Category Archives: Medical

Left to My Own

The future’s here, we are it, we are on our own
On our own, on our own, we are on our own

John Perry Barlow, Throwing Stones

Yesterday I had a most uncomfortable doctor’s appointment. At a practice that I had been fairly positive about, I was kept waiting while the staff ate lunch. I would have gladly had a later appointment. You folks are the ones who scheduled me at that time.

Then I waited a touch in the room. Still didn’t get to see my doctor but rather the kid who looks like he was in high school when I had my surgery six weeks ago.

And then he walked out. This practice has always walked the patients out. Not yesterday. And then it occurred to me: this was the last I was going to see anyone here. I asked as I walked out, “There’s no more follow-ups, are there?” Nope. Insurance covers up through now. Anything else I’ll have to ask for.

I was cut loose. I am left to my own devices at this point.

And that changed everything for me. I think up until now I looked to be taken care of. But there’s no one to take care of me. I have to do it myself.

With that, I changed how I am proceeding with the balance of my recovery time.

I had this procedure so I can move about and hike. Well, damn it, that’s what I am going to do. I will build my stamina back in my leg by doing what I’ve wanted to do all along.

The future is indeed here. And I am on my own.

Knee Replacement, A Week Later

Post-Knee Replacement

Last week I had my right knee replaced. It’s been an amazing week.

I have walked ever since. That just baffles me. No, I am not walking well. I used a cane the first couple days. I used a walker on Sunday and Monday. I am back to the cane.

I began physical therapy on Monday. I felt great. I had my second session today. It hurt. The bike absolutely killed me.

I felt great the day of the surgery. As promised, days two and three were a bit rougher. The pain medication is doing its work. I thought there just was no pain, so we backed off the medications a bit. Yeah, pain demonstrated indeed it was present. Back to the schedule. The good stuff ends early tomorrow. We shall see how that affects things.

All in all, things are going well. I can walk. It no longer hurts getting out of the chair. Sleep has bee tough the last couple nights. Getting comfortable is a problem.

My leg is not perfectly straight. I need to be better with stretching so I am not yelled at next week.

Knee Replacement

22-01-12 Knee Replacement

Today I had my right knee replaced.

Woke up at 4:45 a.m. and left the apartment at 5:33. Arrived and checked in at 6:15. When they called me back to the room we learned that no one could join me. That was a surprise.

AtlantiCare kept me busy. After just a couple minutes, a nurse came in and got the ball rolling. Vitals were taken and I changed into my hospital garb including underwear.

Then my leg was shaved, the doctor came in and briefed me, meds were administered, lots of review of what was going on, what I need to do afterward, the anesthesiologist came in, etc. Lots of action. I had brought a magazine to read as I recall sitting around for my bunion surgery; I never had a chance to open it.

Eventually, the first round of drugs were administered via an IV. I had been told I would be able to see the robotic arm before surgery. That didn’t happen. After the drugs were in me, I was out.

The next thing I remember is waking up back where I began. I remember repeating over and over that I was in pain. Lots of pain. I was asked to rate the pain on a scale of 10. I said 9. In came the anesthesiologist. I received two more shots. I believe one was another pain block, which I think will extend my no pain time now at home.

After a bit, I began to feel better. I was offered cookies. I had fig newtons. I enjoyed that and water. Then Gatorade appeared.

More nurses, a quick check from the doctors, etc. continued. Lots of review of medications and other things came. I know I was not terribly focused. They asked if they should brief my sister of the medications and care. Indeed!

Then the physical therapist came in. She had me walk with a walker. I practiced walking stairs. I was amazed at how well it went.

I am fully aware that pain is in my immediate future. That will suck. But I see that I can get around the apartment. I am a bit wobbly and use either the walker or the cane. But I am walking.

I feel like I will come out of this well. There’s work to be done. It will not be immediate, but I am hopeful.

How do I find satisfaction with what I already own rather than seeking out β€˜perfect’ replacements?

No advice will be given here.

This question probably deals with smaller things than I am thinking of, but it reminded me of my approach when I had a house.

We purchased a development house. We liked it, but it had some issues. My approach as we came to address each of the issues was to address the issue completely.

First up, I believe, was the roof. We had a storm early on that blew a bunch of shingles off. The roof was about 15 years old. Thin, builder grade shingles had been used. We replaced them with 40-year shingles. Whether or not they would last that long, I do not know, but I didn’t plan on being there 40 years later. I wanted to fix the roof once and not have to address it again.

