Rehab...Where are the Celebrities?

The first two days at home were pretty uneventful. My knee was very sore, but the pain meds were effective.  I lived on the couch and bed, iced, did my exercises 5 times a day, and spent time with the family.  I watched every minute of college football on TV.   I went to two Christmas parties, and it was a bit of a challenge to be upright and on my crutches for hours on end (it was days 4 and 5). Frankly, I probably should stayed home, but I have young kids and Christmas is a big deal.  I  basically parked myself in chairs at each party and kept my leg up and answered a million questions.  I was pretty darn sore after getting home though.  Anyway, I was set for my first in town rehab appointment on December 24, 2007.

On Christmas Eve, I met with John Zior at Rocklin Physical Therapy. It was day 5, I was non-weightbearing, very swollen, had about 80 degrees flexation, and was locked at 0 degrees in the brace. This was John's first meniscus transplant rehab, and he had previously reviewed Dr. Stone's protocols and had a plan ready to go. We took my knee out of the brace (which I had been doing several times a day and letting it hang off the bed per Dr. Stone's rehab protocols), and he surveyed the damage. We were facing a few big hurdles. First, my knee was very swollen. Second, I was 10% weightbearing. Third, I was still pretty sore.

John measured my stats (flexation, extension, calf and quad size, etc.). Then, without the brace, John had me do leg lifts. It sounds really simple, but my knee looked and felt like a disaster area, so I had to push really hard just to keep my leg straight. I'm pretty hard core when it comes to training, so I pushed it. I could tell John was excited to work with someone who knew how to train hard.  I also realized Dr. Stone wasn't exaggerating when he said the rehab will be far harder than the surgery.

The last issue that John checked was the numbness I had below my knee. From my kneecap to my ankle was totally numb down my shinbone to the outside of my ankle. I couldn't feel anything. It was good and bad since I couldn't feel the incisions, but I was a bit afraid it would never come back. John had me close my eyes and he poked my knee, but I felt nothing. I had nerve damage from a broken arm a long time ago, so I knew not to panic yet, but what I didn't know was that the situation would get worse in a few weeks.

John finished showing me some more core exercises, and we made appointments three times a week. I would do my own rehab the other days at the gym. I would diligently continue my rehab seven days we week for the first three months. I iced, put my brace on, and waited for my ride. It was off to the Christmas Eve parties for me.

Okay, that hurts

The early morning of day three reminded me why we chose the St. Francis.  The beds are great, the people are fantastic, and we figured we might as well enjoy the night.  The first bathroom trip that night was uneventful.  Tina woke me to take my pain meds, I went to the bathroom, and got back in bed...it was about 2:00 a.m.  I woke suddenly in pretty severe pain...I would say 8-9 of out 10.  I told Tina I needed my pain meds, but she said I was still a few hours away...it was 4:00 a.m.  My knee was just throbbing.  As long as I didn't move at all I was okay, but lifting it to move around was intolerable.  I suffered through the rest of the night, put on my sweats and we went to Dr. Stone's for my second rehab session.  The problem was that I was not in any condition to even sit on the bike again, I begged for a stronger pain killer, and they gave me a shot of Toridol (I think).  I had a 2+ hour drive back home ahead of me, and I was not feeling good at all.

I iced again, packed my knee back into the brace, and left for home...it was Friday, December 20, and we were headed to Rocklin (towards Lake Tahoe) in holiday traffic.  The drive home was miserable and slow.  I couldn't get comfortable, and we forgot our pillows at the hotel, so I was trying anything to get my knee in a reasonable position.  I wasn't in as much pain, but it was the worst 2.5 hour ride I think I have ever had.  

We pulled into our home, and the kids were still at their grandparents.  Tina left to pick them up and I parked myself in bed again...the ice machine was flowing.  Tina took this picture of my knee as we changed the dressing.  This adventure was going to be harder than I thought.  I had a therapy session set for the 23rd with my local PT (John Zior at Rocklin Physical Therapy).  

