Hardware removal

Some folks have told me I have a screw loose. Well, make that 2 screws loose.  And a pair of washers.  Check them out:

 

 I'm still trying to figure out how best to display them.  Glass showcase above the fireplace mantle?  Mounted criss-cross atop a wooden board, like a medieval family Coat of Arms?  Or lying parallel across some toothpick stand, samurai-style?  Please add your thoughts in the Comments.

The surgery went well, and quickly.  I was in the waiting room twice as long as the operating area.  The anesthesiologist and nurse wheeled me back shortly before 3pm, and I woke up in the recovery room at 4.  The actual operation lasted around 15 minutes.  2 incisions, 2 screws yanked out.  No post-op nausea.  After a dozen Graham crackers and a Ginger Ale, time to go home. 

According to my wife, Dr. Scheinberg said my tibia was solid.  No issues or complications.  No need for new screws or bone graft material.  I’ll find out more details next week at my follow-up visit, but, in short, the operation apparently went swimmingly (I never got a chance to use that word. Swimmingly).

Anyway, here’s his handiwork.  With the knee shaved, you can really see the original scar. And my hair is already growing back.

I used crutches the night of the surgery, and again at breakfast the following morning.  But that was more out of precaution than need.  I’m walking around just fine now.  I took half a Vicodin the night of the surgery, the following morning, and again before bed the following evening.  I added the remaining 28 pills to my home pharmacy.

I was told I could drive when I felt “ready.”  For the past 3 days, my wife chauffered me around, Driving Miss Daisy-style.  Her driving was scarier than the actual surgery.  Just kidding, sweetie! I should be ready to drive to work on Tuesday.

I also couldn’t shower for 48 hours after the surgery.  I don’t know how Europeans survive without daily showers.  Good lord.  I almost passed out from my own stench.

Amputees often describe the phantom pain they feel in their newly amputated limb.  We have something in common.  In the first 2 days after the surgery, I still “felt” the screws inside my tender leg.  It wasn't pain, but nonetheless a very odd sensation.  I suspect that as my leg heals, that phantom discomfort will disappear.  At least I hope it does.  Each day the leg shows daily improvement.  It's probably 70% normal 3-4 days after the surgery.  For now, the leg feels a bit like it did after a particularly grueling workout when the hardware was still in.

I meet again with Scheinberg 10 days after the surgery.  I’ll probably get a more detailed summary of the surgery.  Hopefully he'll clear me to resume exercising.  I’m anxious to “test” my leg. I don’t plan on completing a triathalon or entering the Octagon any time soon, but I'd like to pick things up a notch.  The screws had limited how vigorously I could exercise, which, in turn, limited how far I could push my knee.  By year's end, I hope to get a fuller picture of how well the ACI surgery worked.

Enjoy the rest of your Memorial Day Weekend.  

The Hardware Journey - A Brief Detour

I’m about to have surgery to remove the screws.  Well, at least I hope the leg has healed enough so the doc can simply yank them out.  I can’t imagine waking up post-surgery, and learning, “sorry, we had to insert new screws,” or worse, “we had to pack in some bone graft stuff.”   Talk about a major buzzkill.  Anyway, send your positive vibes my way.  I’ll share the details and perhaps post some pictures afterward.

Meanwhile, enjoy one of my favorite “legal victories.”

Before joining the government, I worked for one of those mega law firms with a gazillion lawyers and offices all over the world.  The Uganda office was spectacular.

One of the best parts of being a lawyer is the ability to represent yourself.  It rarely happens, but when somebody tries to screw you, it comes in handy.  Like my dry cleaner tried to do.  Emphasis on “tried to do.” 

My wife and I used the same, local dry cleaner for several years.  They did an admirable job.  Friendly people.  Not too smelly.  The right amount of starch.  Exactly the type of relationship you want with your neighborhood dry cleaner. 

I wore a suit every day.  When you take that much stuff to the cleaners, you understand the cleaner will eventually screw something up.  Death, taxes and lost/ruined shirts.  Not a big deal, but you expect the laundrymat to make things right when it happens.

In August of 1999, the dry cleaner lost 7 of my shirts.  Unfortunately, this included 3-4 brand new custom-made shirts, which cost double or triple a normal men’s dress shirt. In total, the 7 shirts cost $650.   

