The Latest Greatest

Posted in Uncategorized on November 23, 2008 by mitemo

As promised, I have new news.  First, here are some more pics of my ugly scars, some with staples still intact, others with it out…

with staplesStaples in (2)staples removed2 weeks after staples removed

Since my last post, lots have happened, so I’ll try to just give you the coles notes version:

After I was discharged from the hospital, I was given a zimmer splint to attach to my leg 24/7 (this is for the purpose of immobilizing my knee in order to allow the ligaments to heal).  This immobilization continued for 6 weeks after which I started physiotherapy.  Because of the 6 weeks of not moving my knee at all, the tendons on both ends of my kneecap tightened and stiffened, so now the challenge is to get my knee moving.  I was measured as having a 10 degree bend at the start of physio (keep in mind that 90 degrees is what your knee requires to sit).  So my life consists of going to physio every morning, Monday to Friday, having the therapist force my knee to bend, ever so slightly every time.  If you are wondering how that would feel, just imagine: sleeping with your arm bent under your body for the entire night, and waking up and trying to move it…do you know what I mean?  It doesn’t tickle…so when the therapist is forcing my leg to bend, its about 10 times that pain.  I do this every day for 2 to 3 hours.

Fast forward to 4 weeks later, I am still only measuring at 70 – 75 degrees flexion (bend), but I have 100% extention (when your leg is straight, this allows you to walk normally).  So the decision is to book me for the O.R., where they will put me under anaesthesia and do a manipulation (this is where the surgeon will forcibily bend my leg to the desired degree, which is about 120 degrees).  This is impossible to do by the physiotherapist because of 2 reasons: the pain level would be unbearable; and he will not be able to tell if he is tearing what the surgeon repaired, so the doctor has to do this, and I have to be sedated.  The date is set for November 11th, a day that I will never forget.

I wake up in recovery after the manipulation, they have me strapped to a machine called CPM (Continuous Passive Motion), which is a machine that bends my leg for me, and they take me to my room.  So this is Tuesday night, I am strapped to the CPM all night, I don’t sleep a wink because of this machine, and because of the pain (once again, I am on percocets and I have a nerve block in my groin).  Wednesday morning arrives, and my physiotherapist comes and starts working on my knee some more, straps me back on the CPM and off I go, all day on the stupid machine.  Late afternoon, they get me on my feet, I walk the required walk, down the hall, up some stairs, back down, and now I can go home.  But before that, I am advised strongly to rent a CPM for home use, and told that I should stay on that machine as long as possible, as often as possible.  The reason for this is that the human body’s first response is to heal, to grow more scar tissue.  BTW, unbeknownst to me, while I was sedated, the doctor decided to do a scope and clean up all the scar tissue that had formed after the initial surgery, and because there was a screw that was protruding a bit, he decided to take that out too.  So now, I have new stitches that have to heal, and my knee is swollen to unrecognizable size again.

Thursday and Friday morning, I go back to physio, and whoohoo!!! I can achieve 120 degrees.  It’s all good.  I just need to stay glued to the CPM all weekend, continue to go to physio, and all should be well…or so we thought.

Friday, November 15th and Saturday, November 16th, I am strapped to the CPM 20 out of 24 hours a day, I miss physio on Monday because I had to attend a conference, and Tuesday morning I am back at physio…but things are not so rosy any more.  I have lost my extention (I am missing 10 degrees to straigthen my leg) and I lost some of my flexion (I am back to 90 degrees).  Imagine my disappointment and frustration.  So now, we work on getting my knee straight again, at the same time as bending it and getting back the flexion.

It’s been almost 2 weeks since my manipulation, I am at 98 degrees flexion and still not at full extention, I have been given a bunch of things I have to do at home, but am told to only use the CPM at night time, while I sleep.  The rest of the time I have to focus on extention.  It is getting easier to sleep with the machine, I wake up several times a night, but am able to get some rest.  Just last night, I tried to get a few hours of sleep without the machine, and guess what…I couldn’t get comfortable.  No matter how I tried to sleep, I was in pain…so back on the machine I go, and zzz…goodnight.  Weird, I hope I don’t get too used to it.  The CPM costs $25.00 per day to rent.

