Geek Habitat

Thankfully, “all” I’m having is ACL reconstruction and meniscus repair surgery. However, it was interesting stumbling upon this:
virtual knee replacement surgery
It’s interactive (Flash), so some of you may be turned off by it — particularly when it’s time to whip out the bone saw and go to town on the patient’s femur, tibia and patella!

Total knee replacement obviously requires a much larger incision than I’ll emerge from the OR with. I expect I’ll have two 1-3 inch incisions, one above and one below my knee, for the bone-patellar tendon-bone graft; in addition, I will likely have 1-3 small “portal” incisions for the arthroscopic equipment to view and repair my torn meniscus. While there will be drilling, it will be limited to drilling out small bone plugs from my tibia and femur (with the patellar tendon attached), and securing those bone plugs at their new anchor sites. I’m not sure if I’ll have self-absorbing screws or metal screws used to fix the new ACL (the bone-patellar tendon-bone graft) in place. I don’t care either way — it’d be something of a novelty to know I had two small bits o’ metal in my leg — bionic woman!

I’m 4 days away from the knee surgery, and I can’t sleep. Maybe I’m getting any nerves out of my system early? Maybe?

I’ll be calling the specialist’s office later this (Monday) morning, not to reschedule as they desire, but to confirm some details.

First of all, when the office called hoping I’d reschedule, they referred to my procedure simply as “ACL surgery” and I just want to be sure the physician also addresses my medial meniscus tear, as well. I’m not entirely sure he noted it when he spoke with the surgical scheduler, and the last thing I want is to wake up from surgery (or wait 10 days until the first checkup) to find out he didn’t even look at it! My only fear is they dropped the ball and mentioning the torn meniscus repair might require them to reschedule my surgery due to lack of time. However, I’m scheduled for a full 2 hours of surgery time, if needed, so I should hope that’s adequate.

Paranoid? Yes, a little. Better safe than sorry, in this case.

I’d also like to know when I’ll receive prescriptions for any medications I’ll need to take post-operatively (antibiotics, pain killers, anti-inflammatories, etc.) Ideally, I’d like to have those filled and in hand when I return home and need to begin taking them!

Apparently, I’ll be fitted for crutches and my leg immobilization brace prior to surgery. Having never walked on crutches, that should be interesting — doubly interesting since I’m checking in to the hospital at 5:30 AM. I’m not a morning person, and whenever I have to be it’s through the wonders of caffeine, which obviously is restricted (along with all other food and drink) beginning Thursday at midnight. While I don’t mind providing entertainment for the nursing staff as I bumble around getting acclimated to crutches, I do intend to avoid any further hijinks which cause injury!

In San Antonio at the moment, it’s 45 degrees. I am not wearing shorts to the hospital on Friday morning per the surgery scheduler’s request. I’ve found several pairs of lightweight pants that are comfortable and baggy enough to accept the leg brace. Granted, getting in and out of the pants will be a challenge initially, but I don’t see how shorts would be that much different — the “fun” part is reaching one’s toes and getting the material over one’s feet to complete the journey north!

I had a few other questions written down but my reading the past week has helped address those concerns: physical therapy (CPM devices) and anesthesia (if I block this from my mind), to name a couple.

I’d characterize my mood as antsy — I want to get the surgery over with so that the pain coming from my knee is at least a “healing pain” rather than a “God, I hope I’m not doing further damage to my knee” pain! I’ve lost count of how many times my knee has slipped out of its normal range of motion in the past week. Bracing it with my cheapo consumer-grade knee brace (thank you, Target) is only a marginal solution since it provides some stability but also causes me additional pain after twenty to thirty minutes of wear.

