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  • Day228

    What's in a knee?

    April 26, 2018 in Canada ⋅ 🌧 7 °C

    Background---my right knee is janky. Started really bad last year. Would lock up, not bend fully, feel unstable. In light of that, I decided to take a job hiking alone, through the woods of northern Idaho, setting up hair snaring stations to lure grizzly bears in. Turns out, hiking up and down mountains all day did not cure my knee. So, figured something was really wrong. It has become more and more annoying so I decided to see about fixing it. An MRI showed a potential loose body hanging out in the middle of my knee. When I was in BC, an orthopedic surgeon recommended surgery but I didn't have time before moving to Igloolik. When I was in Montreal earlier this month, I did a consult with another surgeon who recommended the same thing. Fast forward to this week.....plan, fly down to Montreal, have surgery next day, fly back following day.

    My knee surgery was done under local anesthetic. In principle, I love this idea because general anesthesia makes me nauseous and there is, of course, increased risk of, you know, dying. In practice, however, local anesthesia sucks.....

    ...walk in, climb on the OR table, watch them scrub me, take out the 1 inch diameter knitting needle length cannulas they're going to stab in my knee. Yeah, no thanks. I really wanted to provide a suggestion of some noise-cancelling headphones that their patients could wear to help pretend they are anywhere but in a damn freezing-ass OR getting mutilated.

    Turns out, I don't care for needles....as I get older, I am worse. I'm also worse after taking blood from so many animals. Don't know why...just don't care for it. (that's code for: I'm a big baby and avoid needles.)

    This particular surgeon was very keen on explaining every detail, which, again, I appreciate in theory...but in practice......less so.

    He tells me they are going to freeze the area where the cannulas go in. I ask what the freezing agent is. He says, "Lidocaine". I go, "that's not freezing, that's the BURNING numbing medicine. No, no, do not care for Lidocaine!" I had to inject lidocaine into the vulvas of pregnant cows as a numbing agent prior to sewing on a transmitter that would alert us via wireless receiver and cell phone when mama was having her calf. Cows don't like Lidocaine. So Jasmine doesn't like Lidocaine. Apparently, however, in my case, there is no choice. Lidocaine is going in. The doc says it's going to burn. No shit. That's why I said, 'no thanks' but no one cares. It did burn. I did not care for it. Next he says it will be numbing agent in the joint itself so it's going to be a bit longer needle (now, why in the world is the length of the needle relevant for a patient to know---is he just 'needling' us??) and that I would feel a lot of pressure as the joint filled up with drug. He says, and I quote, "You will not like this." I find when a surgeon or doctor says you will not like something that means you are gonna hate it. Super. He was right. I'm pretty sure he overfillled my knee. After overfilling my knee, he says, "Okay, now I'm going to bend it". I laughed. Felt like it was going to rupture like sausage in a tight casing being bent backwards.

    I can feel his hands on my knee palpating around. I felt the need to ask, "Um, it's okay that I can still feel your hands all over my knee right?" He laughed and explained that the local anesthetic was extremely local and it was just in the spots where they'd be cutting and inserting the cannulas. I thought, "What if he gets the trajectory of the cannula wrong and gets off into 'live nerve' tissue?" I suggested, "You know, it's cool---I was thinking we could just numb the whole leg...like a femoral nerve block right up here at the hip...just to be sure."

    It was at that point I decided that my knee doesn't bother me that much after all. I can live with the locking, not bending, sliding, grinding pain. I was making deals with the devil in order to eek off that OR table. Where is some damn soothing meditation music?! I am too big a weenie for this! The devil deals didn't work, my knee felt like it was going to burst, and I just laid there making a pitiful "this hurts" face.

    I decided that I didn't want to watch the procedure on the screen that they turned toward me so both myself and surgeon could see what was happening. You see, my brain is a smart little cookie. It says, "I know that you're numb and all, but I can see giant rods digging around in your/my body and that is not right. (My brain has a real moral code on right and wrong regarding its body) In protest, my brain decides that Jasmine will simply vomit and then go 'byyyyeeeee'". Rather than face the situation like a hero, my brain makes me want to vomit and pass out. Even during things as innocuous as a pap smear, my brain says, "Oh no sir-reee Bob. No one is supposed to be up there smarming around with a Q-tip. I'll show those interlopers." And by show them, I mean to say my brain tries to make me unconscious. Like a said, a real fighter.

    Anyway, after some time, the doc says, "wanna see"? And I do. So I eek one eye open and see my ACL on the screen...and I'm hooked. So cool. I realize that I can only open my left eye because if I open my right eye, I can see the doc working those knitting needle cannulas like he's tossing a salad. Not gonna work for me.....dissociation requires that I do not see that. So, I focus on the screen and enjoy the show. The doc walks me through all the parts and I see the meniscus, the cartilage, the ACL graft, and the kneecap (Which he noted looked amazing---"thanks" I said cause I really take care of my kneecaps). Then, he showed me the reason we were all there. There in the middle of my knee joint was a ball of bone that looked to be the size of a jawbreaker because of the magnification. It was taking up the entirety, it seemed, of the femoral notch space. The doc said, "Wow, that's big! Bigger than I expected" and for some reason I was proud. It was like my knee was a rock tumbler and I'd produced this beautiful calcium sphere over years and years.

    Then, without warning, the doc began cutting and whirring away in my knee. Time to vomit said brain! I didn't vomit, but I quickly closed my eyes and pretended I didn't hear the whirring sound. Doc explained he was removing some fat and such around the loose body so he could take it out. He explained it was like a piece of wet soap in the bottom of the bathtub. Easy to grab, but easy too to squirt out of your hands. He wanted to make sure he got a good grip on it. That's when I heard his little tools trying to clamp it. Like little metal alligator mouth chomping. I went back into my head and tried not to hear it.

    Soon after, it was all done and the doc was apologizing that he'd had to open my incision up a little more to take my bone piece out. As soon as I could, I sat up to see the offending piece of bone. It was the size of a small marble. I could not believe that thing was in my knee. Very vindicating in a way---makes a lot of sense why things were not working properly. I don't believe knee joints are designed to hold our rock collections.

    They had me walk off the OR table, go dress myself, and walk out of the clinic. Badda boom badda bing. Full weight bearing. Nothing to heal in the knee itself except the two stab wounds to insert the cannulas. Once swelling goes down, I will hopefully have a much more functional knee!
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