Post-Op Day 2

It's surprising how painful this operation really is. Don't let the smile fool you. Today I woke up on the couch downstairs after taking a high dose of pain medication at 4 am and amazingly enough, the knee hurt a lot more. I thought it couldn't hurt worse than it did on the day of surgery. Turns out I forgot about a few trouble areas. One area that is on FIRE is the hamstring. The hamstrin, if you remember was tapped as an ACL replacement. The hamstring will grow back so you don't "lose" any part of the hamstring but it takes time to heal. Day 2 has brought the hamstring front and center. It's really sore. So the knee is very stiff buttressed by a terribly sore hamstring and you have Day 2. Welcome to rehab.

I've been literally tied to the couch with tubes and straps while the CPM bends my knee for hours upon hours. Yesterday I was bending it at 30 degrees. This morning I was at 35 degrees and this afternoon I'm at 40 degrees. The goal is 5-10 degrees a day until 110 is reached. It was a little alarming to have your good leg still a little numb from the surgery even on day 2. We called the doctor's office and they said it's normal and it probably due to the anesthesia and how I was positioned during the operation. What did they do, jump up and down on my good leg to make my left leg feel better about being butchered? The numb thigh will go away soon. As I type this post the CPM is bending away. The knee feels actually tolerable when I'm resting here using the CPM. The big pain comes when I have to get up. The doctor recommends not doing anything for a week. I'm not supposed to leave the house except to go to doctor's appointments. Dr. Kim asked if I could spend the next 2 weeks at home and just rehab the leg 24 hours a day. I checked with my boss and I can do it.

This is gross but accuracy is what we are going for here. Going to the bathroom is ridiculous right now. There's no stream or pressure. It's like something is numb inside and you just can't cut loose and release the reservoir. Turns out after reading a little bit that the anesthesia numbs that badder control area. That's why my buddy Burk in high school needed a catheter. I'm experiencing this phenomenon unfortunately. As frustrating as this is, there's no desire for "the Tube".

Currently I've been checking emails, watching movies (Grinch who stole Christmas) and playing Xbox with Andrew. He's an Indiana Jones fan and we have to play it all the time, like 4-5 hours worth. I need a new game!!!

Surgery

Today was an interesting, unexpected and fairly painful day. Turns out I underestimated how painful this operation is.

Woke up at 5:50am after a pretty good sleep. If I knew what I know now, I wouldn't have slept quite so soundly. Michele's parents came over at 6 am and her father gave me a blessing to help me through the surgery. His words were beyond comforting and I really felt protected and watched over. I was so glad I had that blessing because I wouldn't have been able to walk in the front door of the surgicenter, but would have entered on a gurney. I'm beyond weak-kneed and I'll faint any sign of pain, blood, needles or hospitals. The title of this blog becomes more relevant, huh? Even the blood pressure monitor makes me faint. I hate that thing. Little did I know that I had NO idea what I was in for. Look at that naive smile!

We got off to a late start and ended up leaving around 6 am. I drove my LR3 with Michele at my side. We had plenty of idle chit-chat with the majority of the banter being me whining about how bad this is going to be. I'm sure Michele wanted to punch me in the face for all the whining and crying I've been doing since the accident. If she had a dime for every time I said, "Oh my knee or my knee really hurts", she'd be a rich woman. To the dismay of all those around me, I prefer to vocalize my discomfort and pain as a way to cope. We arrived and amazingly enough I was able to walk into the surgicenter unassisted and even managed to have plenty of playful banter with the receptionist while filing out the paperwork. We went over all the legal mumbo-jumbo and then got to a few items that made me start to sweat.

The first item was some paperwork concerning my living trust. Living trust's are talked about only when you talk about dying. Am I going to die today? The form was asking if I had a living will in case I died on the operating table that very day. It caused me to pause and reflect if this operation was really worth the risk. I don't want to leave my family now. My mind flashed back to hugging the kids and getting a big kiss from Andrew this morning and I actually thought about postponing the operation. I then remembered the words in my blessing and I immediately became calm and peaceful.

The second item was the out of pocket bill I was required to pay before the surgery. My deductible is fairly high and it turns out I just hit my deductible limit and then some. In hindsight, that was one EXPENSIVE lift ticket that was bought last month. Ouch. After paying the bill I had to wait for the nurse to call for me. Every time anyone opened the door my heart started to race. Finally the nurse called for me while I was taking this picture in the lobby.