The same approach was taken with the windows, the front door, the garage door, facia, soffits, sprinkler system, fence, etc.

The backdoor was an exception. We got a good deal from Home Depot on a nice door. It wasn’t installed properly. Amazingly, the door didn’t hold up quite as well as I had hoped. When we next replaced the door, we did indeed do it properly.

As it turned out, the fence was not a one and done. After I moved out, apparently some of the panels fell down. At least one is still propped up more than a year later. The fence does not look to be in great shape. It is about six years old. Oh, well. Not my issue any longer.

I do think that trying to take care of things properly the first time is the approach.

It occurs to me that applies to my health as well. Back in 2014 I had a problem with my right knee. I went with the counsel the orthopedic provided. I had surgery. The knee hasn’t been right since.

Soon after, I consulted another orthopedic. He was reluctant to dump on another doctor, but he indicated the surgery I had was unnecessary. He explained it as an old approach to the problem and one abandoned because it doesn’t fix the problem. He then shared that what I needed was two knee replacements. I refused as I felt I was too young. At 49, I looked at replacement knees lasting 25 years. That would take me to 74, maybe. But then I would need replacements again. I would have to do this again.

The doctor understood and said to come back when I was ready. It’s seven years later. I am hobbling. If I were to have replacements now, it would take me to 81. If I am alive at that point, I may not need new knees.

I don’t know what the doctor will recommend when I visit. But I am ready. πŸ˜‰

Buying a Knee

Eleven years ago I spent the fall shopping for televisions. I had a tube television whose image was bad. With young children, we felt a television for them was warranted. At the time, Google television was just coming out. Streaming was a new thing. Getting televisions onto one’s home network was the thing. I hadn’t a clue as to how to do all that. It took months of research, shopping, asking questions, and narrowing down things until I pulled the trigger. As far as I know, those televisions are still in use in the house.

More than 20 years ago I had a mole on my chin. It was a large mole. It bothered me. I went to a doctor. She came in and said, “Yup, we’ll take that off.” She pulled out the knife and set to work. I stopped her. I needed more than a minute of the doctor’s time before she took a knife to my face.

Likewise, I used to have tubes inserted into my ears regularly. My doctor got too old to do the work. He had a new colleague. It’s the first time I ever had a doctor I was older than. She too was all ready to get to work when I slowed her down. I needed some comfort in the knowledge she was competent. She was pleasant and seemed to understand. She put me at ease.

Today, in less than an hour, I purchased a knee.

It dawned on me on the way home how cavalier I am in this purchase. I met the surgeon, he reviewed my x-rays, my history, and asked me some questions. Boom! I agreed to let this man cut me, saw off some of my bones, and attach a manmade object inside me.

There was a lot less time and research put into this than the televisions.

Unless I pursue it, the next time I will see the doctor will be ight before I am put out for the surgery. This is insane!

Do I have enough trust in the process and this man specifically not to ask every minute question?

He asked me a question that caught me off guard: Do I have a living will? After I recovered from the shock, I realized that I do.

I’ve changed.

Bunion Surgery

Foot in a Boot

Last academic year I began feeling pain in my right foot. More precisely, I felt pain in the middle toes of my right foot. My suspicion was the bunion on the right big toe was the cause. The way the big toe was bent pushed on the middle toes creating the pain.

After a few months of this, I went to Rothman Institute in Egg Harbor. The doctor confirmed the above.

A colleague of mine had had bunion surgery earlier in the year. All seemed to have gone well. This doctor indicated bunion surgery would correct the problem. After talking to him and doing some research, I decided not to have the surgery at that time. Recovery is huge with this surgery. I had planned to hike mountains in Montana and Wyoming last summer and did not want to jeopardize that.

So, I decided to do as my colleague had done. Plan for surgery in the beginning of November and come back after Christmas. That would reduce the amount of time out of the classroom.

Unfortunately, that plan failed as Gert had medical issues of her own. Her needs came first. She basically went out November and returned after Christmas.

That actually proved helpful to me, in a way. One thing I noted over the summer was that my feet did not hurt. Yes, I climbed mountains. Yes, I would hike for miles on end. But I had no pain . . . until I returned to work in September. Walking on concrete for seven+ hours daily kills my feet. I was resolved to take care of it. Once Gert was healed, I headed back to Rothman to get things going. I went to a different location as I wasn’t thrilled with the 30-year old I had originally met with. The new guy was not a surgeon. He offered me orthopedics, which sounded like he would get a kickback on. Um . . .no! He eventually put me in touch with Dr. Daniel.

