Let the Healing Begin....

I am 200 days out from my knee realignment surgery....and am still healing. I am still in physical therapy two times a week, with one of those days being in the swimming pool. I am a little concerned that my knee "clicks" and seems to be mimicking the same behavior as it was prior to this last surgery.

The doctor seems to think it is scar tissue and my physical therapist thinks it is something in there that is a bit irritated. The doc says it should go away in a few MONTHS. The PT seems to think once it settles down it will behave better.

Know what I think? I think I don't know what to think. I'm a little paranoid. The doc says the knee is tracking well and while it feels "tighter" than before, the clicking and whatever is causing it causes it not to track as it should unless I "hold" it in place. That scares me to be honest. I desperately want to be healed. Fully functional. To be able to walk and run without a worry that my knee will buckle and the knee cap will move out of place. I fear the pain of that more than anything.

The doc says that it is possible that he may have to remove it if necessary. Another surgery. I'm not ready for that. I'll do it if it is necessary but I'm not ready to jump right in and do it. I'll work it for a few months. Let's see what happens.

My knee still buckles a bit once in a while. But the kneecap stays in place. I am continuing to build muscle and strength is returning. My legs may once again be my best feature. I have a bit of a limp but anything is better than where I started. Almost $100,000 in the last three years not to mention what was spent on ER visits, doctor visits, etc. prior to the first surgery.

The first few weeks were difficult. It didn't take long for me to remember how to use my crutches. Nor did it take long to remember how best to get in and out of JB's truck with my brace and crutches. JB, however didn't remember right away and kind of literally left me hanging. He's sitting behind the wheel and I'm kind of dangling off to the side with the door wide open. He's looking at me like "Well?" and I'm looking at him like, "Are you serious?"

Finally I had to speak up. "Dude, I need help." Finally, a look of understanding. He forgot. No kidding.

A week and a half after surgery, he went out of state for a roofing job. I was at home with the kids. I had received permission (sorta) to drive if I could do certain things. So I had to prove to him before he left that I could do it. And do it I did. I was going to succeed if it killed me. Getting into the pickup with the brace and driving with my left foot was not really a smart option so I removed the brace to drive and put it on immediately upon getting out. I still had to use crutches. No weight for two weeks....what a pain.

I had 20 staples and had had 10 removed after the first week. Then I had the other 10 removed the next week. I developed a rash of some sort around the knee. It was so strange that the doc called in several doctors to take a peek. They couldn't decide what it was but they could all come up with what it was not. It was not (Praise the Lord) a reaction to the screws in my bone. A reaction would mean removal. NOT GOOD. It was not poison ivy or anything like that but it did itch like crazy. Benadryl did not help it. They finally issued me some steroids and it went away.

A week after surgery I also watched my ankle disappear. I had what my daughter called a "kankle". My ankle had swollen so much that I didn't have an ankle and what toes I had wasn't much. It looked horrible. YUCK. I went into icing overtime with having my leg propped up as much as possible.

I was in my CPM leg machine up to 14 hours a day. No less than 8. I loved that thing. I had one night when it was painful. I was so fortunate to not feel the same level of pain as everyone else. I'm afraid I might not have been a good patient.

The weather affects my knee quite a bit. Since the first surgery, it has been sensitive to the changes in the weather but since this last one, it is SUPER sensitive. If a weather front is coming into the state, my knee tells me. Oh does it ever tell me. It has something to do with the barometric pressure. Today it has been screaming all morning. And all afternoon. All day. I do mean ALL DAY. I'm just beside myself because it really aches. I haven't brought pain medication with me to work for a while. I wish I had some.

I am anxious to know whether the surgery worked. I am sensitive to the fact that it might not have. The "clicking" bothers me more than anything else. I know I promised God I would accept what He gives me. But I will be disappointed.

Just one of those places in the recovery process where I'm unsure. I'm scared. It happened the first time. It'll probably happen again. I just don't know. I will just have to be patient. I pray that He'll heal me for good.

The Day After/My First Look

Those first few hours are doozies but the next morning is even moreso. But there is not any resting going on....despite that requirement to stay off the leg and rest. The morning after dawned bright and clear and my day was slated to start EARLY.

