Knee Surgery

[EeyoresButterfly]

I found out on Monday that I have to have surgery on my knee to remove a plica band. I have been having problems since my last CP in 06 and I'm glad that I finally know what is wrong and I have a way to fix it. Unfortunately, that requires surgery. I got the call today that it is scheduled for July 9th.

The surgery isn't a big deal, it's athroscopic and theoretically I can be back in class the next day. (I am a graduate student and have two courses I will be taking at that time). The real fun will come at home. I live in a second floor apartment, and the parking lot is down the hill from the building, so lots of steps. Not to mention that I have two lovable yet rambunctious puppies who have to be taken out on their leashes. Puppies and crutches are going to be an interesting combo!

The one thing that I am worried about is the anesthesia. I've never had a real surgery before. I did have my wisdome teeth out, but was awake for it after specifically requesting a local. I asked the doctor if a local would be possible for this and he said they don't work. He mentioned something about a spinal block, but basically I'm going to have to wait to talk to the anesthesiologist about the options and the risks they represent. I really do not want to be put under. Has anybody been through this? Are you familiar with the anesthesiology options and the risks associated with them? I'm having a hard time finding anything good on the internet. Thanks!

[Zazu]

The one thing that I am worried about is the anesthesia.

I've only had general anesthesia twice (been lucky), once was no problem, the other was.

When I had my Achilles tendon reattached, I had a bad reaction to the anesthesia. Didn't come out of it "on schedule", and since it was an outpatient center that had scheduled the bed, they hustled me out to the car -- probably too early. I remained groggy the rest of that day and most of the next. Couldn't keep my dinner down that first night. By the morning of the second day I was back to normal.

When I discussed this with my surgeon, he said it happened about 1/2% of the time to first-time patients, and notes on my reaction would cause the next anesthesiologist to use something different. For my next procedure they did, and I had no trouble.

It's also quite normal to lose some sort-term memory. According to my wife, I had about five minutes of conversation on the way in and fifteen on the way back that I have absolutely no memory of. This is typical as the anesthesia interferes with short-term memory. It does not last -- think of it as unplugging your computer for a moment; what was on screen is gone, but your hard drive keeps the "long-term memories" and you don't lose anything else.

You will have a chance to talk to the anesthesiologist before the procedure. They will ask you a few questions and ask for you to sign some paperwork. If you have questions, ask them *before* signing, as they tend to stay very busy at outpatient clinics and might jackrabbit off once you sign. They gotta have the signature to do the procedure or bill you, so you have some leverage before you sign.

You're up for a fairly minor surgery, much like mine. Actually, less intense than mine, as I had a 3-inch incision while yours is arthroscopic. Should be a walk in the park. Just try not to panic, as that can mess up your metabolism and require *more* anesthetic, which increases the chances of complications like mine.

Chill ... to the extent possible ... and think about walking around the Parks without pain.

[EeyoresButterfly]

Thanks Zazu. The nice thing is this is not being done in an outpatient center. The surgeon only operates in actual hospitals, so that should be a bonus by the sounds of it. I guess for me it's a loss of control issue. I just odn't like the thought of artifically being put to sleep. When I had my wisdom teeth out I specifically asked for a local, the doctor didn't even bring it up when we were discussing anesthesia since most people prefer to be knocked out.

I actually enjoyed it (as much as one can.) There as no recovery time, I could have gone back to work that day. In fact, my mom and I went out to Panera for soup immediately after.

[DisneyMom]

A spinal numbs you from waist down. You remain awake.Had that one for first son. I can't remember how many hours it took-several, I believe to start to get movement back, so it may cause a longer recovery room time.
I was groggy and took too long to wake up after my general anesthesia a few years back, but other than snoring publicly it didn't seem to be a big deal.
Of course, as with any medical procedure, there are horror stories, so I was nervous going in. They started an IV, gave me a med to make me sleepy, then said they would give me another once I was wheeled into Surgery. I remember the nurse commenting she needed to get her pedicure, then I was out.
Can you make arrangements to recover elsewhere where you don't have to climb? Seems like that is your biggest obstacle.
Good Luck and a Speedy Recovery. :)

[EeyoresButterfly]

Unfortunately I really don't have another place to go. As it is I'm going to be lucky to find somebody to drive me. Everybody vanishes during the summer when the university is out of session. My parents and I briefly discussed coming home, but I need to go to class and I would be in a similar situation there anyway.

[Cheshire Figment]

I think I found out the answer to your question last year. About a week after my hip replacement surgery the ball cam out of the socket and actually had not realized it until after about 1½ - 2 weeks (when the rehab took an X-Ray). Since it was a Saturday and the hospital where the surgery was done did not have an ER they sent me to a nearby regular hospital. I was taken into Trauma and sedated but they were unable to do anything.

