Knee Surgery: Pre-Op Jokes and Dr. Pepper

As martial artists, we’ve heard those familiar mantras before: “Fall down seven times, get up eight”; “A black belt is a white belt who refused to give up“; perseverance, indomitable spirt, blah blah blah.

It turns out that martial arts spirit of perseverance and jocky stubbornness to give up has quite come in handy over the last few days. I am four days into recovery from ACL surgery, and recovery has been a full-time job. Let’s go back a few days…

In my last post, I described my worst taekwondo injury to date and following tests and decisions I made with my doctor. We agreed on an ACL repair slated for July 22 at 7 am.

…things didn’t quite go as planned.

Tuesday evening, a few minutes after five pm, I received a very apologetic phone call stating my surgery was cancelled (with less than 12 hours to go) because the insurance company had not yet “approved it.” How could this be? I’d already been quoted an estimate? Shouldn’t this have been straightened out from the beginning?

Once again, COVID-19 has dealt a wacky hand. I won’t go into all the boring details. Suffice it to say, the pandemic and subsequent fallout has slowed down and complicated the healthcare industry, including timeliness of insurance companies approving healthcare procedures. It was rare, but not completely unheard of. Having worked in healthcare for sixteen years, I wasn’t totally surprised. I think my friends and family were more outraged than I was. I was just mentally exhausted and wanted to get my knee fixed.

Just when I was starting to feel good and sorry for myself Thursday morning, my friend in scheduling who worked very hard for me and deserves a raise, called to let me know my surgery had been rescheduled for Friday at the hospital two miles from my home, rather than the surgery center over fifteen miles north on the vast hellscape that is Interstate 35. The catch was: I needed to get to the hospital right away for a rapid COVID-19 screening test. The test wasn’t required by the small outpatient surgery center I’d originally been scheduled to visit, but it was required at the big city hospital where I would be having my surgery. We grimly joked with each other that it would be just my luck to have a positive COVID-19 result and my surgery further put on hold.

Thirty minutes later I was stumping around in my brace from one area of the lobby to the next until a nurse called me back to the patient screening area. In retrospect I was more nervous about the COVID-19 test than I was about my surgery. I’ve had surgery before. I’d never had the dreaded swab up the nose.

Getting a COVID-19 test isn’t so bad, or at least it wasn’t for me. Even the nurse administering the test was a bit surprised as to how easy it was. I looked up at the ceiling light, held my breath, and felt the swab go up up up my right nostril until I thought it might poke the underside of my eyeball, and back out it went. I don’t have the smallest of noses, so perhaps my facial anatomy played to my favor. I told the nurse how much I appreciated what she and her colleagues were doing throughout the COVID-19 crisis. It’s commonplace to thank military veterans for their service. Now seems like the right time to do the same for our healthcare professionals.

My test was negative.

Fun times in pre-op

The morning of the surgery I treasured the tiny sip of water I was allowed with my pre-op nurse-approved morning medication. (Nothing to eat or drink after midnight, and I am a rule follower). I had taken advantage of having Wednesday and Thursday to tidy the house and do laundry and ready it for my convalescence. My caregiver dropped me off around 12:30 (easier since my home was so close) and I took a few deep breaths in the waiting room to calm myself.

“Well hi there!” a nurse named Alice* shouted. I slowly got up and started limping toward her. “Are we doin’ your right shoulder or your right knee?” I stared at her dumbly for a moment.

“I’m just playin’! I see that big ole’ brace. I know we’re doing your right knee!” Alice said, her bright blue eyes twinkling over her mask.

“Oh girl, don’t play with me,” I said, but I was thankful for the levity. Once I was dressed and settled into a bed (after raving over the swag bag that I got with a water bottle, lip balm, and hand sanitizer), Alice and I were joined by Angie, the pre-op nurse I’d spoken to the day before.

“Hey Melanie!” Angie said, twisting her body to wave brightly and squinching her smiling eyes. “It’s so nice to finally meet you!” She and Alice and I joked and bantered as if we were old friends.

I tend to get calm and a little silly in serious moments. When my home was struck by lighting and (sort of) caught fire in 2018 I sat on my couch nonplussed while a half dozen firemen stomped around in my attic. It was no different in pre-op. Alice asked me questions while Angie admired my new “art” (my second tattoo, on my left forearm) and poked a needle into my small veiny left hand.

“Didn’t even flinch,” Angie muttered approvingly. I beamed. Alice conspiratorially let me finish the rest of the water she gave me to swallow some anti-nausea medication. I spoke briefly to my surgeon, who carefully marked my right leg with a marker to ensure everyone was working on the correct limb. It was only after I’d removed the dressing three days later that I realized he’d written his initials on my thigh as if my leg were an old table at a diner.

After a cheery chat with the anesthesiologist, who started talking animatedly about Elvis Presley’s karate teacher when I told him my ACL tear and our reason for becoming new friends was due to taekwondo, I was joined by more very nice nurses who gave me some “jitter juice” to calm me as they wheeled me through a dim hallway to the operating room. (Note: Tell your anesthesiologist they’re your new favorite person because they are.)