In between all of this, I have episodes of meltdown.  I can’t believe that this has happened to me, what did I ever do to deserve this fate?  I could be having a normal conversation with someone, and all of a sudden the tears will start.  I hope I’m not losing it.  Through it all, poor Lucas has to once again be my nurse.  He’s been fantastic…he has not complained once about any of this, has been extremely supportive, and has endured my meltdowns.

For now, it’s back to physio every day (I’m there for 2 to 3 hours every morning), and excercises when I get home.  I’m back on my stupid crutches.  I have not felt like going out much, it’s just too much effort, and my knee feels like it’s on fire when I get home.  It just seems a lot easier to stay in.  I have no idea what I will do if this goes on much longer.  I am hoping for a miracle.

Who knew softball would be so dangerous

Posted in knee injury on October 25, 2008 by mitemo

It all started about 20 years ago.  I started playing softball in an organized “Sunday Brunch League”, and I loved it.  I loved meeting new people, spending my Sundays at the ball park, sometimes getting loaded, sometimes playing ball, but always spending time with friends.  As a matter of fact, most of my friends I have now I met through my years playing ball.  I had never really played softball before that, other than in grade 6 during gym.

My recollection of one of my first fielding bungles was a pop fly that had been hit to mid field, and I was the rover.  As I watched in horror, much like Les Nesman on WKRP In Cincinatti, this ball was coming directly at me, so like a seasoned pro, I squeezed my eyes shut and stuck out my glove.  But all of a sudden I hear the pattering of footsteps near me and at the last second I look down to see who was running at me, and bang, the ball hits me square on the top of my noggin.  I ended up with the stitch marks from the ball on my scalp and a nice little goose egg.  That was my introduction into the game of softball.  It’s a wonder I stuck with it.

Fast forward to the summer of 2008, I am still playing softball.  It’s August 24th, it’s 11 am and our team is playing game one of the playoffs.  It’s the 3rd inning (I think), our team is in the field, I’m at first base.  A fly ball is hit between first and second base , I’ve got my eye on it, I’m running sideways tracking it, tracking it, I can almost see it falling into my glove, and whammo, I’m down.  The first thing I hear as I hit the ground is Ed chiding me, saying, Myra!!! (we were both going for the ball and of course did not call it), and then the pain registers.  I look down, and where my kneecap usually is, I see a gap, an indent, as if my kneecap had collapsed somewhere.  In it’s place were two huge humps.  This all happens in nanoseconds, and then the howling starts.  I didn’t really recognize who was screaming, but later deduced that it was me.  Then in my peripheral I see people running up to me and calling 911.  Everything after that was a blur of pain.  Scott and Heidi were my life lines, they were the ones that kept me calm.  In all my years, I have never experienced physical trauma like I did that day, and I have to say that I would be the happiest person alive if I never have to experience that kind of pain again.  We waited for what seems like forever, but in reality was about a half an hour, for the ambulance.  They “secured” my knee and carted me off to the hospital.  When we finally arrived at St. Michael’s, we were told by the triash nurse that there would be quite a wait as there is no room in emergency.  I asked for painkillers, but alas, was denied (apparently you have to be seen by a doctor before anything is given), and I was forced to endure an hour and a half of wait time, still in pain.  In the meantime, the lovely paramedics that attended me in the ambulance met up with another couple of paramedics in the emerg, and they started chatting…about their mortgage, their high property taxes, the party they went to the night before and how wasted they got…all within just feet of me lying and writhing in pain.  Lucas, who came with me to the hospital, finally must have given them the evil eye or something because all of a sudden the second pair of paramedics “went to grab a bite”…then blessed silence once again.