I was in traction the rest of the weekend and Monday taken back to the Hospital for Special Surgery. On Tuesday I was given general anesthesia and they were able to put me back together; the surgeon said he was within about 3 minutes of the decision to reopen me. He also showed me some bruises on my leg which were the result of his manipulation of my leg (and, BTW, he had a real-time X-Ray of what he was doing

What was explained is that with sedation, as opposed to general anesthesia, (1) your muscles do not fully relax, and (2) sufficient pain can cause you to come out of sedation.

[pattimelt]

As an arthroscopic veteran (4 on one knee alone) let me tell you my story.

Give me general every time!! My only problem is that even though I know what's going to happen, I get excited, cause I'll be able to walk again without pain--so I have a hard time sleeping the night before. I have my doc give me a small dosage sleeping pill for the night before, then I have no problem waking from the general when I'm done with surgery.

The last time I had arthro (I'll either have another one this summer or they will do complete knee replacement), I could walk just fine that day after I got out of the general, but my knee felt "squishy", if you catch my drift. It kinda felt like there was a sponge between my bones in my knee. And I had to eat Tomato soup and a grilled cheese for dinner, cause that's what I found helped my throat after all the oxygen. BUT.. I worked a music convention the NEXT DAY after my surgery, and had NO pain or problems moving.

I imagine it's different for everyone, though, but I've not had any problems with arthro and my knee.

[Princess Susi]

You have come to the right place, the surgery veteran team of Ralph and Susi...between us both we have had approx. 90 surgeries! And I have another one coming up myself! Mine is going to be a general anesthesia for approx 4-5 hours on July 2nd!

General anesthesia will put you *to sleep* so to speak. You will remember nothing of the surgery and it may make you nauseous, so if you are having this type of anesthesia, ask the anesthiologist to add an anti-nauseal to your pre anesthesia meds. They will do that. You will be hooked up to an IV and get meds to make you drowsy and that is when you can have then put the anti-nauseals in. Then you will be wheeled into the surgical bay and they hook you up to a hose and you breathe and they also push more drugs into your IV, and the next thing you know, you are waking up in recovery, sick and hurting (not always tho). The anesthiologist will go over EVERYTHING with you before and answer any questions for you. There is always some risk with general anesthesia.

If you are getting a spinal block, you will be getting a shot in the lower back and it will numb out everything they need to. They can direct the needle to numb out particular areas. You will be awake but won't feel anything. It is safer, but there are always risks with any anesthesia and the doctor will tell you what they are.

If you are getting sedation, you will be given an IV with some drugs that make you sleepy and relaxed. They do not work for me, because I take very large doses of Morphine and Percocet already and have for 2 yrs and they don't really know how much to give me when I already have these opiates in my system. They don't want to overdose a person. If you are not on any drugs or very little drugs, the sedation should work just fine for you.
There are great websites for looking at anesthesia and it's effects as well as for your particular surgery. Look them up. Your best source is your doctor and anesthesiologist.

And Cheshire has it right!

"What was explained is that with sedation, as opposed to general anesthesia, (1) your muscles do not fully relax, and (2) sufficient pain can cause you to come out of sedation."


This is true. Sedation is NOT OUT like a light! You are still awake and aware though foggy and groggy. You can come out of it, with excessive pain. That is why generals work so much better. I have had both. I had sedation BEFORE I was on so much meds and I prefer a general tho there are more risks. Coming out of a general happens very seldom and is a tiny % of patients. I would always go with general for a surgery where they were working on bone or organs.

They have to cut through my abdominal wall (laparotomy) when I get my spine fixed in July and that hurts. When they cut through muscle, you get lots of pain after surgery, so yours should not be as bad. Arthroscopic is great, no real incision and no moving around your organs and vessels.

OH, also remember, everyone's body is different and reacts to meds differently.

Good luck! I hope they can fix it to your satisfaction!

Susi

[joanna71985]

Good luck with everything! I will be keeping you in my thoughts. :)

[February]

Talk to your anesthesiologist (slaughtered the spelling, sorry) about any concerns you have as far as being put under-- any special concerns like allergies to medicines, asthma, anything you think you should mention. I obviously can't give you medical advice but I will concur with the others opinion wise- being out is the way to go if you can.

I had a spinal for cerclage surgery for an incompentent cervix when I was carrying my daughter- and let me tell you it was the longest 2 hours of my life being awake for that. I was terrified and shaking so hard they could hardly get the needle for the spinal in. I've been put under for other surgeries (lap and other things after my second miscarriage) and was 'twilight' for my wisdom teeth but I tried to sit up halfway through and they had to turn up the dial to knock me back out (or however they do it) not fun.

This is just me personally but given the choice I'd always rather sleep through it all unaware.

I hope your knee will feel all better soon!

Bru