Friday, January 28, 2011

Ankle Arthroscopy ( Physical Therapy Day 1)

The first day of physical therapy saw another small storm system drop a few more inches of heavy wet snow onto the area which was just enough for me to call and confirm that the therapist’s office was open.

After I received confirmation that the appointment was still on I looked at the clock and realized that I would be cutting it close with the additional hurtle of removing all of the new snow off of our car.

But then I always haven an ace when it comes to snow, and since my wife wasn’t going to work she obliged me with getting my act together so that we made it there on time.

You know how you talk to someone and a little bit of them and then a little bit of you will trickle out into the details?

This was the case of our conversation with the receptionist, a stylish lady who gave me a glimpse of her past which happened to coincide with my present, which showed me yet again just how small the world really is.

Onto my therapist, who was working as a “stand in” (if you will), for the person I will be assigned to for the remainder of my P.T. sessions.

An auburn haired and bespectacled gem that was quite the character in her own right, she simplified the process for someone like me who doesn’t always pick up on the subtle hints on how to heal.

She was wonderful as she quickly identified and entertained the fact that I am the sum total of a child yet still trapped in a man’s body and that it takes a fair amount of scolding for me to get the point of what I need to do for recovery.

In her paisley “Dansko’s” she took measurements of my ankles to show me what I needed to work on and just how much range of motion I had lost, and then before I knew it she had given me some home work for “range of motion" exercises and sent me on my way.

(Many people in this process have told me that I needed to do these things, this therapist was the first to explain to me the "why"...)

In the amount of time that it took me to gather myself and put my “Robo-boot” back on, my wife and several of the therapist had conspired to restrain me from what I would like to and developed a plan to make me focus on what I had to do to recover.

This story continues with the fact that while I have had a common surgery with a common recovery, I have met some uncommon people along the way…


The "goniometer" used to measure "range of motion" for my ankle

Tuesday, January 25, 2011

Ankle Arthroscopy (Back to the Real World)

Monday of this week saw my status at work change from being on “sick leave” to being on “light duty”.

I have never sustained an injury that put me out of commission for 6 weeks, and I have accumulated hundreds of hours of sick time over my career. (I’m talking like 600 to 700 hours worth).

So this is in fact my first rodeo at this level.

When I was down at home for around 3 odd weeks, everything was surprisingly cohesive and I actually settled into the fact that I was recovering from surgery. It was actually Ok to be “down and out” at home.

Now, I gave at least a months’ notice of my impending surgery to the”powers that be” and I assumed that the situation was a pretty nonchalant affair based on their reaction.

However my very first day back on the J.O.B. was a swirling mishmash of confusion as if the watchman for the Titanic had sounded the alarm for a ship that was ultimately doomed to the bottom of the sea…Ok it wasn’t that bad but pretty good imagery right?

At any rate, I spent the majority of my first day back and a good portion of my second day jumping through the proverbial hoops of administrative bureaucracy.

When it was all said and done I had provided a fancy incarnation of the venerable “Doctor’s note” to our “Occu-Med” people, our “safety officer”, the Department of Human Resources, and some guy selling radios out of the trunk of his car.

My first Physical Therapy session is Thursday of this week and I’m actually quite curious as to what they will have me do.

Look for a follow up post Thursday eve.


Thursday, January 20, 2011

Ankle Arthroscopy (Day... hell if I know.) "Return of the Unicorn"

An artistic rendering of my drug induced request for a unicorn horn post op courtesy of my brother’s daughter.

Word gets around, but really? These beast are mythical creatures held in high regard in the fairy tale community so I don’t understand what all the fuss is about. I think it was a legitimate request under the circumstances…

Today I had my stitches removed, sans the one I managed to pull out at some point.

The Doc was curious as to why I was no longer wearing my “Robo-boot”. I couldn’t think of a good explanation so I resorted to mumbling incoherent reasons under my breath.
The Doc was on to me, and he knew I would stray from the path of rehabilitation.

So in short here is the outcome of my visit with my physician.

I am back in my boot for at least 2 more weeks.
I have Physical Therapy twice a week.
I am NOT allowed to clean my garage again.
I'm NOT allowed on ladders...
I actually have to wear the boot.

I didn’t tell him about my dancing episode because the unicorn has to boogie!!!

Wednesday, January 19, 2011

Bark at the Moon

I interrupt the "excitement" of my ankle arthroscopy for a brief post on the virtues of celestial bodies, specifically those endowed on this evening’s full moon as it cast a blue-white spotlight on the slender pines as they yawed slowly back and forth in the night air.

In the distance hounds howled in a symphony as everything took on a certain wildness that can only be realized when the moon is at its fullest.

