walks and playing with the kids in the yard.  However, I know that soon this will change.
• My foot really hurts.  One thing I didn't expect was for my foot to hurt after all the time not using it.  I guess that is one thing I overlooked.  Even though I have been allowed to put a few pounds on that leg...my foot hurts so bad that it is fairly uncomfortable to use.  But like most things...this too shall pass.  So I am still using it.
• Pain meds in some ways helped the days go by faster.  Now that I am no longer on heavy pain meds it has become increasingly difficult to sleep...both during the day and night. (Currently I wake up around 8-12 times a night)
• My scar is healing and not looking so grotesque.  However, today the actual scar has become very painful.  Anytime something brushes my scar (including my brace) I want to scream.  Hopefully, this gets better soon.
• Lastly, you know you are stir crazy when you have played 55 games of risk in the past 4 weeks.  

Now that I have come to grips with my issues of cabin fever...I am really looking forward to going to the doctor next week.  I am praying that he will finally allow me to bend the leg by opening the locks on my brace.  This will at least allow me to sit in a normal chair and drive.  I think I might even have to take drivers ed again.  I don't think I have ever take 6.5 weeks off of driving.

More to come...today I am at 117 degrees ROM.

5 weeks down

Today marks five weeks post-surgery.  In many ways it is really hard to believe that it was five weeks ago that I under went this surgery.  Here is what is new and some of the highlights of hitting the 5 week mark:

• Today I am done using the walker.  That is right...I am now 100% on crutches.  The change comes because I am allowed to put 25lbs on my leg when getting around.  The balance that this gives me allows me to use the crutches without any fear of falling.  (I actually had to stand with my left leg over the scale and slowly put weight down until I figured out what 25lbs feels like)
• This morning is also my first day off of pain meds.  I have slowly weened myself over the past 10 days off of Percocet and then Vicodin.
• I have one more week of using the CPM machine.  After that I really want to take the machine out to the desert and blow it up.  Anyone want to join me?
• My leg still turns deep red anytime that I stand up.  I look forward to the day that my color tones are the same.  
• I still have to spend several hours a day icing.  Though the scar is looking good the knee joint itself is still pretty swollen and icing helps.
• The goal right now is to be able to do a full leg lift before I go back to the doctor on March 1.  Practice and pain is the name of the game.
• Overall, recovery has really slowed down from the first three weeks.  Now its more about following the routine and making sure I hit all the marks...Today I am at 114 degrees on the CPM, I have 7 more weeks of using crutches, and hopefully PT starts soon.

Today was also an emotionally difficult day.  I sold both of my single speed bikes and shipped them off.  Cycling has been a sport that I have enjoyed over the years and has really provided me a lot fun, friendships, stories, and even exciting adventures.  I don't know what level of cycling I will be able to do in the future but the freedom to Single Speed is now in the past.

Scar Update

The body really is an amazing thing.  After just four weeks my scar is looking pretty good.  Here is a quick look...no worries, this isn't nearly as bad as it was that first week.

4 Week Update

February 14...that means today is Valentine's Day!  So before I forget, Happy V-DAY everyone.

Yesterday was also an important milestone in our house.  Yesterday marked four weeks post-surgery.  In many ways this week is a good time to commemorate the passing of time.  There has been a lot of change over the past few weeks but I still face a long road ahead.

Looking back over the first couple of weeks, I am glad those days are behind me.  On a scale of 1 to 10 being 1 as "no worries" and 10 being "life sucks," the first week after surgery was undoubtedly an 8.  Today I would say I linger around a 3 or a 4.  After spending the first 10 days exclusively in bed, living in the CPM machine, and not showering...life is now pretty good!  I am still living in my locked Bledsoe brace, but getting around the house is getting much easier and less painful.  I have even ventured out of the house to get to church and to get some ice cream.  I no longer have to beg Melissa to do everything and that is a nice place to be.  I now shower every other day, but I am still 100% dependent on Melissa to help me get clean.