Day 2 and Feeling Cocky

I woke up on Day 2 and had breakfast in Bed.  Tina had gone to Starbucks for coffee and scones.  My knee was pretty much numb still from the injection they give you at the conclusion of surgery, and I was feeling no pain.  The numbness was in part from an interference with a nerve (more on that later), but I was feeling pretty darn good for having my knee reamed out the day before.  Dr. Stone scheduled a 1-day post op appointment, so Tina and I made for his office. 

This is where I first figured out how hard the next 4 weeks would be.  Cars are not made to be ridden in with a leg at full extension.  I'm 6'3, so it was even worse.  Second, crutching around the day after surgery is very tiring.  I was still diligently taking my pain meds, and they definitely kept me out of it a bit.  We parked right in front in a disabled spot thanks to my obtaining my temporary handicap parking pass at the DMV (one of the smartest things I did).  

Lola the Great, took my knee out of the knee brace, uncovered the multiple ACE wraps, and cut off the bandages.   My knee was something to behold...it looked like a massive swollen slashed, and slightly bleeding cantaloupe.   Lola changed my dressings, and Dr. Stone came in to debrief me (I'm sure he spoke with me in recovery, but I literally have no memory of that place!!!).

Next, I traveled over to PT with my new best fried, and nemesis, Trish Fong.  Trish is a licensed torterur (PT), and expert in rehabbing this surgery.  The first day rehab is focused on moving the surgical foot and doing your flexation exercises.  Trish taught me some core exercises to focus on, and thoroughly explained the rehab protocols.   I finished with a brief cycle on the exercise bike with my operated leg on a chair, and iced down my knee again.  

We returned to the hotel where I became quite bored.  Tina shopped, I slept, and thought about going out to dinner.  I spent the entire day icing my knee (pictured), and pretty much thinking this surgery was a breeze.  We chose to stay in again, and Tina brought dinner in from a local restaurant.  We watched a movie, iced some more, and shut it down early again...this night would not be fun.

The First Leg of the Triathlon

So I woke up early on M-day at the hotel.  The surgery center is literally a walk away, but I know I won't be walking back.   I'm a bit nervous, but its really early, so Tina and I go over and use the valet parking at the center.  The surgery center is in an office building, so I feel a bit weird riding up the elevator in my sweats with guys in their suits.  They don't look twice...the must be used to it.  Check in was easy, and they took me back to put on my gown.  Nothing like a hospital gown to challenge your manhood.  When I got back to the preop area, Tina was waiting and they cleaned my leg and started an IV.  It went pretty darn fast, and unlike a normal hospital, I never got the sensation that I was in a heard of cattle waiting for my turn.  I walked down the hall towards the OR, and kissed my wife goodbye.  I remember thinking it was the last time I would be walking for a while. 

The OR went smoothly.  They had Christmas music on, gave me a shot of something to loosen me up, and I began to disclose my entire Christmas list.  They positioned me on the table, told me to have a nice nap, and the next thing I remember I was in the recovery area.  

I should qualify my memory of the recovery area...frankly, the only thing I remember is my wife and a nurse putting my shoe on my surgery leg.  I remember the ride to the car in the wheelchair, and I was feeling no pain.  We drove the quarter mile to the hotel, and got settled in the room (it was a long crutch from the lobby to the room).

Tina made a run across the street for a grilled cheese sandwich, and fired up the ice machine...my new best friend.  It was the first of Tina's 5 trips to the ice maker that night.  Tina kept me on my meds, we watched a movie, and I went to sleep early.   The unfortunate part about having IV fluids is you have to go afterwards, and going to the bathroom was not fun.  The good thing was I was sore, but not in pain...that would come later.

Getting Ready for M-Day

Not sure why, but I seem to want to plan everything out. I like schedules for things...and my meniscus transplant would be no different. Since I was having my surgery one week before Christmas, I had to get everything done early. I finished my shopping, got my work in order, and arranged to pick up my temporary handicap parking pass (one of the smartest things I did in the preparation). I recommend anyone having this surgery pick up the handicap parking pass since your mobility will be challenging the first 4-6 weeks after surgery.

