Surgery

Got up real early (4:30am July 22) and completed my usual chores and my wife took me to the surgery center which is in a shopping mall – doesn’t necessarily give you a lot of confidence if you are going for a surgery in a building between a grocery chain and a Mexican fast food restaurant!  Some of my friends previously suggested that I should ask to be cut in an area hospital instead.  Too late for that now!

So, we go there by about 6:00am and we see one patient already checking in.  I was next and after usual paperwork (!) and payment, at about 6:30am, this nurse brings me inside and after changing into a hospital shirt, they give me crutches and show me how to use them – this activity takes about 2mins.  Let’s see – I need crutches for many weeks from this day and they spend two minutes showing me how to use them; I am given disclosures to sign, which if I really want to understand before signing and which probably have no consequence but legal will take hours to comprehend and sign.  They had previously called me to see if I already had a knee brace which I didn't and they provided one.   

I am given a stretcher kinda bed to lie back and fill in more paperwork.  I don’t understand how this is supposed to help – do you think people go through these disclosures an hour before surgery and then what if they say they don’t agree to those?  I almost wanted to do that!  Anyway, the forms include certain items like the surgeon will use his best judgment to do whatever necessary, etc.  Isn’t it why we go to the doctors in the first place?  Anyway, they ask me which knee was the problem one – which was again somewhat crazy – what if I say it is the other one?  The nurse made a circle with a sharpie on ‘the knee’ and the surgeon is supposed to initial it prior to anesthesia.  I am sure they were just reconfirming!  Prior to this, the nurse also shaves the surgical area while I wonder if the hair there will re-grow thicker.  Another young lady comes in and gets my blood pressure – 120/78 – pretty good for just before surgery I thought!  The nurse then wanted to poke me for IV and I tell him that my veins are hard to find – no matter what he tries twice and gets another nurse to do this right.  Then, the anesthesiologist (doctor) comes in and tells me how it goes.  I remember something that happened the previous day.  My colleague at work was joking that I should pay this doctor more or he may not bring me back.  After a little while, another anesthesiologist (assistant ?) comes in and says that he will be taking care of me.  At this point (and also periodically) I wonder what if they give me anesthesia and I may not be able to do anything but still feel the pain and know what’s going on around me?  I have read some stories on this subject on internet.  Oh, well!  It seemed like there was more than one surgery scheduled at the same time and the activity in that room was quite hectic – about 20 nurses, assistants, and doctors spilled in all over.  It seemed like a production environment with things moving really fast with precision.

About this time (say 7:00am), they bring my wife in and I could see she was concerned but was trying to put up a brave face!  We talk about kids activities for the day (it was last day of summer camp for them) and so as not to think of what was coming.  In the meantime, more papers were provided with details on what happens during anesthesia and also post-op instructions.  We try to make sense of it while the reality of the surgery is sinking in.  Around this time, the surgeon comes in and after a brief introduction to my wife, he initials the circle on the knee.  He briefly goes over the intended procedure and tells us that he will have pictures for me.  Due to my skepticism about the ACL tear, I say that hopefully ACL is fine to which he responds something like – he will be surprised if that’s the case.  He gives post-op directions as to when and how long the CPM should be used, pain medicines to use, when to come back, etc.  He also asked me if I got the ice pack and when we said no, he said he recommended one.  I asked him if they had one and he said I will be fitted with one and I should make the payment ($250) at the front desk.  The nurse brings the ice pak made by Breg (Breg Kodiak Intelli-flo knee pad).  Then, another young lady comes and reconfirms my name and DOB – lest someone else be sneaked in for surgery instead of me – right after check-in.  They also infuse antibiotics at this time and around 7:20am or so, I start to get some shivers and they said they are normal (or are they pre-surgery jitters – I do not know).  This is supposed to be an extremely hot day (turned out that the temp. records were broken during the day) and it was freezing (felt like it) inside.  So, the anesthesiologist (I hate typing this word) assistant comes in and gives Valium and tells me that within about 30secs I will feel better.

It is almost 7:30am now and I am trying to calm myself down.  That’s basically what I remember.  The next thing I know, the nurse is shaking me pretty vigorously trying to “wake me up”.  I guess the surgery was done!  My wife was next to me and the nurse (in her hurry to get me out of there) was asking me if I want to drink anything (I am groggy and could barely comprehend anything).  She also wanted to know how I got this injury.  I am blabbering something at this time.  In any case, she said everything went well (didn’t see my doctor or anyone else at this point) and I see that my t-shirt was on (I had to change into one of those hospital shirts when I went in).  She asked my wife to pull-in the van and got me out of there in a real hurry.  I am still groggy and they give me crutches and got me into the van.  Anesthesia (again) is a great thing – just amazing how it works.  I wonder how things were prior to this great breakthrough.  My wife tells me that I was talking to the nurses and they were joking and I was laughing and I said bye to my wife when they were wheeling me to the operating room, etc.  Not a clue of any of this. 

So my wife waits at the surgical center, and at 9:00am sharp, the doctor comes out and asks her to go inside.  He tells her that the surgery went well and that the ACL was in worse shape than anticipated (I guess he had another baseball practice when I was under) and that the meniscus was not as badly torn.  So, in a way it was good news and that two of the radiologists were correct and the MRI center radiologist (full tear) was also correct in the sense that if the ACL is torn to an extent that it is of no use then it is considered a full tear anyway.  But, two of the other radiologists were off.  Can’t blame them, they didn’t have the benefit of clinical diagnosis even though the other two who got it right didn’t either!

The timeline given to us prior to surgery was that we arrive at 6:00am, the surgery will start at about 7:30am and will take an hour-and-a-half followed by an hour in the recovery room.  Guess what, that’s exactly how it went – by the minute.  It was almost like they wanted to stick to that schedule as the nurse literally pushed me into the van at 10am!  Besides my sarcasm, I think the whole process went perfectly for me except that I wish I had another hour or so in the recovery room as I didn’t have my bearings in place for that long.  Got home and was somehow able to use crutches to get in and lie down in the sofa.  My wife bought me a La-Z-Boy chair that I intend to use a lot but not right now.  With little time to sleep the previous night and with all those drugs in the body, I just want to sleep.

Well, besides my comments (may seem like complaints), that are intended to be my observations during the surgery, I am extremely happy how it turned out thus far.  Still long ways to go, but it was a great start.