I’ve read and heard a little about Continuous Passive Motion (CPM) devices, but they’re apparently going out of favor, at least for knee surgeries. CPM devices are sometimes prescribed to patients who will undergo knee replacement or Anterior Cruciate Ligament (ACL) replacement surgery {that’s me}. Using the CPM device causes the patient’s knee to slowly and repeatedly be put through its desired range of motion. It was thought this immediate return to use would help reduce joint stiffness, adhesions and other issues associated with knee surgeries. However, research indicates no long-term benefits to using a CPM device post-operatively over a patient-driven return to mobility (using crutches for 3+ weeks post operatively, accompanied by a gradual increase in weight-bearing plus exercises to strengthen the leg muscles, and supervised physical therapy.) The CPM machines aren’t useless. They have proven to provide an immediate benefit in mobility post-operatively, and provide patients with an immediate sense of participating in their recovery. However, over the long-term they don’t provide any advantages over other methods — patients with or without a CPM machine end up healing to the same level of mobility and joint flexibility.

Given the research, it’s no surprise that my specialist is not prescribing the CPM device for my post-operative recovery. I can’t say I’ll miss it, since the device is typically used for many hours a day, including when a patient sleeps. It takes me long enough to fall asleep, without having a device strapped to a post-operative knee that’s forcing it through the full range of motion while I attempt to sleep!

Justin and I shared an enjoyable evening at home with my brother as our guest. We watched “Chronicles of Riddick” and “King Arthur”, and the guys also did some multiplayer gaming. I enjoyed both movies, but divided my attention between the television and my laptop. I still haven’t managed to spend my $110 gift certificate to Amazon.com, and I was hoping to place the order before Monday. This evening, I discovered the “Burt’s Bees” product line of luxurious and (apparently) wonderfully scented hand and body lotions, bee wax lip balm and other all-natural items. We’ll see how much of what I enthusiastically added to my cart I actually check out with, however. I’m still in browse rather than buy mode, so there’s still time for my mind to change drastically.

As for how my knee is faring, it was doing quite well today until I got overzealous (read: stupid) this evening while hunting for a missing cat toy. Moving furniture around is generally not good for knee injuries, dontcha-know? So, yeah, the left knee is back to hollering, particularly when I bend my knee to go up or down stairs. I tried wrapping it but that lasted all of thirty minutes or so before it seemed to hurt more than help. I really ought to have iced it, rather than putting the knee wrap on. I didn’t have malleable ice packs until I did the shopping on Wednesday, so I keep forgetting I have a pair of them available now.

My current preoccupation (fear would be too strong a word) has nothing to do with the surgery itself, but rather the medical system and its well-known propensity to outrageously overcharge patients. From the linked article, approximately 90% of all hospital bills have excessive over-charges, averaging around $1,300 per hospital stay! A direct quote from the article, from a patient-turned-professional-auditor of hospital bills:

The “Don’t Be Taken for a Ride” section of the article is particularly scary — I have no idea what the answers are to most of those items. It’s enough to make your head swim! I’ve already had a bit of an introduction to the “Why are they doing this, and how much is it costing?” because even though I’d had 2 x-rays taken on January 18th, the specialist’s office insisted on 6 additional x-ray films of my left knee on the 24th, making a total of 8 x-rays on my knee in less than one week. And, ultimately, while the films were all useful for diagnostic purposes (I hope), they were unremarkable — I don’t have any bone fractures or irregularities. I should be fair, and note the x-rays taken at the specialist’s office were more involved than those I’d originally received on the day of my MRI. Three of the x-rays involved me weight-bearing on my left knee, and several were specifically to detect any patella (knee cap) issues, so I do feel the films probably showed more of what the specialist needed to see than my original films.

Unless it becomes incredibly tedious to do so, I’ll post the itemized lists of various procedures (diagnostic as well as surgery and physical therapy) when that data is made available to me.

Of all the reasons I’ve heard for getting a tattoo, this is one of the saddest: a 31-year-old selling permanently tattooed advertising on his body (for cheap)!