My knee is still swollen, but most of the bruising has gone away.  My scar is healing very nicely too.  Last night I made some more progress in that I am now allowed to take off the brace when sleeping.  It felt a little weird but it was very nice to let the leg air out for a lengthy period of time.  I also have begun doing patellar manipulation.  Basically, what that means is that I relax the leg and have to manually move my knee cap around, mainly side to side right now.  This is to help eliminate scar tissue damage and to keep ROM at a comfortable and stable level.  I must say that it isn't the most fun thing I do in my day.  It is also hard to find the knee cap because the knee is still swollen and the knee cap is not noticeable without feeling around for it.

Furthermore, my hair is back after shaving it before surgery and the beard is also coming in very nicely.  I have also lost a total of 20 lbs...much of that being muscle.  I really look different then pre-surgery Lee having lost weight and muscle definition, using a walker, and growing a beard.

Four weeks are now done and hopefully the hardest part is now behind me.

ACL tears create big problems...at least in my case!

Things continue to move forward.  This week marked the first major change in my routine.  No longer do I need to spend 8-12 hours attached to the CPM machine.  I have now graduated.  At least that is how it feels...I now only need to spend 6-8 hours on the CPM machine.  The two extra hours in my day has been a great blessing and allows me to spend a little more time resting, playing with the kids, and time to get out of the house.

Over the last couple of weeks I have answered a lot of questions as to the reason my knee is in the shape that it is...being that I am so young to have a knee in such bad shape.  Here is an article that I think explains some of the why's behind my knee problems.  Really, it all comes back to my ACL tear 6.5 years ago.  Once I tore my ACL and my meniscus...nothing has ever been the same.  As you will see...that happens more often than we may know.

Article written by my Knee Surgeon, Dr. Stefan Tarlow and posted on his blog at http://blog.tarlowknee.com/

This studies examines patient behavior patterns and patient physical ability to resume their "normal life" after surgery for complete ACL (anterior cruciate knee ligament) tear.  

This is information that orthopedic surgeons are aware of but is not common knowledge in the general population.  The point here is that an ACL tear of the knee is a severe and life changing injury, and despite sophisticated treatments based on years of research we as surgeons are not able to return all our patients "back to normal".  

Most people have not returned to their preinjury level of sports participation at 12 months after anterior cruciate ligament (ACL) reconstruction surgery. Twelve months’ follow-up is too early to assess return-to-sport outcomes accurately.

This study was undertaken to evaluate how many people have full return-to-sport outcomes after ACL reconstruction surgery.

Data was collected at 2 to 7 years after ACL reconstruction surgery regarding preinjury sports participation, postoperative sports participation, and subjective knee function. 

A total of 314 participants (age 22-42) were studied at 2-7 years after ACL reconstruction surgery. At follow-up, 45% were playing sport at their preinjury level and 29% were playing competitive sport. Ninety-three percent of the study sample had attempted sport at some time after their ACL reconstruction surgery, and many of these could not participate due to the effects of their knee injury.  Some took as long as 3 years after surgery  to return to full activities, but still not to the exact same activities compared to before the knee injury. 

Here is the point.  Less than 50% of the study sample had returned to playing sport at their preinjury level or returned to participating in any competitive sport when surveyed at 2 to 7 years after ACL reconstruction surgery. People who return to sport within 12 months may not be able maintain their sports participation farther into the future.

Super Bowl Weekend

What a great weekend!  This weekend I enjoyed the freedom of getting out of the house for some fun in the sun.  Saturday night we ventured over to my in-laws for burgers and for a final wheelchair fitting.  The wheelchair has been nice...it allowed me to go outside and to watch my kids play around on the swingset.

We also had a good laugh attack.  I look like such an invalid sitting in my wheelchair with a blanket wrapped around me.  Nevertheless, it was awesome getting a little time outside and time with the kids.

Yesterday, was my biggest outing.  We got up extra early so that I could get time on the CPM machine before heading out to church.  It was great getting to see my church family and to reconnect with friends.  However, when it came to the Super Bowl and party's...it just wasn't going to happen.  The day was tiring and left me with a lot of time to make up on the CPM.  On the side...I did enjoy watching the game and it was nice seeing the Giants pull out another win.

This is going to be my first week that I try to get back to work.  However, any work that is getting done will be from the home and most likely when I have the energy to tackle something.  By no means will it be a full work week...but it is nice to change up the routine a little and to put the movies down.  What a trip!

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.

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.