The Pain at Wounded Knee!

Many of you know that I have a damaged left knee. Here, I will detail exactly how this came to be.

Around May or June of 1998, it was time for my favorite band, ZZ Top to come in concert. The venue was the Pompano Beach Amphitheater. The weather was in the 60s, slightly windy, with a chance of rain. As the concert began, so did the rain! In fact, it rained most of the night. Nevertheless, the band played on and another great show was in the books. Time to go home.

On the way out, Teala lost one of her contacts. Several others were assisting us attempting to locate the missing lens. While looking, I pivoted on my left leg and heard a “pop” from my left knee. It was loud enough that the others standing by heard it as well. Teala asked me “What was that?” I said “nothing”! Meanwhile, in my my own mind, I knew exactly what it was.

Back in my high school days, I played football as well as wrestling. These are two sports that require a great deal of use from your legs. The one thing no one in these sports, or for that matter, any sport, wants to hear, is the “pop”. The pop is usually a torn Anterior Cruciate Ligament (ACL). Which isn’t the most painful injury to have, but, in some instances, other parts of the knee are damaged and along with that damage, comes the pain.

At the time, I had insurance with a company called United Benefits Life. I do not think they are still in business. The plan I was on used doctors that subscribed to the insurance company and the coverage was an HMO. I looked at their list of “approved” Doctors and picked one that was near my office. I will not mention is name here, however, if anyone would like to know the name, contact me and I will give it to you. I do not want to see anyone make the same mistake I made.

After making an appointment with the doctor, he examined me and said we would need to do an MRI, which is pretty standard procedure. He suspected a torn ligament, possibly an ACL. The doctors words to me were “Just take it easy, rest and after the MRI comes back, we will see what to do next”. So far, things had gone as I expected. After calling the doctors office repeatedly for six weeks, I was told that the request for the MRI was turned down.  At this point, I asked, “What do we do now?” I have been walking, if you could call it that, on this knee for seven weeks since I injured it. The problem with a torn ACL is that the ligament stabilizes your knee and without it, you tend to fall down a lot as your knee is very unstable.The doctor sent in a request for another MRI and, exploratory surgery. Finally, in October of 1998, the doctor called and said that the surgery was approved.

This should have been a red flag. The purpose of an MRI is to see in detail, what exactly is wrong and what needs to be corrected. Without it, you, as a surgeon are flying blind. You do not know what you are going to find wrong!

I went and had the surgery done. After the operation, I spoke with the doctor who informed me that I had a 60% tear of my ACL. Now, I may not be the brightest crayon in the box, but I do know that 60% is more than half of something and to me, 40% of an ACL isn’t going to last the rest of my life. Then again, what do I know? After all, I am just a “lowly home inspector”!

Two weeks later, I went back to the doctor and he said everything was healing fine, I had good range of motion, and to go on with my merry existence. Everything should be fine! At this time, I learned that most of this doctors practice includes performing surgeries on older clientele. And by older, I mean 70-plus! I informed him that I was 38, played golf, roller-bladed and was very active. He said everything should be fine.

A week later, I was performing an inspection at a property in Plantation, Florida. My Client and the Realtor were the only people present including myself and the home was vacant. As we were leaving the property, there was a large step leading out the front door. I placed my left leg on that step, and then went to put my right foot next to it. At this time, I felt intense pain, and for those that know me well, that is about twenty times more than the average person can withstand, in my left knee. I turned, twisted, and landed on the ground with a large “thud”.

My Client and the Realtor had looks on their faces as if they had just witnessed the worst thing in their lives! I was laying on my back, my left leg, contorted around and under my right thigh. As I lay there, the image of a building being demolished in a controlled explosion, was racing through  my mind. I told everyone present to leave me alone, give me a couple of minutes, and I’ll be OK!

I got up after a few minutes and could not put any weight on my left leg. Whatever happened, it was much worse than the ACL tear. I called the doctor and he said, “It sound like you sprained your knee”. I informed him that although I am not a doctor, I know my body and this was far worse than anything else I have ever felt from a pain standpoint. He told me to ice it down and I’d be OK.