If only for but a moment the bitter January air yielded to a milder wind that pushed translucent clouds across the moon's face creating ever changing images of light and shadow.

To the Moon and all of it's phases, Wild indeed...

Tuesday, January 11, 2011

Ankle Arthroscopy (Day 7) "The Waiting Game"

Seven days in, I expected this post to come at around 2 weeks, but here I am sitting on my duff having completed my mandatory "range of motion" exercises for the day with the rubber band that I smuggled out of the wife's work out room...(Ok she surrendered it willingly)

Between exercises I couldn't resist stretching the band to its full length like a bow with my ankle then launching it at my dogs who went crazy at the sound of it flying across the room.

Looking at my foot and ankle I’m really surprised at how much bruising there is. For whatever reason I did’t think about bruising when it came to the surgery and afterwards.

The Doctor indicated that the femoral block would get me “over the hump” for the majority of the post-Op pain, but I’m experiencing some pretty good shots of it throughout the day.

I was working on something at the house and accidentally folded my toe into the hardwood floor and it crippled me to ground in seconds, pretty severe, and unexpected to say the least.

But being down with an injury doesn’t mean that one is out, and I managed to find a few old CD’s which led to an impromptu jam session and some “Random Acts of Dancing” as I boogied peg leg style. (Picture the scene in Forrest Gump where he starts dancing to Elvis Presley’s guitar playing)

 ”You got new legs Lieutenant Dan”!!!

Monday, January 10, 2011

Ankle Arthroscopy (Day 6) "First Follow Up"

Monday found me back at the Orthopedics office for the first of several follow up visits after the surgery.

As I negotiated the 3 flights of stairs from the parking deck to the entrance of the facility I chuckled to myself as to whether or not I would qualify for a coveted “handicap” parking spot closer to the sliding doors.

As I cleared the final landing in the stairwell, my momentum got the better of me and I almost went for a "ride” down the last section of steps creating quite a racket with the aluminum crutches.

I laughed out loud and muttered a choice obscenity as I caught myself on the hand railing.
At the bottom of the stairs just out of the trajectory of my stumbling there was a female chatting on her cell phone.

While I’m pretty sure I sounded like the Tin-Man from the Wizard of Oz as I struggled to regain my footing, the women not once looked up nor acknowledged my presence during my acrobatic routine.

As my hopes of receiving a judge’s rating of “5” for execution faded I cruised on by not wanting to interrupt her conversation.

“Clop, Clop, Clop” through the lobby, onto the elevator, and up to the receptionist’s desk where a pleasant office assistant handed me a clip board with the same form I have now filled out no less than 3 times and a pen.

“Waiting Room 5”….all the way at the end…Awesome!!!

“Clop, Clop, Clop” 2, 3, 4…Damn It! Dropped the pen…

I would estimate that there were five to seven people who were present in “room 4” when this occurred.

Granted I moved "lighting quick" for a man on crutches in the recovery of my pen, but no one budged, nor did they offer.

Over my right shoulder I realized there was a television hanging off the wall and that everyone was content where they sat.

The Doctor explained that he shaved off some scar tissue from my talus bone and cleaned up a few other things floating around in my ankle. My big toe received the same treatment and everything looked “good to go”.
“Looks good, start working on range of motion, you can walk on it when your ready, see you in 10 days to get those stitches out”.

I must say I’m bit perplexed as to what part of the recovery will take 6 weeks, but my intentions are to try and follow the Doc’s advice to the letter and not get ahead of myself.

Now for those toe curls…

Saturday, January 8, 2011

Ankle Arthroscopy (Days Three & Four)

So the effects of the "femoral block" wore off and I started getting sensation back in my ankle and toe.

My big toe came back from his "post-Op" slumber pretty grumpy, and he definitely let me know about it.

I would give the pain a 3 or 4 on the pain scale and it ranged from a dull throb to a sharp piercing pain depending on how I moved it in the "Robo-boot".

I joke about the fact that I was given the pain killer "Oxycodone" for pain management, but to be honest I have taken only 4 pills since the surgery on Wednesday as I don't like having the stuff in my body.

The way I look at it is if I can stand the discomfort in a controlled environment like sitting on my couch at home, then I am actually participating in "pain inoculation". The idea being the more comfortable one is with being "uncomfortable" the better you will perform when the "chips are really down" in a far less ideal environment.

Some people who see this will understand exactly what I mean. You can't know how you will respond under stress or injury if you never put yourself in that position.

Anyway, I'm sitting here at "day 4" propped up, relaxing with little to no pain. I won't post again about the ankle until Monday unless something out of the ordinary occurs. (Like me falling flat on my face trying to hop to the bathroom last night at 2:00am after my hand missed the bed railing, THUMP!! I'm down!!!) Good times.