(These were the fancy, high-thread count shirts.  In a shocking coincidence, I was somewhat of a douchebag back then). 

As a regular customer, Christina was on a first-name basis with the store clerk/manager.  When she first arrived to pick up the 7 shirts, the manager couldn’t find them.  With a somewhat stupefied look, she told her, “huh, I remember you dropping them off yesterday.  Maybe they’re still off-site.” 

No big deal, Christina replied.  I’ll come back tomorrow. 

When Christina returned, the shirts were still AWOL.  Christina even helped the lady look for them – they examined every plastic-bag on that electric clothesline in the backroom.  Nothing.  The clerk called the sister dry cleaning franchise.  Still nothing.

After confirming there were no delivery issues, the conversation shifted toward reimbursement for the lost shirts.  The clerk told Christina she needed to confer with the owner. 

The owner was a bigger douchebag than even me.  But he was far dumber. 

And this is when being a lawyer helps.

When Christina discussed reimbursement with the owner, the clerk was there, too.  The conversation did not go well.  Instead of apologizing for losing the shirts – and upsetting a long-time customer – the owner called Christina a liar and claimed she never dropped off the shirts.  Not a good start. 

As a long-time customer on a first-name basis, we stopped receiving and turning in laundry tickets on our orders, leading the owner to automatically accuse Christina over trying to screw him.  Shocked, Christina turned to the clerk who had admitted to receiving the order and spent several hours over the past week searching for the shirts.  Instead of correcting the owner, the clerk slinked away from the conversation.  Apparently job security trumps honesty.  The owner then berated Christina for 5 minutes, like Kobe Bryant scolding Pau Gasol.

Frustrated at the tongue-lashing, Christina turned things over to me.

I met with Mr. Patel (which may or may not be his real name).  I was polite.  I also might have been wearing a custom made shirt. 

I told him I didn’t appreciate him calling my wife a liar, especially since we’ve been customers for many years.  Regardless, I told Mr. Patel that the shirts cost over $650, but in the interest of putting this matter behind us I would accept a $400 check.  Mr. Patel was defiant.  He refused to pay a dime.  I’m sure Mr. Patel’s response usually dissuades most disgruntled customers from pursuing things further.  But I wasn’t like most customers.  Instead, I shared with him that I was a lawyer who would gladly sue him for losing my shirts.  He chuckled and told me to go for it.  I think he grew up watching Rocky.

Egging me on was not a wise move.  I was Drago, and he was Apollo, only not nearly as pretty and charming.

I gave him one last chance.  I pulled out my fancy law firm business card, which listed our offices all over the world. 

“Mr. Patel,” I began, “I don’t think you understand.  If I sue you, I won’t be asking for just the $650.  Oh, no.  I will also ask to be reimbursed all of my attorney’s fees, too.”

He seemed confused, but I continued.

“And see all these offices?  This means I’m very expensive.”

“Besides,” I told him, “you’ll have to hire your own lawyer, and you’ll wind up paying him far more than you would pay me to settle this matter.”

I reiterated my generous offer to accept $400 to avoid a fight.

And then Mr. Patel uttered his famous last words.  “Go ahead and sue me.”

So I did.  And boy, did I f*ck him up.

Under the legal rules, defendants have to respond to a lawsuit within a certain time frame.  Of course, he didn't bother to hire a lawyer -- they cost a lot of money :-)  He missed the deadline and never filed an answer. 

I immediately went to court to obtain what's called a "default judgment." This means the court accepts everything in my lawsuit as true, including the fact that Mr. Patel lost my shirts and owes me $650.

But the fun doesn't end there.  Just like I warned Mr. Patel, the judge also awarded me my attorneys' fees: 12 hours of my time x $185/hr = $2,200.  Grand total -- $2,830.

(This happened 13 years ago.  $185/hour is about as outdated as a rotary phone.  I’m pretty sure my billing rate today would be over $500/hour, perhaps more).

But the fun doesn't end there, either. 

I called Mr. Patel, told him about the judgment the court awarded me and asked for my money.  With some swagger, he said, “yeah, the check is in the mail." 

The little f*cker still refused to pay me!

