Knee need

Today I had a conversation with a doctor who has no connection to orthopedics (or orthopaedics if you're Greek).  He has heard favorable  things about Dr. Conguista, that he is known to have a good reputation as a surgeon and is very conservative.    Moreover, he said that he is not knife-happy, that of 8 of his patients who consulted Dr. C. he only accepted 2 for the TKR surgery.  Only a favored few have survived the cut, so to speak.  Oh, joy.

Endangered Teeth--High School & College

  We were at a high school assembly, waiting for the program to begin.  A classmate, Ruth B.,  sitting a row ahead, was turned  around talking to us in the row behind.   Another girl, Lea, was sitting in a chair in our row with her feet propped against the rungs of a chair next to Ruth's, and pulling the back of that chair toward her.  Ruth was turned around, and I remember she was laughing, when the back of the chair slipped from Lea's grasp and smashed into Ruth's mouth, neatly (in a sense) snapping off her two front teeth.  Chaos ensued.

I'm a freshman in college where gym class is mandatory for at least two years: you could escape the third mandated year if you got an A in gym.  (Not me).   Gym class was eternal; we had to engage in every sport ever heard of at the time, for a period of time, all in the interest of a well rounded education for the teachers we were all supposed to become.  From the main campus we had to walk almost a mile, or so it seemed, to Brubaker Field, the Quad between dorms designated as one of the"athletic venues."  The sport of the week was golf: that meant a group of 20 or so female students who'd mostly never held a golf club before practicing their swings in an enclosed area.   I think we were even told to keep our heads down.  The girl next to me was Prudy, a small intent girl who was on Dean's List.  Suddenly,a scream, then several screams, and Prudy fell to the ground with her hands to her mouth.  But not before I saw that her whole face was covered in blood.  She had been struck square  in the face with the full force of another girl's club.  Not only did she lose teeth, but her face was split open.  I never learned the full extent of her injuries, but she never did return to college.  . 
 

Decisions and Incisions

Let's evaluate: a decision is the selection between two possible actions, while a choice is the selection between two or more objects.  But the line blurs when the selection of an action may involve an object, a foreign object at that.  C.S. Lewis  said "Crying is all right in its own way while it lasts, but you have to stop sooner or later, and then you still have to decide what to do."  There is a lot of truth in that when people are faced with two equally tough choices, they make a third choice, which is to do nothing. 

Part 10: The Knee-Date Set but Mindset?

  The knee is to be Biomet's  Signature replacement, which utilizes MRI technology to create personalized positioning guides, the guides using advanced technology to help surgeons accurately position the knee implants.  To put  it bluntly, the MRI will allow the surgeon to saw off less of the ends of the tibia and femur.  That procedure may still occur only in a parallel universe, but the MRI is easy enough.  So that appointment is easily kept.
   I showed up at the designated  location a little early.  I have undergone two MRI's of  hourly durations, completely enclosed for the entire times, for much more ominous explorations, so a 30-minute MRI did not faze me.  After leaving all metallic belongings outside the room, I entered to meet the technologist.  She seemed quite detached, probably bored, describing the procedure by rote.  A brief description, not mentioning how she would be observing or how she could be contacted  if necessary, as I recalled being told during my previous experiences.  Today's MRI was divided into 4 parts, the first two involving only the legs, and proceeded uneventfully.  The third part meant being fully enclosed in the machine, and started out okay, but after a few minutes, things got heated.  I mean literally heated; hot air seemed to pour out of the machine and my head began to feel  very warm and flushed.  The noise was overpowering, as always, but after a time, it seemed so wrong that I spoke into the speaker advising of the heat.  No reply, which I may not have been able to hear, but she did not come into the room, and allowed the MRI to run its course.  I was at the point of preparing to extricate myself from the thing, but I didn't want to risk wasting  what had already been done.  When the technician did re-enter the room, to prepare for the next, and last, part of the series, I told her how uncomfortably hot the machine had been.  At first she said she didn't know what the cause could be.  I commented that if she didn't know, who would, and asked if  the machine could be malfunctioning.  She didn't think so, she told me, in her don't-give-a-damn monotone, and added that sometimes people do complain about the heat, and then added that the machine was scheduled for maintenance that day.  Yikes.  I said it felt like the fan wasn't working, and she asked if the fan had been on for the other parts of the procedure, including the last section just completed. She's asking me?  Yes, I could feel the air circulating when the fan was on, but not during the fully-enclosed part of the procedure.  She seemed unimpressed, and told me we were finished and I could leave.  She said this from the other side of the room, like she had other  things to do. 
  As I left, I did report my experience to the front desk, where there were two women, who also couldn't have cared less.  The service agent  for the machine was in the building at the time, I was told, that they service the machine every 2 weeks.  A little late for me, and for those other folks who sometimes complain about the heat.  My personal opinion is that the technician was out of it, and had forgotten to turn on the fan, as well as neglecting to respond to my message.
     I considered reporting my experience to the management, but decided against it.  In the event that I do follow through with the surgery, I don't want to be labeled a difficult patient.  They'll probably come to that conclusion soon enough anyway. I won't have another MRI at that site, though I don't think that's part of the procedure anyway.  I just hate it when people don't do their jobs. 
     Speaking of that, I had to return to the lab in Troy today for a do-over because they forgot to do one of the tests ordered for my follow-up appointment.  On my way home, I stopped at the Medical Records Department of the hospital where other lab tests were done, and I learned from reading the report that some of the tests were invalid because of hemolysis, meaning that  the idiot who drew my blood tore through the veins.   I mean, medical care is not like stacking cans in a supermarket, and those people do a pretty profesional job. 

