Doctors notes...

Monday morning around 9am dr Cappaert and dr Arnold (the assisting surgeon) came into my room and Cappaert asked me if i wanted the good news or the bad news first...
"The good i suppose", was my answer.
He told me that the good news was that i had had the op and i didnt need to wait for that anymore!
This didnt bode well...
The bad news was that my knee was a bit of a mess to put it mildly!
I had significant cartilage damage to my kneecap where it glides over the femur.
I had an extremely lax anterior cruciate ligamennt, to the point that the dr thought that maybe it was completely torn.
And i had osteochondritis dissecans, a bone problem that can cause arthritis and osteoarthritis. Even if treated.
What the doc did was to scrape away all the rough bits of cartilage under the kneecap that were scraping on the femur, and try to create the natural groove for the kneecap to run in again. He told me that he hoped that new cartilage would form now that he had scraped away the diseased and dead cartilage and it would start to work in a normal fashion. Although this is hope. There is no certainty of this.
He told me that the cruciate ligament tear is a big op, and that he was not prepared to do any of the ops to fix me any further until i could get my quad muscle on my affected leg to the strength of my good leg!
He said this because any op that he did in the future, would need a recovery period, and that would weaken the quad through inactivity, and with a weak quad, any surgery he would do would be doomed to failure in the long run.
He also told me that i could thank dr Arnold very much, as he had fought my case to be operated on on the sunday, as the anaethetist did not want to do the op as it was not an emergency. This was policy.
But he won his argument and the op went ahead, making me officially the first and only elective surgery ever to be done in the George Provincial Hospital on a sunday!
So i thanked him, and asked where we go to next?
He said that i needed to go home and strengthen my leg muscles to the point that he was happy, so that further operations could be performed.
I was looking at 2, possibly 3 more operations, in order to get back to walking again.
Each op had a recovery period of around 6-10 weeks before the next could be performed, and the final op, the cruciate ligament reconstruction, has a recovery period of 6 months!
So, to cut a long story short, it looks as though i will be on crutches for at least another year, to year and a half!
Not exactly the news anyone would want to hear, but the facts remain...
I suppose i see it that at a worst case scenario, i am already more than half way to walking again from the start of this ordeal, 1.5 years ago, so every day from here on out is a day closer to walking!
I was booked in to see the physio the following day, but she was busy with other patients, so i only got to see her today (tuesday).
She has given me a complete set of physio exercises to be done 4 times a day, and 5 sets of each exercise. She has told me that if i am diligent and work hard, i may be strong enough for my next op in around 3 months time.
Its gonna be a lot of hard work to get me to that point, but i am up for the challenge!
I cant wait to get walking again, so i need to do this, and do it good!
So thats my lot really...i'll post pics of the exercises in my next update, and follow my progress as it happens throughout the rest of this adventure...
Peace & Positivity
Si

Post op assessment...

Wednesday morning arrived and i was about to head out the door to go book myself onto the bed waiting list, when my dad shouted to me that it might be a good idea to pack my bags just in case they have a bed for me. Rather safe than sorry.

So i headed back upstairs to throw some clothes and stuff into my backpack.

Then it was off to the hospital.

I picked up my file around 11am, and headed up to see the ortho guy i normally see. After about 30min wait, i was seen, and was told that the paperwork i supposedly needed to fill in, had been filled in the previous visit, just as i had suspected!

The nurse who helps with the admin said that they had not heard back from the wards yet, and that there may be a bed available.

I was told to wait, and took a seat, not knowing whether i would be heading home again, or booking in for the night?

At 3.30pm i got my answer --- "grab your bag, we've got a bed for you"!

I was over the moon. I called my mum and told her that she could now head home, and i followed the nurse into the orthopaedic ward.

I was shown to a room with 2 beds, and no one in it, so i ended up the first evening, having a room to myself, which was pretty sweet.

Thursday morning one of the ortho surgeons came in, as i came to realise they did every morning, and checked out my file at the foot of my bed and asked me why i was there?!

I told him i was in for a knee arthroscopy. He asked to see my knee, asked me a bunch of questions, and then told me that he thought that i needed a better assessment, and took me off the operating list, and sent me for a bunch more xrays!

He said that the head ortho guy, dr Cappaert, would see me the following morning to evaluate the latest xrays and decide what course of action needed to be taken.