Mr. Patel obviously didn’t learn his lesson the first time.

When defendants refuse to pay, folks are forced to seize assets to satisfy their debt.  Again, being a lawyer helps navigate this process.

I left Mr. Patel a voicemail delicately telling him that if I didn't hear from him within 24 hours, the next thing he'd see would be me, a Dallas sheriff, and a U-Haul loading away sh*t from his store. 

(My lawyer colleagues gave me their shirt sizes in case I confiscated other people’s dry cleaning to satisfy my judgment.  I told them they would look odd if their monogrammed shirts listed somebody else’s initials.  Or if they showed up to work wearing Prom tuxedos).

The threat worked.  Mr. Patel returned my call about an hour later and promised to mail the check.  Because I wasn’t going to fall for the banana in the tailpipe, I insisted on picking it up. 

And I did.  $2,830.  The check didn’t bounce.

Final score: Jim 1 – Weaselly Dry Cleaner 0.

I'm Back

Irony: When good news from the orthopedic surgeon means another surgery.

Jim’s Bionic Knee has been radio silent for the past year. Just like that really old lady in Titanic, it’s time to break my silence.

I’m going under the knife again.

But this time, that’s a good thing. Let me explain.

As I described in previous blog entries, my tibia never fully healed. No particular reason; just bad luck. Well, unless you count my total rejection of milk. Those milk mustache ads always creeped me out.

Because the bone never completely filled in – the doctors described my leg as a poor welding job – I was unable to have the 2 screws removed. Over time, I simply lived with 2 pieces of metal poking out almost entirely from my shin. Frustrating? Sure, but at least I never set off the airport metal detectors.

Eventually, the random twinges of discomfort grew more regular. Nothing too terrible, mind you, but enough that I constantly thought of my leg. After playing soccer a bit more vigorously than usual with my 10-year olds, the “twinge” grew into something closer to “holy mother of god, these screws really f*cking hurt.” One week of regular icing reduced the pain to Defcon Twinge, but I wondered how I was going to survive another 50 years with the screws intact.

And that lead me back to Dr. Scheinberg.

Brief intermission:

Just like last year, we drove to Chicago over Spring Break. Road Trip! The 15-hour drive seemed shorter this year, so I guess that means things are getting better/easier with the kids. Look out Griswalds! Anyway, here are some random observations from the 900-mile journey:

I learned the answer to the question bugging America – What do people in Atoka, OK do on a Friday night? You got it. Party at the Love’s Gas Station. That place was jumpin’.

Unfortunately, I never learned the answer to another pressing question -- Why does every rural Oklahoma town need its own “alternate” business route off the highway? I didn’t realize that a single Grandpa Abel’s Pie Diner counts as a financial district.

Finally, we passed a mule trading post. First thought? What the hell is a mule trading post? After applying some common sense – I guess people barter with their mules here – I was admittedly astonished that the mule trading post concept survived beyond 1870. But I was nonetheless happy to learn of their continued existence. And then I wondered, what could my wife fetch? A quality set of knives? Hmm. I’d accept nothing less than Ginsu.

Ok, back to the knee surgery.

When I last visited with Scheinberg, he actually thought the screws probably could come out, even without the bone being fully healed. I think he said something like, “if your leg’s held up this long, you’re probably fine.” But his use of the word, “probably,” scared me.

This time, the x-rays revealed that most of the bone had filled in. Great news. Another Festivus Miracle! Hallelujah, sweet Baby Jesus, watching his Baby Einstein developmental videos. The leg wasn’t 100%, but pretty darn close.  Scheinberg had no reservations about removing the screws. He didn’t even use the word, "probably." And just like that, I decided to get cut open for the 6th time in my life (4 prior knee operations and 1 shoulder reconstruction).

Of course, no surgery is without risk, and this one is no different. It’s possible that the bones are slightly unstable, and thus the screws still are needed to hold everything together. If so, Scheinberg would replace the existing screws with a “flat-head” version so they won’t bulge out (that’s what she said!). He plans to poke a few holes in the surrounding bone areas to stimulate extra growth from the blood, too.