Finally, a bed came available in the emergency room, I was wheeled in and transferred over (more pain).  They took one look at my knee, hooked me up to an IV, and started a slow drip of a very low dose of pain killers.  Then one doctor came to tell me that they would have to re-set my knee before they can do anything else, and assured me that I would be sedated and that I would feel no pain, and have no recollection of the experience.  They wheel me in for xrays, and a few minutes later, another doctor came and said, ok, let’s re-set this knee and see what we have here.  At that time, I was still fully conscious, and still only had a very low dose of pain killers…still feeling the pain!!! and told the doctor as much.  There were other attending doctors and nurses present, and I told them all that I was not ready for the re-set as I was not sedated. The doctor (Dr. Whelan) then told me that it was going to be a very simple procedure, and that I shouldn’t feel too much pain.  He was very gentle when he started to straighten my mangled knee, but the pain!!!  It was, to say the least, excrutiating.  I am quite sure that I cried like a baby…did I tell you about the pain?  After all was said and done, they took me for more xrays.  Then the doctor came back and told me that he had good news and bad news.  The bad news was that they had to re-set my knee again, they didn’t get it done the first time around (I wish I were a fly on the wall to see the look on my face, I am sure it was showing stark horror).  But the good news is, this time they will sedate me.  And as promised, later on I came to and remembered nothing.  Lucas was a sweetheart and was with me during the entire process (except when they re-set my knee, he didn’t want the doctors there to have to deal with him passing out).  I don’t know what time it is on the clock, all I know is they are waiting for a bed to become available upstairs.  Poor Lucas, he is exhausted, he’s worried about me, and he doesn’t want to leave me, but I convince him he has to go home, and that there’s no point in him hanging around.  Finally, after a few more hours I have a room.  It’s past 9pm by now, and I am all doped up.  I don’t remember much of the night, just nurses coming in every few hours to give me more drugs.

Monday, August 25th: I am now “comfortably” settled into a hospital room, on the 4th floor (the old wing).  I have the room to myself but must share the bathroom with an unknown and unseen person in the adjoining room.  All I have to remember is when I go to the bathroom make sure the adjoining bathroom door is locked, but then I have to remember to unlock it after I am finished (ultimately the nurse had to come to my side many times to unlock it).  There is no news today.  Today is a “wait and see day”.  They tell me that they are waiting for Dr. Whelan, but don’t know when or if he is going to be coming today.  Lucas comes back and spends most of the day with me.

Tuesday, August 26th: Finally get a visit from Dr. Whelan in the afternoon.  He does not have good news for me.  They have to operate.  At the time he told me all the damage that was done to my knee, but as I was not caught up with all my medical terminology, AND was on some heavy duty drugs, I had no clue what he was talking about.  All I knew was that the surgery was going to be quite extensive, at first he said it could take up to 8 hours to repair all the damage, and that there is a slight chance that there could be nerve damage during the surgery, and if that is the case, I could lose the use of my leg from the knee down and have to amputate.  OR, he said I could leave it, he could throw a cast on it, and I would forever walk with a limp and have only very limited use of that leg.  Given those options, I chose to operate.  He assured me the chances of the nerve damage is very rare, it had never happened with any of his patients, but he had to advise me of the remote possibility (so that I don’t sue his ass if it does happen).

That afternoon, he allowed me to go home to get cleaned up, and to get some necessities (I came directly from the ball field and according to Lucas, my feet smelled…well they smelled like ball feet).  But I had to promise to be back by 7am the next morning so that they don’t have to check me out (they just had to give me a day pass), and I wouldn’t lose my bed.  So Lucas took me home that afternoon, and I have to tell you I have never appreciated coming home as much as I did that day.