My physical therapist (wonderful woman by the name of Debra--best physical therapist in the whole world if you ask me and a few others) needed me to come in by 7AM so she could remove the drain (a wonderful disc shaped container that caught the blood and other fluids that were draining out of my knee) and look at the incision and see just how much I was able to do (that's an easy question, and NOTHING would be the answer).

Getting me up was easy...NOT. One night may have brought back memories about how to move, but my body was not cooperating. It took me a bit of time to get back in the groove on how to maneuver, etc. on crutches. I had an advantage this time. I was about 40 lbs lighter than the first surgery so at least there wasn't as much of me to maneuver as there once was. :-)

Getting dressed was easy. I didn't. Debra would have to accept me in my jammies. I wasn't allowed to shower (can't get the leg wet) so I had to take a "stand-up" bath. Okay, well, I was really medicated still and my leg is totally numb and I have no balance yet so the kids (bless their little hearts) bring in a chair (on wheels mind you) for me to sit on. OK. That will work. Things progress slowly. I manage to clean myself up, get my brace on and by the time I'm ready to go, I'm exhausted. I was ready for bed.

But I can't. This drain is absolutely full and I really don't want to mess with emptying it out and it HAS to come out. So I crutch my way out to the truck. Apparently, it had also been too long for my husband between surgeries. I open the door to the passenger side of the truck and he is already seated and ready to go. I look at him expectantly (having not forgotten how attentive he can be at times like this) waiting for his brain to kick in and remember that I cannot get into the truck by myself. Finally, it hits him. He gets out of the truck and as he walks around to my side, you can see the realization sinking in as he remembers and anticipates how demanding this kind of thing is. He also seems to have forgotten how to help me into the truck.

I get positioned, grab onto the handles of the truck and pull up while he supports my leg....kinda. I also have no feeling in the leg, let alone no muscle left at all so I can't LIFT it, and he's not moving it so I'm kind of just hangin' round. I'm looking at him, expectantly of course, and he is returning the look, waiting for me to maneuver my bottom half into what looks like a very nice sized space but feels like a sardine can when bandaged and braced up as I am.

Finally, I realize that God gave me a mouth for a reason and he's obviously not getting what I need. So I remind him that he has to move the leg for me. Finally, I get into the truck, my leg stuck straight out and I'm trying to suck up the pain that has screeched down my leg as I sit in a position that I'm sure would not be doctor recommended.

We reach physcial therapy and he gets out and promptly forgets that I cannot get OUT of the truck by myself either. We finally get me out and he forgets to hand me the crutches. (Yup...need those too dear. Thanks!)

Debra greets me like an old friend. I had grabbed my video for her (Dr. P videos the first part of the surgery which is the arthroscopic part before shutting off the camera and breaking out the saws and other gruesome tools he needs for surgery) so she pops it in and watches it. Then she gets down to business. The brace comes off, she unwraps the bandages, and takes a look and then takes the drainage tube out. This time, I handle the removal well. No dizziness, no stomach upset, nothing. I'm definitely becoming a pro at this stuff! (That, my friends, is a sign of someone who has had too many surgeries!)

Under the bandages, was a surprise...we had noted these "tube things" the night before but didn't know what they were for....it turned out they were to an ice machine. That was new. What in the heck was an ice machine? I wasn't given an ice machine. My husband and I must have had that confused look that dogs get....you know, where they cock their head to the side and look at you as if saying "what?" My physical therapist said that he apparently wanted me to have an ice machine and we should contact the CPM people....they would know. Well, okay then. I know an ice machine sounded good. Anything sounded better than the ice pack that I had.

A phone call and an hour later, we are being sent home with a cooler. Okay, a cooler with a couple of strange attachments. I had been begging for one of these things. Had already invented it in my head....someone else just beat me to actually making it. It was WONDERFUL. Turns out that thing with the funky little tube things actually hooks up to the funky attachments coming from the ice machine. You fill the cooler up with ice (we figured out you could freeze bottles of water--they last longer)and water and viola! You wrap that funky thing around the knee (make sure you have a barrier between the thingy and skin) and flip the switch and ice cold water circulates through and it is just great. Between that little ice machine and my CPM machine, I was in absolute heaven. Oh, let's not forget the pain medication. Always good. Always.