Dr. Daniel is a type A doctor. He told me exactly what would happen, what I needed to do, etc. I liked him. We scheduled the surgery. I was fitted with a boot.

As I waited this morning in the surgery center for the surgery, it occurred to me, I was allowing a man I had spoken to for perhaps 10 minutes to cut me up. πŸ™

He eventually came in and went over things again with Gert present. There were a lot more needles, drugs, and medical stuff that I hadn’t considered. Fentanyl and Propofol were two of the drugs administered. Needless to say, I felt nothing. I awoke quite loopy.

I am now home. There’s some discomfort, but I am okay. Now I recover.

My Knee

On 31 May 2014 my school held its annual Field Day. Like all previous Field Days, I participated with my students. This year was the first year I did not win the 40-yard dash. Ha!

About three days later, I noticed my knee was swollen. I wasn’t particularly concerned, but did mention it to my school nurse. For the next three weeks until school ended, the knee would swell as the day wore on, but drain mostly overnight. Some days were worse than others.

Once summer vacation hit, however, the knee continued to swell. It actually got fairly big. I sought an orthopedist. James recommended one he used after his car accident. She was pleasant, took an X-Ray, drained the knee, and administered a cortisone shot. She mentioned I had the beginning of arthritis and all should be okay.

I felt better, but I sensed the knee was still “tight” and I didn’t have a full range of motion. Three weeks later, the knee swelled again, about twice as large as before. I returned to the orthopedist. She drained the knee again. It wasn’t as pleasant this time as she man-handled the knee. I received no cortisone shot. She prescribed an MRI. She stated she thought I probably had a torn meniscus and that would require surgery.

Aetna got involved. It asked if I would have the MRI across the street where it was less expensive. Sure. I am all for saving cash, even if it’s for the insurance company. The MRI was okay. I walked with a CD of the knee.

I returned to my doctor a couple days later. Good thing I brought the CD as she hadn’t received anything from the MRI place, including the reading. I don’t know why the doctor can’t read and interpret the CD. Anyhow, she said, after calling the MRI place, that it would arrive that day and she would call me. Yeah, that didn’t happen. She also put me in a knee brace and prescribed physical therapy.

This I was off. I loathe the brace, but I wear it. I went to physical therapy. Eh. It was okay.

But the knee didn’t get better. It was still swollen.

Yesterday, I had a check up. The doctor was disturbed that the knee was still swollen. She suggested surgery.

Apparently, I have a “floating kneecap”, which is to say the kneecap is not aligned correctly with the rest of the knee. The correction requires cutting the outer ligament so the kneecap can be moved. The doctor will also scope the knee; she thinks there is debris on there too.

Through all this, she stated I will need a knee replacement down the road. Lovely!

It’s difficult to determine what caused this. It seems like Field Day triggered this, but my sister had the same procedure 25 years ago, so perhaps it’s genetic. Whatever the cause, I’ll be on my butt for a month or so.

My Knee

I recall my sister‘s knee would go out of joint frequently when we were young. It seems to me she had it drained a couple times. For me, I recall once during football practice my knee went out, but I think that was the only time.

Fast forward a few decades. On 31 May of this year, we had field day at my school. Like every year, I competed with my students. I love showing them that the old man can whoop them! It’s one of the pleasures of teaching. πŸ™‚

Then came the 40-yard dash. I have won every year. Not so this year. I placed third. I was shamed.

Two, perhaps three, days later I noticed swelling on my knee. The fluid would rise and then fall through the course of the day depending on how much stress the knee had. Initially, the knee behaved much as I would expect. By the end of the day, the knee would swell. I would raise the knee (recliner) or sleep and the swelling would disappear. The following day, it would slowly swell as I walked on it.

On 17 July, I went to an orthopedist. The doctor was recommended by a friend who had used her to recover from injuries during a car accident. At that appointment, the doctor drained the knee (~50cc) and administered a cortisone shot. Things seemed better, although my knee still felt tight. I knew things weren’t 100%, but it was much improved.

That lasted three weeks. On 4 August, I heard things. At first I thought it was the velcro on my shorts. A day later, I still heard a “ripping” sound. I realized it was my knee, not the shorts. I also began having twinges of pain. Up until now, there had been no pain. I made an appointment to return to the orthopedist.

