Today is the day....I FINALLY see my OS!

[mj5]

So, I actually made it to Thursday! I will leave in about an hour and a 1/2 to go see my OS to see what all the "fuss" is about....he was originally thinking a PKR for my right knee, but a week ago I received a phone call from his office stating that he wanted me to come in and talk about a different surgery. To say I have been driving myself (and everyone around me!) crazy is an understatement. What I did not expect is to feel nervous. I do not normally get nervous going to see the OS. I really like him, I have been seeing him for years--we even have some silly, inside jokes, guess that probably means I have been seeing him too long?! LOL! Anyway, I am actually nervous. I keep telling myself that I have to go in w/ an open mind and really listen to what he has to say.....Wish me luck!

 

[Josephine]

You got that, mj. Looking forward to your report!

 

[mj5]

I LOVE my OS!!!!!!!!!!!! Long story short, he wants to scope my knee first to get a really good look inside before he makes any decisions. He said that he will clean things up in there (if there is anything he can clean up), but the main focus is to really see what is going on and to see exactly where the arthritis is before deciding between the PKR or the TKR. He strongly warned me to not get my hopes up that this will be the quick fix that I would love, but it *could* postpone something more involved for a while. We talked about the fact that he does not feel that he can make the best decision for me w/ out going this route. I am all for having all the info you can have before making such a big decision. After we talked (and I really did listen to everything he had to say--even when talking about the TKR), I told him that if he had told me today he wanted to do the TKR I would have probably said no, not yet. Of course, I may have regretted that, but that was my decision for now. We did talk about it more and he wasn't terribly happy to hear that, but appreciated my honesty and that I was willing to discuss future options once we have more info. A scope is no big deal, I have had several--forgot to ask if he could use existing entry points so my knee doesn't look any more horrid than it already does, but he's the expert and really, what's three more small scars anyway?!

Now that I have time to absorb it all, of course, I have a zillion questions....I want to make sure I ask the anesthesiologist if I can stay awake this time. I have done this before and watched the procedure on a screen. I must say, it was VERY cool! MY OS explained what he was doing and I got to hear him sing--too funny!

On the downside, I hate the thought of being out of work for this and then potentially another procedure, but then again, doing it this way will give me more time to lose some weight.

My OS gave me a steroid injection which will work very short term, but I'll take that for now!

I feel so much better. Not knowing is almost always worse!!

Thanks for listening!

Josephine, I can't wait to hear your opinion on this approach. What do you think?

 

[JudyS]

mj5

I am so glad you are happy with the surprise!!! I am having my first scope on the 17th. I am not afraid of the procedure, just the unknown. I have been considering on and off being awake at least for the part when he tells me what is in there, then going off to sleep when he does his thing.

You said it was cool being awake, are you in any way sedated? Or just no pain? Do they give you a block in your leg?
In the past I opeted to not be sedated in a gastro procedure and It ended up being bad, that is why I am very hesitant now.

Any info will be appreciated.
Thanks
JUdy

 

[mj5]

Hi Judy,
I had a spinal--I guess that is what it was called--I was numb from the waist down, but that wore off fairly quickly after surgery. I know they gave me something to help me relax through the iv, because I wasn't nervous or antsy or anything like that. I remember being wrapped in warm blankets and my OS and the nurses talking to me through the whole thing. Plus I felt great after--no grogginess at all.

That kind of stuff fascinates me, whenever I tell anyone I watched, they think I'm a crazy.

Good luck to you on the 17th! I cannot imagine how hard it would be not to know what could happen.

 

[JudyS]

mj5
I do find it all fascinating too. I had cervical fusion surgery the previous summer. The nurse literally ran in after they were ready to take me to the OR to give my something to relax me. Well, that totally knocked me out.
When I had my hip replacement I made it very clear to all that I wanted to be fully aware when I entered the OR as I wanted to see the parts!!!
I will have to talk to my doc about it next week.
Thanks for the info
Judy

 

[Josephine]

That was the route I went, mj. My surgeon always did diagnostic scopes before to confirm his intial findings. However, the two young chaps that were appointed as definitive knee surgeons shortly after (so he doesn't do so many knees now) do not and were a bit dismissive when I talked to them about it. One said I should have gone to him and I'd have had the TKR by then already.