I changed into my surgery gown and tried to get comfortable on the bed. The pre-op room was the temperature of a large refrigerator. I had to ask for socks to go on my feet because they were frozen. The nurse was great as she let me know exactly what she was doing and how bad it would hurt. Turns out nothing hurt. She was a magician inserting the IV. Sign her up for Vegas. I can't believe how easy it was and how little it hurt. Amazing. Once the IV was started, Michele came in to comfort me. I tried to act tough but she saw right through me. We took some pictures and I waited for Dr. Kim to see me. He came in about 8:45am and asked me how I was feeling and

he marked up my left knee and explained what would happen. He also asked about my ice machine and my knee machine. I told him that both items would be coming to my house that evening. Turns out that I need the ice machine immediately after surgery. Dr. Kim made some phone calls and procured me an ice machine that I could bring home.

After some more pictures and saying goodbye, the nurse administered the first dose of anesthesia in my IV. I haven't been put under since I was a kid when I had my wisdom teeth removed. I don't remember what it felt like going to sleep. I had this great plan to really observe and be aware of exactly how it feels like to go under. The doctor told me that it takes about 10 seconds from injection to being out cold. I was skeptical because I couldn't imagine it working so fast. I turned to the nurse and asked her how fast the anesthesia would take effect. I never heard the answer.

The next memory I had was the blurry fog of anesthesia and waking up in post-op or rather fighting to wake up and make sense of what was happening to me. I didn't dream a thing while I was out. I was stone cold out. It was so weird waking up expecting an answer to my previous question uttered hours ago, "How long until the anesthesia starts to work?" I finally figured out in roughly a nanosecond that I was waking up AFTER the operation because the pain in my left knee was excruciating. I must have been driving the nurse nuts by saying that my knee hurts. She would ask me to rate the pain from 0-10. At the time it felt like she was asking me to do calculus equations by rating my pain. All I knew was that my knee hurt. Duh! Just shoot me and get it over with. Though I don't remember a lot of what happened during the hour and half of trying to wake up, apparently I told her it was an 18 on the pain scale and she loaded me up with all the goodies. I was flying like a kite at the beach. I can relate to drug addicts who get hooked on prescription meds because you just feel so good! (I don't condone drug addiction all you who think I'm a druggie now. I just understand the appeal.) The side effect of all the pain meds is nausea which I experienced a little later in massive doses. There's always opposition to flying high as a kite.

Michele was there to welcome me back. It took me about 10 tries to just get to where I could sit up without fainting or throwing up. I spent roughly an hour trying to get into the wheelchair. Finally I got in the chair and I was wheeled out to the car. Getting me and my new knee into the car was very painful. Any movement at all sent a flame of fire into my knee. Once I got in the car, I decided it was time to get sick and get serious about do some old fashion dry heaving. The nurse told me that nausea was a side effect of the meds and that I would throw up at least once. The car was pretty hot because it was a beautiful day outside. The AC didn't quite work quick enough and I grabbed the pink pan and started up the dry heaving. Throwing up once was not accurate at all. Many times is more like it. I didn't have anything in my stomach but that didn't stop me from trying to heave. After the good abdominal workout I felt like I could go home without too many problems. I did have a wet and cold wash cloth that turned out to be a wonderful friend and a life saver on the ride home. I can't express how good it felt to have that cold water on my forehead and face.

We arrived home and I hobbled into the house and made Camp Chad on the couch in the family family. I had my ice machine hooked up that has a blue tube to an ice chest that continuously pumps ice water to my knee. I have my leg in the CPM as shown. I got some liquids and some food and all the remotes to the TV, DVR, DVD and Tivo and I was ready for my rehab to start. About an hour after I got home, Team McKenna's rep came by the house to deliver the CPM (aka the knee bender). I had heard that the knee bender was a modern-day torture device. I quickly found out that it is an amazing device that gives your knee relief while extending your range of motion. The rep hooked me up to the CPM and the machine was bending my knee to 30 degrees immediately. Again I was surprised at just how much I liked this machine. The goal is to get the knee to bend to 110 degrees within 21 days. What's nice about this thing is that I can leave on my ice machine to cool my knee to a nice 43 degrees while it bends my knee for me.

I got stoked up on some light food and gatorade and pounded some pain pills and got comfortable for the night. I watched my Anaheim Ducks lose to the Calgary Flames. The Ducks are toast. There's no way they're going to the playoffs. I mistakenly thought I could get some sleep in my real bed and around midnight I decided that I could go upstairs and flop in bed. Monster mistake. For anyone getting this operation, don't even think about sleeping in your bed for a while.

Sorry but it's time for bathroom talk. Going to the bathroom is really rough. Your knee hurts so much you can't really bend it and moving around at all is terribly painful. Envision the crutches used for positioning with a throbbing knee wrapped in a huge knee ice brace with awkwardly trying to get to the toilet seat and you have me on my first day of post-op. It is terrible. I only go to the bathroom if my back teeth are floating and the clothes pin just won't hold any longer and I'm about to burst.