So off i went for the xrays, and then returned to bed to while away the rest of the day, wondering whether i would be sent home now, and have to go to the back of the queue again!

Friday morning dr Cappaert arrived around 9am and spoke with me. After checking the xrays out, he said that the femur was healing really well and showing signs of new bone formation around the break site.

The tibia he was not so sure about, as it was difficult to ascertain from the xrays.

He said that, as he stated in December when he booked me in for the op, he thought that a diagnostic arthroscopy would be the best way to go. This way he could be sure what was happening inside the knee and take things from there.

I agreed with him, and he said that he would try and get the op done on the following monday or tuesday now, as they always had busy weekends, and sundays were reserved for emergency cases only.

So i settled in for a weekend in the hospital.

I was very impressed with the professionalism of the staff, the food was not bad at all, and the wards were spotlessly clean. A very good advert for the government run flagship hospital in SA, where they are trying to install a NHS type system.

On saturday night i was told that i should not eat anything after 10pm, as they were pushing to get me done on the sunday, as they had a busy day monday, and then Cappaert was not working, so a different doctor would have to operate on me on tuesday.

On sunday morning around 11am, a nurse arrived to prep me for surgery, and did some tests, gave me my hospital gown to wear, and i had to remove all jewellery and bracelets.

About half an hour later i was lying on my bed and being wheeled down to the operating theatre.

I waited about an hour in the waiting area outside the theatre as they finished up someone before me.

Then it was my turn.

First thing i noticed upon entering the theatre was the 40" LCD screen on the wall, which i commented on, and was told that that was where they watch movies when the op becomes a bit boring!

Haha! A surgeon with a sense of humour. Always a good thing.

I joked with the anaethetist and the surgeon while they put a drip in me and prepared to send me under.

I got the mask over my mouth and nose, and was told it was just pure oxygen, so took a couple of deep breaths, knowing how good it tasted from my scuba diving experiences with it.

The room spun slowly around and then i was gone...

I woke up in the recovery room outside the theatre, and the doc said that the op had gone well, and that he would see me the following morning to discuss the results with me.

I was taken back upstairs, and, feeling rather nauseous, i refused lunch when it was offered.

I was given a shot of morphine by the nurse, and was back to sleep for a couple of hours.

When i woke up, my parents were there for visiting hours.

After that i was starving and happpily ate the feta and mushroom quiche my mom had brought me for supper!

Then it was back to sleep again, dreaming of good news in the morning...

2 hops forward and 1 hop back...!

Well, i said last time that the next time i blogged would be post op...unfortunately, this is not the case!
Monday 4th when i went in to see the docs to book me in for my op, they told me that there were no free beds, and that i should return on the wednesday! I wish it were that simple, as the hospital is a full 2h drive away, and then the return trip if they cant see me!
I mentioned this to the doc, and he gave me a number to phone to check if beds were available so that i was not wasting my trip coming in each time.
I phoned them on the wednesday morning, and they told me that there were still no spare beds, and that i should try again the following monday!
Apparently mondays aren't very promising cos of the weekends events bringing, usually, more trauma victims into the hospital, and hence, the beds getting filled up!
After 2 frustrating weeks of phoning every monday and wednesday, i still have not been seen!
I phoned this morning, and the doctor who will be doing the surgery on me answered, and told me that in his honest opinion, i was wasting my time phoning every week.
He said that the best route to follow would be to come into the hospital on wednesday this week, and to give my name in to the reception that i needed a bed. They would put me on a waiting list for a bed, and when one freed up, i would get it. This would normally happen over the course of the weekend.
I would then stay in the hospital, thus laying claim to my bed, until they could do the operation!
Now, seeing as though they only do these arthroscopy's on a tuesday, wednesday and thursday, it might mean that i spent 4 or 5 days in the hospital without even getting seen to!
He also told me that although they try their best to see everyone who has a bed, as soon as possible, it might be another week before they saw to me!
So, even with a bed, there is no guarantee that i would get operated on within 4 or 5 days...it might be a week longer! Sitting in a hospital, eating hospital food, for up to 10 days or so before i even got the op!
Good grief!
But, not having many options left, i will have to follow these recommendations and go into the hospital on wednesday morning.
I'll know the same day when my admittance date will be. Then its to go stocked up with enough stuff to keep me busy to make it through to the op date, whenever that may be!
The happy days of a patient without medical aid... :(
Hopefully the next time i write will be with happier news...