Saturday, January 11, 2014

Knee stress

After the news about my surgery last week I had a lot of strong emotions, I just wanted to go home crawl up in a ball under a blanket and cry, yep that was basically it.
But we (I went to the hospital with my mom) had a lot more scheduled that day, so I just had to suck it up, something that I’m pretty good at in general.
We went and checked out the rehab hospital in Amsterdam, I didn’t like it, but mostly I didn’t like the idea of it at all, all in all Amsterdam is a no go for those 6 weeks of rehab. Luckily I had 2 options. After that it was time to go to physio, I told her the plan and broke down and cried, I was mostly upset about the long period that I had to be admitted in a rehab hospital. She comforted me by telling me we would find a good place where I would feel okay.
After that we went to my grandfather and all in all it was a long day and I was exhausted by the time I returned home.

By that time I got in a state where I didn’t want to talk about at all, I just wrote my blog and that was it for a few days. I continued the prehab with physio, to get me in the best place possible for surgery. But my knee gave out again,….. it is getting lame, come on you can make it, it’s just 3 more weeks. I have been in an increasingly amount of pain and have been put on painkillers and anti-inflammatories to keep my knee happy and calm. Walking is not really happening anymore these days, well I guess I’m just easing into the stage where I can’t use my leg for 6 weeks. And it is harder than I thought since the other leg is of no use. So I do realize that those 6 weeks in a rehab hospital are extremely necessary, there is no way I could do it at home, safely.
I checked out the other rehab hospital this week and I liked that one better, so I guess I’m starting to feel better about the whole thing. Heliomare is near the beach and has younger patients, the whole atmosphere in general just made me feel better, and there are a lot more sporting options.
Wednesday I had my consult with the anesthesiologist, talking through my options and what I wanted. General anesthesia, that is clear there is no way I’m staying awake for this one, way to stressful considering what happened in 2007. They wanted to give me a nerve block for the postop pain but the surgeon doesn’t want that because he can’t test my nerves that way.



And that just makes me a little stressed, I have felt calm about the procedure itself, comforted myself by saying it won’t happen again. But the truth is that even though chances of it happening again are slim there is no guarantee. The doctor has been honest about that, even though they have an idea why it happened they are not sure. The surgery in 2007 left my right leg paralyzed, the surgery took approximately 100 minutes during  that period there was no blood flow in my leg, my muscles didn’t got enough oxygen got ischemic and died.
So 100 minutes of surgery can’t be done, but with a good planning that long won’t be necessary, but how long is safe for me? How much can my muscles take? A hundred minutes is considered long for ACL surgery, most ACL surgeries won’t take that long, it also is the maximum amount you can have a limb without circulation during surgery.
So in general 100 minutes is safe, borderline, but safe…. Not for me apparently. The thing is no one knows how long is safe for me, it is to be expected that I should be ok if they manage to drastically decrease the amount of time without blood flow. That’s why we chose for a procedure with a donor graft, they can prepare that graft beforehand and that way save a lot of time. Normally they will take a graft from either the hamstring or patellar tendon and prepare a new ACL out if it during the surgery, with a donor graft I save that chunk of time.
Doing the surgery without the tourniquet so with blood flow isn’t safe because the visibility is not good enough and I will lose a lot of blood that way.
I trust this surgeon a lot, and if anyone can do it he can. But there is no certainty and that makes me stressed. And I guess I started realizing that it freaks me out when they explained me that I couldn’t have a nerve block for pain control, because the nerve testing is more important than the most effective way of pain control in my case…

Well I will have morphine and be very enjoyable for other people.

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