Day 1 Post Op

On the overnight into the morning of day 1 post op I woke up quite a bit- either on my own or by the constant nurse checks. Anytime I woke up I would rely upon my friend the morphine pump and give myself a dose every six minutes as directed. Doing so was allowing me to “stay ahead of my pain” as directed so there wasn’t any great discomfort.

Around 5AM I started to get incredibly nauseous. I think that I was quite literally green and all around miserable. Again this wasn’t feeling poorly due to pain but rather due to feeling incredible ill.  Around 7Am or so my Day nurse named Dan came in.  I liked him because he was a take charge kind of guy who had been dealing with these recoveries for quite a while. He asked how much I had been using the morphine pump and immediately knew that was the issue. The pump was working great for the pain but was literally making me sick. I was taken off of the pump and put on oral pain killers primarily Oxycodone. I then spent the next few hours detoxing before I felt better.

They got me cleaned up for the day and introduced me to a couple of tools to help with my recovery. The first is a breathing device that was meant to exercise my lungs and prevent breathing issues.

As you can see from the picture it’s a small plastic device with a mouth piece. You are supposed to put it in your mouth and breath in with enough force to lift a ball inside of the device to the top of a measured grid. To me it seemed stupid and I used it once before relegating it to the window sill for the rest of my stay.

Te device of great value was the CPM, (Continuous Passive Motion Machine). The leg with the knee repair is placed into this machine in bed and strapped in with Velcro straps. You are then given a controller and put in charge after a quick lesson.

Bottom line is this machine will take your leg from a straightened position while lying in bed and bend it upwards as far as you are able to go based upon your pain tolerance. It will also hyper extend your knee about three degrees as well to make sure that you are fully able to strengthen it. The machine does all of the work and all that you have to do is tolerate the pain when it reaches its extremes. Undoubtedly it wasn’t in my top 10 favorite things to do but it is vital to get the knee moving ASAP.

As with any hospital stay there is the inevitable hospital food. I have heard that a lot of hospital food is quite good but I must say that at Ass General- not so much. In fact the food was is my only complaint about my experience here. Thankfully due to the nausea I wasn’t very hungry anyway but this purported Turkey Pot Pie only exacerbated my queasiness.

Of course visitors are a big and important part of the overall experience and both Deb and my Sister were surprised to find me in good spirits and relatively pain free.

I had my first interaction with my physical therapist who was very nice indeed. I was asked to arise from the bed and walk with the aid of a walker. All of that really amazes me because it has been less than twenty-four hours after the surgery. While I didn’t exactly sprint down the hallway with the walker I found that it wasn’t that bad and the pain was minimal at best. I was cautioned that this was probably due to the nerve block still having some impact to help alleviate the pain. I didn’t care because it felt pretty good given what had happened and that’s frankly all that matters to me right now.

It was a long and eventful day that started with me feeling very sick and ends with me feeling pretty darned good about the overall experience so far.

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Surgery Day!

Surgery was to be done at Mass General Hospital in Boston. I live about forty-five miles north of there in New Hampshire. Surgery was schedules for 1:30 and we had to report to the surgical unit two hours in advance of that. I was being accompanied on my big adventure by my wife Deb, my daughter Nicole and my sister Candy. By plan we had all agreed to document, remember and or photograph anything along the way for the sake of this journal.

The ride in was pretty uneventful and Boston traffic was kind to us. As it turns out we had to park in the 5th floor of the parking garage, ($9 per day parking), and proceeded to the elevator. The elevator was taking forever and the clock was ticking so I made the command decision to walk down the stairs. It was one last chance to brutalize my knee and it was most vocal in its displeasure over my choice.

Outside the entrance of the hospital we stopped so that I could pose before going in. My favorite picture was the one where I looked like I was crying before I went in.

I must admit that it is a strange feeling to be walking in to the place and knowing that within a couple of hours you would be cut open, have your knee cap removed, buzz saws taken to your bones, screws, hammers and glue used and for this I am volunteering? There is indeed a lot of trust that we put into of medical professionals.

We went to the Wang pre-surgical waiting room. I gave my name and we sat down. We took some quick pictures of us sitting there.

Lots of unhappy looking people in hospital gowns were sitting there with their family. We sat down and I assumed we would be there for a while, be called over for intake info, get gowned up at some point spend time with my family before being led off to the OR after some emotional goodbyes- the stuff that movies are mode of. Wrong!