So, that trip to physical therapy and to get the ice machine wore me out. I was ready to collapse. We go home, get me in bed, medicate me, make sure I'm "iced" and in my machine, oops....forgot to go to the bathroom. What a pain. Go to the bathroom. Climb back into bed, reattach the ice machine (it does get to be a pain after a bit of time passes), get in the CPM, everything is going, I'm medicated, I have snacks available, reading material, tv remote (not that any of this matters once the pain medicine kicks in), and I'm appropriately propped up and comfortable, and I'm gone. Asleep. For a while anyway.

Saturday morning I get up and decide to get the changing of the bandages over with. I'm wanting a bath. I want to go to church the next day. JB will be going to work and I need help....I figure he won't want to do the bandages so I crutch on out to the living room. I send the kids on various missions. Rikki, get me a towel, Ryan, get me bandages, JB, get me alcohol, the isopropyl kind, blah blah blah. Somehow I manage to sit myself down right in front of the door. I am required by the doctor to be in my brace when I'm up. He does not want me to risk injury or bending of the knee. It is very unstable and the screws can easily be torn loose and destroy all the work he's done (not to mention cause me intense pain). So I undo the brace (that, too, becomes a pain after a while), undo the miles of ace bandage and start removing the bandages.

And there it was. What the heck is that?!?!!? I know my eyes must have popped out of my head. I expected the same as the last time, blue fishing line stretching the length of the incision. Oh no. I had staples! OH MY GOSH. The kids were ugh-ing and saying things like ooh gross, and does it hurt (is that really a necessary question?) and all I can see are staples! 20 to be exact. I'm sure you are wondering why I'm upset over staples. No, it isn't because it looked like I was Frankenstein's cousin, and I wasn't worried about scarring, I'm past that. Those staples may have went in when I was asleep, but they were coming out when I was awake. THAT WAS THE PROBLEM.

Fishing line slides out.....Staples, well, from past observations on my son, they use a friggin staple remover! Holy moley...and we all know if you leave them in too long, things start growing back. I couldn't allow that to happen. After a couple of intense minutes, I finally came to grips with reality. And I figured if I needed to, I'd medicate myself prior to the appt and I'd be good. Along with the 20 staples, I had two fishing line stitches where the cameras had gone. I didn't think twice about those. A snip of scissors and out they come. No pain. (yeah right--I'll tell you about that later)

I got a good look at my leg. It was quite ugly, actually. Swollen. My foot was looking pretty large. Quite large actually. So large, that I was just a tad concerned. I took a paper towel and doused it with alcohol and started rubbing all the yellow medicinal crap off my leg. It looked much better. I tried to leave the incision alone as it needed to scab and I didn't want to stretch the incision or break the scab so the scar wouldn't stretch out like the previous one. It burned something awful but again, I am blessed in that I don't feel every bit of the pain, just a percentage. Once I was rebandaged, I got breakfast and went back to bed and was "iced" down. At this point, we had not figured out about the bottles of frozen water and they were loading my ice machine every few hours...we're a little slow on the uptake.

Having been told to stay away from dark colas (they pull the potassium from your bones and slow the healing process), I became an avid fan of Diet Sprite. Not my first choice but it fit the bill. And when you are medicated, who cares?

Later, our friends, Jeff and Ragan came over with Shelby in tow. Jeff was going to play cards (Texas Hold 'Em night) and Ragan and Shelby came to visit me. Of course, I wasn't too much company. My cousin came in and sat down and we chatted a bit about my knee and I got the usual "how ya feelin'?" questions from everyone. After about an hour of that, I was on my way back to bed. I was just worn out. JB would not sleep with me so Rikki slept with me again. Of course, I don't know why anyone bothered to sleep with me, since no one would wake up to help me to the bathroom....what good were they?