If all goes as expected, the surgery will last 15 minutes, and I’ll be home a few hours after arrival. Scheinberg doesn’t think I’ll need crutches afterward, though he’ll probably limit my activity for about 2 weeks (ie, no exercising). And yes, I'm keeping the screws. I plan to display them in a jar, hopefully still covered in blood, atop the fireplace mantle. Not even the Stanley Cup could rival the screws for conversation starters.

A few more Road Trip observations:

I learned you should never drive into smoke. I mean, that’s what the highway sign said. Good to know.

The roadside gas station casino in Chochtaw, OK was packed at 9am.

Honestly, there’s nothing more arousing than the multi-flavor condoms inside the rest stop men's rooms. Next time, I’m road-tripping without the kids.

And finally, I can say with complete confidence that Smokey and the Bandit is always checked out at Blockbusters across Oklahoma. I wish I could borrow Netflix's algorithm to confirm the exact location of everybody who rents Smokey and the Bandit.

So that’s my update. Just over a year since the last blog entry. The surgery is scheduled next month. I promise not to wait another year to post again. Meanwhile, I’d like to hear how some of my fellow knee patients are doing, including some of my followers I haven’t heard from in awhile. I also appreciated and enjoyed the email exchanges over the past few months with several folks who found my blog after googling, “ACI knee surgery rehab.” Keep in touch. And go Mavs.

2+ Year Knee Update

2 years, 3 months is a long time. Think about it. Ellin had yet to smash Tiger’s Escalade with a 9-iron. LeBron hadn’t taken his talents to South Beach. Obama thought he could “change” the country. And Snookie was a term of endearment, not a pudgy reality star.

I also had 2 holes in my kneecap and a perfectly healthy leg.

Obviously, a lot has changed since then.

So let’s begin with the obvious starting point. If I could do it all over again, would I still choose ACI? I honestly don’t know. Before going under the knife, my knee didn’t hurt THAT badly. I could sense it was about to take a turn for the worst, but it wasn’t there yet. Today, my knee doesn’t hurt at all, which is a good thing, obviously. On the flip side, the lack of pain pre-surgery also meant that I never experienced the unbridled joy of having a pain-free knee, post-surgery. So when I say my knee doesn’t hurt today, I say it with a shoulder shrug, not the fist pump of a guy who just birdied 18 to win the Masters.

Unfortunately, the surgery also produced some unexpected drawbacks, completely unrelated to my knee. I went in with one problem, and woke up with a brand-new one.
The osteotomy didn’t fully heal. My tibia remains “somewhat fractured.” (By the way, somewhat fractured is an actual medical term). While the bone didn’t fuse entirely, however, enough bits and pieces did to hold the leg together. Dr. Champine described my leg as a “poor welding job.”

Now, the screws were inserted to keep the leg intact, and the surgeon had warned me the area surrounding the screws would be sensitive. At the same time, I was assured they could be removed once the tibia fully healed, meaning I spent that first year or so biding my time until the leg healed enough to remove them.

Well, I can stop waiting; the leg never healed. So the million dollar question today for me is: Has the leg healed enough for the screws to be removed?

Champine says, “probably.” He believes – and his partner, Dr. Scheinberg, concurs – that since the leg has held up for 2+ years, it’s “probably” not going to fall apart now. Of course, patients really don’t like when doctors use the word, “probably.” I like to measure risk. Can I catch VD from that Vietnamese “masseuse”? Probably, so I’m not going to ask for the happy ending. Easy decision. So even though my current choice also involves screws, this one is a bit more complicated.

Ok, quick intermission from my knee situation:

Over Spring Break, we road-tripped to Chicago to see family. My parents still live in the same house in which I grew up. After spending the week at my childhood home, I’m not sure what seemed weirder: sleeping in my old bedroom with my wife, or the lack of Michael Jordan or Paulina Porizkova posters on the wall.

By the way, did you know Illinois leads country in vanity license plates? Even minivans have them. I actually saw a guy driving a minivan with “Peters 64” plates. Advertising that you own a minivan? I thought you were supposed to be ashamed of them.

