Finally, I got the new server up and running, migrated all my projects over, and fixed the blog (hopefully for good). Plus, while I'm on sick leave, I actually have some time. So I'm hoping to scribble away and annoy the few people who still remember my existence in the virtual world.
First, about the surgery. I was posting info on my condition on Twitter as things were happening, but for those who weren't following, I'll write it up here too, maybe even in more detail.
I was operated on Thursday, March 11th, by surgeon Dmitry Guzenko at www.jlmc.lv. He specializes in knee injuries. My surgery was a reconstruction (plasty) of the anterior cruciate ligament. What follows will include some physiological details. Don't want to know – don't read. You've been warned.
I arrived at the hospital on Wednesday, a little before 3 PM. In principle, there was no real need for this; I could have shown up the next morning and saved myself 25 lats – that's how much it costs for a hospital bed per day. It was a four-bed ward, and I only had one neighbor – a relatively young, seemingly untalkative Latvian guy. The next day, however, he bounced back from his surgery and we chatted briskly, especially when a third guy was moved in with us. The Latvian was discharged quickly though, and the new neighbor turned out to be a cheerful older fellow, a factory worker.
Now, about the surgery itself.
In the middle of the day on Wednesday, the doctor showed me how the surgery goes using slides. Long story short: they extract a tendon from another muscle (in my case, the knee flexor), fold it 3-6 times, drill a hole in the knee joint, insert it in there, and secure it with an endo-button (a titanium plate with a plastic cord).
Endo-button
Then they forbade me to eat and gave me a laxative in the form of suppositories. First time in my adult life using suppositories, and laxatives too for that matter. In case anyone didn't know, it's needed so that when the anesthesia kicks in, the person doesn't empty their bowels right on the operating table.
After the laxative, they also gave me what seemed like a sleeping pill or a sedative, hell if I know, I didn't ask.
The anesthesiologist also dropped by and explained that the pain relief would be epidural. This means they deliver the painkiller via an injection in the back so that it enters the spinal cord. In cases where it can be applied, it's better than general anesthesia – less traumatic for the body and easier to calculate the dose without doing harm.
Late in the evening, a nurse came by and told me to tag along. I thought for a second they were going to give me an enema, but I was spared – they handed me a razor and told me to shave my knee. She specifically emphasized being careful so the doctor would have an easy time cutting me later without shaving cuts getting in the way. I shaved the knee, and trudged back to the ward.
I woke up early in the morning, around 6, because I went to bed early too. Plus the nurses and orderlies were walking around, jabbing various blood-thinning meds into my stomach to prevent blood clots.
They wheeled me to surgery around 8:30. The anesthesiologist's assistant was a very cheerful lady named Tamara; she bantered for a long time and promised to hug me. Which she ended up doing. They injected the anesthesia with some difficulty – apparently, my back muscles were too strong. As a result, Auntie Tamara bent me over so hard to spread out my spine that I couldn't even breathe for a bit. After the injection, they quickly tossed my legs onto the table, and almost immediately I couldn't move them myself – it knocks them out completely dead.
Then they slapped a breathing mask on my face with laughing gas (probably oxygen, or maybe they added a sedative in there too). They blocked me off from the surgeons with a screen (or maybe blocked them off from me), Auntie Tamara popped a special player in my ears and asked what kind of music I desired. As usual, I failed to articulate my musical preferences, as a result of which I spent an hour enjoying the works of Andrea Bocelli. Thanks to the sedative, I was completely spaced out, so it made absolutely no difference to me what was warbling in the background.
By the way, I would have gladly watched them cut me open, but it didn't occur to me to ask beforehand, and the hospital staff assume by default that patients dislike medical stuff and are scared of blood. So if you want to see something like that (highly unlikely), ask in advance, and ask everyone you possibly can.
The surgery lasted about 1.5 hours, judging by what I overheard at the end. When it was over, I only managed to ask the surgeon what was up with my meniscus (I had a tear in it). He informed me they removed 1/4 of it and ran off. In total, 6 people were involved in running the surgery. Add in the taxes, the equipment, the meds, and the price stops looking so high.
Right after the surgery I felt quite lucid, tweeted and called friends. But an hour or two later, the anesthesia started wearing off, and that's when I found out what true misery feels like. And the sensation wasn't exactly like pain, just like there was a huge pressure on the leg and it was lying really uncomfortably. No matter how you tossed and turned, it remained uncomfortable. It doesn't sound very agonizing, but I was climbing the walls, swearing quietly in English, I just couldn't bear it.
I didn't suffer for too long – I asked for a painkiller. It helped a lot, although not completely. Things got genuinely unpleasant when I discovered I couldn't take a leak. By the time I called the nurse (a special nurse came over, the head nurse I think), the situation had escalated to the extreme. The nurse inserted a catheter where it belonged and told me that if I had waited just a little longer, they would have had to call the surgeon. Terrifying. Don't hold it in, kids, if you can't go to the bathroom and your bladder muscles aren't obeying you – it can end badly! Especially since Tamara, the anesthesiologist's assistant, had warned me.
Luckily, it all worked out. In the evening, a fake punk and anarchist came to visit. I didn't invite anyone else because my condition still wasn't super – you guys probably wouldn't have enjoyed chatting with me like that. The punk is patient, he listened to my moans and mumbles stoically.
I was also strictly told not to walk and basically avoid any vertical position on the first day. If you don't follow this, the epidural anesthesia can give you a wild headache in the days that follow. I couldn't really walk much anyway, so that wasn't an issue. Well, maybe tossing around and lying half-sitting sometimes, but I simply couldn't stand being in the same position. Fortunately, I didn't get a headache afterwards.
I'll write the continuation about the surgery tomorrow.
P.S.
There is a lot of useful info regarding ACL injuries in this post:
https://altsara.livejournal.com/118756.html
Whatever anyone says, LiveJournal, even while constantly degrading towards lowbrow clickbait, still remains a bastion of the intellectual approach. In the rest of the internets, you won't find such a thoughtful post.