Within five minutes my name gets called out and I acknowledge. A rushed looking nurse comes over and says that it’s time to go. I ask where we’re going and she says “for surgery!” We were all more than a bit shocked and in retrospect I was pretty happy because it eliminated potential drama. Mt family was directed to the Gray Family waiting room. Quick hugs were given and it was funny because it was a pretty public experience so after I said goodbye to my family I said goodbye to everyone in the waiting room as well. Some even waved and said goodbye to me.

The nurse walked me down the hall and into a prep area. She said that the doctor was in surgery and ahead of schedule so we were going to move quickly.  So much happened so quickly it was truly amazing. I was disrobed and put into the hospital johny. An IV was placed and a stool softener was given as an advanced strike on the inevitable constipation brought on by surgery and narcotics. I was warned that everyone I met would be verifying my name, date of birth and which knee I was having surgery on. I was even required to point to the knee if in fact I was too retard to know my right from my left. In addition to this a special sock was placed on my good leg to indicate that they should ignore that leg. They also used markers to circle the knee to be operated on and on Doctor actual wrote his initials on it. I cracked a joke about how a few multi-million dollar lawsuits makes everyone a little sensitive. They didn’t laugh and they just agreed.

The anesthesiologists came in to talk to me- and yes there were a few. Back in the day a bottle of whiskey and a broken arrow to bite on was enough- apparently they’ve made advances since then.

They explained that two things were going to be done to me during surgery. I would have a spinal tap where they place a needle between a couple of vertebra and numb your body from “the nipple line down.” I would also have a nerve block done where they insert a needle into a particular knee in my left leg and this somehow eliminates any pain specific to that leg.

The procedure to get the nerve block in was nearly a surgical procedure itself. I told the anesthesiologists that I had watched a video of the procedure on YouTube which they were surprised by. I told them that I likes when the tested it by putting a charge into a muscle that makes it jump around thereby showing they were in the right spot. This actually seemed to get them much more engaged in the procedure and include me as well.

There were two anesthesiologists and a nurse who did the procedure. They had to be certain to get the needle in an exact spot so they used and ultra-sound type of machine to visualize where the needle was in relation to the nerve. They turned the screen towards me to watch as well. To me it looked like a VHS black and with video of Jello in motion. They seemed o see things that I couldn’t but I was happy for them! They were pretty excited to tell me that they were ready to make the muscle jump. With that they out a charge to it and indeed that muscle started break dancing!

After a couple hundred more questions about which knee it was I was wheeled to the operating room where they would apply the spinal tap. Outside the OR I had another surgeon introduce himself to me. He said that he would be assisting my surgeon and he works with my surgeon’s office. My impression was that he was a relatively new surgeon who is learning the ropes from my tenured doc. For the rest of the blog I’ll refer to him as Jr. Surgeon, Jr. Surgeon seemed nice enough and then told me he had a few minutes and was going to grab a quick lunch. Someone in the OR told him we were about to start so he then told me “guess I’m not going to get lunch.”  I told him that I wasn’t too sure about being operated on by someone who’s hungry but he laughed and assured me that he would be o.k.

I was wheeled into the OR and was told that they were going to administer the spinal tap. They had me it up and slouch forward over an another table. I nice young nurse positioned herself in front of me and whose sole job was to make me believe that having a needle stuck between my vertebra was really not that bad. There were two anesthesiologists who were working on putting the tap in. I understand how hospitals work and they are always having tenured docs teach the up and comers how to do things. This was clearly the case here as a very young Asian doc was being walked through the process by a clearly older doc.

The reality is that this didn’t go well. The spinal cord is obviously a very sensitive area to work in and the needle’s placement must be precise. I’ll give her an A for effort but she just couldn’t get it done. Needle in, needle out… she just couldn’t get that precise spot that was needed. The seasoned Doc tried to talk her through it in a very professional way trying not to indicate to me that he was trying to talk her through it. The nurse in front of me was doing her best to be sweet with the gentle pat on my arm and assurances that I “was doing a great job.” As if I was doing anything other than having a needle repeatedly stuck in my back!

