On Monday, February 19, I go "under the knife"!

I have been having left knee pain for longer than I can recall. I'm not sure exactly, don't remember, when it was first diagnosed, but I know it wasn't a problem before I came to Minnesota, so has to be post 2010. I don't even recall it being an issue for the first 5 years as I was working at Winona. I think it has come on since my time at Mayo, so post 2015. I measure time according to WHERE I work. It is usually the easiest measure to mark time for me. 

When I first received the diagnosis of advanced arthritis, I recall being surprised. The pain felt like I had possibly torn something, but no, it is just the ravages of time, slowly slicing away at youth. I have managed it mostly with steadily increasing amounts of daily anti-inflammatory medications, NSAIDS, with ibuprofen being the best, and topical applications. Mostly, it has been managed fairly well, not interfering with my ability to move, to work, and to enjoy my passion of falconry, albeit not to any kind of heroic level. I get around, but seldom run anywhere.

One of the first things I have asked my healthcare provider was if it could possibly be rheumatoid arthritis, as I have a positive maternal familial history for this. My mother, my aunt (her sister), and my grandfather all suffered from this disabling disease. There is a blood test for this. I have had it done twice, and both times it has come back negative. If twice, then I must have had an initial diagnosis when working at Winona, as I was under a different provider, different insurance, so maybe this all does date just prior to 2015. Anyway, it is apparently just good old-fashioned osteoarthritis . . . the inevitable injury of time and age and joints just wearing out. My most recent x-rays indicate my right knee is also affected, but it does not bother me nearly as bad as the left. The left has been a pain in my posterior for quite some time.

I did have fluid removed in 2019, steroid injections, and was fitted with and wore a professional knee/leg brace for awhile, but it healed up, and returned to its mostly tolerable level of pain. This all changed this last year between October and November.  Since that time I have consulted with Orthopedic Surgery, and have been approved for Left Total Knee Arthroplasty.  That's happening five days from now, from the writing of this post.  I still have three work shifts to finish up, then will be on medical leave until mid May. 

I am of a positive outlook, but still a bit nervous. This will be my first surgery that I can remember. I had tonsils removed probably around age 5 or so, I don't remember exactly, and definitely don't remember the details. After all my pre-op appointments a week ago, I decided I wanted a mascot for the whole affair, thus my cute little crippled crow up there. I have ordered a couple shirts for Rich and myself to wear as I am recovering. They should arrive by Thursday. 

The surgery is proposed to me to be "day surgery". That just seems nuts!! After the procedure, which my surgeon says will take about 45 minutes, I will be moved to recovery where I will awake from anesthesia, then be moved to a hospital room. If through the day I meet goals of being awake and able to stand and move with aids, and most likely also demonstrate an awake bladder and bowel (a nice way of saying able to urinate and/or defecate) I will be discharged home with care by Rich. This is all under the Mayo umbrella, but I will actually be admitted to Methodist, which is the hospital downtown right by the Clinic. I work at Saint Marys, the original founding hospital of Mayo, about a half mile West of downtown Rochester, but all orthopedic surgery happens and patients recover at Methodist. 

Here is a concise video of what will happen to my knee. This is a super cleaned up version. I have sought out actual procedure videos which are far more graphic. Let's just say I will be quite glad to be unconscious for all this. I don't want to hear the doctor sawing and pounding with hammers and drills, which he most definitely will be using.

Interestingly to me, he will be using a robotic-assisted device. There are several of them in use, but his surgeon team member who has met initially with me (Mayo is a teaching hospital, so there are always new "baby docs" learning everywhere) told me they use one called VELYS. It is a more precise way to map the area of bone to be excised, and allows for extremely minute balancing of the hardware being installed. I did find a long video demonstrating this. Watch at your own discretion. This does show an actual surgery with exposed bones. Not everyone's cup of tea! While uploading it to this blog post I also find it is "age restricted" so you will have to follow the link to watch it.

I found this very interesting video below presented by a Mayo Orthopedic Surgeon from Jacksonville, Florida from 11 years ago. It covers some of my journey, although I never did the rooster comb injection.  Also, the technology must have improved since then, as I am told my surgery will take about 45 minutes, and the plan is that I will NOT stay in the hospital but discharge the same day, if goals are met. 

I am also amazed that I will not be under general anesthesia. In other words, I'm not going to be totally konked out! I will be having an epidural for pain management, and will be administered a "twilight" medication, so will snooze through the procedure, monitored carefully by an anesthesiologist, but in a possibly arousable state.  !!??  I trust this will be fairly similar to the colonoscopy I had a few years ago. I don't remember any of that either. It must be a drug that puts you into a sleepy state where you don't lay down any memories. Possibly Midazolam. Maybe I'll find out exactly what that drug is this next week.  Either way, I asked, and was told YES that I may wear a headset and listen to music, so, that is what I'm going to do!

Here is a very extensive video of placement of an epidural and/or spinal. WARNING - LOTS OF NEEDLES! The medical professional in me finds these kinds of videos very interesting! Respiratory Therapists are usually under the jurisdiction of the Anesthesia department, with a Medical Director in that field, although my own range of practice doesn't rub elbows with them. Patients under general anesthesia are intubated and on a ventilator operated and monitored either by an Anesthesiologist (doctor) or CRNA (nurse anesthetist), as that form of anesthesia does eliminate the respiratory drive. The kind of anesthesia I will be receiving will not require intubation, so will be much less invasive.

What more can I say here!  I will be under the care of some of the best doctors and nurses. After all, it is Mayo Clinic! I have trust in their skills and abilities. Since my approval for surgery I have found other people who have had the surgery, and they are all positive about their improved health. 

I do so hope I have excellent outcomes, and will return to mobility and less/no pain.  Losing this falconry season was very distressing. Hopefully this next season I will be fit on a new knee and a spring in my step.