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…..