So I get to bed and decide that I need a bath. I want to go to church in the morning. And my foot has taken on this leprous look...skin is peeling and disgusting. I am not sure what in the world was going on there but it was just gross. So we go to the bathroom and sit me down on a chair. We have to undo everything and I'm sitting there stripped down to my underwear and bra (any further and Rikki would freak) and I take a bath. After much convincing, Rikki reluctantly washes my foot. After all, I can't reach it. Once bathed (that takes a heck of alot more energy than one would think), I manage to get positioned over the bathtub, get balanced and I manage to get my hair washed. I get in my jammies and crutch it on back to the bed. I'm halfway back in and positioned when, you guessed it. I didn't go to the bathroom while I was up. DARN IT. I weigh my choices. Like there are a lot. I mean it's go or don't go. Right? If I didn't go, I'd sit there, knowing I have to go and it would drive me nuts. If I go, then I have to go through all that getting up and out stuff. AGAIN. Dehydration sounds pretty good about now.
So I get up, make my way back to the bathroom, wondering how in the world can I solve this getting up and down problem....(I never did come up with a good answer--but it kept me busy thinking of other things) and I finally make it back to bed. I get up and in and propped and fastened and prepped for ice, etc. and I can tell that the pain is coming. I can feel the heat of the pain. Rikki connects the hoses and turns the ice machine on and AAAAHH....>RELIEF. The ice cold water immediately relieves everything. There are no words to describe how good it feels. Praise the Lord! Praise IGLOO. Praise whoever came up with that idea!

While I lay there, Rikki paints my toenails...they have to be pretty for church tomorrow. I can wear my sandals since I'm not doing anything but crutching it. I'm definitely not moving fast enough to do anything wrong. The polish finally dries and I'm done. The television is on, I have my magazines, I've been appropriately dosed with pain killers, anti-inflammatories, and I have my Diet Sprite....I'm good..........until....yes.....oh my gosh, did I drink that much?!!?!? I finally figure out it is all the IV fluids they gave me....I was certain I had not drunk the entire Indian Ocean....but it sure felt like it. Anyway, we all know the drill. What a night this will be.

The Surgery

The day was warm and bright. Spring in Oklahoma. Of course, I wasn't blessed with a morning surgery so I woke up hungry and thirsty. Made worse by the fact that I couldn't have anything to eat or drink.

I had carefully planned how to adjust my weightwatcher points (I like to defy the odds and did not gain or lose any weight during the recovery phase of my first surgery--typical gain is 30 lbs) so I could watch my intake after surgery. I did not want to destroy what I had worked so hard for in the past three years.

I dreamed of what I would have to eat after surgery....and dreamed of what I couldn't have prior to! Anyway, I had some time to kill....I took a shower, brushed my teeth, and put on my "surgery" clothes. Post surgery I would come out with bandages and a brace the size of Texas. And I had lost a lot of weight and didn't have any "big" clothes anymore. I needed clothes that would allow enough room in the leg to accommodate this brace. I had picked out a cute "jammy" outfit with Tweety Bird on the front. I had borrowed crutches, I had on clean underwear (I am vain, I bought new underwear too), clean socks (who wants to show the doctor anything but brand new underwear and clean socks?), and I shaved my legs.

Finally it was time to go. We stopped by and picked up my CPM machine. This marvelous invention bends your leg for you over and over. I will be spending many hours per day in this blessed piece of machinery.

JB and I reached the surgery center, checked in and promptly discovered that the crutches I borrowed were not the same height. Great. So he would take care of that. He announced he was hungry. That, translated into "Can I leave you here and go get something to eat?" I answered back, "Join the club", which, translated into, "Heck no you can't leave and go eat when I cannot!" Nice try though.

Apparently things were delayed. That helps with anxiety....if one wishes to increase it. Finally, I get called back. You know, I recognized the nurse as the same one who had taken me back to be prepped for the second surgery (bone spur removal from the kneecap). It's really rather sad when a nurse who sees hundreds upon hundreds of patients and she still recognizes you. She greeted me with something that let me know she remembered me, ..."So, you are back again huh?"

I got the standard questions, she handed me a couple of pills, gave me two drops of water to swallow them with and then promptly followed that with, "have you had anything to eat or drink since Midnight last night?" DO YOU HAVE AMNESIA? YOU JUST GAVE ME WATER!!!! I wanted to say that but I didn't. What I did say was, "Other than what you just gave me? No, I have not had anything to eat or drink."

Prepping for surgery is something else. I'm scared of needles, I'm fascinated by what certain drugs do to the body, I'm anxious, I'm scared I will die on the table, all sorts of things to think about. First and foremost is that IV...you see, as scared as I am of needles, the IV is the ticket to peace. If I can get that, everything else comes through there. No more needle sticks. And who cares about them slicing flesh open? I won't be awake for that.

I always question the nurse with the needles. ALWAYS. Of course, I expect lies at this point. I don't believe that any nurse who needs to get a needle into someone who is afraid of them, will say that she is bad at it. I'm not stupid enough to think that I'll get the truth but the reassurance of being very good at it helps.