Meanwhile, I was still waiting to see if Dr. Stone would have compatible tissues for me in time. Then I got the cough. I was coughing my lungs out the first week of December, and not thinking much of it. Then I got the call from the Stone Clinic that they had my tissues and we were a go...the cough will still there. Thankfully, a few days prior to the surgery, my cough went away. The last item of our organization was to pick the hotel in which we were going to stay during the surgery. My wife and I planned to go down the day before, have my pre-op, pick up meds at the pharmacy, and have a nice dinner. We would be staying three nights, and I wanted to be comfortable after the surgery, so we chose our favorite hotel -- the Saint Francis located on Union Square. At 12:30 on December 17, 2007, I said goodbye to my staff, and Tina and I drove to SF, dropping the kids off at the in-laws for a few days on the way.

We arrived at the Stone Clinic around 4:00 p.m., went over everything with Lola, the great PA, and she provided me with the prescriptions to fill that evening. While I was joking about how easy knee surgery was (after all, I have had three previous scopes on that knee), Lola was quick to point out this was much more than a simple scope. Tina and I ran our errands, had dinner, and I shaved my leg as per the pre-op instructions. I couldn't help but wonder how I would be feeling in 24 hours...the smile you see above is a nervous smile. For the first time ever, I was a bit scared about this knee operation.

It was M-Day minus one.

The Stone Clinic

After researching the heck out of the meniscus transplant, it seemed like a possible solution to my knee problems.  There wasn't much on the surgery on the internet, but I was ready to do something to move forward with recovery.  In November 2007, I made an appointment with Dr. Kevin Stone at the Stone Clinic in San Francisco.  I brought my wife Tina down with me, and we were very impressed with Dr. Stone and his team (literally, you meet just about the entire team during the initial visit).  Dr. Stone gave me an MRI (within his facility), and confirmed my lack of functional meniscus, and a new tear in the small remnant I had.  He fully explained the allograft procedure, we met with the different people on his team to help facilitate the surgery and rehab.  Tina and I went to dinner to talk it over.  It was a short discussion ... Dr. Stone was offering me a second knee if I was willing to rehab it.  I was thrilled to have some hope to return to sports, and a mostly to get rid of that Freaking Knee pain.   I made an appointment for my surgery set about a month later, but the Dr. Stone and his team were going to have to find a properly sized allograft before we could confirm anything.  I was set for December 18, 2007 -- if the tissues could be found.  It was time to get myself ready for the surgery.  I started prehab immediately (with the counsel from Kelly and Trish), and waited for the call that they found a large medial meniscus allograft.  

You Have Dead Parts in You?

Literally a day or two after my knee locked up I remembered an email from an old teammate of mine who had mentioned he had a meniscus transplant.  I went through my archives and emailed him to see what he had done, and what a meniscus transplant really entailed.  First of all, my teammate went to med school at a prestigious Ivy League school, and he is ridiculously smart.  So I figured if he had this surgery and was happy with the result, I would check into it for myself.  The problem was he had the surgery 5 years prior, and it was done during his residency in Colorado -- 1500 miles away.   He explained they implanted a cadaver meniscus through a pretty rough surgery, but after a long rehab he was completely pain-free.  I discounted his concerns about the roughness of the surgery a bit since he was a pitcher (just kidding), and then I started my search to see if this was an option for me.  The problem was, there were only a few references on the internet for the procedure at all, when I searched for surgeons who perform this surgery, there were even less.  However, I read every site, study, reference, and journal study I could find.  Ultimately, the same name kept coming up, Dr. Kevin Stone, in San Francisco as "the" guy to do this surgery.  I reviewed Dr. Stone's website, including the detailed references regarding this surgery, and decided I would travel the 2 hours down to SF to see if he could help me.