Thursday, September 25, 2008

Surprise, Surprise!

Today is my first full day of my sitting around the house staying off my feet in the name of surgical recovery. I have to admit that I'm not very good at it. Consequently, I've been more ambulatory than I might supposed to be, but the doctor told me I could put as much weight on it as I could tolerate. What he didn't know is how restless I am and my remarkable tolerance for pain.

To describe the surgery in a little more detail, it was supposed to be a repair or trimming of the right lateral meniscus on my right knee, a knee that has seen its fair share of slicing, dicing, and bacteria. The pre-surgical MRIs revealed a lotof black and white "stuff" inside my knee, things the untrained eye would have difficulty making sense of, but what my doctor told me looked liked "an irregularity in the vicinity where I had described the pain." I'm glad he knew at this point I wasn't making up the entire scheme simply to get my "surgery on my knee" card punched again (the 10th one's free, I believe!)

The MRI did reveal some dark cavities that were remnants of my ACL repair-attempt surgery 4 years ago, oh the nightmare. After a successful hamstring graft, the new ACL was coming along great when after several weeks, the severe pain and swelling that occurred overnight meant I had an infection. Immediately thrown back into surgery for and "irrigation" and "debrisment" which means "cut me open and wash everything really good," I was in the hospital for several days and was taking powerful antibiotics through a peripherally inserted central catheter (picc) line, as I would continue daily at home for the next 6 weeks. The infection left, my knee was getting stronger, then suddenly . . . .

. . . the severe pain and swelling that occurred overnight meant I had an infection . . . again. It had returned, and this time with a vengeance. Thrown into surgery again, this time the doctor removed everything from the first surgery, the hardware and the graft, or so I was told. With the bacteria hiding inside my knee on the titanium screw used to hold my new, healing ACL in place, the only option was to get rid of it all, lest we risk yet another infection or even death. With another central line, nearly a week in the hospital, and another 6 weeks of intense Vancomycin antibiotic through another picc line, the infection finally went away, and was left with some ugly scars, major bills, and an ACL-less right knee, again . . . . or so I had thought.

During yesterday's surgery, I gave the doctor permission to do whatever course of action he needed to take to get me back to where I could run again. He had a blank check to prod, poke, drill, scrape, glue, tattoo, or anything he needed to do. I wanted this to be my last surgery, and I wanted to run. I also paid that extra $10 for the sterile "bacterial-free" operating room. We also agreed not to insert another ACL, since the apparent scar tissue from the previous 3 surgeries was acting like a "virtual" ACL, holding my knee in place remarkably well. The torn meniscus was not as big a tear as we had thought, so the excess was simply trimmed away. He did, however, discover a couple of things inside he didn't expect to find.

Behind my patella, there was some damaged cartilage, simply from wear and tear, and indication that my knees were in fact not the most suitably designed patellas for a runner. That would explain a lot of developing pain in BOTH of my knees prior to the accident that damaged the meniscus. He was able to trim that up rather nicely, although it had some very dire consequences as far as I'm concerned which I will get to shortly.

The biggest surprise of all was that there was, in fact, a sliver of the original ACL graft, not the entire thing, but a thin band that was doing its best to hold my knee together. This puzzled everybody. I distinctly remember being told on my third surgery with the infection that "everything came out," and that is was heartbreaking to remove the graft because "it was looking so good." I don't see how I could have misinterpreted that statement, but apparently I did. We're guessing the bone had ossified enough around a portion of the graft that it was able to remain even with the supporting hardware removed! That would explain why I was able to run my marathon, much to the amazement and bewilderment of myself and everyone who thought I was an ACL-less runner.

I have to say that I am actually very, very relived to know that of those horrible three surgeries, with all the time, pain, heartache, drama, and money, that a sliver of the purpose of them all remains inside of me. I'm comforted to know that I DO, in fact, have slightly more than scar tissue holding my right knee together, although I am still left puzzled over how that could have been miscommunicated to me and my wife.

Anyway, today I'm in very little physical pain, even though I can still see, feel, and smell the seepage that is oozing from the surgical site. I'm getting comfortable wearing these "man hose" over my legs, although it's a look I don't think I'm going to keep.

So back to the fallout of yesterday's surgery and the implication of the unexpected patellar cartilage damage. I'm done with running. That is running every day. Running for life. Running for fitness. Running for pleasure. Running for peace of mind. Running for good. The doctor said with the continual pounding, my knees would continue to grind away at the cushioning cartilage behind them, causing more pain and more deterioration, which would mean more quick-fix surgeries until there was nothing left to trim. Not a good scenario.

I still haven't come to grips with this yet. Getting back into running was the whole reason I braved this surgery to begin with, and now it's been the one thing that will trigger the end of those days. Sure, I can bike. I can swim. I can walk. I can run on an elliptical. But none of those is running, and none can take me where running could: weaving around the sidewalks of downtown, around rivers, through trees, and parks. All I needed was a gym bag in the back of my car with a water bottle and my running shoes and I was free to set out from anywhere at any time.

For now, I'm glad the pain in my knee is gone, or will be gone, and I don't want to do anything that will make it return, I just don't know if I'm ready lifestyle change that comes with the artificialness of running on a treadmill or the silly, awkwardness I feel on a bike. Besides, I know how inhospitable drivers of automobiles can be to bicyclers. As for swimming, the cheapest health club with a pool is $60 a month, and my tub is too small to swim laps in. I guess the only thing that comes close to what I want to do is speed walking. Hey, it IS an Olympic event!

Any ideas?
Speedwalkers look almost as funny in still-frame as they do in real-time.


Anonymous said...

Hey, I won my age bracket in a speed walking race a long time ago. You better check with the doctor first.

Speed walking is cool !!!!

kwkorpi said...

Yeah! speedwalking is cool if your at a swimming pool and have to go to the bathroom. It gets you to the restroom the quickest way possible without having the lifeguard blow his whistle at you.

Congrats on your 1st place medal. Maybe I'll start walking competitively? Look out 30-somethings . . .