So after getting ready to go to sleep I stumbled into bed without crying too much. It's a killer to get that leg up and in the sheets. I slept surprisingly well for about 4 hours when I woke up in sheer terror. My knee felt like it was hobbled. Remember in the movie "Misery" when Kathy Bates hobbles the poor  book author while tied to a bed. That was how I envisioned my knee was. Obviously the pain medicine had worn off and I didn't have ice on it and the full pain of this major operation hit me with full force. I wiggled out of bed and tried to get dressed. While struggling to get positioned to go to the bathroom with crutches all over the place, Michele came in to see if I needed help. She must have been surprised to see me half dressed flopping around the bathroom. Marriage - for better or worse honey, right? Well she got the worse part of the deal last night. She helped me get downstairs and filled my ice machine and get me comfortable - at 4 am. She's been a real trooper and I love her more each day, especially during this ordeal. She must love me or she would have turned around and went to bed and left me on the bathroom floor at 4 am.

Surgery scheduled for tomorrow!

I'm pretty nervous for this operation tomorrow. I learned a few days ago that my surgery is scheduled for 8:45 am instead of 10:45. I have to be there at 7:30am and it's in Temecula, CA which is about 30 minutes away from us in San Marcos. My mother and father-in-law are coming down this evening so that they can watch the kids while Michele brings me to the Golden Triangle Surgicenter. We will have to leave at 6:30 just to be sure we get there on time. Needless to say I've been roosting like a pregnant mother preparing for birth. I've been doing everything I want to get done while I can still walk. I limp when I walk but the limp isn't as bad as it has been in the past. My knee actually feels pretty good although I just can't bend it beyond 90 degrees.

So last Saturday I stained the wood on our new hot tub and did various other projects around the house. I watched the BYU basketball game in which I was hoping the Cougars would advance to the sweet sixteen. BYU played terrible and they gave the game away. It was difficult to watch and I was frustrated.

Today, I took my LR3 down to the dealership to have them fix some things that are still covered by the warranty which runs out at the end of the month. We also had CJ Fellers come over and fix some sprinkler pipe that got crushed during our turf installation in the backyard. I can't eat or drink anything past around 9 pm tonight so I have to be sure I'm properly hydrated tonight or I won't be able to sleep. I'm mentally prepared for the operation and I'm hoping it will go well. I'm a little anxious about the "going under part" or more accurately the "waking up part". I don't want to die during a routine ACL operation. There's no way I'm going to take one sip of water after 9pm because water can affect the anesthesia effect. I don't want to wake up during the operation or be put under so much I don't wake up. I have a lot of life left to live.

Days leading up to surgery

Here's my knee. Looks a little swollen but overall not too bad. Looks can be deceiving and the inside is what counts for this day. Today I learned first hand from my surgeon that I completely tore my ACL. I got my MRI done last Wednesday at Escondido Imaging. The MRI was pretty interesting. I was amazed at how loud the MRI machine was. I tried not to move but each time the machine would kick into a new cycle I would jump. I was able to get a copy of the MRI as I left the center and I immediately posted the information online so that my brother Kirk, an orthopedic surgeon in Colorado could look at it. I actually downloaded the MRI info to my computer and tried to analyze the images. The images were a complete mess and I could barely understand anything. I could see an outline of my knee and various components but that was all. I thought I saw my ACL attached to the knee bone but it turns out I was dead wrong. My brother Kirk called me after a few days and he said that my ACL was indeed torn. He said without a physical inspection of the knee, he couldn't really diagnose anything else.

Today I went to see Dr. Kim. He asked me how I was doing. I replied that I was hanging in there. The next utterance Dr. Kim said, "Your ACL was torn in two. I looked on the MRI and the ACL is basically gone. You'll need surgery." Boom. There it was. Cut and dry and no nonsense. I gathered myself quickly and then asked to see the MRI, not because I doubted him but I was curious how in the world he was able to decipher anything from the mess of images known as the MRI. He pulled up the main photo and rotated it to show where the ACL should be and that there was nothing left but a dark mess of muck. He told me that I actually have 2 options in dealing with this injury. Option A - don't fix it, allow it to heal but I'd have to quit all my sports and activities or wear a brace that may or may not prevent further injury. Basically I'd have to give up my active lifestyle, no surfing, no skiing, no anything. Option B - ACL replacement surgery. 4-6 months of rehab and I'd be as good as new. Needless to say I opted for surgery immediately.

Dr. Kim explained that the reason why the knee swells up so much when the ACL ruptures is due to blood leakage. The ACL carries blood and when it rips or tears it leaks blood all over. Internal bleeding results in a huge fat swollen knee. Pretty gross. He then explained how the ACL is repaired or rather replaced. Almost always now days, they harvest a strain of the hamstring and screw it into the opposite knee bones. The hamstring is not a blood carrier and it is very, very strong. The ACL holds your tibia to your knee joint. Without it, your tibia could come up and out from your knee producing a terrible injury. Plus without a ACL, the knee can move around and produce complicated injuries. Dr. Kim makes an orthoscopic incision about an inch long and goes in and cleans out the knee and replaces the ACL. Pretty cool way to repair the ACL in my opinion. I was pretty optimistic at this point when I suddenly remembered the experience my friend Burk Adams had when he tore his ACL in high school. I started to sweat and became light headed. I had to lay down on the table or I would have fainted.