Ok, back to my knee update:

Thus far, I’ve chosen the conservative approach and opted against undergoing the surgery to remove the screws. Maintaining the status quo. By all accounts, this surgery is minor. A few days on crutches. Not a big deal in the grand scheme of knee surgeries, so I don’t fear the recovery. But I don’t want to risk the consequences if it turns out that the screws really were holding my leg together. If so, I would need some sort of bone graft to shore up my shin. And THAT’S a big f*cking deal.

To give you an idea of what’s potentially at stake here, I have no “daily living” issues. I can walk just fine. No issues with stairs. I can bike and use the elliptical machines at the gym. I avoid impact exercises – running, squatting, jumping or explosive plyometrics – but otherwise no functional restrictions. I’m plenty capable of jogging around the soccer field with the kids, even cutting without too much difficulty during scrimmages with 9-year olds. In fairness, I’m a slow, 38-year old dad playing with third graders, and these kids aren’t Brazilian. I actually weigh a bit less than I did pre-surgery, and think I might even regain my 2-pack abs by summer if I keep up my current exercise routine. Overall, I’m pretty content.

On the other hand, the screws in my shin remain sensitive. I mean, really sensitive. A little tap on my shin will drop me to my knees quicker than a hooker looking for a quick $20. Um, not that I have any idea what the going rate is for those types of things….
Until lately, the screws weren’t too big of a deal; I could tolerate them. During recent workouts, however, some of the basic leg strengthening exercises – short arc leg extensions; shuttle leg presses; even hamstring curls – have started to stress the outside of my shin. And guess what? The mere sensation that metal screws might rip through your leg like Mr. Kool Aid bursting through that brick wall is not a good feeling.

Ok, time for the Second Intermission:

Just like a strong jawline or piercing blue eyes define somebody’s face, the random shops dotting the sides of the highways provide a glimpse of state’s personality. On my Spring Break road trip, I discovered that Missouri leads the country in adult video stores and firework stands, which says a lot about the Show Me state. In fact, sometimes there were 2 adult video stores next to each other at the same rest stop -- the porn version of McDonald's and Burger King. That made me wonder -- do truck drivers comparison shop at adult video stores? Do they broadcast over their CBs, “Breaker Breaker. This is Little Bear. The Bobby’s XXX in Joplin has a wider foot fetish selection than Soft Skins.” One of the adult video stores also advertised an adjacent "men's only spa," and even used a picture of a geisha. Why not just throw up a billboard that says, "Happy Endings Available"? And, oh yeah, the local Mizzou gas station is called, Kum and Go. I'm not kidding. And you can find them next to the adult video stores.

Ok, back to the blog:

While the screws have nothing to do with my knee, I can’t truly test my knee for fear of aggravating the screws. Perhaps if the osteotomy had healed, I would have a better appreciation for how well the ACI grafts worked. But the screws prevent me from playing, for example, competitive volleyball or taking jiu-jitsu lessons, which I envisioned as the true measuring stick of a successful surgery. And that’s disappointing. Grumble, grumble.

Here are some other observations:
• My quad remains a bit weak, and I really don’t ever see it gaining full strength. Not only do the screws limit certain exercises, but the osteotomy permanently altered my mechanics, making it difficult to isolate my quad and build up the “teardrop” muscle. You can only do so many straight leg raises.

• I still have a decent amount of crepitus, but no pain associated with any of the crunching. I planned on getting my knee scoped to clean up the crunching at the same time the screws were removed, but obviously that never happened.

• Every so often I experience a twinge of weakness on the inside of my knee. It’s more like a pinch, something that creates the sensation that my knee might give out. But the knee doesn’t. I’m not sure if there’s something slightly defective with my knee, or whether that’s caused by my lack of inner/outer thigh and hip strength.

So here’s where I am 2 years, 3 months after ACI. Part of me wants to tough it out by keeping the screws. I try to convince myself removing the screws just isn’t worth risking a bone graft and the attendant lengthy recovery. But man, my screws can be aggravated as easily as a sleep deprived new parent, and I wonder how much “quality of life” can be gained if they were taken out. I still haven’t made a decision, and probably won’t until my kids’ soccer seasons end next month.

Until then, I’d love to hear from others about their knee experiences, along with updates from other ACI patients who follow my blog. In addition, I welcome any ideas or suggestions on blog topics from my “readers.”