However, turned out to be exactly the right thing for me as my knee improved greatly after being washed out (no debridement) and has gone from strength to strength since. Plus I met a man in the out patients waiting room at The Royal National Orthopaedic Hospital summer 07 who had been going against the surgeon's advice for six years just having arthroscopic washouts once or twice a year and he was walking well and doing everything he wanted to.

Now this may not work for everyone, but as my surgeon very wisely pointed out, damaged or not, you can't beat your own knee and there's no going back once it's done. So end result is I highly recommend this approach and you may even be lucky enough to be able to postpone the inevitable afterwards as I did.

 

[Simon]

After the first 2 surgeries, the next 7 plus the scopes as well as the BTKR I had done with epidurals and No (yes that is no) sedation at all. I was totally awake, breathing on my own and for everything before the BTKR I was able to watch the screen for the scopes. The reason we went this route as my original problem was malalignment and by being awake, I was able to move the knee and this made it easier for the OS to figure out what was going on and get a better alignment. For the BTKR, I was able to watch the computer as it drew the knee and indicated where the cuts should go etc. I did get a little peak of the surgery.

With the first ones it was interesting to see the personality change of the OS. He is British with a Benny Hill sense of humor but in the OR he was very down to it. We had some long discussion as things were going on and he pointed stuff out as he was doing the scope. With the BTKR I didn't have any conversations but I sure could tell they were having a problem on the right (I thought they might with a bone graft in there) with a lot of talk and then I knew when the anesthesologist started giving them a countdown on the tourniquet time. Aftterwards, he told me the top of the tibia had cracked (complication from the graft) and they were trying to decide if they were going to put a stem tibia implant but the time was a problem. It all worked out.

The only problem I had was would get cold but they brought in some warm blankets. With the BTKR they used a bear hug warming device and I was too warm. The anesthesiologist with the BTKR was really nice as she even gave her bottle of water so that she could dab the lips which were getting dry.

Anyway, this is clearly not the route for most but I have worked in medicine for along time and I had a very good relationship with my original OS so he knew there would not be a problem.

SImon

My original driving force is I had a horrible time after the first 2 with nausea and urinary retention so I thought the less anesthesia the better. I guess that is just my body because after the BTKR I had horrible nausea and vomiting and spent 7 hours in recovery where they must have tried ever drug in the book but as the epidural wore off,things just kept getting worse. I was so thirsty but even ice chips or sucking on a giner ale soaked sponge would set me off. THis is not a common reaction, so don't worry. I have similar reaction if I go out on a boat.

 

[JudyS]

Simon
I sure don't think I would attempt without some sedation. It made me a little queasy just reading your post!!! Also I would need to be reassured that I had a signal to knock me out!!!
I think I have figured out the nausea with me is do to the pca pump. But, like you , the urinary retention issue keeps appearing. Last time when I had epidural steroid injections in my thoracic spine, they ended up using a catheter. What worried me, as I then left for home, was if I continued to have a problem. The nurse told me my only option was to come to the ER.
Not exactly what I want to do after having surgery!!!

Well, I will talk this over with my doc next week
Thanks for your input
Judy

 

[Shamrocker]

Fascinating that some of you were interested in and capable of watching your own procedures. I had the exact opposite reaction. Although I've never been squeamish about blood and never had any difficulty watching real or fictional medical/surgical scenes, I knew without a doubt I did not want to see, hear or feel any portion of my own surgery. I love, love, love me some Versed (or whatever they gave me).

Odd thing is, beginning immediately after my surgery, I found myself unable to watch anything remotely resembling "gore" on television, nor even hear anyone speak of it. I wouldn't even look at my own incision for weeks (luckily, I had several helpers to check it daily for signs of infection). Crazy, I know. It was the strangest thing to have to look away from the screen during some of my favorite programs. This has never bothered me before. I think it's begun to diminish at nearly 3 months post-op. What a strange after-effect. But kudos to those of you courageous souls willing to take it all in.