Burk, pictured left, blew out his knee playing football in his senior year at Meridian High School in Meridian, ID. A couple of his friends and I went to the hospital to give Burk our support. While we were walking in the hall to go to his room we heard a scream followed by faint sobbing and then pleading stemming from one Burk Adams. It turned out that Burk needed a catheter due to his surgery. As a boy in high school, a catheter is pretty painful especially during the insertion. Burk was doped up on pain medication but he knew that the catheter (aka "The Tube") was coming. He pleaded to the nurse to let him have another half hour to pee. He kept saying "No tube. No tube!" Nurse said she couldn't wait because his bladder was terribly full and he simply wasn't able to relieve himself. So all of his friends stayed outside in the hall while the nurse plugged in the Tube into Burk. It sounded as if the tube was a garden hose because Burk was vocal with his discomfort. After that event, I considered Burk to be the bravest guy I'd ever known. I have always been very wimpy when it comes to blood, needles and hospitals in general. I couldn't take it and I had to sit down with my feet up to avoid fainting. So, ever since that fateful day I've been terrified of being in the hospital and having a catheter. Just the thought of it makes me light headed.

Dr. Kim gave me the best possible news under the existing circumstances. He said that ACL surgery is an outpatient operation now and that I wouldn't need a catheter. I was so relieved. No Tube, no needles, and hopefully no pain. That was my plan. Dr. Kim gave me the date of March 23rd for the surgery at 10:45 am. Sounds good. I'm going to continue to ice my knee and bend my knee to prepare myself for the operation in two weeks.

Accidents do Happen

While skiing at Big Bear with my varsity scouts on 2/27/2010, just a few days after my 42nd birthday, at approximately 3:00pm I blew out my knee. Turns out it was a complete ACL rupture in the left knee.

The day was a perfect day for the hard core skier. This photo left to right has Ben Memmott (scout advisor), Weston Joyce and Jadon Neuendorf (age 14 and 15). Don't let the age fool you. These boys board like they were born and raised in Park City, Utah. True powder hounds.

It was snowing an inch an hour and the snow was deep and untracked. Visibility was quite poor but any snowhound worth his salt could simply "feel" their way down the mountain. I was skiing with Weston Joyce and Jadon Neuendorf (aka "The Wreckin' Crew") who are my 2 varsity scouts under my tutelage. Two California snowboarders who can really rip, true tree mongers who like big air and deep powder. Giving us a round number of 4 was Ben Memmott, my co-leader and former Utah boarder who was loving the fresh California powder.

A lethal combination of great snow and poor visibility buttressed by a desire to catch big air was my downfall - literally. I came ripping through the trees around 3 pm just to the right of Jadon. I pulled a 360 just one run earlier and was feeling pretty good - age 42 and I still got it. As I barreled down the trees I neared the main run by the bottom of the lift 4. Photo to the right was taken just after the yard-sale that happened just up the mountain from the base of 4.

I looked down and eyed a nice little rock that I could launch off. As I flew in the air I then realized I had more air and more speed than anticipated and I prepared for landing. The problem was that I flew over my sloped landing and instead dropped right onto the flat hard-pack. I landed awkward and my skis shot out from under me. No big deal, happens all the time, right? Not this time. My right ski popped off with ease but my left ski binding didn't release. In slow motion I fell backwards and my body twisted right but my ski boot firmly attached to the ski stayed fixed. The sequence of events was an audible "pop" coming from my left knee, almost a crunch rather than a pop, then accompanied by a direct and intense pain in my knee. The pain was such that initially it literally took my breath away. Granted that I'm a self-proclaimed and widely known wimp, this was pain that would make even the toughest of men cry. I grabbed my knee and silently sobbed but outwardly screamed out that I was hurt. People on the ski lift were asking if I was okay. I couldn't answer because too many four lettered words were delicately teetering on the tip of my tongue and any attempt to speak would have sent them flying. I tried to walk it off thinking the pain was just temporary but deep down I knew I was hurt badly. I told the others to stay and ski while I wait for them in the lodge. I skied down and every passing minute my knee hurt worse and worse succeeded by massive swelling. I knew I was toast. Went to the orthopedic surgeon's office on Monday and after an MRI it was confirmed that my ACL was completely ruptured, torn in two, nothing left. Immediately I started to mentally prepare for surgery and this is my day-to-day account of my ACL surgery and rehab.