Wednesday, August 27th: I am back at the hospital by 7 am, and here I shall stay for a few more days.  Throughout the day, I am still in the dark as to when this surgery will take place, all I know is that they will not take me in the O.R. after 9pm as it is such a long surgery.  They tell me to be ready anytime, gave me the gown with the open back, and told me that I should be ready. Sure enough, around 7:30 pm they tell me it’s time…they have an O.R. available.  I am wheeled down to the O.R. where we are met by a team of anaestheseologists, nurses, and doctors.  They hook me up to other IV’s, place an oxygen mask over my face, and within seconds I am out!!!  About six hours later, I wake up in the recovery room.  I don’t feel anything other than groggy, and to tell the truth I don’t remember much after that.  I just remember waking up again in my room, the nurse giving me more drugs, changing my ice packs, checking my IV, etc.  The surgery took 5 1/2 hours and was a success.  I am now hooked up to a morphine drip, have a nerve blocker in my groin to control the pain, and am hooked up to a catheter…whoo hoo, it’s party time in my head!!!

Thursday, August 28th: they move me to the 9th floor, also an orthopedic floor, because the long weekend was coming, and they were short staffed.  There were only a handful of us on the 4th floor anyway.  So I was eventually moved to a nice bright room, beside the window.  I have the room to myself at first, but was assured that there was going to be a roommate.  I get my tv hooked up (it’s $10.00 per day), and as I was having a nice afternoon watching my soaps, in comes my roommate.  She is just fresh out of the O.R.  I know how she feels.  The curtains were drawn between us to give her privacy in her moving in.  A few minutes after the nurse clears out, I hear from behind the curtain: “would you mind turning down your tv!!!”.  It was not a request, it was a demand.  My tv was not on very loud, and so I plugged in my headset and thought, “Oh god, what a nightmare she’s going to be”.  Eventually we do get talking, and she seemed not so bad.  But as it turns out, my initial impression was the correct one…she turned out to be very nasty, very rude and demeaning toward the nurses that were caring for her.  It’s no wonder they would take their sweet time in retrieving her bedpan from underneath her…she would be forced to sit on the thing for up to a half hour at a time sometimes, hehehe.  I’m sure each shift that came on was given the heads up on her.  Then the Physiotherapists came to get me out of bed.  Their aim is to get me sitting on a chair beside the bed leave me there for lunch, and have a nurse put me back to bed.  In their attempt to get me out of bed, the first thing one did was to put my shoes on for me.  My shoes have velcro straps, but she had difficulty fastening them, so I joked, “I thought they were idiot proof”.  Note to self: don’t insult the people that could potentially cause you a lot of pain.  I don’t think they were too impressed cause I didn’t see them again after that day.  Anyway, they got me out of bed (it was extremely painful, the blood flow to the knee) and put me in the chair for my lunch, but they said that I was far from ready to go home.  Still on the morphine drip, and taking some oral pain killers too…I think they are Ocxycotin and Ocxycodone, as well as percocets and Tylenol III (now the party in my head is getting out of control, and I am starting to hallucinate).

Friday, August 29th: Dr. Whelan says I should be ready to go home today.  WHAT??? I have not even been able to stand up yet.  I have no idea how I was going to cope at home.  I know Lucas is there to help, but come on, no one should be expected to undertake those kinds of responsibilities.  What was I going to do? They had told me that I had to be able to get out of bed, and use the crutches on the stairs before I could go home.  I told Dr. Whelan I was not ready yet, and he assured me that if that was the case I could stay for the weekend.  I didn’t want to, but felt that I had no choice…who was going to wake me up every 2 hours to give me my pain killers (sadly they took out my morphine drip), to change my ice pack, how was I going to be able to get to the bathroom…so I opted to stay for the weekend.  Later that day, the head nurse comes and wants to move me to the 15th floor because I was stabilized and they needed the bed for new patients.  At first, I thought I had no choice, so I said ok.  But upon further thought, the 15th floor is not an orthopedic floor, the nurses there are not trained for my particular injuries, if I needed anything, they would have to come from the 9th floor to attend to me.  I had this vision of being left in a room totally neglected.  So I called the head nurse back in, and told her that I did not want to move.  As it turned out, she did not make me move.  One of the other nurses told me after that she did not know why they wanted to move me, since there were no scheduled surgeries on a long weekend.

