Chondromalacia

I had my post-surgical appointment with the orthopaedist today and everything is in order. He showed me the images from inside my knee of the problem and the repair job that was done. Basically the cartilage under the patella or kneecap was damaged- the image showed it looking as if it had been shredded! Chondromalacia is the term usually used to describe damage to the cartilage under the patella and it generally affects young people who engage in physical activity. I have to do physical therapy twice a week for eight weeks which should help me regain full mobility in my knee. At the moment it is quite tight and I cannot bend or stretch it out fully. I also have some pain that varies between mild discomfort and bad and which he said would take time to go away, with some days being bad and some being good! I have had a few rough nights already and I hope that is the worse it gets. He said I could go back to work next Monday, the same day I see the podiatrist and once he gives me the all clear, I will be back to work on July 23rd.

It has been six months now that I have been home! I honestly never thought I would have been away from work for so long when the MRI results in January showed a torn tendon in my foot! I am thankful to Allah that the problems with my foot and knee were diagnosed and that unlike millions of people around the globe, including right here in the richest country in the world, I have been able to receive treatment. The next step is to work on strengthening the different tendons and muscles in and around my foot and knee while avoiding over exertion. It will probably still be a while though before I can go back to the gym and resume my training programme.

Surgery!

The surgery went well yesterday morning. One minute I was on the operating table and the next I was in the recovery room! The lead up to the surgery was the nerve racking part. I got to the hospital around 6:15 am, checked in and waited to be summoned inside. There were quite a few people in the waiting room at that early hour, some scheduled for surgery and some accompanying them. After I was summoned to a little room, I was visited by a number of people: a physician’s attendant who asked me a number of questions about my medical history and lifestyle, a nurse who give me my hospital clothes and explained to me how I had to wear everything, another nurse who took my vitals and asked me questions about medical history, a nurses aide who shaved my knee, the orthopaedist who went over what was going to happen and what I should do after the surgery until I saw him on Monday, the anaesthesiologist who also asked me questions about my medical history and lifestyle and discussed the anaesthetic options and finally one of the nurses who was going to be in the operating room who asked me a few questions and signed some forms. Most of the others also had me sign various consent forms and in between I was asked to change into the hospital outfit. After that I was led to the operating room nearby where I climbed up onto the table, got the intravenous drip inserted and asked the anaesthesiologist how long it would take before I went to sleep; when I woke up I was in the recovery room with an oxygen mask on my face!

The anaesthetic options were either regional where I would be numb from the waist down or general where I would be asleep. While I contemplated the regional so I could view the procedure on the monitor, the anaesthesiologist said that there was only one monitor in the room I would be in and so I would not be able to see and that recovery from the spinal anaesthesia was longer than from general. We therefore decided on general.

I woke up with some pain in my knee and the nurse reluctantly gave me some morphine. I was groggy so I can’t recall if she give me more when I complained again about the pain but I do remember her saying that they didn’t want to give me too much morphine because it would make me sleepy and I was already woozy and they wanted me to be able to leave shortly! The orthopaedist came around to see me while I was still a bit dazed so I am not too clear about what he told me. Subject to correction he said something about shattered pieces of cartilage which he had to remove. When he passed back he said he would discuss it with me on Monday. Overall the service and care was excellent and very professional. After some crackers and juice and a trip to the bathroom- they have to make sure everything is functioning before release- I was able to leave with my friend who came up to meet me.

So that was my surgery. The orthopaedist prescribed some Percoset but warned me not to take any unless it was absolutely necessary since the drug is addictive and has narcotic properties. I was given me this contraption like a cooler which is filled with ice and water and via a hose circulates cold water through a cooling pad on my knee. It has to be worn for three hours, followed by a one hour rest and then worn again for three hours and so on. I have to remove the bandage on Saturday and take a shower.

Surgery Early in the Morning!

My knee arthroscopy is tomorrow. I have not really been thinking about it much and actually just wanted it to be over and done with as the pain in my knee has just been increasingly getting worse. However when the hospital called me around 5 pm today to give me the time of the surgery and the time I have to get there etc it hit me that I was going to be on an operating table in less than twenty-four hours! The procedure is scheduled at 8:30 am and I have to report to the hospital at 6:30. Thankfully the driver from work will take me. I should be ready to go home around 12:30/ 1 pm so a friend will come to the hospital around that time and will call the driver when I am released to take us back home. I have to stop thinking about it before I get too nervous! I am a bit of a loner and prefer my own company but it is at times like this that you miss your family!

Arthroscopy and Indigenous Sacrifices

I went to the orthopaedist on Tuesday. I saw a different one who came to the same conclusion as the first- the ongoing and worsening pain and the laxity in my knee was a cause for concern and an arthroscopy would shed some light about the cause and also allow for proper treatment. I am therefore scheduled to have the procedure done on July 11th. I am due to go back to work on the 9th but I also have to see the podiatrist the same day so he can give me the all clear. Obviously I will not be going back to work until later in July now that I am having surgery on my knee!

In February I had written a post about environmental dilemmas and I came across an article today that markedly highlights this predicament. The Madidi National Park in Bolivia is rich in biological diversity and indigenous culture. It is also rich in natural resources and is therefore being viewed as a source to drive economic development for the entire country. While the notion of the collective good and economic prosperity for all is lofty, the issue of irreversible damage to the environment and native culture is just as critical. For centuries, indigenous people have had to pay the price for the desire of other people to enrich themselves and the cycle shows no sign of stopping.

Arthroscopy of the Knee

While everything has largely been going well with my foot recovery process, the pain in my knee has not decreased and has worsened as I put more weight on the foot and do more exercises at therapy. It reached a stage where it was difficult to fall asleep at night and so I took a trip to the orthopaedist on Monday. He did x-rays and neither those nor the MRI from January explain why the pain is so severe. He now wants to perform an arthroscopy of my knee to enable him to diagnose and treat the problem. For those who don’t know (and I didn’t either until he told me) it’s a minimally invasive surgery that allows the surgeon to diagnose and treat problems without open knee surgery- a few small incisions are made through which an arthroscope (pen shaped instrument which has a tiny video camera and light source attached) is inserted, allowing the surgeon to view inside the joint and if necessary operate using small instruments inserted through tiny separate incisions. As arthroscopy only requires a few small incisions, there is usually no need to stay in the hospital more than a few hours after surgery, the healing and recovery process is much quicker and there is not much scarring. Most patients are able to return to work within a week and once all the post surgery recovery exercises and steps are done, full recovery is expected.

This all sounds rather straightforward but it is a surgical procedure, something which I am not exactly enthusiastic about! I was relieved that the tendons in my foot healed without surgery but now my knee has decided to be stubborn! The doctor’s office has scheduled the arthroscopy for July 11th subject to insurance approval, but I have not yet made a final decision on if to have it done- while the pain I am feeling has me leaning towards the surgery, I still have some doubts. I am scared that I may not be able to run, play cricket, swim, scuba dive, work out at the gym or do all the travelling I plan to do in the future. I have been doing research and I also plan to go back to speak to the doctor about the lingering doubts.

As if my knee’s misbehaviour isn’t enough my foot has been hurting more than the usual since yesterday evening and today I started using the cane again to take some of the weight off of it. I can definitely see myself taking a painkiller tonight to help me sleep.