Knee Saga Part 9--The Office Visit

I kept the appointment, in East Greenbush, driving myself there without giving anyone advance notice.  As I've indicated, I need to husband my resources for as long as possible. I filled out the paperwork, underwent a series of X-rays, and then met with Dr. C.  Since I tend to put myself into a catatonic state when I'm a patient, I honestly am unable to describe his appearance.  I recognized him from his picture, but that's all I could say about what he looked like.  He did appear to be one of those larger than life individuals, not just in his physical stature; his bio mentioned he played football for 4 years at Columbia University.  He seemed to possess an incredible energy and presence, in a low key way, an unusual descriptor for  a doctor, at least in my personal experience.  He spoke for a while and then asked me into the viewing area to see the x-rays.  I always hate that; I don't like to see pictures of any part of my body, especially knowing of the defects that were found.   Not much cartilage there, he pointed out, nor there, bone spurs here and here and there, worn knee puts strain on leg, etc. etc.  Back in the office, he went over the findings, and courteously, it seemed to me, suggested that I talk it over with my family, and then advise what I wanted to do.  At this point, I said I knew what I wanted to do;  if I left without coming to a decision, I figured I would not go back.  That's been my history, unfortunately.  "You can make the necessary appointments at the front desk,"  he said, and then in a nice touch, if I needed to contact him, wrote his secretary's number on his card, so as to "avoid the hell that is our telephone system."
  I have the date set for the surgery so all that remains is to overcome  about 20 hurdles before that that can happen.    TBC

Knee Saga Part 8--The Rationale

The  only grandparent who was alive when I was born was my mother's mother, who died when I was 12 years old.  In most of my memories she sits in her chair by her kitchen window, drinking tea from a bowl, crippled by what was then called rheumatism.  She used a cane when she walked:  when we were little, Nanny sometimes would walk with Helen and my mother to check out the gardens and the fruit trees, and whatever animals were on the property.  Earlier there had been chickens and goats, and later on only a dog and cat.  She walked slowly with effort; I never knew her to move about freely, even though she was "only" 78 when she died.  I think her hips might have been the most severely affected, but her knees were most likely not in the best shape either. 
   My mother loved the outdoors; she could not feel at home when confined inside.  When she was still in her teens, she was hired to work  at the Shirt Factory in Lansingburgh, operating a sewing machine.  She told me she couldn't stand it, and never went back after the first day.  She had to have access to the outdoors.  My mother actually liked physical labor; she enjoyed working in her vegetable garden, and a special pleasure was raking.  She used to walk all over the village, taking my sister and me with her on summertime evening strolls; later she would walk to Sara's house, and of course to the post office.  The time came, though, when her knees threatened her mobility. My father drove her to Dr. S. in Mechanicville.  He injected her ailing and failing knees with cortisone over  a period of time. Initially she regarded the injections as miraculous, but sadly the effect did not last and her knees continued to  deteriorate.  She no longer walked through the village, her garden grew smaller over the years, and in her later years she took to sleeping downstairs to avoid the climb to her bedroom.  My mother was a brave and strong woman; the closest she ever came to complaining was to remark, frequently,  "I'd be all right if it wasn't for my knees."   I believe she would have opted for knee replacement if it had been available to her, and I think she would be in favor of me having it too.  Anything I have of value came from my mother, so I think I will do what I think she would want for me.  That is why I made and kept the appointment with the doctor  who was rumored to be not only the best orthopedist in the area, but the best looking.  Who could resist.....TBC

Knee Saga Part 7--The Action

  Suspicious of being so intrigued, I related to my husband the incident of the wonder orthopedist, Dr. C.  "Oh, he said, "Don has gone to him, but he has to wait and go back or something or something...."  He is not good with  details, particularly where medical lore  is involved.  So the next time I saw Don, I asked him about his visit to Dr. C. Don says that "All the  guys at the Y sing the praises of Dr. C."  and that's why he was inspired to make an appointment with him. Don had not yet kept his return visit because of other issues, but the first words out of his mouth were, "He is a really handsome man.  And if a man says that about another man, you know it must be true."  Intrigue has now transformed to burning curiosity, so I googled his practice and found a picture of him.  YeGads!   They say the camera doesn't lie, but some things just do not ring true.  So what to do about my worsening knee?  Why, schedule a visit with Dr. C. of course.  I need to find out some things for myself.  TBC  (The Visit)