Saturday, August 30: It’s my birthday. I know, I know, I chose to stay in this hell-hole.  But in the end, I think it was a wise choice.  I was given a small piece of birthday cake that I couldn’t eat, compliments of the kitchen staff at the hospital (BTW, I am so drugged up, no appetite…I couldn’t even eat the food my parents brought).

Sunday, August 31: My other doctor, the intern Shane Keetbass, aka Dr. McSteamy (BTW, Dr. Whelan is also known as Dr. McDreamy), came by this morning and was quite surprised to see me still there.  I just had surgery a few days ago for crying out loud.  He lightly smacked my left leg (this is the donor leg, where they took the hamstring and used it to repair part of the damage in my right leg, so this also has had surgery), and told me that I should do everything as normal with this leg, and to start walking on it as soon as possible.

Monday, September 1: It’s labour day.  No activity.  Since I have been in this hell-hole, it has been beautiful out, as if Mother Nature were mocking me.  I am still in a tonne of pain, and still heavily medicated.

Tuesday, September 2: I am outta here.  The physiotherapists finally came back, they have me sitting up, going to the bathroom (at this point, I had not gone number 2 for the entire time I have been here), and so I stayed in that bathroom for a while.  After that they had me go back to bed, they were coming back in the afternoon to take me to the “gym”, where I will attempt the stairs.  It is mandatory for me to go through this excercise before they let me out.  So off we went, I went up 4 steps (quite unsteadily), and came back down.  And voila, I am ready to go home.  But I have to prepare my home…I have to order a walker, a toilet seat, and a transfer bench for my bathtub.  All the makings of a geriatric bathroom.

So now, we are downstairs in the parking lot of my building.  The challenge is to get me upstairs, down the long hall, and into my unit.  It was more of a challenge than my feeble body could handle at that time.  It was all I could do to navigate going up the ramp on my crutches (the walker and paraphernalia was being delivered the next day).  When we got into the lobby, I was already in tears.  Luckily, one of the residents was in the lobby with her husband and children, and they went and got their office chair (with wheels) and he rolled me while she carried my crutches (Lucas had all my other stuff to carry), and brought me to my apartment…thank god for Mia and Gerald.Throughout my stay in the hospital I have had visitors come and go: Dave’s ball team sent me flowers via one of their players, Mike R came by to visit a few times (he works in the hospital), Colin, Heidi, Scott, Scott’s mom and dad (Pat and Stan), Ed, Jim, Tammy, my colleagues, my family, and my rock, Lucas.  Thanks everyone, for coming to see me.

So to sum up my injuries, I had my ACL, MCL, and PCL, as well as my Medial Lateral Meniscal torn.  They call it a multi-ligament knee dislocation.  They used my left leg as donor leg – hamstrings; they also used cadaver parts to repair all the damage.  A Zimmer splint immobilizes my knee completely.

I have pasted the doctor’s findings from my file:

MRI of the right knee.

Findings: There is a large joint effusion.

There is subchondral edema seen within the articular surface of the patella, the distal anterior femur, lateral femoral condyle, and fibular metaphysis.

The lateral meniscus is flipped, such that the posterior horn and the anterior horn both lie anteriorly.

The medial meniscus appears intact.

There is complete rupture of the entire ACL except for several fibers proximally on the femur which appear intact.

There is a full thickness intrasubstance tear of the PCL, with some intact tissue at its proximal and distal ends.

There is a sprain of the proximal 1 cm of the popliteus tendon; however, the tendon remains intact.

There is a full thickness tear the distal MCL, with its distal end lying just medial to the medial meniscus.

There is a tear of the medial retinaculum.

There is a fracture of the tip the fibula, a Result Truncated

Before reset in ER