After a while it was agreed that seasoned Doc would “give it a try” Either I had a dark cloud over me at that moment or there was simply something in my something in the anatomy of my spine that made me a difficult case. Apologies were free flowing and I assured them that I was more than willing to put up with what I needed to in order to have a successful tap. At the thirty minute mark a decision was made to have someone leave the OR and seek out another anesthesiologist come in who apparently has magical and mystical powers!

This Doc arrives in the OR on a beautiful white horse and had a giant “T” on his chest. Well- not quite- but that’s how the other Docs acted when he got there. As this guy preps himself for the procedure he tries to make reassuring small talk by asking me what I do when I’m not being operated on. My response was to say that I usually spend my days avoiding having needles stuck in my spine! There were laughs all around in that which had become a tense environment so that was a plus.

Now in fairness to the other two Docs, Super Doc had a bit of a hard time to but was ultimately successful. He told me “you may feel something weird here” and with that it felt like a bolt of electricity went through my left leg making it flail about and twitch for a second or two. I told Super Doc that he had just put Elvis in my leg and he laughed saying that should be a technical medical term. Bottom line is that a procedure that should have taken a few minutes took forty-five instead. Again they were flush with apologies but I reassured them that if that’s the worst that happened to me on this day it wouldn’t be a bad day.

They laid me down on the surgical table and a flurry of activity started again. I knew that a catheter was coming and felt some sensation “down there” I asked if they were putting it in and they said that they were but that I shouldn’t feel it. I told them that I couldn’t really feel it but as I guy I’m acutely aware of any trespassers in that particular zip code.

The anesthesiologist above my head told me that they were about to start. I knew that I wouldn’t feel anything but asked him how aware I was going to be of what was going on. His reply was funny stating- “Hey I’m your bartender and I can set you up where you will not know a thing or as low as being fully awake and aware. How many beers do you want?”  Well I’m different than most folks and wanted to know everything that was going on so I ordered two beers for a light buzz and was fully awake and aware through the full surgery.

Now the whole thing seemed to go by very quickly and this was confirmed by my wife who was updated in the waiting room when surgery started and when surgery was over. She said it was a duration of one hour and fifteen minutes.

Thankfully I had watched the videos of this surgery on YouTube, (links in previous posts), so I know what to expect. There were indeed power saws used to cut off bone, there were drills and there was lots and lots of hammering. I had been amazed when watching the videos of how hard they pounded the replacement joints on with hammers and this was the case with me. They were full force blows with typical associated hammering noises as if you were building a deck! Of course I couldn’t feel it but the force was enough that I could sense my whole body moving by the force of the blows. Always looking for an opportunity for a joke I reminded my “bartender” that I was indeed getting hammered at Mass General. At another point I started softly singing that 60’s favorite…if I had a hammer, I’d hammer in the morning, I’d hammer in the evening all over this land….

I was told that they were finishing up and sure enough I heard the stapler start to click away closing the incision. It was then a transfer onto a gurney, warm blankets and a ride to the recovery room. I was amazed and relieved at how quickly it was over and how well I felt at that point. Not a bit of pain and I was wide awake.

In the recovery room I met Anna my nurse who was incredibly sweet. I was told that all I had to do was get some sensation in my left foot where I could move it slightly and I could go to my room and see my family. I was introduced to my morphine pump who quickly became my best friend. I was encouraged to “stay ahead of the pain” meaning not waiting until I felt pain to use it. I liked their thinking! I was able to click the trigger once every six minutes and of course it would just ignore you, not work and call you a sissy if you tried to do it sooner, (not rally bout the sissy thing). The time in the recovery room took longer than I expected and probably took about two and a half hours. I was very sensitive to the fact that my family had spent six and a half hours waiting. I have been on that end of it and I know that it is anything but fun!

They got the word to head for my room and got there before me. They had assumed, as I had, that I would be all drugged up and out of it. As I had asked that they document things with pictures they had fiendish plans of posing me and taking obnoxiously embarrassing pictures. Imagine their surprise when I was wheeled into the room and was as awake and alert as if I was meeting them out for dinner!  They did but me a lovely pink pen, a pink balloon and pink flowers in recognition of my sensitive side, (not!)

I filled them in on my day and they filled me in on theirs- clearly at that point I had indeed had the better day. I demonstrated the morphine pump to them every six minutes. And finally insisted that they go home as I was feeling well, in good hands and they still had the commute back.