This jitter juice is some good shit, I thought. I hope there’s more. In what probably took seconds, I was given a dose of something even more magical in my hand, took maybe two or three breaths under an oxygen mask on my face and….

I was having a very pleasant dream. A nice lady in scrubs and glasses and a mask and a surgical cap and…

“You were moaning in your sleep,” a post-op nurse said wryly when I blinked open my eyes and looked around.

“Oh sorry. That’s embarrassing.” I felt so tired and so heavy. I wanted to shift my right leg but I couldn’t. There wasn’t much pain thanks to a long-lasting local nerve block, but my leg felt like it weighed a thousand pounds. I was sad that they only left one of those comfy thick surgery socks on my feet. My right toes poked out nakedly from a thickly wrapped Ace bandage that snaked to my upper thigh.

“…reconstruction surgery,” I heard one of the nurses say. I learned that the surgeon tried a partial repair, but that didn’t take, and he ended up doing a full reconstruction. The surgery took about three hours instead of one. Maybe that’s why I felt so worn out, but I was actually relieved. In my heart I trusted reconstruction more than repair. Now I had a whole brand new ACL to play with.

Turns out I like Dr. Pepper. I’m now a real Texan. 

The nurse gave me a small cup of ice water to sip along with a small cup of requested Dr. Pepper because I was jonesing for caffeine since I couldn’t have anything all morning. I’ve spent most of my life hating Dr. Pepper and only very recently discovered I like it in small, infrequent doses. In my post-anesthesia haze, my Texan-ness must have been shining through. The nurse removed the oxygen tube from my nose and gave me a shot of Demerol to stop my shivering. I was so tired, and things were moving too quickly. I wasn’t ready to shimmy into my clothes yet, but somehow I did. I was dumped into a wheelchair and gently hoisted into my caregiver’s car with an ice pack machine tucked under my tender right leg.

And then I was in a really happy mood. I was fairly alert, but I do remember trying in vain to make a phone call when we discovered my pain meds hadn’t been processed by my neighborhood pharmacy. Why in the world wouldn’t the call go through?

I was trying to make a call using the calculator app on my phone.

The night wasn’t over. Soon after arriving home, a physical therapist showed up with a giant contraption called a “continuous passive motion” (CPM) machine. I was to hook my leg into the machine for 4-6 hours a day and let it bend my leg back and forth. Gone are the days of lying in bed for a week at a time. Today’s knee surgery patients are expected to be icing and moving, moving and icing, and getting into physical therapy right away.

I spent the next hour letting the machine do its work while I answered texts, updated social media, and slowly picked at a plate of Saltine crackers. The ED part of my brain was kind of thrilled that I’d lost my appetite (and it’s not really back yet). After hooking up yet another machine to my propped up leg (it kept an ice pack around my leg perpetually cold for about 6-8 hours. Excessive? Nope. Doctor’s orders.) I got a few hours of fitful sleep on my back.

Saturday was a blur of the CPM, the ice machine, and a growing nest of books. I’m so used to flying from one room to the next in my house with my hands full of stuff that it was difficult but somewhat welcome to slow down and rely on someone else while I crutched around my condo. I got my medication thanks to my doctor making a late evening phone call. I felt pretty good, given that I’d endured a longer surgery than anticipated.

And then the local anesthesia wore off.

It. Hurt. So. Much. I nearly wept with pain. I could barely lift my leg because it felt so heavy, and I was frustrated and so exhausted. Painkillers help, but post-surgical pain is inevitable. Like a good black belt, I soldiered through, not without a lot of cursing and whining and medication, but I persevered. The quicker I could rehab and get off narcotics, the quicker I could get back to drinking alcohol. Priorities, you see.

So it was really a blessing in disguise that my surgery was rescheduled. It was very close to home, and the person caring for me had a full four days off to look after me and help me. So…thanks, crappy American health insurance system I guess?

By Sunday night I was like a little kid who’d missed a nap: cranky, sleep-deprived, anxious (was I doing too much aftercare movement? Not enough? Was I going to get a blood clot??), frustrated, and absolutely mentally and physically exhausted. I hadn’t washed my hair since Friday. My leg hurt. My face was still puffy and sallow, and my voice was still hoarse from the oxygen tube that was put down my throat during surgery. I was so drained. My caregiver patiently looked up the Sideshow Bob episodes of The Simpsons on Disney+ to cheer me up, and then finally, I fell into a deep sleep.

I would write more here about my first day of physical therapy, but my CPM machine calls. Until next time…

Can’t stop. Won’t stop. Not quitting. I’m coming back stronger.

Stay tuned for my upcoming book– “Kicking and Screaming: a Memoir of Madness and Martial Arts” published by She Writes Press. Coming to a bookseller near you April 20, 2021!

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*Names changed