He should at least be pricing the advertisements the way stock photographers price their images — the wider the distribution, and/or the longer the duration of use, the higher the price. Lifetime, exclusive rights = $$BIG MOOLAH$$

You’d have to pay me more than a one-time fee of $510 before I’d sport a permanent tattoo anywhere on my body. He could make far more than that selling ads on a semi-popular website, and without the hassle and embarassment of tattoos! In fact, {Pssst!} if he were running Google AdSense on his website before CNN featured him, he’d already have earned enough to get those two ghastly things removed and make a deposit and first month’s rent on a new apartment! [His website]

And of all the markets to provide permanent advertising to, he chose pharma (pharmaceuticals — a shady area of Internet commerce) and a “save Martha” campaign. C’mon, at least “Save the Whales” or even “Free Kevin Mitnick” have more staying power than Martha’s white collar prison blip.

The only way this type of marketing would be remotely profitable is if it were employed by a tattoo junkie who (1) performed publicly, and thus gave his “ad properties” frequent exposure and (2) was willing to get his body literally covered in the ads, similar to the never-really-caught-on get a free car (wrapped with marketing messages) scheme.

Oh well, it takes all kinds. I’m a little more practical — for the right price, I’d wear a different t-shirt a day with someone’s ad message on it (within reason). My tagline to recruit fellow walking billboards? “Save instantly on clothing and laundry costs while earning money for college tuition!” Oops, wait, I think the U.S. military already uses that slogan… Damn, back to the drawing board!

Justin called me this evening (Friday) to relay a message left on our home answering machine at 3:45 PM; I was at my parents enjoying an overdue visit with them and my brother. The message was from the scheduler at my knee specialist’s office. Here’s the content of the message, nearly verbatim:

This pisses me off on so many levels.

First off, who the hell calls a female senior in high school a “little girl,” except her own parents or grandparents? It would be different if she was 12 years old or younger — you know, actually a little girl …or if she was a student and moving up her surgery a week would prevent her from failing …or any million other more valid reasons I can think of without trying. Ideally, the only reason the doctor’s office should call another surgical patient to reschedule is for an EMERGENCY, but see, I am flexible. But for cosmetic reasons for someone’s senior prom? Puh-leeze! Justin and other family members have already requested time off work for my surgery and post-operative care. I’ve already stressed through one week of pre-surgical preparation and spent time exercising, planning and getting situated so I’ll have a comfortable and productive recovery period (particularly while I’m confined to the first floor of our home). Afterall, our business doesn’t cease to exist just because I’m recouperating from surgery. So this request, this favor I’m being manipulated (“little girl”) into wanting to grant, is a slap in the face. It’s unprofessional.

I don’t give a flying flip about some “little girl” and her senior prom. I shouldn’t have to. A senior prom just doesn’t rank up there in my mental criterion of “Worthy Reasons to Ask Strangers to Make Sacrifices for You.” Somehow it’s my problem this “little girl” may have to attend her prom on crutches and in a leg brace? Has no one considered that Life Happens and this may be a perfect exposure to adulthood for this “little girl”? If I understand their message correctly, she’s already got the 11th scheduled for her surgery; how is moving up her surgery by one week going to somehow secure/ensure her senior prom?

This pisses me off more than I can articulate, perhaps because I cannot wrap my mind around it — cannot understand it. It’s a personality flaw — I look for logic in all things, and I can spin my wheels looking for logic where there is none. There is no logic, but the reality in this case is one of two things: (1) “little prom girl” is a relative of the doctor or someone on the doctor’s staff, or (2) “little miss prom” and her mommy were so melodramatic that the doctor’s office is willing to antagonize one or more other patients just to (potentially) shut them up.

TO “A LITTLE GIRL”:
Welcome to adulthood, missy. If your prom is so damn important that it can’t be “marred” by a leg brace and/or crutches, why don’t you postpone your surgery until after the blessed event? What, I couldn’t hear that — Because you don’t want to wait any longer than you have to? Because it hurts? Because you’re scared with every step you take that you’ll fall and get hurt worse? Because you want the healing to start as soon as possible? Well, then, honey, that’s possibly the first thing I can see that we have in common. Good luck with your surgery… on the 11th!