Other than that there was normal intake stuff done on my y the floor nurses, blood work, vital signs and a consistent clicking noise every six minutes. Surgery day was finally over, click, click, click…..

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Preface to the Next Posts

As I type this I am five days post op. Mt intent, however unrealistic was to post every day from surgery day forward. In hind sight that was a ridiculous expectation. As much as I love being on the computer I can assure you that for the first few days your priorities change quickly.

What I did do was keep active notes each day and take photos when I could. I will indeed be posting these as posts named surgery day, post op day 1, post op day 2…and they will not be looking ahead to what I know is coming in the later days.

I also tend to write my blogs with a lot of humor and funny pictures. That may be less of the case here. There is so much information and real pictures to share I don’t want to sacrifice useful real life experience in exchange for “yuk yuks”.

I try to be anal about spelling, grammar… but bear in mind as I’m typing this I am on narcotics and in pain so again- when all else fails I have chosen to lower my standards!

Beyond that I am now even further convinced of the value of this journal for those who are facing this surgery. Despite all my scattered research I feel like I had no clue as to what was coming.

I hope that you find this useful.

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19 Days Pre-Op – Physical Exam with Surgeon’s Office and pre-admittance testing and interview at Mass General.

My wife and I had a very busy and productive four hours in Boston this past Thursday. If anyone had told me the amount of work and preparation that went into preparing for knee replacement surgery I would have never believed them! What follows is a description of that days events.

Pre-op appointment at the surgeon’s office:

We met with the surgeon’s nurse practitioner for a thorough exam, interview and briefing. The first thing I should do is let you know that I don’t take a whole lot seriously and if there is any chance at humor I will take it. I love when people buy into that attitude and embrace the silliness. This NP did not embrace my humor! That in no way stopped me but it made it somewhat less fun!

We were led into an exam room and she left for a moment or two. That’s when I spotted a sample of the artificial knee joint on the counter. I‘m not real good about boundaries either and pick the pieces up and started playing with them. I was most surprised by the larger of the two halves being as heavy as it was. I guess it makes sense as they can’t be made out of recycled cans and are meant to be durable but definitely much, much more heavy duty than I would have expected. Feeling like an old school Soviet Spy I whipped out my Blackberry and snapped a picture that I am pasting below.

When the NP came back in we then went through about a forty-five minute question and answer period with a very basic physical exam in the midst of it.  She was real good about answering our questions than ran the gamut from insurance related questions, actual surgery questions to the rehab and recovery period.

We were most concerned about the release from the hospital and my ability to go directly home. Due to where we live once in our home I am blessed because everything is on one floor. The downside is that to get into that single level I have to navigate a total of forty-eight stairs. As it turns out even before surgery the Surgeon’s office assigns a rehab case manager to me who will do a pre-surgery phone interview with me that will cover issues and concerns such as these. She is in charge of coordinating my in-hospital physical and occupational therapy and those same efforts after release from the hospital. If it is determined that I cannot access or egress from our home safely then there may be cause to put me in a rehab facility for a few days after surgery.

I did learn that my surgery is scheduled for 2PM on August 10th and that I am scheduled to arrive at the hospital two hours before the surgery time. While in some ways I would have preferred an earlier surgery time this will likely work better for us. We are travelling south from New Hampshire into Boston and the morning rush hour and traffic backups may have added just a bit too much stress.

I also learned that my surgeon uses the most up to date knee replacement technique that includes the use of computers to align things appropriately. I thought that this was pretty cool as in my own research I had watched this type of knee replacement surgery on Youtube. I’m including a couple of sample links below:

The NP also asked a ton of personal health related questions to make sure that all pertinent information is gathered that could be of importance to the surgery procedure itself. This was a bit tedious as I had just been through a complete pre-op physical with my general practitioner the day before and had been inundated with similar questions.

After all of this Deb and I were then sent on our way across the street to Mass General for my scheduled appointments there.

Pre-op tests at Mass General:

Let me just get this out of the way early on- so far I love Mass General. It is huge and can seem to be intimidating but so far we have had nothing but excellent experiences with the hospital and staff. I am most hopeful that at the end of this journal I will still be espousing my love for this hospital.

Deb and I found the pre-admission testing area and registered there. Immediately I was handed a clipboard with a medical history questionnaire that was four pages long. This was now to be my third time in two days that I would have to answer these same types of questions!