Disney

Well, I figure it’s been long enough since my last blog post. Almost 8 months, in fact. Actually, I started writing this post over the Xmas holidays, but then I got busy lying to my kids that Santa really exists, and, before you know it, two more months slipped by. Wait, do you still believe in Santa? My bad. I guess I should’ve included a “Santa is fake” disclaimer.

I’ve passed a few milestones along the way, including the 2-year mark. I’m not really sure how to describe the past 2 years, other than to note the usual clichés: the recovery is a marathon, not a sprint; the surgery seems like it happened just yesterday; blah, blah. Eventually, I’ll post a 2-year update about my knee. And I promise I won’t wait another 8 months to do so.

But not today.

Instead, I’m going to share my recent Disney adventures. The Florida one, not the SoCal one.

Alright, let me get the usual Disney platitudes out of the way. Every story you hear about how Disney bends over backwards to accommodate visitors – especially kids – is dead-on. All of Disney’s employees were phenomenal – the hotel workers, ride operators, character helpers, the bus drivers. You name it. Even the cleaning people who didn’t speak English. Very friendly. And not fake-friendly. You know the type. The superficial syrupy-sounding people who deserve to be punched in the kidneys. These Disney people were genuine. I don’t know how they remain this friendly, day-in, day-out. After five minutes of kids tugging on my shirt, I’m pretty sure I would start playing Wack-A-Mole with anybody shorter than 3 feet tall. Honestly, I was most impressed with the girl portraying Jasmine. Not only was she smoking hot, but she never broke character, like an old school WWF wrestler. Well, except for the time when the creepy old man started groping her. That freaked out Jasmine, not to mention ruining the Disney experience for some family’s little Princess. Rough memory for a kid, right?

But I assume most Disney travelers know these tips. Therefore, this blog entry shares some observations that, perhaps, are news to you.

First, a random observation.

Disney’s bathrooms never ran out of paper towels. I’m pretty sure I visited every crapper in the park. No, I didn’t have diarrhea, just two little kids needing to piss constantly. Incredibly, there was never an empty paper towel dispenser. Never. I wonder if Disney employs a stable of Sherpas just to fetch paper towels.

Ok, now to my main observation. I’ve never seen so many f*cking fat people in one place in my life. Enough fatties to keep The Biggest Loser busy for 40 years. Holy lard asses, Batman.

Here’s another under-the-radar scoop about Disney – they lead the world in rascal scooters. All those fatties scoot around the park all day rather than trying to walk off the BonBons. Disney was like a giant bumper car park for very large people.

Now here’s the really annoying part. Call me crazy, but I thought rascals were only for non-ambulatory people. You know, the crippled; extreme elderly; or even the morbidly obese people who simply cannot walk on their own. Not at Disney. I lost count how many times some gump of sh*t scooted up to the entrance, parked their rascal, and walked onto the ride. Seriously? At first I thought Disney had some kind of magical healing power, like one of those Sunday morning revivalist churches where worshippers gets blessed, and hallelujah! they rise up and hop onto roller coasters. And get this -- these fat f*cks go straight to the front of the line!

Thankfully Disney’s “Fast Pass” limits the wait time for most rides. But picture this scene: you spend 45 minutes creeping along 2-3 feet every 15 seconds to ride Space Mountain. Like an Oasis in the middle of the Sahara, the final turnstiles appear on the horizon. You can sense Shang-ri-La. You inch closer, squeezing through the final set of gates, reaching the coveted “next rider” status. The moment of truth. Space Mountain, baby!

But as you prepare to board the coaster, you hear a wheezing puttering sound, like a 1970 Pinto desperately in need of a new muffler. “Hold on, folks,” says the ride operator. He’s smiling, of course, because all Disney employees smile more than the Joker. As you struggle to comprehend the last-second delay, the Blob dismounts from his rascal and steals your ride. Sure, it’s just 1 more ride to wait, but those 45 seconds feel more the 45 minutes you just spent in line. You want to enjoy the ride, but you’re kinda ticked about Tubby stealing your turn. And you can’t shake the fear that his 470lbs might’ve stressed Space Mountain’s brakes. Can this car handle those twists and turns? Will I go flying off the track? And why is this seat so God damn warm?

Anyway, the kids had a blast. A definite “must” vacation for families.