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!

A few tips for ACI patients

ACI surgery hasn't been like any other surgery I have had before.  Because it is so different and new, I wanted to pass along a few observations and tips for others that might be thinking of or are planning to have ACI surgery.  Here are a few things noticed in my initial weeks of recovery.

1. Stock pile lots of movies...you can just plan that the first few weeks you will spend sitting in a recliner or in bed.  To help pass the time I have watched way too many movies and TV shows.  Netflix instant stream has been a huge blessing.

2. Get married...I cannot imagine going through this on my own.  Seriously!!!  You will need someone to help you with your brace, CPM machine, fix you meals, to get random things for you, help you get to the bathroom, and lastly...bathe you.  I am pretty close with my parents but would much rather help from my wife than my mom when it comes to certain things on the list.  Be ready to lose some dignity as you walk through the recovery...don't fight it.

3. Have WIFI and a computer or ipad...my ipad hasn't left my side for the last two weeks.  I use it for everything from checking the web, watching Netflix, to updating the blog.  It has really kept me from going crazy.

4. Develop a routine...without having a specific routine it would have been very difficult to get all the hours on the CPM machine.  Needing to put in 8-12 hours/day on the CPM machine forces you think about how you are going to spend every minute you are free, as in finding time to ice, to spending time with the kids, to getting a shower.  The time you have gets eaten up very quickly.

5. Buy a toilet seat riser...get one with handles.  The handles really help you push off back to your feet.  Also, I look forward to placing the "cadillac crapper" on the toilet when guests come over for visits.  It will be a great conversation starter!

6. Know your insurance...I am already getting surprised by what the insurance company covers and what they don't.  Make sure you have a good understanding of what your benefits include, keep track of all your paperwork, and be prepared to appeal anything that comes back not covered.  For instance...we just found out our insurance wants to cover the CPM machine for 21 days and not the entire 6 weeks.  You never know how and where this blessing/curse will show up.

7. Lean on loved ones...you are going to need help and lots of it...even more if you have kids.  For the first little while you will need someone with you 24/7.  If your spouse needs to run an errand you will need to find a friend or family member to come and babysit you.  Furthermore, your spouse will need a break and it is ok to ask a friend to come and sit with you as they get a little rest.  We have been extremely blessed to have people bring us meals, take the kids to the park, help around the house, etc.  We couldn't have done it without having some outside help!

The knee continues to heal.  Here is a quick pic of the scar as it stands now:

Also, we picked up something to help me get out of the house this weekend.  I am looking forward to going to church this Sunday for the first time in a few weeks.  This wheelchair we found on Amazon has the leg extensions to support my leg in the immobilizer. (which was harder to find than you could imagine)

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.

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.

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.

Here We Go!!!

Who knew how special today would really be?  Today I am preparing for the idea, that I am going to be cloned this month.  That's right!  I am going to be cloned- at least some of me.  Actually...if I am more specific only the stem cells from my knee cartilage are being cloned.


Let me do a little explaining...


This blog is being created to chronicle my journey and to help others who are facing similar circumstances.  I am about to undergo a knee operation called Autologous Chondrocyte Implantation, or ACI.  You can read more about the actual procedure here.


On August 1, 2011 I completed the first stage of the process.  What happened was over the years my left knee has started to deteriorate to a large degree.  In June 2005, I tore my ACL playing basketball when a large ogre of a man fell and rolled into my left knee.  The injury left me with no ACL and two tears in my meniscus.  Not fun...but not the end of the world.  My doctor went in and "fixed" the issues and created for me a new ACL using part of my patella tendon in August of 2005.  For the most part I was fixed and participated in fairly normal activity...though I had a nagging phobia of playing basketball.


In October 2010, the same knee was re-injured by a different ogre who attempted to tackle me while playing flag football.  The result of this injury was a small tear in the cartilage.  After attempting to go through life as normal as I could- the final straw that broke the camel's back came in June 2011 while bowling.  Yes, and I know what you are thinking...bowling is a vicious sport.


On August 1, 2011 we scheduled an Arthroscopic Chondroplasty to inspect the knee, to clean it out, and to perform a possible micro-fracture of the knee.  However, that wasn't to be the case.  What was found in the knee pretty much left the surgeon speechless...what was found were multiple, large lesions (or defects of the cartilage).


Medically speaking:
- Grade IV lesion measuring anterior to posterior 4cm x 2cm medal lateral and medial femoral condyle.
- Lateral femoral condyle lesion measuring 3cm x 3cm, uncontained in its lateral-most edge (note: uncontained is a bad thing)
- 3cm anterior posterior x 2.5cm medial to lateral trochlear lesion
- 1.5cm x 1.5cm lesion of the patella central


In laymen's terms...I have one jacked up knee.  To be even clearer...today I went to visit the surgeon who will be doing the operation for the first time and his first two words after looking at my surgery pictures were "Holy Crap!" (would have been even better if he put BATMAN at the end of that)


Anyways, during the Aug. 1st surgery my doctor realized that my knee was really bad and that I was a prime candidate for ACI- so he went ahead and biopsied my cartilage stem cells.  Right now...part of me is in Massachusetts getting ready to be replicated.  I know it sounds like something out of an old alien movie...but it is true.


When the cloned cartilage cells are ready, I will head back into surgery...January 16, 2012 to be more precise.  While the first operation is performed arthroscopically, the second one is the real deal. It's called an arthrotomy, which is a fancy way of saying the patient wakes up with one of those Frankenstein scars stretching vertically across the knee (about 12 inches in length).  Now after they get done ripping my knee open they will work to relocate my fibula, my knee cap, and "patch" the large lesions with tissue, and then inject my harvested stem cells underneath the patches just created.  Right now we are just waiting for my cells to reproduce and to head into surgery.  


What is being predicted is that I will need to spend 2-3 nights in the hospital, 10-12 weeks on crutches (non-weight bearing), and 18 months in rehab...all in hopes that I get 10 more years out of my knee before I need a total knee replacement.


This blog is intended to chronicle my adventure through surgery and the grueling rehab.  Furthermore, the blog will give me a creative way to deal with my boredom and pain.