I was taken in within minutes by a robust black woman who matched my irreverent humor pattern to a tee! Every humorous shot I could fire at her was returned with an even larger volley. The thirty or so minutes I spent with her actually teetered on flat out fun!

The first stop in the circuit with her was the EKG. Nothing too exciting there in terms of the procedure. She did make note of the fact that my resting heart rate was about 105. I explained to her that for years I had been tachycardic, (heart beat over 100), and she was satisfied with that.  She also said my blood pressure was a little high but I explained that Dr. GP had just adjusted my blood pressure meds the day before.

The next step with her was a urine test. The good news is that I had been up all night studying for it, (insert cymbal crash here). She said do you think you can produce a little urine for me?” Fact was I had to pee like a race horse at that moment! I asked her how many ounces she was looking for and she told me that she only needed “a splash” and I was welcome to do what I wanted with the rest!

The best part of my interaction with her came during the blood draw. I have done this in the past with other ladies who were about to take my blood and it worked like a charm here too. As I was sitting there and she was preparing to draw the blood I just softly said “Sometimes I pass out!” Well the look on her face was great and she immediately got all flustered and said “really?” I confessed that it was just a joke and started laughing at her reaction.

In return for my efforts she got all sassy with me telling me that it’s not funny that when taking my blood she “ought to miss.” Not one to let it go I pointed out that the pressure was now on her because if she did miss it would look like she had done so on purpose! That was met by her boasting how she never misses. She even showed me a clipboard with a list that looked to be over fifty patients long that she had drawn blood from that day without missing. I again reminded her that the pressure was on her not to miss

Well don’t ya know- she missed! I have to tell you I was just laughing and laughing. She became so flustered and could not stop repeating that she never misses and that I made it happen because of my messing with her head! Now I told her that the real pressure was on and that she’d better not miss a second time. I swear she actually started sweating profusely. She even pointed that out to me as she was mopping her brow.

She tried again- and missed again!  Now this was too much for me and I laughed harder and harder and she protested harder and harder relative to her previously excellent track record. Again the clip board came out as a visual representation of her excellence in action prior to meeting me on this day. Fact of the matter is she asserted that she was done with me and someone else was going to take my blood. I told her that I was going to tell everyone else that she missed seven times. She said I’d better not- but I did. She had one of the other ladies come over to draw my blood and she got it on the first attempt. All the more funny for me and the more frustrating for her.

When the blood work was done she had to go and bring Deb in for the next steps and she just gave Deb a look and without even knowing the circumstance Deb just looked at her and said “I’m sorry.” She then went on a rant to Deb telling her that I had better take Deb out to dinner and that she admired Deb’s necklace and that I should have to buy Deb the matching earrings and ring as well.

The side lesson related to this delightful woman was that in our conversations I learned that she had just finished a year-long battle with breast cancer and its terrible treatment regimen. Most recently she had been diagnosed as Cancer free. With all this she was still a joy of a person with a wonderful disposition. So what in the world do I have to complain about regarding knee replacement surgery?

Pre-op nurse intake interview at Mass General:

This was pretty uneventful. The bottom line is that for the fourth time in two days I had to answer a “gazillion” questions about my health history. Same questions- same answers. I’m pretty well convinced that you have to answer these same questions at every stage as everyone in the medical community needs to “cover their arse”  due to the litigious reality that is our society.

The one thing that I did learn from her is related to the anesthesia type that I may receive for surgery. As it stands now I will have a “nerve block with conscious sedation.” Bottom line is that in this type of anesthesia they do not have to put me completely out and intubate me, (put a breathing tube in). This is supposedly safer and allows for less complications and quicker recovery.  Some useful links that I have found:

The bottom line is that in theory I may be somewhat awake during the two hour surgery but there will likely be no memory

Pre-op anesthesia nurse intake interview at Mass General:

You’ve guessed it- fifth time in two days with the same health history questions!  This nurse was very helpful with all types of information. At all steps during the day discussions had occurred with at all stations on this day as to the meds I take – and the supplements I take and what and when to stop taking before surgery. Turns out something as mundane as fish oil has to be stopped a week before surgery. Same goes for baby aspirin as both thin out the blood. No alcohol based products can be used on my body the day of surgery- things like lotion and cologne are a no-no!