Vintage Rock for your listening pleasure;

Ginger Baker, Jack Bruce & Eric Clapton... "Sunshine of your love".

Friday, January 7, 2011

Ankle Arthroscopy (Day Two)

DAY 2:

Day 2 was a bit rough as my body was still waning itself off of the anesthesia which made it difficult to sleep.

From 8 am on the day of the surgery to around 11am the following day I probably got around 2 hours sleep.

The only real adverse reaction I have had thus far was that my cheeks became flush similar to a sun burn as a reaction to the anesthesia.

The femoral block that the anesthesiologist administered prior to surgery was still working and I would describe the feeling as if your entire leg were asleep. No feeling or sensation in my foot or toes whatsoever.

The first requirement “post op” is to keep my foot elevated for 72 hours. Sounds easy enough, but I’m not one to lay there in bed prostrate, so I usually end up on the couch for most of the day.

From this point I’m going to start describing my pain and comfort levels on the “1 to 10” scale that you typically see used at the hospital.
On the second day there was no pain, and my only discomfort was a result of sitting there with my leg up…All day.

They say another snow storm is on the horizon for next week so as I sit here typing I’m wondering if my gamble of putting the surgery off until 2011 is going to work out after all.
There’s probably never a “good” time for something like this, and it’s always going to shift the burden somewhere else.
The funny thing is that my wife recruited my own mother to keep “over watch” on me during the 72 hours of foot elevation, so at 38 I’m back to taking orders from my mom. (So is "The circle of Life")

Another area I’m going to cover is the financial aspect of having the surgery;

Here is the break down so far;

2 Consultation visits at $40.00 a visit “Co-pay” with insurance.

No Co-Pay for the initial X-rays. (Covered by Insurance)

$100.00 Co-pay for the MRI prior to surgery

$300.00 Co-Pay for the actual Arthroscopic surgery
Sum total of $480.00 “out of pocket” thus far.

Thursday, January 6, 2011

Ankle Arthroscopy (Day One)

THE ankle surgery is a done deal and I was really impressed with the level of competence, efficiency, and affability of the staff and Doctors.
So my plan is to do a “running journal” here on the blog of my experiences with ankle arthroscopy and the process of recovery. I’m also going to try and convey the details via a “photo essay” as well.

There may be an actual video of the procedure, but I don’t know that I will be able to get my hands on it. That being said, I’m going to use a mix of photos that I took with some “file photos” from the web to paint a picture of the experience.

The next step in the process is a follow up visit with the Doc Monday to change the bandages and such.

{Throughout the post I have used the term “nurse” and “Doctor” to describe my caregivers, though I am sure this is not an accurate description of their individual titles. I came away with a healthy respect for them regardless of their positions in the hospital.)

-On a side note; When I describe the female nurse as “a tall blonde” that’s because she fit the profile, So to the guys; get your minds out of the gutter, you filthy beast!!!

Here is how the story begins…

Day 1:

My wife and I weren’t in the waiting room of the Ambulatory care Center for a hot minute before a tall blonde nurse called my name and took me back to my “room” and instructed me to put on my obligatory hospital gown and the accompanying hair net. (More on the hair net later)

She put the IV in my left hand telling me that I had “great veins” along the way, and I was ready to roll.

I was told that I could keep one sock on the foot that was not to be operated on; and I thought to myself how ridiculous that would look so I opted to go with bare feet, “because a man in a gown with a hair net and one sock was considerably more goofy than a man barefoot with the same right?…

I went over my surgery with the Doc who can be described as a super laid back fellow, so much so that it can be disconcerting when you first meet him, but rest assured he’s a good guy.

After a brief consultation I opted to have some additional work done on my big toe, “That’s right… my big toe”.

Shortly thereafter I was introduced to the anesthesiologist, a guy with a full beard, piercing eyes and a wicked cool disposition.

He and the blonde nurse did several things to me that included a “femoral block” and another “block” for which I can’t remember the name. These would help mitigate the pain later on.
(More on the blocks on day 2)

Then the real fun began…

I heard them utter the words of giving me the “cocktail”, and from that point on I was “good to go”.

They took great care of me and asked me no less than 15 times to repeat which foot I was having the surgery on. I recall the anesthesiologist explaining to his peers that I was a “happy drunk”.

Things began to get fuzzy from here but there were some really odd occurrences that I find absolutely hilarious.

At some point I began asking the staff if they had yet to see the Movie “The Spirit” because for whatever reason in my altered state I associated my surgery with the “human headed foot” that Samuel L. Jackson’s character the “Octopus” created in the movie.