I get the IV in, JB comes back. Then he's asked to leave again so they can administer the "Milk of Amnesia" drug so that they can deaden the nerve in my leg. This is interesting. For many reasons. Here are a few:
1. Deadening the nerve in the leg allows for less trauma to the body during surgery. Therefore, less pain and faster recovery.
2. It is quite entertaining to experience the "dead" feeling in one's leg and "fight" the drug as it takes effect. (I have always lost this battle)
3. The drug, Verced, aka Milk of Amnesia, twilight drug) is absolutely interesting because it allows you to stay awake but not remember what happens. They have to be able to speak to me while placing the needle in the correct spot but need for me to not remember the feeling of pain or whatever.

I was looking forward to this one. I had it for the first surgery and still replay it because I just have not figured out how it works. They tell you they will inject it into the IV, in a moment the drug takes effect, they do the procedure and then it wears off. Okay. They told JB that when they do the procedure he will have to leave. He agrees but still sits there. I watch them put it in the IV (it's white like milk, hence the name milk of amnesia). JB is sitting there while the drug takes effect. Seemingly in what seems to be an instant for me, I "come to" and realize JB is still sitting in the chair. I said, "Are we going to do this or not?"
He tells me they did do it.
I said, "No they didn't. You are still here."
He tells me he had left and came back.
All-right then, I'll just see if they did it. I touch my leg and it is on the way to being "dead". They DID do it!

Okay, so this time around I'm going to pay more attention to things. Anesthesiologist comes in, talks to me about the surgery and prepares me for the Verced. He gives it to me and he goes about his business but I'm still aware! Just as I said, "Uh, doc, I'm still here." My memory waved bye and left.
Sure enough, when I "come to" my leg is on its way to dying.
Doc comes back to check on it and we converse about keeping me alive during surgery. He finds my sense of humor either funny or insulting. I hope it is not the latter as he is the one person you don't want to tick off prior to surgery.

Surgery will be delayed...Dr. Pascale comes around, wearing hip waders (which makes me question SEVERAL things about the surgical world), says hello to JB, talks to me and tells me he's running late. I give JB permission to go eat as I'm tired of hearing him mention food. And he needs to take care of my crutch situation. I'll be drugged enough as it is, I don't need to be lopsided.

So I lay there, play with my now "dead" leg by attempting to move it up and down on the bed. I send text messages to my brother who is having fun going through the procedures and prepping with me. He's sick just like his little sister! And what better way to do it? He has no reason to have surgery himself so he can live vicariously through me!

Finally, and I do mean FINALLY, they come get me. They wheel me down the hall (we are at a Surgery Center, not hospital by the way--totally outpatient procedure) and into the surgical "suite". (seems to me that suite implies something cozy and nicely decorated which, this room is NOT cozy and I debate the definition of "nicely" when it comes to the decorations adorning this room. It is cold....I am given several warm blankets (which I'm sure they remove as soon as I'm "out") and they start preparing me for surgery. They attach the electrodes (which are also cold) to my chest and lay me out as if I'm being crucified (which always ups the fear and anxiety a bit). The anesthesiologist asks me a couple questions, and I remind him that waking me up is his number one goal. They joke with me about which leg it is (I like to pop quiz the surgical staff to be sure that everyone has reported to the correct room and have the correct patient and procedure). This time (every surgery they have marked my leg differently) they have marked NO on my left leg. Now, one has to assume that that means that the doctor will know that the remaining leg is the YES leg.

The anesthesiologist is really getting into the humor thing and making comments that I'm not expecting...and his demeanor and words kind of make me wonder what I might have said when I was under the Milk of Amnesia drug...too late to worry about that now. He's just told me (obviously thinks this as well) that I talk too much. Before I can reply, things blur, I get warm, and I can feel myself slipping away and I'm gone.

I come to slowly...I hear the nurse call my name. She's very far away...and she's nice, but commanding. She feeds me an ice chip and I can hear her voice become louder. And then I feel the pain. The closer her voice comes to me, the worse the pain gets. I try to ignore her, wanting only to go back to sleep. There isn't any pain there.