It was at this time, that I realized that this guy was a f***ing quack! Here I am, unable to walk and the expert advise given, was “to ice it down”? I immediately changed insurance companies and then started looking for a new doctor. At this time, I happened to stumble on a name, Dr. Robert Baylis who was listed as a board certified orthopedic surgeon and many other accreditations. He was also a sports medicine doctor. These type of doctors specialize in athletes. I contacted Dr. Baylis and made an appointment.

I met  Dr. Baylis and told him the story. We are now in the second week of November. After hearing the story, he said he would examine me. He did and his findings were that I had a torn ACL. Well, no shit Sherlock..I just told you that! I was beginning to wonder exactly what type of racket these doctors were running, when Dr. Bayliss said..No…No….You do not have an ACL  at all. It is completely gone. Your Posterior as well as you Medial ligaments are torn, and you most likely have torn cartilage, if you even have any left, and torn meniscus. That doesn’t sound good!

It wasn’t. Dr. Balyis said that there would be no need for an MRI as there was no question in his mind that there would be extensive damage found and he would just have to do the surgery and fix what he could. He also informed me that I would most likely be a candidate for total knee replacement. I should mention that Dr. Baylis is not one of these “slice first and ask questions later” surgeons. He tries to let the patient keep the original parts as well as reduce surgeries as with each surgery, there are risks and damage.

In December of 1998, I had my second surgery of the year. ACL reconstruction. The MCL and PCLs heal them selves so all that was left to contend with was the cartilage, or more precisely, the lack of it and the torn meniscus. The meniscus was trimmed and then, to address the missing cartilage, holes were drilled in the bones in order to produce artificial cartilage which would act as a cushion. After the surgery, Dr. Baylis said it was just about as bad as it gets. I had to stay off the leg for six weeks, then began rehabilitation.

Immediately after the surgery, I was in a machine, Passive Continuous Motion machine (PCM),that constantly extended and retracted my leg so as not to lose any range of motion. I was in that machine about 22 hours a day, for six weeks. My range of motion was very high compared to the average individual and I owe that to hard work, dedication, and that machine.

One of the drawbacks of this surgery is that almost immediately, your leg atrophies, significantly. This required, first, some therapy to maintain the range of motion, basic exercises to learn how to walk again, and strength and conditioning. Til this day, stretching is still the hardest part of the regiment. I loved doing the strength portion of the rehabilitation. Speaking of which, I pushed my self and nine months after the surgery, my legs were stronger than ever. I could leg press 1,000 pounds and several of the members and trainers at the gym, took notice at how hard I worked and the results that were obtained. My doctor was also amazed as I was the quickest to recover from such a devastating injury, that he had seen.

In January of 2000, I began to experience pain in my left knee. It wasn’t in the joint or the ACL and was just a “stabbing” pain at my kneecap. I went back to the doctor and he did an X-Ray. When your body and in particular, bones, are damaged, they regrow as a way to heal themselves. Unfortunately, in some instances, the bones heal in a different direction than what they were in originally. Which is what happened. A bone spur was growing downward from my kneecap and stabbing whatever is under your kneecap.

Time for surgery number three. Dr. Baylis went in and 45 minutes later, all was done. A little grinding, some trimming of more meniscus, and I was good as new! I remember Dr. Baylis saying after the first surgery, this won’t be the last one. Your knee is a mess and we are going to try and do everything to avoid the inevitable, replacement. This surgery was good for five years.

In May of 2005, The week before my wedding, my good friend Paul had the bright idea of going to Bimini for my bachelor party. At the time, Paul had a recently renovated 45 foot Hatteras and as a frequent diving buddy that I was, thought it would be a god idea to go via the boat. At the time, this seemed like a great idea.