On Thursday, 7 August I met again with the doctor. My knee had swollen much worse than it had ever been. The doctor drained it. It really hurt when she did. There was no shot. She ordered an MRI. She suggested that the meniscus was torn. The MRI would say for certain. The thinking was that if it was torn, she would go in and remove the loose stuff. That would put me out of work at the beginning of the school year.

Meanwhile, I went to Florida. A funny thing happened there; my knee didn’t hurt. I walked much better there too. Only getting into Mom‘s car and sliding my leg under the steering wheel caused discomfort. I returned and went to work. Up and down I climbed on chairs and desks. The swelling has begun to return. πŸ™

On Tuesday, 19 August, I had an MRI. A little background. My orthopedist is in a complex with MRI and physical therapy attached. I made the MRI appointment there. It is billed through the hospital, but all under the same roof. After I did that, Aetna, my insurance, called and asked if I would be willing to have the MRI somewhere that cost less. I concurred. It turns out it was directly across the street. No biggy.

But it was. This “discount MRI” was not read on time for my appointment. My doctor indicated where I had it done had an inferior machine. I’ll never agree to do that again.

Today I had my appointment with the orthopedist. I took her the disc of the MRI since the discount house had forwarded her nothing. The report is really what is needed and I hadn’t been given that either. Apparently, this afternoon it will be completed.

The good news is that the meniscus is not torn. The bad news is that the kneecap is out of whack. Hmmm . . . I mentioned that my sister had had that issue 25 years ago and had surgery to correct it. The doctor said that very well may be in my future. I asked if the procedure has improved in the intervening years. Apparently not. Cut ligaments is the cure.

But before we go that route, she put on a knee brace that I have to wear. In addition, I have to complete physical therapy to see if I can strengthen the interior knee muscle. While it doesn’t seem like that will fix it, the doctor is hopeful. All this means I will not miss the beginning of the school year. As for what the future holds, she said six to 12 weeks is the normal out time for the surgery. Yikes!

So, that is what is up with the knee. Fun stuff . . . not!

Tooth Pulled

I missed a couple days of work this week. I wasn’t dying, but I did have headaches. Last night I began having pain in my mouth. I awoke in the middle of the night with intense mouth pain.

When I went to work today, the pain was bad. It was so bad I called the dentist during my prep period. I realized I needed to take care of the pain in my mouth prior to the Christmas break. I thought I could arrange an appointment after school today or tomorrow or on Saturday.

When I called, I was told all they had was this afternoon before they closed for a week.

I went down to the principal and explained the situation. I was leery given I had already missed two days this week. She said to go ahead and take the afternoon off. I made the appointment.

Prior to me leaving, the substitute they pulled from another classroom came to check on the plans. As we walked over to the desk she stated, “You don’t remember me, do you?” Well, no I didn’t.

She introduced herself. As she said her name, I knew exactly who she was. She was a student in my third class (I think). Now here she is substituting. She said I was a tough teacher. She stated she was 26. Hmmm . . .

Anyhow, I went to the dentist’s office. I saw Dr. ******. She is a mess. They couldn’t get the X-rays to work correctly, so they re-took them thrice. She couldn’t make the hydraulics on the chair work properly either. She stated my wisdom tooth needed to be pulled. No surprise, of course. Back in August another dentist here was prepared to do so when I balked. I wasn’t in pain and I am not in the habit of removing body parts for convenience. I had evolved on the issue with my current pain. But she refused to pull it. That was probably wise given how fumbling she was, but I was concerned my pain wasn’t going away.

She prescribed me an antibiotic and a pain killer. She then stated she would refer me to the oral surgeon. As the receptionist dealt with another patient, I called the oral surgeon and made an appointment. The receptionist then stated I would not be able to go today as she needed to mail the referral. Huh? I had been calm but felt my anger rising. She went and checked and verified that I could take it over.

The oral surgeon is in the same complex as the children’s pediatrician. Beetle was scheduled for a well visit there about an hour later. These folks (oral surgeon) could not have been any more professional. They added me as a new patient in no time. I had more X-rays (standing up and having the machine revolve about me). Then the doctor came in to consult with me. I explained my apprehension, etc. He was excellent. He stated he could have the tooth out without issue. I acquiesced.

In no time my mouth was numb. Pulling the tooth was as simple as could be. I left with gauze and a script for hydrocodone. I bled for about 90 minutes. I had absolutely no pain. I can feel where the tooth was, but nothing problematic has occurred.

And the best thing: my pain is gone. How great is that!