I must have moaned or made a noise as she starts talking to me. Encouraging me to respond to her. She keeps calling my name. I silently wish I had changed my name. The pain becomes more intense. She asks if I want some pain medication, I nod yes. She goes away and I try to slip back to sleep, endure the pain until she comes back.

I don't know what she gave me but it didn't even begin to touch the pain. I was given morphine, more of whatever she gave me the first time and finally, the doctor gave permission for another nerve block. Here we go with the Milk of Amnesia again. Finally, after about 20 minutes, I was able to tolerate the pain and somehow, with the help of a nurse, and JB, managed to get clothes on. JB was getting increasingly frustrated.

It was Texas Hold 'Em night and it looked like he was going to be late. Oh yes, he intended on dumping me at the house with the children in charge and heading off to play poker. Not that I would care. One, I'm not going anywhere anyway, and I'm so drugged, I could not care less if he said he was headed to Alaska. Give me my pain medication and Have a good time!

My husband, as frustrated as he was, couldn't understand just how many drugs I had and why it was important to wait and see if I reacted. Finally we got the okay and he headed to get the truck. He had bought me brand new crutches and had them adjusted for me. It was a beautiful thing. He dutifully listened to instructions and loaded me up in the truck where I sat, almost drugged to the point of drooling. I was hungry...and I needed prescriptions filled. You would think that as drugged as I was he wouldn't want me traipsing around the Wal-mart, much less even entertain the thought that I might not be ABLE to do that. You'd think I would have more sense, but hey, I was medicated!

I remember apologizing many times about taking so long and for hurting so bad and further delaying his game. I recall him saying it wasn't my fault...

We get to the Walmart and I must have looked pretty ragged but in I went. Medicated and all. We filled prescriptions, I grabbed magazines, and some things to drink and he grabbed ice. Then we headed home. He gets me in the door, onto the couch (I was NOT ready for bed) and off he goes to play. I'm not allowed to be up on my leg since it is "dead" and I'm forbidden to even touch my right foot to the floor for two weeks. Well, THAT certainly wouldn't be a problem. He places my CPM in the bed where I will eat and sleep and watch television in it for the next three weeks. And it is also the best way to keep my leg elevated and it hurts much less. I live in the CPM. I love it.

My husband will not sleep in the same bed after a knee surgery...(he likes to migrate) he's afraid of hurting me. And I will keep him awake if I'm in pain. So he sends our teenage daughter to sleep with me. (remember, I'm not allowed up by myself) Well, after assuring me that she would be sure to get up with me throughout the night she falls asleep. Well, I had been given plenty of fluids through that IV. So much that it wasn't long before I had to make my first call for help. Well, drugged as I am the effort on my part was not too great and I'm more of a "I can do it myself" kind of gal.

There are reasons for the orders that doctors give you. I'm just fortunate enough to have been given mercy and grace and protection from the Lord. I'm sure it wasn't a pretty sight, but I did get up and go to the bathroom by myself. Not the smartest thing I've ever done. And it certainly wasn't the easiest from what I can recall. Getting out of bed was an ordeal in itself. It entailed stopping the CPM machine, undoing the velcro straps on the leg, lifting my leg (with my good foot) cause I have NO MUSCLE TONE, grabbing crutches and making my way around the furniture to the bathroom. Getting there took a while and figuring out how to seat myself took some doing but what I didn't take into account was my ability to get back up from the seated position.

Now, this is the picture. My leg has a ton of bandages, a restrictive brace that does not allow any bending whatsoever, not weight is to be put on the leg, crutches are my only support (other than the wall and toilet) and I'm freshly medicated. Now, imagine that seated on the toilet. Mind you, the brace, comes to about mid-thigh so when you sit, the leg is forced straight out. Now I could fix that but then I wouldn't be seated properly and it would cause, well, the process would not be able to proceed without a mess.

So I finish my business thinking I have done pretty darned well for myself. I haven't fallen, I've had my "moment" and I'm pretty confident that I will be able to return to bed.

At this point, I realize that it has been awhile since I was on crutches and I'm not quite so good with my balance yet. I am too medicated to get up. OH MY GOSH. What now? I can't be stuck on the toilet! It's too uncomfortable. I want my bed!

I'm not only a I can do it type of gal, but I am also a stubborn one. I finally get up, coming close to falling but catching myself. I hobble back to the bed, and I manage to just get to the point where I will use my good foot to lift up the right leg when Rikki stirs and says, "Mama what are you doing?" Do you need to go to the bathroom?"