We gathered up six other friends and off we went. Things were going along as well as can be expected, when I decided it was time to make another Tequila Sunrise and, check on the rods and other assorted items that were stored down in the staterooms. Did I mention that the seas were around 3-5 feet? Now, three to five foot seas in a 45 foot boat, especially the Hatteras, aren’t much of a big deal. Unless of course, you are in the bottom of the vessel standing on one leg, especially if that leg has a surgically repaired knee!

The boat came up out of a wave and slammed down on another at the precise moment I decided to reach over and replace a loose fishing rod. There was a familiar pain emanating from my left knee. It wasn’t a pop but it was painful. I suspected I had torn some more meniscus. Thirty or forty Tequila Sunrises later, a day with the Miami Dolphin cheerleaders and the return trip, seemed to have quelled the pain. I never told the wife that I had injured my knee until after we got back from the honeymoon.

When we returned, I saw Dr. Baylis and he ordered an MRI. The MRI revealed that there was a bunch of bone growth and some more torn meniscus. Another surgery was scheduled and the knee was “cleaned out”. It must have been pretty bad because after this surgery, the knee felt great. It also appeared as though we were starting to develop a time line. The knee was fine for another five years.

Fast forward to February, 2010. While at Disney on perhaps the coldest day of the century, my left knee was locking up. This was something new. My knee had never locked up before. I gutted it out for three days in Disney and then when I returned home, time to see Dr. Baylis again. Another MRI was done and this time, it was revealed that there was more bone growth, bone spurs, and more torn minescus. The problem this time was that the bone spurs were growing around my ACL which was restricting its functionality and eventually, the bones would fuse around it rendering it useless.

April, 2010. Time for more surgery. Now there was a serous problem as the decision to perform the surgery could have some adverse effects. As the bones were growing under the ACL, it was being stretched and once the bone was removed, the fear was that the ACL would become loose and then, break shortly after the surgery requiring another reconstruction. The decision was made to do the surgery.

As there was so much bone growth, there was a lot of cutting that had to be done. This was going to require more recovery time. There would be no, “three days and you are good as new” recoveries that I was used to in the previous two surgeries! The wounds bled for almost ten days. For the first time, there was now fluid in my knee that was oozing out and required daily changes of my bandages. The actual pain was worse than most of the other surgeries as this is what happens when you cut into bone.

After returning to the doctor, there was still a locking sensation present, but now, it was in the back of my knee instead of the joint where it was prior to the surgery. It was actually present prior to the surgery, but the joint locking in the knee itself, was the major problem, which has been corrected. I went for therapy and the locking was still present.

One of the problems with getting older is arthritis. This occurs more frequently with injuries and as if the rest of the knee wasn’t such a mess, I now had an “arthritic” knee as well. What this means is that our plans of staving off a knee replacement are waning. It has now become an unavoidable inevitability, but unfortunately, if the knee is replaced, a new set of problems arise, which at this time, I don’t care to even think about!

At this time, I am getting by with an arthritis knee brace and am doing everything in my power to strengthen my leg. It may be a fruitless goal, however, I want to give myself every opportunity to avoid knee replacement.

So, what have I learned?

1. Do not settle on the first doctor that you are referred to
2. If you have a joint injury, seek out a sports medicine doctor.
3. Which ever doctor you choose, make sure he is a “cutting edge” surgeon (Dr. Baylis actually built his own “jig” for elbow surgery, which will be documented on this blog).
4. Make sure you have the best insurance that you can afford.
5. Learn all you can about your specific injury.
6. Check out your doctor every way you can think of. Go to a rehabilitation hospital near the doctor and ask how many of the patients he has sent there required “extended ” stays or had “complications”.

The purpose of writing this post, and a couple of other posts that deal with health-care issues, is to help others learn from my mistakes. I would honestly hate for someone to have to go through some of the things that I have.

Feel free to contact me or make any comments.

As I am preparing to enter phase three, weightlifting, of my rejuvenation process, I took measurements of various parts of my body. As I suspected, there was a great difference in my leg measurements. My left quadriceps was 1 1/2 inches smaller in diameter than my right leg and my left calf was 3/4 of an inch smaller them my right leg! It looks like there is going to be a different method of training with regards to my legs!