To the important practical side of life she provided great insight as well. I explained how I was more worried about Deb on surgery day than for myself. She then stepped us through what Deb could anticipate on that day, the right places to go, best places to park, timing of the day…. It was also good to hear that the family surgical waiting room has a full time staff person there who receives real-time updates from the operating room that they will share with her. The most important thing she provided to Deb and I was assurance that she would not be alone or forgotten in the process. She explained that the vast majority of Mass General patients are not from Boston and a lot are not even from the United States so the staff is acutely sensitive to helping family members during this process.

After this last step we were free to go home. It was about a four hour process but not too bad considering all that was accomplished. Time to pay the $9 parking and head home.

This post was ridiculously long- apologies. Stand by for next update posts.

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20 Days Pre-Op – Physical Exam with Dr. GP

This morning I had my pre-op physical with my general practitioner – Dr. GP. This is a requirement put upon me by my surgeon’s office. It really does seem to be a bit redundant to me because tomorrow I have to drive into Boston to have pre-op appointments down there. Tomorrow I will be meeting with the nurse practitioner from the surgeon’s office. I’ll also be heading across the street to MA General for a pre-op appointment with the anesthesiologist, various blood work and whatever else they feel like putting me through.

Today’s appointment took over an hour and a half because I have a very thorough Doc.  We went over my medical history and current conditions including high blood pressure, cholesterol and Type II diabetes. Bottom line is that the doctor said I was in great shape- round! (Insert cymbal crash here.)  So the Doc tells me I’m fat so I tell him I want a second opinion. He replies “O.K – you’re ugly too!” (Insert another cymbal crash here!)

So all in all it was just a thorough physical but here is the question I’m left with- Is a rectal exam really needed for knee surgery? Frankly I’m not a real fan and best I can tell he was in up to his elbow! I would have hoped he would have at least bought me a beer after that. I’m not sure if I feel worse for me having gone through it or for him having to do it- but all for a bad knee?!?!

Ok- here’s something different that I found- knee replacement poetry. This is indeed a cultured site!

Knee Replacement Poetry:

Could Have Been Worse

Maybe the cause was arthritis?
And a joint filled with gritty detritis?
And walking was tough
With those bone edges rough
Still, it could have been spastic colitis.

On to Boston tomorrow- stay tuned….

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Welcome to My Knee Replacement Journal

Welcome to My Knee Replacement Journal.

The whole purpose of this site is to provide a bit of one stop shopping for information related to the entire knee replacement process from the patient’s perspective. The information will be provided by me as a firsthand account covering the pre-surgical, surgical and post surgical recovery process. As I have tried to do my own research in preparation for the surgery I was able to find sites that covered the many aspects of this experience but there was no one source to obtain a sense and understanding of the process purely the patient’s perspective- thus the inspiration for this site.

About me:

(ok- this isn’t me but I couldn’t resist)


50 years old

Married for 30+ years

Three grown children

Undertall, (or what some would call overweight)

I work a sedentary desk job in the financial industry.

Incredibly handsome!

I have two other blog sites here on WordPress that you can reference: that is a site documenting my weight loss and exercise journey  that sped up my need for a new knee,

and that is a just a personal site of mine for various writings and family and Church photos….

What you should expect from this site:

Probably not that much so as not to set the bar too high for me! What you will get is my first hand experience of the process. I will start with the process of the pre-operative appointments, insurance issues, family issues… and then post about the surgery and each step of the rehab & recovery process,  tend not to take anything too seriously so there will indeed be humor in the writing as well as comical pictures that I strip off the internet that are related to this journey. When able I will post my own pictures and video clips… that may relate to this experience. As a starting point I am posting a link to a concise two-minute video that shows a knee replacement surgery. Not for the faint of heart- or those prone to fainting:

For fear of being sued I won’t name particular Doctors, nurses… by name. I’ll use fictitious names to help with the narrative of the story. I will tell you that the surgery will take place on August 10th 2010 at Mass General Hospital in Boston.

What I expect of you:

Please don’t let this be a one sided conversation. I encourage the posting of comments and your personal experiences as well. I hope to learn from others who are facing this process or have already experienced it. ‘d rather see this site become a resource for everyone’s experience- not just mine.

Tomorrow I will start to document all of this with a post about my required pre-operative appointment with my general practitioner- henceforth known ad Dr. GP.

So starts the journey….

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