OH MY GOSH. I wanted to say, "No baby, I'm good. Mama's just running a couple laps."
But what I said was closer to "I just went."
And this is what I hear, "Why didn't you wake me up?" Is she serious? I've learned real quick no one takes a medicated person serious. For some reason, people believe that when you are medicated, you just don't know what you are doing at all.

I finally get back in bed, have Rikki switch ice packs and just as I get settled, yup, you guessed it. I have to go....again. So I let her know. And do you know she has the nerve to say, "You just went, you have to go again?"

Background--how it got "this way"

I remember the day it happened. The day that would impact my life far greater than I ever anticipated was possible.

I was 14 years old and in the last half of my 8th grade year. My best friend, Angie, and I had been walking through town, just jabbering like teenage girls do. It was mid winter, snow was everywhere and it was fairly nippy out. And, of course, we were on the lookout for boys. What teenage girl isn't?

We met up with some boys, and to tell you the honest truth, I cannot even remember who they were or if we even knew them well. All I know is a snowball fight got started. As we fought, the fight went with us, through the streets of town. And then it happened. I had a snowball ready, my arm went back and I let it go. And it went, along with me, straight to the ground. Ever watched television and they show things in slow motion? Well, that is what happened with this.

As I threw the ball, I twisted and my kneecap slid out to the side. I felt my leg collapse, the pain was excruciating. As I went down and my body went into automatic reflex to protect my knee, the kneecap slipped back in as painfully as it had slipped out. I hit the ground screaming in agony. BUT, don't forget there were boys around. And here's another interesting note. I don't remember what happened to them. I don't remember getting back to Angie's house. All I remember was sucking it up in front of the boys. Tears streamed down my face.

A trip to the emergency room was in the near future as my dad raced me there. The swelling had been intense and very quick. They put me in a leg brace, gave me some pills for pain (nothing good mind you because I don't believe they helped all that much) and sent me home on crutches.

To spare you, that was the beginning. After the initial sublex (THAT...would be the official medical term for what my knee cap did), my knee was never the same. I refused to allow a needle to be used to drain the fluid on the kneecap. I adopted the massage method and spent many hours massaging the fluid back into my leg. Physical therapy was tried. Braces were tried. Nothing seemed to help. Every few months, it would sublex and I would hit the floor. A few ER trips to the hospital, more braces, physical therapy and declare me better.

But, over time, the swelling decreased. The pain wasn't as intense. And, it occurred with more frequency. What I didn't know was my body was becoming immune to the pain. Mind over matter I guess. And I learned how to cope. I learned what was liable to send it into a "sublex" action and what wouldn't. I stopped "cornering" quickly. I was still active but very protective of my knee. Occasionally I would have a serious sublex that would send me to the ER. But for the most part, I went on with life.

That sounds like things were normal. And for me, that was my normal. It got to be so normal that I could be walking alone, or just standing still and my knee would sublex and I wouldn't even acknowledge it. I would be grateful that it wasn't serious and just move on. I had given up on help and accepted that this condition, whatever one wanted to call it was just something I had to live with. And what happened in May of 1998 proved it.

I was playing softball and was on first. The next batter knocked the ball far into the outfield. I took off. Well, the batter behind me was a guy, and he was athletic and he was quick. Remember I didn't "corner" well so I rounded second base and that was all there was. My knee sub-lexed, I went down and it was bad. He's screaming, "Get up, run!" He helps me up and I take off but there's a problem. My knee cap is not staying in place at all and my leg is (according to witnesses) flopping all over the place. To be honest, I don't know how in the world I ever made it to home plate. But JB was there waiting. He grabbed hold of me, apparently having witnessed whatever was happening with my knee. The coach was there and people gathered around me. I was crying. They all figured I was in immense pain. And that was the other problem. I felt nothing. After the initial surge of pain, I felt nada. I wasn't crying because I hurt. I was crying because my kneecap wouldn't stay put. Just barely brushing the ground with my toe sent it out of place and to the side.

I was hysterical. JB was asking if he should take me to the hospital. The coach, among others, were rushing around talking about how much pain I was in and grabbing ice, etc. I didn't know what to do. I whispered to JB that my kneecap wouldn't stay in and I showed him by gently touching my toe to the ground. That did it. He looked at me and said that he thought we should go to the hospital. So off we went.