During that scene “Octopus” stared in bewilderment at his creation as it hopped around while he muttered to himself “that is just damn weird”.

Now imagine a guy on a gurney doped up and trying to explain the correlation of his surgery and the movie to several Doctors…I can assure you that my composure continued to devolve from there.

Shortly thereafter I was being wheeled down the corridors to the operating room, and I remember asking the nurse how I would go about getting a cooler hat than the one I was wearing, (Hair net) as hers was multicolored and cloth. She indicated that I would have to stay there with them if I wanted a better hat… fair enough.

I recall speaking briefly with another nurse, female, blonde as well, wearing dark rimmed glasses and sporting a nose ring. I thought to myself, “punk rock nurse, cool as hell”, but I don’t think I conveyed my admiration verbally…then again.

We made our way into the “OR” which seemed like an excessively bright cavernous and unusually cold room and from a distance I noticed a burly solid looking guy sporting a woodland digital camouflage hair net.

I couldn’t help myself…and I blurted out “That’s what I’m talking about! that’s the hat I want” Marine digital camo”!!! (Don’t ask why I know this)

He responded with; “That’s right 8 years in the Marine Corps”.

“Cool as hell”, I thought again.

I was moved to a much smaller table where my arms were spread out to my sides and I remember seeing an older gentleman with an “Alabama” hairnet to my right. I don’t believe we spoke.

As I laid there staring up at the ceiling I was given several instructions for which I have no recollection, but then a set of eyes peered over from behind my head, absolutely stunning eyes reassuring and kind, the best kind of eyes to gaze into if you’re going to be in that position.

I don’t know who she was, but I gathered that she may have been the same brunette nurse or Doctor that I had also spoken with earlier about what I do not know.

Her voice was quite soothing as well, but our contact was brief and the last thing I recall was her placing the oxygen mask over my face and then I was out.

I believe the surgery ran around an hour and a half total though I can’t say for sure.

I “came to” later in a recovery room and the same folks were there attending to me. (Looking back there seemed to be a bunch of people involved in the procedure).

Ash was waiting for me as well and as I drifted in and out of consciousness I jovially ranted on about how the staff hit my foot repeatedly with a rubber mallet during the operation…(This of course didn’t happen)

As things went on in recovery I requested that the staff give me a “unicorn horn” poking out of my head for whatever reason, because I suppose unicorns are cool?..

Then Ash, who was there throughout the operation, informed me that as I got dressed back into street clothes I proceeded to make a sock puppet with my right hand and continued to explain to the “punk rock nurse” that “Steve” wasn’t there every time I was asked a question. (A sock puppet, go figure)…

I do recall someone asking my wife if I was always like this, and that her reply was “No, and that I was usually quite serious”.

Another short pleasant brunette nurse wheeled me out to my car as Ash pulled around and helped me into the vehicle and we were off to get the prescription filled for the pain meds.

I am now equipped with a bad ass black Robo-boot that will stabilize my ankle for at least 3 weeks.
I wonder if you can get them in clipless?

Sunday, January 2, 2011

Exit the Tiger

SO I missed this post by 2 days as we bid farewell to 2010 " The Year of the Tiger".

New Years rang in quietly at our household, the roll of the dice saw me on call for the end of the year.

2011 will put me at 4 years in my current position of my professional career that has spanned 13 years.

(That's 3 years longer than expected).

My first few months in the position were absolutely "trial by fire" as 2 of the people I dealt with both passed away in tragic events. One at the beginning of  their career, one near the end. Both as a result of the consequences of their individual actions.

Emotions can do some wicked things if you don't keep them in check,but they are also the first thing one remembers after an event, and what we base our reflections on at the end of a year.

How many times have you said to yourself after a significant event, "I remember feeling like..."

For instance;

-At my wedding; I felt that beyond a shadow of doubt I was making the right decision regardless of the turmoil that swirled in the background as is often the case when two families come together. (I remember this feeling like it was yesterday).

-When our Pitbull Blitzy passed away in 2010, and the horrible feelings I had of helplessness as we battled unsuccessfully with her cancer, and  the resolution of having to put her down.(I remember this even when I don't want to).   

-The reoccurring feeling of freedom and that "can't quite describe it" emotion you get when your rolling through the woods on a perfect trail with that perfect line and the residual effect of what we will do time and time again to reproduce those feelings that let us know were still alive. (I try to make more of these memories when I can).

Going into 2011 with an impending ankle surgery was the plan all along, but it doesn't remove the "feelings" of anxiousness that comes with it.

So I suppose my "New Years Resolution" for 2011 is to live in such a way that will cultivate as many memories of feeling "alive" as possible.

This sums it up....