I was afraid I would need surgery. They did an x-ray and gave me something for pain. I believe it was Demerol. Good stuff for childbirth but it didn't help much with the knee thing. They braced me, told me to call an orthopaedic guy and sent me home. I was on crutches for two weeks and in a brace for four weeks. I went to physical therapy once. And that was it. Back to what I knew as normal.

Until I heard about Dr. Pascale. Now he is awesome. He is one of the top 10 orthopaedic surgeons in the United States. A friend of mine told me about him and I figured I had nothing to lose. It couldn't hurt to go see him to see what he had to say. And, technology was such that there just might be something that he could do for me. The situation was such that I couldn't play with my kids and I so wanted to do that. And it was dangerous for me no matter what I was doing. And, I wasn't getting younger.

So I visited Dr. Pascale on a semi-cold day in January 2002. Apparently, he has med students spend time with him as part of their college credits or something. The habit is they come in first, look at you, give you what they think is their best diagnosis and then the doctor comes in and they do this thing together. A learning experience. And what a learning experience it was.....for the student. And the doctor. You see, apparently, my condition might not be rare, but how I had grown immune to the pain and what I could do exceeded what they had ever seen. And the poor college student had all he could handle with me. They seem to think they are very knowledgeable. He found out he wasn't quite as smart as he thought he was.

X-rays didn't show anything wrong....and he (the college student)comes in, acting all smart and educated about knees and said, "Okay, well we'll start you off with physical therapy for a month and then we'll see you back..." I stopped him right there. With tears of anger and hopelessness in my eyes, I said, "Nope. I'm going home. Physical therapy won't help this. If that is all you are going to do, you are wasting my time and I'm not doing it. I'll see you later."

He was slightly taken aback. He tried to push it. I again repeated what I had said. And then I added a little more "umph" to it. I said, "Dude, this (nodding toward my knee as I grabbed the kneecap between my thumb and finger and proceeded to pick it up and move it in every direction before placing it back where it belonged), will not respond to physical therapy. I am not able to strengthen the muscle to keep it place for the therapy to do ANY good. I'm outta here."

At that point, the doctor came in, did his little thing, asked me to straighten my knee and bend it (picture sitting on the bed, swinging the leg out and back). Each time I did, the kneecap would slide out to the side and back in place. Every time. He agreed with me. There was no other option but surgery. (To this day, I love having fun with the college med students....they learn alot from me)

Less than two weeks later, I had my first surgery. He tightened the muscle on the left side of the knee and cleaned out the bone particles I had floating around the knee area, and put me back together. I had nice long incision and 6 long weeks of recovery. And months of physical therapy. Dr. Pascale hooked me up with Debora Horsch. She's great. Months later, I was better but I could tell it wasn't stable. And about a year after the surgery, I noticed something wasn't right. It was growing more unstable and I could feel it wanting to come out.

An x-ray showed a bone spur directly in the center on the under side of my knee cap. I had arthroscopic surgery this time and three weeks off work for it to heal. That surgery was more painful than the first one. But, I had gotten off light since I still didn't have feeling like a normal person would. That called for caution but it was great because I cannot imagine the pain I would have been in if I was feeling it full force.

Around March 05, after having recovered from back surgery and feeling well, I discovered that as I strengthened my leg muscles, my knee was feeling pretty unstable. And the thigh muscle wasn't building up. So I went back to Dr. Pascale. While he didn't dismiss me (I am, after all, the one IN my body), he agreed that a re-alignment was called for and it was our last hope at fixing me. He had refrained from doing it before during the first surgery because he had sincerely hoped that the tightening of the muscle would be sufficient and this was a huge surgery.

We decided that we would do the realignment on Thursday, May 5th, 2005. He would open me up, do some cleaning, and then he would cut the bone, move it over to align the bone and thigh muscle directly over the center of the knee (putting the kneecap squarely in place and muscles lined up so as to keep it there) and screw it in place. It would be over 6 months of recovery time plus physical therapy. I anxiously awaited the day. And I prayed. And prayed. And prepared to accept whatever the outcome would be. After all, this is it. My last chance. And, I figured, I had nothing to lose. It couldn't get worse....the worst it could be was stay the same.

Then the day came...